reglab/statecodes huggingface dataset:
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter H. Incentive Payment Program for Certain Nursing Facilities › Section 546.0352. Incentive Payment Program

Text of section effective on April 01, 2025
Sec. 546.0352.  INCENTIVE PAYMENT PROGRAM.  (a)  If feasible, the executive commissioner by rule may establish an incentive payment program for nursing facilities that choose to participate.  The program must be designed to improve the quality of care and services provided to recipients.
(b)  Subject to Section 546.0354, the incentive payment program may provide incentive payments in accordance with this section to encourage facilities to participate in the program.
(c)  The executive commissioner may:
(1)  determine the amount of any incentive payment under the incentive payment program; and
(2)  enter into a contract with a qualified person, as the executive commissioner determines, for the following services related to the program:
(A)  data collection;
(B)  data analysis; and
(C)  technical support.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter H. Incentive Payment Program for Certain Nursing Facilities › Section 546.0353. Common Performance Measures

Text of section effective on April 01, 2025
Sec. 546.0353.  COMMON PERFORMANCE MEASURES.  (a)  In establishing an incentive payment program, the executive commissioner shall adopt common performance measures to be used in evaluating nursing facilities that are related to structure, process, and outcomes that positively correlate to nursing facility quality and improvement.  The common performance measures:
(1)  must be:
(A)  recognized by the executive commissioner as valid indicators of the overall quality of care recipients receive; and
(B)  designed to encourage and reward evidence-based practices among nursing facilities; and
(2)  may include measures of:
(A)  quality of care, as determined by clinical performance ratings published by the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, or another federal agency;
(B)  direct-care staff retention and turnover;
(C)  recipient satisfaction, including the satisfaction of recipients who are short-term and long-term facility residents, and family satisfaction, as determined by the Consumer Assessment of Healthcare Providers and Systems Nursing Home Surveys relied on by the Centers for Medicare and Medicaid Services;
(D)  employee satisfaction and engagement;
(E)  the incidence of preventable acute care emergency room services use;
(F)  regulatory compliance;
(G)  level of person-centered care; and
(H)  direct-care staff training, including a facility's use of independent distance learning programs for continuously training direct-care staff.
(b)  The executive commissioner shall maximize the use of available information technology and limit the number of performance measures adopted under this section to achieve administrative cost efficiency and avoid an unreasonable administrative burden on participating nursing facilities.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter H. Incentive Payment Program for Certain Nursing Facilities › Section 546.0354. Subject to Appropriations

Text of section effective on April 01, 2025
Sec. 546.0354.  SUBJECT TO APPROPRIATIONS.  The commission may make incentive payments under an incentive payment program only if money is appropriated for that purpose.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter I. Medicaid Generally › Section 546.0401. Medicaid Long-Term Care System

Text of section effective on April 01, 2025
Sec. 546.0401.  MEDICAID LONG-TERM CARE SYSTEM.  (a)  The commission shall ensure that the Medicaid long-term care system provides the broadest array of choices possible for recipients while ensuring that the services are delivered in a manner that is cost-effective and makes the best use of available funds.
(b)  The commission shall also make every effort to improve the quality of care for recipients of Medicaid long-term care services by:
(1)  evaluating the need for expanding the provider base for consumer-directed services and, if the commission identifies a demand for that expansion, encouraging area agencies on aging, independent living centers, and other potential long-term care providers to become providers through contracts with the commission;
(2)  ensuring that all recipients who reside in a nursing facility are provided information about end-of-life care options and the importance of planning for end-of-life care; and
(3)  developing policies to encourage a recipient who resides in a nursing facility to receive treatment at that facility whenever possible, while ensuring that the recipient receives an appropriate continuum of care.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter I. Medicaid Generally › Section 546.0402. Administration and Delivery of Certain Waiver Programs; Public Input

