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>> THE TIME IS 10:00 A.M. ARE YOU READY TO PROCEED?
[1. Welcome and opening remarks]
>> GOOD MORNING. THE MEETING WILL COME TO ORDER.
MAY THE RECORD REFLECT THAT THIS MEETING OF THE HHSC EXECUTIVE COUNCIL CONVENED AT 10:00 AM ON AUGUST 20TH.
WILL YOU PLEASE CALL THE ROLL? >> YES, SIR.
MEMBERS, WHEN I CALL YOUR NAME, PLEASE RESPOND WITH HERE OR PRESENT. IF YOU ARE ATTENDING ON BEHALF OF A MEMBER PLEASE STATE YOUR NAME AND THE CHIEF YOU ARE REPRESENTING WHEN YOU REPLY. STEPHANIE MUTH.
>> GOOD MORNING, HALEY TURNER, DEPUTY EXECUTIVE COMMISSIONER ON
BEHALF OF CHIEF JORDAN. >> IMELDA GARCIA.
>> HERE. >> RAYMOND CHARLES WINTER.
>> AUDREY O'NEILL. THAT CONCLUDES THE ROLL CALL.
>> ALL RIGHT. JUST A COUPLE OPENING REMARKS.
TODAY IS AN EXCITING DAY AS MANY STAFF WERE ATTENDING A RIBBON CUTTING CEREMONY. SO THIS WAS A NEW CENTER IN COLLABORATION WITH THE DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES THAT WILL SERVE TEENS IN STATE CARE WHO NEED A HIGHER LEVEL OF SUPPORT THAN TRADITIONAL SETTINGS CAN PROVIDE. THE CENTER WAS FUNDED LAST SESSION. IT IS AN EXAMPLE OF THE GOVERNORS AND LEGISLATORS COMMITMENT TO HELPING MORE CHILDREN GET THE MENTAL HEALTH CARE THEY NEED.
I'D ALSO LIKE TO WELCOME BACK STEPHANIE STEVENS AS OUR STATE MEDICAID DIRECTOR. STEPHANIE PREVIOUSLY SERVED IN THIS ROLE FROM 2020-2023. SHE'S REPLACING EMILY, WHO LEFT US LAST WEEK ACTUALLY AFTER 17 YEARS OF SERVICE.
STEPHANIE, WE ARE SO GLAD YOU ARE BACK WITH US.
NEXT ON THE AGENDA WE HAVE IMELDA GARCIA, THE INTERIM DSHS COMMISSIONER PROVIDING AGENCY UPDATE.
>> GOOD MORNING EVERYONE. GOOD TO BE WITH YOU TODAY.
I WANTED TO PROVIDE A COUPLE HIGHLIGHTS OF WHAT THE DEPARTMENT OF STATE HEALTH SERVICES HAS BEEN DOING OVER THE PAST COUPLE WEEKS. LAST WEEK WE SUBMITTED OUR LEGISLATIVE APPROPRIATIONS REQUEST FOR THE 28-29 BIENNIUM.
OUR REQUESTS INCLUDES $2.4 BILLION IN BASE FUNDING ALONG WITH SIX EXCEPTIONAL ITEMS TOTALING OVER $230 MILLION.
FOR EXCEPTIONAL ITEMS, WE ARE REALLY FOCUSING ON THE CORE WORK THAT MUST BE DONE. WE DID NOT INCLUDE ANY NEW ACTIVITIES OR NEW SERVICES AS PART OF THOSE EXCEPTIONAL ITEMS. IN ADDITION TO THAT, WE HAVE BEEN ACTIVELY WORKING ON OUR SUNSET ACTIVITIES, PARTICIPATING AND HELPING THEM WITH THAT.
SO WE ARE VERY EXCITED TO BE ABLE TO RECEIVE THAT REPORT IN ORDER TO BE ABLE TO WORK WITH THE SUNSET COMMISSION.
AND JUST AS A QUICK INFECTIOUS DISEASE UPDATE, FOR THOSE OF YOU FOLLOWING THE NEWS, THERE HAVE BEEN QUITE A FEW FOODBORNE OUTBREAKS THAT HAVE BEEN GOING ON NOT ONLY HERE IN TEXAS, BUT NATIONALLY. THE FIRST 1I WANTED TO SPEAK ABOUT WAS THE SALMONELLA OUTBREAK.
THE CDC ISSUED A PUBLIC SAFETY ALERT LAST WEEK, AUGUST 14TH, REGARDING JALAPENO CONSUMPTION. NATIONALLY, THE OUTBREAK CONTAINS 345 CASES ACROSS 27 STATES, 36 HOSPITALIZATIONS.
AS OF LAST WEEK WE ONLY HAVE FOUR CASES IN TEXAS THAT HAVE BEEN CONNECTED TO THAT OUTBREAK. WE WILL CONTINUE TO WORK WITH ALL OF OUR LOCAL PUBLIC HEALTH PARTNERS ACROSS THE STATE AS WE WORK ON THAT INVESTIGATION. AND THE LARGER ONE THAT'S BEEN GOING ON IS A CYCLOSPORA OUTBREAK, WHICH IS A GASTROINTESTINAL ILLNESS CAUSED BY A PARASITE.
CDC HAS REPORTED FROM MAY FIRST THROUGH AUGUST 17TH OVER 16,000 CASES NATIONALLY, WITH 850 HOSPITALIZATIONS AND TWO DEATHS ACROSS MOST OF THE UNITED STATES, SO 47 STATES HAVE BEEN INCLUDED IN THIS OUTBREAK. DURING THE SAME TIME.
FOR US IN TEXAS, WE HAVE HAD 410 CASES WITHOUT INTERNATIONAL TRAVEL. THAT MEANS THEY ACQUIRED THE DISEASE HERE IN THE STATE. MOST OF THOSE WERE LAB CONFIRMED. BUT BECAUSE OF HOW FOODBORNE INVESTIGATIONS GO, WHERE YOU HAVE TO ASK PEOPLE, WHAT ALL DID YOU EAT AND GO BACK THREE WEEKS, THOSE INVESTIGATIONS AND SURVEYS
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TAKE A WHILE TO COMPLETE. I DON'T KNOW IF YOU'RE LIKE ME, YOU DON'T REMEMBER WHAT YOU HAD FOR BREAKFAST YESTERDAY.SO TRYING TO GET PEOPLE TO REMEMBER THREE WEEKS AHEAD OF THAT IS QUITE CHALLENGING. WE WILL CONTINUE TO WORK ON THE CYCLOSPORA OUTBREAK AND BE COMMUNICATING AS THOSE THINGS CONTINUE TO EVOLVE. ON EBOLA, THE EBOLA OUTBREAK IN THE DEMOCRATIC REPUBLIC OF THE CONGO CONTINUES TO INCREASE IN CASES. AS OF LAST WEEK THERE WERE ALMOST 5000 CASES REPORTED, WITH OVER 2300 DEATHS.
THIS IS THE MOST RAPIDLY EVOLVING EBOLA OUTBREAK THAT THEY'VE HAD. WE STILL HAVE NO CASES IN THE UNITED STATES. SINCE THE OUTBREAK BEGAN, WE HAVE BEEN MONITORING JUST UNDER 1000 TRAVELERS FOR SYMPTOMS IN THE EVENT THAT THEY DEVELOP THEM.
95% OF THOSE TRAVELERS HAVE ACTUALLY BEEN FROM UGANDA, NOT FROM THE DEMOCRATIC REPUBLIC OF THE CONGO.
