77R12061 KLA-D                           
         By Coleman, Kitchen                                    H.B. No. 895
         Substitute the following for H.B. No. 895:
         By Coleman                                         C.S.H.B. No. 895
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to a demonstration project to provide certain medications
 1-3     and related services through the medical assistance program.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is
 1-6     amended by adding Section 32.053 to read as follows:
 1-7           Sec. 32.053.  DEMONSTRATION PROJECT FOR CERTAIN MEDICATIONS
 1-8     AND RELATED SERVICES. (a)  The department shall establish a
 1-9     demonstration project to provide to a person through the medical
1-10     assistance program psychotropic medications and related laboratory
1-11     and physician services necessary to conform to a prescribed medical
1-12     regime for those medications.
1-13           (b)  A person is eligible to participate in the demonstration
1-14     project if the person:
1-15                 (1)  has been diagnosed as having a mental impairment,
1-16     including schizophrenia or bipolar disorder, that is expected to
1-17     cause the person to become a disabled individual, as defined by
1-18     Section 1614(a) of the federal Social Security Act (42 U.S.C.
1-19     Section 1382c(a)), as amended;
1-20                 (2)  is at least 19 years of age, but not more than 64
1-21     years of age;
1-22                 (3)  has a net family income that is at or below 200
1-23     percent of the federal poverty level;
1-24                 (4)  is not covered by a health benefits plan offering
 2-1     adequate coverage, as determined by the department; and
 2-2                 (5)  is not otherwise eligible for medical assistance
 2-3     at the time the person's eligibility for participation in the
 2-4     demonstration project is determined.
 2-5           (c)  Notwithstanding any other provision of this section, the
 2-6     department shall provide each participant in the demonstration
 2-7     project with a 12-month period of continuous eligibility for
 2-8     participation in the project.
 2-9           (d)  Participation in the demonstration project does not
2-10     entitle a participant to other services provided under the medical
2-11     assistance program.
2-12           (e)  The department shall establish an appropriate enrollment
2-13     limit for the demonstration project and may not allow participation
2-14     in the project to exceed that limit.  Once the limit is reached,
2-15     the department shall establish a waiting list for enrollment in the
2-16     demonstration project.
2-17           (f)  To the extent permitted by federal law, the department
2-18     may require a participant in the demonstration project to make
2-19     cost-sharing payments for services provided through the project.
2-20           (g)  To the maximum extent possible, the department shall use
2-21     existing resources to fund the demonstration project.
2-22           (h)  Not later than December 1 of each even-numbered year,
2-23     the department shall submit a biennial report to the legislature
2-24     regarding the department's progress in establishing and operating
2-25     the demonstration project.
2-26           (i)  Not later than December 1, 2006, the department shall
2-27     evaluate the cost-effectiveness of the demonstration project,
 3-1     including whether the preventive drug treatments and related
 3-2     services provided under the project offset future long-term care
 3-3     costs for project participants.  If the results of the evaluation
 3-4     indicate that the project is cost-effective, the department shall
 3-5     incorporate a request for funding for the continuation of the
 3-6     program in the department's budget request for the next state
 3-7     fiscal biennium.
 3-8           (j)  This section expires September 1, 2009.
 3-9           SECTION 2. The state agency responsible for implementing the
3-10     demonstration project required by Section 32.053, Human Resources
3-11     Code, as added by this Act, shall request and actively pursue any
3-12     necessary waivers or authorizations from the Health Care Financing
3-13     Administration or other appropriate entities to enable the agency
3-14     to implement the demonstration project not later than September 1,
3-15     2002.  The agency may delay implementing the demonstration project
3-16     until the necessary waivers or authorizations are granted.
3-17           SECTION 3.  This Act takes effect immediately if it receives
3-18     a vote of two-thirds of all the members elected to each house, as
3-19     provided by Section 39, Article III, Texas Constitution.  If this
3-20     Act does not receive the vote necessary for immediate effect, this
3-21     Act takes effect September 1, 2001.