[1. Welcome and opening remarks]
[00:00:07]
>> GOOD MORNING. THE MEETING WILL COME TO ORDER. MAY THE RECORD REFLECT THAT THIS MEETING OF THE HHSC EXECUTIVE COUNCIL CONVENED AT 10:01 A.M. ON AUGUST 21ST, 2025.
>> MEMBERS, AS I CALL YOUR NAME, PLEASE REPLY WITH HEAR OR PRESENT.
>> COMMISSIONER O'NEIL IS ATTENDING ON BEHALF OF THE DFPS AS ACTING COMMISSIONER FOR DFPS.
>> THANK YOU. MS. RAG LYNN WILL COMPLAIN THE PROCESS FOR USING MICROSOFT TEAMS PLATFORM FOR THIS MEETING.
>> GOOD MORNING. THIS MEETING IS BEING CONDUCTED IN COMPLIANCE WITH THE TEXAS OPEN MEETING AND IS OPEN TO THE PUBLIC. TODAY'S MEETING IS BEING HELD AS A MICROSOFT TEAMS MEETING, AS WELL AS IN PERSON. IT IS BEING WEB CAST LIVE AND BEING RECORDED. IN ACCORDANCE WITH HHSC POLICY, THE USE OF AI NOTE TAKERS IS EXPRESSLY PROHIBITED IN THIS MEETING.
PRODUCERS WILL NOT USE AWE NONMOUSE AGENTS IN THE MEETING. IF A BOT SHOULD IN ENTRANCE, IT WILL BE REMOVED.
FOR THE SAKE OF THOSE VIEWING THE WEB CAST AND TO COMPLY WITH THE TEXAS OPENING MEETINGS ACT, WE ASK THAT EACH TURN THEIR CAMERAS ON AND STATE YOUR NAME EACH TIME SPEAKING.
WE ASK THAT YOU SPEAK CLEARLY IN THE MIC.
ONCE YOU'RE FINISHED SPEAKING, WE ASK YOU TURN OFF YOUR CAMERA. PLEASE LEAVE YOUR CAMERAS OFF AND YOUR MICROPHONE MUTED UNTIL YOU NEED TO SPEAK.
ALSO, WE RECOMMEND MEMBERS AND PRESENTERS USE HEADSETS.
IF POSSIBLE TO PREVENT FEEDBACK AND OTHER NOISE WE ASK THAT MEMBER AND PRESENTERS PARTICIPATING VIRTUALLY, PUT YOUR CELL PHONE ON MUTE OR VIBRATE, AND IF YOU NEED TO TAKE A CALL, PLEASE TURN OFF YOUR VIDEO AND MICROPHONE. FOR MEMBERS, STAFF AND PRESENTERS PARTICIPATING, WE ASK THAT YOU SPEAK DIRECTLY INTO YOUR MICROPHONE SO YOUR VOICE CAN BE HEARD AND THESE MICROPHONES ARE DIRECTIONAL, SO THEY WILL ONLY PICK UP SOUND WHEN DIRECTED INTO THE MIC.
PLEASE PUT YOUR CELL PHONES ON MUTE OR VIBRATE.
IF YOU NEED A CALL, STEP OUT OF THE ROOM SO THE SOUND DOES NOT CARRY BACK INTO THE MEETING. MEMBERS OF THE PUBLIC WERE ABLE TO PREREGISTER TO PROVIDE COMMENTS IN TODAY'S MEETING.
MEMBERS OF THE PUBLIC WOULD LIKE TO PROVIDE PUBLIC COMMENTS TODAY WHO DID NOT PREREGISTER WHO ARE ATTENDING IN PERSON SHOULD COMPLETE THE REGISTRATION FORM ON THE TABLE OUTSIDE THE DOOR AND PLEASE BRING YOUR COMPLETED FORM TO THE STAFF AT THE FACILITATOR'S TABLE. THE AGENDA CAN BE SOUND ON THE HHSC WEBSITE. YOU SELECT THE MEETINGS AND ADVANCE IN THE DROPDOWN MENU, AND THEN CLICK THE LINK FOR THE EXECUTIVE COUNCIL AGENDA.
COMMISSIONER YOUNG, I TURN THE FLOOR BACK TO YOU.
>> THANK YOU. GOOD MORNING AND WELCOME, EVERYONE. I WOULD LIKE TO THANK HHSC STAFF FOR ALL THEY HAVE DONE TO HELP TEXANS RECOVER AFTER THE DEVASTATING FLOODS IN JULY. TEAM MEMBERS ANSWERED THE CALL TO SERVE IN SO MANY DIFFERENT WAYS, MAKING SURE TEXANS HAD ACCESS TO FOOD, COUNSELING AND OTHER RESOURCES. THEY HELPED COORDINATE OUTREACH EFFORTS WITH STATE AND LOCAL OFFICIALS. TEXAS NOW AND IN THE FUTURE HAS BEEN A TOP PRIORITY IN THE SUMMER.
IN JUNE, WE BROKE GROUND ON A HOSPITAL IN AMARILLO, AND IN JULY, WE BEGAN CONSTRUCTION OF THE LUBBOCK PSYCHIATRIC CENTER. THESE FACILITY ALSO INCREASE ACCESS TO IN- PAY TIENT PSYCHIATRIC CARE. JUST AS MODERN FACILITIES HELP US SERVE TEXAS, IT IS PEOPLE WHO DRIVE OUR MISSION FORWARD. LAST MONTH WE ANNOUNCED OUR NEW OMBUDSMAN. LISA IS A FAMILIAR FACE,
[00:05:02]
SHE'S SERVED IN SEVERAL POSITIONS HERE, INCLUDING OMBUDSMAN IN HER OVER 30 YEARS OF PUBLIC SERVICE.WE'RE EXCITED TO WELCOME HER BACK.