SO AT THE FEDERAL LEVEL, THE DEPARTMENT OF STATE HAS ISSUED A TITLE 42 ORDER PREVENTING ANYBODY THAT HAD BEEN IN THE DEMOCRATIC REPUBLIC OF CONGO FROM RETURNING BACK TO THE UNITED STATES WITHOUT SPENDING 21 DAYS, THE INCUBATION PERIOD FOR EBOLA, OUTSIDE OF THE COUNTRY.
SO THEY ARE TRYING TO MAKE SURE THAT WE ARE MINIMIZING ANY POTENTIAL RISK COMING INTO THE UNITED STATES.
LASTLY, JUST A QUICK UPDATE ON NEW WORLD SCREWWORM.
THIS IS AN INFESTATION CAUSED BY A FLY, NOT A WORM.
BUT AS OF LAST WEEK, THERE HAVE BEEN A NEW CASE IDENTIFIED IN VAL VERDE COUNTY. IN TOTAL, THERE HAVE BEEN 45 ANIMAL CASES ACROSS 16 COUNTIES IN TEXAS.
THANKFULLY, WE STILL DON'T HAVE ANY HUMAN CASES IN TEXAS AND WE WILL CONTINUE TO PARTNER WITH SISTER AGENCIES ON ALL OF THOSE INVESTIGATIONS. DAVID, I'LL PASS IT BACK TO YOU.
>> THANK YOU FOR THAT UPDATE. PLEASE NOTE THAT AGENDA ITEM 1D FROM DPS HAS BEEN TABLED. WE WILL MOVE TO THE NEXT ITEM, RAYMOND WINTER WILL PROVIDE THE INSPECTOR GENERAL'S UPDATE.
>> THANK YOU, DAVID. GOOD MORNING.
I'M RAYMOND WINTER, INSPECTOR GENERAL FOR HEALTH AND HUMAN SERVICES. OUR OFFICE SUPPORTS THE AGENCY'S MISSION BY UPHOLDING ACCOUNTABILITY AND TRANSPARENCY ACROSS HEALTH AND UNIT SERVICES PROBLEMS. -- PROGRAMS. OUR MISSION INVOLVES CONDUCTING AUDITS, INSPECTIONS, SUPPORTING LAW ENFORCEMENT AS WELL AS ADMINISTRATIVE INVESTIGATIONS TO PROTECT PUBLIC RESOURCES AND THE CLIENTS WE ALL SERVE. SINCE OUR LAST MEETING, WE HAVE RECOVERED AN ADDITIONAL $47.83 MILLION THROUGH THE END OF JULY FOR TAXPAYERS IN TEXAS, BRINGING OUR TOTAL RECOVERIES FOR THIS FISCAL YEAR AS OF THE END OF JULY TO $433 MILLION.
I WANT TO HIGHLIGHT TWO AREAS FROM MY OFFICE THAT HAVE ALREADY MET THEIR ANNUAL ESTABLISHED TARGETS BEFORE THE END OF THE FISCAL YEAR. OUR SURVEILLANCE UTILIZATION REVIEW UNIT AND BENEFITS PROGRAM INTEGRITY UNIT.
SUR IS MADE UP OF CLINICIANS AND NURSES AS WELL AS CODERS AND PROGRAM SUPPORT STAFF WHO CONDUCT RETROSPECTIVE REVIEWS TO DETECT AND RECOVER OVERPAYMENTS IN THE MEDICAID SYSTEM.
FOR HOSPITAL UTILIZATION REVIEWS, MEDICAL RECORDS FROM THE HOSPITALS AND THE NURSES REVIEW AND PATIENT HOSPITAL CLAIMS TO ASSESS MEDICAL NECESSITY.
THEY DO DIAGNOSIS RELATED CONSISTENCY REVIEWS CONSISTENTLY WITH FEDERAL CODING GUIDELINES AS WELL AS QUALITY CARE REVIEWS.
THROUGH THE END OF JULY, THE SUR UNIT HAS CONDUCTED APPROXIMATELY 13,000 INPATIENT HOSPITAL CLAIMS REVIEWS AND RECOVERED ALMOST $17 MILLION, EXCEEDING THE ANNUAL PERFORMANCE TARGET BY OVER 3.5 MILLION. THE BPI UNIT INVESTIGATES ALLEGATIONS OF FRAUD, WASTE, AND ABUSE BY HHS PROGRAM RECIPIENTS INCLUDING VERIFIED RECIPIENTS AND INDIVIDUALS SUSPECTED OF USING FALSIFIED IDENTITIES TO OBTAIN BENEFITS THEY ARE NOT QUALIFIED FOR BY LAW. THE BPI WORKS WITH PROGRAMS SUCH AS SNAP, MEDICAID, CHIP, AND WICC.
MORE THAN 100 BPI INVESTIGATORS CONDUCT ADMINISTRATIVE AND CRIMINAL INVESTIGATIONS WHICH MAY RESULT IN ADMINISTRATIVE ORDERS TO REPAY DOLLARS THAT MAY RESULT IN RECIPIENT DISQUALIFICATION AND/OR A COURT ORDERED RESTITUTION.
WE ALSO MAKE REFERRALS TO PROSECUTORIAL AUTHORITIES THAT
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COULD RESULT IN INCARCERATION. THROUGH THE END OF JULY, BPI HAS CONDUCTED OVER 17,000 INVESTIGATIONS, RECOVERED $62 MILLION FROM TAXPAYERS, WHICH EXCEEDED BOTH FY 2026 TARGET AS WELL AS FY25 ACCOMPLISHMENTS.I WANTED TO HIGHLIGHT BOTH THESE AREAS FOR YOU ALL TODAY.
WE COMMEND THEM FOR THEIR OUTSTANDING WORK.
THESE RESULTS ARE A TESTAMENT TO THE DEDICATION, CHARACTER, AND LEADERSHIP OF THESE RESPECTIVE UNITS WITHIN OUR OFFICE, AND I WANTED TO GIVE THEM THAT SHOUT OUT.
THANK YOU FOR YOUR TIME AND I'M HAPPY TO ANSWER QUESTIONS.
[2. Agency updates]
>> THANK YOU FOR THAT UPDATE. NEXT ON THE AGENDA IS AN UPDATE FROM STEPHANIE STEFFENS, PROVIDING AN UPDATE ON BAYLOR SCOTT AND WHITE TRANSITIONING MEDICAID AND CHIP CONTRACTS FOR
CENTRAL AND WEST TEXAS. >> THANKS, DAVID.
GOOD MORNING EVERYONE. I'M THE STATE MEDICAID DIRECTOR.
GOOD TO BE HERE WITH YOU, AND GOOD TO BE BACK AT HHSC.
AS DAVID SAID, WE WANTED TO GIVE A REMINDER OF A TRANSITION THAT'S OCCURRING IN MEDICAID AND CHIP.
BAYLOR SCOTT AND WHITE IS LEAVING THOSE PROGRAMS AS OF THE END OF THE MONTH. THAT INCLUDES THEIR SCOTT AND WHITE AND FIRST CARE HEALTH PLANS.
MEMBERS WERE NOTIFIED OF THIS CHANGE AND HAD UNTIL MID-JULY TO CHOOSE A PLAN. WE ARE SEEING SLIGHTLY LOWER CHOICE RATES THAN WE TYPICALLY SEE ACROSS THE PROGRAM.