Text of section effective on April 01, 2025
Sec. 546.0402.  ADMINISTRATION AND DELIVERY OF CERTAIN WAIVER PROGRAMS; PUBLIC INPUT.  (a)  To the extent authorized by law, the commission shall make uniform the functions relating to the administration and delivery of Section 1915(c) waiver programs, including:
(1)  rate-setting;
(2)  the applicability and use of service definitions;
(3)  quality assurance; and
(4)  intake data elements.
(b)  Subsection (a) does not apply to functions of a Section 1915(c) waiver program that is operated in conjunction with a federally funded state Medicaid program that is authorized under Section 1915(b) of the Social Security Act (42 U.S.C. Section 1396n(b)).
(c)  The commission shall ensure that information on individuals seeking to obtain services from Section 1915(c) waiver programs is maintained in a single computerized database that is accessible to staff of each of the state agencies administering those programs.
(d)  In complying with the requirements of this section, the commission shall regularly consult with and obtain input from:
(1)  consumers and family members;
(2)  providers;
(3)  advocacy groups;
(4)  state agencies that administer a Section 1915(c) waiver program; and
(5)  other interested persons.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter I. Medicaid Generally › Section 546.0403. Recovery of Certain Assistance; Medicaid Account

Text of section effective on April 01, 2025
Sec. 546.0403.  RECOVERY OF CERTAIN ASSISTANCE; MEDICAID ACCOUNT.  (a)  The executive commissioner shall ensure that Section 1917(b)(1) of the Social Security Act (42 U.S.C. Section 1396p(b)(1)) is implemented under Medicaid.
(b)  The Medicaid account is an account in the general revenue fund.  Any funds recovered by implementing the provisions of Section 1917(b)(1) of the Social Security Act (42 U.S.C. Section 1396p(b)(1)) must be deposited in the Medicaid account. Money in the account may be appropriated only to fund long-term care, including community-based care and facility-based care.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter J. Medicaid Waiver Programs › Section 546.0452. Risk Management Criteria for Certain Waiver Programs

Text of section effective on April 01, 2025
Sec. 546.0452.  RISK MANAGEMENT CRITERIA FOR CERTAIN WAIVER PROGRAMS.  (a)  In this section, "legally authorized representative" has the meaning assigned by Section 546.0101.
(b)  The commission shall consider developing risk management criteria under home and community-based services waiver programs designed to allow individuals eligible to receive services under the programs to assume greater choice and responsibility over the services and supports the individuals receive.
(c)  The commission shall ensure that any risk management criteria developed include:
(1)  a requirement that if an individual who will be provided services and supports has a legally authorized representative, the representative is involved in determining which services and supports the individual will receive; and
(2)  a requirement that if services or supports are declined, the decision to decline is clearly documented.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter J. Medicaid Waiver Programs › Section 546.0453. Protocol for Maintaining Contact Information of Individuals Interested in Medicaid Waiver Programs

Text of section effective on April 01, 2025
Sec. 546.0453.  PROTOCOL FOR MAINTAINING CONTACT INFORMATION OF INDIVIDUALS INTERESTED IN MEDICAID WAIVER PROGRAMS.  The commission shall develop a protocol in the office of the ombudsman to improve the capture and updating of contact information for an individual who contacts the office of the ombudsman regarding Medicaid waiver programs or services.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter J. Medicaid Waiver Programs › Section 546.0456. Eligibility of Certain Children for Medically Dependent Children (Mdcp) or Deaf-Blind With Multiple Disabilities (Dbmd) Waiver Program; Interest List Placement

Text of section effective on April 01, 2025
Sec. 546.0456.  ELIGIBILITY OF CERTAIN CHILDREN FOR MEDICALLY DEPENDENT CHILDREN (MDCP) OR DEAF-BLIND WITH MULTIPLE DISABILITIES (DBMD) WAIVER PROGRAM; INTEREST LIST PLACEMENT.  (a)  Notwithstanding any other law and to the extent allowed by federal law, in determining a child's eligibility for the medically dependent children (MDCP) waiver program, the deaf-blind with multiple disabilities (DBMD) waiver program, or a "Money Follows the Person" demonstration project, the commission shall consider whether the child:
(1)  is diagnosed as having a condition included in the list of compassionate allowances conditions published by the United States Social Security Administration; or
(2)  receives Medicaid hospice or palliative care services.
(b)  If the commission determines a child is eligible for a waiver program under Subsection (a), the child's enrollment in the applicable program is contingent on the availability of a slot in the program. If a slot is not immediately available, the commission shall place the child in the first position on the interest list for the medically dependent children (MDCP) waiver program or deaf-blind with multiple disabilities (DBMD) waiver program, as applicable.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter K. Medically Dependent Children (Mdcp) Waiver Program › Section 546.0501. Limitation on Nursing Facility Level of Care Requirement

