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.
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