I WOULD LIKE TO EXTEND A WARM WELCOME TO AUDREY O'NEIL AS HE STEPS IN AS ACTING COMMISSIONER OF DFPS.
SHE IS NO STRANGER TO THE AGENCY, AS SHE ALSO SERVES AS A DFPS DEPUTY COMMISSIONER OF PROGRAMS OVERSEEING ADULT AND CHILD PROTECTIVE SERVICES, CHILD PROTECTIVE INVESTIGATIONS. WELCOME, AUDREY.
LOOKING AHEAD, THE AGENCY IS PREPARING FOR THE AGENCY'S REVIEW BY THE SUNSET ADVISORY COMMISSION. THE AGENCY SELF- EVALUATION WILL BE SUBMITTED BY SEPTEMBER 1, AND WILL SERVE AS A RESOURCE FOR THE SUNSET COMMISSION TO PROVIDE RECOMMENDATIONS TO THE TEXAS LEGISLATION IN 2027.
IN CLOSING, I WANT TO THANK ALL OF YOU FOR YOUR COMMITMENT TO THE HHSC MISSION.
AT THIS TIME, I WOULD LIKE TO RECOGNIZE SERVICES OFFICER EMILY ZALKOVSKY TO PROVIDE UPDATES ON THE PATIENT DRIVEN PATIENT MODEL.
>> THANK YOU, COMMISSIONER. YES, I WANT TO COVER THESE THINGS AND A THIRD ITEM THAT IMPACTS PROGRAMS FOR OLDER ADULTS AND PEOPLE WITH DISABILITIES.
THESE THREE THINGS ARE IMPLEMENTING SEPTEMBER 1, SO VERY SOON. THE FIRST ONE IS THE ATTENDANT RATE INCREASE, SO THE LEGISLATURE IN THIS PAST SESSION APPROPRIATED FUNDS FOR US TO INCREASE RATES FOR ATTENDANCE AND OTHER DIRECT CARE WORKERS IN OUR STATE PLAN AND WAIVER PROGRAMS THAT SEVEN OLDER ADULTS AND PEOPLE WITH DISABILITIES. WE HAVE BEEN WORKING ON THAT VERY QUICKLY AFTER THE SESSION ENDED. ALSO WORKING TO GET APPROVAL OF THOSE RATE INCREASES AND MAKING SURE THAT PROVIDERS AND MANAGED CARE ORGANIZATIONS THAT SERVE THESE POPULATIONS UNDERSTAND HOW TO INCORPORATE THOSE RATES INTO THEIR PROGRAM, MAKING SURE THAT THEY'RE COMMUNICATING WITH CLIENTS WHO ARE USING THE CONSUMER DIRECTED SERVICES MODEL SO WE CAN UPDATE SERVICE PLANS AND BUDGETS TO TAKE INTO ACCOUNT THIS RATE INCREASE FOR SEPTEMBER 1. SO WE'LL CONTINUE KEEPING PEOPLE UPDATED AS WE WORK WITH CMS ON THE APPROVALS AND AFTER SEPTEMBER 1, IF PEOPLE HAVE QUESTIONS OR PROVIDERS NEED HELP IMPLEMENTING WE WILL ADDRESS THOSE ISSUES. WE WANTED TO LET YOU KNOW THAT IS IMPLEMENTING VERY SOON. ALSO, AN IMPACT TO PROGRAMS FOR OLDER ADULTS AND PEOPLE WITH DISABILITIES, IMPLEMENTS SEPTEMBER 1, IS A RATE CHANGE FROM RESOURCE UTILIZATION GROUP TO PATIENT DRIVEN PAYMENT MODEL, WHICH IS A WAY TO PAY NURSING FACILITIES.
SO WE HAVE BEEN WORKING WITH NURSING FACILITY PROVIDERS TO MAKE SURE THEY UNDERSTAND THE RATE CHANGE FROM THESE TWO DIFFERENT METHODOLOGIES THAT ARE IMPLEMENTING SEPTEMBER 1, AND WORKING WITH HEALTH PLANS BECAUSE OF THE WAY THAT THESE RATES ARE SET IMPACT THE TWO NURSING FACILITY WAIVERS, WHICH IS THE STAR PLUS PROGRAM AND THE MEDICALLY DEPENDANT CHILDREN PROGRAM. SO THE IMPACT THERE IS THAT MCOS ARE GOING TO BE USING A DIFFERENT KIND OF PAYMENT MECHANISM TO WORK WITH SERVICE PLANS AND SET SERVICE PLAN LIMITS. THEY WILL BE ASSESSING MEMBERS THROUGHOUT THE YEAR, AND THAT WILL -- THAT WILL TAKE THIS NEW PATIENT DRIVEN PAYMENT MODEL INTO ACCOUNT. ONE OF THE THINGS ABOUT THIS MODEL, IT IS SUPPOSED TO BE ABLE TO BETTER KIND OF TRANSLATE PEOPLE'S NEEDS TO THEIR SERVICE LIMITS AND THE PAYMENT FOR THOSE LIMITS -- OR THE PAYMENT FOR THOSE SERVICES. AND SO THERE SHOULD BE SOME MORE REGULARITY THERE AS FAR AS MAKING SURE PEOPLE'S SERVICE PLANS AND THE FUNDING THAT THEY HAVE IN THOSE WAIVERS REALLY TRANSLATES TO THE NEEDS THEY NEED TO HAVE SERVED. LAST BUT NOT LEAST, ALSO IMPLEMENTING SEPTEMBER 1, IMPACTING OLDER ADULTS AND PEOPLE WITH DISABILITIES WHO ARE DUAL ELIGIBLES.
WE ARE IMPLEMENTING RIDER 32 FROM THE 88 SESSION.
AND THAT DIRECTED US TO MAKE SURE THE HEALTH PLANS ARE PAYING FOR MEDICAID ONLY SERVICES FOR DUAL ELIGIBLES. RIGHT NOW, THERE'S A BUCKET OF SERVICES WHERE A PROVIDER WOULD BILL TMHP FOR THOSE SERVICES. NOW THEY'RE GOING TO BE BILLING A MEMBER'S MANAGED CARE ORGANIZATIONS FOR THOSE SERVICES. SO THAT'S MORE OF AN IMPACT ON THE HEALTH PLAN, THE MCO AND PROVIDERS, AND WE HAVE BEEN COMMUNICATING WITH PROVIDERS AND MCOS TO MAKE SURE THEY UNDERSTAND THAT CHANGE.
SO WANTED TO GIVE EVERYBODY A LITTLE INFORMATION AND A HEADS UP THAT THOSE ARE COMING, AND WE HAVE MECHANISMS IN PLACE TO RECEIVE ANY QUESTIONS OR CHALLENGES KIND OF AFTER SEPTEMBER 1 TO HELP PROVIDERS AND MCOS AND CLIENTS TO WORK THROUGH ANY QUESTIONS THEY MAY HAVE. THANK YOU.
>> ANYONE HAVE QUESTIONS? THANK YOU, MS. ZALKOVSKY.
[00:10:02]
NOW WE WILL HEAR FROM DR. JENNIFER SHUFORD WHO WILL PROVIDE AN UPDATE.>> THANK YOU, COMMISSIONER YOUNG, AND THANKS FORGIVING US THE CHANCE TO GIVE AN UPDATE TODAY.
WE ARE BUSY WITH LEGISLATIVE IMPLEMENTATION FOLLOWING THE 89TH LEGISLATURE REGULAR SESSION, AND WE ARE THANKFUL FOR THE FUNDING OF THE LEGISLATURE APPROPRIATED TO OUR AGENCY.
ONE OF OUR AGENCY'S REQUESTS THAT WAS FUNDED INVOLVED SYPHILIS IN PREGNANT WOMEN AND CONGENITAL SYPHILIS, WHICH IS WHEN IT IS PASSED FROM A PREGNANT WOMAN TO HER BAEBY DURING PREGNANCY.
WE HAVE SEEN INCREASES OVER THE LAST DECADE, SOMETIMES WITH DEVASTATING EFFECTS LIKE STILLBIRTH.
WITH THESE NEW FUNDS, WE ARE PLANNING A PROGRAM TO ENSURE PREGNANT WOMEN GET TREATED FOR SYPHILIS BEFORE THE BABY GETS THE INFECTION AND ENSURE THAT BABIES WHO ARE EXPOSED TO GET MEDICAL FOLLOWUP. SO WE'RE DEVELOPING THOSE PLANS RIGHT NOW AND ARE EXCITED TO MAKE A DIFFERENCE IN TEXAS.
WE WERE ALSO GIVEN FUNDS TO DEVELOP A PILOT PROGRAM THAT SUPPORTS EMS PROVIDERS IN GIVING WHOLE BLOOD TO SUPPORT PATIENTS IN THE FIELD BEFORE THEY GET TO THE HOSPITAL. SO ON THEIR DRIVE, GETTING WHOLE BLOOD AS A RESUS TAYTIVE MEASURE, AND IN CASES OF TRAUMA OR HEMORRHAGE. AND SO THIS INTERVENTION COULD IMPROVE THE HEALTH OUTCOMES OF PATIENTS TREATED BY EMS ACROSS THE STATE. SO AGAIN, EXCITED TO BE DEVELOPING THE PLANS FOR THAT PROGRAM. OUR AGENCY IS BUSY WITH OTHER ACTIVITIES, AS WELL. OUR PUBLIC HEALTH LABORATORY BROUGHT UP FOUR ADDITIONAL NEW- BORN SCREENINGS, ROLLING THEM OUT OVER THE LAST WEEK. THESE TEST ALSO SCREEN FOR DISEASES, INCLUDING MPS 1, 2, AND INFANTILE CRAB DISEASE.
AND SO WE ARE UP NOW TO 59 CONDITIONS THAT WE ARE SCREENING NEWBORNS FOR. SO NEWBORNS GET SCREENED RIGHT AFTER DELIVERY AND ANOTHER ONE, ONE TO TWO WEEKS LATER.
THIS CAN REALLY IDENTIFY THOSE DISEASES THAT IF WE INTERVENE EARLY, WE CAN PREVENT DISABILITY AND DEATH. SO IT'S AN EXCITING PROGRAM TO BE INVOLVED IN AND WE APPRECIATE THE OPPORTUNITY TO EXPAND THAT THIS THE WORLD OF PUBLIC HEALTH INFECTIOUS DISEASES, THOSE INFECTIONS THAT ARE SPREAD BY MOSQUITOS AND TICKS, WE'RE WATCHING WEST NILE AND LOOKING FOR TRANSMISSION ACROSS OUR STATE.
