S.C.R. No. 58
                             SENATE CONCURRENT RESOLUTION
    1-1        WHEREAS, The Senate Health and Human Services Committee found
    1-2  in its report to the 74th Texas Legislature that many Medicaid
    1-3  clients prefer home and community-based services rather than
    1-4  institutional care and that these alternatives to institutional
    1-5  care are often less costly to the State of Texas and provide more
    1-6  flexible service alternatives; and
    1-7        WHEREAS, Some individuals receiving services through the
    1-8  ICF-MR program in six-bed Level I facilities function at high
    1-9  levels and could be served with home and community-based services
   1-10  if the necessary supports were made available; and
   1-11        WHEREAS, Providing these necessary supports is consistent
   1-12  with the state's intention to emphasize community-based services
   1-13  over institutionalization and also may result in net savings to the
   1-14  state; and
   1-15        WHEREAS, Home care services are similarly advantageous to
   1-16  Medicaid clients and to the state, but the current Medicaid home
   1-17  health benefit is limited and results in an inability to maximize
   1-18  appropriate use of this service; and
   1-19        WHEREAS, The Senate Health and Human Services Committee
   1-20  identified specific barriers to the use of cost-effective home care
   1-21  services, and in its report to the 74th Legislature recommended
   1-22  that the Texas Department of Health identify and remove such
   1-23  barriers; now, therefore, be it
   1-24        RESOLVED, That the 74th Legislature of the State of Texas
    2-1  hereby direct the State Medicaid Office, in conjunction with the
    2-2  Texas Department of Mental Health and Mental Retardation and with
    2-3  participation from consumers, family members, and providers, to
    2-4  structure a range of service and delivery options under the
    2-5  authority of Section 1915(c) of the Social Security Act (home and
    2-6  community-based services) in order to provide more flexibility for
    2-7  people eligible to receive services in the six-bed Level I ICF-MR
    2-8  program, and in a manner that ensures that service alternatives
    2-9  will be cost-effective, will meet the needs of the individual, and
   2-10  will not increase overall Medicaid program costs; and, be it
   2-11  further
   2-12        RESOLVED, That the Texas Department of Health conduct a
   2-13  feasibility study to be completed by May 1, 1996, and to include
   2-14  input from physicians, hospitals, home and community support
   2-15  services agencies, and consumers to identify and remove barriers to
   2-16  the use of cost-effective home care services, including but not
   2-17  limited to:
   2-18        (1)  the array of services available;
   2-19        (2)  arbitrary limits on number of visits allowed;
   2-20        (3)  the definition of "medically necessary";
   2-21        (4)  coverage of preventive services; and
   2-22        (5)  the interpretation of "homebound" for children; and, be
   2-23  it further
   2-24        RESOLVED, That the secretary of state forward an official
   2-25  copy of this resolution to the State Medicaid Office, the Texas
   2-26  Department of Health, and the Texas Department of Mental Health and
   2-27  Mental Retardation.