[00:00:05]
>> GOOD MORNING EVERYONE. THE MEETING WILL COME TO ORDER.
MAY THE RECORD REFLECTS THAT THIS MEETING OF THE HHSC EXECUTIVE COUNCIL CONVENED AT 10:00 A.M. ON MARCH 19TH 2026.
MY NAME IS EMILY ZALKOVSKY, CHIEF MEDICAID OFFICER.
I AM PRESIDING OVER TODAY'S MEETING.
MS. KATE BROWN WILL PROVIDE MEETING LOGISTICS AND CONDUCT
ROLL CALL FOR THIS MEETING. >> GOOD MORNING.
MY NAME IS KAYLA CATES BROWN, ASSOCIATE DIRECTOR OF THE ADVISORY COMMITTEE COORDINATION OFFICE GOOD FOR THOSE WHO ARE PARTICIPATING IN PERSON, PLEASE SPEAK DIRECTLY INTO THE MICROPHONE SO YOUR VOICE AND COMMENTS ARE HEARD.
MEMBERS OF THE PUBLIC WHO WISH TO PROVIDE ON-SITE PUBLIC COMMENTS AND DID NOT PREREGISTER SHOULD COMPLETE THE PUBLIC, REGISTRATION FORM AND RETURN IT TO THE FACILITATORS TABLE.
PUBLIC COMMENTS ARE LIMITED TO . A TIMER WILL BE USED.
THE BROADCAST FROM TODAY'S MEETING AND RELATED MATERIALS WILL BE AVAILABLE ON THE HHS WEBSITE AT HHS.NET TEXAS.GOV FROM THE HOME PAGE, PLEASE SELECT THE ABOUT PAGE AND THEN CHOOSE LIVE ARCADE MEETINGS IN THE DROP-DOWN MENU AS WELL AS ANY RELATED MEETING MATERIALS WILL BE AVAILABLE ON THE HHS WEBSITE AT HHS DOT TEXAS.GOV. FROM THE HOME PAGE, SELECT THE ABOUT PAGE AND THEN CHOOSE THE LIVE AND ARCHIVE MEETINGS IN THE DROP-DOWN MENU'S, THEN YOU WILL SEE THE LINK FOR THE HHS EXECUTIVE COUNCIL MEETING. AT THIS TIME, I WOULD LIKE TO CALL ROLE. MEMBERS, WHEN I CALL YOUR NAME, PLEASE RESPOND WITH PRESENT. STEPHANIE MUTH.
JORDAN DIXON. MAURICE MCCREARY JR.
AUDREY O'NEILL. DR. JENNIFER SHUFORD PEERED.
>> HERE. >> RAYMOND CHARLES WINTER.
>> I WOULD LIKE TO ACKNOWLEDGE THAT SUSAN BILES, PRINCIPAL DEPUTY FOR THE INSPECTOR GENERAL OFFICE IS PRESENT ON BEHALF OF RAYMOND CHARLES WINTER. ELIZABETH FARLEY, CHIEF OF STAFF IS PRESENT TODAY ON BEHALF OF THE DEPARTMENT OF FAMILY PROTECTIVE SERVICES COMMISSIONER AUDREY O'NEILL.
AND HEATHER FLEMING, INTERIM CHIEF PROGRAM AND SERVICES OFFICER IS PRESENT ON BEHALF OF THE CHIEF PROGRAM AND SERVICES OFFICER. MR. DAVID CHO'S DRUM, DEPUTY EXECUTIVE COMMISSIONER OF REGULATORY SERVICES IS PRESENT ON BEHALF OF THE CHIEF POLICY REGULATORY OFFICER, JORDA JORDAN DIXON. CHIEF ZALKOVSKY, THIS CONCLUDES ROLL CALL AND I RETURN IT TO Y YOU.
>> THANK YOU. I DID WANT TO PROVIDE SOME BRIEF REMARKS ABOUT THE EXECUTIVE COUNCIL.
WE ARE MAKING UPDATES TO THE EXECUTIVE COUNCIL TO ENHANCE TRANSPARENCY AND STRENGTHEN STAKEHOLDER ENGAGEMENT.
WE VIEW THESE MEETINGS AS AN OPPORTUNITY FOR STAKEHOLDERS TO PROVIDE CRITICAL FEEDBACK TO THE AGENCY.
SPECIFIC AGENCY UPDATES WILL NOW BE CLEARLY POSTED ON THE AGENDA AS WE HAVE DONE TODAY, AS REFLECTED, YOU WILL HEAR A LITTLE BIT ABOUT TEAMS AND THE HEALTHY FOOD UPDATE WHICH IS ON THE AGENDA AS OF SPECIFIC ITEMS. NEXT MONTH'S MEETING WILL WELCOME SEVERAL LEADERSHIP STAFF AS COUNCIL MEMBERS FOLLOWING THE RECENT ORGANIZATIONAL REALIGNMENT, INFORMATION ABOUT THE REALIGNMENT IS AVAILABLE ON OUR WEBSITE.
NEXT WE WILL HEAR FROM COMMISSIONER DR. SHUFORD.
JENNIFER SHUFORD WILL PROVIDE THE DEPARTMENT OF STATE HEALTH
SERVICES UPDATE. >> THANK YOU, CHIEF ZALKOVSKY.
I AM DR. JENNIFER SHUFORD AND I'M COMMISSIONER OF THE HEALTH SERVICES. I WANT TO THANK THE EXECUTIVE COMMISSIONER STEPHANIE MUSE FOR GIVING ME THIS OPPORTUNITY TO UPDATE YOU ON SOME OF THE RECENT WORK.
AS WE HAVE DISCUSSED PREVIOUSLY, DH SHS IS UNDER REVIEW.
WE HAVE BEEN WORKING WITH SUNSET REVIEW STAFF TO ANSWER QUESTIONS ABOUT OUR AGENCY'S PROGRAMS AND RESPONSIBILITIES AND WE THANK ALL OF OUR PARTNERS WHO HAVE BEEN GIVING ADDITIONAL INFORMATION TO THE SUNSET STAFF ABOUT PUBLIC HEALTH AND DSHS'S PLACE IN IT. IT'S A LOT OF WORK ON EVERYONE'S PART AND I AM THANKFUL FOR MY STAFF WHO HAVE DUG IN AND DONE A LOT OF SUNSET RESPONSES IN ADDITION TO THEIR NORMAL DAILY DUTIES. I WANT TO THANK THE SUNSET STAFF WHO ARE ASKING REALLY ILLUMINATING QUESTIONS AND DOING IT SO RESPECTFULLY. ALL OF THE COOPERATION OF OUR
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STAKEHOLDERS AND PARTNERS ACROSS TEXAS.I ALSO WANTED TO GIVE AN UPDATE ABOUT WILDFIRE RESPONSE.
THE DRIER WEATHER AND HIGH WINDS ACROSS THE STATE RECENTLY HAVE INCREASED RISK FOR WILDFIRES ACROSS TEXAS.
DUE TO THESE CONDITIONS, THE TEXAS A&M FOREST SERVICE AND TEXAS SERVICE OF DEPARTMENT MANAGEMENT AT THE STATE OPERATIONS CENTER HAVE REQUESTED ACTIVATION OF OUR EMERGENCY MEDICAL TASK FORCE RESOURCES TO SUPPORT THESE ONGOING FIRE OPERATIONS. AS OF OUR REPORT LAST WEEK, THERE WERE 29 FIRES BURNING ACROSS THE STATE OVER 18,000 ACRES. DS HS AS LEAD AGENCY FOR MEDICAL AND PUBLIC RESPONSE ACTIVITIES IN TEXAS HAS MANY EMERGENCY VEHICLES AND EMERGENCY MEDICAL STAFF THAT ARE DEPLOYED ALL ACROSS TEXAS IN SUPPORT OF THOSE MISSIONS.
AS FAR AS WORLD CUP PREPA PREPARATIONS, WE ARE CONTINUING ALL OF OUR WORK ON PREPARING FOR WORLD CUP.
AS PART OF OUR PUBLIC HEALTH PLANNING, WE ARE ANTICIPATING BETWEEN A MILLION AND A MILLION AND A HALF ADDITIONAL VISITORS ACROSS TEXAS DUE TO THOSE WORLD CUP GAMES THAT ARE BEING PLAYED IN HOUSTON AS WELL AS UP IN ARLINGTON.