WE HAVE NOT SEEN ANY LOCAL TRANSITION OF DENGUE SO FAR.
SO THAT'S IN LINE WITH PREVIOUS SEASON. BUT MOSQUITO SEASON IN TEXAS LASTS FOR A WHILE.
WE'VE BEEN FOLLOWING A MEASLES OUTBREAK IN THE SOUTH PLAINS REGION THAT STARTED IN JANUARY. WE HAVE IDENTIFIED 762 CONFIRMED CASES ASSOCIATED WITH THAT OUTBROKE. THOSE ARE JUST THE ONES THEY HAVE BEEN ABLE TO CONFIRM WITH THE PUBLIC HEALTH SYSTEM.
THIS RESULTED IN 99 DOCUMENTED HOSPITALIZATIONS OVER 40 CASES OF MEASLES RELATED PNEUMONIA AND TWO DEATHS IN SCHOOL- AGED CHILDREN WITH MEASLES RELATED COMPLICATIONS. BECAUSE WE HAVE NOT HAD ANY FURTHER MEASLES CASES ASSOCIATED WITH THAT OUTBREAK SINCE JULY, WE HAVE DECLARED THAT OUTBREAK OVER.
HOWEVER, WE KNOW THERE'S STILL LOTS OF MEASLES BEING TRANSMITTED IN THE COUNTRY AND THE WORLD.
WE EXPECT MORE CASES OF PLEASELES IN TEXAS, AND WITH THE DECREASE IN VACCINE COVERAGE RATES, SOME OF THOSE CASES COULD EXPAND INTO OUTBREAKS, SO WE ARE WATCHING THAT CAREFULLY AND TRYING TO GET THE MESSAGE OUT TO BE WATCHING FOR SIGNS AND SYMPTOMS OF MEASLES IN PEOPLE ACROSS OUR STATE. AND THEN WE ARE ALSO GEARING UP FOR RESPIRATORY VIRUS SEASON. WE'RE AT THE END OF AUGUST.
SOME OF THOSE FLU VACCINE CLINICS ARE GEARING UP.
SO I'LL HAVE MORE INFORMATION ABOUT THOSE RESPIRATORY VIRUSES AT THE NEXT MEETING.
>> THANK YOU. ANY QUESTIONS? THANK YOU, DR. SHUFORD.
NEXT, INSPECTOR GENERAL RAYMOND CHARLES WINTER WILL GIVE THE QUARTERLY REPORT.
>> GOOD MORNING. THANK YOU FOR THE OPPORTUNITY TO ADDRESS THE COUNCIL. I'M PLEASED TO GIVE THE REPORT ON WHAT WE'VE BEEN DOING.
AS OF THE END OF JULY, WE HAVE RECOVERED $430 MILLION FROM TAXPAYERS THROUGH OUR ENFORCEMENT EFFORTS.
IT LOOKS LIKE IT EXCEEDS THE BENCHMARK SET FOR US, AND BY THE END OF THE FISCAL YEAR, WE'LL BE AROUND $450 MILLION, MAYBE MORE.
SO I'M PLEASED WITH THE WORK OF OUR STAFF AND THEY'RE JUST
[00:15:04]
DOING AN OUTSTANDING JOB. WE'RE REALLY MAKING AN EFFORT TO INCREASE OUR OPERATIONAL TEMPO, RETURN MORE VALUE TO TEXAS TAXPAYERS, AND CONTINUE ALL THE GOOD WORK THAT WAS DONE UNDER MY PREDECESSOR WITH THE OFFICE OF INSPECTOR GENERAL ON PROTECTING THE PEOPLE THAT ARE SUPPOSED TO BE GETTING THE SERVICES THAT YOU ALL DELIVER AND ENSURE THAT TEXAS TAXPAYERS GET VALUE FOR THEIR INVESTMENTS. A COUPLE OF HIGHLIGHTS, WE WERE PART OF A TASK FORCE THAT INCLUDED REPRESENTATIVES OF THETHE FBI, OF THE DEPTH OF DOJ AND FRAUD AND CONTROL UNIT, AND WE WERE INSTRUMENTAL IN THE INVESTIGATION AND ARREST OF A SOUTH TEXAS DOCTOR. HE WAS SENTENCED TO TEN YEARS IN PRISON IN FEDERAL PRISON FOR A LENGTHY SCHEME WHERE HE WAS SUBMITTING FALSE CLAIMS FOR ESSENTIALLY PREDESCRIBING SERVICES TO PEOPLE WHO DIDN'T NEED IT.HE FILED MORE THAN $118 IN CLAIMS, ESSENTIALLY PRESCRIBING SERVICES AND HEALTH CARE FOR PEOPLE THAT SIMPLY DID NOT NEED THE SERVICE. OFTEN PUTTING PEOPLE AT RISK FOR SEVERE AND PERMANENT SIDE EFFECTS.
MORE THAN -- HE RECEIVED ALMOST $30 MILLION FROM THIS SCHEME AND HE'S GOING TO BE REQUIRED TO PAY THAT BACK, INCLUDING $6.
4 MILLION BACK TO MEDICAID. IT WAS OTHER PROGRAMS AS WELL THAT WERE VICTIMIZED. IN DALLAS, WE SETTLED A CASE AGAINST A MEDICAID PHARMACY VENDOR FOR INVENTORY.
