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9 Document(s) [ Subject: Medicaid eligibility ]

Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Cancer Prevention and Research Institute of Texas | Caseworkers | Child Protective Services | Children's Health Insurance Program | Dental care | Foster care | Health care | Health care costs | Health insurance | Immunizations | Long-term care | Managed care | Medicaid | Medicaid eligibility | Medical research | Mental health services | Nursing homes | Patient Protection and Affordable Care Act | Public health | State Health Services, Texas Department of | State supported living centers |
Library Call Number: L1836.82 H349
Session: 82nd R.S. (2011)
Online version: View report [186 pages]
Charges: This report should address the charges below.
1. Monitor the potential impact of the Patient Protection and Affordable Care Act (PPACA) on insurance regulations, Medicaid and CHIP, health care outcomes and overall health of all Texans, and the state budget in Texas. Additionally, monitor the current constitutional challenges to PPACA and other court cases associated with PPACA, and ensure that the state does not expend any resources until judicial direction is clear. (Joint charge with Senate State Affairs Committee)
2. Monitor the potential impact of the Patient Protection and Affordable Care Act (PPACA) on insurance regulations, Medicaid and Children's Health Insurance Program (CHIP), health care outcomes, health care workforce, overall health of all Texans, and the state budget in Texas. Additionally, monitor the current constitutional challenges to PPACA, and other court cases associated with PPACA, and ensure that the state does not expend any resources until judicial direction is clear. (Joint charge with Senate State Affairs Committee)
3. Evaluate the implementation of cost-containment strategies across the Health and Human Services Enterprise to determine if and how each strategy can be expanded upon to achieve additional savings next biennium. The evaluation should include but is not limited to: the expansion of managed care, co-­pays in Medicaid, electronic visit verification, and independent assessments for long-­? term care services. The evaluation should also consider new cost-containment strategies that will increase efficiencies and reduce costs. This evaluation should include but not be limited to: Medicaid, Early Childhood Intervention Services, and immunizations.
4. Review the state's current investment in health care innovation, including translational research and the Cancer Prevention Research Institute, which focuses on rapid transfer of new technology experimentation directly into the clinical environment. Make recommendations to improve the health of Texans and encourage continued medical research in the most cost-effective manner possible.
5. Review existing policies for prior authorization and medical necessity review across the Medicaid Program, including nursing homes and orthodontic services. Make recommendations on how these policies could be improved to save money by reducing unnecessary utilization and fraud.
6. Review the Medicaid Home and Community Based Services Waivers to identify strategies to lower costs, improve quality, and increase access to services. Areas of the review should include, but are not limited to:
  • Functional eligibility determinations to ensure services are only being delivered to individuals that qualify;
  • Financial eligibility determinations to ensure parental income and resources are considered when the client is a minor;
  • Coordination of acute and long-term care services;
  • Development and use of lower-cost community care waiver options;
  • Coordination with the Department of Family and Protective Services (DFPS) for waiver services for children in conservatorships;
  • Reinvesting savings into accessibility of community care for individuals waiting for services.
7. Evaluate the management structure and supervision of CPS caseworkers with an emphasis on rural areas. Identify any legislative changes that could assist DFPS in maximizing efficiency, improving quality casework and supervision, and increasing caseworker retention. Identify any legislative changes that could improve the quality of care children receive while in Child Protective Services custody, including improving permanency outcomes.
8. Examine the delivery and financing of public health services in our state, including how federal funds are distributed by the state to local health departments and whether the work done by Regional Health Departments operated by the Department of State Health Services overlap unnecessarily with local health departments.
9. Review the state's public mental health system and make recommendations to improve access, service utilization, patient outcomes and system efficiencies. Study current service delivery models for outpatient and inpatient care, funding levels, financing methodologies, services provided, and available community-based alternatives to hospitalization. The review should look to other states for best practices or models that may be successful in Texas. The study shall also review and recommend "best value" practices that the state's public mental health system may implement to maximize the use of federal, state, and local funds.
10. Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to:
  • Health Care Quality and Efficiency - Monitor implementation of initiatives aimed at improving health care quality and efficiency in Texas, including: the transition of Medicaid and the CHIP to quality-based payments, establishment of the Texas Institute of Health Care Quality and Efficiency, implementation of the Health Care Collaborative certificate, patient-centered medical home for high-cost populations, development and use of potentially preventable event outcome measures, and reduction of health care-associated infections. Include recommendations on how to improve and build upon these initiatives, including improving birth outcomes and reducing infant and maternal mortality;
  • Federal Flexibility - Monitor implementation of initiatives to increase state flexibility, including the Health Care Compact and the Medicaid Demonstration Waiver;
  • Foster Care Redesign - Monitor implementation of the initiative to redesign the foster care system;
  • Implementation of DOJ Settlement agreement to address State Supported Living Center concerns.
Committee: Senate Health and Human Services
Title: Interim Report
Library Catalog Title: Interim report to the 82nd Legislature
Subjects: Adult Protective Services | Aging and Disability Services, Texas Department of | At-risk youth | Child abuse | Children's Health Insurance Program | Cloning | Community support services | Crime prevention | Diet and nutrition | Emergency management | Families | Family and Protective Services, Texas Department of | Family violence | Federal government | Foster care | H1N1 virus | Health care | Health care providers | Health insurance | Human services | Long-term care | Medicaid | Medicaid eligibility | Medical Board, Texas | Medical errors | Medical research | Mental health services | Mentally ill persons | Nurses | Obesity | Physicians | Quality of care | Senior citizens | State budgets | Stem cell research | Texas Integrated Eligibility Redesign System |
Library Call Number: L1836.81 H349
Session: 81st R.S. (2009)
Online version: View report [272 pages  File size: 6,511 kb]
Charges: This report should address the charges below.
1. Upon passage of federal legislation relating to reform of the health care industry and health insurance industry that the Texas Health and Human Services Commission estimates will costs the State of Texas $2 to 2.5 billion per year in General Revenue beginning as early as 2013, study the implications of such legislation on Texas, the health care industry, and public and private insurance. Study and monitor the implementation of the insurance regulatory changes, changes to high risk pool, and any other insurance mandates. Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget. Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs. (Joint charge with Senate State Affairs Committee)
2. Study the benefits, efficiencies and costs, and effectiveness of the social service related prevention and early intervention programs at the health and human services agencies, the juvenile and adult criminal justice agencies and other government agencies that have programs that address mental illness, substance abuse, child abuse and neglect, domestic violence, single-parent families, absentee fathers, early pregnancy, and unemployment. Study other states' prevention programs and efforts to administer these programs through a merged prevention department. Make recommendations to improve the efficiency and effectiveness of these programs.
3. Review the timeliness and efficiency of the Health and Human Service Commission's eligibility system. Include a review of staffing levels and staffing distribution; implementation of Rider 61; and the increased demand on the system. Make recommendations to improve the efficiency and effectiveness of the system, focusing on policy changes that will not create a large financial burden for the state.
4. Study and make recommendations on the state's role for facilitating the exchange of health care information in the future, including using the Medicaid exchange as a framework for the statewide exchange of health information between health care providers to improve quality of care; what information the state should provide; how to use this information to improve care management, prevent medical errors, and reduce unnecessary services; and policies and statutory changes needed to ensure that privacy is protected. Study the feasibility of developing multiple regional health information technology exchanges in Texas.
5. Study the state's current and long-range need for physicians, nurses, dentists and other allied health and long-term care professionals. Provide recommendations for ensuring sufficient numbers of health care professionals, focusing on medically underserved and rural areas of the state as well as the Border region. Consider health care delivered by Advanced Practice Nurses in terms of access, cost and patient safety and include an assessment of independent prescriptive authority with those states in which prescriptive authority is delegated by a physician. Make recommendations to enhance the efficient use of Advanced Practice Nurses in Texas.
6. Explore strategies to support the needs of aging Texans, including best practices in nursing home diversion, expediting access to community services, and programs to assist seniors and their families in navigating the long-term care system with the goal of helping seniors remain in the community. Study the guardianship program implemented by the Department of Aging and Disabilities and the Department of Adult Protective Services, including the efficiency and effectiveness of the program, the relationship between the two agencies, the appropriate rights for parents, and whether clients and their assets are adequately protected to ensure the state is appropriately identifying seniors in need of protection.
