[1. Welcome and opening remarks]
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>> GOOD MORNING, THIS MEETING WILL COME TO ORDER, MAY THE RECORD REFLECT THAT THIS MEETING OF THE HHSC EXECUTIVE COUNCIL CONVENED AT 10:04 A.M. ON APRIL 23RD 2026, WILL YOU PLEASE
CALL THE ROLL. >> GOOD MORNING MY NAME IS TESSA I'M THE HHSC EXECUTIVE COUNCIL LIAISON, MEMBERS WHEN I CALL YOUR NAME PLEASE RESPOND WITH HEAR AND PRESENT.
>> JORDAN DIXON. >> SYLVIA HERNANDEZ-
>> DR. JENNIFER SHUFORD. >> PRESENT.
>> RAYMOND CHARLES WINTER. >> 15.
>> AND EMILY ZALKOVSKY. >> HERE.
>> I WOULD LIKE TO ACKNOWLEDGE THAT JENNIFER DEPUTY COMMISSIONER OF OPERATIONS IS PRESENT TODAY ON BEHALF OF THE DEPARTMENT OF FAMILY PROTECTIVE SERVICES COMMISSIONER, AUDREY O'NEILL. AND HEATHER FLEMMING IS HERE ON BEHALF OF JORDAN DIXON FOR BEHAVIORAL HEALTH SERVICES AND AGING. THIS CONCLUDES THE ROLL CALL.
>> THANK YOU CAN YOU GO AHEAD AND PROVIDE THE MEETING
LOGISTICS FOR THE PARTICIPANTS. >> GOOD MORNING MY NAME IS KAYLA CATES BROWN EXECUTIVE DIRECTOR OF THE ADVISORY DIRECTOR, COORDINATION OFFICE. FOR THOSE PARTICIPATING IN PERSON PLEASE SPEAK DIRECTLY INTO THE MICROPHONE SO YOUR VOICE AND COMMENTS ARE HEARD, THE BROADCAST FROM TODAY'S MEETING AND THE RELATED MATERIALS WILL BE AVAILABLE ON THE HHSC WEBSITE AT HHS.TEXAS.GOV.
FROM THE HOME PAGE SELECT ABOUT AND IN THE TOP NAVIGATION BANNER THEN CHOOSE LIVE AND ARCHIVED MEETINGS FROM THE DROP-DOWN MENU. RELATED MEETING MATERIALS CAN BE FOUND BY CLICKING THE LINK FOR THE HEALTH AND HUMAN SERVICES COMMISSION EXECUTIVE COUNCIL. MEMBERS OF THE PUBLIC WHO WISHED TO PROVIDE ON SITE COMMENTS AND DID NOT PRE-REGISTER SHOULD COMPLETE THE PUBLIC COMMENT REGISTRATION FORM AND HAND IT IN TO THE FACILITATOR AT THE DOOR. PUBLIC COMMENTS ON ALL AGENDA ITEMS WILL BE TAKEN DURING AGENDA ITEM FOUR.
AND MAY BE LIMITED TO 3 MINUTES. EXECUTIVE COMMISSIONER I
RETURNED THE FLOOR TO YOU. >> THANK YOU WE WILL START THE MEETING TODAY WITH AGENDA ITEM 1C WHICH IS OPENING REMARKS AND I HAVE A FEW UPDATES THAT I WANT TO SHARE.
THIS IS OUR FIRST MEETING SINCE THE AGENCY REALIGNMENT THAT OCCURRED ON APRIL FIRST, SO WE HAVE A COUPLE OF NEW MEMBERS REPRESENTED TODAY ON THE COUNCIL SO I WANT TO RECOGNIZE DAVID WHO IS REPRESENTING REGULATORY, WOOD WHO IN ADDITION TO THE CHIEF FINANCIAL OFFICER HAS ASSUMED RESPONSIBILITIES OF THE CHIEF OPERATING OFFICER, MOLLY REGAN WHO IS THE HEAD OF FAMILY RESOURCES AND ELIGIBILITY SERVICES AND SILVIA HERNANDEZ WHO WAS HERE IN HER ROLE AS OUR CHIEF INFORMATION OFFICER.
AND JORDAN DIXON WHO WAS NOT HERE BUT HEATHER FLEMMING WHO WAS REPRESENTING HER HERE, SHE WAS PREVIOUSLY ON THE COUNCIL BUT SERVED IN A DIFFERENT ROLE SO NOW SHE WILL BE REPRESENTING BEHAVIORAL HEALTH, VISIBILITY AND AGING SERVICES.
SO WE ARE VERY EXCITED ABOUT THAT REALIGNMENT AND THE FOCUS ON THE PROGRAMS AND THE POPULATIONS THAT WE SERVE, AND I WANT TO WELCOME ALL THE NEW MEMBERS TO THE COUNCIL.
AND ALSO, A BITTERSWEET CONGRATULATIONS TO DR. SHUFORD FOR HER APPOINTMENT AS A -- DEPUTY DIRECTOR AND CHIEF MEDICAL OFFICER AS THE CENTERS FOR DISEASE CONTROL AND PREVENTION WHICH, IT IS A GREAT LOSS FOR THE STATE OF TEXAS BUT A GREAT WIN FOR THE COUNTRY. SO WE APPRECIATE EVERYTHING THAT YOU HAVE DONE IN YOUR ROLE AS THE HHSC COMMISSIONER BUT THANK YOU FOR YOUR SERVICE AND TO THE STATE AND THE COUNTRY AND I KNOW YOU WILL REMEMBER TEXAS WHEN YOU WERE AT THE CDC AS W WELL. WE ARE WORKING ON READJUSTING AND ADJUSTING OUR APPROACH A LITTLE BIT WITH THE EXECUTIVE COUNCIL AND WE WANT IT FOCUS ON TRANSPARENCY, PROVIDE AGENCY UPDATES BUT REALLY PRESENT THE OPPORTUNITY ALSO TO HAVE INPUT
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FROM OUR KEY STAKEHOLDERS, WE TRULY VALUE THAT STAKEHOLDER INPUT AS I LIKE TO SAY IT IS WITH GOOD INFORMATION THAT WE MAKE A DECISION SO THE PURPOSES OF SOME OF THE TRANSITIONS THAT YOU WILL BE SEEING IN THE WAY WE APPROACH THE COUNCIL ARE REALLY INTENDED TO MAXIMIZE THAT VALUE OF STAKEHOLDER INPUT.A COUPLE OF THINGS I WILL PROVIDE AN UPDATE ON IS THE REVIEW. AS YOU KNOW THE HEALTH AND UNIT SERVICES COMMISSION CONTINUES TO WORK WITH SUNSET THROUGH THE REVIEW PROCESS. ONE THING I WANTED TO BE SURE THAT EVERYONE IN ATTENDANCE WAS AWARE IS THAT THE PUBLIC HAS UNTIL THE END OF APRIL TO PROVIDE COMMENTS TO THE SUNSET TEAM AND YOU CAN FIGURE OUT HOW TO CONTACT THEM EITHER THROUGH THEIR WEBSITE DIRECTLY BUT THERE IS ALSO MORE INFORMATION THAT IS AVAILABLE ON THEIR REVIEW PAGE ON THE HHSC WEBSITE.
THERE HAS BEEN A LOT OF LEGISLATIVE ACTIVITY, THE AGENCY IS WORKING ON ASSESSING THE AGENCY NEEDS THROUGH THE LEGISLATIVE APPROPRIATIONS REQUEST PROCESS, AND I THINK FOR THOSE OF YOU THAT MAY HAVE TUNED IN TO THE SENATE HEALTH AND HUMAN SERVICES COMMITTEE MEETING A FEW WEEKS AGO ONE OF THE THINGS THAT THE AGENCY IS VERY AWARE OF IS WITH SOME OTHER CHANGES AND I BELIEVE IT WAS TWO MEETINGS AGO, WE SHARED THE CHANGES RELATED TO THE SNAP PROGRAMME AND THE FEDERAL FUNDS RELATED TO THAT AND WE ARE REALLY FACING BUDGET CLIMATE THAT IT IS GOING TO BE A SIGNIFICANT ASK POTENTIALLY FROM THE HEALTH AND HUMAN SERVICES AGENCIES TO CONTINUE TO DO WHAT WE ARE DOING TODAY. WE ARE REALLY FOCUSED ON FISCAL RESPONSIBILITY AS WE DESIGN THAT BUT ALSO AS WE LOOK AT OUR OPERATIONS TODAY TO ENSURE THAT WE ARE MAXIMIZING -- MAXIMIZING THOSE FUNDS THAT ARE GOING TO OUR CLIENT SERVICES.
WITH THAT I WILL TURN IT OVER TO DR. SHUFORD.
>> THANK YOU, THANK YOU FOR HAVING ME TODAY AND GIVING ME TIME TO GIVE A SHORT UPDATE ABOUT THE SHS, A LOT OF WHAT I SAY WILL ECHO WHAT THE EXECUTIVE COMMISSIONER JUST SAID, WE TWO ARE GETTING TOGETHER OUR LAR, WE HAVE A PUBLIC HEARING ON APRIL 30TH AT THE DSHS BUILDING MORTON AND WE WILL BE SEEKING PUBLIC INPUT AND THIS HAS BEEN A FANTASTIC FORUM FOR US TO HEAR DIRECTLY FROM RESIDENTS OF OUR STATE AS WELL AS OUR STAKEHOLDERS ABOUT WHAT IS IMPORTANT TO THEM AND WHAT THEY NEED TO SEE WITH HOW WE CAN BEST REPRESENT THE NEEDS OF THE STATE AND UPCOMING LEGISLATIVE SESSION.
WE LOOK FORWARD TO -- INPUT AT THAT TIME.
WE ARE ALSO UNDERGOING SUNSET REVIEW ALONG WITH THE OTHER HEALTH AND HUMAN SERVICES AGENCIES HERE AND IF YOU GO TO OUR WEBSITE AT THE TOP THERE IS A YELLOW BANNER THAT TALKS ABOUT SUNSET REVIEW AND HOW YOU CAN GIVE FEEDBACK AND I WANT TO THANK ALL OF OUR PARTNERS AND STAKEHOLDERS ACROSS THE STATE AS WELL AS MY OWN EMPLOYEES WHO HAVE BEEN GIVING INPUT TO THE SUNSET COMMISSION STAFF IN ORDER TO REALLY MAKE OUR AGENCY BETTER FOR THE FUTURE AND SO I APPRECIATE THE TIME THAT EVERYONE HAS DEDICATED TO THAT. GIVING YOU A FEW UPDATES ABOUT THINGS THAT I MENTIONED PREVIOUSLY, I TALKED ABOUT THE PARASITIC FLY THAT CAN CAUSE INFESTATIONS USUALLY WE SEE IT IN ANIMALS BUT ALSO IT CAN BE IN HUMANS, AND THERE HAVE BEEN ADDITIONAL ANIMAL CASES IDENTIFIED WHICH IS ONE OF THE NORTHERN STATES OF MEXICO RIGHT ACROSS OUR TEXAS BORDER.
AND SO WE ARE LOOKING -- WE ARE ON HIGH ALERT LOOKING FOR CASES IN THE UNITED STATES, WE ARE ALSO JUST STRENGTHENING THE RELATIONSHIP AND COMMUNICATION BETWEEN US AND THE TEXAS ANIMAL HEALTH COMMISSION, PARKS AND WILDLIFE AND MAKING SURE THAT WE ARE COMMUNICATING WELL SO THAT ANYTHING THAT IS THREATENING TO COME INTO OUR STATE OR ANY SUSPECTED CASES HERE IN TEXAS ARE ACTED ON IMMEDIATELY. AND WE'VE HAD A FEW CASES WHERE WE HAVE ACTED TO RULE OUT THIS, SO I FEEL LIKE OUR PROCESS IS BEING REFINED AND WE ARE IN A GOOD POSITION AS A STATE TO RESPOND IF AND WHEN THAT HAPPENS.