WE EXPECT THAT THE SURGE OF VISITORS WILL IMPACT THE HEALTH CARE SYSTEM AS WELL AS DISEASE SURVEILLANCE.
WE EXPECT A LOT OF OUT-OF-STATE TRAVELERS, A LOT OF INTERNATIONAL TRAVELERS AS WELL AS PATIENTS HERE WHO DON'T HAVE PROVIDERS IN TEXAS. WE ARE ACTIVELY PLANNING INTERNALLY TO SUPPORT THAT POTENTIAL SURGE IN HEALTH CARE AND PUBLIC HEALTH NEEDS AND WE ARE WORKING WITH PARTNERS BOTH LOCAL, STATE, AND FEDERAL PARTNERS TO MAKE SURE OUR ACTIVITIES ARE ALL COORDINATED. AND LASTLY, MEASLES.
THERE IS ONGOING MEASLES ACTIVITY ACROSS THE UNITED STATES AND AROUND THE WORLD.
WE ARE MONITORING THAT SITUATION CLOSELY.
IN 2026, TEXAS HAS REPORTED 136 CASES.
WE ARE NOW UPDATING A DASHBOARD AGAIN ON OUR WEBSITE.
WE DID THAT DURING 2025. WE STOPPED DOING THAT WHEN OUR OUTBREAK ENDED LAST YEAR PEERED WITH THE INCREASE IN CASES AGAIN, WE PUT THAT BACK UP. IT LIST CASES BY COUNTY AND WHETHER THEY WERE LOCALLY ACQUIRED IT DUE TO DOMESTIC TRAVEL OR INTERNATIONAL TRAVEL OR UNKNOWN.
THAT INFORMATION WILL BE ON THE MEASLES PAGE ON OUR WEBSITE.
THERE ARE A LOT OF OTHER ACTIVITIES GOING ON RIGHT NOW, BUT THOSE ARE THE HIGHLIGHTS I WANTED TO HIT TODAY.
I AM HAPPY TO TAKE ANY QUESTIONS AND I APPRECIATE YOUR ATTENTION TODAY. THANKS.
>> ALL RIGHT. THANK YOU, DR. SHUFORD.
AGENDA ITEM 1 EACH ONE IS THE DEPARTMENT OF FAMILY PROTECTIVE SERVICES COMMISSIONERS UPDATE AND IT IS TABLED TODAY.
WE WILL MOVE ON TO AGENDA ITEM 1F.
SUSAN BILES WILL GIVE THE OFFICE OF INSPECTOR GENERAL UPDATE.
>> THANK YOU. I WANTED TO START BY TALKING ABOUT THE FRUSTRATION THAT I KNOW A LOT OF PROVIDERS ARE FEELING RIGHT NOW ABOUT THE DELAYS AND PROVIDER ENROLLMENT SCREENINGS AT OUR OFFICE. HISTORICALLY, WE HAVE BEEN ABLE TO DO THESE SCREENINGS IN TEN BUSINESS DAYS BUT RIGHT NOW WE HAVE ALMOST A 300% INCREASE IN OUR VOLUME.
HISTORICALLY WE HAVE GOTTEN ABOUT 22% OF APPLICATIONS THAT COME IN AND RIGHT NOW WE ARE GETTING ABOUT 70% OF APPLICATIONS THAT COME IN SO WE JUST DO NOT PHYSICALLY HAVE THE STAFF TO KEEP IT AT THE TEN DAYS.
OUR INVENTORY HAS BEEN AGING SIGNIFICANTLY AND I KNOW THIS IS A HUGE SOURCE OF CONCERN AND FRUSTRATION FOR PEOPLE.
WE HAVE ADDED NEW STAFF, INCREASED ALMOST 40%, WE HAVE REQUESTED SYSTEMS IMPROVEMENTS AS WELL AS IMPLEMENTING PROCESS CHANGES TO TRY TO GET THIS NUMBER DOWN.
WE ARE CURRENTLY WORKING APPLICATIONS IN THE ORDER THAT THEY ARE RECEIVED. WE ARE ALSO TRYING TO PRIORITIZE THOSE WHO HAVE UPCOMING REVALIDATION DEADLINES.
TO PREVENT ANY GAPS IN SERVICE FOR EXISTING PROVIDERS AND THEIR CLIENTS. I WANT YOU ALL TO KNOW THAT WE RECOGNIZE THE DELAYS CREATE A LOT OF STRESS AND FRUSTRATION FOR EVERYBODY AND WE ARE WORKING AS FAST AS WE CAN TO MAINTAIN COMPLIANCE BUT ALSO GET THESE DONE AND A MORE TIMELY MANNER.
SWITCHING GEARS, I DID WANT TO HIGHLIGHT AN UPCOMING PROJECT THAT WE ARE WORKING ON TO ENCOURAGE FRAUD, WASTE, AND ABUSE REPORTING. WE ARE WORKING ON ADDING LINKS TO THE YOUR TEXAS BENEFITS WEBSITE AND MOBILE APP TO ENCOURAGE CLIENTS TO PLAY AN ACTIVE ROLE IN REPORTING FRAUD AND THE NEW LINKS WILL GO DIRECTLY TO OUR NEW REFERRAL
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WEBSITE THAT WE HOPE IS MORE USER-FRIENDLY.THAT DESIGN IS CURRENTLY UNDERWAY AND WE ARE EXPECTING IT TO BE IMPLEMENTED IN JUNE. I WILL CLOSE OUT BY HIGHLIGHTING A RECENT CASE AND SOME OF OUR RECOVERIES.
SEVERAL YEARS AGO WE INITIATED AN INVESTIGATION INVOLVING THE MISUSE OF MEDICAID FUNDS BY A CDS EMPLOYER WHO WAS ARRANGING CARE FOR HER SEVERELY DISABLED SON.
THE INVESTIGATION IDENTIFIED A PROLONGED FAILURE TO ENSURE THAT THE SERVICES WERE ACTUALLY PROVIDED TO HER SON AS WELL AS A FINANCIAL LOSS OF OVER $200,000. BASED ON OUR FINDINGS, WE REFERRED TO THIS TO THE MEDICAID FRAUD CONTROL UNIT AND THEY WORKED WITH THE U.S. ATTORNEY'S OFFICE OF THE NORTHERN DISTRICT IN TEXAS TO PROSECUTE THIS PERSON.
SHE PLED GUILTY AND ON FEBRUARY 18TH, SHE WAS SENTENCED TO 17 YEARS IN PRISON IN ORDER TO PAY FULL RESTITUTION.
THIS IS A GREAT EXAMPLE OF PARTNERSHIP BETWEEN STATE AND FEDERAL AGENCIES AS WELL AS THE IMPACT IT CAN HAVE NOT JUST ON DOLLARS, BUT ALSO ON CLIENT SAFETY.
FINALLY, OUR FEBRUARY RECOVERIES WERE $28.7 MILLION BRINGING OUR TOTAL TO THE YEAR OF $181 MILLION.
WE WILL BE RELEASING OUR Q2 QUARTERLY REPORT AT THE END OF THIS MONTH FOR ANYONE THAT IS INTERESTED IN MORE DETAILS ABOUT OUR WORK OVER THE LAST QUARTER. THANK YOU ALL FOR YOUR TIME THIS
[2. Agency Updates]
WE WILL NOW MOVE ON TO AGENDA ITEM 2, AGENCY UPDATES.AT THIS TIME, I WOULD LIKE TO RECOGNIZE JORDAN NICHOLS, MEDICAID AND SCHIP OPERATIONS MANAGEMENT TO PROVIDE THE UPDATE ON THE PROVIDER ENROLLMENT AND MANAGEMENT SYSTEM.
>> GOOD MORNING. MY NAME IS JORDAN NICHOLS AND AS CHIEF SPEED 25 INTRODUCED ME, I'M THE DEPUTY ASSOCIATE COMMISSIONER WITHIN THE SERVICES.
I'M HERE TODAY TO TALK ABOUT PROVIDER ENROLLMENT.
LET'S ADVANCE TO THE NEXT SLIDE, PLEASE.