7. Examine how the state could enact policies to improve the overall health of Texans, focusing on programs that compliment individually-based prevention with community­based prevention to reduce obesity rates by increasing physical activity, improving nutrition, and improving self-management of chronic diseases such as diabetes. Examine obesity-related health disparities between different ethnic groups and ways to narrow these gaps. Consider the fiscal and health impact of second-hand smoke on businesses and service sector employees. Study state-level initiatives to incorporate these individual and community-based prevention strategies, including initiatives pursued in other states.
8. Study the state's ability to appropriately respond to the H1N1 influenza pandemic by examining issues related to vaccine distribution and capacity. Consider the benefit of providing the state's independent school districts and various health authorities with standardized protocols for issues including, but not limited to, vaccine administration, absenteeism and the cancellation of school and other school-related events. Assess the state's ability to track and record H1N1 vaccinations through the ImmTrac registry, and review statutes governing ImmTrac to increase the effectiveness and efficiency of immunization information systems.
9. Study current state health care quality improvement initiatives in Texas, including statewide health care-associated infection and adverse event reporting, reimbursement reductions in the Texas Medicaid program for preventable adverse events, potentially preventable readmissions identification, health information technology implementation, pay-far-performance programs, and other initiatives aimed at improving the efficiency, safety, and quality of health care in Texas. Identify statutory changes that may build upon efforts to improve quality of care and contain health care costs in Texas. Study policies that encourage and facilitate the use of best practices by health care providers including the best way to report and distribute information on quality of care and the use of best practices to the public and to promote health care provider and payment incentives that will encourage the use of best practices. The study/recommendations could also include assessing the best way to bring provider groups together to increase quality of care, the use of best practices, and reduce unnecessary services.
10. Study current practices of the Texas Medical Board relating to disclosure of complaints.
11. Review the types of human stem cell and human cloning research being conducted, funded, or supported by state agencies, including institutions of higher education. Make recommendations for appropriate data collection and funding protocols.
12. Review the Medicaid HCBS waivers (CBA, STAR Plus, CLASS, MDCP, DBMT, TxHmL) and develop recommendations to assure that people with significant disabilities, regardless of disability label or age, receive needed services to remain in or transition to the community. Review should look at the delivery system, eligibility, service packages, rate structures, workforce issues and funding caps. Examine options for the provision of services for children aging out of the Medicaid system. Make recommendations for streamlining/combining these waivers, ensuring that these waivers are cost effective or create cost savings, and developing policies that contain costs in an effort to increase access to these services. The review should examine other states' community care waivers and provide recommendations relating to efforts that have been successful in other states.
13. Study the type, duration, frequency and effectiveness of mental health services available to and accessed by abused and neglected Texas children. Recommend strategies to address the impact of the trauma, and enhance therapeutic services available to this population in an effort to eliminate the cycle of abuse and neglect.
14. Monitor the implementation of legislation addressed by the Senate Committee on Health & Human Services, 81st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
  • Monitor Department of Family and Protective Services' implementation of the U.S. Fostering Connections Act, including the new Kinship Care program. Include recommendations on how to optimize the use of monetary assistance to qualified relative caregivers.
  • Monitor the Department of Aging and Disability Services (DADS) implementation of SB 643, relating to Texas' state-supported living centers (SSLCs), implementation of Special Provisions relating to All Health and Human Services Agencies, Section 48. Contingency Appropriation for the Reshaping of the System for Providing Services to Individuals with Developmental Disabilities, and implementation of the United States Department of Justice (DOJ) Settlement Agreement terms.
Committee: Joint Health Services, Interim
Title: Interim Report
Library Catalog Title: Interim report / Joint Legislative Interim Committee on Health Services.