THE WORLD CUP PREPARATIONS, I'VE TOLD YOU ABOUT THAT AS WELL, IT'S A HUGE EVENT THAT'S HAPPENED NATIONALLY, BUT IN TEXAS WE ARE HOSTING TWO VENUES FOR THESE GAMES, HOUSTON AND THE DALLAS AREA. THOSE GAMES START ON JUNE 14TH, FOR TEXAS, THEY START ON JUNE 14TH AND END ON JULY 14TH.
THERE WILL BE NINE GAMES PLAYED, THERE WILL BE SEVEN GAMES DOWN IN THE HOUSTON AREA YET THERE'S ALSO INTERNATIONAL MEDIA HUB IN
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THE DALLAS AREA. SO WE ARE EXPECTING A LOT OF TRAFFIC THROUGH TEXAS AND SO WE EXPECT TEAMS TO BE ARRIVING HERE IN MAY TO BE PRACTISING AND PREPARING FOR THOSE GAMES.SO WE LIKEWISE ARE PREPARING, WE ARE INCREASING OUR DISEASE MONITORING BUT AGAIN WE ARE STRENGTHENING OUR RELATIONSHIPS WITH OTHER AGENCY PARTNERS ACROSS THE STATE OUR LOCAL HEALTH DEPARTMENT AND OTHER LOCAL JURISDICTIONAL PARTNERS AND THEN WORKING WITH FEDERAL AGENCIES AS WELL TO MAKE SURE THAT TEXAS IS READY TO RESPOND TO ANY SORT OF THREAT BE IT SOMETHING FOR INFECTIOUS DISEASE, OTHER DISEASES, OTHER HEALTH CONDITIONS, THINGS LIKE HEAT RELATED ILLNESSES, OR ANY OTHER SORT OF MEDICAL OR PUBLIC HEALTH RESPONSES THAT NEED TO HAPPEN, DSHS WILL BE THERE TO RESPOND.
WE ARE ALSO FOLLOWING MEASLES CASES THAT ARE HAPPENING ACROSS THE UNITED STATES BUT IN TEXAS AS WELL WE'VE HAD 180 CASES DOCUMENTED THIS YEAR AND 2026, THIS IS NOTHING COMPARED TO 762 CASES THAT WE CONFIRMED CASES THAT WE DOCUMENTED DURING 2025 BUT THIS STILL REPRESENTS A MUCH HIGHER CASE COUNT THAN WHAT WE HAD SEEN IN YEARS PRIOR TO LAST YEAR AND SO WE ARE UPDATING THOSE CASE COUNTS ON OUR WEBSITE EVERY WEEK SO BE SURE TO CHECK THERE AND IT'S BROKEN DOWN BY COUNTY SO EVERYONE CAN UNDERSTAND WHAT THAT WOULD LOOK LIKE IN THEIR SPECIFIC COMMUNITY. AND THEN THE ONLY LAST THING I WAS GOING TO SAY IS THAT I'M VERY EXCITED ABOUT THE POSITION THAT'S BEING OFFERED TO ME AT CDC AS THE CHIEF MEDICAL OFFICER AS THE OPPORTUNITY THAT I HAVE THERE HOWEVER, I LOVE TEXAS, I LOVE DSHS, THE PEOPLE I WORK WITH ARE THE MOST DEVOTED PUBLIC SERVANTS AND PUBLIC HEALTH AND SERVICE TO TEXANS IS IN THEIR BLOOD AND I WILL MISS THAT COMMUNITY OF MY FOLKS AT DSHS AND LOCAL HEALTH PARTNERS ALL ACROSS THE STATE.
KNOW THAT I WILL BE MISSING TEXAS LIKE CRAZY BUT EXCITED FOR THOSE NEXT OPPORTUNITIES SO THANK YOU.
>> THANK YOU DR. SHUFORD. NEXT WE WILL HEAR FROM THE DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES AND I WILL
TURN IT OVER TO JENNIFER. >> GOOD MORNING, A COUPLE OF THINGS WE WANTED TO SHARE WITH IT UNIVERSE, FIRST WE ARE EXCITED TO ANNOUNCE THE PLATFORM WHICH IS THE SEARCH ENGINE FOR MULTI-AGENCY REPORTABLE CONDUCT, EASY TO SPELL NOT EASY TO SAY.
THIS IS ACROSS AGENCY BACKGROUND CHECK SYSTEM SO THAT THE AGENCIES THAT ARE INVOLVED IN THIS AT THE DEPARTMENT OF FAMILY PROTECTIVE SERVICES THE HEALTH AND HUMAN SERVICES COMMISSION, TEXAS EDUCATION AGENCY AND TEXAS JUVENILE JUSTICE DEPARTMENT.
ALL OF THOSE AGENCIES WILL BE SHARING INFORMATION ABOUT INDIVIDUALS WHO PROBABLY SHOULD NOT BE WORKING WITH THE POPULATIONS THAT ARE SERVED UNDER THOSE DIFFERENT AGENCIES WE WILL BE SHARING BACKGROUND INFORMATION, IF AN EMPLOYEE HAS BEEN EMPLOYED AT ONE AGENCY THAT INFORMATION WILL BE SHARED WITH ANOTHER AGENCY, THE LEGISLATURE CALLED THIS PASSING THE TRASH, THEY DID NOT WANT PEOPLE WHO WERE NOT GOOD PEOPLE TO BE WORKING WITH DIFFERENT POPULATIONS ACROSS THE STATE.
CMARQ HAS BEEN YEARS IN THE MAKING AND IT ROLLED OUT IN APRIL FIRST WE STARTED WITH OUR FIRST GROUP, TEXAS JUVENILE JUSTICE DEPARTMENT STARTED PROCESSING BACKGROUND CHECKS USING THE CMARQ SYSTEM AS OF I THINK LAST WEEK AT THE END OF LAST WEEK WE'VE DONE 800 CHECKS SO FAR FOR THEM, THEY ARE RELATIVELY SMALL IT WAS A GOOD GROUP TO START WITH, THE NEXT GROUP IS A BIT BIGGER, AND GOING TO POSE POTENTIALLY SOME MORE CHALLENGES, TEXAS EDUCATION AGENCY WILL START ROLLING IN ON MAY THE FIRST, AS YOU MAY KNOW THERE'S ABOUT 1200 SCHOOL DISTRICTS ACROSS THE STATE SO THAT WILL BE OF COURSE THE VOLUME IS GOING TO BE A LOT GREATER AND WE WILL REALLY SEE THE SYSTEM AND WHETHER IT WORKS, IT IS NOT JUST THE COMPUTER SYSTEM PART OF IT BUT ALSO THE BACKGROUND CHECK.
IT HELPED US GET THE HUMAN FUNCTIONS SO PEOPLE CAN MAKE THIS WORK. WE WILL START ON THAT ON MAY THE FIRST AND THEN THE DEPARTMENT OF FAMILY PROTECTIVE SERVICES IS STARTING ON JUNE THE 1ST AND THEN HHSC IS STARTING IN TWO WAVES, ONE IN AUGUST AND ONE AT THE GROUND IN SEPTEMBER.
SO BY THE END OF SEPTEMBER WE SHOULD BE FULLY UTILIZING THIS NEW SYSTEM AND WE ARE EXCITED ABOUT THE OPPORTUNITIES THAT IT PRESENTS. THE OTHER THING THAT I WANTED TO MENTION IS WE HAVE THE PLEASURE TO BE WORKING WITH THE HEALTH AND HUMAN SERVICES COMMISSION ON STANDING UP THE CHIRAL CENTER FOR YOUTH. WE CONTINUE TO SEE HIGH NUMBER OF CHILDREN IN OUR CARE WHO HAVE REALLY HIGH ACUITY NEEDS, AND FOR WHOM IT'S DIFFICULT TO FIND PLACEMENTS.
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THE HEALTH AND HUMAN SERVICES COMMISSION IS STANDING UP THE FACILITY THAT WILL SERVE THESE KIDS AT THE HIGHEST -- THE KIDS WITH THE HIGHEST NEEDS WE HAVE THE HARDEST TIME FINDING A PLACE FOR. WE HAVE BEEN WORKING WITH THEM ON THE RULES AND ON THE FACILITY AND WE ARE REALLY EXCITED ABOUT THIS NEW OPPORTUNITY TO PARTNER IN MEETING THE NEEDS OF THESE KIDS AND HELPING THEM TO HEAL OVER TIME.I WILL ALSO MENTION AS THE COMMISSIONER MUTH MENTIONED WE ARE GOING THROUGH SUNSET AND WE ARE IN THE PROCESS AS YOU MIGHT IMAGINE SO I WILL NOW GO INTO MORE PROCESS THAN THAT BUT IT HAS BEEN A VERY GOOD PROCESS SO FAR I THINK THE SUNSET COMMISSION STAFF ARE REALLY DIGGING IN AND ASKING GREAT QUESTIONS IT'S A LOT OF WORK BUT I THINK IT WILL BE REALLY BENEFICIAL WHEN WE SEE WHAT THE RECOMMENDATIONS FOR US ARE.
I WILL TURN IT BACK. >> THANK YOU I THINK BOTH OF THOSE UPDATES FROM CMARQ AND THE CENTER FOR YOUTH ARE AN EXAMPLE OF HOW WHEN WE WORK TOGETHER ACROSS SYSTEMS WE CAN REALLY GET TO BETTER OUTCOMES FOR THE YOUTH AND THE INDIVIDUALS THAT WE SERVE IN GENERAL. IT IS AN HONOR TO PARTNER AND HAVING BEEN ON BOTH SIDES OF THAT EQUATION IT IS AN HONOR TO PARTNER WITH YOU ALL ON BOTH OF THOSE.
NEXT I WILL TURN IT OVER TO MR. WINTER, WHO WILL PROVIDE AN OFFICE FROM THE INSPECTOR GENERAL.
>> GOOD MORNING COMMISSIONER AND MEMBER OF THE COUNCIL, THANK YOU FOR THE OPPORTUNITY TO ADDRESS EVERYONE THIS MORNING.
AS YOU KNOW, OUR MISSION IS TO PROTECT AND SAFEGUARD HEALTH AND HUMAN SERVICES ACROSS THE STATE AND WE HAVE A VARIETY OF TOOLS TO HELP US DO THIS JOB. WE CONDUCT AUDITS CORRECTLY CONDUCT INVESTIGATIONS, INSPECTIONS, UTILIZATION REVIEWS, AND APPROPRIATE ENFORCEMENT ACTIONS AGAINST PEOPLE WHO ARE ENGAGING IN MISCONDUCT RESULTING IN A LOSS OF THE SYSTEM. ALL OF OUR EFFORTS ARE SUPPORTED BY A VERY ROBUST DATA ANALYSIS OPERATION WITHIN OUR ORGANIZATION. PHONE NUMBERS FOR THE LAST QUARTER IN THAT SECOND QUARTER THAT ENDED JUST RECENTLY WE RECOVERED ALMOST $96 MILLION IN QUARTER TWO OF 2026 AND THAT INCLUDES ABOUT 89 MILLION RESULTING FROM THE PROVIDER INTEGRITY INITIATIVES AND ALMOST 7 MILLION FROM OUR BENEFICIARY INVESTIGATIONS. I WOULD LIKE TO HIGHLIGHT TWO OTHER -- TWO OF, ONE RECENTLY WAS AT ONE SEVEN CENTS SETTLEMENT WITH A HOME HEALTH PROVIDER WHO WAS ENGAGED IN AN IMPROPER BILLING SCHEME. WE PARTNERED WITH THE U.S.
DEPARTMENT OF AGRICULTURE AND UNDERCOVER OPERATION INTO THIS AND INVOLVING FRAUD. IT WAS A 1.7 MILLION RECOVERY AND IT WAS AN EXAMPLE OF OUR COOPERATION WITH OTHER AGENCIES.