YOU MAY BE AWARE THAT YOU PARTICIPATE IN TEXAS MEDICAID OR OTHER STATE HEALTH PROGRAMS, PROVIDERS MUST ENROLL IN THE PROGRAM AND PERIODICALLY REVALIDATE THEIR INFORMATION, USUALLY EVERY FIVE YEARS. SOME MEDICAID AGENCIES SCREEN REENROLLMENT APPLICATIONS TO ENSURE THAT THE PERSON OR ORGANIZATION APPLYING IS ELIGIBLE TO PARTICIPATE.
WE CHECK NATIONAL AND STATE DATABASES FOR CRIMINAL AND FRAUDULENT ACTIVITY TO PREVENT BAD ACTORS FROM PARTICIPATING.
IN TEXAS, MOST OF THOSE ACTIVITIES ARE HANDLED BY THE OFFICE OF INSPECTOR GENERAL. TEXAS HAD A SYSTEM KNOWN AS THE PROVIDER ENROLLMENT AND MANAGEMENT SYSTEM WHERE THEY CAN APPLY FOR ENROLLMENT AND MANAGED CHANGES TO THEIR INFORMATION.
THIS IS THE MANNER ENROLLMENT PROCESS ARE MANAGED BY THE TEXAS MEDICAID AND HEALTH CARE PARTNERSHIP.
UNFORTUNATELY, THE CURRENT SYSTEM IS NOT VERY USER-FRIENDLY AND HAS CAUSED A LOT OF DIFFICULTIES FOR PROVIDERS.
NEXT SLIDE, PLEASE. FORTUNATELY, THE TEXAS LEGISLATURE HAS MADE A SIGNIFICANT INVESTMENT DURING THE 2025 LEGISLATIVE SESSION. THEY ARE USING THAT MONEY TO REVAMP AND MAKE IT SMARTER, FASTER, AND EASIER TO USE.
WE HAVE FOUR GOALS FOR THIS PROJECT THAT ARE GUIDING OUR CHANGES. PROVIDERS SHOULD BE ABLE TO COMPLETE APPLICATIONS TIMELY AND EFFICIENTLY.
THE PROCESS FOR CEMENTING APPLICATIONS OR CHANGES SHOULD BE TRANSPARENT AND PREDICTABLE. PROVIDERS, STATE STAFF SHOULD ALL BE ABLE TO WORK EFFICIENTLY IN THE SYSTEM TO REDUCE COST AND ADMINISTERED OF BURDEN, AND THE SYSTEM SHOULD BE FAST, SECURE, AND WORK AS EXPECTED. NEXT LINE, PLEASE.
HOW WILL WE ACHIEVE THIS? THE SLIDE SHOWS THE INVESTMENT STRATEGY AND HOW IT IS STRUCTURED TO MEET THESE GOALS.
WE COMPLETED OUR DIAGNOSES PHASE IN LATE FALL 2025.
THIS INCLUDED ANALYSIS OF CALL-CENTER TRENDS, ISSUES WITH SUBMITTED APPLICATIONS, RESOURCE USAGE, FREQUENTLY VIEWED PAGES, AND DIRECT PROVIDER FEEDBACK HERE AND WE MAPPED ISSUES THROUGH WORK BECAUSE OF SO WE ARE ADDRESSING WHAT DRIVES CONFUSION, REWORKS, PLAYS, NOT JUST THE SYMPTOMS. WE ARE NOW IN THE REIMAGINED PHASE.
WE ARE REVIEWING EACH MAJOR WORKFLOW STARTING WITH NEW ENROLLMENT AND REDESIGNING PROCESSES TO ADDRESS FINDINGS FROM OUR DIAGNOSIS PHASE. THIS WORK INCLUDES SIMPLIFYING REQUIREMENTS, IMPROVING USER EXPERIENCE, REWRITING THE SYSTEM AND INSTRUCTIONS IN PLAIN LANGUAGE, AND MODERNIZING INTERNAL PROCESSES AT THE SAME TIME.
AS WORKLOADS ARE FINALIZED, THEY TRANSITION INTO SYSTEM DEVELOPMENT. THAT IS THE BUILD PHASE.
WE ARE ADDRESSING PROVIDER FACING AND WORKER SITE FUNCTIONALITY SO THAT THE PEOPLE WORKING ON APPLICATIONS CAN DO THEIR WORK BETTER AND FASTER. AT THE SAME TIME WE ARE MAPPING CHANGES TO BUSINESS PROCESSES, ENSURING WE ACCOUNT FOR NEW
[00:15:02]
EFFICIENCIES AND ILLUMINATE MANUAL STEPS WERE POSSIBLE.WE WILL BE TESTING THE SYSTEM THROUGHOUT THIS PROCESS.
WE WILL LAUNCH THE SYSTEM BY THE END OF FISCAL YEAR 2027.
THE DEPLOYMENT TIMING AND APPROACH WILL BE BASED ON READINESS ACROSS THE SYSTEM WHICH INCLUDES TECHNOLOGY, STABILITY, PROVIDER PREPAREDNESS, STAFF READINESS, AND DATA EQUALITY. THIS COULD BE A PHASED APPROACH OR A FULL DEPLOYMENT AND WE AWAIT THE TRADE-OFFS OF THAT DECISION RIGHT NOW. OUR GOAL IS TO TAKE A MEASURABLE RISK APPROACH INCLUDING SOFT LAUNCH OPTIONS SO THAT THE TRANSITION IS SMOOTH AND STABLE. WE ARE ENGAGING PROVIDERS THROUGHOUT TO GET FEEDBACK ON THE SYSTEM CHANGES AND ENSURE THAT WE ARE BUILDING A SYSTEM THAT WORKS FOR PROVIDERS.
NEXT SLIDE, PLEASE. WHILE WE WORK ON THE NEW SYSTEM, WE ARE TAKING STEPS TO STRENGTHEN TODAY'S SYSTEM AND SUPPORTING PROCESSES ALONG WITH INCREASING STAKEHOLDER ENGAGEMENT APPEARED FOR AN OPERATIONS PERSPECTIVE, THE BUSINESS OPERATIONS VENDOR HAS INCREASED THEIR STAFFING BY 190% TO PROCESS APPLICATIONS FASTER. ON AVERAGE, THEY ARE REVIEWING APPLICATIONS WITHIN THREE BUSINESS DAYS OF SUBMISSION.
THEY HAVE IMPROVE IMPROVED STAFF TRAINING PROCESSES INCLUDING CROSS TRAINING STAFF TO WORK MULTIPLE APPLICATION TYPES, INCREASE AND IMPROVE TRAINING FOR THE STAFF, AND CREATING A STANDARDIZE EFFICIENCY NOTIFICATIONS WHEN RETURNING APPLICATIONS FOR CORRECTIONS. WE ARE ALSO MAKING IMPROVEMENTS TO THE PROVIDER NOTIFICATIONS AND WEBSITES TO BE CLEAR ABOUT ENROLLMENT REQUIREMENTS AND TIMELINES.
WE'VE INTRODUCED NEW TOOLS FOR PROVIDERS SUCH AS A PROVIDER ENROLLMENT CHATBOT TO HELP WITH COMMON QUESTIONS.
WE HAVE ALSO WORKED WITH THE TECHNICAL VENDOR TO MAKE CHANGES TO THE CURRENT SYSTEM INCLUDING OPTIMIZING SYSTEM INTEGRATIONS TO REDUCE THE NUMBER OF APPLICATIONS THAT GET STUCK, ENHANCING THE SYSTEM ARCHITECTURE TO MAKE THE SYSTEM FASTER AND MORE STABLE, AND INCREASING THE AMOUNT OF TIME PROPRIETORS TO FIX APPLICATIONS. THROUGHOUT THESE CHANGES, WE HAVE ENGAGED STAKEHOLDERS WITH INTENTION.
IN 2025, WE HAVE A PROVIDER ENROLLMENT WORKGROUP ACROSS THE TEXAS MEDICAID SPECTRUM IN 20 MAJOR ASSOCIATIONS.
THIS GROUP HAS ACTIVE PARTICIPANTS, HAS PROVIDED CRITICAL FEEDBACK WE MAKE QUARTERLY INPUT ON THE NEW SYSTEM AND OTHER ENROLLMENT ISSUES.
