Bill Caption

Fiscal Notes

The fiscal implications of the bill cannot be determined at this time, due to the lack of specific estimates of both reduced revenue and potential lost savings and related to the delay of transition of certain programs into managed care.

No fiscal implication to units of local government is anticipated.

Bill Analysis

5/25/2015 update:

The bill was amended on the Senate floor by making the transition to managed care of services provided to persons enrolled in the TxHmL mandatory. We continue to support HB 3523.

The second chamber sponsor is Senator Perry.

Updated chamber analysis below:

Current statute in Section 534.053 of the Government Code authorizes the continuation of the Intellectual and Developmental Disability System Redesign Advisory Committee through January 1, 2026. It would also authorize the committee to establish work groups that meet at other times in order to study and make recommendations on issues the committee deems appropriate.

The bill would require the Health and Human Services Commission (HHSC) to consult and collaborate with the advisory committee on its annual report in order to incorporate an assessment of the system redesign for the delivery of Medicaid acute care services and long-term services to persons with intellectual and developmental disabilities (IDD). The Department of Aging and Disability Services (DADS) would be required to consult and collaborate with the advisory committee in order to identify private services providers or managed care organizations (MCOs) to develop a service delivery model involving a managed care strategy. DADS and the advisory committee would be required to assess the effect of the managed care strategies based on access and quality of acute care services and long-term services in addition to other criteria. The bill would require HHSC and DADS, in consultation and collaboration with the advisory committee, to analyze the outcomes of providing acute care Medicaid benefits to individuals with IDD under managed care.

The bill would allow the Department of Aging and Disability Services (DADS) to contract directly with providers participating in certain long-term-care waiver programs (Texas home living [TxHmL], community living assistance and support services [CLASS], or the deaf-blind with multiple disabilities [DBMD]) to provide certain attendant and habilitation services through the STAR+PLUS program and would give the agency regulatory and oversight authority over those providers for the delivery of those services.

The bill would delay the mandatory transition to managed care of services provided to persons enrolled in the TxHmL from not later than September 1, 2017 to not later than September 1, 2018. HHSC would be required to conduct an assessment of the outcomes of the TxHmL transition and include those findings in their annual report.

Vote Recommendation Notes

The primary objective of the legislation is to update and clarify statutory language in the Government Code regarding the redesign of the long-term care supports system, including an integration of managed acute care services, for individuals with intellectual and developmental disabilities. We support HB 3523 because the enhanced language would help ensure the system redesign goals are achieved in a comprehensive manner.