Text of section effective on April 01, 2025
Sec. 546.0501.  LIMITATION ON NURSING FACILITY LEVEL OF CARE REQUIREMENT.  To the extent allowed by federal law, the commission may not require that a child reside in a nursing facility for an extended period of time to meet the nursing facility level of care required for the child to be determined eligible for the medically dependent children (MDCP) waiver program.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter K. Medically Dependent Children (Mdcp) Waiver Program › Section 546.0502. Consumer Direction of Services

Text of section effective on April 01, 2025
Sec. 546.0502.  CONSUMER DIRECTION OF SERVICES.  Notwithstanding Sections 546.0102(b) and 546.0103(1), a consumer direction model implemented under Subchapter C, including the consumer-directed service option, for the delivery of services under the medically dependent children (MDCP) waiver program must allow for the delivery of all services and supports available under that program through consumer direction.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter K. Medically Dependent Children (Mdcp) Waiver Program › Section 546.0503. Assessments and Reassessments

Text of section effective on April 01, 2025
Sec. 546.0503.  ASSESSMENTS AND REASSESSMENTS.  (a)  The commission shall ensure that the care coordinator for a Medicaid managed care organization under the STAR Kids managed care program provides for review the results of the initial assessment or annual reassessment of medical necessity to the parent or legally authorized representative of a recipient receiving benefits under the medically dependent children (MDCP) waiver program.  The commission shall ensure that providing the results does not delay the determination of the services to be provided to the recipient or the ability to authorize and initiate services.
(b)  The commission shall require the signature of a parent or legally authorized representative to verify the parent's or representative's receipt of the results of the initial assessment or reassessment from the care coordinator.  A Medicaid managed care organization may not delay the delivery of care pending the signature.
(c)  The commission shall provide to a parent or legally authorized representative who disagrees with the results of the initial assessment or reassessment an opportunity to request to dispute the results with the Medicaid managed care organization through a peer-to-peer review with the treating physician of choice.
(d)  This section does not affect any rights of a recipient to appeal an initial assessment or reassessment determination through the Medicaid managed care organization's internal appeal process, the Medicaid fair hearing process, or the external medical review process.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter K. Medically Dependent Children (Mdcp) Waiver Program › Section 546.0504. Quality Monitoring by External Quality Review Organization

Text of section effective on April 01, 2025
Sec. 546.0504.  QUALITY MONITORING BY EXTERNAL QUALITY REVIEW ORGANIZATION.  The commission, based on the state's external quality review organization's initial report on the STAR Kids managed care program, shall determine whether the findings of the report necessitate additional data and research to improve the program.  If the commission determines additional data and research are needed, the commission, through the external quality review organization, may:
(1)  conduct annual surveys of recipients receiving benefits under the medically dependent children (MDCP) waiver program, or their representatives, using the Consumer Assessment of Healthcare Providers and Systems;
(2)  conduct annual focus groups with recipients described by Subdivision (1) or their representatives on issues identified through:
(A)  the Consumer Assessment of Healthcare Providers and Systems;
(B)  other external quality review organization activities; or
(C)  stakeholders; and
(3)  in consultation with the STAR Kids Managed Care Advisory Committee and as frequently as feasible, calculate Medicaid managed care organizations' performance on performance measures using available data sources such as the collaborative innovation improvement network.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter K. Medically Dependent Children (Mdcp) Waiver Program › Section 546.0505. Quarterly Report

Text of section effective on April 01, 2025
Sec. 546.0505.  QUARTERLY REPORT.  Not later than the 30th day after the last day of each state fiscal quarter, the commission shall submit to the governor, the lieutenant governor, the speaker of the house of representatives, the Legislative Budget Board, and each standing legislative committee with primary jurisdiction over Medicaid a report containing, for the most recent state fiscal quarter, the following information and data related to access to care for recipients receiving benefits under the medically dependent children (MDCP) waiver program:
(1)  enrollment in the Medicaid buy-in for children program implemented under Section 532.0353;
(2)  requests relating to interest list placements under Section 546.0455;
(3)  use of the Medicaid escalation help line established under Subchapter R, Chapter 540, if the help line was operational during the applicable state fiscal quarter;
(4)  use of, requests for, and outcomes of the external medical review procedure established under Section 532.0404; and
(5)  complaints relating to the medically dependent children (MDCP) waiver program, categorized by disposition.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
For expiration of this subchapter, see Section 546.0555.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter L. Quality Assurance Fee Program › Section 546.0551. Quality Assurance Fee for Certain Medicaid Waiver Program Services

