S.B. 1743 78(R)    BILL ANALYSIS


S.B. 1743
By: Zaffirini
Human Services
Committee Report (Amended)



BACKGROUND AND PURPOSE 

Under the Community-Based Alternatives (CBA) Program, the Texas Department
of Human Services adopted individual cost ceilings equal to the cost of
serving an individual in a nursing home, to ensure that the waiver program
would be a cost-neutral alternative to a nursing home. However, individual
cost ceilings resulted in negative outcomes for some clients. As proposed,
S.B. 1743 applies an individual cap of 133.3 percent of an individual's
cost limit for other individuals in waiver programs whose cost may exceed
the allowable individual amount. 

RULEMAKING AUTHORITY

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

ANALYSIS

SECTION 1. Amends Chapter 32B, Human Resources Code, by adding Section
32.057, as follows: Sec. 32.057. LIMITATION ON MEDICAL ASSISTANCE IN
CERTAIN ALTERNATIVE COMMUNITY-BASED CARE SETTINGS.  
(a) Defines "institution" and "medical assistance waiver program." 
(b) Prohibits the Health and Human Services Commission (HHSC), except as
provided by Subsection (c) or (d), from providing services under a medical
assistance waiver program to a person receiving medical assistance if the
cost of providing those services exceeds the individual cost limit
specified in the medical assistance waiver program.  
(c) Requires HHSC to continue to provide services under a medical
assistance waiver program to a person eligible for and receiving those
services on September 1, 2003, if continuation of those services meets
certain conditions.  
(d) Authorizes HHSC to continue to provide services under a medical
assistance waiver program to a person who is ineligible to receive those
services under Subsection (b) and to whom Subsection (c) does not apply if
certain conditions are met.  
(e) Authorizes the Texas Board of Human Services (board) or the
commissioner of human services (commissioner) to exempt a person from the
cost limit established under Subsection (d)(1) if the board or
commissioner finds an undue hardship to the person in providing comparable
services at the appropriate institution.  
SECTION 2. Effective date: September 1, 2003. Provides that this Act
applies to a person receiving medical assistance on or after the effective
date of the Act regardless of when eligibility for that assistance was
determined. 

EFFECTIVE DATE

September 1, 2003. 

EXPLANATION OF AMENDMENTS

Committee Amendment Number 1 amends SB 1743 in SECTION 1 of the bill, in
proposed Section 32.057 (d) (1), Human Resources Code (page 2, line 17),
between "program" and the semicolon, insert "for six consecutive months".