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Amend CSHB 2292 (Senate committee printing) by adding the
following appropriately numbered SECTION to Article 2 of the bill
and renumbering subsequent SECTIONS accordingly:
SECTION ____. (a) Subchapter B, Chapter 32, Human
Resources Code, is amended by adding Section 32.057 to read as
follows:
Sec. 32.057. CONSUMER-DIRECTED SERVICES PROGRAM. (a) In
this section:
(1) "Consumer" means a participant in the
consumer-directed services program established under this section
who receives a stipend under the program.
(2) "Home and community-based services" include:
(A) personal care services;
(B) a home modification and assistive device that
may increase the consumer's independence;
(C) respite services, as defined by Section
142.001, Health and Safety Code; and
(D) personal assistance services, as defined by
Section 142.001, Health and Safety Code.
(3) "Medical assistance waiver program" means:
(A) the community-based alternatives program;
(B) the community living assistance and support
services program;
(C) the deaf-blind/multiple disabilities
program;
(D) the consolidated waiver pilot program; or
(E) the medically dependent children program.
(b) The department by rule shall establish a
consumer-directed services program in which certain individuals
enrolled in a medical assistance waiver program are given a monthly
stipend to direct the delivery of home and community-based services
provided to the individual under the waiver program.
(c) The department shall work in conjunction with the Texas
Rehabilitation Commission, the comptroller, and any other
appropriate agency to develop the consumer-directed services
program.
(d) In establishing the consumer-directed services program,
the department shall:
(1) ensure that the amount of a consumer's stipend is
based on the assessed functional needs of a consumer and the
financial resources available to the medical assistance waiver
program providing services to the consumer;
(2) develop purchasing guidelines to assist consumers
in using the stipend to purchase necessary and cost-effective home
and community-based services;
(3) design the program in a manner in which a private
entity or local governmental entity may apply with the department
for approval to act as the fiscal intermediary for a consumer for
the limited purpose of:
(A) managing the consumer's stipend;
(B) computing federal and state employment
taxes;
(C) preparing and filing income tax forms and
reports; and
(D) distributing money to a service provider;
(4) ensure that a consumer is the employer of and
retains control over the selection, management, and dismissal of an
individual providing home and community-based services; and
(5) develop a system to monitor the program to ensure:
(A) adherence to existing applicable program
standards;
(B) appropriate use of funds; and
(C) consumer satisfaction with the delivery of
services.
(e) The Texas Rehabilitation Commission and comptroller
shall provide information to the department as necessary to
facilitate the development and implementation of the
consumer-directed services program.
(f) The department may not implement the consumer-directed
services program within the consolidated waiver pilot program
before January 2, 2004.
(g) The department, in consultation with the Centers for
Medicare and Medicaid Services, shall:
(1) determine which state or other government-funded
programs are appropriate for inclusion in the consumer-directed
services program; and
(2) provide for the inclusion of cost-sharing
provisions as practicable.
(h) Not later than February 1 of each year, the department
shall submit to the governor, the lieutenant governor, and the
clerks of the standing committees of the senate and house of
representatives with primary jurisdiction over long-term care
services a report on the effectiveness, including the
cost-effectiveness, of the consumer-directed services program.
The report must include recommendations for improvements to the
program.
(i) This section expires September 1, 2007.
(b) The state agency responsible for implementing the
consumer-directed services program required by Section 32.057,
Human Resources Code, as added by this section, shall request and
actively pursue any necessary waivers or authorizations from the
Centers for Medicare and Medicaid Services or other appropriate
entities to enable the agency to implement the program not later
than January 1, 2004. The agency may delay implementing the program
until the necessary waivers or authorizations are granted.