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Please see attached for HHSC’s presentation and below for a summary of the HHSC Stakeholder Forum.
 

HHSC Stakeholder Forum
October 13, 2014

 
FY 2016-17 Summary of LAR Request

  • 28% or 4.8B increase from FY 2014-15
  • The state will have a $981.4M shortfall in funds appropriated to CHIP and Medicaid this biennium due to increased medical costs, utilization and caseloads
  • HHSC’s Base Request for the 2016-17 biennium totals $58.8 billion All Funds, which is an increase of $5.7 billion All Funds, or 10.8 percent, over the estimated 2014-15 biennial budget of $53.1 billion All Funds
  • 2016-17 Base Request totals $23.5 billion GR, which is an increase of $3.2 billion GR, or 15.5% above the estimated 2014-15 biennial budget of $20.4 billion GR
  • Medicaid caseload in 2014 totaled 3,785,028; caseloads are projected to be 4,664,392 in FY 2017
  • Maintain requests for:
    • Enrollment Broker Services
    • OIG lease costs
    • Medicaid Fraud and Abuse Detection System
    • Data Center Services
    • Claims Administrator costs
    • Replacement of equipment at the regional laundry
    • HHSC vehicle fleet to support program operations
    • Defense on children’s litigation
  • Enhancement or improvement requests for:
    • Increase Existing Family Violence Capacity
    • Implement Asset Verification System
    • Support Workload Distribution Solution for Eligibility
    • Establish Small House Nursing Facilities
    • Security Enhancements for Regional HHS Client Facilities
    • Expansion of Food Service & Nutrition Care Management Software
    • Improve Medicaid Staffing and Support
  • IT Improvement Requests:
    • HHS Recruitment & Retention Initiatives
    • Cyber Security
    • Network Performance and Capacity
    • Telecommunications
    • HHSAS Financials Upgrade
    • Employee Technical Support

Managed Care Expansion

  • September 1, 2014 HHSC expanded managed care to cover the Medical Rural Service Areas (MRSA) and individuals with intellectual and developmental disabilities (IDD)
    • Added behavioral health services to MCO benefits
      • Available to adults with severe and persistent mental illness and children 3-17 with a diagnosis of mental illness or exhibit serious emotional disturbance
      • HHSC coordinates with MCOs and LMHAs to provide guidance and deal with implementation issues
      • HHSC is using the Adults Needs and Strengths Assessment and the Child and Adolescent Needs and Strengths assessment to ensure consistency
    • The IDD population had a higher rate of choosing their MCO than in previous expansions
    • HHSC is conducting “listening sessions” across the state to get feedback from the people in their communities
  • Upcoming Expansions:
    • March 1, 2015 – nursing facility services will be cared in to managed care
    • March 1, 2015 – a dual demonstration project will begin in 6 counties in Texas for adults that receive both Medicare and Medicaid benefits
    • September 1, 2016 – STAR KIDS will begin for children 20 and younger who have Medicaid through SSI or a 1915© waiver program

 
1115 Waiver Update

  • There are 1,491 approved and active DSRIP projects in Texas
    • Major focus on behavioral health, access to primary care, chronic care management and preventative care
  • The five year waiver is set to expire on September 30, 2016
  • HHSC must submit a transition plan to CMS by March 31, 2015
  • A renewal request must be submitted to CMS by September 30, 2015
    • The renewal request must include a demonstration summary, demonstration objectives and provide evidence of how objectives were met
    • HHSC will work with stakeholders to develop the waiver renewal request
    • If Texas submits a 3 year renewal request with no changes to the waiver terms and conditions, CMS has 6 months to approve or deny
    • If Texas requests a 5 year renewal than both HHSC and CMS may request changes to the current waiver terms