ANOTHER ONE I WOULD LIKE TO HIGHLIGHT FOR YOU, FORT WORTH OFFICE, WE RECOVERED $4 MILLION FROM A DENTAL PROVIDER WHO WERE ENGAGED IN AN ILLEGAL KICKBACK SCHEME.
AND THIS IS THE FIRST OF WHAT WE HOPE TO BE MANY SUCCESSFUL RESOLUTIONS AND MANNERS COMING OUT OF THAT OFFICE.
SO THANK YOU FOR YOUR SUPPORT FOR OUR EFFORTS, AND OUR MISSION TO PROTECT THE TAXPAYER FUNDS AND OF COURSE THE PEOPLE WHO ARE
SERVED BY THESE SERVICES. >> THANK YOU FOR THAT UPDATE.
[2. Agency updates]
NOW WE WILL MOVE ON TO AGENDA ITEM TWO A AND 2B, OUR FIRST UPDATE TODAY WILL BE ON THE WOMEN, INFANTS AND CHILDREN COMMONLY REFERRED TO AS VIC AND ELECTRONIC BENEFIT TRANSFER.WELCOME. >> GOOD MORNING, MY NAME IS CRYSTAL, I AM THE DEPUTY EXECUTIVE COMMISSIONER FOR FAMILY HEALTH SERVICES UNDER THE NEW FAMILY ELIGIBILITY DIVISION FAMILY HEALTH SERVICES CONSISTS OF 45 PROGRAMS THAT PROVIDE HEALTH, INDEPENDENT AND SOCIAL STATUS SUPPORT FOR FAMILIES ACROSS THE STATE THROUGHOUT THE LIFE SPAN.
THIS OFTEN INCLUDES DEVELOPMENT SERVICES, WITH OUR WIC PROGRAM.
I'M EXCITED TO BE HERE TODAY TO TALK ABOUT THE WIC PROGRAM AND MOVE TO ONLINE BENEFITS. I THOUGHT WHAT WE WOULD DO TODAY WE WOULD START WITH A QUICK OVERVIEW OF THE WIC PROGRAM AND
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WE WILL GET INTO SOME OTHER NEW INITIATIVES WE HAVE AND SO WHAT WE CALL THE WIC PROGRAM IS A FEDERAL PROGRAM THAT IS FUNDED THROUGH THE U.S. DEPARTMENT OF AGRICULTURE, AND IT IS TECHNICALLY CALLED THE SPECIAL SUPPLEMENTAL PROGRAM FOR WOMEN INFANT AND CHILDREN WHICH IS WHERE THE NAME WIC COMES FROM.770,000 CLIENTS PER MONTH CAN WE DO THAT THROUGH SYSTEM OF LOCAL AGENCIES THAT HAVE 484 CLIENTS ACROSS THE SPACE.
AND IN TEXAS WE ROUGHLY SERVE ABOUT 53% OF THE TOTAL INFANT POPULATION. THE WIC PROGRAM HAS FOUR KEY
GOALS PROVIDED BY -- >> SPEAKER-02: ASSISTANCE, NUTRITION, ACCESS TO NUTRITIOUS FOOD AND A ROBUST NETWORK TO MAKE SURE FAMILIES ARE GETTING CONNECTED TO SERVICES THAT THEY MIGHT NEED OUTSIDE OF WHAT THE WIC PROGRAM PROVIDES.
WIC PROVIDES ACCESS TO THESE SERVICES THROUGH -- THROUGHOUT PREGNANCY, POSTPARTUM, INFANCY AND EARLY CHILDHOOD.
AND WHILE THE PROGRAM PROVIDES SERVICES TO WOMEN AND CHILDREN, THE PROGRAM HAS REALLY EVOLVED TO TRY TO BETTER FATHERS, GUARDIANS AND GRANDPARENTS AS WELL.
TO RECEIVE THE BENEFITS FAMILIES MUST QUALIFY ON WHAT THAT MEANS IS YOU MUST BE PREGNANT, BREASTFEEDING MOM, AND INFANT OR A CHILD UNDER THE AGE OF FIVE. THEY MUST LIVE IN TEXAS AND THEY MUST MEET THE INCOME REQUIREMENT WHICH IS AT OR BELOW 185% OF THE FEDERAL GUIDELINES AND THEY AUTOMATICALLY QUALIFY WITH A FOSTER PARENT. IF THERE IS AN AUTOMATIC INCOME QUALIFICATION FOR THOSE THAT ARE ALREADY ENROLLED THEY ARE ABLE TO AUTOMATICALLY BE ELIGIBLE AND ENROLL IN WIC.
AND FINALLY CLIENT MUST HAVE IT TO PARTICIPATE IN THE PROGRAM.
WHEN A CLIENT IS ENROLLED IN THE PROGRAM THEY WILL COMPLETE AN ADDITIONAL ASSESSMENT AND COUNSELING SESSION WITH THE FAMILIES AND WHAT THAT LOOKS LIKE IS THEY WILL REVIEW HOW TO CALCULATE AND GROWTH STATS TO MAKE SURE THINGS ARE PROGRESSING AS EXPECTED. THEY WILL CHECK IRON LEVELS FOR PREGNANT POSTPARTUM WOMEN AND CHILDREN, IF THE IRON LEVELS ARE LOW, THERE IS -- FAMILIES WILL BE REFERRED TO TO AN APPROPRIATE HEALTH CARE PRACTITIONER AND ALSO WIC WILL CONDUCT A THOROUGH HEALTH HISTORY FOR ALL CLIENTS. CLIENTS ALSO GET NEW SYSTEMS WHICH IS REALLY GOING OVER THE RESULTS FOR THAT HEALTH CARE ASSESSMENT AND REALLY TALKING WITH THE FAMILY ABOUT ANY GOALS THAT THEY HAVE, THEY WILL ALSO TALK TO PARENTS ABOUT WHAT THAT TRANSITIONING IS FOR THEIR CHILDREN FROM THE BOTTLE OR WHEN THEY MIGHT WANT TO START STORING FOOD AND REALLY HAVE THAT OPPORTUNITY TO PREPARE FAMILIES FOR WHAT IS COMING NEXT.
AND THEN OF COURSE IT WILL ALSO DETERMINE WHAT OTHER REFUNDS WILL BE DETERMINED. WIC PROVIDES A LOT OF BREASTFEEDING SUPPORT FOR CLIENTS SO THEY HAVE ACCESS TO PEER COUNSELORS, BREAST PUMPS THAT ARE AVAILABLE AS WELL FOR CLIENTS, AND LACTOSE AND SUPPORT SERVICES WHERE THEY CAN GET ADDITIONAL ASSISTANCE. FOOD PACKAGES ARE GRANTED TO THE CLIENTS AND THESE FOOD PACKAGES CONTAIN KEY NUTRIENTS BASED ON THE INDIVIDUAL CLIENT NEEDS. AND SO THE PACKAGES DIFFERENT AMOUNT BASED ON THE CLIENT AND THOSE BENEFITS ARE ACQUIRED KNOWN AS A WIC EBT CARD AND THE CLIENT CAN USE THOSE CARDS.
TO DATE WE WILL TALK ABOUT A NEW PROCESS FOR THAT THAT WIC IS GOING THROUGH. WIC ONLY OFFERS THE ASSISTANCE THAT MEET NUTRITIONAL STANDARDS. AND SO IN ADDITION TO THE HELP THAT CLIENTS GET AND THEY DEPLOY OUTSIDE SO THERE IS AN APP THAT CLIENTS HAVE ACCESS TO WHERE THEY CAN MOVE EITHER NUTRITION, LOOK AT THE GROWTH CHART, AND FOOD BENEFITS THE WEBSITE ALSO OFFERS SMARTVIEW LIVE CLASSES OR SMART PAID COURSES AND THEN BREAST MILK COUNT.COM IS THE -- THE BEST SUPPORT THAT OFFERS A WEALTH OF INFORMATION FOR INDIVIDUALS BREASTFEEDING AND IS
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ALSO A BILINGUAL WEBSITE WITH THAT INFORMATION AS WELL.WIC IN PARTNERSHIP ALSO HOSTS OUR LACTOSE AND SUPPORT HOTLINE WHICH ANSWERED 25 HOURS SEVEN DAYS A WEEK 12 MONITOR THE FEEDING CONCERNS AND SO IN CLINIC OUTSIDE OF CLINIC, WIC PARTICIPANTS RECEIVE A TON OF SUPPORT AND BENEFITS BY ENROLLING IN THE PROGRAM TO HELP SUPPORT THRIVING FAMILIES.
I WILL HAND THINGS OVER FOR HER TO TALK ABOUT THE ONLINE
INITIATIVE. >> THANK YOU, GOOD MORNING I HAVE THE PLEASURE OF SERVING AS THE ASSOCIATE COMMISSIONER FOR EARLY FAMILY NUTRITION AND DEVELOPMENT WHICH HAS OVERSIGHT OVER THE WIC PROGRAM. WE'RE VERY EXCITED TO BRING THIS UPDATE TO YOU TODAY, IT'S VERY TIMELY AS WE ARE IN THE MIDDLE OF THIS TRANSITION. AND SO WHAT WE WILL BE COVERING TODAY IS REALLY ALL ABOUT OUR NEW TEXAS WIC CARD AND THE PIECES BEHIND THAT. SO WE ARE MOVING WHAT HAS DRIVEN US IS THE MOVE FROM AN OFFLINE SYSTEM WHERE WE HAD BEEN THROUGH AN ONLINE SYSTEM WHERE BENEFITS ARE ACTUALLY HOSTED IN AN ELECTRONIC BENEFIT SUPPORT IN THE CLOUD.
IT DOESN'T MEAN THAT CLIENTS ARE ABLE TO SHOP ONLINE, WITH THEIR BENEFITS, THAT IS A SEPARATE PROJECT THAT THEY CONTINUE TO WORK ON A RULE SET FOR THAT TEXAS MAY CONSIDER ROLLING OUT IN DUE COURSE BUT NOT AT THIS TIME.
SO CLIENTS HAVE STARTED RECEIVING THEIR NEW CARDS STARTED APRIL 1 AND WE ARE HEARING REALLY WONDERFUL THINGS ABOUT THE TRANSITION FROM OUR LOCAL AGENCIES ON THE GROUND WHO SERVE OUR CLIENTS DAY IN AND DAY OUT.
AND THEN CLIENTS WILL START USING THEIR CARDS IN THE STORE TO REDEEM THEIR BENEFITS ON JULY FIRST.
THAT IS OUR LAST REALLY BIG MILESTONE THAT IS OUT THERE THAT WE ARE BOTH ANXIOUS AND EAGER TO GET TO.
NEXT SLIDE, PLEASE. AND SO THIS IS JUST VISUAL IMAGERY FOR YOU, OUR CURRENT CARD WITH A CHIP IS ACTUALLY ON THE LEFT AND THEN OUR NEW CARD WHICH WE CALL MAX STRIPE IT DOES NOT HAVE A CHIP IT WILL BE SWIPED AT THE REGISTER IS ON THE RIGHT. WE WENT AHEAD AND CHANGED UP THE DESIGN SO CLIENTS WILL NOT GET CONFUSED BETWEEN THEIR TWO CARDS AND WE ARE REALLY PLEASED WITH HOW THIS LOOKS.
NEXT SLIDE. AND SO HOW DOES THIS WORK WITH BENEFITS? OUR EBT CARD, THE BENEFITS INSTEAD OF BEING ISSUED TO THE CARD AS THEY ARE TODAY WHERE THEY ARE STORED ON THAT CHIP CARD AS I SAID THEY WILL BE PUSHED INTO AN ELECTRONIC BENEFITS ACCOUNT IN THE CLOUD AND SO THE BENEFITS ARE STORED THERE, THE CARD ALLOWS ACCESS TO THOSE BENEFITS ONE OR THE OTHER REALLY WONDERFUL THINGS ABOUT THIS MOVE IS THAT THE BENEFITS CAN BE MODIFIED AND ISSUED WITHOUT THE CLIENT PHYSICALLY GOING INTO THE CLINIC WITH THEIR CARD. WHAT THAT MEANS IS YOU COULD HAVE A MOM WHO IS NOT ABLE TO FIND THE TYPE OF FORMULA THAT HAS BEEN ISSUED TO HER, SHE CAN CALL UP A LOCAL CLINIC AND SAY I CANNOT FIND THIS FORMULA ANYWAY, ARE WE ABLE TO CHANGE THE TYPE OF FORMULA THAT I CAN ACCESS AND IN CLINIC THEY ARE ABLE TO GO AHEAD AND MAKE THAT REALTIME CHANGE SO THAT MOM IN THE STORE CAN GO AHEAD AND GET THAT FORMULA WITHOUT HAVING TO GO TO THE CLINIC AND THEN COME BACK TO THE STORE.
IT ALSO ALLOWS FOR REALTIME AS I SAID VIEW OF THOSE BENEFIT REDEMPTIONS SO TODAY MOM GOES TO THE STORE, SHE USES HER CARD AT THE CHECKOUT LINE, SHE GETS THE RECEIPT THAT WILL TELL HER HOW MUCH OF HER BENEFITS SHE HAS LEFT.
AND SO SHE HAS TO USE THAT FOR A FEW DAYS UNTIL THE APP UPDATES WITH THAT BENEFIT CHANGE. NOW AS SOON AS MOM USES THAT CARD AT THE POINT OF SALE SYSTEM THE BENEFITS WILL BE UPDATED IN REALTIME. NO HAVING TO WORRY ABOUT KEEPING THIS PIECE OF PAPER AND HANGING ON TO IT FOR THREE TO FIVE DAYS, SHE WILL HAVE ACCESS TO IT RIGHT AWAY TO HOW MANY BENEFITS SHE HAS LEFT. NEXT SLIDE, PLEASE.
AS CRYSTAL MENTIONED WE DO HAVE A MY WIC APP, UPTAKE HAS BEEN WONDERFUL ANYWHERE FROM 60 TO 70% OF OUR PARTICIPANTS USE THIS APP AND SO IT IS ALSO A PLACE IN ADDITION TO BEING ABLE TO SEE BENEFITS, IT CAN HELP WITH SHOPPING.
YOU CAN GO INTO THE STORE, I GET THIS JAR OF PEANUT BUTTER BUT I DON'T KNOW IF THIS JAR OF PEANUT BUTTER QUALIFIES IF I CAN PURCHASE THIS WITH MY WIC BENEFITS.
I CAN SCAN THAT WITH THE APP AND IT WILL TELL ME YES, THIS IS COVERED, NO THIS IS NOT COVERED. AND IT ALLOWS FOR IF MOM IS
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PRETTY SURE THAT THIS SHOULD BE COVERED FOR HER TO SUBMIT IN REALTIME A TICKET TO SAY THIS IS SHOWING UP AS NOT AUTHORIZED BUT I THINK IT SHOULD BE AUTHORIZED. IT ALSO HELPS WITH GUIDED CERTIFICATION. CERTIFICATION IS THE ELIGIBILITY PROCESS AND THE MY WIC APP CAN GO AHEAD AND REQUEST INFORMATION THAT IS NECESSARY FOR THE CERTIFICATION LIKE INCOME, LIKE IDENTITY VERIFICATION, ET CETERA.THAT ALLOWS THEM ALL OF THE DOCUMENTATION, THAT SPEAKS TO THE MANAGEMENT SYSTEM SO IT'S ALL IN ONE PLACE.
IT ALSO ALLOWS FOR PUSH NOTIFICATIONS AND ALERTS SUCH AS YOU HAVE AN APPOINTMENT COMING UP, OR IT'S TIME TO SCHEDULE AN APPOINTMENT FOR YOUR NUTRITION EDUCATION CLASS THAT YOU SIGNED UP FOR IS COMING UP. SO THIS HAS BEEN IN PLACE FOR A FEW YEARS BUT IN RECENT YEARS WE'VE REALLY DONE A LOT OF WORK TO GET IT TO WHERE IT IS TODAY GETTING CLIENT FEEDBACK AND THEN CERTAINLY WITH THE TRANSITION TO OUR NEW CARD WE'VE MADE SOME ADDITIONAL UPDATES SOME ENHANCEMENTS TO THE APP THAT WE WILL CONTINUE TO LOOK TO. SO WHAT DO OUR CLIENTS NEED TO KNOW WHEN ONE OF OUR REALLY WONDERFUL CREATED WIC STAFF CAME UP WITH A SLOGAN GET IT. , SWIPE IT.
THOSE ARE THE THREE KEY STEPS. CLIENTS GO INTO THE CLINIC BEFORE THE DRIVE FIRST, THEY RECEIVE THEIR NEW CARDS.
THEY THEN SET THEIR PIN, IDEALLY THEY ARE DOING IT IN CLINIC, IT'S THE EASIEST WAY TO MAKE SURE IT'S DONE.
THERE'S OTHER WAYS I WILL GET INTO ABOUT HOW THEY CAN SET THEIR PIN. WHEN IT COMES TO REDEMPTION DAY, JULY FIRST THEY GO AND THEY SWIPE THEIR CARD.
SO I AM REALLY PROUD OF THE CREATIVITY OF THE TEAM IN THIS BECAUSE I THINK IT'S SUPER EASY TO UNDERSTAND FOR CLIENTS.
NEXT SLIDE. AND WE HAVE ENSURED THAT WE HAVE A VARIETY OF METHODS THAT CLIENTS CAN LEVERAGE AND INTERSECT WITH IF THEY NEED SUPPORT WITH THIS CARD TRANSITION. OR REALLY JUST ANYTHING.
WE'VE TALKED ABOUT THE APP, WE ALSO HAVE A CARD MANAGEMENT ALIGNED THAT HAS AN ID R WHICH I FORGOT WHAT IT STANDS FOR BUT YOU ARE SMART PEOPLE, SO IT HAS THIS AND YOU CAN USE THAT TO SET THE PIN OR I HAVE LOST MY CARD AND I NEED TO LOCK IT TO MAKE SURE THAT NOBODY ELSE USES IT AND YOU CAN ALSO, A CLIENT CAN ALSO CONTACT THEIR LOCAL OFFICES, IT'S ONE OF THE PLACES CLIENTCO REALLY QUICKLY IF THEY'RE HAVING ANY TROUBLES.
AND THEY CAN VISIT TEXAS TRANTHREE.ORG WHICH WE PUT UP ADDITIONAL INFORMATION HERE NEXT SLIDE.
AND SO OUR CLIENT COMMUNICATIONS IN ADDITION TO SWIPE IT WE HAVE ANOTHER WONDERFUL EXAMPLE OF SOME OF THE MATERIAL THAT HAS BEEN CREATED FOR USE IN OUR WIC CLINICS.
THEY HAVE BEEN DISPLAYING THIS COMING SOON MATERIAL SINCE FEBRUARY. THEY ARE BEGINNING TO RECEIVE THE MATERIAL FOR THE REDEMPTION DAY AND REPLACE IN CLINIC THAT MATERIAL WE ALSO HAVE HAD A VERY INTENSIVE DIGITAL CAMPAIGN LIKE I SAID THROUGH USE OF OUR WEBSITE BUT ALSO LEVERAGING SOCIAL MEDIA, HELPING PROVIDE MESSAGING TO OUR LOCAL AGENCIES FOR THEM TO BE ABLE TO SUPPORT ON THEIR SOCIAL MEDIA SITES THAT DIGITAL MESSAGING MADE SURE THAT WE HIT THE GROCERY STORES SO THEY HAVE WHAT WE SAY WINDOW CLINGS.
FOR PARTNERS WE'VE CREATED ADDITIONAL INFORMATION TO FOOD BANKS SO THAT THEY CAN USE ALL OF THE MATERIAL WE HAVE CREATED AND SUPPORT AND AMPLIFY THAT MESSAGING WITH CLIENTS WHO COME INTO THE FOOD BANK WHO ARE ALSO WIC PARTICIPANTS.
WE'VE COVERED A COUPLE OF MORE WAYS, THAT A CLIENT CAN SET A PIN AND THIS IS ALSO AN EXAMPLE GIVEN TO THE CLIENT IF THEY DO NOT SET THEIR P.I.N. IN CLINIC TO REMIND THEM HOW THEY CAN SET THEIR PIN AHEAD OF THAT JULY FIRST REDEMPTION DAY.
NEXT SLIDE. IN SUMMARY CLIENTS ARE REACHING THEIR NEW CARDS RIGHT NOW, AND THEY WILL CONTINUE TO DO SO UNTIL JUNE 30TH AND THEN ON JULY FIRST THEY WILL BE ABLE TO GO INTO THE STORE AND BEGIN USING THOSE NEW PARTS.
THEY DO HAVE TO SET A PIN WHICH IS SOMETHING WE HEARD FROM A PARTNER STATE WHO ALREADY HAS GONE TO THE REDEMPTION DAY AND SAID WE'VE HAD A REAL PROBLEM WHEN WE WERE NOT ABLE TO GET CLIENTS TO SET A PIN IN CLINIC AND THEY ARE NOW TRYING TO USE THEIR CARD IN THEIR STORE AND IT IS NOT WORKING.
[00:35:03]
SO WE'VE LEARNED A LESSON FROM OUR PARTNER IN THAT WAY AND REALLY EMPHASIZING GOING AHEAD AND SETTING THAT PIN AS EARLY AS POSSIBLE. AND OF COURSE AS USUAL WE HAVE MORE INFORMATION ON TEXASWIC.ORG.AND OF COURSE I WOULD BE REMISS IF I DID NOT ACKNOWLEDGE OUR EXTREMELY IMPRESSIVE WIC STAFF. THIS HAS BEEN YEARS IN THE MAKING TO GET TO THIS POINT, I HAVE ONLY BEEN OVER THIS PROGRAM FOR A LITTLE OVER A YEAR SO MUCH OF THIS WORK WAS HAPPENING WELL BELOW -- WELL BEFORE I GOT INTO MY ROLE AND I HAVE JUST BEEN SO PROUD TO WORK ALONGSIDE THE TEAM AS THEY HAVE WORKED THROUGH ALL KINDS OF OBSTACLES, SHORT TIMELINES, WORKING WITH MULTIPLE VENDORS AND THEY FOUND A WAY TO COME THROUGH.
IT HAS JUST BEEN A PLEASURE TO DO THAT ALONGSIDE THEM.
AND AT THIS POINT THAT CONCLUDES THE PRESENTATION BUT WE ARE
HAPPY TO ANSWER ANY QUESTIONS. >> THANK YOU, I THINK THAT WAS A VERY GOOD SUMMARY PARTICULARLY I APPRECIATE THE BENEFITS TO THE WIC FAMILIES OF BOTH THE REALTIME INFORMATION ABOUT BENEFITS THAT ARE LEFT AND THE ABILITY TO HAVE THEIR PRESCRIPTION CHANGED WITHOUT THE TRIP TO THE CLINIC.
THAT IS OBVIOUSLY GOING TO HAVE A BIG POSITIVE IMPACT ON OUR FAMILIES. ANY QUESTIONS? OKAY. THANK YOU.
>> THANK YOU. >> NEXT WE ARE GOING TO HEAR FROM EMILY ZALKOVSKY AND SHE WILL GIVE US AN UPDATE ON ALIGNING TECHNOLOGY BY LINKING INTEROPERABLE SYSTEMS OR AS WE
SAY MUCH SIMPLER ATLAS. >> HELLO I'M EMILY ZALKOVSKY, CHIEF MEDICAL OFFICER WE LOVE OUR ACRONYMS SO ALIGN TECHNOLOGY FOR LINKING INTEROPERABLE SYSTEMS FOR CLIENT OUTCOMES OR ATLAS, IS AN MCO INCENTIVE PROGRAM TO LEVERAGE HEALTH INFORMATION EXCHANGE CONNECTIVITY WITH OUR IN-NETWORK HOSPITALS TO IMPROVE CARE COORDINATION FOR MEMBERS ENABLE QUALITY MEASUREMENT AND SUPPORT VALUE BASED CARE.
WE HAVE ALREADY HAVE ONE YEAR OF THIS PROGRAM UNDER OUR BELT, WE ARE RELAUNCHING IT IN YEAR TWO, WE ORIGINALLY HAD CONTEMPLATED THAT THAT DID NOT THINK THAT THE HOSPITALS AND THE NCOS WERE IN ALIGNMENT ON A FEW THINGS BUT THEY SEEMED TO REACH ALIGNMENT WHICH IS GOOD NEWS AND SO WE ARE RELAUNCHING THIS PROGRAM FOR YEAR TWO AND IT IS NOT ONLY DO WE BELIEVE THAT HEALTH INFORMATION EXCHANGE BETWEEN PROVIDERS AND NCOS AND PROVIDERS TO EACH OTHER IS HELPFUL FOR CARE COORDINATION AND OTHER THINGS BUT AT THE FEDERAL LEVEL, THE ENTITIES THAT SET VARIOUS QUALITY MEASURES ARE ALSO MOVING TO DIGITAL QUALITY MEASUREMENT MEANING THEY WILL NOT BE HAVING PEOPLE LOOK AT PAPER CHARTS ET CETERA TO UNDERSTAND OUTCOMES, THEY WILL EXPECT DIGITAL INFORMATION SO THIS HELPS US MOVE THE NEEDLE FOR SOME OTHER PROVIDERS IN THAT WAY.
BUT THERE ARE SOME STRATEGIC FOCUSES FOR YEAR TWO THAT WE HAVE -- INCENTIVIZING -- INCENTIVIZING THEM TO WORK WITH AND LOOK AT THEIR PROVIDERS AND TO MEASURE WHERE THEY ARE SO THAT IN FUTURE YEARS WE CAN TAKE THE BASELINE INFORMATION WE WOULD GATHER FROM YEAR ONE ADDITIONAL DETAIL INFORMATION IN YEAR TWO AND MAKE SOME DIFFERENT TARGETS THROUGHOUT THE YEARS WITH THE PROGRAM AS THE YEARS GO BY.
THE YEAR TWO STRATEGIC FOCUS AREAS FOR THE PROGRAM ARE CONNECTIVITY GROWTH SO THAT IS EXPANDING ACTIVE HIV HEALTH INFORMATION EXCHANGE ACROSS NETWORK CLASSES SO INCLUDES RURAL CLASSROOMS CHILDREN'S HOSPITALS, STATE, STATE OWNED INSTITUTIONS FOR MENTAL DISEASE. WE ALSO ARE LOOKING AT EARLY IMPLEMENTATIONS SO MEASURING HOW THEY ARE ESTABLISHING OPERATIONAL PROCESSES FOR HIE UTILIZATION, WE'RE ASKING THE MCO TO IDENTIFY BARRIERS TO DATA EXCHANGE AS WELL AS RESOLUTIONS SO SYSTEMATICALLY IDENTIFYING CONNECTIVITY BARRIERS AND THEN IN THE IMPLEMENTATIONS STRATEGIES THAT CAN BE IMPLEMENTED TO MITIGATE THOSE BARRIERS AS WELL AS THE LAST STRATEGIC FOCUS WITH ITS QUALITY PREPARATION.
ESTABLISHING FOUNDATIONAL INFRASTRUCTURE FOR FUTURE QUALITY MEASUREMENTS. WE HAVE AN EYE TOWARDS THE FUTURE OF USING DATA THAT MCOS AND PROVIDERS SHARED TOGETHER TO BE ABLE TO MEASURE QUALITY, MEASURE THE QUALITY OF SERVICES THAT OUR MEMBERS ARE RECEIVING. SO THIS PROGRAM WE'VE SHARED INFORMATION WITH I.T. MANAGED CARE PLANS THEY ARE WORKING WITH OUR PROVIDERS. THEY WILL BE REQUIRED TO SUBMIT A REPORTING TOOL THAT IF THE MACOS WILL BE REQUIRED TO SUBMIT A SINGLE COMPREHENSIVE REPORTING TOOL TO OSCARG DUE IN JULY, LOOKING AT AND REPORTING ON ALL THESE DIFFERENT DOMAINS THAT I'VE TALKED ABOUT SO WE CAN SEE WHERE THE BARRIERS ARE,
[00:40:02]
WHERE MCO AND PROVIDERS ARE WORKING WELL TOGETHER AND MAKE PLANS FOR FUTURE HIE INITIATIVES AT HHSC.WE LOOK FORWARD TO IMPROVING HEALTH INFORMATION EXCHANGE WITH THE EYE TOWARDS QUALITY OF SERVICES FOR MEMBERS.
AND THAT CONCLUDES MY PRESENTATION.
>> THANK YOU EMILY. ANY QUESTIONS? OKAY. SO LAST BUT NOT LEAST ON THIS AGENDA ITEM I AM GOING TO ASK TREY WOULD TO GIVE OUR UPDATE ON
RURAL TEXAS JOBS. >> I'M ALSO FINE BEING LEAST, I DON'T TAKE OFFENSE AT THAT ANYWAY.
I AM THE CHIEF FINANCIAL AND OPERATIONS OFFICER FOR HHSC.
I'LL GIVE A QUICK SUMMARY OF WHERE WE ARE WITH THE ROYAL TEXAS STRONG TRANSFORMATION PROGRAM.
HHSC HAS RECEIVED APPROVAL FROM CMS FOR THE REVISED YEAR ONE BUDGET ALLOCATIONS WHICH IS GOOD NEWS AS A REMINDER YEAR ONE OF THAT PROGRAM RUNS FROM DECEMBER 29TH OF 2025 THROUGH SEPTEMBER 30TH OF THIS YEAR. THE ESTIMATED BUDGET IS OVER $281 MILLION. A QUICK SUMMARY OF THE INITIATIVES THAT ARE ROLLING OUT, IN THIS YEAR, INITIATIVE ONE MAKE RURAL TEXANS HEALTHY AGAIN, FUNDING WILL BE DISTRIBUTED ACROSS TWO PARTS, PART ONE WILL BE ESTIMATED 60 MILLION, THAT WILL BE ALLOCATED TO SUPPORT RURAL HOSPITAL DISTRICTS AND PUBLICLY OWNED AND OPERATED HOSPITALS IN OUR JURISDICTION, FUNDING WILL BE PROVIDED ON A COST REIMBURSEMENT BASIS TO ENHANCE OR CREATE COMMUNITY BASED PREVENTION, WELLNESS AND NUTRITION PROGRAMS OR SERVICES AIMED AT IMPROVING DIABETES OBESITY HEART DISEASE AND MATERNAL HEALTH OUTCOMES. REQUEST FOR ENROLLMENT WENT LIVE LAST NIGHT SO IT'S A VERY FIRST THING WE ROLLED OUT IT OPENED AND WENT LIVE LAST NIGHT. PART TWO WILL BE AN ESTIMATED $56 MILLION COULD HAVE THE SAME GOALS AS PART ONE, IT COULD BE TARGETED TO A SLIGHTLY DIFFERENT AUDIENCE OR DIFFERENT GROUP.
IT WILL BE A COMPETITIVE AWARD FOR PRIVATE AND PUBLIC HOSPITALS. THEY'RE ANTICIPATED TO BE RELEASED IN THE COMING WEEKS, THE NEXT INITIATIVE ROLLING OUT THIS WEEK IS INITIATIVE FOUR, NEXT GENERATION OF THE SMALL TOWN DOCTOR AND TEAM, THIS WILL BE AN ESTIMATED 98.9 MILLION AND WILL BE ALLOCATED TO ACCELERATE WORKFORCE INVESTMENT IN OUR RURAL COMMUNITIES. REQUESTS FOR APPLICATIONS ARE ANTICIPATED TO BE RELEASED IN THE COMING WEEKS.
THE FINAL ONE THAT WE HAVE IS GOING TO BE INITIATIVE SIX, AND AGAIN THESE ONES ARE THE ONES WE ARE ROLLING OUT INFRASTRUCTURE AND CAPITAL IMPROVEMENT FOR RURAL TEXAS, THIS WILL BE AN ESTIMATED 56.2 MILLION AND WILL BE ALLOCATED TO SUPPORT ALLOWABLE CAPITAL INFRASTRUCTURE NEEDS FOR RURAL HEALTH CARE PROVIDERS WHO REQUEST FOR APPLICATIONS ARE EXPECTED TO BE RELEASED AGAIN IN THE UPCOMING WEEKS.
WE ALSO DID A SHORT VIDEO THAT WAS POSTED ONLINE SUMMARIZING SOME OF THESE AND TALKING ABOUT WHAT FOLKS NEED TO DO TO GET READY FOR THIS, THAT IS ALSO GONE LIVE, I BELIEVE A COUPLE OF DAYS AGO AND OF COURSE WE HAVE ALL OF OUR INFORMATION ON OUR RURAL HEALTH TRANSFORMATION PROGRAM WEBSITE WHICH INCLUDES ALL OF OUR BUDGET DOCUMENTS, ALL THAT KIND OF INFORMATION FOLKS WILL NEED TO KNOW. AND THAT CONCLUDES MY PRESENTATION HAPPY TO ANSWER ANY QUESTIONS.
>> THANK YOU, REALLY AN UNPRECEDENTED OPPORTUNITY FOR THE STATE WITH THIS INVESTMENT TO BOTH IMPROVE THE RURAL HEALTH CARE DELIVERY BUT ALSO HEALTH OUTCOMES AT THE RURAL OF THE STATE. SO REALLY EXCITED ABOUT RECEIVING THE FUNDS AND LAUNCHING THIS PROGRAM.
[3. Rule proposals]
MEMBERS, ANY QUESTIONS? ALL RIGHT PIERRE SO WITH THAT WE WILL MOVE TO AGENDA ITEM THREE A WHICH IS REAL PROPOSALS THAT HAVE BEEN SUBMITTED TO THE TEXAS REGISTRAR FOR PUBLICATION IN WHICH THE PUBLIC COMMENT. REQUIRED BY THE ADMINISTRATIVE PROCEDURE ACT HAS NOT CLOSED AS OF THE DATE OF THIS COUNCILMEETING. >> THANK YOU GOOD MORNING.
AGENDA ITEM 3A1 RURAL 25R016 WILL BE PRESENTED BY LINETTE
VERY HAPPY TO BE HERE, MY NAME IS LINETTE SANDERS AND I AM THE REGISTRY ENFORCEMENT DIRECTOR, OF REGULATORY ENFORCEMENT AND REGULATORY SERVICES DIVISION AND I'M WITH YOU TODAY I HAVE OUR REGISTRY ENFORCEMENT MANAGER ROBERT PEGG.
HHSC IS UPDATING THE CONTACT REGISTRY RULES, BY PROPOSING AMENDMENTS TO RULES ENTITLED 26 PART ONE CHAPTER 561 AND REPEALING RULES ENTITLED 26 PART ONE CHAPTER 7-ELEVEN.
[00:45:05]
PROPOSAL PROJECT 25 R016 IMPLEMENT THE BILL 1849 FROM 88 -- FOUL APA AND HOUSE BILL FROM THE 89TH REGULATORY SESSION.SENATE BILL 1849 CREATED AN INTERAGENCY REPORTABLE CONTACT SEARCH ENGINE ALSO KNOWN AS CMARQ.
ALSO REFERRED TO AS TO ENSURE STATE AGENCIES DO NOT EMPLOY INDIVIDUALS WHOSE HISTORIES OF REPORTABLE CONDUCT.
