1-1     By:  Naishtat (Senate Sponsor - Carona)              H.C.R. No. 151

 1-2           (In the Senate - Received from the House May 16, 1997;

 1-3     May 16, 1997, read first time and referred to Committee on Health

 1-4     and Human Services; May 18, 1997, reported favorably by the

 1-5     following vote:  Yeas 11, Nays 0; May 18, 1997, sent to printer.)

 1-6                         HOUSE CONCURRENT RESOLUTION

 1-7           WHEREAS, Serving Medicaid long-term care clients in the

 1-8     community has been shown to be a cost-effective alternative to

 1-9     institutional care, and many clients would strongly prefer to

1-10     remain in their homes, if possible, rather than enter a nursing

1-11     facility; and

1-12           WHEREAS, In 1993, the Texas Department of Human Services

1-13     (TDHS) applied for a federal waiver to provide community-based

1-14     services to as many as 22,000 clients who would otherwise receive

1-15     nursing home care; and

1-16           WHEREAS, Due to funding constraints, the 74th Legislature

1-17     appropriated enough to fund only 13,100 waiver slots for the past

1-18     biennium; and

1-19           WHEREAS, Currently, as many as 6,100 authorized slots remain

1-20     unused in the program while approximately 2,000 Texans have applied

1-21     for community-based services and have been placed on a waiting

1-22     list; as a result, these individuals must either become nursing

1-23     home residents even though they do not want to be, or choose to go

1-24     without care; and

1-25           WHEREAS, TDHS previously had unrestricted ability to fund

1-26     shortfalls in one program with surpluses in another by transferring

1-27     money among line items within its overall budget; however, the

1-28     agency's interpretation of current law prevents such transfers to

1-29     expand community-based services without explicit legislative

1-30     direction; and

1-31           WHEREAS, The state must now submit a waiver amendment to the

1-32     Health Care Financing Administration to reduce the number of waiver

1-33     slots to correspond to the funding limitations in the

1-34     appropriations bill; and

1-35           WHEREAS, In its report to the 75th Legislature, the

1-36     Comptroller of Public Accounts recommended that the Community Based

1-37     Alternatives program be enhanced to serve as many Texans as

1-38     possible, and the Texas Legislature is convinced that taking such

1-39     action will greatly benefit individual Texans who need long-term

1-40     care and will prove to be a more cost-effective use of public

1-41     funds; now, therefore, be it

1-42           RESOLVED, That the 75th Legislature of the State of Texas

1-43     hereby direct the Texas Department of Human Services to fill as

1-44     many slots in the Community Based Alternatives program as there are

1-45     eligible clients; and, be it further

1-46           RESOLVED, That in implementing this directive, TDHS and HHSC,

1-47     as appropriate, take the following steps:

1-48           (1)  monitor expenditures by HHS agencies and to the extent

1-49     possible transfer funds not needed by HHS agencies to fill the

1-50     slots in the Community Based Alternatives program;

1-51           (2)  show in its budget outcome measures a level of certainty

1-52     that Community Based Alternatives clients are diverted from nursing

1-53     home care;

1-54           (3)  work with the Legislative Budget Board to develop the

1-55     outcome measures; and

1-56           (4)  adopt any further amendments to eligibility criteria

1-57     necessary to achieve the budget outcome measures; and, be it

1-58     further

1-59           RESOLVED, That TDHS, subject to the budget outcome measures

1-60     and budget neutrality requirements mentioned above and with

1-61     concurrence from the Health and Human Services Commission and the

1-62     Legislative Budget Board, petition the Health Care Financing

1-63     Administration for additional Community Based Alternatives waiver

1-64     slots beyond the original 22,000 requested in the waiver

 2-1     application of 1993; and, be it further

 2-2           RESOLVED, That the secretary of state forward an official

 2-3     copy of this resolution to the commissioner of human services of

 2-4     the Texas Department of Human Services.

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