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🚨 Final Rules for MDCP Nursing Facility Diversion– Public Hearing & Stakeholder InputDate/Time: Monday, Oct 12, 2026 | 10:00 AM
The Health and Human Services Commission (HHSC) will conduct a hybrid public hearing to solicit feedback and public comment on the final proposed rule amendment to Texas Administrative Code, Title 1, Part 15, Chapter 353, Subchapter M, Section 353.1155. This rule amendment creates diversion slots that will allow certain individuals who are at risk of nursing facility admission to access the Medically Dependent Children Program, and will replace the Money Follow the Person (MFP)/Rider 28 limited-stay pathway. This will be a hybrid hearing conducted both IN PERSON and ONLINE.
Attendees who would like to provide public comment should see the Public Comment section below.
🔗 https://www.hhs.texas.gov/about/meetings-events/2026/10/12/public-hearing-notice-medically-dependent-children-program-nursing-facility-diversion-slots
The proposed final rule maintains the dramatic changes proposed under the informal rule proposal earlier this year, with the addition of a new definition of "medically fragile' which would apply to the entire MDCP program as currently drafted. These changes include:
- MDCP NF Diversion to replace the current Money Follows the Person / Rider 28 limited-stay pathway to access MDCP for children with complex medical needs in crisis.
- A revised diversion model
- Significant changes to eligibility criteria and access
- Codying new non-standard medical definitions in administrative code
- 120 slots funded under the proposed new process vs historic uptake numbers from FY26 (239) and FY25 (225)
These changes come at a time when many state Medicaid programs are navigating evolving federal funding and policy dynamics, where access and eligibility pathways, anticipated budget constraints, and utilization controls are often closely evaluated.
📣 Families, providers, and advocates are encouraged to stay informed, share lived experiences, watch for action alerts, and participate in the public process.
Members of the public who would like to provide public comment may choose from the following options:
1. VIRTUAL COMMENTS: To provide virtual comments, you must PRE-REGISTER IN ADVANCE by NO LATER THAN 5 PM, SUNDAY 10.11.26 by completing a Public Comment Registration form at https://texashhs.org/MDCP_PCReg_Oct12_2026
Be sure to mark the correct box on the Public Comment Registration form and provide your name, either the organization you are representing or that you are speaking as a private citizen, and your direct phone number. If you have completed the Public Comment Registration form, you will receive an email the day before the public hearing with instructions for providing virtual public comment.
There will be no open discussion during the public comment period. Comment time for each individual will be determined by the total number of people registered to speak in the time allotted. Comments may be limited to three minutes per speaker. Each speaker providing oral public comments virtually must ensure their face is visible and their voice audible to the other participants while they are speaking. Each speaker must state their name and on whose behalf they are speaking (if anyone). If you pre-register to speak and wish to provide a handout before the public hearing, please submit an electronic copy in accessible PDF format that will be distributed by HHSC staff to HHSC staff. Handouts are limited to two pages (paper size: 8.5” by 11”, one side only). Handouts must be emailed to [email protected] immediately after pre-registering, but no later than 5:00 p.m. Sunday, October 11, 2026, and include the name of the person who will be commenting. Do not include health or other confidential information in your comments or handouts.
2. WRITTEN COMMENTS: Members of the public may provide written public comments by completing a Public Comment Registration form at https://texashhs.org/MDCP_PCReg_Oct12_2026. A member of the public who wishes to provide written public comments must email the comments to no later than 5:00 p.m. Sunday, October 11, 2026. Please include your name and the organization you are representing or that you are speaking as a private citizen. Written comments must be emailed to HHSC immediately after pre-registering and include the name of the person who will be commenting. Email can be sent to: [email protected]. Written comments are limited to two pages (paper size: 8.5” by 11”, one side only). Do not include health or other confidential information in your comments. Staff will not read written comments aloud during the public hearing, but comments will be provided to the appropriate State staff.
3. IN-PERSON ORAL COMMENTS: Members of the public may provide oral public comment during the public hearing in person at the public hearing location either by pre-registering using the form above or without pre-registering by completing a form at the entrance to the hearing room. There will be no open discussion during the public comment period. Comment time for each individual will be determined by the total number of people registered to speak in the time allotted. Comments may be limited to three minutes per speaker. Do not include health or other confidential information in your comments.
Note: These procedures may be revised at the discretion of HHSC.
Contact: Questions regarding agenda items, content, or public hearing arrangements should be directed to MDCPPolicy [at] hhs.texas.gov.
Persons who want to attend the public hearing and require assistive technology or services should contact MDCPPolicy [at] hhs.texas.gov at least 72 hours before the public hearing so appropriate arrangements can be made.
This public hearing will be webcast. Members of the public may attend the public hearing in person at the address above or access a live stream of the public hearing at: https://texashhsmeetings.org/HHSWebcast. Select the tab for "Winters Live" on the date and time for this public hearing.
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