2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 542 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Individuals With an Intellectual or Developmental Disability › Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models › Section 542.0119. Evaluations and Reports

Text of section effective on April 01, 2025
Sec. 542.0119.  EVALUATIONS AND REPORTS.  (a)  The commission, in collaboration with the advisory committee and pilot program work group, shall review and evaluate the progress and outcomes of the pilot program and submit, as part of the annual report required under Section 542.0054, a report on the pilot program's status that includes recommendations for improving the pilot program.
(b)  Not later than September 1, 2026, the commission, in collaboration with the advisory committee and pilot program work group, shall prepare and submit to the legislature a written report that evaluates the pilot program based on a comprehensive analysis.  The analysis must:
(1)  assess the effect of the pilot program on:
(A)  access to and quality of long-term services and supports;
(B)  informed choice and meaningful outcomes using person-centered planning, flexible consumer-directed services, individualized budgeting, and self-determination, including a pilot program participant's inclusion in the community;
(C)  the integration of service coordination of acute care services and long-term services and supports;
(D)  employment assistance and customized, integrated, competitive employment options;
(E)  the number, types, and dispositions of fair hearings and appeals in accordance with federal and state law;
(F)  increasing the use and flexibility of the consumer direction model;
(G)  increasing the use of alternatives to guardianship, including supported decision-making agreements as defined by Section 1357.002, Estates Code;
(H)  achieving the best and most cost-effective funding use based on a pilot program participant's needs and preferences; and
(I)  attendant recruitment and retention;
(2)  analyze the experiences and outcomes of the following systems changes:
(A)  the comprehensive assessment instrument described by Section 533A.0335, Health and Safety Code;
(B)  the 21st Century Cures Act (Pub. L. No. 114-255);
(C)  implementation of the federal rule adopted by the Centers for Medicare and Medicaid Services and published at 79 Fed. Reg. 2948 (January 16, 2014) related to the provision of long-term services and supports through a home and community-based services (HCS) waiver program under Section 1915(c), 1915(i), or 1915(k) of the Social Security Act (42 U.S.C. Section 1396n(c), (i), or (k));
(D)  the provision of basic attendant and habilitation services under Section 542.0152; and
(E)  the benefits of providing STAR+PLUS Medicaid managed care services to individuals based on functional needs;
(3)  include feedback on the pilot program based on the personal experiences of:
(A)  individuals with an intellectual or developmental disability and individuals with similar functional needs who were pilot program participants;
(B)  families of and other persons actively involved in the lives of individuals described by Paragraph (A); and
(C)  comprehensive long-term services and supports providers who delivered services under the pilot program;
(4)  be incorporated in the annual report required under Section 542.0054; and
(5)  include recommendations on:
(A)  a system of programs and services for the legislature's consideration;
(B)  necessary statutory changes; and
(C)  whether to implement the pilot program statewide under the STAR+PLUS Medicaid managed care program for eligible individuals.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.