With the Texas Legislature’s 86th Regular Session currently underway, the Texas Council for Developmental Disabilities (TCDD) will be providing regular updates on what’s happening at the Capitol.
The Budget Conference Committee
A Conference Committee has been appointed for House Bill (HB) 1, the legislation that dictates the state budget of Texas for the Fiscal Year 2020-21 biennium. The committee, which is comprised of five members of the House and five members of the Senate, meets to negotiate the differences between the House and Senate versions of HB 1 in order to reach a unified concurrent budget resolution. Once the committee finishes their deliberations, they send the agreed-to version of the bill back for a final up-or-down vote in each chamber, with no possibility of further amendment. Those votes are expected to take place just days before the legislative session ends on May 27.
For the 86th Regular Session, Lt. Governor Dan Patrick appointed the following budget conferees:
- Sen. Jane Nelson (R-Flower Mound) – Chair
- Sen. Joan Huffman (R-Houston)
- Sen. Lois Kolkhorst (R-Brenham)
- Sen. Robert Nichols (R-Montgomery)
- Sen. Larry Taylor (R-Friendswood)
For the House conferees, Speaker Dennis Bonnen selected the following Representatives:
- Rep. John Zerwas (R-Fort Bend) – Chair
- Rep. Greg Bonnen (R-Galveston)
- Rep. Sarah Davis (R-Houston)
- Rep. Oscar Longoria (D-Hidalgo)
- Rep. Armando Walle (D-Houston)
The Bottom Line
The House and Senate versions of the budget have notable differences in a few key areas. Overall, the House version costs $251 billion in state and federal funds, while the Senate version comes in slightly lower at $248 billion. Some of that variation is accounted for by the House plan to withdraw $2.3 billion from the Economic Stabilization Fund, also known as the Rainy Day Fund.
Both bills allocate funding for new projected patients (enrollment growth) under Medicaid, with the House allocating $68.6 billion and the Senate allowing $67 billion. The Senate’s lower budget allocation would include a $900 million cut to Medicaid through a cost-containment rider, which directs the Texas Health and Human Services Commission (HHSC) to yield savings through:
- the prevention of fraud, waste, and abuse;
- maximizing federal flexibility under the program; and
- achieving programmatic and administrative efficiencies.
Neither chamber’s budget would cover the full projected growth in Medicaid costs over the biennium, which means that the 87th Texas Legislature will be expected to pass a supplemental appropriations bill to cover unfunded liabilities.
Interest List Reduction
The Senate allocated $66.6 million in funds for the purpose of reducing Medicaid waiver interest lists. Specifically, the bill aims to provide:
- 60 additional slots in the Medically Dependent Children’s Program,
- 240 additional slots in the Community Living and Support Services list,
- 1,320 more slots in the Home and Community-based Services list, and
- eight additional slots in the Deaf-Blind Multiple Disabilities program.
However, the Senate did not provide any funding to increase slots for the Promoting Independence initiative, which seeks to ensure appropriate care settings for people with disabilities. The House, on the other hand, set aside a total of $97 million for Promoting Independence but no dollars for interest list reduction. The House’s 2,476 Promoting Independence slots would be divided as follows:
- 500 slots for individuals in crisis and/or at imminent risk of institutionalization
- 500 slots for individuals in State-Supported Livings Centers (SSLCs) and large or medium intermediate care facilities for individuals with intellectual disabilities
- 236 slots for children aging out of foster care
- 40 slots for children in transition from general residential operations facilities
- 500 slots for individuals moving from nursing facilities
- 500 slots for individuals diverted from admission to a nursing facility
- 200 slots for individuals moving from state hospitals
Early Childhood Intervention
The House edition of the budget fully funds HHSC’s request of $72.6 million for the Early Childhood Intervention (ECI) program, while the Senate version provides only $17 million for the program. Lower funding would not provide enough money to keep up with the enrollment or cost growth in ECI. Moreover, the Senate version does not allow HHSC to exceed the amount allotted whatsoever, but the House version gives HHSC the ability to do so with written approval from the Legislative Budget Board and the Governor.