THE MANAGED CARE ORGANIZATIONS HAVE INCREASED PROVIDER OUTREACH EFFORTS TO ENSURE PROVIDERS ARE EDUCATED ON THE IMPORTANCE OF TAKING TIMELY ACTION. THEY'VE ALSO HOSTED NUMEROUS EVENTS TO PROVIDE HANDS-ON ASSISTANCE TO PROVIDE ASSISTANCE TO THOSE WHO ARE STRUGGLING. WE WILL CONTINUE TO GATHER INPUT FROM STAKEHOLDERS TO ENSURE THAT THE NEW SYSTEM MEETS THEIR NEEDS. NEXT SLIDE, PLEASE.
FINALLY I WANT TO TALK ABOUT REVALIDATION.
I MENTIONED EARLIER THAT PROVIDERS HAVE TO RENEW THEIR ENROLLMENT INFORMATION EVERY FIVE YEARS.
THIS IS KNOWN AS THE REVALIDATION PROCESS AND THIS PROCESS WAS PAUSE FOR ABOUT THREE YEARS DURING THE COVID-19 PUBLIC HEALTH EMERGENCY. SINCE THAT PROCESS HAS RESUMED, WE HAVE SEEN PROVIDERS ARE STRUGGLING TO MEET REQUIRED TIMELINES. WE KNOW THE SYSTEM NEEDS IMPROVEMENT, BUT WE ARE SEEING A LACK OF ACTION FROM SOME PROVIDERS. IT'S VERY IMPORTANT FOR PROVIDERS TO UNDERSTAND THAT THE ENTIRE REVALIDATION PROCESS MUST BE COMPLETED BY THE REVALIDATION DUE DATE.
SUBMITTING THE APPLICATION IS JUST THE FIRST STEP.
AFTER SUBMISSION, THE REVIEW THE APPLICATION, SITE VISITS MAY BE REQUIRED, AND REVIEWS MAY BE REQUIRED.
PROVIDERS MAY HAVE TO SUBMIT ADDITIONAL INFORMATION OR MAKE CORRECTIONS AFTER AN INITIAL SUBMISSION.
THE PROCESS TAKES TIME WHICH IS WHY WE ALLOW THEM TO START THE PROCESS OUT TO 180 DAYS BEFORE THE DUE DATE AND ENCOURAGE THEM TO START AS SOON AS POSSIBLE. THEY HAVE LOTS OF HELPFUL RESOURCES ON THE WEB PAGE AND WE ENCOURAGE PROVIDERS TO USE THOSE TO THEIR FULL ADVANTAGE. OVER THE LAST YEAR OR SO, THEY HAVE PROVIDED SOME REVALIDATION FLEX ABILITIES TO HELP PROVIDERS PAIRED FOR EXAMPLE, THROUGH MAY 31ST OF THIS YEAR, PROVIDERS WHO DON'T COMPLETE THE REVALIDATION PROCESS BY THEIR DUE DATE CAN RECEIVE AN EXTRA 180 DAYS TO COMPLETE THE PROCESS. WE HAVE MORE INFORMATION ABOUT THESE FLEX ABILITIES ON THE PROVIDER ENROLLMENT WEB PAGE.
HOWEVER, PROVIDERS SHOULD NOT DELAY ACTION BECAUSE OF THE FLEXIBILITIES. THEY SHOULD CONTINUE TO WORK WEAKLY AND ADHERE TO DEADLINES FOR FLEXIBILITY'S ARE TEMPORARY AND WILL END. PROVIDERS ARE EXPERIENCING DELAYS IN ENROLLMENT AND REVALIDATION DUE TO HIGH VOLUME OF REQUESTS UNDER THE OFFICE OF INSPECTOR GENERAL AND WE ARE WORKING ON CHANGES TO ENSURE THAT PROVIDERS ARE NOT DISENROLLED WELL UNDER STATE REVIEW.
WE ARE ALSO WORKING ON A RENEWED COMMUNICATION PLAN THAT WILL REVIEW ORGANIZATIONS, PROVIDER ASSOCIATIONS, TEAM HPE AND ENSURING THAT THEY ARE AWARE OF THE IMPORTS OF REVALIDATION.
IF THEY ARE STUCK OR HAVE QUESTIONS ABOUT REVALIDATION, THEY SHOULD CONTACT VIA EMAIL. I'VE LISTED THAT ON THE SITE HERE. THEY ALSO HAVE ACCESS TO THE CONTACT CENTER. THANK YOU FOR THE OPPORTUNITY TO
PRESENT TODAY. >> THANK YOU, JORDAN.
DOES ANYBODY HAVE ANY QUESTIONS? OKAY.
[00:20:06]
>> I WOULD LIKE TO RECOGNIZE NEXT RACHEL PATTON TO PROVIDE HER UPDATE ON THE IMPLEMENTATION OF SENATE BILL 379 REGARDING
GOOD MORNING. AS CHIEF O'NEILL TO ZALKOVSKY SAID, HAVE ACCESS AND AGILITY SERVICES HERE AT HHSC.
I WOULD LIKE TO TALK ABOUT THE SNAP FOOD RESTRICTION WAIVER ALSO KNOWN AS SENATE BILL 379. IN MAY, GOVERNOR ABBOTT DID NOTIFY THE USDA OF THE STATES INTENT TO SUBMIT A WAIVER TO PROHIBIT PURCHASE OF CERTAIN ITEMS WITH SNAP FUNDS.
THEY INCLUDE SWEETENED DRINKS AND CANDY.
IN THE LAST LEGISLATIVE SESSION, THE TEXAS LEGISLATURE DID PASS SENATE BILL 379 WHICH DID ALIGN WITH THOSE PROHIBITIONS.
THAT WAS SIGNED INTO LAW IN 2025.
ALSO ON JUNE 20TH WE DID SUBMIT A WAIVER TO IMPLEMENT THESE PROHIBITIONS. THEY APPROVED OUR WAIVER ON AUGUST 4TH 2025 WITH AN IMPLEMENTATION DATE OF APRIL 1ST 2026. ANYONE WANTING TO VIEW THE WAIVER CAN VIEW THAT AT THE SHOWN HERE ON THE SLIDE.
NEXT PAGE ON THE NEXT SLIDE. I WANT TO TALK A LITTLE BIT ABOUT THE DEFINITIONS ON THE RESTRICTIONS.
WE WILL TALK ABOUT TWO TODAY PEERED THE FIRST IS SWEETENED DRINKS AND THE SECOND IS CANDY. SWEETENED DRINKS ARE CERTIFIED AS A NONALCOHOLIC BEVERAGE THAT CONTAINS 5 GRAMS OR MORE OF ADDED SUGAR AND ANY AMOUNT OF ARTIFICIAL SWEETENERS.
EXCLUDED FROM THIS PROHIBITION ARE BEVERAGES THAT CONTAIN MILK OR MILK PRODUCTS, SOY, RICE, OR SIMILAR MILK SUBSTITUTES.
THOSE BEVERAGES THAT CONTAIN 50% OR MORE VEGETABLE OR FRUIT JUICE BY VOLUME. ALSO EXCLUDED ARE NATURAL SWEETENERS THAT ARE DERIVED FROM PLANTS.
THESE ARE THINGS SUCH AS STEVIA LEAK EXTRACT AND MONK FRUIT ALSO WITH 5 GRAMS OR LESS OF ADDED SUGAR.
YOUR MEDICAL GRADE ELECTROLYTES USED FOR DEHYDRATION FOR THE SECOND DEFINITION I WANT TO TALK TO ABOUT TODAY ON THE NEXT LIGHT IS GOING TO BE THE DEFINITION OF CANDY.
THIS IS ACTUALLY DEFINED IN OUR TEXAS ADMINISTRATIVE CODE AND IT IS A CONFECTION MADE WITH NATURAL OR ARTIFICIAL SWEETENERS. EXAMPLES OF CANDY INCLUDE CANDY BARS, GUMDROPS, GUM, TAFFY, NUTS OR RAISINS, FRUITS THAT HAVE BEEN CANDID, CRYSTALLIZED, GLAZED, OR COATED WITH CHOCOLATE, YOGURT, CARAMEL, OR NUTS ROASTED WITH A SWEETENER.
I WOULD LIKE TO NOTE THAT THE TERM CANDY DOES NOT INCLUDE PRODUCTS THAT ARE SPECIFICALLY USED FOR COOKING.
