HB 4117

relating to the development of a strategic plan for home and
community-based services provided under Medicaid and the child
health plan program and the establishment of an advisory committee
on home and community-based services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Chapter 526, Government Code, as effective April
1, 2025, is amended by adding Subchapter R to read as follows:
SUBCHAPTER R.  HOME AND COMMUNITY-BASED SERVICES
Sec. 526.0851.  DEFINITIONS.  In this subchapter:
(1)  "Home and community-based services" means
person-centered care that addresses the needs of an individual with
functional limitations who needs assistance with daily living, is
delivered to the individual in the individual's home or community,
and enables the individual to remain in the individual's home or
(A)  acute care and long-term services and
(B)  services and supports for an individual's
physical, emotional, mental, social,  and vocational needs; and
(C)  any other services necessary to enable an
individual to remain in the individual's home or community.
(2)  "Home and community support services agency" means
a person licensed under Chapter 142, Health and Safety Code, who
provides for pay or other consideration home health, hospice, or
personal assistance services as those terms are defined by Section
142.001, Health and Safety Code, in a client's residence, an
independent living environment, or another appropriate location.
Sec. 526.0852.  STRATEGIC PLAN; REPORT.  (a)  The commission
shall develop and, subject to Subsection (c), implement a strategic
plan to ensure that Medicaid recipients and child health plan
program enrollees in this state have access to home and
community-based services provided by a home and community support
(b)  The strategic plan must include:
(1)  a proposal for developing a viable rate
methodology for each home and community-based service provided by a
home and community support services agency that will ensure access
(2)  an assessment of the unmet needs for home and
community-based services of Medicaid recipients and child health
(3)  access to care standards for services provided by
a home and community support services agency specific to each home
and community-based services program under Medicaid and the child
health plan program, which may include standards based on:
(A)  the amount of delivered units of service as a
percentage of authorized units of service;
(B)  the number of in-network home and community
(C)  the types of services provided;
(D)  the geographic areas served;
(F)  the capacity to provide services;
(4)  an assessment of the potential costs, including
costs to the state, associated with the lack of adequate access to
home and community-based services in this state, including an
(A)  any projected long-term savings from
providing timely access to home and community-based services;
(B)  the costs associated with providing services
in an institutional or hospital setting, as compared to providing
services in a home or community-based setting; and
(C)  the potential immediate and long-term costs
associated with a lack of access to services in a timely manner; and
(5)  set dates for achieving the goals identified in
(b-1)  Not later than January 1, 2026, the commission shall
submit the strategic plan developed under Subsection (b) to the
Legislative Budget Board for approval.  The board must review and
provide the commission with comments on the plan before determining
whether to approve the plan.  This subsection expires September 1,
(c)  The commission may not implement the proposal described
by Subsection (b)(1) until the Legislative Budget Board approves
(d)  Not later than November 1 of each even-numbered year,
the commission shall submit a report on the commission's
development and implementation of the strategic plan to:
(3)  the Legislative Budget Board.
Sec. 526.0853.  ADVISORY COMMITTEE.  (a)  In this section,
"advisory committee" means the home and community-based services
advisory committee established under this section.
(b)  The commission shall establish the home and
community-based services advisory committee as an advisory
committee or a subcommittee of the medical care advisory committee
established under Section 32.022, Human Resources Code, to:
(A)  developing a viable long-term payment
methodology for services provided by home and community support
(B)  addressing issues relating to home and
(2)  develop a sustainable strategy to support home and
(3)  make recommendations for cost savings in program
(B)  reductions in hospitalizations;
(C)  prior authorization of services; and
(D)  care coordination efforts; and
(4)  review and offer comments on the strategic plan
(c)  The advisory committee is composed of the following
members appointed by the executive commissioner:
(1)  one member who is an ex officio nonvoting
representative of the commission; and
(2)  an odd number, not to exceed 15, of voting members
(i)  at least one association representing
(ii)  at least one association representing
home and community support services agencies;
(iii)  at least two associations or
coalitions representing Medicaid recipients who receive home and
community-based services in this state;
(iv)  at least one rural home and community
support services agency providing services to Medicaid recipients
who receive home and community-based services;
(v)  at least one statewide home and
community support services agency providing services to Medicaid
recipients who receive home and community-based services; and
(vi)  another discipline involving
expertise in financing Medicaid home and community-based services;
(B)  at least one person who is the parent of and
caregiver to a child who receives home and community-based services
as a Medicaid recipient or child health plan program enrollee;
(C)  at least one person who is a recipient of home
and community-based services under Medicaid;
(D)  at least one person who provides financial
(E)  at least one person who provides electronic
(d)  A member of the advisory committee serves without
(e)  The advisory committee is abolished and this section
SECTION 2.  As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall appoint the members of the home and
community-based services advisory committee established under
Subchapter R, Chapter 526, Government Code, as added by this Act.
SECTION 3.  This Act takes effect September 1, 2025.