WE HAVEN'T RECEIVED ANY COMPLAINTS ABOUT THIS TRANSITION, BUT WE CONTINUE TO WORK WITH THE HEALTH PLANS INVOLVED AND CONTINUE TO MONITOR ON THE BACK END THE MOVEMENT OF MEMBERS TO MAKE SURE THEY SMOOTHLY TRANSITION TO ONE OF THE OTHER EXISTING PLANS. WE ALSO ALWAYS LIKE TO REMIND FOLKS THAT THERE ARE CONTINUITY OF CARE REQUIREMENTS THAT ALLOW THESE MEMBERS IMPACTED BY THIS TRANSITION TO CONTINUE TO SEE THEIR CURRENT PROVIDER AND CONTINUE TO RECEIVE AUTHORIZED SERVICES FOR A PERIOD OF TIME THROUGHOUT THIS TRANSITION.
PLEASE LET US KNOW IF YOU HEAR OF ANY ISSUES, AND WE WILL CONTINUE TO WORK WITH PLANS, MEMBERS, AND PROVIDERS TO MAKE SURE THE TRANSITION GOES SMOOTHLY.
[3. Rule proposals]
THANK YOU. >> THANK YOU, STEPHANIE.
I GUESS WE ARE READY TO MOVE INTO THE RULES PROPOSALS NOW.
WE WILL MOVE TO RULES PROPOSALS SUBMITTED TO THE TEXAS REGISTER WHICH ARE CURRENTLY WITHIN THE OPEN PUBLIC COMMENT PERIOD.
WE WILL START OUT WITH LIZETTE CURRY FROM DSHS TO PROVIDE A SUMMARY ON THE PROPOSED RULE CONCERNING THE STATEWIDE HEALTH
COORDINATING COUNCIL. >> GOOD MORNING.
I'M DR LIZETTE CURRY, A RESEARCH SPECIALIST IN THE OFFICE OF THE... I PREVIOUSLY COORDINATED THE STATEWIDE COUNCIL WHICH ENDED UNDER RECENT LAW.
HHSC ON BEHALF OF DSHS IS REMOVING REFERENCES TO THE STATEWIDE HEALTH COORDINATING COUNCIL, NURSING ADVISORY COMMITTEE UNDER THAT COUNCIL, AND A SECTION OF STATE LAW THAT ENDED ON SEPTEMBER FIRST, 2025 FROM THE TEXAS ADMINISTRATIVE CODE. HHSC PROPOSES AMENDMENTS TO RULES IN THE TEXAS ADMINISTRATIVE CODE TITLED 25 PART ONE CHAPTER 13 AND THE REPEAL OF TEXAS ADMINISTRATIVE CODE TITLE 25 PART SIX, CHAPTER 571, SUBCHAPTER EIGHT.
PROPOSAL PROJECT 26R-042 CARRIES OUT PART OF HOUSE BILL FROM THE 89TH REGULAR HOUSE SESSION IN 2025.
HOUSE BILL 3801 ABOLISHED THE STATEWIDE HEALTH COORDINATING COUNCIL AND ITS NURSING ADVISORY COMMITTEE AND REPEALED TEXAS HEALTH AND SAFETY CODE CHA CHAPTER 104 EFFECTIVE SEPTEMBER 12025. THE PROPOSED AMENDMENTS REMOVE REFERENCES TO THOSE TOPICS FROM TEXAS ADMINISTRATIVE CODE CHAPTER 13 AND USE PLAIN LANGUAGE TO MAKE THE RULES EASIER TO READ. THE PROPOSED REPEAL REMOVES UNNECESSARY RULES FROM TEXAS ADMINISTRATIVE CODE TITLE 25 PART SIX CHAPTER 571 SUBCHAPTER A, SECTIONS 571.1 AND 571.2.
THE PUBLIC WILL BENEFIT FROM RULES THAT ARE CURRENT, CONSISTENT WITH STATE LAW, AND EASIER TO UNDERSTAND.
MEMBERS, ANY QUESTIONS? OKAY, THANK YOU.
NEXT WE WILL HAVE SHARON JACOB FROM HHSC HEALTH CARE REGULATION TO PROVIDE THE NEXT THREE SUMMARIES ON MOBILE STROKE
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UNITS, FREESTANDING EMERGENCY MEDICAL CARE, LIFE SUPPORT CERTIFICATION EXEMPTIONS, AND LICENSED CHEMICAL DEPENDENCYCOUNSELORS. >> YES, THE NEXT THREE.
I'M SHARON JACOB, -- YES, IT IS ON.
I'M THE DIRECTOR OF POLICIES AND RULES WITHIN THE CHIEF REGULATORY SERVICES OFFICE WITHIN THE HEALTH CARE REGULATION DIVISION. HHSC IS CREATING RULES FOR MOBILE STROKE UNITS IN TITLE 26 PART ONE CHAPTER 505.
THE PROJECT IMPLEMENTS HOUSE BILL 4743 FROM THE 89TH REGULAR SESSION. AMENDING THE TEXAS HEALTH AND SAFETY CODE SECTION 241.023 TO ALLOW A GENERAL OR SPECIAL HOSPITAL TO ADD AN MCU. IT SPECIFIES EXEMPTIONS FOR EMS USE FROM CERTAIN LICENSING RULES.
THE PUBLIC WILL BENEFIT BECAUSE ALLOWING A GENERAL HOSPITAL LICENSE TO INCLUDE A MOBILE STROKE UNIT WILL INCREASE ACCESS
TO TIMELY CARE. >> MEMBERS, ANY QUESTIONS?
THIS ONE IS FOR THE FREESTANDING EMERGENCY MEDICAL CARE LIFE SUPPORT CERTIFICATION EXEMPTION. HHSC IS AMENDING THE LIFE SUPPORT CERTIFICATION REQUIREMENTS FOR MEDICAL STAFF, PRIVILEGES, IN TITLE 26, PART ONE, CHAPTER 509 CONCERNING FREESTANDING EMERGENCY MEDICAL CARE LIFE SUPPORT CERTIFICATION EXEMPTIONS. CURRENTLY, TO HAVE MEDICAL STAFF PRIVILEGES AT AN FMC FACILITY, PHYSICIANS MUST HAVE LIFE SUPPORT CERTIFICATION, PEDIATRIC ADVANCED LIFE SUPPORT, AND ADVANCED TRAUMA LIFE SUPPORT ATLS.
THIS PROJECT CREATES AN EXEMPTION TO ALLOW FACILITIES TO GIVE PRIVILEGES TO PHYSICIANS WITHOUT ADDITIONAL LIFE SUPPORT CERTIFICATION IF THE PHYSICIAN IS BOARD CERTIFIED IN EMERGENCY MEDICINE FROM THE AMERICAN BOARD OF EMERGENCY MEDICINE, EM, OR THE AMERICAN OSTEOPATHIC BOARD OF EMERGENCY MEDICINE.
THIS PROJECT WAS FROM REQUEST. AND THEY ALREADY HAVE THE KNOWLEDGE AND SKILLS REQUIRED FOR EMERGENCY LIFE SUPPORT WITHOUT NEEDING ADDITIONAL LIFE SUPPORT CERTIFICATIONS.
PATIENTS WILL BENEFIT FROM THIS AS IT PARTIALLY ELIMINATES THE REQUIREMENT OF COST WHICH WILL SUPPORT TIMELY ACCESS TO CARE FOR PATIENTS AND POTENTIALLY PREVENT ADDITIONAL COSTS FROM
BEING PASSED ON TO THE PATIENT. >> MEMBERS, ANY QUESTIONS? ALL RIGHT, AND YOU HAVE ONE MORE?
THANK YOU. >> THIS HAS TO DO WITH LCDC INACTIVE STATUS AND INTERIM STANDARDS.