Subjects: Children's Health Insurance Program | Health and Human Services Commission, Texas | Medicaid | Medicaid application process | Medicaid eligibility | Medical reimbursements | Prescription drug costs | Prescription drugs |
Library Call Number: L1836.77 h35
Session: 77th R.S. (2001)
Online version: View report [140 pages  File size: 6,984 kb]
Charges: This report should address the charges below.
1. Monitor Medicaid and Children's Health Insurance Program (CHIP) cost issues, including: a)Medicaid cost containment activities, including implementation of Article II Special Provisions contained in Sec. 33 of SB 1, 77th Legislature, Regular Session; b)Implementation of SB 43, 77th Legislature, Regular Session, regarding Medicaid simplification; c)Health and Human Services Commission (HHSC) reorganization of Medicaid and CHIP administration; d)CHIP and Medicaid acute health reimbursement rates, including implementation of legislation passed by the 77th Legislature, SB 1053, 77th Legislature, Regular Session, SB 1299, 77th Legislature, Regular Session, and SB 1, 77th Legislature, Regular Session, HHSC, Sec. 54 and Art. II Special Provisions, Secs. 29 and 30; e)Medicaid and CHIP caseload and cost projections; f)federal actions affecting Medicaid and CHIP costs; and g)any other items deemed pertinent by the Joint Committee.
2. Study the cost effectiveness of twelve month continuous eligibility for Medicaid and CHIP and make recommendations to the 78th Legislature.
3. Monitor the implementation legislation passed by the 77th Legislature regarding interagency bulk purchasing of pharmaceuticals, HB 915, 77th Legislature, Regular Session, and SB 1, 77th Legislature, Regular Session, Art. IX, Sec. 6.47.
Committee: House Human Services
Title: Interim report
Library Catalog Title: House Committee on Human Services, Texas House of Representatives interim report, 2000 : a report to the House of Representatives, 77th Texas Legislature.
Subjects: Americans with Disabilities Act | Bankruptcy | Community care | Community support services | Disability benefits | Human Services, Texas Department of | Liability insurance | Long-term care | Medicaid | Medicaid eligibility | Medical liability insurance | Medical reimbursements | Medicare | Nursing homes | Persons with disabilities | Supplemental Nutrition Assistance Program | Welfare | Welfare reform |
Library Call Number: L1836.76 h88
Session: 76th R.S. (1999)
Online version: View report [98 pages  File size: 765 kb]
Charges: This report should address the charges below.
1. Study issues created by the transition of the TANF program to federal law when the state's waiver expires in 2002. Include a review of the final TANF regulations and how other states use TANF funds outside the traditional cash assistance program. Consider policies to improve outcomes for people leaving welfare.
2. Study issues surrounding the financial difficulties experienced by some nursing home companies, including the reasons for bankruptcies and closures, state policies and resources for dealing with them, and impacts on residents.
3. Assess the state's responsibilities and policies regarding supports for individuals with disabilities in community-based settings.
4. Study the current public assistance eligibility, application and review processes, and other Department of Human Services' client communications to ensure that clients are getting the supports necessary to make a successful transition to self-sufficiency.
Committee: Senate Health and Human Services
Title: Interim report - Reforming Medicaid
Library Catalog Title: Reforming Medicaid in Texas : interim report.
Subjects: Child nutrition programs | Fraud | Health and Human Services Commission, Texas | Human Services, Texas Department of | Managed care | Medicaid | Medicaid eligibility | State budgets | Welfare fraud |
Library Call Number: L1836.73 m468
Session: 73rd R.S. (1993)
Online version: View report [137 pages  File size: 7,824 kb]
Charges: This report should address the charges below.
1. Review and evaluate the options provided by the State Medicaid Director and make recommendations for state or federal administrative action that could be taken in the short term under current law, if any, with the goal of fundamentally changing the Medicaid delivery system to achieve significant savings in the Texas Medicaid Program in FY '96-'97.
2. Review Medicaid and other related programs in Texas and other states, such as Tennessee and Oregon, to identify cost-saving methods that have proven successful or have the potential to prove successful.
3. Identify barriers at the federal level, whether statutory or administrative, that restrict or limit Texas' ability to achieve substantial Medicaid cost-savings.
