1-1 AN ACT
1-2 relating to the operation of certain Medicaid waiver programs for
1-3 children with disabilities or special health care needs.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
1-6 is amended by adding Section 32.052 to read as follows:
1-7 Sec. 32.052. WAIVER PROGRAMS FOR CHILDREN WITH DISABILITIES
1-8 OR SPECIAL HEALTH CARE NEEDS. (a) This section applies to
1-9 services under the medical assistance program provided to children
1-10 younger than 23 years of age with disabilities or special health
1-11 care needs under a waiver granted under Section 1915(c) of the
1-12 federal Social Security Act (42 U.S.C. Section 1396n(c)).
1-13 (b) In this section, "permanency planning" means a
1-14 philosophy and planning process designed to achieve family support
1-15 through the facilitation of a permanent living arrangement that has
1-16 as its primary feature an enduring and nurturing parental
1-17 relationship.
1-18 (c) In developing and providing services subject to this
1-19 section, the department shall:
1-20 (1) fully assess a child at the time the child applies
1-21 for assistance to determine all appropriate services for the child
1-22 under the medical assistance program, including both waiver and
1-23 nonwaiver services;
1-24 (2) ensure that permanency planning is implemented to
2-1 identify and establish the family support necessary to maintain a
2-2 child's permanent living arrangement with a family;
2-3 (3) implement a transition and referral process to
2-4 prevent breaks in services when a child is leaving a medical
2-5 assistance waiver program or moving between service delivery
2-6 systems due to a change in the child's disability status or needs,
2-7 aging out of the current delivery system, or moving between
2-8 geographic areas within the state;
2-9 (4) identify and provide core services addressing a
2-10 child's developmental needs and the needs of the child's family to
2-11 strengthen and maintain the child's family;
2-12 (5) provide for comprehensive coordination and use of
2-13 available services and resources in a manner that ensures support
2-14 for families in keeping their children at home;
2-15 (6) ensure that eligibility requirements, assessments
2-16 for service needs, and other components of service delivery are
2-17 designed to be fair and equitable for all families, including
2-18 families with parents who work outside the home; and
2-19 (7) provide for a broad array of service options and a
2-20 reasonable choice of service providers.
2-21 (d) To ensure that services subject to this section are cost
2-22 neutral and not duplicative of other services provided under the
2-23 medical assistance program, the department shall coordinate the
2-24 provision of services subject to this section with services
2-25 provided under the Texas Health Steps Comprehensive Care Program.
2-26 (e) The Health and Human Services Commission shall establish
2-27 an advisory committee to provide recommendations on the delivery of
3-1 services subject to this section to the commission and each
3-2 appropriate agency providing those services. The advisory
3-3 committee must meet regularly and must include parents of children
3-4 receiving services subject to this section and representatives of
3-5 appropriate advocacy organizations. The advisory committee shall
3-6 provide recommendations relating to:
3-7 (1) administration of services subject to this section
3-8 in a manner that eliminates duplication of assessment, evaluation,
3-9 and services provided under the Texas Health Steps Comprehensive
3-10 Care Program;
3-11 (2) coordination of services in a manner that provides
3-12 accessibility to comprehensive services without gaps in service
3-13 delivery;
3-14 (3) procedures for obtaining authorization for
3-15 services subject to this section and other nonwaiver services under
3-16 the medical assistance program, including procedures for appealing
3-17 denials of service;
3-18 (4) encouragement of the use of waivers under Section
3-19 1915(c) of the federal Social Security Act (42 U.S.C. Section
3-20 1396n(c)) to provide the state with the flexibility to provide
3-21 services outside the scope, amount, or duration of nonwaiver
3-22 services available under the medical assistance program;
3-23 (5) determination of policies that ensure that a child
3-24 receiving services subject to this section has access to
3-25 comprehensive waiver services for adults when the child ages and
3-26 loses eligibility for services for children;
3-27 (6) ensuring that the medical assistance waiver
4-1 programs serve the interest of the child and support families;
4-2 (7) encouraging medical assistance waiver services to
4-3 have flexibility to provide services that are outside of the scope,
4-4 amount, or duration of state plan services; and
4-5 (8) evaluation of the quality and effectiveness of
4-6 services subject to this section.
4-7 (f) In the manner provided by the General Appropriations
4-8 Act, a member of the advisory committee established under
4-9 Subsection (e) who is the parent of a child receiving services
4-10 subject to this section is entitled to reimbursement of travel
4-11 expenses incurred by the member while conducting the business of
4-12 the committee.
4-13 SECTION 2. If before implementing any provision of this Act
4-14 a state agency determines that a waiver or authorization from a
4-15 federal agency is necessary for implementation, the state agency
4-16 shall request the waiver or authorization and may delay
4-17 implementing that provision until the waiver or authorization is
4-18 granted.
4-19 SECTION 3. The importance of this legislation and the
4-20 crowded condition of the calendars in both houses create an
4-21 emergency and an imperative public necessity that the
4-22 constitutional rule requiring bills to be read on three several
4-23 days in each house be suspended, and this rule is hereby suspended,
4-24 and that this Act take effect and be in force from and after its
4-25 passage, and it is so enacted.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 2873 was passed by the House on April
29, 1999, by the following vote: Yeas 139, Nays 0, 2 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 2873 on May 26, 1999, by the following vote: Yeas 144, Nays 0,
2 present, not voting.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 2873 was passed by the Senate, with
amendments, on May 24, 1999, by the following vote: Yeas 30, Nays
0.
_______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor