The House Committee on Human Services met on May 4th to discuss a full agenda. This report covers all five bills discussed: SB 73 (Miles), SB 271 (Perry), SB 642 (West), and HB 4058 (Meza).The archive of this hearing can be found here.

This report is intended to give you an overview and highlight of the discussions on the various topics the committee took up. It is not a verbatim transcript of the hearing but is based upon what was audible or understandable to the observer and the desire to get details out as quickly as possible with few errors or omissions.

 

Vote Outs:

HB 1190 (Krause) (5-2)

  • CS removes requirement for a SOA hearing before individual is added to central registry
  • Reconsidered vote (6-1)
    • G Hinojosa changed her vote

HB 3761 (Guillen) (6-1)

  • Reported to the full house, due pass and printed, sent to local and consent calendar

HB 4169 (Sanford) (6-1)

  • CS is lege council draft of bill filed- no substantive changes
  • Reported to the full house, due pass and be printed

SB 383 (Powell) (6-1)

  • Companion to HB 413
  • Requires facilities to disclose if they have proper certification or license to take care of those with Alzheimer’s
  • Prevents false marketing

SB 930 (Zaffirini) (7-0)

  • Companion to HB 3306

SB 1103 (Seliger) (7-0)

SB 1138 (Hughes) (7-0)

  • Companion to HB 1886, same language as CSHB 1886

SB 1829 (Hinojosa) (7-0)

  • To L&C, companion to 3238

 

Agenda:

SB 73 (Miles) Relating to providing access to local public health entities and certain health service regional offices under Medicaid.

  • Klick – Bill requires the Executive Commissioner HHSC to establish separate provider type for local public health entities for purposes of enrollment as a provider for reimbursement under Medicaid
  • Passed but ran out of time last session
  • CS will address fiscal note

 

Stephen Williams, Texas Association of City and County Health Officials – For

  • TACCHO actively works with commission on public health charity program to help support local health departments
  • Viable reimbursement solution for uninsured
  • Crucial for local health departments to receive reimbursements for services provided to Medicaid patients
  • Hopes bill is the first step managed care organizations being more intentional in contracting with local health departments
  • Without reimbursement, services are paid for by local tax dollars instead of already allocated state funds
  • Shaheen – Do county health care programs fall under this?
    • Not necessarily
    • Strictly related to is administrative process
    • When state transitioned to managed care, local health departments weren’t always recognized
  • Shaheen – Who are the local health departments that this affects, is this local county health indigent program?
    • Not necessarily
    • Any local or county health department that provides services
    • County indigent health care would not benefit from this
    • Sole purpose is to ensure local health departments get paid
  • Klick – Thinks it can be confusing because in larger counties there can be city health departments. But is familiar with how helpful they are and how they have been during COVID

 

Left Pending

 

SB 271 (Perry) Relating to applicants for employment at assisted living facilities.

  • Klick – Requires background checks for nurses
  • Registries must be checked annually
  • Requires Assisted Living facilities to conduct background checks in for every state the applicant has worked in the last 5 years
  • If facility hires someone while background check is still pending, new employee may not have any direct contact with residents until completion

 

Diana Martinez, Texas Assisted Living Association – For

  • Check both nurse registry and criminal record annually
  • Current system will not catch people moving from out of state if they had not committed a crime in Texas
  • Some companies use national check, but is very expensive
  • Bill gives an extra layer of protection for facilities

Klick, in Closing

  • Texas’ economy is a draw to new people everyday
  • Bill is common sense for Increasing mobile workforce

 

Left Pending

 

SB 642 (West) Relating to the provision of mental health services for certain children at risk of relinquishment.

