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.
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