By Zaffirini S.C.R. No. 55
74R5154 RNS-D
CONCURRENT RESOLUTION
1-1 WHEREAS, In its report to the 74th Legislature, the Senate
1-2 Health and Human Services Committee concluded that significant
1-3 reform and improvement of the Medicaid program could be achieved if
1-4 the State of Texas obtains waivers of current federal requirements
1-5 in the areas of cost sharing and eligibility and obtains additional
1-6 waivers to conduct pilot studies of long-term care, mental health
1-7 and substance abuse, and consumer-oriented support for persons with
1-8 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, A waiver to allow a guaranteed eligibility period of
1-16 12 months is advantageous since most clients who become ineligible
1-17 for Medicaid benefits are not able to secure other health insurance
1-18 coverage, with the result that: a client has a disincentive to
1-19 find work and lose eligibility; local governments incur additional
1-20 expense, since there is no federal match for providing care to the
1-21 uninsured; and managed care will be more difficult to implement,
1-22 since there is no incentive for managed care organizations to
1-23 participate in Medicaid if clients are only eligible for a short
1-24 period; and
2-1 WHEREAS, A waiver to allow an integrated managed care pilot
2-2 study of long-term care for the elderly and persons with
2-3 disabilities would be advantageous because integration of these
2-4 services into a statewide managed care program promises to reduce
2-5 cost shifting and the need for institutional care, improve access
2-6 and quality, and create greater accountability for outcomes;
2-7 however, very few states have implemented such services, and a
2-8 pilot study is necessary to accurately estimate potential savings;
2-9 and
2-10 WHEREAS, A waiver to allow an integrated managed care pilot
2-11 program for mental health and substance abuse services would be
2-12 advantageous because integration of these services promises to
2-13 reduce cost shifting between the acute care system and the mental
2-14 health and substance abuse services system; however, a pilot study
2-15 is necessary to determine how best to implement the program and to
2-16 accurately estimate potential savings; and
2-17 WHEREAS, A waiver to allow a consumer-oriented pilot program
2-18 for persons with mental retardation and other developmental
2-19 disabilities would be advantageous because consumer-centered
2-20 decision-making would increase competition, improve quality of
2-21 care, and allow families and individuals to make choices that best
2-22 suit their needs; however, there is insufficient experience with
2-23 such programs in other states, and a pilot study is needed before
2-24 statewide implementation; now, therefore, be it
2-25 RESOLVED, That the 74th Legislature of the State of Texas
2-26 hereby direct the State Medicaid Office to apply for a federal
2-27 waiver to allow copayments by Medicaid clients; and, be it further
3-1 RESOLVED, That the waiver application provide that services
3-2 not be denied to a client who is unable to make the copayment and
3-3 that the schedule of copayments specified in the application be as
3-4 follows: $1 copayment for an office visit, $1 copayment for a
3-5 prescription drug, and $6 copayment for a nonemergency visit to an
3-6 emergency room; and, be it further
3-7 RESOLVED, That the State Medicaid Office apply for a federal
3-8 waiver to allow a guaranteed Medicaid eligibility period of 12
3-9 months; and, be it further
3-10 RESOLVED, That the State Medicaid Office apply for a federal
3-11 waiver to allow an integrated managed care pilot program for
3-12 long-term care for the elderly and for persons with disabilities
3-13 and that the program be implemented in both an urban and a rural
3-14 area, if possible; and, be it further
3-15 RESOLVED, That the State Medicaid Office apply for a federal
3-16 waiver to allow an integrated managed care pilot program for mental
3-17 health and substance abuse services and that the program be
3-18 implemented in both an urban and a rural area, if possible; and, be
3-19 it further
3-20 RESOLVED, That the Health and Human Services Commission
3-21 develop a plan for statewide expansion of integrated mental health
3-22 and substance abuse services; and, be it further
3-23 RESOLVED, That the plan developed by the Health and Human
3-24 Services Commission be submitted to the Senate Health and Human
3-25 Services Committee not later than March 1, 1996, and that the plan
3-26 be included in the legislative appropriations request of that
3-27 agency; and, be it further
4-1 RESOLVED, That the State Medicaid Office apply for a federal
4-2 waiver to allow a pilot program for individuals with mental
4-3 retardation and other developmental disabilities and that the pilot
4-4 program be consumer-oriented and include a decision support system
4-5 and functional assessment; and, be it further
4-6 RESOLVED, That the State Medicaid Office apply for a federal
4-7 waiver to allow a cost-sharing pilot program for certain recipients
4-8 of ICF-MR and waiver services, to be implemented in both an urban
4-9 and a rural area, if possible; and, be it further
4-10 RESOLVED, That the secretary of state forward an official
4-11 copy of this resolution to the State Medicaid Office and to the
4-12 Health and Human Services Commission.