1-1                                   AN ACT
 1-2     relating to the provision of catastrophic case management services
 1-3     under 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.  CATASTROPHIC CASE MANAGEMENT. (a)  The
 1-8     department shall develop and implement a catastrophic case
 1-9     management system to be used in providing medical assistance to
1-10     persons with catastrophic health problems.
1-11           (b)  The system must provide for the assignment of a case
1-12     manager to a recipient of medical assistance with catastrophic
1-13     health problems that are likely to:
1-14                 (1)  require the services of multiple, specialized
1-15     health care providers; and
1-16                 (2)  result in major medical costs.
1-17           (c)  The department shall identify the services to be
1-18     provided by a case manager assigned under the system.  The services
1-19     must include assessment of the recipient's needs and coordination
1-20     of all available medical services and payment options.  The
1-21     services may include other support services such as:
1-22                 (1)  assistance with making arrangements to receive
1-23     care from medical facilities;
1-24                 (2)  assistance with travel and lodging in connection
 2-1     with receipt of medical care;
 2-2                 (3)  education of the recipient and the recipient's
 2-3     family members regarding the nature of the recipient's health
 2-4     problems;
 2-5                 (4)  referral to appropriate support groups; and
 2-6                 (5)  any other service likely to result in better care
 2-7     provided in a cost-effective manner.
 2-8           (d)  Not later than January 15 of each odd-numbered year, the
 2-9     department shall report to the legislature on the implementation of
2-10     the system.  The report must include a statement of:
2-11                 (1)  the number of recipients of medical assistance who
2-12     received catastrophic case management services under the system
2-13     during the preceding two years; and
2-14                 (2)  the estimated savings under the medical assistance
2-15     program resulting from implementation of the system during the
2-16     preceding two years.
2-17           SECTION 2.  If before implementing any provision of this Act
2-18     a state agency determines that a waiver or authorization from a
2-19     federal agency is necessary for implementation of that provision,
2-20     the agency affected by the provision shall request the waiver or
2-21     authorization and may delay implementing that provision until the
2-22     waiver or authorization is granted.
2-23           SECTION 3. This Act takes effect September 1, 2001.
         _______________________________     _______________________________
             President of the Senate              Speaker of the House
               I certify that H.B. No. 1516 was passed by the House on April
         20, 2001, by a non-record vote.
                                             _______________________________
                                                 Chief Clerk of the House
               I certify that H.B. No. 1516 was passed by the Senate on May
         15, 2001, by the following vote:  Yeas 30, Nays 0, 1 present, not
         voting.
                                             _______________________________
                                                 Secretary of the Senate
         APPROVED:  __________________________
                              Date
                    __________________________
                            Governor