76R10950 KKA-F                           
         By Maxey                                              H.B. No. 2873
         Substitute the following for H.B. No. 2873:
         By Maxey                                          C.S.H.B. No. 2873
                                A BILL TO BE ENTITLED
 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 department shall establish an advisory committee to
2-27     provide recommendations to the department on the delivery of
 3-1     services subject to this section.  The advisory committee must meet
 3-2     regularly and must include parents of children receiving services
 3-3     subject to this section and representatives of appropriate advocacy
 3-4     organizations. The advisory committee shall provide recommendations
 3-5     relating to:
 3-6                 (1)  administration of services subject to this section
 3-7     in a manner that eliminates duplication of assessment, evaluation,
 3-8     and services provided under the Texas Health Steps Comprehensive
 3-9     Care Program;
3-10                 (2)  coordination of services in a manner that provides
3-11     accessibility to comprehensive services without gaps in service
3-12     delivery;
3-13                 (3)  procedures for obtaining authorization for
3-14     services subject to this section and other nonwaiver services under
3-15     the medical assistance program, including procedures for appealing
3-16     denials of service;
3-17                 (4)  encouragement of the use of waivers under Section
3-18     1915(c) of the federal Social Security Act (42 U.S.C. Section
3-19     1396n(c)) to provide the state with the flexibility to provide
3-20     services outside the scope, amount, or duration of nonwaiver
3-21     services available under the medical assistance program;
3-22                 (5)  determination of policies that ensure that a child
3-23     receiving services subject to this section has access to
3-24     comprehensive waiver services for adults when the child ages and
3-25     loses eligibility for services for children;
3-26                 (6)  ensuring that the medical assistance waiver
3-27     programs serve the interest of the child and support families;
 4-1                 (7)  encouraging medical assistance waiver services to
 4-2     have flexibility to provide services that are outside of the scope,
 4-3     amount, or duration of state plan services; and
 4-4                 (8)  evaluation of the quality and effectiveness of
 4-5     services subject to this section.
 4-6           (f)  In the manner provided by the General Appropriations
 4-7     Act, a member of the advisory committee established under
 4-8     Subsection (e) who is the parent of a child receiving services
 4-9     subject to this section is entitled to reimbursement of travel
4-10     expenses incurred by the member while conducting the business of
4-11     the committee.
4-12           SECTION 2.  If before implementing any provision of this Act
4-13     a state agency determines that a waiver or authorization from a
4-14     federal agency is necessary for implementation, the state agency
4-15     shall request the waiver or authorization and may delay
4-16     implementing that provision until the waiver or authorization is
4-17     granted.
4-18           SECTION 3.  The importance of this legislation and the
4-19     crowded condition of the calendars in both houses create an
4-20     emergency and an imperative public necessity that the
4-21     constitutional rule requiring bills to be read on three several
4-22     days in each house be suspended, and this rule is hereby suspended,
4-23     and that this Act take effect and be in force from and after its
4-24     passage, and it is so enacted.