Text of section effective on April 01, 2025
Sec. 546.0551.  QUALITY ASSURANCE FEE FOR CERTAIN MEDICAID WAIVER PROGRAM SERVICES.  (a)  In this section, "gross receipts" means money received as compensation for services under an intermediate care facility for individuals with an intellectual disability waiver program, such as a home and community services waiver or a community living assistance and support services waiver.  The term does not include:
(1)  a charitable contribution;
(2)  revenues received for services or goods other than waivers; or
(3)  any money received from consumers or their families as reimbursement for services or goods not normally covered under a waiver program.
(b)  The executive commissioner by rule shall modify the quality assurance fee program under Subchapter H, Chapter 252, Health and Safety Code, by providing for a quality assurance fee program that imposes a quality assurance fee on persons providing services under a home and community services waiver or a community living assistance and support services waiver.
(c)  The executive commissioner shall establish the fee at an amount that will produce annual revenues of not more than six percent of the total annual gross receipts in this state.
(d)  The executive commissioner shall adopt rules governing:
(1)  the reporting required to compute and collect the fee and the manner and times of collecting the fee; and
(2)  the administration of the fee, including the imposition of penalties for a violation of the rules.
(e)  Fees collected under this section must be deposited in the waiver program quality assurance fee account.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter L. Quality Assurance Fee Program › Section 546.0552. Waiver Program Quality Assurance Fee Account

Text of section effective on April 01, 2025
Sec. 546.0552.  WAIVER PROGRAM QUALITY ASSURANCE FEE ACCOUNT.  (a)  The waiver program quality assurance fee account is a dedicated account in the general revenue fund.  The account is exempt from the application of Section 403.095.
(b)  The account consists of fees collected under Section 546.0551.
(c)  Subject to legislative appropriation and state and federal law, money in the account may be appropriated only to the commission to:
(1)  increase reimbursement rates paid under:
(A)  the home and community services waiver program; or
(B)  the community living assistance and support services (CLASS) waiver program; or
(2)  offset allowable expenses under Medicaid.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter L. Quality Assurance Fee Program › Section 546.0553. Reimbursement Under Certain Medicaid Waiver Programs

Text of section effective on April 01, 2025
Sec. 546.0553.  REIMBURSEMENT UNDER CERTAIN MEDICAID WAIVER PROGRAMS.  Subject to legislative appropriation and state and federal law, the commission shall use money from the waiver program quality assurance fee account, together with any federal money available to match money from the account, to increase reimbursement rates paid under:
(1)  the home and community services waiver program; or
(2)  the community living assistance and support services (CLASS) waiver program.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter L. Quality Assurance Fee Program › Section 546.0554. Invalidity; Federal Money

Text of section effective on April 01, 2025
Sec. 546.0554.  INVALIDITY; FEDERAL MONEY.  If any portion of Section 546.0551, 546.0552, or 546.0553 is held invalid by a final order of a court that is not subject to appeal, or if the commission determines that the imposition of the quality assurance fee and the expenditure of the money collected as provided by those sections will not entitle this state to receive additional federal money under Medicaid, the commission shall:
(1)  stop collecting the quality assurance fee; and
(2)  not later than the 30th day after the date the commission stops collecting the quality assurance fee, return any money collected under Section 546.0551, but not spent under Section 546.0553, to the persons who paid the fees in proportion to the total amount paid by those persons.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter L. Quality Assurance Fee Program › Section 546.0555. Expiration of Quality Assurance Fee Program

Text of section effective on April 01, 2025
Sec. 546.0555.  EXPIRATION OF QUALITY ASSURANCE FEE PROGRAM.  If Subchapter H, Chapter 252, Health and Safety Code, expires, this subchapter expires on the same date.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter M. Volunteer Advocate Program for Certain Elderly Individuals › Section 546.0601. Definitions

