BILL ANALYSIS



H.B. 648
By: Ramsay
05-01-95
Committee Report (Amended)


BACKGROUND

     The Texas Department of Human Services (DHS) allows Medicaid
recipients residing in nursing homes, ICF-MR or personal care
facilities a personal needs allowance of $30 per month to cover
such personal needs as haircuts, personal toiletries, dry cleaning,
and community events.  
     Federal law has required a minimum allowance of $30 since
1988.  Most other states allow recipients a higher allowance. 
Also, Medicaid recipients who remain at home or receive services in
the community through the nursing facility waiver program are
allowed to keep $85 for their monthly personal needs.  This
discrepancy should be minimized, but tight state budgets have
repeatedly precluded attempts to raise the allowance.  Both state
and federal funds are used to provide the allowance.


PURPOSE

     H.B. 648 would raise the personal needs allowance from $30 to
$35 per month, thereby providing residents of institutional care
paid by Medicaid more flexibility and control over their personal
expenditures.


RULEMAKING AUTHORITY

     It is the committee's opinion that H.B. 648 does not expressly
grant any additional rulemaking authority to a state officer,
department, agency or institution.


SECTION BY SECTION ANALYSIS

Section 1.  Amends Sec. 32.024, Human Resources Code, by adding new
subsection (t), as follows:

(t)  Requires DHS to set the personal needs allowance at $35 per
month for residents of long-term care facilities, including nursing
facilities, ICFs-MR, personal care facilities, or other similar
facilities operating with medical assistance (Medicaid) funds. 
Permits DHS to send such allowance directly to residents receiving
SSI.  Has no applicability to recipients in the nursing facility
waiver program.

Section 2.  Effective date, September 1, 1995, applicable only to
allowances paid on or after that date only.

Section 3. Emergency clause.


EXPLANATION OF AMENDMENTS

     Committee Amendment No. 1 decreased the amount of the increase
in the personal needs allowance by $5, such that DHS would set the
allowance at $35.


SUMMARY OF COMMITTEE ACTION

     The Human Services Committee convened in a public hearing on
March 20, 1995, and  the Chairman laid out H.B. 648.  Rep. Ramsay
explained the bill.  The following witnesses provided testimony for
H.B. 648:

Gary Dean Kay, The Texas Advocates, Austin
Gordon Israel, Draco Residences, Inc., Austin
Stephanie Thomas, ADAPT, Austin
James Templeton, ADAPT, Austin
Bob Kafka, ADAPT, Austin
Barrett Markland, Advocacy, Inc.
David Wittie, ADAPT, Austin
Mary Jo Magruder, TX Planning Council for Developmental
Disabilities
Phill Parmer, Texas Silver-Haired Legislature
John Holtermann, Texas Silver-Haired Legislature
Carlos Wayne Brawner, Guadalupe Self Advocates/Texas Advocates
William Jerome Boeck, Guadalupe Self Advocacy
Kellie Welden, Guadalupe Advocates
Barbara Hokom, Martin Luther Homes of Texas, Inc.; Persons with
Developmental Disabilities    residing in long-term care facilities
Win Frankel, Texas Silver-Haired Legislature
Kevin Tracy, Texas Advocates
Wayne Spahn, ADAPT
Jennifer McPhail, ADAPT
Danny Saenz, Austin
Kim Kirchoff, Texas Ass'n of Regional Councils
Melody Chatelle, Living Centers of America, Texas Health Care Ass'n
David Latimer, Texas Ass'n of Homes & Services for the Aging
Ed Allen, Texas Health Care Ass'n
Mike Bright, ARC of Texas

No one testified against or neutral on H.B. 648.  Rep. Ramsay
closed on the bill and H.B. 648 was left pending.

     While convened in a formal meeting on May 1, the committee
took up H.B. 648 which had been pending.  The Chairman offered
Committee Amendment No. 1 and explained its effect.  Rep. Naishtat
moved that Committee Amendment No. 1 be adopted and hearing no
objection, the amendment was adopted.  The Chairman recognized Rep.
Naishtat to move that the committee report H.B. 648 favorably as
amended; Rep. Davila seconded the motion.  The motion prevailed by
the following record vote of 8 Ayes, 0 Nays, 0 PNV and 1 Absent.