THIS IS A CASE WHERE WE FOUND A PATTERN RECENTLY WHERE AMONG SOME OF OUR PROVIDERS WHERE THEY'RE BILLING US FOR SERVICES AND FOR QUANTITIES OF SERVICES AND DRUGS AND OTHER PRODUCTS THAT THEY DON'T HAVE ON THEIR SHELF.
SO IF THEY CLAIM THEY'RE DISPENSING 20 UNITS OF A CERTAIN DRUG AND THEY NEVER BOUGHT ANY, THAT PRESENTS A PROBLEM.
SO THIS PHARMACY SETTLED A CASE WITH US FOR $670,000.
IN ABILENE, WE JUST RECENTLY SETTLED A CASE WITH A HOSPITAL SYSTEM FOR, AMONG OTHER THINGS, DOUBLE CHARGES.
I THINK WE TALKED IN THIS SETTING BEFORE ABOUT HOW MEDICAID RULES AND REGULATIONS AN INFUSION IS INCLUDED IN AN EVALUATION AND MANAGEMENT CODE. SO IT WOULD BE FOR THE PROVIDER TO BILL US, AND TACK ON A CLAIM FOR THE INJECTION OR INFUSION, THINGS OF THAT NATURE. SO WE SETTLED WITH A HOSPITAL SYSTEM IN ABILENE FOR ALMOST $500,000. TURNING TO OUR ELECTRONIC BENEFIT TRANSFER MONITORING UNIT, WHICH IS THE S.N.A.P. PROGRAM AND OTHERS, WE HAVE RECENTLY RESOLVED A MATTER WITH ONE OF OUR EMPLOYEES WHO WAS ILLEGALLY ACCESSING S.N.A.P.
INFORMATION AND CHANGING HIS ACCOUNTS AND ILLEGALLY DIVERTING MONEY.
THIS INDIVIDUAL UNLAWFULLY ON -- OBTAINED $40,000 IN BENEFITS AND WE REFERRED THAT TO CRIMINAL PROSECUTION. WE HAVE ALSO REFERRED A RETAIL STORE FOR ADMINISTRATIVE ACTIONACTION WE FOUND AN UNUSUALLY EXPENSIVE SERIES OF TRANSACTIONS.
OUR INVESTIGATION FOUND THAT CUSTOMERS WERE USING S.N.A.P. BENEFITS TO PAY OFF OTHER ACCOUNTS THAT THEY WEREN'T ENTITLED TO DO, IN VIOLATION OF FEDERAL REGULATIONS.
THE STORE OWNER CONFIRMED THEY ENDORSED THIS PROHIBITIVE PROCESS AND PROCEDURE BUT PROFESSED THEY DID NOT KNOW IT WAS AGAINST THE RULES.
WE HAVE COLLABORATED AND REFERRED THIS TO THE UNITED STATES DEPTH OF AGRICULTURE.
YOU CAN READ ABOUT THESE THINGS IN OUR THIRD QUARTERLY REPORT, WHICH IS NOW AVAILABLE ON OUR WEBSITE, AND WE WILL SHORTLY BE PUBLISHING OUR FOURTH QUARTERLY REPORT AT THE END OF SEPTEMBER. OTHER THAN THOSE REPORTS AND EFFORTS, WE LOOK FORWARD TO CONTINUING COLLABORATION AND WORKING CLOSELY DURING THE SUNSET PROCESS IN THE MONTHS AND YEARS AHEAD. AND I'M JUST DELIGHTED TO BE HERE AND BE PART OF THIS GROUP.
MEMBERS, THIS INCLUDES AGENDA ITEM ONE, WE WILL LOOK TO ITEM TWO, AND LET THE RECORD
[2. Rule proposals]
REFLECT THAT CHIEF MICHELLE ALLETTO HAS JOINED. ITEM TWO, THE RULES[00:20:02]
ARE DIVIDED INTO THREE SECTIONS ON THE AGENDA.AGENDA ITEM -- THERE ARE NO PROPOSALS LISTED UNDER ITEM 2- A, ADMINISTRATIVE PROCEDURES ACT, PUBLIC COMMENT PERIOD HAS CLOSED.
WE WILL MOVE TO 2-B. RULE PROPOSALS THAT HAVE BEEN SUBMITTED TO THE TEXAS REGISTER FOR PUBLICATION BUT THE COMMENT PERIOD REQUIRED BY THE PROCEDURES ACT HAS NOT ENDED, AND MAY NOT HAVE YET BEGUN AS OF THE DATE OF THIS COUNCIL MEETING. ANY MEMBER HAVE QUESTIONS OR COMMENTS ON ANY OF THE RULES IN 2-B? IF COUNCIL MEMBERS HAVE NO QUESTIONS, I OPEN THE FLOOR TO PUBLIC COMMENT. ARE THERE ANY PUBLIC COMMENT CARDS?
>> EXECUTIVE COMMISSIONER, THERE ARE NO PUBLIC COMMENT REGISTRATIONS FOR AGENDA ITEM 2-B.
WE WILL NOW MOVE TO ITEM 2-C. THE RULE PROPOSALS UNDER THIS HAVE NOT YET BEEN SUBMITTED TO THE TEXAS REGISTER FOR PUBLICATION AND COMMENT.