Text of section effective on April 01, 2025
Sec. 546.0601.  DEFINITIONS.  In this subchapter:
(1)  "Designated caregiver" means:
(A)  a person designated as a caregiver by an elderly individual receiving services from or under the direction of the commission or a health and human services agency; or
(B)  a court-appointed guardian of an elderly individual receiving services from or under the direction of the commission or a health and human services agency.
(2)  "Elderly individual" means an individual who is at least 60 years of age.
(3)  "Program" means the volunteer advocate program created under this subchapter for elderly individuals receiving services from or under the direction of the commission or a health and human services agency.
(4)  "Volunteer advocate" means a person who successfully completes the volunteer advocate curriculum described by Section 546.0602(2).
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter M. Volunteer Advocate Program for Certain Elderly Individuals › Section 546.0602. Program Principles

Text of section effective on April 01, 2025
Sec. 546.0602.  PROGRAM PRINCIPLES.  The program must adhere to the following principles:
(1)  the intent of the program is to evaluate, through the operation of pilot projects, whether providing the services of a trained volunteer advocate selected by an elderly individual or the individual's designated caregiver is effective in achieving the following goals:
(A)  extend the time the elderly individual can remain in an appropriate home setting;
(B)  maximize the efficiency of services delivered to the elderly individual by focusing on services needed to sustain family caregiving;
(C)  protect the elderly individual by providing a knowledgeable third party to review the quality of care and services delivered to the individual and the care options available to the individual and the individual's family; and
(D)  facilitate communication between the elderly individual or the individual's designated caregiver and providers of health care and other services;
(2)  a volunteer advocate curriculum must be maintained that incorporates best practices as determined and recognized by a professional organization recognized in the elder health care field;
(3)  the use of pro bono assistance from qualified professionals must be maximized in modifying the volunteer advocate curriculum and the program;
(4)  trainers must be certified on the ability to deliver training;
(5)  training shall be offered through multiple community-based organizations; and
(6)  participation in the program is voluntary and must be initiated by an elderly individual or the individual's designated caregiver.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter M. Volunteer Advocate Program for Certain Elderly Individuals › Section 546.0603. Agreements With Nonprofit Organizations; Organization Eligibility

Text of section effective on April 01, 2025
Sec. 546.0603.  AGREEMENTS WITH NONPROFIT ORGANIZATIONS; ORGANIZATION ELIGIBILITY.  The executive commissioner may enter into agreements with appropriate nonprofit organizations to provide services under the program.  A nonprofit organization is eligible to provide services under the program if the organization:
(1)  has significant experience in providing services to elderly individuals;
(2)  has the capacity to provide training and supervision for individuals interested in serving as volunteer advocates; and
(3)  meets any other criteria prescribed by the executive commissioner.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter M. Volunteer Advocate Program for Certain Elderly Individuals › Section 546.0604. Funding

Text of section effective on April 01, 2025
Sec. 546.0604.  FUNDING.  (a)  The commission shall fund the program, including the design and evaluation of pilot projects, modification of the volunteer advocate curriculum, and training of volunteers, through existing appropriations to the commission.
(b)  Notwithstanding Subsection (a), the commission may accept gifts, grants, or donations for the program from any source to:
(1)  carry out the design of the program;
(2)  develop criteria for evaluating any proposed pilot projects operated under the program;
(3)  modify a volunteer advocate training curriculum;
(4)  conduct training for volunteer advocates; and
(5)  develop a request for offers to conduct any proposed pilot projects under the program.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter M. Volunteer Advocate Program for Certain Elderly Individuals › Section 546.0605. Rules

Text of section effective on April 01, 2025
Sec. 546.0605.  RULES.  The executive commissioner may adopt rules as necessary to implement the program.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
For expiration of this subchapter, see Section 546.0655.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter N. Advancing Care for Exceptional Kids Pilot Program › Section 546.0651. Definition

Text of section effective on April 01, 2025
Sec. 546.0651.  DEFINITION.  In this subchapter, "pilot program" means the pilot program established under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter N. Advancing Care for Exceptional Kids Pilot Program › Section 546.0652. Pilot Program

Text of section effective on April 01, 2025
Sec. 546.0652.  PILOT PROGRAM.  The commission shall collaborate with the STAR Kids Managed Care Advisory Committee, recipients, family members of children with complex medical conditions, children's health care advocates, Medicaid managed care organizations, and other stakeholders to develop and implement a pilot program that is substantially similar to the program described by Section 3, Medicaid Services Investment and Accountability Act of 2019 (Pub. L. No. 116-16), to provide coordinated care through a health home to children with complex medical conditions.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter N. Advancing Care for Exceptional Kids Pilot Program › Section 546.0653. Federal Guidance and Funding

