HB 4282

relating to the provision of residential services under the
Medicaid home and community-based services (HCS) waiver program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Subchapter G, Chapter 546, Government Code, as
effective April 1, 2025, is amended by adding Section 546.0303 to
Sec. 546.0303.  PROVISION OF RESIDENTIAL SERVICES UNDER HOME
AND COMMUNITY-BASED SERVICES (HCS) WAIVER PROGRAM.  (a)  In this
section, "Medicaid residential facility" means a Medicaid provider
that is a group home, host home, or similar congregate care setting
operated under the commission's authority and that provides
residential services to recipients under the home and
community-based services (HCS) waiver program.
(b)  A Medicaid residential facility may refuse to accept a
recipient as a resident of the facility if:
(1)  the facility has reached the facility's service
capacity as identified in the commission's data system;
(2)  the recipient has a history of or propensity for
(A)  severe emotional behavior that has resulted
(B)  actions that could severely affect the health
or safety of other facility residents; or
(3)  the recipient is physically aggressive in a manner
that presents a danger to other facility residents or to facility
staff and has continuing episodes of that physical aggression that
(A)  medical or behavioral treatment; and
(c)  Before a recipient who is medically fragile or has
serious bodily injuries is placed in a Medicaid residential
facility, the commission shall determine whether the facility has
the capacity and capability to provide the necessary care and
services to the recipient.  In making the determination, the
commission shall consider the scope of services the facility may
provide in accordance with the facility's current license or other
authorization.  The commission may not require the facility to make
any modifications that would enable the facility to serve the
SECTION 2.  If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for the implementation of that
provision, the agency affected by the provision shall request the
waiver or authorization and may delay implementing that provision
until the waiver or authorization is granted.
SECTION 3.  This Act takes effect September 1, 2025.