UNDER THE ADMINISTRATIVE PROCEDURES ACT. ANY MEMBER OF THE COUNCIL HAVE QUESTIONS OR COMMENTS UNDER 2-C? IF COUNCIL MEMBERS HAVE NO QUESTIONS, I OPEN THE FLOOR TO PUBLIC COMMENT.
ARE THERE ANY PUBLIC COMMENT CARDS?
>> EXECUTIVE COMMISSIONER YOUNG, THERE IS ONE PUBLIC COMMENT REGISTRANT FOR 2-C. SHE WILL READ THE RULES SUMMARY FOR WHICH PUBLIC COMMENTS NEED TO BE HEARD AND I WILL NEED THE LOGISTICAL ANNOUNCEMENTS.
>> THANK YOU. ITEM 2- C 1, CHAPTER 169 ALLOWS DOCTORS TO PRESCRIBE LOW THC CANNABIS TO PATIENTS DIAGNOSED WITH A MEDICAL CONDITION LISTED IN SECTION 169.003.
AND WHO MAY MEET REQUIREMENTS FOR THE TEXAS USE PROGRAM. THE PROPOSED RULES EXPLAIN HOW PHYSICIANS CAN REQUEST TO ADD MEDICAL CONDITIONS TO THE LIST. SET STANDARDS FOR MEDICAL DEVICES PREDESCRIBED IN OTHER PROGRAMS AND ESTABLISH A TIMELINE FOR APPROVING SUCH DEVICES.
THE PROPOSAL IMPLEMENTS TEXAS OCCUPATIONS CODES CHAPTER 169169 AMENDED BY HOSPITAL 4- 6 89TH REGULAR LEGISLATION 2025.
>> THIS IS KAYLA BROWN, I WILL NOW READ THE PUBLIC COMMENT. HEALTH AND HUMAN SERVICE IN COMPLIANCE WITH THE TEXAS OPEN MEETING ACT PROVIDES THE OPPORTUNITY FOR THE PUBLIC TO ADDRESS COUNCIL MEMBERS FOR PUBLIC ACCOUNTABILITY AND TRANSPARENCY.
EACH COMMENTER WILL HAVE THREE MINUTES.
THE TIMER WILL BE SHOWN ON THE SCREEN.
IF THE COMMENTER IS VIRTUAL, THE TIMER WILL BE SHOWN ON THE SCREEN. IF YOU ARE A PERSON, THE TIMER WILL REFLECT YELLOW WHEN YOU HAVE ONE MINUTE REMAINING, RED WHEN YOUR TIME IS UP. YOU MUST CONCLUDE YOUR REMARKS.
PLEASE BE RESPECTFUL OF THE PUBLIC COMMENT TIME LIMITATIONS. PLEASE REMEMBER THAT CONFIDENTIAL INFORMATION SHOULD NOT BE SHARED.
AS A REMINDER, COMMENTERS MUST COMPLY WITH APPLICABLE FEDERAL AND STATE REGULATIONS REGARDING ACCESS, USE OF DISCLOSURE OF HEALTH INFORMATION OR OTHER SENSITIVE INFORMATION. THIS INCLUDES BUT NOT LIMITED TO TITLE 42, CODE OF FEDERAL REGULATIONS PART TWO, WHICH RESTRICTS THE USE OF INFORMATION PERTAINING TO DRUG AND ALCOHOL ABUSE AND TREATMENT IN HEALTH AND SAFETY CODE, CHAPTER 6- 11 .006, WHICH RESKRIKTS DISCLOSURE OF CONFIDENTIAL INFORMATION.
I WOULD LIKE TO CALL ON MR. RICHARDSON. STATE YOUR NAME AND ORGANIZATION YOU'RE REPRESENTING TODAY. LIMIT YOUR COMMENTS TO THE TOPIC FOR WHICH YOU REGISTERED TO SPEAK ON.
DO NOT SPEAK ON BEHALF OF ANOTHER PERSON WHO HAS COMMENTED ON. COMMENTERS HAVE SIGNED UP TO SPEAK ON THEIR OWN BEHALF. YOU HAVE A THREE- MINUTE TIME LIMIT OF WHICH YOU WILL INDICATE THE END OF YOUR REMARKS. YOU MAY PROCEED.
>> THANK YOU. AND THANK YOU TO HHSC EXECUTIVE COUNCIL FOR YOUR TIME. I'M NIKO RICHARDSON, THE CEO OF TEXAS ORIGINAL COMPASSIONATE CULTIVATION, THE LARGEST TEA- CUP LICENSE RIGHT NOW IN TEXAS OF THE THREE.
WE HAVE PRETTY SERIOUS CONCERNS ABOUT THE WAY THAT
[00:25:01]
THESE RULES ARE CURRENTLY WRITTEN.THE DRAFT RULES. WE BELIEVE AS CURRENTLY WRITTEN, THIS RULE WILL CREATE SOME SERIOUS OBSTACLES FOR PROVIDING REASONABLE ACCESS TO PATIENTS COUNTER TO THE INTENT OF HB-46. THERE ARE CURRENTLY THREE DISPENSING ORGANIZATIONS IN TEXAS. ONE OF MY COMPETITORS IS IN THE AUDIENCE RIGHT NOW. BETWEEN THE TWO OF OUR LICENSES, WE FULFILL 90% OF CURRENT PRESCRIPTIONS UNDER TEACUP IN TEXAS TODAY.
SO IT'S BASICALLY THE ENTIRE MARKET.
