Tex. Gov't Code Section 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 (Financial Assistance and Service Programs), Human Resources Code;

(3)

Medicaid;

(4)

nutritional assistance programs under Chapter 33 (Nutritional Assistance Programs), Human Resources Code;

(5)

long-term care services, as defined by Section 22.0011 (Definitions), Human Resources Code;

(6)

community-based support services identified or provided in accordance with Subchapter D, Chapter 546 (Long-term Care and Support Options for Individuals with Disabilities and Elderly Individuals); 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.

Source: Section 545.0104 — Call Centers, https://statutes.­capitol.­texas.­gov/Docs/GV/htm/GV.­545.­htm#545.­0104 (accessed Jun. 5, 2024).

545.0001
Definitions
545.0002
Development and Implementation of Integration Plan
545.0003
Methods to Address Fraud and Eligibility Error Rate
545.0004
Contract for Integration Plan Implementation
545.0005
Use of Other Agencies’ Staff and Resources
545.0006
Funding
545.0051
Consolidated Recipient Identification and Benefits Issuance Method
545.0052
Expansion of Billing Coordination and Information Collection Activities
545.0053
Service Delivery Area Alignment
545.0054
Program to Improve and Monitor Certain Outcomes of Medicaid Recipients and Child Health Plan Program Enrollees
545.0055
Minimum Collection Goal for Recovery of Certain Benefits
545.0056
Distribution of Earned Income Tax Credit Information
545.0057
Application Assistance for Financial Assistance Recipients Eligible for Federal Programs
545.0101
Memorandum of Understanding Regarding Medicaid and Child Health Plan Program Eligibility Determinations for Certain Children
545.0102
Verification of Immigration Status of Certain Applicants for Public Assistance Benefits
545.0103
Verification of Sponsorship Information for Certain Benefits Recipients or Enrollees
545.0104
Call Centers
545.0151
Definition
545.0152
Electronic Recording of Hearing
545.0153
Administrative Review
545.0154
Judicial Review
545.0201
Compliance with Solicitation Prohibitions
545.0202
Marketing Activities by Medicaid or Child Health Plan Program Providers
545.0203
Reimbursement Claims for Certain Medicaid or Child Health Plan Services Involving Supervised Providers
545.0204
Participation of Diagnostic Laboratory Service Providers in Certain Programs

Accessed:
Jun. 5, 2024

§ 545.0104’s source at texas​.gov