THESE WILL BE THINGS LIKE CHOCOLATE CHIPS OR SPARKLES.
THOSE ARE ALSO DEFINED IN THE TEXAS ADMINISTRATIVE CODE.
IF WE GO TO THE NEXT LIGHT, I WOULD LIKE TO TALK TO TODAY ABOUT OUR IMPLEMENTATION. IT BEGAN ENGAGING RETAILERS BACK IN MAY OF 2025. THE PURPOSE OF THIS ENGAGEMENT WAS TO DISCUSS THE IMPACT OF CHANGES AND ESTABLISH A TIME FRAME FOR THAT IMPLEMENTATION.
SINCE THEN, WE HAVE HELD BIWEEKLY MEETINGS WITH OUR RETAILERS ON AN ONGOING BASIS. THE PURPOSE OF THOSE MEETINGS WAS TO COORDINATE WITH OUR 22,000 RETAILERS STATEWIDE AND TO PROVIDE GUIDANCE ON THE CHANGES AND HELP TO PREPARE THEM AHEAD OF THIS IMPLEMENTATION. STAKEHOLDER WORK GROUPS BEGAN IN JULY OF 2025. THIS WAS TO PROVIDE INFORMATION TO STAKEHOLDERS AND INTERESTED PARTIES ARE AROUND THIS.
THIS INCLUDED GETTING THEIR INPUT ON COMMUNICATION MATERIALS AND VARIOUS OUTREACH STRATEGIES PEERED WE WANTED TO MAKE SURE OUR CLIENTS THAT WE SERVE AND TO UTILIZE S.N.A.P. BENEFITS ARE INFORMED OF THE CHANGES. WE HAVE ALSO PUBLISHED TOOLKITS FOR ā CLIENTS AND RETAILERS AS WELL AS OTHER DOCUMENTS.
THESE ARE THINGS LIKE FREQUENTLY ASKED QUESTIONS, CLIENT POSTERS, FLYERS, RETAILER SIGNAGE, AND GUIDANCE.
WE HAVE DEVELOPED THOSE NOT ONLY IN PARTNERSHIP WITH THE RETAILERS, BUT ALSO AS WE ARE WORKING WITH FNS.
RETAILERS ARE ALSO WORKING TO POST THINGS IN THEIR STORES TO THOSE THAT THEY SERVE AS WELL. IN ADDITION, YOU MAY HAVE SEEN OUR NEWS RELEASES AND SOCIAL MEDIA POSTS AS WELL.
IF WE GO TO THE NEXT SLIDE, I WOULD LIKE TO TALK A LITTLE BIT ABOUT THE CURRENT STATUS. WE ARE ON TRACK TO IMPLEMENT APRIL 1ST OF 2026. WE DO CONTINUE OUR STAKEHOLDER WORK GROUPS ON A BIWEEKLY CADENCE JUST TO CONTINUE OUR OUTREACH EFFORTS AND MAKING SURE WE ARE PROVIDING TECHNICAL ASSISTANCE AND A FURTHER REFINING ANY OF OUR IMPLEMENTATION PLANS WITH INPUT OF THOSE RETAILERS.
WE HAVE ALSO ADDED AN ADDITIONAL TOUCH POINT BIWEEKLY SO WE ARE TALKING TO RETAILERS WEEKLY BY PROVIDING AN ADDITIONAL
[00:25:01]
TECHNICAL ASSISTANCE OPPORTUNITY JUST TO ANSWER QUESTIONS THAT RETAILERS MAY HAVE RELATED TO PRODUCTS THAT MAY OR MAY NOT BE ALLOWED. WITH THIS IMPLEMENTATION, AS WITH OTHER S.N.A.P. BENEFITS, THE RETAILERS ARE RESPONSIBLE FOR IDENTIFYING WHICH PRODUCTS MAY BE PURCHASED WITH S.N.A.P.BENEFITS AND ENSURING THAT THEY ARE ALIGNING WITH THOSE REGULATIONS AND IN ALIGNMENT WITH THAT WAIVER.
WE ARE ALSO IN THE PROCESS OF GATHERING RETAILER ATTESTATIONS AT THIS POINT BECAUSE OUR IMPLEMENTATION DATE IS RIGHT AROUND THE CORNER. WITH THE ATTESTATION, THE RETAILERS ATTESTING TO THE FACT THAT THEY ARE READY AND AWARE OF THE CHANGES AND ARE READY TO IMPLEMENT ON APRIL 1ST.
WE ARE ALSO IMPLEMENTING A PREIMPLEMENTATION CLIENT SURVEY WHICH IS AVAILABLE AT THE SURVEY LINK AND THE QR CODE ON THE SLIDE. BECAUSE WE WOULD LIKE TO SEE THE PRE AND POST CLIENT BEHAVIOR CHANGES RELATED TO THIS WAIVER WHICH WE WOULD OF COURSE SHARE WITH FNS.
IN TERMS OF OVERSIGHT, WE WILL WORK WITH FNS TO CONTINUE THE CURRENT OVERSIGHT. THEY WILL PROVIDE OVERSIGHT AS THEY DO FOR SNAP PROGRAMS TODAY RELATED TO THE RETAILER.
IF WE GO TO THE NEXT SLIDE HERE. INCLUDED HERE ARE LINKS TO PAGES THAT HAVE CHANGES INCLUDING FREQUENTLY ASKED QUESTIONS.
YOU CAN VISIT THE SNAP PURCHASE RESTRICTIONS WHICH PROVIDES INFORMATION ON ALLOWABLE PRODUCTS, FREQUENTLY ASKED QUESTIONS AS WELL AS ANY SIGNAGE OR HELPFUL INFORMATION FOR INTERESTED PARTIES OR THOSE WE SERVE.
FOR STAKEHOLDER OR RETAILER RESOURCES, YOU CAN VISIT THE AMBASSADOR TOOLKIT. WE ALSO UTILIZE THE MONTHLY AMBASSADOR MEETINGS TO DISCUSS THIS CHANGE WITH THE RETAILERS AND ANY OTHER INTERESTED STAKEHOLDERS.
THAT CONCLUDES MY PRESENTATION FOR YOU TODAY AND I AM HAPPY TO TAKE ANY QUESTIONS THAT YOU MAY HAVE.
>> THANK YOU, RACHEL. ANY QUESTIONS FROM THE COUNCIL? NO? THANK YOU SO MUCH FOR YOUR TIME.
[3. Rule proposals]
ALL RIGHT. WE WILL NOW MOVE TO AGENDA ITEM THREE, PROPOSALS THAT HAVE BEEN SUBMITTED TO THE TEXAS REGISTER FOR PUBLICATION AND WHICH THE PUBLIC, PERIOD REQUIRED BY THE PROCEDURE ACT HAS NOT CLOSED AS OF THE DATE OF THIS COUNCILRULE 24R031 WILL BE PRESENTED BY OWEN WHEELER.
>> GOOD MORNING. MY NAME IS OWEN WHEELER.
I AM A MANAGER OF THIRD-PARTY RECOVERIES WITH THE INSPECTOR GENERAL PEERED WITH ME TODAY AND SCOTT MERCHANT, AN ATTORNEY WITH THE INSPECTOR GENERAL.
TEXAS HEALTH AND HUMAN SERVICES CAN PROPOSES RULES AND THE TEXAS ADMINISTRATIVE CODE TITLE ONE PART 15 CHAPTER 373, MEDICATED STATE RECOVERY PROGRAM. SUBCHAPTER A, SUBCHAPTER B, SUBCHAPTER C. AS A WAY OF, THE ONLY BUS RECONCILIATION ACT REQUIRES ALL STATES TO IMPLEMENT A RECOVERY PROGRAM. WE RECOVER THE COST PAID BY MEDICAID FOR LONG-TERM CARE BENEFITS RECEIVED BY CERTAIN PEOPLE ON MEDICAID UPON THEIR DEATH.
TEXAS IMPLEMENTED THE PROGRAM ON MARCH 1ST 2005.
THE PURPOSE OF PROPOSAL PROJECT TO 4R031 IS TO CLARIFY PROVISIONS IN THE MEDICAID RECOVERY PROGRAM CONSISTENT WITH APPLICABLE FEDERAL LAW. HHSC AS A STATE MEDICAID AGENCY IS REQUIRED TO OPERATE AND RECOVER THE COST OF MEDICAID LONG-TERM BENEFITS RECEIVED BY CERTAIN MEDICAID RECIPIENTS.
THE PROPOSAL ALSO IMPLEMENTS HOUSE BUILT FOR 611 REGULAR SESSION 2023 WHICH MAKES SUBSTANTIVE AMENDMENTS TO THE TEXAS GOVERNMENT CODE THAT MAKES THE STATUTE MORE ACCESSIBLE, UNDERSTANDABLE, AND USABLE. THE PUBLIC WILL BENEFIT BECAUSE THE CHANGES OF THE FINANCIAL THRESHOLD IS BASED ON FIND INFLATION RAISING THE AMOUNT PAID BY MEDICAID AND THE VALUE F THE ESTATE BEFORE IT CAN RECOVER, MEANING FEWER PEOPLE WITH LIMITED ASSETS WILL BE AFFECTED.
THE CHANGES HELPED TO MAKE THE RULES EASIER TO READ.
THESE CHANGES ARE NOT SUBSTANTIVE.
QUESTIONS? >> I THINK WE GO TO QUESTIONS AT THE END OF ALL THREE. IS THAT CORRECT?
>> THAT IS CORRECT. >> THANK YOU.
[00:30:09]
NEXT, RULE 24R093, PROPOSED RULE WILL BE PRESENTED.>> THE TEXAS HEALTH AND HUMAN SERVICES CAN IS PROPOSING NEW RULES ENTITLED 26 CHAPTER 307 SUBCHAPTER EIGHT TREND TO ESTABLISH RULES AND THE TEXAS ADMINISTRATIVE CODE FOR THE COORDINATED SPECIALTY CARE OF FIRST EPISODE PSYCHOSIS PROGRAM.
THE PROGRAM PROVIDES OUTPATIENT MENTAL HEALTH TREATMENT FOR INDIVIDUALS AGES 15 THROUGH 30 WHO ARE EXPERIENCING A FIRST EPISODE OF PSYCHOSIS. THE PROPOSED RULES CODIFY EXISTING REQUIREMENTS FOR THE IMPLEMENTATION AND PROVISION OF PROGRAM SERVICES ACROSS TEXAS. HHSC ENGAGE IN EXTERNAL STAKEHOLDERS THROUGH MEETINGS IN NOVEMBER OF 2024 AND RECEIVED INFORMAL COMMENTS IN JULY 2025. BASED ON STAKEHOLDER FEEDBACK, THEY PROVIDED THE UNIFORM ASSESSMENT TIMELINE TO TEN DAYS, REMOVED CERTAIN MEDICAL STAFF ATTENDANCE REQUIREMENTS FOR TREATMENT TEAM MEETINGS, AND CLARIFIED TRANSITION OF CARE REQUIREMENTS. THE PROPOSED RULES ARE EXPECTED
TO BE ADOPTED IN JULY 2026. >> THANK YOU.
>> RULE 26R003 PROPOSED RULE WILL BE PRESENTED BY CRYSTAL
PHELAN. >> GOOD MORNING EXECUTIVE COUNCIL. I AM CRYSTAL PHELAN, DEPUTY ASSOCIATE COMMISSIONER FOR CHILD CARE REGULATION AND PROGRAM OPERATIONS. HHSC IS UPDATING RULES ENTITLED 26 PART ONE CHAPTER 748 MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS BY PROPOSING FIVE AMENDMENTS AND ONE REPEAL. PROPOSAL PROJECT 26R003 IMPLEMENTS HOUSE BILL 3153 AND SECTION 8 TREND OF HOUSE BUILD 2789 FOR THE 89TH REGULAR LEGISLATIVE SESSION AND HOUSE BILL 16 FOR THE SECOND SPECIAL SESSION.
HOUSE BILL 3153 REQUIRES GENERAL RESIDENTIAL OPERATIONS TO CONDUCT EMPLOYMENT VERIFICATION TO THE EXTENT POSSIBLE BY CONTACTING THE PREVIOUS EMPLOYERS SUBMITTED ON THE APPLICATION. THE BILL ALSO REQUIRES GENERAL OPERATIONS TO PROVIDE A TRAINING TO THEIR STAFF ON MAINTAINING PROFESSIONAL AND APPROPRIATE RELATIONSHIPS WITH CHILDREN.
TO INCLUDE RECOGNIZING THE SIGNS OF ABUSE AND NEGLECT AND EXPLOITATION AND TO ALSO REPORT -- AND TRAINING ON REPORTING. HOUSE BUILD 2789 REMOVES MANY OF THE REQUIREMENTS RELATING TO TRESPASSING NOTICES POSTED AT GENERAL RESIDENTIAL OPERATIONS OPERATING AS A RESIDENTIAL TREATMENT CENTERS. FOR EXAMPLE, THE NOTICE IS NO LONGER NEED TO INCLUDE THE NAME AND ADDRESS OF THE PERSON UNDER WHOSE AUTHORITY THE NOTICE IS POSTED.
THE PROPOSED RULES TO RETAIN BEING AT LEAST EIGHT AND A HALF AN 11 INCHES IN SIZE, DISPLAYING THE NOTICES AND CLEARLY VISIBLE AREAS, AND ALSO HHSC PROVIDING THESE NOTICES WITHOUT CHARGE.
HOUSE BILL 16 REQUIRES THAT GENERAL RESIDENTIAL OPERATIONS DELIVERS TRAINING ON HOW TO RESPOND TO A BEHAVIOR INTERVENTION CRISIS WITH THE GOAL OF LIMITING LAW ENFORCEMENT. THIS WILL INCLUDE CRISIS INTERVENTION TRAINING AS WELL AS DE-ESCALATION.
THESE PROPOSED RULE CHANGES WILL BENEFIT THE PUBLIC WITH INCREASED PROTECTION FOR CHILDREN AND COMPLIANCE WITH STATE LAW DUE TO REMOVING SOME OF THE BURDENSOME REQUIREMENTS ON THE TRESPASSING SIGNS AND ADDING THE TRAINING TO INCREASE AWARENESS AND PROTECTION OF CHILDREN.
THANK YOU. >> THANK YOU TO ALL THE PRESENTERS. IT DOES ANY MEMBER OF THE COUNCIL HAVE QUESTIONS OR COMMENTS ON ANY OF THE RULES AND AGENDA ITEM THREE? OKAY.
[00:35:08]
>> OTHER THAN THEY ARE STILL OPEN FOR PUBLIC COMMENT.
>> ARE THERE ANY PUBLIC COMMENT CARDS?
>> CHIEF, ZALKOVSKY, THERE ARE NO PUBLIC COMMENT CARDS FOR AGENDA ITEM 3A. THIS CONCLUDES THE PUBLIC
COMMENT FOR AGENDA ITEM 3A. >> THANK YOU.
[4. Advisory committee recommendations]
WE WILL NOW MOVE ON TO AGENDA ITEM FOUR, ADVISOR COMMITTEE RECOMMENDATIONS BUT I WOULD LIKE TO INTRODUCE AND WELCOME THE ADVISORY CHAIR TO LAY OUT THE RECOMMENDATIONS PREPARED BY MEMBERS OF THE TEXAS WELL ADVISORY COMMITTEE.>> THANK YOU FOR ALLOWING ME TO BE HERE TODAY.
I WAS JUST SHOWING YOU WHAT MY CHAIR EXERCISE WAS FOR THE AGING TEXAS ADVISORY COMMITTEE THAT WE RECOMMEND.
MY NAME IS IT RAMSEY AND I AM THE CHAIR OF THE COMMITTEE.
THE RECOMMENDATIONS AND ARE PREPARED FOR YOU ARE BY THE MEMBERS OF THE COMMITTEE AND THE OPINIONS AND SUGGESTIONS EXPRESSED IN RECOMMENDATIONS ARE THE MEMBERS OWN AND DO NOT REFLECT THE VIEWS OF THE TEXAS HEALTH COUNCIL, THE TEXAS SERVICE COMMISSION ALTHOUGH, THE COMMISSIONER STAFF DID HELP ME PREPARE THIS RESEARCH REPORT TO MAKE ITS A SINK FOR YOU.