THE CURRENT RULE REQUIRES PHYSICIANS TO PRESCRIBE INDIVIDUAL INHALATION DEVICES WITH LITTLE THOUGHT TO THE FEASIBILITY OF THE DOS TO FULFILL THOSE ORDERS.
DOS HAVE TO FULFILL SPECIFIC FORMULATIONS UNDER TEN MILLIGRAM DOSES INTO VAPORIZATION DEVICES OR NEBULIZERS.
IN ORDER TO DO THAT, THE DOS NEED TO WORK DIRECTLY WITH THE MANUFACTURERS OF THE DEVICES TO MEASURE THE VAPOR FLOW THAT GOES THROUGH THE DEVICE AND MATCH THAT WITH A SPECIFIC PERCENTAGE CONCENTRATION OF CANNABIS OIL IN ORDER TO GET THAT MEASURED DOSE IN FIVE OR TEN MILLIGRAM PER INHALATION. THESE DEVICES THAT I'M TALKING ABOUT, ORDERING THEM IS UPWARDS OF 20 WEEKS, AND MINIMUM ORDER SIZE IS 10,000 UNITS. NEARLY ALL OF THESE ICES OPERATE ON A LOCK AND KEY METHODOLOGY.
MEANING THERE IS A DEVICE THAT YOU FILL AND INHALATION HEATING ELEMENT THAT HEATS IT. AND THEY WORK WITH A SPECIFIC FORMULATION THAT WORKS WITH THE HEATING ELEMENT THAT IS PROGRAMMED FOR DOSING BASED ON POTENCY METRICS.
OUR CHIEF CONCERN IS THAT DOCTORS ARE LOOKING TO THE DOS RIGHT NOW TO KNOW WHICH DEVICES THEY WILL BE USING.
IF DOCTORS ARE PICKING INDIVIDUAL DEVICES AND PRESCRIBING THOSE DEVICES, THERE WILL BE A LARGE NUMBER OF PRESCRIPTIONS THAT WE CANNOT FILL, BECAUSE DOS HAVE LIMITED ABILITIES. OUR RECOMMENDATION WOULD BE FOR HHSC TO APPROVE GUIDELINES FOR VAPORIZATION OF PULMONARY INLY NATION -- INHALATION AND ALLOW THE DOS TO SUBMIT OPTIONS. DOCTORS WILL THEN HAVE THE ABILITY TO SELECT FROM THOSE LISTS AND THEN WE CAN FILL EVERY ORDER THAT COMES IN. IF WE FLIP THE PROCESS ON ITS HEAD, I DON'T KNOW HOW MANY WE WON'T BE ABLE TO FILL, BUT IT WILL BE A LARGE NUMBER.
>> ANY QUESTIONS, MEMBERS? THANK YOU, MR.
RICHARDSON. >> THANK YOU FOR YOUR TIME.
COMMISSIONER YOUNG, THIS CONCLUDES THE PUBLIC
[3. Advisory committee recommendations]
COMMENT PORTION OF AGENDA ITEM 2-C.>> WE WILL NOW MOVE TO AGENDA ITEM 3.
ITEM 3 IS ADVISORY COMMITTEE RECOMMEND NATION ATION RECOMMENDATIONS. I WILL ASK TO HAVE A SUMMARY PRESENTED, THEN I WILL ASK COUNCIL MEMBERS FOR THEIR QUESTIONS AND COMMENTS BEFORE OPENING THE FLOOR TO PUBLIC COMMENT. IF ADDITIONAL INFORMATION IS NEEDED, WE WILL HAVE STAFF CONTACT YOU TO FOLLOW UP.
THE COMMENT WILL BE LIMITED TO THREE MINUTES.
I WOULD LIKE TO INTRODUCE A STATEMENT FROM THERESA
>> GOOD MORNING, THANK YOU VERY MUCH.
I APPRECIATE THE OPPORTUNITY TO PRESENT. SO OUR REPORT STARTS ON PAGE 35 OF THE PACKET. JUST A BRIEF OVERVIEW.
THIS CONTINUES TO RECEIVE UPDATES FROM OTHER HHSC ADVISORY COMMITTEES WITHIN MEDICAID AND CHIP SERVICES DIVISION OF HHSC IN ORDER TO ENHANCE COLLABORATION AND MINIMIZE DUPLICATION OF EFFORT. UPDATES FROM OTHER HHSC ADVISORY COMMITTEES INCLUDE, AND WE DO HAVE A LIST OF OUR COMMITTEES ON PAGE 40, BEHAVIORAL ADVICE COMMITTEE, E- HEALTH ADVISORY COMMITTEE, COGNITIVE CARE, TEXAS COUNCIL ON CONSUMER DIRECTION, VALUE BASED PAYMENT AND QUALITY IMPROVEMENT ADVISORY COMMITTEE, HOSPITAL PAINTED A VISERY COMMITMENT, INTELLECTUAL
[00:30:04]
DISABILITY SYSTEM REDESIGN COMMITTEE.AND POLICY COUNCIL FOR CHILDREN AND FAMILIES. WE WOULD LIKE TO EXTEND SIGNIFICANT THANKS AND PRAISE TO HHSC ON THE COLLABORATIVE NATURE ON THE WORK COMPLETED IN CONJUNCTION. PROJECTS AND SUBJECT MATTERS THAT HAVE BEEN MONITORED THROUGHOUT THE YEAR, THOUGH IN NO PARTICULAR ORDER ARE LISTED ON PAGES 41 AND 42. I WILL NOT GO INTO DETAIL WITH THOSE. IT'S VERY LENGTHY.
