House Bill No. 4282 aims to amend the Government Code by adding Section 546.0303, which outlines the provisions for residential services under the Medicaid home and community-based services (HCS) waiver program. The bill defines a "Medicaid residential facility" as a group home or similar setting that provides residential services to recipients of the HCS waiver program. It allows these facilities to refuse admission to recipients based on specific criteria, including reaching service capacity, a history of severe emotional behavior that may lead to violence, or physical aggression that poses a danger to others. Additionally, the bill mandates that before placing medically fragile recipients in such facilities, the commission must assess the facility's capacity to provide necessary care.

Furthermore, the bill stipulates that if a state agency determines that federal authorization is required for any provision of the Act, the agency may delay implementation until such authorization is obtained. The Act is set to take effect on September 1, 2025.