HOUSE BILL 3560 REQUIRES PRIVATE PSYCHIATRIC HOSPITALS AND OTHER MENTAL HEALTH FACILITIES LICENSED UNDER HEALTH AND SAFETY CODE CHAPTER 577 TO COMPLY WITH THE EMPLOYEE MISCONDUCT REGISTRY RULES. THESE PROPOSED RULES ESTABLISH A PROCESS TO DETERMINE WHETHER A PERSON REACHED -- MEET THE REQUIREMENTS AND EMPLOYEE MISCONDUCT REGISTRY AND ESTABLISH CRITERIA FOR A PERSON TO SUBMIT A REQUEST TO BE REMOVED FROM THE EMPLOY -- EMPLOYEE MISCONDUCT REGISTRY.
THE PROPOSED RULES WILL BE BENEFICIAL TO THE PUBLIC BECAUSE THE PROPOSED RULES ARE CONSISTENT WITH STATUTORY REQUIREMENTS AND MAKE VERIFYING ELIGIBILITY STATUS EASIER FOR ENTITIES SEEKING TO EMPLOY AN INDIVIDUAL WHO IS FULFILLING AN EMPLOYMENT CONTRACT OR VOLUNTEER POSITION OR A LICENSOR.
ENTITIES CAN COMPLETE THE VERIFICATION USING ONE CENTRALIZED SEARCH. THE SEMARC COMBINES REGISTRIES INCLUDING THIS THAT WERE PREVIOUSLY SEPARATED DEPENDING ON WHICH POPULATION THEY SERVE. THIS IMPROVES PUBLIC SAFETY BY PROVIDING EASY IDENTIFICATION OF INDIVIDUALS WITH HISTORIES OF REPORTABLE CONDUCT SUCH AS ABUSE OR NEGLECT AGAINST A CHILD OR AN ADULT MAKING THIS INFORMATION AVAILABLE IN ONE PLACE INSTEAD OF SEPARATED ACCORDING TO THE POPULATION THEY SERVE.
PLEASE NOTE THERE ARE OTHER HHSC RULES BEING PROPOSED TO IMPLEMENT THE REST OF SENATE BILL 1849.
AND WITH THAT SAID, IF YOU HAVE ANY QUESTIONS FOR US AT THIS
TIME HAPPY TO TAKE THEM. >> TIMELY UPDATE SINCE THAT TIES TO MS. SIMS UPDATE ABOUT THE LAUNCHING OF SEMARC.
ANY QUESTIONS MEMBERS? THANK YOU SO MUCH.
NEXT. >> 26R028 WILL BE PRESENTED BY
CHRISTEL. >> GOOD MORNING, THANK YOU COMMISSIONER MUTH. MY NAME IS CHRISTOPH ALLEN, DEPUTY ASSOCIATE AND I AM HERE TODAY TO TALK TO YOU ABOUT AMENDMENTS TO OUR RULES ENTITLED 26 PART ONE CHAPTER 745 CONCERNING CHILD CARE REGULATION EXEMPTIONS AND PUBLIC HEARING REQUIREMENTS. THIS PROPOSAL PROJECT IMPLEMENTS HOUSE BILL 4529 AND 3597 FROM THE 89TH REGULAR LEGISLATIVE SESSION. HOUSE BILL 4529 ADD TWO ENTITIES THAT ARE CERTIFIED TO OPERATE AND REGULATED BY THE UNITED STATES DEPARTMENT OF DEFENSE TO THE LIST OF ENTITIES THAT ARE EXEMPT FROM BEING REGULATED BY THE CHILD CARE REGULATION. THESE TWO ENTITIES INCLUDE A CHILD CARE FACILITY LOCATED ON A FEDERAL MILITARY BASE OR OTHER FEDERAL PROPERTY, AND A MILITARY FAMILY CHILD CARE PROVIDER.
HOUSE BILL 3597 REQUIRES GENERAL RESIDENTIAL OPERATIONS TO HOLD PUBLIC HEARINGS BEFORE BEING ISSUED A LICENSE CERTIFICATE OR EXPANDING CAPACITY. IF THE GENERAL RESIDENTIAL OPERATION IS LOCATED IN A COUNTY THAT HAS A POPULATION OF LESS THAN 500,000. IT WAS PREVIOUSLY 300,000.
THE PUBLIC WILL BENEFIT FROM THE PROPOSED RULE CHANGES WITH REDUCTION IN REGULATORY BURDEN FOR OPERATIONS ALREADY REGULATED BY THE UNITED STATES DEPARTMENT OF DEFENSE.
INCREASED PUBLIC AWARENESS OF MATTERS AFFECTING COMMUNITIES AND A COUNTY WITH A POPULATION LESS THAN 500,000 FOR THOSE
[00:50:01]
GENERAL OPERATIONS. RESIDENTIAL OPERATIONS.ANY QUESTIONS? >> NO, THANK YOU SO MUCH,
APPRECIATE THAT. >> THANK YOU HAVE A GOOD DAY.
>> NEXT AGENDA ITEM 3A3 PROPOSED RULE WILL BE PRESENTED BY JO
JOSHUA. >> GOOD MORNING, MY NAME IS JOSHUA, I'M THE DIRECTOR OF POLICY AND RULES WITHIN LONG TERM CARE REGULATION ALSO REFERRED TO AS LTC I AM HERE TO -- HERE TODAY TO PRESENT THE PROPOSAL PROJECT 25 R003 WHICH IMPLEMENTS SENATE BILL 1849 FROM THE 80TH REGULAR SESSION SENATE BILL 1849 CREATED AN INTERAGENCY REPORTABLE CONDUCT SEARCH ENGINE KNOWN AS THE SEARCH ENGINE FOR MULTI-AGENCY REPORTABLE CONDUCT ALSO REFERRED TO AS SEMARC. TO ENSURE STATE AGENCIES DO NOT EMPLOY INDIVIDUALS WITH HISTORY OF OR CONDUCT.
WHILE THE DEPARTMENT OF INFORMATION AND RESOURCES IS RESPONSIBLE FOR CREATING THE ACTUAL SEARCH ENGINE SOME OTHER STATUTES IN CHAPTER REQUIRE HHSC TO AMEND RULES RELATING TO THE EMPLOYEE MISCONDUCT REGISTRY SEARCH ENGINE.
AND BACKGROUND SEARCHES FOR LTCR PROVIDERS.
HHSC ALSO THE RULES FOR FORMING CLARITY AND CONSISTENCY, PROPOSED RULE AMENDMENTS TO THE TEXAS ADMINISTRATIVE CODE TITLE 26 PART ONE, INCLUDE CHAPTER 550, LICENSING EXCHANGES FOR -- PRESCRIBED PEDIATRIC CENTERS, CHAPTER 553, LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES, CHAPTERS 554, NURSING FACILITY REQUIREMENTS, FOR LICENSURE AND MEDICAID CERTIFICATION, CHAPTER 555 NURSING FACILITY ADMINISTRATORS, CHAPTER 556, NURSE AIDES, CHAPTER 557 MEDICATION AIDS, PROGRAM REQUIREMENTS, CHAPTER 559, DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS, CHAPTER 560, DENIAL OR REFUSAL CHAPTER 565, HOME AND COMMUNITY BASED PROGRAM AND COMMUNITY FIRST CHOICE CERTIFICATION STANDARDS.
AND CHAPTER 566 TEXAS AND LIVING PROGRAM AND COMMUNITY FIRST CHOICE STANDARDS. THE RULES WILL PROVIDE PUBLIC SAFETY AND PROTECT INDIVIDUALS AND REGULATED SETTINGS FROM INDIVIDUALS WITH A HISTORY OF REPORTABLE CONDUCT.
THOSE OTHER HHSC RULES BEING PROCESSED TO IMPLEMENT THE REST OF THE REQUIREMENTS FOR SENATE BILL 1849.
>> THANK YOU, ANY QUESTIONS? OKAY GREAT THANK YOU SO MUCH.
>> THANK YOU. >> AGENDA ITEM 3A FOR PROPOSED RULE 250 -- 25R01 FOUR WILL BE PRESENTED BY STACEY.
>> GOOD MORNING I AM STACEY WITH SERVICES, I'M DIRECTOR OF POLICY AND FINANCIAL MANAGEMENT HERE TODAY I HAVE A RULE PROPOSED RULE PRESENTATION FOR AMENDMENT TO TEXAS ADMINISTRATIVE CODE TITLE ONE PART 15 CHAPTER 353 MANAGEMENT CARE.
OUTPATIENT PHARMACY SERVICES AND ANOTHER CHAPTER IN 354 MEDICAID HEALTH SERVICES, CONCERNING THE NEW DRUG PROGRAM TEMPORARY NON-PREFERRED DRUGS. PROPOSAL PROJECT 20 5R0 14 IMPLEMENTS 03H FROM HOUSE BILL WHICH WAS PASSED DURING THE 80TH REGULAR LEGISLATIVE SESSION. THE DRUG PROGRAM MANAGES A LIST OF DRUGS THAT ARE AVAILABLE TO MEDICAID MEMBERS, SOME OF THESE DRUGS HAVE PRIOR AUTHORIZATIONS WHICH MEANS THE MEMBER HAS TO MEET CERTAIN CRITERIA FIRST TO QUALIFY FOR THE DRUG.
THE DRUG UTILIZATION REVIEW BOARD WHICH IS A BOARD THAT IS
[00:55:01]
PUBLICLY ON A QUARTERLY BASIS REVIEWS AND RECOMMENDS THIS PRIOR ORGANIZED -- AUTHORIZATIONS HOUSE BILL 30 SECTION 38 AND A NEW TYPE OF PRE-AUTHORIZATION CALLED TEMPORARY NON-PREFERRED AS A RESULT HHSC IS NOW REQUIRED TO GIVE SOME DRUGS THAT ARE NEW TO THE MEDICAID DRUG LIST THIS NEW PRIOR AUTHORIZATION STATUS ON THE TEMPORARY BASIS.THEN ONCE THE DRUG UTILIZATION REVIEW BOARD IS ABLE TO REVIEW THE DRUG, THE NEXT QUARTERLY MEETING, THE BOARD WILL REVIEW AND RECOMMEND A PERMANENT PRE-AUTHORIZATION STATUS FOR THE DRUG. THESE PROPOSED RULES ADD THE TERM AND THE DEFINITION OF TEMPORARY NONCONFIRMED AS STATED IN THE HOUSE BILL 3286, THE TEXAS ADMINISTRATIVE CODE, THE LANGUAGE IS ALSO UPDATED SO IT'S WRITTEN IN PLAIN LANGUAGE WHICH IS A STATE REQUIREMENT. AND I'M HAPPY TO ANSWER ANY
THANK YOU STACIE. >> AGENDA ITEM 3A5 PROPOSED RULE 26R004 WILL BE PRESENTED BY JAMES BRADY.
>> GOOD MORNING COMMISSIONER, EXECUTIVE COUNCIL MEMBERS AND STAKEHOLDERS. I'M JAMES BRADY OPERATIONS MANAGER FOR THE HHSC ELECTRONIC VISITOR, FOR SOME BACKGROUND ELECTRONIC VISITOR IS A COMPUTER BASED SYSTEM THAT ELECTRONICALLY VERIFIES DOCUMENTS AND SERVICE DELIVERY FOR CERTAIN MEDICAID SERVICES. IT HELPS PREVENT FRAUD, WASTE, AND ABUSE WHILE MAKING SURE MEDICAID RECIPIENTS RECEIVE CARE THAT IS AUTHORIZED FOR THEM. HHSC IS UPDATING ELECTRONIC VERIFICATION RULES BY PROPOSING AMENDMENTS TO TEXAS ADMINISTRATIVE TITLE ONE, PART 15 CHAPTER 354, MEDICAID HEALTH SERVICES SUBCHAPTER ZERO. DUE TO THE MEDICAID PLAN CONTRACTS ENDING AFFECTED DECEMBER 25 AS REQUIRED BY THE SENATE FOR MEDICARE AND MEDICARE SERVICES RULES 354 TO 400-3354, FOUR, 005 AND 354, 006 ARE BEING AMENDED THROUGH -- TO REFLECT ENDED DECEMBER 23RD 2025, AND THAT ELECTRONIC VERIFICATION WAS REQUIRED FOR STARPLUS SERVICES IF DELIVERED BEFORE JANUARY FIRST 2026. THE PROPOSED AMENDMENT TO RULE 354 TO 4013 REMOVES FREE TASK REVIEWS FROM THE -- THE LIST OF.
