By: Zaffirini, Moncrief S.C.R. No. 55
SENATE CONCURRENT RESOLUTION
1-1 WHEREAS, In its report to the 74th Legislature, the Senate
1-2 Health and Human Services Committee concluded that cost containment
1-3 and significant reform and improvement of the Medicaid program
1-4 could be achieved if the State of Texas obtains waivers of current
1-5 federal requirements in the areas of cost sharing and eligibility
1-6 and obtains additional waivers to conduct pilot studies of
1-7 long-term care, mental health and substance abuse, and
1-8 consumer-oriented support for persons with mental retardation; and
1-9 WHEREAS, With respect to cost sharing, copayments for medical
1-10 services have been shown to reduce inappropriate utilization of
1-11 services and to promote a client's sense of responsibility for the
1-12 client's own care; therefore, a waiver of federal regulations
1-13 prohibiting cost sharing should benefit both the Medicaid
1-14 beneficiary and the State of Texas; and
1-15 WHEREAS, Managed care organizations may develop policies in
1-16 addition to copayments to encourage a client's responsibility for
1-17 the client's own care; and
1-18 WHEREAS, Client access to a 24-hour telephone health advice
1-19 line may reduce inappropriate use of health care services by
1-20 increasing client confidence in health care decision-making; and
1-21 WHEREAS, A waiver to allow a guaranteed eligibility period of
1-22 12 months is advantageous since most clients who become ineligible
1-23 for Medicaid benefits are not able to secure other health insurance
1-24 coverage, with the result that: a client has a disincentive to
2-1 find work and lose eligibility; local governments incur additional
2-2 expense, since there is no federal match for providing care to the
2-3 uninsured; and managed care will be more difficult to implement,
2-4 since there is no incentive for managed care organizations to
2-5 participate in Medicaid if clients are only eligible for a short
2-6 period; and
2-7 WHEREAS, A waiver to allow an integrated managed care pilot
2-8 study of long-term care for the elderly and persons with
2-9 disabilities would be advantageous because integration of these
2-10 services into a statewide managed care program promises to reduce
2-11 cost shifting and the need for institutional care, improve access
2-12 and quality, and create greater accountability for outcomes;
2-13 however, very few states have implemented such services, and a
2-14 pilot study is necessary to accurately estimate potential savings;
2-15 and
2-16 WHEREAS, A waiver to allow an integrated managed care pilot
2-17 program for mental health and substance abuse services would be
2-18 advantageous because integration of these services promises to
2-19 reduce cost shifting between the acute care system and the mental
2-20 health and substance abuse services system; however, a pilot study
2-21 is necessary to determine how best to implement the program and to
2-22 accurately estimate potential savings; and
2-23 WHEREAS, A waiver to allow a consumer-oriented pilot program
2-24 for persons with mental retardation and other developmental
2-25 disabilities would be advantageous because consumer-centered
2-26 decision-making would increase competition, improve quality of
2-27 care, and allow families and individuals to make choices that best
3-1 suit their needs; however, there is insufficient experience with
3-2 such programs in other states, and a pilot study is needed before
3-3 statewide implementation; now, therefore, be it
3-4 RESOLVED, That the 74th Legislature of the State of Texas
3-5 hereby direct the State Medicaid Office to apply for a federal
3-6 waiver to allow copayments by Medicaid clients if those clients
3-7 have access to a 24-hour telephone health advice line; and, be it
3-8 further
3-9 RESOLVED, That the waiver application provide that prenatal
3-10 and well-child visits be exempted from the copayment for office
3-11 visits and include provisions for capping contributions from a
3-12 client who a physician determines should make regular office visits
3-13 to address a chronic medical condition and from a long-term care
3-14 client who has already made a copayment; and, be it further
3-15 RESOLVED, That the State Medicaid Office encourage managed
3-16 care organizations to develop policies in addition to copayments to
3-17 encourage a client's responsibility for the client's own care; and,
3-18 be it further
3-19 RESOLVED, That the State Medicaid Office apply for a federal
3-20 waiver to allow a guaranteed Medicaid eligibility period of 12
3-21 months; and, be it further
3-22 RESOLVED, That the State Medicaid Office apply for a federal
3-23 waiver to allow an integrated managed care pilot program for
3-24 long-term care for the elderly and for persons with disabilities
3-25 and that the program be developed with input from the public and be
3-26 implemented in both an urban and a rural area, if possible; and, be
3-27 it further
4-1 RESOLVED, That the State Medicaid Office apply for a federal
4-2 waiver to allow an integrated managed care pilot program for mental
4-3 health and substance abuse services and that the program be
4-4 developed with input from the public and be implemented in both an
4-5 urban and a rural area, if possible; and, be it further
4-6 RESOLVED, That the Health and Human Services Commission
4-7 develop a plan for statewide expansion of integrated mental health
4-8 and substance abuse services; and, be it further
4-9 RESOLVED, That the Health and Human Services Commission
4-10 submit a preliminary plan for expansion of sites to the Senate
4-11 Health and Human Services Committee by November 1, 1996, and a plan
4-12 for statewide expansion by November 1, 1998, and that the plan be
4-13 included in the consolidated budget request; and, be it further
4-14 RESOLVED, That the State Medicaid Office apply for a federal
4-15 waiver to allow a pilot program for individuals with mental
4-16 retardation and other developmental disabilities and that the pilot
4-17 program be consumer-oriented and include a decision support system
4-18 and functional assessment; and, be it further
4-19 RESOLVED, That the State Medicaid Office apply for a federal
4-20 waiver to allow a cost-sharing pilot program for certain recipients
4-21 of ICF-MR and waiver services, to be implemented in both an urban
4-22 and a rural area, if possible; and, be it further
4-23 RESOLVED, That the secretary of state forward an official
4-24 copy of this resolution to the State Medicaid Office and to the
4-25 Health and Human Services Commission.