HHSC IS UPDATING THE RULES FOR LICENSED CHEMICAL DEPENDENCY COUNSELORS, LCDCS, BY PROPOSING AN AMENDMENT TO SECTION 562.21 AND REPEALING 562.19 WITHIN TITLE 26, PART ONE, CHAPTER 562.
THE PROJECT REPEALS THE INACTIVE LICENSE STATUS TO ELIMINATE POTENTIAL COSTS AND LATE FEES CAUSED BY MISSED RENEWAL DEADLINES. IT ALSO SIMPLIFIES THE COUNSELOR INTERIM SUPERVISION PROCESS BY REMOVING OUTDATED ASSESSMENT FORMS AND ALIGNING COMPLETE PROCESSES WITHIN THE STANDARD COMPLAINT PROCESS. THE CHANGES ALSO SUPPORT REGULATORY REFORM AS THEY REDUCE UNNECESSARY REGULATORY BURDENS, LOWER POTENTIAL COMPLIANCE COSTS, AND IMPROVE CLARITY AND ACCURACY OF THE RULES. THE PUBLIC AND STAKEHOLDERS WILL BENEFIT FROM COST SAVINGS AS WELL AS REDUCED PROVIDER REGULATORY BURDEN. IN ADDITION, THE NEW RULES WOULD ELIMINATE POTENTIAL CONFUSION AS THEY ARE CLEARER, MORE ACCURATE, AND MORE CONSISTENT ACROSS THE RULES FOR HEALTH CARE REGU
REGULATION. >> ANY QUESTIONS OR COMMENTS? OKAY. SHARON, THANK YOU SO MUCH.
NEXT, JOSHUA, HHSC LONG TERM CARE REGULATION.
HE'LL PROVIDE A SUMMARY ON THE SURVEY AND LICENSE RENEWAL OF PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS.
>> GOOD MORNING. CAN YOU HEAR ME? EXCELLENT. GOOD MORNING.
MY NAME IS JOSHUA, DIRECTOR OF POLICY AND RULES WITHIN THE LONG TERM CARE REGULATORY POLICY AND RULES OFFICE.
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HHSC IS UPDATING THE LICENSE RENEWAL RULES FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS BY PROPOSING AMENDMENTS TO THE RULES OF TITLE 26 PART ONE, CHAPTER 550 SUBCHAPTER F.THIS RULE PROJECT IS A STATUTORY INITIATIVE ORIGINATING FROM STAKEHOLDER FEEDBACK AND CHANGES SUPPORT AND REGULATORY REFORM.
THE PROJECT CHANGES INSPECTION FREQUENCY FROM ANNUALLY TO EVERY THREE YEARS IN ALIGNMENT WITH LICENSURE RENEWAL AND INSPECTION TIMEFRAMES STATED IN TEXAS HEALTH AND SAFETY CODE SECTIONS 248 A 053 AND 248 A 102. THIS PROPOSAL ALSO DELETES OR UPDATES OBSOLETE REFERENCES AND CLARIFIES EXISTING LANGUAGE TO IMPROVE OVERALL READABILITY. THE PUBLIC WILL BENEFIT BECAUSE THE SURVEY AND LICENSE RENEWAL RULES WILL NOW ALIGN AND ARE WRITTEN IN PLAIN LANGUAGE TO BE EASIER TO UNDERSTAND.
IN ADDITION, ADMINISTRATIVE AND OPERATIVE BURDENS WILL BE REDUCED, ALLOWING FOCUS ON DAILY OPERATIONS AND CARE WHILE HHSC
MANAGES OVERSIGHT. >> MEMBERS, ANY QUESTIONS? THANK YOU, JOSHUA. WE WILL NOW HAVE CHRISTINA FROM HHSC PROVIDING A SUMMARY ON HOSPITAL AUGMENTED REIMBURSEMENT PROGRAM OR HARP METHODOLOGY. CHRISTINA.
>> GOOD MORNING BJORK I'M CHRISTINA KNIPP, MANAGER OF THE HOSPITAL SUPPLEMENTAL PAYMENTS TEAM WITHIN THE CHIEF FINANCIAL OPERATIONS DIVISION OF THE FINANCE DEPARTMENT.
HHSC PROPOSES AN AMENDMENT TO A RULE IN PART 15, CHAPTER 355, SUBCHAPTER J, DIVISION FOR, CONCERNING HARP.
HHSC IS UPDATING THE HARP METHODOLOGY RULE.
THE PURPOSE OF THE PROPOSAL IS TO ESTABLISH A CALCULATION THAT ALLOWS ANY UNUSED PAYMENT CAPACITY TO BE DISTRIBUTED TO OTHER ELIGIBLE HOSPITALS WITHIN THE SAME CLASS BASED ON AN ALLOCATION PROPORTIONATE TO THE REMAINING MEDICAID PAYMENTS INCLUDING SUPPLEMENTAL PAYMENTS. UNDER THIS PROPOSED RULE, IF UNUSED HARP PAYMENT CAPACITY EXISTS, HOSPITALS PARTICIPATING IN THE PROGRAM WITHIN THE SAME CLASS MAY BE ELIGIBLE TO RECEIVE ADDITIONAL HARP SUPPLEMENTAL PAYMENTS.
>> ALL RIGHT. QUESTIONS, COMMENTS? THANK YOU, CHRISTINA. NEXT WE WILL HAVE LESLIE REID FROM HHSC PROVIDING A SUMMARY ON THE PROPOSED RULE CONCERNING MEDICAID REIMBURSEMENT FOR NURSING FACILITY SERVICES.
>> GOOD MORNING. MY NAME IS LESLIE REID, DIRECTOR OF PROGRAM POLICY FOR MEDICAID AND CHIP SERVICES.
HHSC IS UPDATING MEDICAID REIMBURSEMENT RATE RULES BY PROPOSING AMENDMENTS TO RULES IN TITLE 26 PART ONE, CHAPTER 554 AND TITLE ONE PART 15 CHAPTER 353 AND PROPOSING TO REPEAL A RULE IN TITLE ONE PART 15 CHAPTER 353.
THE PROPOSAL PROJECT 24R074 IMPLEMENTS LEGISLATION FROM THE 88 AND 89TH LEGISLATURES. THE 2024-25 GENERAL OPERATIONS ACT, 88TH LEGISLATURE, REGULAR SESSION 2023.
