By:  Vowell                                            H.B. No. 968
       73R2226 CBH-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the placement of certain persons in nursing facilities
    1-3  and to the funding of those services.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
    1-6  is amended by adding Section 32.0265 to read as follows:
    1-7        Sec. 32.0265.  NURSING FACILITY SERVICES FOR CERTAIN PERSONS.
    1-8  (a)  Regardless of a person's mental condition as identified by a
    1-9  preadmission screening and annual resident review, the department
   1-10  shall provide medical assistance to a person who resides in or is
   1-11  applying for admission to a nursing facility if:
   1-12              (1)  the department determines that the person is
   1-13  financially eligible for medical assistance; and
   1-14              (2)  the person's primary physician, who may be a
   1-15  medical specialist, determines and documents that:
   1-16                    (A)  it is in the person's best interest for
   1-17  medical reasons to remain in or be admitted to an identified and
   1-18  accepting nursing facility; and
   1-19                    (B)  there is a medical necessity under medical
   1-20  assistance eligibility guidelines for the nursing facility care.
   1-21        (b)  Specialized services to meet the needs of the person may
   1-22  be provided in the nursing facility.
   1-23        (c)  The department shall ensure that a preadmission
   1-24  screening and annual resident review for a child are conducted
    2-1  using medical conditions, cognitive, and functional limitations,
    2-2  including the exempting conditions from the level II assessment and
    2-3  the conditions that allow a person to be admitted to or remain in a
    2-4  nursing facility and to receive specialized services, that are
    2-5  comparable to and no more stringent than those used for adults.
    2-6  The department shall also ensure that the documentation for the
    2-7  assessment reflects comparable information specific to the child.
    2-8        SECTION 2.  Subchapter B, Chapter 533, Health and Safety
    2-9  Code, is amended by adding Section 533.044 to read as follows:
   2-10        Sec. 533.044.  PAYMENT FOR ALTERNATIVE PLACEMENT OF CERTAIN
   2-11  CHILDREN.  (a)  The department shall pay for the cost of placing a
   2-12  child with mental illness, mental retardation, or a related
   2-13  condition in a setting that is determined to be geographically
   2-14  acceptable and otherwise appropriate for the child's continued
   2-15  emotional and medical needs, including medical monitoring and
   2-16  intervention, if:
   2-17              (1)  the child is residing at a nursing facility or is
   2-18  applying for admission to a nursing facility;
   2-19              (2)  the child's primary physician, who may be a
   2-20  medical specialist, determines and documents that the child has a
   2-21  medical condition that warrants care in the nursing facility;
   2-22              (3)  the department determines after a preadmission
   2-23  screening and annual resident review that the child is not eligible
   2-24  for admission or continued residence in the facility;
   2-25              (4)  appropriate medical support cannot be identified
   2-26  in the child's own community; and
   2-27              (5)  an ICF-MR facility determined to be appropriate
    3-1  and acceptable does not exist or is not immediately available.
    3-2        (b)  A determination under Subsection (a)(5) shall be made by
    3-3  the child's parents or guardians and the child's primary physician,
    3-4  who may be a medical specialist.
    3-5        (c)  The department shall consult a psychologist or
    3-6  psychiatrist in determining the specialized services necessary for
    3-7  a child who has identified mental health or mental retardation
    3-8  needs and who is placed in an alternate treatment setting under
    3-9  this section.
   3-10        SECTION 3.  The importance of this legislation and the
   3-11  crowded condition of the calendars in both houses create an
   3-12  emergency and an imperative public necessity that the
   3-13  constitutional rule requiring bills to be read on three several
   3-14  days in each house be suspended, and this rule is hereby suspended,
   3-15  and that this Act take effect and be in force from and after its
   3-16  passage, and it is so enacted.