IN 2005, WE ANTICIPATED CONTINUING A COLLABORATIVE PARTNERSHIP WITH HHSC STAFF, AND WILL COLLABORATE WITH THE STAFF TO PROACTIVELY MONITOR LEGISLATIVE DIRECTION AND AGENCY MEDICAID CARE PROJECTS. OUR COMMITTEE RECOMMENDATIONS ARE AS FOLLOWS. RECOMMENDATION NUMBER ONE IS TO HHSC TO EDUCATE HEALTHY TEXAS WOMEN PROVIDERS AND MANAGED CARE ORGANIZATIONS IN A TIMELY MANNER ON THE PROCESS FOR HEALTHY TEXAS WOMEN PROVIDERS TO CONTRACT AND CREDENTIAL WITH THOSE MCOS FOR SIGNIFICANT TRADITIONAL PROVIDERS TO ENSURE AN ADEQUATE NETWORK OF HTW PROVIDERS IN MANAGED CARE.
OUR SECOND RECOMMENDATION IS TO HHSC IS ADDITIONAL FOCUS ON NETWORK ED ED ADEQUATE SI AND WE RECOMMEND MEASURING THE NETWORK'S ABILITY TO ACCOMMODATE TIMELY ACCESS TO DENTAL SERVICES FOR ALL MEDICATE NUMBERS UNDER H- 21, AND WE RECOMMEND MEASURING BOTH PRIMARY AND SPECIALTY CARE FOR STAR PLUS AND STAR KID MEMBERS WITH FOCUS ON THOSE MEDICALLY COMPLEX CONDITIONS.
IF THE ABOVE CANNOT BE ACCOMMODATED WITHIN THE EXISTING SURVEY, WE THEN RECOMMEND A SEPARATE AND DISTINCT SURVEY BE IMPLEMENTED TO EVALUATE DENTAL NETWORK ACCESS AND STAR PLUS AND STAR KIDS POPULATIONS, TAKING INTO CONSIDERATION THE MEMBERSHIP'S UNIQUE NEEDS FOR TIMELY PRIMARY AND SPECIALTY CARE ACCESS.
AND FINALLY RECOMMENDATION THREE, WE RECOMMEND TO HHSCHHSC REVISE THE NAME CHARGE OF THE SERVICE AND CARE COMMITTEE TO REFLECT THE ADDITION OF SERVICE DELIVERY MODELS TO THE SCOPE OF THE SUBCOMMITTEE. THIS RECOMMENDATION HAS BEEN COMPLETED, AND A SUMMARY OF THE IMPLEMENTATION IS FOUND ON PAGE TEN OF THIS REPORT.
THAT CONCLUDES MY SUMMARY REPORT. THANK YOU.
>> I HAVE A QUESTION. HI, ON RECOMMENDATION TWO, CAN YOU -- THE MEASURES THAT YOU WOULD LIKE TO ADD TO IS TIMELY ACCESS TO DENTAL ACCESS.
>> THE MEASURES OF PRIMARY AND SPECIALTY CARE FOR STAR PLUS AND STAR KIDS MEMBERS WITH PARTICULAR FOCUS ON THOSE WITH MEDICALLY COMPLEX CONDITIONS.
>> THANK YOU FOR COMING TO PRESENT.
I DID JUST WANT TO ADD A LITTLE BIT OF CONTEXT ON RECOMMENDATION TWO.
I DID WANT TO TELL -- I THINK THE COMMITTEE KNOWS THIS, BUT WE ARE GOING TO BE ADDING DENTAL INTO THE AVAILABILITY FOR 2027, SO TAKING THAT RECOMMENDATION, THANK YOU VERY MUCH.
>> AND THEN THE SECOND ONE, WE JUST NEED TO TALK ABOUT HOW THOSE STUDIES WORK, BECAUSE WHEN THERE IS A FERRAL REQUIRED FOR THE SPECIALTY CARE, YOU REALLY CAN'T DO KIND OF THAT SECRET SHOPPER METHOD, BUT OF COURSE, THERE'S OTHER WAYS THAT WE LOOK AT NETWORK ADEQUACY.
SO THAT IS A CHALLENGE ON THE SPECIALTY CARE SIDE.
>> I APPRECIATE THAT. THANK YOU SO MUCH.
>> ANYONE ELSE? MADAME CHAIR, THANK YOU SO MUCH FOR PRESENTING TO US.
>> ARE THERE ANY PUBLIC COMMENT CARDS?
>> EXECUTIVE COMMISSIONER YOUNG, THERE ARE NO PUBLIC COMMENT REGISTRANTS FOR 3-A.
[4. Recent Rule Adoptions - Information item not for discussion]
>> THANK YOU. THAT CONCLUDES 3-A.
NOW WE MOVE TO AGENDA 4. THE RULES LISTED UNDER AGENDA 4 HAVE BEEN EITHER SUBMITTED FOR ADOPTION OR PUBLISHED AS ADOPTED IN THE TEXAS REGISTER SINCE THE JULY 17TH, 2025 EXECUTIVE COUNCIL
[00:35:02]
MEETING, AND ARE PROVIDED FOR YOUR INFORMATION.THIS BRINGS US TO ITEM 5 AND CONCLUDES ALL BUSINESS.
THANKS TO THE COUNCIL MEMBERS FOR THEIR TIME.
PLEASE NOTE FOR
* This transcript was compiled from uncorrected Closed Captioning.