SRC-VRA C.S.H.C.R. 56 78(R)BILL ANALYSIS Senate Research CenterC.S.H.C.R. 56 By: Delisi (Nelson) Health & Human Services 5/1/2003 Committee Report (Substituted) DIGEST State Medicaid spending currently accounts for approximately 22 percent of total state spending, and under the Federal Medical Assistance Percentage, the federal share of state Medicaid spending provided to the State of Texas has decreased by 4.2 percent over the past 10 years. Average monthly Medicaid caseloads in the State of Texas are projected to increase to 2,885,583 by fiscal year 2005 from 2,376,193 in fiscal year 2003. Prescription drug costs are a major factor driving Medicaid expenditures, and annual Medicaid prescription levels in the State of Texas are projected to rise to 40,257,515 by fiscal year 2005, from 33,859,094 in fiscal year 2003. The Congressional Budget Office projects that Medicaid spending under the current system will more than double by the year 2012 and the Social Security Act grants the secretary of health and human services broad authority to waive certain laws relating to Medicaid or SCHIP for the purpose of conducting pilot, experimental, or demonstration projects that are likely to promote the objectives of the program and demonstration waivers allow states to change provisions of their Medicaid and SCHIP programs, including eligibility requirements, the scope of services available, the freedom to choose a provider, a provider's choice to participate in a plan, the method of reimbursing providers, and the statewide application of the program. PURPOSE C.S.H.C.R. 56 submits the following resolutions: Requests the 78th Legislature of the State of Texas to respectfully urge the secretary of the United States Department of Health and Human Services to authorize any section 1115 demonstration waivers, and any other related waivers, requested by the State of Texas for the purposes of implementing a consumer-directed care program for the purpose of attendant care and other community care services under the state Medicaid program and, requests the Texas secretary of state forward official copies of this resolution to the president of the United States, the speaker of the house of representatives and the president of the senate of the United States Congress, the secretary of the United States Department of Health and Human Services, and all the members of the Texas delegation to the congress with the request that this resolution be officially entered into the Congressional Record of the United States of America.