HHSC IS CONDUCTING THESE REVIEWS BACK IN 2023 AND ALSO ADDS HHSC AND THE MANAGED ORGANIZATION WILL CONDUCT ALTERNATIVE DEVICE USAGE REVIEWS. NOW FREE TEXT REVIEWS ARE BEING REMOVED AS WE ADDED ADDITIONAL FIELDS FOR ENTRY OF CLOCKING IN AND CLOCKING OUT TIMES AND THE SYSTEM THAT A PROVIDER COULD LOG IN FOR MANUAL VISITS. IF THE PROVIDER HAD A MANUAL VISIT IN THE SYSTEM THEY WOULD BE REQUIRED TO DOCUMENT THE CLOCK IN AND CLOCK OUT TIMES AND THE BILL FURTHER EVV VISITS.
ALTERNATIVE DEVICE USAGE REVIEWS ARE BEING ADDED TO RULE 354, 4013 AS WE ARE REDUCING THE ALLOWABLE USAGE OF ALTERNATIVE DEVICES OVER THE NEXT FOUR YEARS.
WE STARTED IN SEPTEMBER FIRST 2025, USERS OF THE EVV SYSTEM MAY ONLY USE AN ALTERNATIVE DEVICE FOR 75% OF THEIR VISITS.
THIS DECREASES BY 25% EACH YEAR WITH A FINAL ALLOWABLE PERCENTAGE DEVICE OF 5% STARTING SEPTEMBER FIRST 2028.
THE REASON WE IMPLEMENTED THE REDUCTION WAS TO INCREASE PROGRAM INTEGRITY. HHSC IS ALSO AMENDING RULES AND 354.4006. TO ADD THAT A PROGRAM PROVIDER OR EMPLOYER MUST USE EVV IF MEDICAID PAYS FOR ANY PART OF THE SERVICES THAT REQUIRE EVV. THESE CHANGES CLARIFY THAT EVV MUST BE USED AT THE SERVICES THAT REQUIRE EVV ARE PAID FOR BY BOTH MEDICAID AND A THIRD PARTY SUCH AS PRIVATE INSURANCE.
NOW IN TERMS OF STAKEHOLDER INVOLVEMENT, PRIOR TO MAKING THE CHANGES FOR THE USAGE OF ALTERNATIVE DEVICES, HHSC PUBLISHED A DELIVERY IN APRIL 2024 REQUESTING PUBLIC COMMENTS ON OUR CHANGES TO THE ALTERNATIVE POLICY.
ADDITIONALLY, HHSC HOLDS MONTHLY AND BI MONTHLY WORKGROUP MEETINGS FOR EVV STAKEHOLDERS. THESE MEETINGS PROVIDE INFORMATION TO STAKEHOLDERS ON ACTIVITIES, AND THE OPPORTUNITY TO ASK QUESTIONS SUGGEST IMPROVEMENTS AND ESCALATE ISSUES THAT MAY NEED ASSISTANCE WITH. HHSC SHARED THE ALTERNATIVE
[01:00:04]
DEVICE LIMITS WITH COMPLIANCE POLICIES AND THE COMPLIANCE POLICIES WITH THE STAKEHOLDERS THERE IN THE WORKGROUP MEETINGS AND FOR THE PROPOSED RULES TODAY, HHSC POSTED THE DRAFT RULES ON ITS WEBSITE FOR AN INFORMAL COMMENT.FROM NOVEMBER 12TH 2025 TO NOVEMBER 25TH 2025.
THESE PROPOSED RULES ARE SCHEDULED TO BE ADOPTED IN AUGUST 2026. AND WITH THAT I WILL TAKE ANY
QUESTIONS THAT YOU MAY HAVE. >> THANK YOU, MEMBERS ANY QUESTIONS? THANK YOU SO MUCH.
>> THANK YOU. NOW WE WILL MOVE TO THE NEXT AGENDA ITEM WHICH IS 3B AND THESE ARE FOR REAL PROPOSALS THAT HAVE BEEN SUBMITTED TO THE TEXAS REGISTER BUT NOT PUBLISHED AND THE PUBLIC COMMENT. UNDER THE ADMINISTRATIVE PROCEDURES ACT HAS NOT YET OPENED AS OF THE DATE OF THIS MEETING HOWEVER WE DO WELCOME COMMENTS AT THIS MEETING.
>> THANK YOU AGENDA ITEM 3B1, RULE 25R018 WILL BE PRESENTED BY
GILLIAN. >> GOOD MORNING, MY NAME IS GILLIAN, I'M A DEPUTY ASSOCIATE COMMISSIONER WITH CHILD CARE REGULATIONS. HHSC IS PROPOSING A RULE UPDATE ENTITLED 26 PART ONE CHAPTER 745, RELATED TO BACKGROUND CHECKS FOR REGULATED CHILD CARE OPERATIONS.
THIS RULE PROPOSAL IMPLEMENTS SENATE BILL 1849 FROM THE 80TH REGULAR LEGISLATIVE SESSION SENATE BILL 1849 ADDED CHAPTER 10 TO THE TEXAS HEALTH AND SAFETY CODE AND ALSO AMENDED CHAPTER 42 OF THE TEXAS HUMAN RESOURCES CODE.
AS YOU HAVE HEARD OTHERS TALK ABOUT THIS MORNING, THIS BILL REQUIRED THE CREATION OF AN INTERAGENCY REPORTABLE CONDUCT SEARCH ENGINE THAT INCLUDES FINANCE OF REPORTABLE CONDUCT FOR PARTICIPATING STATE AGENCIES.
AND IT IS CALLED SEMARC, THE SEARCH ENGINE FOR MULTI-AGENCY REPORTABLE CONDUCT. THIS SPECIFIC PROPOSED RULE CHANGE DEFINES THE SEARCH ENGINE REQUIRED BY STATUTE, REQUIRES CHILD CARE REGULATIONS USE OF THE SEARCH ENGINE IS ANY PART OF THE BACKGROUND CHECK REQUIRED BY CHAPTER 745 AND CLARIFIES THAT REPORTABLE CONDUCT FINDINGS MAY PREVENT A PERSON FROM BEING PRESENT IN AN OPERATION OR MAY AFFECT A PERSON'S ABILITY TO RECEIVE OR MAINTAIN ADMINISTRATOR'S LICENSE.
THE PUBLIC BENEFIT FROM THE PROPOSED RULE CHANGE WILL INCREASE PROTECTIONS FOR CHILDREN AND REGULATED SETTINGS FOR PERSONS WITH A HISTORY OF REPORTABLE CONDUCT.
DO YOU HAVE ANY QUESTIONS? >> I THINK WE ARE SEEING ALL THAT SEMARC RULES FROM THE DIFFERENT PROGRAMS THAT ARE BEING IMPACT COME THROUGH, THANK YOU.
>> NEXT AGENDA ITEM 3B, RULE 26R067 WILL BE PRESENTED BY JILL
I AM JOE WILLIAMS DIRECTOR OF FOOD AND DRUG SAFETY UNIT AT DEPARTMENT OF STATE HEALTH SERVICES.
DSHS UPDATING LICENSING FEES RELATED TO MOBILE FOOD VENDORS, AND PROPOSING AMENDMENT TO RULES ENTITLED 25 PART ONE CHAPTER 229, SUBCHAPTER U AND Z. THE PROPOSED AMENDED LICENSING FEES WILL PREVENT A CONFLICT WITH NEW CHAPTER 226 WHICH IS A RESULT OF HOUSE BILL 2844 FROM THE 88TH REGULAR SESSION AND NEW HEALTH AND SAFETY CODE CHAPTER 47B AND 226 GOES INTO EFFECT 2026. THE PUBLIC WILL BENEFIT BECAUSE MOBILE FOOD RULES WILL BE IN ONE CHAPTER AND THE RULES WILL ALIGN WITH STATUTES AND WILL BE EASIER TO UNDERSTAND.
I'M HAPPY TO TAKE ANY QUESTIONS. AND I THINK I HAVE THE NEXT ONE
AS WELL. >> YOU CAN STAY RIGHT THERE.
[01:05:02]
>> MR. WILLIAMS WILL ALSO PRESENT THE RULE FOR 3B3,
D S. -- DSHS IS UPDATING RULES TO MOBILE FOOD VENDORS BY PROPOSING A REPEAL TO RULES ENTITLED 25 PART ONE CHAPTER 228 ALSO KNOWN AS TEXAS FOOD ESTABLISHMENT RULES SUBCHAPTER H. THE PROPOSED REPEAL WILL PREVENT A CONFLICT WITH NEW CHAPTER 226 WHICH IS A RESULT OF HOUSE BILL 2844 FROM THE 89TH REGULAR SESSION AND WHICH GOES INTO EFFECT ON MAY 31ST 2026. THE PUBLIC WILL BENEFIT BECAUSE THE MOBILE FOOD VENDOR RULES WILL NOW BE IN ONE CHAPTER AND THE RULES WILL ALIGN WITH THE STATUTE AND THEY WILL BE EASIER TO UNDERSTAND. HAPPY TO TAKE ANY QUESTIONS.
>> THANK YOU SO MUCH. >> THANK YOU.
[4. Public comment ]
>> WE ARE READY TO MOVE ON TO AGENDA ITEM FOUR WHICH IS PUBLIC COMMENTS. ARE THERE ANY PUBLIC COMMENT
CARDS? >> YES EXECUTIVE COMMISSIONER, THERE ARE TWO PRE-REGISTERED PUBLIC COMMENTERS TODAY, FOR AGENDA ITEM NUMBER 4. I WILL READ THE PUBLIC COMMENT ANNOUNCEMENT NOW AND THEN WE WILL BEGIN WITH THE FIRST COMMENTER. HEALTH AND HUMAN SERVICES IN COMPLIANCE WITH THE TEXAS OPEN MEETING ACT PROVIDES THE OPPORTUNITY FOR THE PUBLIC TO ADDRESS COUNCIL MEMBERS.
FOR PUBLIC ACCOUNTABILITY AND TRANSPARENCY.
ANYONE WISHING TO PROVIDE PUBLIC COMMENT MAY BE ASKED TO LIMIT THEIR REMARKS TO 3 MINUTES. THE TIME WILL REFLECT YELLOW WHEN YOU HAVE ONE MINUTE REMAINING AND STOP WHEN THE TIME IS UP. PLEASE BE RESPECTFUL OF THE PUBLIC COMMENT TIME LIMITATIONS. PLEASE REMEMBER THAT CONFIDENTIAL INFORMATION SHOULD NOT BE SHARED.
AS A REMINDER COMMENTERS MUST COMPLY WITH APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS REGARDING ACCESS USE OR DISCLOSURE OF HEALTH INFORMATION OR OTHER SENSITIVE PERSONAL INFORMATION. THIS INCLUDES BUT IS NOT LIMITED TO TITLE 42 CODE FEDERAL REGULATIONS PART TWO, WHICH RESTRICTS THE USE OF INFORMATION PERTAINING TO DRUG, ALCOHOL ABUSE AND TREATMENT IN TEXAS HEALTH AND SAFETY CODES.
CHAPTER 611 .006. WHICH RESTRICTS DISCLOSURE OF CONFIDENTIAL INFORMATION OR RECORDS.
AT THIS TIME I WOULD LIKE TO BEGIN PUBLIC COMMENT AND CALL ON LINETTE I BELIEVE IN THE VIRTUAL PLATFORM.
YOU MAY PROCEED, MA'AM. WE ARE NOT HEARING YOU.
IS IT POSSIBLE YOU ARE MUTED? >> HOW ABOUT NOW?
>> YES, MA'AM, GO AHEAD AND PROCEED.
