SRC-VRA S.B. 1743 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 1743
By: Zaffirini
Health & Human Services
4/8/2003
As Filed


DIGEST 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, institution, or agency. 

SECTION BY SECTION 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.