4. Make recommendations for state legislation, if necessary, to substantially reduce the growth in demand for spending in the 1996-97 Medicaid budget and following budget periods.
5. Review compliance by the Texas Health and Human Services Commission with the requirements of HB 7, 72nd Legislature, 1st Called Session and subsequent amendments thereto.
6. At the direction of the Lieutenant Governor, investigate allegations of fraud, mismanagement or waste in any health and human services program or agency involving substantial loss or risk of future loss to the state.
Supporting documents
Committee: Senate Health and Human Services
Title: Interim Report - Interest groups' recommendations on Medicaid reform
Library Catalog Title: Interest groups' recommendations on Medicaid reform.
Library Call Number: L1836.73 h349i 1&2
Session: 73rd R.S. (1993)
Committee: Senate Health and Human Services
Title: Committee documentation: daily minutes record, draft minutes, testimony of Richard C. Ladd, HHSC Commissioner (HHSC accomplishments, reorganization, LBB budget recommendations, DHS summary of impact of legislative budget estimates), guardianship
Library Catalog Title: Minutes
Library Call Number: L1803.9 H88 73
Session: 73rd R.S. (1993)
Online version: View document [30 pages  File size: 529 kb]
Committee: Senate Medicaid and Family Services, Select
Title: Interim report
Library Catalog Title: Report and recommendations / Select Committee on Medicaid and Family Services.
Subjects: Medicaid | Medicaid application process | Medicaid eligibility | Medically uninsured | Prenatal care |
Library Call Number: L1836.70 m469
Session: 70th R.S. (1987)
Online version: View report [51 pages  File size: 2,174 kb]
Charge: This report should address the charge below.
1. Develop an immediate strategy to implement the opportunities created by new federal and state legislation. The Committee shall examine and evaluate the various options available to the state which will enhance the potential for expanded health and human services for needy Texans. At the same time, the Committee shall explore ways to attract the maximum amount of federal dollars to fund the cost of those programs. The Committee is charged with the responsibility of making recommendations to the Lieutenant Governor, the Legislature and the Board of the Department of Human Services in the following ares: 1. To determine what specific action should be taken or programs initiated during the current biennium which will allow the Department of Human Services to take advantage of current federal laws allowing expanded Medicaid benefits to eligible recipients through the use of matched federal funds. 2. To determine what action should be taken by the State of Texas during the current biennium with Congress or the Administration which might provide additional opportunities for the State of Texas to expand health and human services programs through the use of matched federal funds, and 3. To determine what specific legislative initiatives should be considered by the 71st Legislature consistent with the strategy of maximizing the use of federal funds to enhance the delivery of essential health and human services to needy Texans.
Committee: Senate Medicaid and Family Services, Select Subcommittee on Local Funds
Title: Interim Report
Library Catalog Title: Local Funds Subcommittee report to the Select Committee on Medicaid and Family Services.
Subjects: Medicaid | Medicaid application process | Medicaid eligibility | Medically uninsured | Prenatal care |
Library Call Number: L1836.70 m469l
Session: 70th R.S. (1987)
Online version: View report [69 pages  File size: 2,709 kb]
Charge: This report should address the charge below.
1. Develop an immediate strategy to implement the opportunities created by new federal and state legislation. The Committee shall examine and evaluate the various options available to the state which will enhance the potential for expanded health and human services for needy Texans. At the same time, the Committee shall explore ways to attract the maximum amount of federal dollars to fund the cost of those programs. The Committee is charged with the responsibility of making recommendations to the Lieutenant Governor, the Legislature and the Board of the Department of Human Services in the following ares: 1. To determine what specific action should be taken or programs initiated during the current biennium which will allow the Department of Human Services to take advantage of current federal laws allowing expanded Medicaid benefits to eligible recipients through the use of matched federal funds. 2. To determine what action should be taken by the State of Texas during the current biennium with Congress or the Administration which might provide additional opportunities for the State of Texas to expand health and human services programs through the use of matched federal funds, and 3. To determine what specific legislative initiatives should be considered by the 71st Legislature consistent with the strategy of maximizing the use of federal funds to enhance the delivery of essential health and human services to needy Texans.

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