JKC H.B. 460 75(R)    BILL ANALYSIS


HUMAN SERVICES
H.B. 460
By: Maxey
03-24-97
Committee Report (Unamended)



BACKGROUND 

Support for consolidation of existing long-term care waivers has been
growing for several years. In 1994, the Long-Term Care Task Force Report
recommended a review and consideration of waivers. During the 1996 House
Human Services Committee's interim hearings on long-term care, advocacy
groups urged the committee to re-examine consolidation.  In December 1996,
Health Care Financing Administration (HCFA) staff members met with
consumers and stated that there was no prohibition on waiver
consolidations. In fact, many states are seriously considering such an
option in order to minimize administrative duplication, maximize the
services provided, and to provide flexibility for each state in
determining the appropriate services for each individual based upon that
individual's needs. 

The passage of HB 460 will not directly result in the consolidation of
waivers; it merely calls for the Health and Human Services Commission to
complete a report on the feasibility of consolidation.  The legislation
does not modify any existing funding that is appropriated for waivers, nor
will it have any impact on appropriated amounts during the 1998-99
biennium. 

PURPOSE

HB 460  requires the Health and Human Services Commission to report to the
Legislature, by January 15, 1999, on the "feasibility and advisability" of
replacing all or several long-term care Medicaid waivers with a single
waiver.  

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any
additional rulemaking authority to a state officer, department, agency or
institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.Requires the Health and Human Services Commissioner to report to
the Legislature by January 15, 1999 on the feasibility and advisability of
replacing all or several of the Medicaid long-term care waivers with a
single waiver.  The report must consider the waivers or authorizations
obtained for the following: 
 
(1)community-based alternatives program administered by the Texas
Department of Human Services; 

     (2)community living assistance support and services program
administered by the Texas Department of Human Services; 

(3)home and community services program under the Omnibus Budget
Reconciliation Act (OBRA), PL 100-203, Nursing Home Reform Amendments of
1987, administered by the Texas Department of Mental Health and Mental
Retardation; 

(4)deaf and blind services program administered by the Texas
Rehabilitation Commission; and 
 
(5)medically dependent children program administered by the Texas
Department of Health. 

SECTION 2. Emergency clause.