Text of section effective on April 01, 2025
Sec. 546.0653.  FEDERAL GUIDANCE AND FUNDING.  The commission shall seek guidance from the Centers for Medicare and Medicaid Services and the United States Department of Health and Human Services regarding the design of the program and, based on the guidance, may actively seek and apply for federal funding to implement the program.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter N. Advancing Care for Exceptional Kids Pilot Program › Section 546.0654. Report

Text of section effective on April 01, 2025
Sec. 546.0654.  REPORT.  Not later than December 31, 2024, the commission shall prepare and submit to the legislature a report that includes:
(1)  a summary of the commission's implementation of the pilot program; and
(2)  if the pilot program has been operating for a period sufficient to obtain necessary data:
(A)  a summary of the commission's evaluation of the effect of the pilot program on the coordination of care for children with complex medical conditions; and
(B)  a recommendation as to whether the pilot program should be continued, expanded, or terminated.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter N. Advancing Care for Exceptional Kids Pilot Program › Section 546.0655. Expiration

Text of section effective on April 01, 2025
Sec. 546.0655.  EXPIRATION.  The pilot program terminates and this subchapter expires September 1, 2025.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter O. Mortality Review for Certain Individuals With Intellectual or Developmental Disability › Section 546.0701. Definition

Text of section effective on April 01, 2025
Sec. 546.0701.  DEFINITION.  In this subchapter, "contracted organization" means an entity that contracts with the commission to provide the services described by Section 546.0702(b).
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter O. Mortality Review for Certain Individuals With Intellectual or Developmental Disability › Section 546.0702. Mortality Review System

Text of section effective on April 01, 2025
Sec. 546.0702.  MORTALITY REVIEW SYSTEM.  (a)  The executive commissioner shall establish an independent mortality review system to review the death of an individual with an intellectual or developmental disability who, at the time of the individual's death or at any time during the 24-hour period preceding the individual's death:
(1)  resided in or received services from:
(A)  an ICF-IID operated or licensed by the commission or a community center; or
(B)  the ICF-IID component of the Rio Grande State Center; or
(2)  received services through a Section 1915(c) waiver program for individuals who are eligible for ICF-IID services.
(b)  The executive commissioner shall contract with an institution of higher education or a health care organization or association with experience in conducting research-based mortality studies to conduct independent mortality reviews of individuals with an intellectual or developmental disability.  The contract must require the contracted organization to form a review team consisting of:
(1)  a physician with expertise regarding the medical treatment of individuals with an intellectual or developmental disability;
(2)  a registered nurse with expertise regarding the medical treatment of individuals with an intellectual or developmental disability;
(3)  a clinician or other professional with expertise in the delivery of services and supports for individuals with an intellectual or developmental disability; and
(4)  any other appropriate individual as the executive commissioner provides.
(c)  A review under this subchapter must be conducted:
(1)  in addition to any review conducted by the facility in which the individual resided or the facility, agency, or provider from which the individual received services; and
(2)  after any investigation of alleged or suspected abuse, neglect, or exploitation is completed.
(d)  To ensure consistency across mortality review systems, a review under this subchapter must collect information consistent with the information required to be collected by another independent mortality review process established specifically for individuals with an intellectual or developmental disability.
(e)  The executive commissioner shall adopt rules regarding the manner in which the death of an individual described by Subsection (a) must be reported to the contracted organization by a facility or waiver program provider described by that subsection.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter O. Mortality Review for Certain Individuals With Intellectual or Developmental Disability › Section 546.0703. Access to Information and Records

Text of section effective on April 01, 2025
Sec. 546.0703.  ACCESS TO INFORMATION AND RECORDS.  (a)  A contracted organization may request information and records regarding a deceased individual as necessary to carry out the organization's duties.  The requested information and records may include:
(1)  medical, dental, and mental health care information; and
(2)  information and records maintained by any state or local government agency, including:
(A)  a birth certificate;
(B)  law enforcement investigative data;
(C)  medical examiner investigative data;
(D)  juvenile court records;
(E)  parole and probation information and records; and
(F)  adult or child protective services information and records.
(b)  On request of the contracted organization, the custodian of the relevant information and records relating to a deceased individual shall provide those records to the organization at no charge.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter O. Mortality Review for Certain Individuals With Intellectual or Developmental Disability › Section 546.0704. Mortality Review Reports