ARTICLE TWO, HHSC. HOUSE BILL 4611 FROM THE 80TH LEGISLATURE IN 2023, AND SENATE BILL 457 FROM THE 89TH LEGISLATURE IN 2025. THE 2024 GENERAL APPROPRIATIONS ACT, HOUSE BILL ONE, WRITER 25 REQUIRED HHSC TO TRANSITION TEXAS MEDICAID REIMBURSEMENT RATE METHODOLOGY FOR LONG TERM STAY NURSING FACILITY SERVICES FROM RESOURCE UTILIZATION GROUP OR RUG TO A TEXAS VERSION OF THE PAYMENT DRIVEN PAYMENT MODEL FOR LONG TERM CARE, PDPM LTC. BECAUSE STAR PLUS HOME AND COMMUNITY BASED SERVICES AND THE MEDICALLY DEPENDENT CHILDREN PROGRAM ARE MEDICAID NURSING FACILITY WAIVER PROGRAMS, FEDERAL REGULATIONS REQUIRED UPDATING TO THESE PROGRAMS COST LIMITS THAT WERE BASED ON THE RUG METHODOLOGY BASED ON THE PDPM METHODOLOGY. ACCORDINGLY THE PROPOSAL ALIGNS TERMINOLOGY WITH PDPM, LTC, UPDATES METHODOLOGY AND
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ESTABLISHES A REIMBURSEMENT METHODOLOGY EFFECTIVE SEPTEMBER FIRST, 2025. HOUSE BILL 4611 FROM THE 88TH LEGISLATURE UPDATED CITATIONS TO THE TEXAS GOVERNMENT CODE AS PART OF THE LEGISLATURE'S ONGOING STATUTORY REVISION PROGRAM. THIS PROPOSAL UPDATES RELEVANT TEXAS GOVERNMENT CODE CITATIONS. SENATE BILL 457 FROM THE 89TH LEGISLATURE ELIMINATED THE NURSING FACILITY ENHANCEMENT RATE PROGRAM. THEREFORE, THE PROPOSAL REMOVES REFERENCES TO THIS RATE. THE PROPOSAL WILL ALSO REPEAL A RULE WHICH MINIMIZES THE MINIMUM PAYMENT AMOUNT PROGRAM, WHICH WAS REPLACED BY THE QUALITY PROGRAM FOR NURSING FACILITIES.THE PUBLIC WILL BENEFIT BECAUSE THESE RULES WILL ALIGN TERMINOLOGY WITH THE PDPM LTC METHODOLOGY, REMOVE OBSOLETE REFERENCES, IMPROVE CONSISTENCY ACROSS MEDICAID REIMBURSEMENT RULES, AND ENSURE THE RULES REQUEST -- REFLECT CURRENT
RULES. >> ANY QUESTIONS? THANK YOU. NEXT WE ARE GOING TO HAVE LAURA CAZABAN FROM HHSC PROVIDING A SUMMARY ON PROPOSED RULE REPEAL RELATED TO A MEMORANDUM OF UNDERSTANDING.
>> GOOD MORNING. I'M LAURA CAZABAN, ASSOCIATE COMMISSIONER WITHIN THE BEHAVIORAL HEALTH, DISABILITY AND AGING SERVICES OFFICE HEALTH AND SPECIALTY CARE SYSTEM.
HHSC PROPOSES THE REPEAL OF TITLE 26, CHAPTER 3, SUBCHAPTER E AND CHAPTER 300, SUBCHAPTER B. PROPOSAL PROJECT 26R0044 REMOVES UNNECESSARY RULES FROM THE TAC. TEXAS EDUCATION CODE REQUIRES A MEMORANDUM OF UNDERSTANDING OR AN MOU BETWEEN STATE AGENCIES PER THE PROVISION OF PUBLIC EDUCATION AND RESIDENTIAL FACILITIES. THESE TITLE 26 RULES ADOPT A TEXAS EDUCATION RULE THAT PROVIDES THE TERMS OF THE MOU.
THIS PROPOSED REPEAL IS IN RESPONSE TO HOUSE BILL TWO AND SENATE BILL 568 FROM THE 89TH LEGISLATURE REGULAR SESSION 2025, WHICH AMENDED THE TEA CODE BY REMOVING THE REQUIREMENT TO HAVE THE MOU IN RULE. ALL THE STATUTES STILL REQUIRES, PROPOSING THE REPEAL BECAUSE THE MOU IS NO LONGER REQUIRED TO BE IN THE RULE. THE PUBLIC WILL BENEFIT BY REMOVING IT BECAUSE THE ADMINISTRATIVE CODE WILL FOCUS ON REQUIREMENTS THAT STILL NEED TO BE IN THE RULE.
WE HAVE CRYSTAL FROM HHSC CHILD CARE REGULATIONS TO PRESENT THE LAST TWO SUMMARIES IN THIS AGENDA ITEM.
THAT'S THE LICENSED CHILD CARE CENTERS REGULATORY REFORM FOLLOWED BY A NEW RULE CONCERNING CHILD CARE HOME
REQUIREMENTS. >> GOOD MORNING.
IT'S GOOD TO BE HERE TODAY. MY NAME IS CRYSTAL PHELAN, ASSOCIATE COMMISSIONER FOR REGULATIONS AT CHILD CARE APPROPRIATION. HHSC IS UPDATING RULES IN 26 PART ONE CHAPTER 746 CONCERNING LICENSED CHILD CARE CENTERS.
THE UPDATE INVOLVES A REGULATORY REFORM TO INCLUDE REPEALING AND AMENDING CURRENT RULES AND THE PROPOSAL OF A NEW REQUIREMENT.
PROPOSAL PROJECT 26R057 AMENDS, SIMPLIFIES, REMOVES, AND STREAMLINES REQUIREMENTS WHILE PROTECTING HEALTH SAFETY AND WELL-BEING OF CHILDREN IN CARE AT A LICENSED CHILD CARE CENTER.
THE PROPOSAL REPEALS SIX RULES, REPEALS AND CONSOLIDATES 16 RULES INTO NINE RULES, AND AMENDS EIGHT RULES, ELIMINATES THE QUESTION AND ANSWER FORMAT, REMOVES CROSS-REFERENCES TO OTHER RULES TO REDUCE COMP COMPLEXITY, REMOVES DUPLICATIVE LANGUAGE, AND REDUCES THE OVERALL NUMBER OF RULES AND REQUIREMENTS TO ALIGN WITH REASONABLE REGULATION.
HHSC REVIEWED EXISTING CHILD CARE RULES RELATED TO RECORD KEEPING AND REPORTING TO DETERMINE IF ANY RULES NEED TO BE REVISED TO ENSURE ACCOUNTABILITY OF CHILD CARE PROVIDERS RECEIVING TEXAS WORKFORCE COMMISSION'S CHILD CARE SERVICES SUBSIDIES. THE AMENDED RULE REQUIRES A PERMIT HOLDER TO COMPLY WITH CHILD CARE SERVICES RULE REQUIREMENTS IF RECEIVING CHILD CARE SERVICES SUBSIDIES.
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THE PROPOSAL ALSO AMENDS RULES TO MAKE NONSUBSTANTIVE CHANGES, WHICH REMOVES BETWEEN CHILD AND CENTER.THE PUBLIC WILL BENEFIT THROUGH REDUCED ADMINISTRATIVE BURDENS BY EASING OR ELIMINATING CERTAIN REGULATIONS AND GREATER CLARITY
ANY QUESTIONS? CRYSTAL, WE APPRECIATE THE WORK YOU AND THE TEAM HAVE DONE ON REGULATORY REFORM.
A VERY IMPORTANT EFFORT THAT WE ARE DOING IN REGULATORY SERVICES. THANKS FOR YOUR LEADERSHIP.
>> THANK YOU. APPRECIATE THAT.
>> OKAY. MOVE YOU CAN MOVE TO THE NEXT,
CHILD CARE REQUIREMENTS. >> HHSC IS UPDATING RULES ENTITLED 26 PART ONE, CHAPTER 747 FOR CHILD CARE HOMES. THE UPDATES INVOLVE PROPOSING A NEW ROLE IN EACH CHAPTER AND AMENDING A CURRENT RULE IN CHAPTER 747. PROPOSAL PROJECT 26R072 IMPLEMENTS REQUIREMENTS UNDER SECTION 8 OF SENATE BILL 225 FROM THE 87TH REGULAR LEGISLATIVE SESSION, WHICH ADDS TEXAS HUMAN RESOURCE CODE HR SEE SECTION 42.0562.
