SRC-JFA H.C.R. 151 75(R)   BILL ANALYSIS


Senate Research Center   H.C.R. 151
By: Naishtat (Carona)
Health & Human Services
5-17-97
Engrossed


DIGEST 

In 1993, the Texas Department of Human Services (DHS) received a federal
Medicaid waiver from the the Health Care Financing Administration (HCFA).
The waiver allowed DHS to serve up to 22,000 clients in community care,
through the Community Based Alternatives (CBA) program, rather than in
nursing homes.  The waiver program was not fully funded by the state for
the current biennium, but proved to be in high demand, and has a waiting
list of approximately 8,000 individuals.  In addition to the need to fund
the current 22,000 available slots, there is a need for additional CBA
slots under the federal Medicaid waiver.  In order to make full use of the
current available waiver and to request more slots from HCFA, state law
requires DHS to have legislative direction.   

This resolution would direct the DHS to fill as many slots in the CBA
program as there are eligible clients; authorize DHS and Health and Human
Services to perform certain actions in implementing this directive;
authorize DHS to petition HCFA for additional waiver slots; and forward an
official copy of this resolution to the commissioner of human services.  

PURPOSE

As proposed, H.C.R. 151 submits the following resolutions:

To direct the Texas Department of Human Services (DHS) to fill as many
slots in the Community Based Alternatives (CBA) program as there are
eligible clients.  

Provides that in implementing this directive, DHS and the Health and Human
Services (HHS) as appropriate, to monitor expenditures by HHS agencies and
to the extent possible transfer funds not needed by HHS agencies to fill
slots in the CBA; to show in its budget outcome measures a level of
certainty that CBA clients are diverted from nursing home care; to work
with the Legislative Budget Board (LBB) to develop the outcome measures;
and to adopt any further amendments to eligibility criteria necessary to
achieve the budget outcome measures.   

Provides that DHS, subject to the budget outcome measures and budget
neutrality requirements mentioned above and with concurrence from the
Health and Human Services Commission and LBB, petition the Health Care
Financing Administration for additional CBA waiver slots beyond the
original 22,000 requested in the waiver application of 1993. 

Provides that the secretary of state forward an official copy of this
resolution to the commissioner of human services of DHS.