Text of section effective on April 01, 2025
Sec. 546.0704.  MORTALITY REVIEW REPORTS.  Subject to Section 546.0705, a contracted organization shall submit:
(1)  to the commission, the Department of Family and Protective Services, the office of independent ombudsman for state supported living centers, and the commission's office of inspector general a report of the findings of the mortality review; and
(2)  semiannually to the governor, the lieutenant governor, the speaker of the house of representatives, and the standing committees of the senate and house of representatives with primary jurisdiction over the commission, the department, the office of independent ombudsman for state supported living centers, and the commission's office of inspector general a report that contains:
(A)  aggregate information regarding the deaths for which the organization performed an independent mortality review;
(B)  trends in the causes of death the organization identifies; and
(C)  any suggestions for system-wide improvements to address conditions that contributed to deaths reviewed by the organization.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter O. Mortality Review for Certain Individuals With Intellectual or Developmental Disability › Section 546.0705. Use and Publication Restrictions; Confidentiality

Text of section effective on April 01, 2025
Sec. 546.0705.  USE AND PUBLICATION RESTRICTIONS; CONFIDENTIALITY.  (a)  The commission may use or publish information under this subchapter only to advance statewide practices regarding the treatment and care of individuals with an intellectual or developmental disability. A summary of the data in the contracted organization's reports or a statistical compilation of data reports may be released by the commission for general publication if the summary or statistical compilation does not contain any information that would permit the identification of an individual or that is confidential or privileged under this subchapter or other state or federal law.
(b)  Information and records acquired by the contracted organization in the exercise of the organization's duties under this subchapter:
(1)  are confidential and exempt from disclosure under Chapter 552; and
(2)  may be disclosed only as necessary to carry out the organization's duties.
(c)  The identity of:
(1)  an individual whose death was reviewed in accordance with this subchapter is confidential and may not be revealed; and
(2)  a health care provider or the name of a facility or agency that provided services to or was the residence of an individual whose death was reviewed in accordance with this subchapter is confidential and may not be revealed.
(d)  Reports, information, statements, memoranda, and other information furnished under this subchapter to the contracted organization and any findings or conclusions resulting from a review by the organization are privileged.
(e)  A contracted organization's report of the findings of the independent mortality review conducted under this subchapter and any records the organization develops relating to the review:
(1)  are confidential and privileged;
(2)  are not subject to discovery or subpoena; and
(3)  may not be introduced into evidence in any civil, criminal, or administrative proceeding.
(f)  A member of the contracted organization's review team may not testify or be required to testify in a civil, criminal, or administrative proceeding as to observations, factual findings, or conclusions that were made in conducting a review under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter O. Mortality Review for Certain Individuals With Intellectual or Developmental Disability › Section 546.0706. Limitation on Liability

Text of section effective on April 01, 2025
Sec. 546.0706.  LIMITATION ON LIABILITY.  A health care provider or other person is not civilly or criminally liable for furnishing information to the contracted organization or to the commission for use by the organization in accordance with this subchapter unless the person acted in bad faith or knowingly provided false information to the organization or the commission.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 547 - Mental Health and Substance Use Services › Subchapter A. Delivery of Mental Health and Substance Use Services › Section 547.0001. Evaluation of Certain Contractors and Subcontractors

Text of section effective on April 01, 2025
Sec. 547.0001.  EVALUATION OF CERTAIN CONTRACTORS AND SUBCONTRACTORS.  (a)  To ensure the appropriate delivery of mental health and substance use services, the commission shall regularly evaluate program contractors and subcontractors that provide or arrange services for individuals enrolled in:
(1)  the Medicaid managed care program; and
(2)  the child health plan program.
(b)  The commission shall monitor:
(1)  penetration rates as those rates relate to mental health and substance use services provided by or through contractors and subcontractors;
(2)  utilization rates as those rates relate to mental health and substance use services provided by or through contractors and subcontractors; and
(3)  provider networks used by contractors and subcontractors to provide mental health or substance use services.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.