The committee has requested written submissions on the following topics. Below are resources related to those topics.

 

Charge 1: Examine the primary drivers of increased health care costs in Texas. This examination should include a review of:

 

Charge 2: Study the opportunities to better coordinate how public dollars are spent on health care.

 

Charge 3: Identify emerging and proven delivery system improvements and sustainable financing models that could reduce the cost of health care.

 

Topics:

Health Care Access and Medicaid: Examine innovative approaches and delivery models to reduce health care costs for both patients and taxpayers, including policies that other states have implemented. Consider recommendations to implement such models. Study the impact that "direct care" health care models may have on Medicaid beneficiaries for acute care and mental health services, including potential cost savings and improvement in quality metrics. Examine efforts other states have made seeking to implement direct care models, particularly in Medicaid or in charitable health care delivery.

 

Impacts of COVID-19 on Long-Term Care Facilities: Consider the following issues in light of the COVID-19 pandemic: 

     1) Review the state's response to the pandemic, specifically as it relates to emergency regulations that prohibited visitation of 
         residents of long-term care facilities by family members. Examine the physical and mental health impacts of the visitation policy on
         long-term care residents.

 

     2) Review emergency waivers of regulations of long-term care facilities during the pandemic and make recommendations on whether regulations should be permanently waived or removed.

 

Charge 2.2 - 2.5: Review how Texas is preparing for state and federal budgetary changes that impact the state's health programs, including: 

     2.2) The next phase of the 1115 Healthcare Transformation and Quality Improvement Program Waiver;

     2.3) Texas' Targeted Opioid Response Grant;

     2.4) The Centers for Medicare and Medicaid Services proposed Medicaid Fiscal Accountability rule; and

     2.5) The Healthy Texas Women  Section 1115 Demonstration Waiver.

 

Charge 4: Examine the long-term services and support system of care in Texas. Study workforce challenges for both institutional and community services, with a focus on home- and community-based services in the state's STAR+PLUS program. Review what impact funding provided by the 86th Legislature to increase the base wage for community attendant services and the increased funding for rate enhancements have on workforce retention and quality. Consider options to both stabilize and expand the workforce. Review the long-term care programs and services available to Texas' seniors, including community alternatives to institutional care available through programs like the Program of All-Inclusive Care for the Elderly. Examine the adequacy of current funding mechanisms, including Medicaid reimbursement rates and supplemental or add-on payments, to incentivize high-quality care. Consider mechanisms to promote a stable, sustainable and quality-based long-term care system to address current and future needs of the state. 

 

Charge 5: Examine the adequacy of Medicaid reimbursements for nursing facilities, including existing incentive-based payment models and the Quality Incentive Payment Program. Consider and make recommendations to incentivize innovative models of care delivery in nursing home facilities. Study the impact of the STAR+PLUS managed care program on nursing facility care, operations and patient health outcomes, and consider recommendations to improve administrative processes between facilities and managed care organizations. 

 

Charge 2.1: Review how Texas is preparing for state and federal budgetary changes that impact the state's health programs, including: 

     2.1) The Family First Prevention Services Act (FFPSA).

 

In particular,

Charge 3: Monitor the implementation and expansion of Community-Based Care by the Department of Family and Protective Services. Specifically: