1-1 By: Maxey, Danburg (Senate Sponsor - Zaffirini) H.B. No. 2873 1-2 (In the Senate - Received from the House April 30, 1999; 1-3 May 3, 1999, read first time and referred to Committee on Human 1-4 Services; May 13, 1999, reported favorably, as amended, by the 1-5 following vote: Yeas 4, Nays 0; May 13, 1999, sent to printer.) 1-6 COMMITTEE AMENDMENT NO. 1 By: Zaffirini 1-7 Amend H.B. No. 2873 as follows: 1-8 (1) In SECTION 1 of the bill, in proposed Section 32.052(e), 1-9 Human Resources Code (House engrossment, page 2, line 5), strike 1-10 "department" and substitute "Health and Human Services Commission". 1-11 (2) In SECTION 1 of the bill, in proposed Section 32.052(e), 1-12 Human Resources Code (House engrossment, page 2, line 6), strike 1-13 "to the department". 1-14 (3) In SECTION 1 of the bill, in proposed Section 32.052(e), 1-15 Human Resources Code (House engrossment, page 2, line 7), between 1-16 "section" and the period, insert "to the commission and each 1-17 appropriate agency providing those services". 1-18 A BILL TO BE ENTITLED 1-19 AN ACT 1-20 relating to the operation of certain Medicaid waiver programs for 1-21 children with disabilities or special health care needs. 1-22 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-23 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, 1-24 is amended by adding Section 32.052 to read as follows: 1-25 Sec. 32.052. WAIVER PROGRAMS FOR CHILDREN WITH DISABILITIES 1-26 OR SPECIAL HEALTH CARE NEEDS. (a) This section applies to 1-27 services under the medical assistance program provided to children 1-28 younger than 23 years of age with disabilities or special health 1-29 care needs under a waiver granted under Section 1915(c) of the 1-30 federal Social Security Act (42 U.S.C. Section 1396n(c)). 1-31 (b) In this section, "permanency planning" means a 1-32 philosophy and planning process designed to achieve family support 1-33 through the facilitation of a permanent living arrangement that has 1-34 as its primary feature an enduring and nurturing parental 1-35 relationship. 1-36 (c) In developing and providing services subject to this 1-37 section, the department shall: 1-38 (1) fully assess a child at the time the child applies 1-39 for assistance to determine all appropriate services for the child 1-40 under the medical assistance program, including both waiver and 1-41 nonwaiver services; 1-42 (2) ensure that permanency planning is implemented to 1-43 identify and establish the family support necessary to maintain a 1-44 child's permanent living arrangement with a family; 1-45 (3) implement a transition and referral process to 1-46 prevent breaks in services when a child is leaving a medical 1-47 assistance waiver program or moving between service delivery 1-48 systems due to a change in the child's disability status or needs, 1-49 aging out of the current delivery system, or moving between 1-50 geographic areas within the state; 1-51 (4) identify and provide core services addressing a 1-52 child's developmental needs and the needs of the child's family to 1-53 strengthen and maintain the child's family; 1-54 (5) provide for comprehensive coordination and use of 1-55 available services and resources in a manner that ensures support 1-56 for families in keeping their children at home; 1-57 (6) ensure that eligibility requirements, assessments 1-58 for service needs, and other components of service delivery are 1-59 designed to be fair and equitable for all families, including 1-60 families with parents who work outside the home; and 1-61 (7) provide for a broad array of service options and a 1-62 reasonable choice of service providers. 1-63 (d) To ensure that services subject to this section are cost 2-1 neutral and not duplicative of other services provided under the 2-2 medical assistance program, the department shall coordinate the 2-3 provision of services subject to this section with services 2-4 provided under the Texas Health Steps Comprehensive Care Program. 2-5 (e) The department shall establish an advisory committee to 2-6 provide recommendations to the department on the delivery of 2-7 services subject to this section. The advisory committee must meet 2-8 regularly and must include parents of children receiving services 2-9 subject to this section and representatives of appropriate advocacy 2-10 organizations. The advisory committee shall provide recommendations 2-11 relating to: 2-12 (1) administration of services subject to this section 2-13 in a manner that eliminates duplication of assessment, evaluation, 2-14 and services provided under the Texas Health Steps Comprehensive 2-15 Care Program; 2-16 (2) coordination of services in a manner that provides 2-17 accessibility to comprehensive services without gaps in service 2-18 delivery; 2-19 (3) procedures for obtaining authorization for 2-20 services subject to this section and other nonwaiver services under 2-21 the medical assistance program, including procedures for appealing 2-22 denials of service; 2-23 (4) encouragement of the use of waivers under Section 2-24 1915(c) of the federal Social Security Act (42 U.S.C. Section 2-25 1396n(c)) to provide the state with the flexibility to provide 2-26 services outside the scope, amount, or duration of nonwaiver 2-27 services available under the medical assistance program; 2-28 (5) determination of policies that ensure that a child 2-29 receiving services subject to this section has access to 2-30 comprehensive waiver services for adults when the child ages and 2-31 loses eligibility for services for children; 2-32 (6) ensuring that the medical assistance waiver 2-33 programs serve the interest of the child and support families; 2-34 (7) encouraging medical assistance waiver services to 2-35 have flexibility to provide services that are outside of the scope, 2-36 amount, or duration of state plan services; and 2-37 (8) evaluation of the quality and effectiveness of 2-38 services subject to this section. 2-39 (f) In the manner provided by the General Appropriations 2-40 Act, a member of the advisory committee established under 2-41 Subsection (e) who is the parent of a child receiving services 2-42 subject to this section is entitled to reimbursement of travel 2-43 expenses incurred by the member while conducting the business of 2-44 the committee. 2-45 SECTION 2. If before implementing any provision of this Act 2-46 a state agency determines that a waiver or authorization from a 2-47 federal agency is necessary for implementation, the state agency 2-48 shall request the waiver or authorization and may delay 2-49 implementing that provision until the waiver or authorization is 2-50 granted. 2-51 SECTION 3. The importance of this legislation and the 2-52 crowded condition of the calendars in both houses create an 2-53 emergency and an imperative public necessity that the 2-54 constitutional rule requiring bills to be read on three several 2-55 days in each house be suspended, and this rule is hereby suspended, 2-56 and that this Act take effect and be in force from and after its 2-57 passage, and it is so enacted. 2-58 * * * * *