  • G Hinojosa – Bill updates and streamlines the residential treatment center relinquishment avoidance program
  • Relinquishment avoided program helped youth who were mentally ill and being released back out into the world
  • Current law mandates that access to this program requires DFPS and CPS must investigate the parents prior to receiving services, even if there is no abuse allegation
  • Bill allows family to obtain mental health treatment without investigation
  • Normal wait time can be as long as 6-12 weeks
  • Many families don’t have that time
  • Required HHSC to adopt protocols for children who need immediate help
  • Frank – Appreciates bill being brought

 

Colleen Horton, Hogg Foundation for Mental Health – On

  • Worst thing can happen to parent is being forced to relinquish child because of extreme mental issues
  • Many changes have been made since creation in 2013 but more are needed
  • Wants changes to be made that were recommended by stakeholders
  • Needs to focus on the kids who need immediate help
  • Very little information or guidance is provided to parents

 

Santiago Cernigliaro, Texas Alliance of Child and Family Services – For

  • Families are dealing with red tape to get access to this help
  • Bill allows for families to have clear path to help
  • Prevents unnecessary investigations and relinquishing parental rights to access help
  • Keeps kids out of already overpopulated foster program
  • Noble – Great bill, would only like for this to go into effect immediately instead of September
  • Klick – Agrees

 

Left Pending

 

HB 4058 (Meza) Relating to a study on the provision of applied behavior analysis services to children with autism under Medicaid and other public benefits programs.

  • Determines efficacy of ABA services provided to children with autism
  • ABA therapy is based on respondent and operational conditioning to change behaviors
  • Formally called behavioral modification
  • HHSC budgeted 14 million dollars for focused autism therapies
  • TEA has provided 10 million-dollar grants to autism educational services
  • HHSC budgeted another 10 million for autism educational services
  • Average cost for treatment of a single child 70,000 a year
  • Cost is increasing by double digits every year, while child increase is only increasing by single digit
  • Need study to determine true cost to the state
  • Need to ensure that Texan children with autism need to be getting the best therapy

 

Lyric Holmans, NeuroDivergent Consulting and Self – For

  • ABA is controversial therapy
  • Is an autistic adult
  • Has seen first-hand the negative effects of this therapy
  • ABA is marketed with fear mongering tactics, claiming that parents must do this, or else child will fail in school or never be successful in life
  • Research behind this has largely been funded by people who would benefit financially
  • ABA is more expensive than other proven therapies
  • Frank – Asked about dollar amounts being spent
    • Doesn’t have
    • But shows that data is needed

 

Joy Davis, Texas Coalition Against Behavioral Coercion – For

  • Mother of autistic child
  • Believes it is in best interest of state to have up to date data on these programs
  • Some children in ABA spend up to 40 hours a week on it
  • How can children learn other things if they spend that much time on ABA
  • Previous study was only accessed by those who had means to pay for it out of pocket
  • Making autistic kids uncomfortable to make normal people comfortable is not right
  • Hall – Thank you for being here and advocating for you children

 

Mariel Fernandez, BlueSprig Pediatrics, TxABA – On

  • Has worked with children with Autism for 20 years
  • CMS, US Surgeon General, CDC, American Academy for Pediatrics and National Institute for Health and National Institute for Mental Health have all endorsed ABA as being most effective treatment for autism
  • Research shows that intensive ABA from quality provider works and those children make dramatic progress and improvements
  • In 2014, Meadow Center for Preventing Educational risk did report on Autism Program
  • Purpose was to identify the necessary components for effective early help programs and how these treatments should be conducted, for kids 10 and younger
  • Person with poor treated autism is estimated to spend 3.2 million over a lifetime
  • Short term cost of ABA can save 2.8 million per person across 55 years
  • Texas could save 290,000 per autistic children a year over 18 years
  • Estimated 80,000 kids waiting to access ABA
  • Frank – Is 19% ethicacy different from what you have
    • Yes
    • Will get stat
  • Hinojosa – Do you have an opinion on why people have such different opinions
    • Autism is a spectrum and is very different person to person
    • Programs target some areas, but doesn’t mean they don’t focus on other things also
  • Hinojosa – Asked if study would be helpful or does information already exists
    • Thinks it’s important to have latest information prevalent
    • As rates continue to change can’t gage total costs or future costs

 

Anna Sciarillo, Texas Analysis on Behavioral Analysis Public Policy Group – On

  • To teach ABA one must pass all the certifications
  • Cost can seem high, but without it children will incur larger and more long term costs
  • Average cost for intensive ABA for 2 years is 130,000 while average cost for institutional care 30 years 5.64 million

 

Meza, in Closing

  • Asked fewer people to testify in interest of time
  • Fiscal note exists in comp because it exists as an outside study, not inside
  • Study would examine benefits of funding by Medicaid or others
  • Study ABA for ethicacy and good cost-benefit analysis

 

Left Pending