SRC-HRD H.B. 2084 75(R)   BILL ANALYSIS


Senate Research Center   H.B. 2084
By: Hildebran (Nelson)
Health & Human Services
5-15-97
Engrossed


DIGEST 

In December 1996, the interim report on long-term care from the Texas
House Committee on Human Services was published.  The report directed the
"Department of Human Services and the appropriate state agencies to
develop a voucher system of long-term care services as a pilot program." 

Rather than creating a separate program to pilot vouchers, this bill would
create a voucher option in two existing long-term service programs.  Both
the Texas Department of Human Services (DHS) Client-Managed Attendant
Services program and the Texas Rehabilitation Commission  (TRC) Personal
Attendant Services Program currently have two payment options: 10 agency
delivered (where the assistant is the employee of the provider agency) and
20 block grant "flow  through" (where a consumer can receive a lump sum
and pay the assistant directly, and the assistant is the employee of the
consumer).  The intent is not to eliminate these options, but rather to
create a true choice model, with a spectrum of payment options. 

This bill requires DHS, TRC, the comptroller, and other appropriate
agencies, to establish a voucher pilot program relating to long-term care
in the DHS Client-Managed Attendant Services Program and the TRC Personal
Attendant Services program. 

PURPOSE

As proposed, H.B. 2084 requires the Department of Human Services (DHS),
the Texas Rehabilitation Commission (TRC), the comptroller and other
appropriate agencies, to establish a voucher pilot program relating to
long-term care in the DHS Client-Managed Attendant Services Program and
the TRC Personal Attendant Services program.                               
                                                                  
RULEMAKING AUTHORITY

Rulemaking authority is granted to the Department of Human Services in
SECTION 1 (Section 22.032(b), Human Resources Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 22, Human Resources Code, by adding Sections
22.032 and 22.033, as follows: 

Sec. 22.032.  VOUCHER PILOT PROJECT.  Defines "consumer," "long-term
care," "personal assistance service," and "respite services."  Requires
the Department of Human Services (DHS), by rule, to develop and ensure the
implementation of a pilot project in which the use of vouchers is
established as a payment option for the delivery of long-term care
services, personal assistance services, and respite services.  Requires
DHS, in adopting rules under this section, to take certain actions  in
reference to the pilot project.  Requires the Texas Rehabilitation
Commission (TRC) and the comptroller to provide information to DHS as
necessary to facilitate the development and implementation of the pilot
project.  Requires DHS to implement the pilot project according to certain
provisions.  Requires DHS, not later than March 1, 1999, to submit to the
governor and the 76th Legislature a report on the feasibility of expanding
the voucher payment pilot project statewide to Medicaid-funded service
programs.  Provides that this section expires September 1, 2002. 

 Sec. 22.033.  WORK GROUP.  Provides that a work group is created to
assist DHS in developing, implementing, and evaluation the voucher payment
pilot project under Section 22.032.  Sets forth the composition of the
work group.  Requires a majority of the members of the work group to be
composed of consumers of personal assistance services or respite services.
Provides that a member of the work group serves at the will of the
appointing agency.  Requires the commissioner of human services and the
commissioner of TRC to jointly appoint a member of the work group to serve
as presiding officer, and requires members of the work group to elect any
other necessary officers.  Requires the work group to meet at the call of
the presiding officer.  Provides that a member of the work group receives
no additional compensation for serving on the work group.  Provides that
the work group is not subject to Article 6252-33, V.T.C.S.  Provides that
this section expires September 1, 2002. 

SECTION 2. (a) Effective date: September 1, 1997.

(b) Requires DHS to establish the pilot project required  by Section
22.032, Human Resources Code, as added by this Act, not later than January
1, 1998. 

SECTION 3. Emergency clause.