1-1 By: Moncrief, Zaffirini S.C.R. No. 58 1-2 (In the Senate - Filed February 16, 1995; February 16, 1995, 1-3 read first time and referred to Committee on Health and Human 1-4 Services; March 16, 1995, reported adversely, with favorable 1-5 Committee Substitute by the following vote: Yeas 9, Nays 0; 1-6 March 16, 1995, sent to printer.) 1-7 COMMITTEE SUBSTITUTE FOR S.C.R. No. 58 By: Moncrief 1-8 SENATE CONCURRENT RESOLUTION 1-9 WHEREAS, The Senate Health and Human Services Committee found 1-10 in its report to the 74th Texas Legislature that many Medicaid 1-11 clients prefer home and community-based services rather than 1-12 institutional care and that these alternatives to institutional 1-13 care are often less costly to the State of Texas and provide more 1-14 flexible service alternatives; and 1-15 WHEREAS, Some individuals receiving services through the 1-16 ICF-MR program in six-bed Level I facilities function at high 1-17 levels and could be served with home and community-based services 1-18 if the necessary supports were made available; and 1-19 WHEREAS, Providing these necessary supports is consistent 1-20 with the state's intention to emphasize community-based services 1-21 over institutionalization and also may result in net savings to the 1-22 state; and 1-23 WHEREAS, Home care services are similarly advantageous to 1-24 Medicaid clients and to the state, but the current Medicaid home 1-25 health benefit is limited and results in an inability to maximize 1-26 appropriate use of this service; and 1-27 WHEREAS, The Senate Health and Human Services Committee 1-28 identified specific barriers to the use of cost-effective home care 1-29 services, and in its report to the 74th Legislature recommended 1-30 that the Texas Department of Health identify and remove such 1-31 barriers; now, therefore, be it 1-32 RESOLVED, That the 74th Legislature of the State of Texas 1-33 hereby direct the State Medicaid Office, in conjunction with the 1-34 Texas Department of Mental Health and Mental Retardation and with 1-35 participation from consumers, family members, and providers, to 1-36 structure a range of service and delivery options under the 1-37 authority of Section 1915(c) of the Social Security Act (home and 1-38 community-based services) in order to provide more flexibility for 1-39 people eligible to receive services in the six-bed Level I ICF-MR 1-40 program, and in a manner that ensures that service alternatives 1-41 will be cost-effective, will meet the needs of the individual, and 1-42 will not increase overall Medicaid program costs; and, be it 1-43 further 1-44 RESOLVED, That the Texas Department of Health conduct a 1-45 feasibility study to identify and remove barriers to the use of 1-46 cost-effective home care services, including but not limited to: 1-47 (1) the array of services available; 1-48 (2) arbitrary limits on number of visits allowed; 1-49 (3) the definition of "medically necessary"; 1-50 (4) coverage of preventive services; and 1-51 (5) the interpretation of "homebound" for children; and, be 1-52 it further 1-53 RESOLVED, That the secretary of state forward an official 1-54 copy of this resolution to the State Medicaid Office, the Texas 1-55 Department of Health, and the Texas Department of Mental Health and 1-56 Mental Retardation. 1-57 * * * * *