THIS PROJECT IMPLEMENTS REQUIREMENTS UNDER SECTION 8 -- C, SORRY ABOUT THAT. REQUIRES HHSC COLLECTS INFORMATION ON ANY LISTED, REGISTERED, OR LICENSED CHILD CARE HOME EMPLOYEE WHO HAS REVOKED THEIR STATE ISSUED LICENSE, REGISTRATION, OR OTHER OCCUPATIONAL AUTHORIZATION BY LICENSED AUTHORITY WHICH PREVIOUSLY ALLOWED THE EMPLOYEE TO PRACTICE OR ENGAGE IN A PARTICULAR BUSINESS, OCCUPATION, OR PROFESSION. THIS INCLUDES ANY LISTED, REGISTERED, AND LICENSED CHILD CARE HOME PERMIT HOLDERS OR PROSPECTIVE EMPLOYEES. TO BEST SAFEGUARD CHILDREN, PARENTS AND GUARDIANS, WE NEED TO COMPLETE ACCURATE INFORMATION ABOUT CAREGIVERS. THIS NEW RULE MAKES CERTAIN THAT PAST EFFICIENCIES ASSOCIATED WITH AN INDIVIDUAL CAREGIVER KNOWN TO THE PARENTS AND GUARDIANS OF CHILDREN IN CARE.
THE PROPOSAL ALSO STRENGTHENS RULES RELATED TO A CHILD CARE HOMES COMPLIANCE WITH THE TEXAS WORKFORCE COMMISSION S. CHILD CARE SERVICES PROGRAM REQUIREMENTS IF THE HOME RECEIVES SUBSIDIES. THE PROPOSED RULES WILL PROVIDE INCREASED PROTECTION FOR CHILDREN AND LISTED REGISTERED AND LICENSED CHILD CARE HOMES AND GREATER ACCOUNTABILITY FOR CHILD CARE HOMES RECEIVING CWC CHILD CARE SUBSIDY.
>> VERY GOOD. ANY QUESTIONS? THANK YOU, CRYSTAL. WE WILL MOVE TO ITEM 3B, PROPOSALS SUBMITTED TO THE TEXAS REGISTER BUT NOT PUBLISHED.
THE PUBLIC COMMENT PERIOD HAS NOT OPENED FOR THESE NEXT FEW RULES. I THINK, CRYSTAL, YOU ARE UP AGAIN TO PRESENT A SUMMARY ON CHILD CARE LICENSURE, SCREENINGS, AND LIABILITY INSURANCE.
>> THANK YOU. HHSC IS UPDATING RULES ENTITLED 26, 744, 745, 746, 747, AND 748 BY PROPOSING 28 AMENDMENTS AND EIGHT REPEALS. PROPOSAL PROJECT 26R009 IMPLEMENTS SECTIONS TWO, THREE, FOUR, FIVE, AND NINE OF HOUSE BILL 2789 AND SECTION 27 FROM THE 89TH REGULAR LEGISLATIVE SESSION. BOTH BILLS AMEND TEXAS HUMAN RESOURCE CODE CHAPTER 42. HOUSE BILL 2789 REMOVED THE REQUIREMENT FOR A CHILD IN CARE TO HAVE A TUBERCULIN SKIN TEST, REDUCED THE LIABILITY INSURANCE COVERAGE REQUIREMENTS FOR CHILD CARE OPERATIONS THAT ARE LICENSED, REGISTERED, AND LISTED, INCREASED. OF VALIDITY OF AN INITIAL LICENSE FROM SIX MONTHS TO 12 MONTHS, REMOVED REQUIREMENTS FOR A CHILD CARE CENTER OR LICENSED CHILD CARE HOME TO MAINTAIN SCREENING RECORDS FOR VISION, HEARING, AND ANY OTHER SPECIAL SENSES OR COMMUNICATION DISORDERS FOR CHILDREN ATTENDING THE OPERATION. SENATE BILL 1619 SECTION 27 ADDED THE TERM EPINEPHRINE DELIVERY SYSTEM TO THE TEXAS HUMAN RESOURCE CODE CHAPTER 42 TO EXPAND THE ALLOWABLE AND ASSIGNED EPINEPHRINE DEVICES TO INCLUDE AN EPINEPHRINE NASAL SPRAY IN ADDITION TO AN EPINEPHRINE AUTOINJECTOR.
THE PROPOSED RULES REMOVE REQUIREMENTS RELATED TO
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TUBERCULOSIS TESTING, REDUCE LIABILITY INSURANCE COVERAGE REQUIREMENTS, UPDATE. OF VALIDITY OF THE INITIAL LICENSE, UPDATE AND REMOVE REQUIREMENTS RELATED TO VISION AND HEARING SCREENING RECORDS AND CHILD CARE CENTERS AND LICENSED CHILD CARE HOMES, UPDATE F AND F IN TERMINOLOGY, AND UPDATE POLICY REQUIREMENTS FOR MAINTAINING AND ADMINISTERING AND UNASSIGNED EPINEPHRINE DELIVERY SYSTEM IN CHILD CARE CENTERS WHILE REMOVING THE POLICIES OF SCHOOL AGE AND BEFORE OR AFTER SCHOOL AGE PROGRAMS. THE PUBLIC WILL BENEFIT FROM THE PROPOSED RULE CHANGES THROUGH INCREASED AFFORDABILITY FOR OPERATIONS THAT MUST MAINTAIN LIABILITY INSURANCE, DECREASED ADMINISTRATIVE BURDENS RELATED TO RECORD KEEPING ON THE PART OF CHILD CARE OPERATIONS, AND THE ADDITION OF THE EPINEPHRINE NASAL SPRAY AS A TYPE OF UNASSIGNED EPINEPHRINE DELIVERY DEVICE THAT CAN BE USED IN CHILDTHANK YOU, CRYSTAL. >> THANK YOU.
>> NEXT WE WILL HAVE RACHEL PHILLIPS FROM HHSC PRESENTING A SUMMARY ON EARLY CHILDHOOD INTERVENTION.
MY NAME IS RACHEL PHILLIPS, AND I LEAD THE POLICY MEDICAID AND BILLING TEAM WITH HHSC EARLY CHILDHOOD INTERVENTION.
HHSC IS PROPOSING UPDATES TO EXISTING RULES AND CREATING NEW RULES FOR THE EARLY CHILDHOOD INTERVENTION PROGRAM IN TITLE 26, PART ONE, CHAPTER 350 OF THE TEXAS ADMINISTRATIVE CODE.
RULE PROJECT 26R022 WAS INITIATED TO IMPLEMENT HOUSE BILL 5629 AND SENATE BILL 14 FROM THE 89TH TEXAS LEGISLATURE.
HOUSE BILL 5629 REQUIRES STATE LICENSING AGENCIES TO RECOGNIZE SIMILAR OUT-OF-STATE LICENSES HELD BY MILITARY SERVICE MEMBERS, MILITARY VETERANS, OR MILITARY SPOUSES THAT ARE IN GOOD STANDING AND SIMILAR SCOPE OF PRACTICE.
SINCE HHSC IS RESPONSIBLE FOR CREDENTIALING EARLY INTERVENTION SPECIALISTS, THE RULES UPDATE THE MINIMUM QUALIFICATIONS FOR THOSE RULES. SENATE BILL 14 REQUIRES STATE AGENCIES TO WRITE PROPOSED RULES IN PLAIN LANGUAGE THAT THE GENERAL PUBLIC CAN EASILY UNDERSTAND.
THE PROPOSED RULES ALSO ALIGN EARLY CHILDHOOD INTERVENTION RULES WITH TEXAS EDUCATION AGENCY RULES AND CURRENT PRACTICES. THE RULES ADD DEAFBLINDNESS AS AN ELIGIBILITY CATEGORY FOR EC SERVICES AND CLARIFY REFERRAL REQUIREMENTS FOR CHILDREN WHO ARE OR MAY BE DEAF OR HARD OF HEARING, BLIND OR VISUALLY IMPAIRED, OR DEAFBLIND.