THIS IS A REMINDER THAT AGING TEXAS WELL ADVISORY COMMITTEE WAS ESTABLISHED IN 2005 WITH THE PURPOSE AND THE TASK OF THE COMMITTEE TO ADVISE THE EXECUTIVE COMMISSIONER TO MAKE RECOMMENDATIONS AND STATE LEADERSHIP ON MATTERS SUCH AS IDENTIFYING AND DISCUSSING AGING POLICY ISSUES, ASSESSING THE STATE GOVERNMENT READINESS TO ADDRESS ISSUES FACING OLDER TEXANS, TO PROMOTE LOCAL COMMUNITY PREPAREDNESS FOR AGING TEXANS, TO ASSIST BY PROVIDING RECOMMENDATIONS ON AGING ISSUES, AND THE AGING TEXAS STRATEGIC PLAN AND TO ADOPT BYLAWS FOR THE OPERATIONS OF THE COMMITTEE WHICH WE RECENTLY DID.
NOW GETTING INTO THE RECOMMENDATIONS FOR DURING THE FISCAL YEAR 2025, WE IDENTIFIED FOUR PRIORITY AREAS THAT WERE CONSIDERED AND ADOPTED WHICH INCLUDED SOCIAL ENGAGEMENT RELATED TO ISOLATION, AFFORDABLE HOUSING, FAMILY CAREGIVING, AND HEALTH AND LONG-TERM CARE. THE FOLLOWING RECOMMENDATIONS FOR EACH PRIORITY PROVIDE THE BROAD SCOPE OF RECOMMENDATIONS ACROSS ALL FOUR PRIORITIES. YOU CAN REFER TO THE POSITION STATEMENT FOUND IN APPENDIX B ON PAGE 26 OF AGING TEXAS WELL STRATEGIC PLAN UPDATE FOR '26 AND R '27 FOR A DETAILED PRIORITY SPECIFIC RECOMMENDATIONS.
TO GET INTO OUR SIX RECOMMENDATIONS THAT WE DISCUSSED, RECOMMENDATION ONE IS TO INTEGRATE AGING AND SOCIAL CONNECTION INTO POLICY AND PLANNING.
BY PROVIDING AGING SOCIAL CONNECTION AND CAREGIVER CONSIDERATIONS ACROSS STATE AND LOCAL POLICYMAKING INCLUDING HOUSING, TRANSPORTATION, HEALTH, WORKFORCE, LAND USE AND DIGITAL INFRASTRUCTURE. YOU PROACTIVELY SUPPORT AGING IN PLACE AND REDUCE ISOLATION. RECOMMENDATION 2.
STRENGTHEN COMMUNITY-BASED INFRASTRUCTURE FOR AGING IN PLACE. THIS IS TO INVEST IN SCALABLE COMMUNITY-BASED SOLUTIONS THAT EXPAND AFFORDABLE HOUSING, PROMOTES SOCIAL ENGAGEMENT, AND SUPPORTS CAREGIVERS AND LEVERAGE LOCAL PARTNERSHIPS WITH ATTENTION TO REGIONAL AND RURAL INTERESTS. RECOMMENDATION THREE.
IMPROVE SYSTEM COORDINATION AND PERSON CENTERED NAVIGATION.
ADVANCED INTEGRATED PERSONAL SYSTEMS THAT SEMPER FI ACCESS ACROSS HEALTH CARE, LONG-TERM SERVICES, AND SUPPORTS HOUSING, CAREGIVING RESOURCES ARE ALIGNED WITH NO WRONGDOER PRINCIPAL.
[00:40:02]
RECOMMENDATION FOR COKE. SUPPORT AND SUSTAIN CAREGIVING WORKFORCE. STRENGTHEN THE DIRECT CARE WORKFORCE AND FAMILY CAREGIVING CAPACITY THROUGH SUSTAINABLE FUNDING, TRAINING, CAREER PATHWAYS, RESPITE, AND CAREGIVING FRIENDLY WORKPLACE POLICIES.RECOMMENDATION FIVE. LEVERAGE TECHNOLOGY AND DATA TO EXPAND ACCESS AND IMPACT. THIS IS TO EXPANDED DIGITAL INCLUSION, TELEHEALTH, AND DATA INFORMED DECISION-MAKING TO IMPROVE ACCESS, SERVICE DELIVERY, AND OUTCOMES PARTICULARLY IN RURAL COMMUNITIES.
AND THE LAST RECOMMENDATION, RECOMMENDATION SIX, IS TO PROMOTE EARLY PLANNING, AWARENESS, AND SHARED RESPONSIBILITY. IT IS TO ENCOURAGE EARLY AND INFORM PLANNING FOR AGING, CAREGIVING, HOUSING, AND LONG-TERM CARE THROUGH PUBLIC AWARENESS, EDUCATION, AND ENGAGEMENT. SHARING RESPONSIBILITY AMONG INDIVIDUALS, FAMILIES, COMMUNITIES, EMPLOYERS.
WE RECOGNIZE THAT MANY OF OUR RECOMMENDATIONS ARE GEARED MORE TOWARDS STATE LEADERSHIP. SPECIFICALLY HOWEVER, IT CAN ASSIST IN MOVING THE RECOMMENDATIONS FORWARD BY LEADING CROSS SECTOR COLLABORATION AND COORDINATION FOR AGING POLICY PARTICULARLY IN HOUSING, TRANSPORTATION, AND DISASTER. ALIGNING BROADBAND, TELEHEALTH, DIGITAL LITERACY EFFORTS WITH AGING OUTCOMES, PARTICULARLY FOR RURAL AND ISOLATED TEXANS. REINFORCING POLICIES THAT INTEGRATE CAREGIVERS AS WELL AS COORDINATING RESPITE, TRAINING, AND NAVIGATION EFFORTS ACROSS PROGRAMS. ALIGNING PROGRAMS UNDER NO WRONGDOER AND PERSON CENTERED PRINCIPLES. JUST TO REMIND YOU WHAT NO WRONGDOER MEANS IS ANY INDIVIDUAL MAY SEEK HELP AND CONTACT ANY PART OF THE ORGANIZATION REGARDLESS OF THE INITIAL ENTRY POINT MUST BE GUIDED, TRANSFERRED, AND DIRECTLY CONNECTED TO THE APPROPRIATE SERVICE.
DO NOT TURN AWAY OR MERELY REDIRECT INDIVIDUALS.
INSTEAD, STAFF MUST ASSESS THEM AND NAVIGATING TO THE CORRECT DEPARTMENT EXTERNAL PARTNER. THAT CONCLUDES MY RECOMM RECOMMENDATION. HOPEFULLY YOU WILL HAVE NO REAL QUESTIONS FOR ME. I WILL HAVE TO GO FIND AN ANSWER
IF YOU DO. >> WE ARE ABOUT TO FIND OUT IF WE HAVE QUESTIONS. DOES ANY MEMBER OF THE COUNCIL
HAVE QUESTIONS OR COMMENTS? >> I DO HAVE A COMMENT.
THANK YOU FOR TRAVELING TO BE HERE WITH US TODAY.
HELPING TO PROVIDE INFORMATION TO THE COMMISSION AND THE WORK HERE. THANK YOU.
>> THANK YOU. I APPRECIATE THAT.
>> I WOULD LIKE TO SECOND THAT APPEARED I HAVEN'T SEEN YOU IN A WHILE AND IT'S GREAT TO SEE YOU TODAY.
I KNOW THAT YOU NOTED MOST OF THE RECOMMENDATIONS ARE FOR STATE LEADERSHIP, MAYBE NOT NECESSARILY US, BUT WE DO HAVE A LOT OF INITIATIVES UNDERWAY RELATED TO THOSE TOPICS.
WE KNOW THERE CAN BE MORE WORK THAT IS DONE.
THANK YOU. >> I HAVE BEEN ENJOYING WORKING WITH YOU IN THE PAST. I'M IN MY SUNSET YEARS, YOU KNOW. SO I STUMBLE UPON THIS ADVISORY COMMITTEE. I'M TRYING TO FIGURE MY PLACE IN IT, BUT I FEEL COMFORTABLE WORKING WITH THE STATE.
OF COURSE, I FEEL COMFORTABLE WORKING WITH MY AGE GROUP, I THINK. STILL TRYING TO GET THERE, BUT I APPRECIATE ALL YOUR COMMENTS. THANK YOU VERY MUCH.
