H.B. 2142 78(R)    BILL ANALYSIS


H.B. 2142
By: Naishtat
Human Services
Committee Report (Unamended)



BACKGROUND AND PURPOSE 

Prior to the 77th Legislative Session, individuals receiving
community-based services in the Department of Human Services waiver
programs would lose eligibility for those services when their needs and
associated program costs increased to exceed the individual cost ceilings
required to demonstrate cost-neutrality.   

To address this issue, the 77th Legislature enacted Rider 7(b), as part of
the General Appropriations Act, which directed the Department of Human
Services to monitor and maintain cost-neutrality in the aggregate for
Community Based Alternatives and all other Medicaid waiver programs at the
Department of Human Services.   

House Bill 2142 would codify Rider 7(b) and would "grandfather in" those
individuals who are receiving community-based services through Rider 7(b)
authority on September 1, 2003, and would impose a cap of 133.3% of an
individual's cost limit for other individuals who are receiving services
through a community waiver program, and whose costs might exceed the
individual's cost limit, as long as to do so would not jeopardize the
department's ability to maintain federal requirements of budget neutrality
of the program.  

RULEMAKING AUTHORITY

This bill does not expressly delegate any additional rulemaking authority
to a state officer, department, agency, or institution. 

ANALYSIS

House Bill 2142 prohibits the Department of Human Services (department)
from providing services to an individual in one or more of the Medicaid
community waiver programs when the cost of providing those services
exceeds the individual cost limit specified in the waiver program.   

HB 2142 authorizes the department to continue providing services to an
individual in a Medicaid community waiver program on September 1, 2003, if
the continuation of services is necessary for the person to live in the
most integrated setting, and continuing the provision of those services
does not effect the department's compliance with the federal requirements
on waiver programs of costneutrality.  The bill would also authorize the
department to continue serving an individual in a community waiver program
that does not meet the above criteria if the cost of serving that
individual in the community does not exceed 133.3% of the individual cost
limit and does not interfere with the department's compliance with federal
requirements of program cost-neutrality. 

HB 2142 authorizes the Texas Board of Human Services or the Commissioner
of the Department of Human Services to exempt a person from the 133.3%
cost limit if the board or commissioner finds an undue hardship to the
person in providing comparable services at the appropriate institution.   

EFFECTIVE DATE

September 1, 2003.