THIS PROJECT ALSO CODIFIES PROCEDURES FOR RE ESTABLISHING INDIVIDUALIZED FAMILY SERVICE PLAN SERVICES AFTER THOSE SERVICES WERE SUSPENDED OR DISCONTINUED OR AFTER A CHILD WAS DIS ENROLLED OR DISCHARGED. ADDITIONAL REVISIONS UPDATE TERMINOLOGY AND CITATIONS, REORGANIZE SECTIONS, AND CORRECT CROSS-REFERENCES TO MAKE THE RULES CLEARER AND MORE CONSISTENT. THESE AMENDMENTS WILL BENEFIT FAMILIES OF INFANTS AND TODDLERS WHO ARE DEAFBLIND BY ENSURING THEY HAVE ACCESS TO APPROPRIATE SERVICES FROM QUALIFIED PERSONNEL AND WILL BENEFIT ECI PROVIDERS BY EXPANDING WORKFORCE CAPACITY THROUGH AN ADDITIONAL PATHWAY TO OBTAINING THE EARLY INTERVENTION SPECIALIST CREDENTIAL.
THE AMENDMENTS ALSO SUPPORT CONSISTENT IMPLEMENTATION OF ECI SERVICES, CLARIFY SERVICE ON REFERRAL PROCESSES FOR FAMILIES AND PROVIDERS, AND ASSIST TEXAS IN MEETING OVERSIGHT RESPONSIBILITIES UNDER PART C OF THE INDIVIDUALS WITH
DISABILITIES EDUCATION ACT. >> VERY GOOD.
I DON'T SEE ANY QUESTIONS, SO THANK YOU.
NEXT, WE WILL HAVE GRACE DEB FROM HHSC PRESENTING A SUMMARY CONCERNING HOSPITAL PAYMENT ADVISORY COMMITTEE.
MY NAME IS GRACE AND I'M A FINANCIAL ANALYST FOR THE PROVIDER FINANCE DEPARTMENT. THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION, HHSC, PROPOSES A NEW RULE IN TEXAS ADMINISTRATIVE CODE TITLE ONE PART 15 CHAPTER 351 SUBCHAPTER B DIVISION ONE CONCERNING HOSPITAL PAYMENT ADVISORY COMMITTEE.
THIS RULE RECREATES THE HOSPITAL PAYMENT ADVISORY COMMITTEE AS ITS OWN ADVISORY COMMITTEE IN STATE RULES.
IN THE PAST, HPAC OPERATED UNDER THE MEDICAL ADVISORY COMMITTEE.
HOWEVER, HHSC SEPARATED HPAC IN 2024.
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THIS RULE FORMALLY REFLECTS THE CHANGE AND UPDATES THE RULES TO MATCH HOW THE COMMITTEE CURRENTLY OPERATES.THE RULE OUTLINES HPAC'S PURPOSE, MEMBERSHIP, AND RESPONSIBILITIES. HPAC WILL CONTINUE TO ADVISE HHSC ON PAYMENT ISSUES INCLUDING MEDICAID SUPPLEMENTAL PAYMENT PROGRAMS AND DISPROPORTIONATE SHARE HOSPITAL PAYMENTS.
THE RULE ALSO KEEPS THE RURAL HOSPITAL ADVISORY COMMITTEE AS A SUBCOMMITTEE OF HPAC, INCREASES MEMBERSHIP FROM 14 TO 15 MEMBERS, AND UPDATES MEMBER CATEGORIES TO BETTER REPRESENT TEXAS COMMUNITIES AND HOSPITALS ACROSS THE STATE.
THE PUBLIC BENEFITS FROM THIS RULE BECAUSE HPAC WILL CONTINUE PROVIDING OUTPUT -- INPUT, HELPING IN RURAL AREAS OF TEXAS.
>> VERY GOOD. ANY QUESTIONS, COMMENTS? THANK YOU GRACE. NEXT WE ARE GOING TO HAVE KATE LAYMAN FROM HHSC PRESENTING A SUMMARY CONCERNING THE CAPACITY TO AVOID NURSING FACILITY STAYS FOR CHILDREN.
>> GOOD MORNING. MY NAME IS KATE LAYMAN AND I'M A DIRECTOR OF PROGRAM POLICY WITH MEDICAID AND CHIP SERVICES DIVISION OF HHSC. WE ARE PROPOSING AN AMENDMENT TO TITLE ONE OF THE TEXAS ADMINISTRATIVE CODE PART 15, CHAPTER 353 COMMA SUBCHAPTER CONCERNING THE CAPACITY TO AVOID NURSING FACILITIES DAYS FOR CHILDREN.
THIS RULE AMENDS RULES FOR THE MEDICALLY DEPENDENT CHILDREN PROGRAM OR MD C. P. THE 89TH TEXAS LEGISLATURE APPROPRIATED FUNDING TO ALLOW HHSC TO INCREASE ACCESS BY ADDING DIVERSION SLOTS AND ELIMINATING THE UNLIMITED STAY MODEL. RULES ARE NECESSARY TO DESCRIBE THE CRITERIA A PERSON MUST MEET TO USE A DIVERSION SLOT AND DESCRIBE THE PROCESS THEY MUST FOLLOW TO REQUEST A SLOT.
THE RULES WILL BE EFFECTIVE DECEMBER 12026.
THESE SLOTS WILL HELP CHILDREN WITH SERIOUS MEDICAL NEEDS, MEET SPECIFIC CRITERIA TO GET SERVICES WITHOUT HAVING TO GO THROUGH THE PROCESS OR FIRST ENTERING A NURSING FACILITY.
THE PROPOSED RULE CLARIFIES THE CLINICAL CRITERIA A PERSON MUST MEET TO USE A DIVERSION SLOT AND DESCRIBES THE PROCESS THOSE ELIGIBLE INDIVIDUALS MUST FO FOLLOW.
IN ADDITION TO THE CHANGES NEEDED TO ALLOW FOR THE USE OF THE APPROPRIATIONS, HHSC ALSO UPDATED THE RULE FOR FORMATTING, CLARITY, AND CONSISTENCY AND REMOVED MEDICAID BY AND FOR CHILDREN REFERENCES TO MATCH CURRENT ELIGIBILITY POLICY.
THE PROPOSED AMENDMENT DOES NOT CHANGE FINANCIAL OR FUNCTIONAL ELIGIBILITY CRITERIA, THE SERVICE ARRAY, OR SERVICE LIMITS. THE PUBLIC BENEFIT OF THIS PROPOSED RULE IS THAT DIVERSIONS WILL ALLOW CHILDREN WITH SERIOUS MEDICAL NEEDS TO ACCESS SERVICES IMMEDIATELY WITHOUT HAVING TO GO THROUGH THE ENTRANCE LIST PROCESS OR FACILITY.
BY ENABLING EARLIER ACCESS TO THESE SERVICES, THE RULE WILL HELP FAMILIES CARE FOR THEIR CHILDREN AT HOME AND MAY ALSO REDUCE UNNECESSARY NURSING FACILITY STAYS OVERALL.
THESE CHANGES SUPPORT A GOAL TO PROVIDE SERVICES IN THE LEAST RESTRICTIVE AND MOST COST EFFECTIVE SETTING.
PUBLIC FEEDBACK HAS BEEN SOLICITED THROUGH A PUBLIC MEETING HELD MARCH 26 THROUGH SMALLER MEETINGS WITH SPECIFIC STAKEHOLDER GROUPS, AND THROUGH THE POSTING OF DRAFT RULES ON THE HHSC WEBSITE. OVERALL FEEDBACK HAS BEEN POSITIVE IN TERMS OF MOVING AWAY FROM THE LIMITED STAY PROCESS.