In its Legislative Appropriations Request, HHSC included an exceptional item requesting $389 million to provide an across the board 50-cent per-hour raise for community attendants. Neither chamber’s appropriation came close to being this robust. The House provided $87 million, which would raise attendant wages by 10 cents an hour. The Senate, meanwhile, authorizes only $23 million in additional spending and seeks to establish a program to improve pay for only some attendants based on the longevity of their employment.
Disability-related Bills Advance at the Legislature
Last week, the following disability-related bills were passed by the full Texas House and now head over to the Senate for consideration:
- HB 12, relating to early childhood intervention and rehabilitative and habilitative services.
- HB 288, relating to the personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities.
- HB 873, relating to behavior improvement plans and behavioral intervention plans for certain public school students and notification and documentation requirements regarding certain behavior management techniques.
- HB 1365, relating to authorizing the possession, use, cultivation, processing, distribution, transportation, research, testing, and delivery of low-THC cannabis for medical use by patients with certain debilitating medical conditions and the licensing of cannabis dispensing organizations, cannabis research organizations, and cannabis testing facilities; establishing the cannabis therapeutic research review board; authorizing fees.
- HB 1635, relating to health benefit plan coverage for early childhood intervention services.
- HB 2897, relating to the provision of services by the Texas Department of Criminal Justice’s developmentally disabled offender program.
- HB 3193, relating to the licensing of a home and community support services agency; increasing fees.
- HB 3703, relating to the dispensing, administration, and use of low-THC cannabis; authorizing low-THC cannabis research; authorizing a fee.
- HB 3991, relating to the deaf-blind with multiple disabilities waiver program.
- HB 4531, relating to the rights and treatment of and services provided to certain adult sexual assault survivors.
- HB 4533, relating to the system redesign for delivery of Medicaid acute care services and long-term services and supports to persons with an intellectual or developmental disability or with similar functional needs.
- HB 4543, relating to implementation of the system redesign for the delivery of Medicaid benefits to persons with intellectual or developmental disabilities.
Hearings to Watch
Below is a sample of the hearings TCDD will be monitoring this week. During these hearings, legislative committees will consider important disability-related bills. To receive notifications about new hearings that are scheduled with short notice, follow us on Twitter. You can find live and archived broadcasts of committee hearings on the House or Senate websites.
The Senate Committee on State Affairs hosted a public hearing on Monday morning. Its agenda included the consideration of HB 2734 by Rep. Dustin Burrows, which would create a form that a court-appointed guardian of an SSLC resident may sign to authorize the center to make an anatomical gift on the resident’s behalf. The bill passed out of the House on May 2 with unanimous support.
The Senate Finance Committee also met for a hearing on on Monday morning. Among the bills taken up was Rep. Senfronia Thompson’s House Joint Resolution 5, which would propose a constitutional amendment to establish a Texas mental and behavioral health research fund. It would provide dollars for research, treatment, and access to services in the state for behavioral health, mental health, and substance use and addiction issues. This resolution passed through the House on April 15 by a vote of 110-32.
The House Human Services Committee will hold a hearing Tuesday morning. Set to be discussed is Senate Bill (SB) 2021 by Sen. Borris Miles, which seeks to build on the success of local health departments (LHDs) participating in the Medicaid 1115 Waiver Delivery System Reform Incentive Payment (DSRIP) program by directing managed care organizations to include LHDs in their provider networks for at least three years. SB 2021 was passed through the Senate on May 3 with unanimous support.
The Senate Transportation Committee will hold a hearing Wednesday morning. The list of bills to be considered includes HB 643 by Rep. John Raney, which would allow individuals to apply for a disabled parking placard in the county in which they are receiving medical treatment regardless of whether it is the county in which they normally reside. HB 643 was passed out of the House on May 3 without objection.