During a hearing this week, the Health and Human Services Commission (HHSC)
submitted its exceptional items request to the House Appropriations Committee’s
(HAC) Subcommittee on Article II. Exceptional items are priorities the agency
considers of great importance in addition to the base budget. There were differences
between the exceptional items submitted to the HAC Subcommittee on Article II and
the exceptional items submitted to the Senate Finance Committee (SFC) in January — see TCDD blog post, “HHSC Submits Exceptional Items to Senate Finance Committee”.
The Senate and the House base budget bills reflect different starting points. Below are some examples of how the base budget bills for the two chambers of the legislature are different.
The House includes more funding for the Medicaid entitlement cost growth item, so the HHSC request to meet anticipated need is much smaller on the House side than on the Senate side.
The House’s base budget includes a restoration of half of the pediatric therapy rate reductions approved by the 84th Texas Legislature.
The House meets the 84th Texas Legislature’s commitment to the waiver caseload levels, or those anticipated to be receiving services, by the end of the biennium.
The HHSC presentation to the HAC Subcommittee on Article II includes exceptional items that have been revised since HHSC submitted its exceptional item request to SFC. HHSC revised its exceptional items to remove items the House included in its base budget, and also added new items in response to critical feedback provided by HAC last week.
Below you’ll find information about the exceptional items HHSC submitted to the HAC Subcommittee on Article II that may be of interest to people with disabilities in Texas.
New and Revised
Exceptional Item 14 (Senate Exceptional Item 13): This exceptional item request is reduced from the $108M GR, $256M AF request that was submitted to SFC to $17.3M GR, $39.4M AF because the House’s base budget meets the 84th Texas Legislature’s commitment to finish funding interest list reduction. The $17.3M GR funding would be used to develop a viable state supported living center cost reduction plan.
Exceptional Item 17 (new): This item is a placeholder for construction of new facilities, including state hospitals and state supported living centers.
Exceptional items of interest that remain the same for both the House and the Senate include day habilitation compliance, Early Childhood Intervention (ECI) caseload maintenance, and promoting independence.
Exceptional items that are still not included among HHSC’s requests include new interest list reduction, community attendant wages, and Intensive Behavioral Intervention for children with autism. These items were among the exceptional items that were included in HHSC’s original request submitted in September. These items are no longer under consideration by the 85th Texas Legislature.
Not Included at this Week’s Hearing
Items that were not discussed during the hearing this week were the Texas Home Living and Home and Community-based Services rate reductions reported to the Senate Finance Workgroup on Healthcare Costs, see Slide 20 of HHSC’s “Presentation to the Senate Finance Workgroup on Healthcare Costs,” February 3, 2017. It remains unclear how the rate reductions would impact attendant wages — particularly with respect to the rates under consumer direction.