WE DID RECEIVE SOME FEEDBACK ON THE CLINICAL CRITERIA AND MADE ADJUSTMENTS BASED ON THAT FEEDBACK TO WHAT WILL BE POSTED IN THE TEXAS REGISTER NOW. IT WILL BE POSTED FOR FORMAL COMMENT ON AUGUST 21ST THROUGH SEPTEMBER 21ST.
I'M HAPPY TO TAKE ANY QUESTIONS. >> ANY QUESTIONS?
>> AS KATE SAID, I WOULD JUST LIKE TO THANK STAKEHOLDERS FOR THEIR INPUT INTO THIS CHANGE. AS KATE SAID, I HOPE YOU'LL SEE THAT WE HAVE BEEN RESPONSIVE TO COMMENT IN THIS CURRENT RULE.
I'D ALSO LIKE TO THANK KATE AND THE REST OF THE MEDICAID AND CHIP SERVICES TEAM FOR YOUR WORK ON DEVELOPING THIS RULE.
I KNOW WE ARE EXCITED ABOUT IT, AND OUR GOAL IS TO REALLY MAKE
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THIS PROCESS BETTER FOR KIDS WHO NEED MD CP SERVICES.THANK YOU. >> THANK YOU, KATE.
OUR LAST SUMMARY TODAY WILL BE FROM MIRIAM FROM HHSC WITH A SUMMARY CONCERNING BASE WAGE RULES AND REFERENCES.
>> MY NAME IS MIRIAM MOSER, MANAGER WITH THE PROVIDER FINANCE DEPARTMENT LONG TERM SERVICES SECTION.
HHSC IS UPDATING RULES RELATED TO RATE SETTING METHODOLOGIES FOR PERSONAL ATTENDANCE SERVICES TO REFLECT CURRENT POLICY.
THIS PROJECT REMOVES OUTDATED RULES AND REFERENCES INCLUDING PROVISIONS TIED TO A FORMER PERSONAL ATTENDANT REQUIREMENT ESTABLISHED IN TITLE ONE PART 15 CHAPTER 355, SECTION 7051, RELATING TO THE BASE WAGE FOR A PERSONAL ATTENDANT BEFORE SEPTEMBER FIRST, 2025. PROJECT 26R085 IS IN ACCORDANCE WITH THE 2026-27 GENERAL APPROPRIATIONS ACT SENATE BILL 1/89 LEGISLATURE REGULAR SESSION 2025, ARTICLE TWO, HEALTH AND SERVICES COMMISSION.
PROVIDING FUNDING TO SUPPORT A NEW AVERAGE ATTENDANT WAGE.
SECTION 355-7052 RELATING TO REIMBURSEMENT METHODOLOGY FOR DETERMINING ATTENDANT COST COMPONENT WAS ADOPTED IN SEPTEMBER 2025 TO ESTABLISH A NEW METHODOLOGY FOR DETERMINING ATTENDANT SERVICES RATES IN ACCORDANCE WITH 23 AND SECTION 355-7051 BECAME OBSOLETE EFFECTIVE SEPTEMBER 12025.
THIS PROJECT REPEALS REFERENCES TO THE OBSOLETE RULE, SO THE AFFECTED RULES ACCURATELY REFLECT CURRENT RATE SETTING REQUIREMENTS FOR ATTENDANT SERVICES.
THIS PROJECT ALSO UPDATES OTHER TAX CITATIONS AND SEVERAL RULES INCLUDED IN THE PROJECT. THE CITATION UPDATES DO NOT CHANGE THE MEANING OR CONTENT OF THE RULES.
THE PUBLIC WILL BENEFIT FROM THIS PROJECT AS IT WILL MAKE THESE SECTIONS CLEARER AND EASIER TO NAVIGATE.
>> ALL RIGHT, ANY QUESTIONS? THANK YOU.
[4. Public comment ]
AGENDA ITEM FOUR IS PUBLIC COMMENT.TESSA, DO WE HAVE ANY PUBLIC COMMENT CARDS?
>> AT THIS TIME WE HAVE ONE PRE-REGISTERED FOR AGENDA ITEM
NUMBER 3. >> I THINK THIS MATTER, WHILE PEOPLE HAVE TRIED TO OVER COMPLICATE IT, I THINK IT'S A VERY SIMPLE MATTER. 23 A AND B OF SENATE BILL ONE, GENERAL APPROPRIATIONS ACT, MAKES IT VERY CLEAR THAT THE LEGISLATURE ESTABLISHED A BASE WAGE, NOT AN AVERAGE WAGE.
HHSC IS CIRCUMVENTING THE LEGISLATURE'S INTENT AND COMPLETELY REVAMPING THE ADMINISTRATIVE CODE TO FIT THEIR OWN NEEDS IN ORDER TO CONVINCE PEOPLE THAT THERE IS IN FACT AN AVERAGE WAGE. ADDITIONALLY, JUST LOOKING TOWARDS SOME OF THE HANDOUTS I GAVE YOU GUYS IN RESPONSE TO THIS, THIS IS PART OF A LARGER DOCUMENT WE SUBMITTED TO ANOTHER COMMISSION AS WELL, WHERE IT SPECIFICALLY STATES EVERY SINGLE ONE OF THESE REFERENCES THAT YOU'RE EDITING, REPEALING, AND REFERENCES HHSC DID NOT PROPOSE TO REPEAL OR AMEND FOR ALMOST AN ENTIRE YEAR THAT THE BASE WAGE HAS NOT BEEN IMPLEMENTED AT THE LEGISLATURE AS INTENDED. ADDITIONALLY ON THE PART OF HHSC THERE'S BEEN A LACK OF TRANSPARENCY WITH REGARD TO THE WORDING AND PHRASING OF THESE DIFFERENT AMENDMENTS AND REPEALS, AT LEAST ON THE AGENDA SIDE OF THINGS.
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RIGHT NOW FROM HHSC ITSELF, THERE'S NO LINK TO ACCESS THESE BASE WAGE REFERENCES, MINUTES, OR REPEALS.WE DON'T UNDERSTAND ENTIRELY WHY THE COMMISSION IS SUBVERTING THE LEGISLATURE ON THIS MATTER, BUT WE ARE TESTIFYING IN OPPOSITION AGAINST IT. THERE'S NO NEED FOR THESE RULES OR REPEALS OR AMENDMENTS TO PASS.
WE RESPECTFULLY OPPOSE IT, AND IF THERE'S ANY ADDITIONAL QUESTIONS YOU WOULD LIKE ANSWERED, PLEASE FEEL FREE TO REACH OUT FOR ME WITH THE INFORMATION I GAVE THE COMMISSION BEFORE TESTIFYING. THANK YOU VERY MUCH.
>> THANK YOU. THANK YOU FOR YOUR COMMENTS.
DOES ANYONE HAVE ANY QUESTIONS? OKAY.
THANK YOU FOR YOUR FEEDBACK AND YOUR COMMENTS CERTAINLY WE'LL BE CONSIDERED. NO OTHER PUBLIC COMMENT? OKAY. THANK YOU, COUNCIL MEMBERS, FOR YOUR TIME. ALL BUSINESS HAS BEEN COMPLETED.
PLEASE NOTE FOR THE RECORD THAT AT 10:51 A.M., THIS MEETING IS ADJOURNED.
* This transcript was compiled from uncorrected Closed Captioning.