>> THANK YOU. >> AND NOW I WILL SHOW YOU MY
EXERCISE. >> ARE THERE ANY PUBLIC COMMENT
CARDS? >> CHIEF, ZALKOVSKY, THERE ARE NO PUBLIC REGISTRANTS FOR AGENDA ITEM 4A.
CHIEF ZALKOVSKY, BEFORE HE MOVED TO AGENDA ITEM 5, WE RECEIVED ONE PUBLIC REGISTERING CARD. MS. DIANE LANE.
GIVE US A MOMENT FOR HER TO COME UP HERE.
I WORK IN THE MENTAL HEALTH FIELD.
I DO CREDENTIALING FOR PROV PROVIDERS.
WE ALSO HAVE A GROUP OF THERAPISTS THAT I WORK WITH THAT I DO BUILDING AND CREDENTIALING FOUR.
IN THE PAST YEAR, IT HAS BEEN IMPOSSIBLE TO GET PROVIDERS ONTO MEDICAID AND I'M JUST SPEAKING FROM MY HEART.
I DON'T REALLY HAVE ANYTHING PREPARED, BUT I HAVE A PROVIDER
[00:45:06]
PSYCHOLOGIST THAT HE JUST GOT CREDENTIALED YESTERDAY.HE HAS BEEN WAITING SINCE NOVEMBER OF LAST YEAR AND IT TOOK US CALLING OUR CONGRESSMEN TO GET HIM CREDENTIALED ON MEDICAID. I REALLY DON'T KNOW WHERE THE DISCONNECT IS, BUT HERE'S WHAT WE ARE RUNNING INTO.
MENTAL HEALTH PROVIDERS CAN'T GO ON MEDICAID.
THEY HAVE TO GET ON MEDICARE FIRST.
SO IT TAKES THEM 3-6 MONTHS TO GET ON MEDICARE AND IT TAKES 6-9 MONTHS TO GET ON MEDICAID. THEN THEY HAVE TO GET ON THE MCO'S WHICH IS SUPERIOR COMMUNITY FIRST AND THE ONES THAT HELP THE CHILDREN. SO BY THE TIME A THERAPIST GETS CREDENTIALED, AND ORDER TO OFFER THEIR CLIENTS MEDICARE MEDICAID, IT'S A YEAR. AND BY THEN, THEY ARE ALREADY ON ALL OF THE COMMERCIAL PANELS AND THEY HAVE ENOUGH CLIENTS, THEY DON'T NEED MEDICAID CLIENTS. AND MEDICAID PAYS LESS.
SO THIS IS KEEPING OUR THERAPISTS FROM BEING ABLE TO SEE A MEDICAID AND MEDICARE FOR MENTAL HEALTH.
I DON'T KNOW WHAT THE ANSWER IS, BUT I'M SURE THERE'S AN ANSWER OUT THERE. I KNOW THAT IN THE PAST WE HAVE GOTTEN A HOPEFUL NEWS THAT IF WE GOT ON MEDICAID, WE WOULD BE ON THE MCO BUT THAT NEVER HAPPENED. I THINK IT REALLY NEEDS TO BE UNDERSTOOD THAT THERE IS A REAL BLOCKADE HERE FROM US BEING ABLE TO SERVE THE MEDICAID AND MEDICARE POPULATION.
WE ARE IN SAN ANTONIO AND SO THAT POPULATION IS BIG.
WE ARE UNABLE TO GET OUR PROVIDERS -- I'VE ACTUALLY BEEN FIRED BY A COUPLE PEOPLE FOR CREDENTIALING BECAUSE MEDICAID TOOK SO LONG TO GET THEM ON. THERE'S NOTHING I CAN DO ABOUT IT. I JUST REALLY HOPE THAT IT CAN BE UNDERSTOOD THAT THIS IS A REAL BLOCKADE FOR THE MEDICAID CLIENTS. AND JUST ONE LAST THING, IT IS AS HARD TO GET A PROVIDER OFF OF MEDICAID AS IT IS TO GET THEM ON IT. BECAUSE YOU HAVE TO GO BACK IN AND DO THE WHOLE SYSTEM AGAIN TO REMOVE YOURSELF FROM MEDICAID AND SO THERE'S A LOT OF PROVIDERS OUT THERE THAT ARE SIGNED UP FOR MEDICAID, BUT NOT TAKING MEDICAID CLIENTS.
IT JUST... IT JUST MAKES A COPY OF THE WHEEL NOT TURN ANYMORE BECAUSE THERE'S PEOPLE STUCK ON THERE AND IT'S TOO MUCH TROUBLE TO GO IN AND TAKE THEMSELVES BACK OFF SO THEY DON'T DO IT. I APPRECIATE YOUR TIME AND HOPE THAT YOU CAN TAKE TO HEART THAT THIS IS A POPULATION THAT NEEDS THE MENTAL HEALTH HELP AND WE ARE HAVING A HARD TIME GETTING
IT TO. >> THANK YOU FOR YOUR COMMENTS.
WE HEARD FROM JORDAN EARLIER ABOUT PAINS.
I WILL SAY, WE RECOGNIZE THIS AS AN ISSUE.
WE WANT NOTHING MORE THAN OUR PROVIDERS TO HAVE AN EASY TIME IN ROLLING AND OUR CLIENTS TO HAVE AN EASY TIME GETTING ACCESS TO SERVICES. THAT IS THE INTENT BEHIND THE REDESIGN. NOT TO ONLY MAKE A SYSTEM THAT LOOKS GOOD, BUT HAS PROCESSES BEHIND IT THAT WORK AND REDUCE ADMINISTRATIVE BURDEN AND PULL INFORMATION FROM MEDICARE AND OTHER PLACES SO THEY DON'T NEED TO ENTER MULTIPLE TIMES.
I JUST WANT TO LET YOU KNOW I HEAR YOU.
WE ARE WORKING ON IT. BY THE END OF NEXT SUMMER, ALTHOUGH WE ARE WORKING ON THE CURRENT SYSTEM TO MAKE THINGS EASIER, BUT ALSO REDESIGNING THE SYSTEM BY THE END OF NEXT SUMMER, THE NEW SYSTEM SHOULD BE IN PLACE.
I THINK IT WILL BE HOPEFULLY WORTH THE WAIT, BUT WE ARE TRYING TO EASE THINGS WITH THE CURRENT PROCESS AS WELL.
IF YOU CAN STAY FOR A FEW MINUTES AFTER THE MEETING, I WOULD LIKE TO TALK TO A LITTLE BIT MORE IF YOU CAN.
>> OKAY. I THINK ONE THING TO CONSIDER, I DON'T KNOW WHY MEDICAID DOES NOT USE CAQ H.
AS MUCH AS I DON'T LIKE UNITED HEALTH, THEY DO HAVE A REALLY GOOD CREDENTIALING SYSTEM AND THEY PULL EVERYTHING AND I REALLY WISH THAT MEDICAID COULD DO THE SAME THING BECAUSE IT
WOULD SPEED THE PROCESS UP. >> WE HAVE LOOKED INTO THAT.
WE ARE LOOKING AT ALL OPTIONS AS PART OF THE REDESIGN.
THANK YOU. DOES ANYBODY ELSE HAVE COMMENTS
OR QUESTIONS? >> THANK YOU SO MUCH FOR COMING TODAY. THAT'S OKAY.
IT IS ONLY WHEN PEOPLE WHO ARE IN IT EVERY DAY TAKE THAT EXTRA INITIATIVE AND TELL US WHAT THEY ARE EXPERIENCING.
IT HELPS US DO GOVERNMENT WORKS SO MUCH BETTER.
JUST KNOW THAT YOUR EFFORTS ARE REALLY APPRECIATED.
THANK YOU FOR TAKING THE TIME. >> THANK YOU VERY MUCH.
[00:50:15]
>> THIS CONCLUDES THE PUBLIC COMMENT.
I TURN THE FLOOR OVER TO YOU. >> ALL RIGHT.
THIS CONCLUDES ALL BUSINESS -- WE HAVE NO MORE PUBLIC COMMENT, CORRECT? THIS CONCLUDES ALL BUSINESS ON THE AGENDA. THANK YOU TO THE COUNCIL MEMBERS FOR YOUR TIME. PLEASE NOTE FOR THE RECORD
* This transcript was compiled from uncorrected Closed Captioning.