For this weekly feature, the Texas Council for Developmental Disabilities (TCDD) profiles a noteworthy bill going through the legislative process. The bill may relate directly to TCDD’s Public Policy Priorities or another disability-related issue.
Bill of the Week: HB 1941
House Bill (HB) 1941, relating to peer support specialists for certain individuals with an intellectual or developmental disability (IDD) and peer services for those individuals under Medicaid. HB 1941 was authored by Rep. Elizabeth “Liz” Campos, from San Antonio, House District 119.
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We’ve created a Bill of the Week one-pager (PDF, 462 KB) for HB 1941. This is a simplified explanation of the bill that you can share with your representative and personal network.
Background
Peer supports are services where individuals are provided knowledge, experience, or emotional, social, and practical help by people with similar backgrounds, as defined by the Texas Health and Human Services Commission (HHSC). In 2017, Texas lawmakers passed HB 1486 to create a new Medicaid peer-services benefit. The bill also defined the training and certification of substance use and mental health peer workers. However, the bill did not provide Medicaid billing for peer-support services for people with IDD.
Recently, TCDD funded grant projects to build peer-support networks for people with IDD. Three grantees – Baylor College of Medicine, Imagine Art, and the University of Massachusetts Chan Medical School – have trained people with IDD who live independently to serve as peer-support specialists for people receiving community-based services. There have been many notable outcomes from these grantee projects, such as:
- developing peer-support model curricula;
- establishing one-to-one peer supports to mentor people with disabilities transitioning from pediatric medicine to adult Medicaid services;
- creating a certification process for specialists, which was recognized by the HHSC peer-services director as a potential foundation for state service models; and
- increasing self-advocacy and communication among individuals with IDD.
These outcomes have clearly demonstrated the benefits of peer-support services for people with IDD. The grantees have communicated with HHSC the need to expand the Medicaid benefit to cover the services.
What does the bill do?
HB 1941 includes “peer support services provided to individuals with an intellectual or developmental disability” among the services available under Medicaid. The bill requires HHSC to develop and adopt rules to:
- establish accessible and validated training requirements;
- distinguish certification and supervision requirements;
- define the scope of services an IDD peer-support specialist may provide;
- distinguish IDD peer supports from other services that require a license or certification; and
- protect the health and safety of people receiving peer-support services.
The bill would also establish a workgroup of people affected by the legislation to provide input on these rules. The HHSC executive commissioner would appoint members to the workgroup, which would be comprised of the following people:
- One peer-support specialist focused on mental health and substance-use disorder
- One peer-support specialist focused on IDD
- A representative from the HHSC Peer and Recovery Services Programs, Planning and Policy unit
- A representative from the HHSC Office of Disability Services Coordination
- A representative from TCDD
- A representative from Texas Parent to Parent
- A representative from Texas Advocates
- A person certified as a trainer by the Learning Community for Person Centered Practices under the People Planning Together program
The executive commissioner would designate one workgroup member as the presiding officer. Once established, the workgroup would meet once every month and would be abolished upon the adoption of the IDD peer-support rules.
The bill specifies that the new rules would not apply to peer-support services provided to residents of state-supported living centers. If passed, HB 1941 would take effect on Sept. 1, 2025.
“People with IDD live with severe chronic conditions that are due to mental and/or physical impairments. The “peer-to-peer” services that we envision will help these individuals with their mobility, learning, speech, self-help, and independent living.”
Rep. Liz Campos, bill author
Where is the bill in the process?
On Jan. 17, 2025, HB 1941 was filed for the 89th regular session. Since committee assignments have not been named yet, the bill is waiting to be referred.
Who supports the bill and why?
The following comments were provided at an April 18, 2023, hearing on a bill nearly identical to HB 1941:
- CTD: Dennis Borel, who at the time was executive director of the Coalition of Texans with Disabilities, testified in support of the bill. He explained how peer-support services are well established nationwide and utilized in 39 states. He noted that Medicaid does not cover Texas peer-support services for individuals with IDD, something this bill would fix. Borel also highlighted the workforce issue that generally exists in all disability services, and how this bill would help “fill that gap in the workforce with fairly modestly paid positions by people who bring exceptional credentials to this field.”
- Texas Council of Community Centers: Isabel Casas, then the government relations director for IDD services for the Texas Council of Community Centers, provided testimony in favor of the bill. She explained how peer-support specialists are not only trained to assist individuals with IDD but also pull from their own lived experiences. This helps specialists navigate the stress and frustration that can come from social challenges, abuse, bullying, and other trauma. She pointed out that peers offer assistance such as emotional support, knowledge, skills, honoring self-determination, and providing resources. Casas also noted that, “increasing access to this service will provide individuals with IDD more resources to develop social skills while learning how to advocate for their own needs.”
- Peer-Support Specialist: Jordan Smelley, a certified mental health peer specialist and a person with IDD, testified in support of the bill. Smelley shared that not every peer specialist in Texas has the personal lived experiences of IDD, which can include delayed social skill development; navigating Medicaid home and community-based service waivers and Texas Workforce Vocational Rehabilitation programs; and challenges with the ability to recognize red flags, read nonverbal language, or understand the appropriateness of topics for different settings. He stated, “These are all things that not everyone with mental health or substance use [issues] have to navigate, but many people with IDD do.” Smelley suggested that peer specialists without these lived experiences can struggle to support someone with IDD based on a lack of fully understanding their situation and that the bill would address this problem.
The following groups also registered their support for the legislation but provided no testimony: The Arc of Texas, City of Uvalde, Clarity Child Guidance Center, Disability Rights Texas, Methodist Healthcare Ministries, NAMI Texas, National Association of Social Workers Texas, Texans Care for Children, Texas Parent to Parent, and United Ways of Texas.
Who opposes the bill and why?
At the 2023 hearing, two individuals registered opposition but provided no testimony or indication regarding their concerns with the bill.
Additional Testimony
The following comments were offered at the 2023 hearing:
- TCDD: Lauren Gerken, a senior public policy analyst for TCDD, testified on the bill. Gerken explained how peer-support specialists are trained and certified to share lived experiences and offer guidance and support to help people meet their basic needs and find the best pathway to recovery. She noted that TCDD has funded projects to pilot IDD peer-support training models, which have improved communication, self-advocacy, and person-directed planning among individuals. In her written remarks, she pointed out that “peer support is not a novel concept … these practices are already available through home and community-based services for those with mental health needs, and those services can be replicated and adjusted for the IDD community.”
How much will the bill cost?
The Legislative Budget Board found that a bill nearly identical to HB 1941 would not impact the state budget in a significant way.
Is there a Senate companion to the bill?
There is no Senate companion to HB 1941.
Stay Informed
For the latest information about where HB 1941 is in the process, follow the bill on the Texas Legislature Online. To receive future legislative updates from TCDD, follow us on Facebook, X, Instagram, and LinkedIn.
