bill setting a $15 hourly floor for Medicaid personal attendants

The text as introduced · 865 words

89R2216 KKR-D

By: Lalani
H.B. No. 836

A BILL TO BE ENTITLED

AN ACT

relating to establishing a minimum base wage for certain personal

attendants under Medicaid and other programs administered by the

Health and Human Services Commission.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter F, Chapter 540, Government Code, as

effective April 1, 2025, is amended by adding Section 540.0281 to

read as follows:

Sec. 540.0281. COMPLIANCE WITH MINIMUM BASE WAGE FOR

CERTAIN PERSONAL ATTENDANTS. A contract to which this subchapter

applies must require the contracting Medicaid managed care

organization to ensure provider compliance with the minimum base

wage requirement for personal attendants under Section 546.0752.

SECTION 2. Chapter 546, Government Code, as effective April

1, 2025, is amended by adding Subchapter P to read as follows:

SUBCHAPTER P. PERSONAL ATTENDANT SERVICES

Sec. 546.0751. DEFINITIONS. In this subchapter:

(1) "Consumer direction model" means a consumer

direction model implemented under Subchapter C.

(2) "Contractor" means a person that contracts with

the commission, a Medicaid managed care organization, or an

employer or designated representative under a consumer direction

model to provide personal attendant services to individuals

eligible to receive those services under a program administered by

the commission.

(3) "Personal attendant" means an individual who is

engaged as an employee or subcontractor to directly provide

personal attendant services to an individual eligible to receive

those services under a program administered by the commission.

(4) "Personal attendant services" means nonmedical

services that enable an individual to engage in the activities of

daily living or to perform the physical functions required for

independent living, including:

(A) bathing, dressing, grooming, feeding,

exercising, toileting, positioning, routine hair and skin care, and

other personal care services;

(B) transfer or ambulation, transportation, and

other mobility support services;

(C) light housekeeping, grocery shopping, meal

preparation, laundry, and other household assistance;

(D) assisting with self-administered

medications;

(E) monitoring health-related needs and other

health management needs; and

(F) in-home respite services.

Sec. 546.0752. MINIMUM BASE WAGE FOR PERSONAL ATTENDANTS.

(a) This section applies only with respect to the following

programs administered by the commission:

(1) Medicaid, including a waiver or other program

established under:

(A) Section 1115 of the Social Security Act (42

U.S.C. Section 1315);

(B) Section 1915(b), (c), or (k) of the Social

Security Act (42 U.S.C. Section 1396n(b), (c), or (k)); or

(C) Section 1929 of the Social Security Act (42

U.S.C. Section 1396t); and

(2) a program authorized under Subtitle A, Title XX,

of the Social Security Act (42 U.S.C. Section 1397 et seq.).

(b) Notwithstanding Section 62.051 or 62.151, Labor Code,

or any other law, a contractor must pay a personal attendant who is

engaged to provide personal attendant services under a program to

which this section applies a base wage that is not less than the

greater of:

(1) $15 an hour; or

(2) the federal minimum wage under Section 6, Fair

Labor Standards Act of 1938 (29 U.S.C. Section 206).

Sec. 546.0753. COMPLIANCE MONITORING; REPORTING

VIOLATIONS. (a) The commission shall monitor compliance with the

minimum base wage required under Section 546.0752.

(b) The executive commissioner by rule shall establish a

process by which a personal attendant may confidentially report a

violation of Section 546.0752. The process must ensure that a

personal attendant is not retaliated against for reporting a

violation.

Sec. 546.0754. RESPONSIBILITY OF CERTAIN CONTRACTORS UNDER

CONSUMER-DIRECTED SERVICES OPTION. A person who contracts with the

commission to provide financial management services or consumer

managed personal attendant services under a consumer direction

model shall ensure that an employer or designated representative

complies with the minimum base wage requirement for personal

attendants under Section 546.0752.

Sec. 546.0755. FUNDING. In addition to money appropriated

by the legislature, the commission shall seek and accept federal

money and grants to help fund the minimum base wage requirement for

personal attendants under Section 546.0752.

Sec. 546.0756. ANNUAL REPORT. Not later than December 1 of

each year, the commission shall submit to the legislature a report

on the effectiveness of the minimum base wage for personal

attendants required under Section 546.0752.

Sec. 546.0757. RULES. The commission shall adopt rules

necessary to implement this subchapter.

SECTION 3. Section 546.0752, Government Code, as added by

this Act, applies beginning with the 2026 calendar year.

SECTION 4. The report required to be submitted during the

2026 calendar year under Section 546.0756, Government Code, as

added by this Act, must contain an assessment of the effect

increasing the minimum base wage under Section 546.0752, Government

Code, as added by this Act, had on the provision of personal

attendant services under the applicable commission-administered

programs, including a determination of whether:

(1) the quality of personal attendant services

provided under the programs improved; and

(2) the retention rate of personal attendants

increased as a result of the wage increase.

SECTION 5. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the agency affected by the provision shall request the waiver or

authorization and may delay implementing that provision until the

waiver or authorization is granted.

SECTION 6. This Act takes effect September 1, 2025.