>> THANK YOU. MY NAME IS LINETTE I'M THE EXECUTIVE DIRECTOR FOR BIG BEND REGIONAL HOSPITAL DISTRICT, THE LARGEST HOSPITAL DISTRICT IN TEXAS.
WE ARE ONE OF THE FEW HOSPITAL DISTRICTS THAT REPRESENTS TWO COUNTIES BOTH ON THE TEXAS AND MEXICO BORDER AND ONE OF THE MOST REMOTE PARTS OF THE COUNTRY.
I CREATED A HANDOUT FOR YOU ON THE HANDOUT THERE IS A MAP OF TEXAS THE TWO BORDER COUNTIES THAT ARE THE REGIONAL DISTRICT AND THE OTHER COUNTY IN BLUE REPRESENT REEVES HOSPITAL DISTRICT TODAY I WANT TO COMPARE THESE TWO HOSPITAL DISTRICTS.
LOOKING AT THE TABLE, YOU WILL SEE THAT WE HAVE SIMILAR POPULATIONS THE NEXT LINE SHOWS THE LANDMASS WHERE YOU CAN SEE THAT THE BIG BEND HOSPITAL DISTRICT HAS ABOUT FIVE TIMES THE SQUARE MILES. THE NEXT LINE SHOWS THE FUNDING BALANCE FOR BOTH ENTITIES. SHOCKINGLY DIFFERENT FUND BALANCES. AND HOW WAS THAT POSSIBLE GIVEN WE ARE NEIGHBORING COUNTIES? BUT WE ARE SO FINANCIALLY DIFFERENT, THE REASON IS OIL. FUNDS, THE HOSPITAL DISTRICT HAS OIL FUNDS AND THE BIG BEND HOSPITAL DOES NOT NEXT ON THE NEXT SLIDE YOU WILL SEE THE AMOUNT OF MONEY SPENT ON CARE.
THE BIG BEND HOSPITAL DISTRICT HAS FIVE TIMES THE EXPENSES OF THE OTHER, WHY IS THIS? OUR EXPENSES ARE SO MUCH GREATER BECAUSE IT COSTS MORE TO PROVIDE HEALTH CARE SERVICES WHERE WE LIVE AND THE NEED IS GREATER. SO FUNDING FROM RURAL TEXAS FOR HOSPITAL DISTRICTS SHOULD BE BASED ON NEED NOT EVENLY DIVIDED AND IN THE PAST TWO HHSC REVISIONS FOR TEXAS STRONG
[01:10:01]
LANGUAGE AND FUNDING FOR AN ISSUE TO NUMBER 1 FOR HOSPITAL DISTRICTS HAS BECOME MORE RESTRICTED.AND BOTH REVISIONS LANGUAGE ALLUDES TO POTENTIAL EQUAL DIVISION OF FUNDING AND THIS METHODOLOGY WOULD NOT BE TRANSFORMATIVE NOR WOULD IT SERVE THE COMMUNITIES THAT NEED IT MOST, AS YOU CAN SEE FROM THIS COMPARISON.
THIS METHODOLOGY WOULD BE DEVASTATING, A REIMBURSEMENT TYPE METHODOLOGY WOULD ALSO BE DETRIMENTAL BECAUSE WE CANNOT SPEND MONEY THAT WE DON'T ALREADY HAVE IN OUR BUDGET.
I AM VERY CONCERNED ABOUT THE LACK OF TRANSPARENCY BY HHSC AND THIS ENTIRE PROCESS. THE LIST OF HOSPITAL DISTRICTS, THOSE HOSPITAL DISTRICTS HAVE NOT BEEN RELEASED AND NOR HAS THE FUNDING METHODOLOGY. AND FINALLY I WILL LEAVE YOU WITH THIS, AMONG ALL THE ENTITIES TO APPLY FOR FUNDING FOR RURAL TEXAS.ORG THE HOSPITAL DISTRICTS ARE YOUR BEST PARTNERS. WE HAVE FULL TRANSPARENCY, FULL ACCOUNTABILITY, TO THE PUBLIC. UNLIKE OTHER NONPROFIT ORGANIZATIONS, THE HOSPITAL DISTRICTS ARE OPEN, WE ARE SUBJECT TO THE OPEN MEETINGS ACT AND PUBLIC INFORMATION ACT SO WE ARE YOUR TRUE TRANSPARENT PARTNER BUT I FEAR THAT OUT OF CONVENIENCE OR IN A HURRY TO DISTRIBUTE THIS FUNDING TO THE HOSPITAL DISTRICTS UNDER INITIATIVE ONE, THAT HHSC WILL HIT THE EASY BUTTON AND JUST DIVIDE IT EVENLY SO WE ASK YOU TO PLEASE CONSIDER TO BALANCE THE HEALTH EQUITY AND DISTRIBUTE FUNDING TO THE HOSPITAL DISTRICTS BASED ON NEED
THANK YOU. >> THANK YOU FOR YOUR COMMENTS TODAY, MEMBERS ARE THERE ANY QUESTIONS?
>> I WILL NOW CALL ON OUR SECOND PUBLIC COMMENT REGISTRANT.
MR. JORDAN, SPEAKING ON BEHALF OF AGENDA ITEM RULE THREE IV.
>> GOOD MORNING CAN YOU HEAR ME? >> YES, WE CAN AND WE CAN SEE
YOU, YOU MAY PROCEED. >> THANK YOU GOOD MORNING MY NAME IS JORDAN, I SERVE IN A SYSTEMS LEVEL ROLE SUPPORTING PROVIDERS ACROSS TEXAS MEDICAID AND I ALSO BRING LIVED EXPERIENCE NAVIGATING THE SYSTEM TO ACCESS MEDICALLY NECESSARY CARE. I WANT TO BE CLEAR AT THE BEGINNING I STRONGLY OPPOSE PROPOSED RULE 25 R003 AS WRITTEN. NOT BECAUSE I OPPOSE ADDING NEW MEDICATIONS TO THE FORMULARY BUT BECAUSE OF HOW THIS RULE IS STRUCTURED AND WHAT IT ALLOWS TO HAPPEN IN PRACTICE.
ON PAPER THIS RULE IS FRAMED AS EXPANDING ACCESS BUT IN REALITY IT CREATES A NEW BARRIER. UNDER PROPOSED RULE 25 R003 NEW DRUGS ARE AUTOMATIC CLASSIFIED AS TEMPORARY PREFERRED NON-PREFERRED, AND REQUIRED PRIOR AUTHORIZATION MEANING ACCESS IS RESTRICTED BY THAT FALL AND CONTROLLED AT THAT MANAGED CARE ORGANIZATION LEVEL. SO IN PRACTICE MANAGED CARE ORGANIZATIONS CAN DENY ACCESS AT THE PLANNED LEVEL WITHOUT ESCALATION WITHOUT CENTRALIZED CLINICAL REVIEW AND WITHOUT TRANSPARENCY. THIS IS NOT THE -- THEORETICAL THIS EXACT MECHANISM IS ALREADY HAPPENING UNDER CURRENT PRIOR AUTHORIZATION AND PROCESSES. I HAVE PERSONALLY EXPERIENCED THIS MULTIPLE TIMES WHERE REQUESTS WERE DENIED AT THE PLANNED LEVEL WITHOUT BEING EVALUATED FOR FULL CLINICAL REVIEW. AND THIS CONCERN IS REINFORCED BY RECENT ENFORCEMENT ACTIONS BY THE STATE OF TEXAS.
ON MARCH SEVENTH 2025, ATTORNEY GENERAL ANNOUNCED A $40 MILLION SETTLEMENT WITH THE HEALTH CARE TAXES RESOLVING ALLEGATIONS THAT THE CLIENTELE TO TIMELY STAR PLUS MEMBERS FOR REQUIRED SERVICES AND CONCEALED THAT NONCOMPLIANCE FROM THE STATE.
HIGHLIGHTING THE RISK OF ALLOWING CRITICAL DECISIONS TO REMAIN AT THE PLANNED LEVEL WITHOUT REQUIRED STATE REVIEW.
WHEN OVERSIGHT IS OPTIONAL COMPLIANCE BECOMES INCONSISTENT AND PATIENTS BEAR THE RISK. AND THERE IS A REAL CONSEQUENCE TO THAT GAP. AND FAIR HEARINGS THE PROGRAM DOES NOT ATTEND WHEN THERE HAS NOT BEEN A FORMULARY EXCEPTION REQUEST DECISION. THAT MEANS THE STATE LEVEL CLINICAL AUTHORITY IS NOT PRESENT TO EXPLAIN OR DEFEND THE DENIAL. THAT RAISES SERIOUS DUE PROCESS CONCERNS. UNDER GOLDBERG VERSUS KELLY AND MATTHEW VERSUS ALDRIDGE TO UNITED STATES SUPREME COURT RULINGS INDIVIDUALS HAVE A RIGHT TO A MEANINGFUL REVIEW BEFORE BEING DEPRIVED OF BENEFITS. INCLUDING A COMPLETE RECORD AND PARTICIPATION FROM THE APPROPRIATE DECISION MAKING AUTHORITY. WHEN THIS PROGRAM IS NOT INVOLVED THE PROCESS IS INCOMPLETE AND THE RISK FOR
[01:15:05]
DENIAL INCREASES. AND THAT IS DIRECTLY TIED TO HOW THIS ROLE IS STRUCTURED. MY RECOMMENDATION IS STRAIGHTFORWARD AND NECESSARY. REQUIRED THAT ALL DMP PRIOR OPERATION -- BE -- PRESENTED AS A FORMULARY REQUEST AND REQUIRED DETERMINATION BEFORE ANY DENIAL TERM OCCUR.THIS ENSURES CASE BY CASE CLINICAL REVIEW WHICH VENDOR DRUG PROGRAM HAS CLAIMED IN THEIR OWN BOARD MEETINGS THAT THAT DOES EXIST. HOWEVER IN FIVE FAIR HEARINGS THAT I HAVE HAD THAT PROCESS WAS NEVER TAKEN.
BECAUSE MY MCO REFUSED TO SUBMIT A FORMULARY EXCEPTION REQUEST.
IF WE CONTINUED THE RULE AS PROPOSED THEN THIS ACTION WILL KEEP HAPPENING AND IT WILL LEAD TO THE HHSC TO CONTINUING HAVING TO SPEND MORE FOR HEALTH CARE BECAUSE THE HEALTH NEEDS OF PERSONS WHEN YOU DELAY ACCESS TO MEDICALLY NECESSARY CARE INCREASES. THE FINAL EXAMPLE I HAVE IS BECAUSE IT TOOK TWO AND A HALF YEARS FOR ME TO GET ACCESS TO THIS I AM NOW ON OXYGEN AND THAT IS SOMETHING THAT COULD HAVE BEEN PREVENTED HAD I BEEN GRANTED ACCESS TO MEDICATION I NEED DUE TO MY SYNDROME AND LIFE THREATENING ALLERGY THAT THE STATE AS WELL AS THE HEALTH CARE HAS KNOWN ABOUT SINCE I STARTED THE FAIR HEARING PROCESS IN 2023.
THANK YOU AND I AM HERE TO ANSWER ANY QUESTIONS YOU MAY
HAVE. >> THANK YOU SO MUCH, MEMBERS
ARE THERE ANY QUESTIONS? >> NO QUESTIONS, THANK YOU SO
MUCH. >> I BELIEVE THAT IS IT FOR OUR PUBLIC COMMENT TODAY, IS THAT CORRECT?
>> YOU ARE CORRECT EXECUTIVE COMMISSIONER MUTH.
>> THANK YOU COUNCIL MEMBERS FOR YOUR TIME, THIS CONCLUDES ALL OF THE BUSINESS ON THE AGENDA AND PLEASE NOTE FOR THE RECORD THAT AT 11:21 P.M. -- A.M. IT IS NOT THAT LONG, THIS
* This transcript was compiled from uncorrected Closed Captioning.