Text of section effective on April 01, 2025
Sec. 545.0104.  CALL CENTERS.  (a)  If cost-effective, the executive commissioner by rule shall establish at least one but not more than four call centers to determine and certify or recertify an individual's eligibility and need for services related to the following programs:
(1)  the child health plan program;
(2)  the financial assistance program under Chapter 31, Human Resources Code;
(3)  Medicaid;
(4)  nutritional assistance programs under Chapter 33, Human Resources Code;
(5)  long-term care services, as defined by Section 22.0011, Human Resources Code;
(6)  community-based support services identified or provided in accordance with Subchapter D, Chapter 546; and
(7)  other health and human services programs, as appropriate.
(b)  The commission shall contract with at least one but not more than four private entities to operate the call centers unless the commission determines that contracting would not be cost-effective.
(c)  Each call center:
(1)  must be located in this state, except that this subdivision does not prohibit a call center located in this state from processing overflow calls through a center located in another state; and
(2)  shall provide translation services as required by federal law for consumers who are unable to speak, hear, or comprehend the English language.
(d)  The commission shall develop consumer service and performance standards for the operation of each call center and make those standards available to the public.  The standards must address a call center's:
(1)  ability to serve consumers in a timely manner, including consideration of:
(A)  consumers' ability to access the call center;
(B)  whether the call center has toll-free telephone access;
(C)  the average amount of time a consumer spends on hold;
(D)  the frequency of call transfers;
(E)  whether a consumer is able to communicate with a live individual at the call center; and
(F)  whether the call center makes mail correspondence available;
(2)  staff, including employee courtesy, friendliness, training, and knowledge about the programs listed under Subsection (a); and
(3)  complaint handling procedures, including:
(A)  the level of difficulty involved in filing a complaint; and
(B)  whether the call center's complaint responses are timely.
(e)  The commission shall develop:
(1)  mechanisms for measuring consumer service satisfaction; and
(2)  performance measures to evaluate whether each call center meets the standards the commission develops under Subsection (d).
(f)  The commission may inspect a call center and analyze the call center's consumer service performance through a consumer service evaluator posing as a consumer.
(g)  Notwithstanding Subsection (a), the executive commissioner shall develop and implement policies that provide an applicant for services related to a program listed under Subsection (a) with an opportunity to appear in person to establish initial eligibility or comply with periodic eligibility recertification requirements if the applicant requests a personal interview.  In implementing the policies, the commission shall maintain offices to serve applicants who request a personal interview.  This subsection does not affect a law or rule that requires an applicant to appear in person to establish initial eligibility or comply with periodic eligibility recertification requirements.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.