88R8476 SCP-F
 
  By: Johnson S.B. No. 1675
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a pilot project to provide medical nutrition assistance
  to certain Medicaid recipients in this state.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.077 to read as follows:
         Sec. 32.077.  HEALTHY FOOD IS GOOD MEDICINE PILOT PROJECT.
  (a)  In this section:
               (1)  "Community-based organization" means an
  organization that:
                     (A)  is exempt from the payment of federal income
  taxes under Section 501(a), Internal Revenue Code of 1986, by being
  listed as an exempt entity under Section 501(c)(3) of that code;
                     (B)  provides medical nutrition assistance;
                     (C)  has an established agreement with a medical
  provider to implement medical nutrition assistance under this
  section; and
                     (D)  employs:
                           (i)  at least one registered dietitian
  nutritionist;
                           (ii)  culinary personnel; and
                           (iii)  support personnel capable of
  providing patient referrals to a medical provider, sourcing
  ingredients, and packaging and delivering meals to medical
  nutrition assistance recipients.
               (2)  "Medical nutrition assistance" means:
                     (A)  provision of medically tailored meals to
  individuals who have a chronic disease, including diabetes,
  congestive heart failure, chronic pulmonary disease, kidney
  disease, or other chronic disease, that is impacted by the
  individual's diet and limits at least one activity of the
  individual's daily living to support treatment and management of
  the disease; and
                     (B)  provision of medically tailored meals to
  individuals who experience food insecurity and have at least one
  chronic health condition directly impacted by the nutritional
  quality of food to support treatment and management of the
  condition.
               (3)  "Medical provider" means:
                     (A)  a federally qualified health center as
  defined by 42 U.S.C. Section 1396d(l)(2)(B); or
                     (B)  a participating provider, as defined by
  Section 32.101.
               (4)  "Medically tailored meal" means food prepared as
  prescribed by a dietician or other qualified health care
  professional to address an individual's chronic disease or health
  condition and any associated symptoms.
         (b)  The executive commissioner shall seek a waiver under
  Section 1115 of the federal Social Security Act (42 U.S.C. 1315) to
  the state Medicaid plan to develop and implement a five-year pilot
  project to demonstrate the cost effectiveness and improved health
  care outcomes of Medicaid recipients in this state who are provided
  medical nutrition assistance through medical providers and
  community-based organizations in not more than six service delivery
  areas. 
         (c)  The pilot project must be established in service
  delivery areas located in:
               (1)  a municipality with a population greater than
  670,000; or
               (2)  a county:
                     (A)  with a population greater than 65,000;
                     (B)  that is located on an international border;
  and
                     (C)  in which at least one World Birding Center
  site is located.
         (d)  The commission may collaborate and contract with
  managed care organizations, the state Medicaid managed care
  advisory committee, community-based organizations, and medical
  providers in administering the pilot project.
         (e)  In implementing the pilot project, the executive
  commissioner by rule shall establish eligibility criteria for
  Medicaid recipients to participate in the pilot project.
         (f)  The commission shall, to the extent allowed by a waiver
  obtained under Subsection (b), establish reimbursement rates for:
               (1)  a medical provider who through medical personnel,
  including dieticians, nutritionists, social workers, and community
  health workers, provides the following services:
                     (A)  assessments and screening of recipients to
  determine eligibility for participation in the pilot project; and
                     (B)  development of individual care plans and
  health outcome tracking for pilot project participants; and
               (2)  community-based organizations that provide the
  following services:
                     (A)  referral of recipients to a medical provider
  for assessment and screening for eligibility for participation in
  the pilot project;
                     (B)  ingredient sourcing and meal preparation for
  pilot project participants;
                     (C)  meal delivery to pilot project participants;
  and 
                     (D)  community outreach, including education on
  disease management, nutrition and health, and access to community
  nutrition services.
         (g)  The commission shall submit reports to the legislature
  on the results of a pilot project implemented under this section as
  follows:
               (1)  an initial report to be submitted not later than
  the first anniversary of the date the pilot project is implemented
  under this section;
               (2)  a second report to be submitted not later than 30
  months following the date the pilot project is implemented; and 
               (3)  a final report to be submitted not later than three
  months after the pilot project concludes.
         (h)  A report submitted to the legislature under Subsection
  (g) must include:
               (1)  the number of participants in the pilot project;
               (2)  any relevant medical outcomes for the
  participants, including:
                     (A)  insulin medication amounts required by
  participants with diabetes;
                     (B)  cardiac markers, sodium and potassium
  levels, and biometric parameters;
                     (C)  body mass index measurements;
                     (D)  blood pressure;
                     (E)  glomerular filtration rates and albumin
  levels; and
                     (F)  hospital admissions and emergency room
  visits;
               (3)  any cost savings or increased expenditures
  incurred as a result of the pilot project; and 
               (4)  a commission recommendation on whether to
  terminate, continue, or expand the pilot project.
         (i)  This section expires September 1, 2029.
         SECTION 2.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall apply for and actively pursue a waiver
  under Section 1115 of the federal Social Security Act (42 U.S.C.
  Section 1315) to the state Medicaid plan from the federal Centers
  for Medicare and Medicaid Services or any other federal agency to
  implement Section 32.077, Human Resources Code, as added by this
  Act.  The commission may delay implementing Section 32.077, Human
  Resources Code, as added by this Act, until the waiver applied for
  under this section is granted.
         SECTION 3.  This Act takes effect September 1, 2023.