78R6877 KLA-D

By:  Coleman                                                      H.B. No. 1555



A BILL TO BE ENTITLED

AN ACT

relating to a demonstration project to provide certain medications 
and related services through the medical assistance program.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 32, Human Resources Code, 
is amended by adding Section 32.061 to read as follows:
	Sec. 32.061.  DEMONSTRATION PROJECT FOR CERTAIN MEDICATIONS 
AND RELATED SERVICES.  (a)  The department shall establish a 
demonstration project to provide to a person through the medical 
assistance program psychotropic medications and related laboratory 
and physician services necessary to conform to a prescribed medical 
regimen for those medications.
	(b)  A person is eligible to participate in the demonstration 
project if the person:
		(1)  has been diagnosed as having a mental impairment, 
including schizophrenia or bipolar disorder, that is expected to 
cause the person to become a disabled individual, as defined by 
Section 1614(a) of the federal Social Security Act (42 U.S.C. 
Section 1382c(a)), as amended;
		(2)  is at least 19 years of age, but not more than 64 
years of age; 
		(3)  has a net family income that is at or below 200 
percent of the federal poverty level;
		(4)  is not covered by a health benefits plan offering 
adequate coverage, as determined by the department; and
		(5)  is not otherwise eligible for medical assistance 
at the time the person's eligibility for participation in the 
demonstration project is determined.
	(c)  Notwithstanding any other provision of this section, 
the department shall provide each participant in the demonstration 
project with a 12-month period of continuous eligibility for 
participation in the project.
	(d)  Participation in the demonstration project does not 
entitle a participant to other services provided under the medical 
assistance program.
	(e)  The department shall establish an appropriate 
enrollment limit for the demonstration project and may not allow 
participation in the project to exceed that limit.  Once the limit 
is reached, the department shall establish a waiting list for 
enrollment in the demonstration project.
	(f)  To the extent permitted by federal law, the department 
may require a participant in the demonstration project to make 
cost-sharing payments for services provided through the project.
	(g)  To the maximum extent possible, the department shall use 
existing resources to fund the demonstration project.
	(h)  Not later than December 1 of each even-numbered year, 
the department shall submit a biennial report to the legislature 
regarding the department's progress in establishing and operating 
the demonstration project.
	(i)  Not later than December 1, 2008, the department shall 
evaluate the cost-effectiveness of the demonstration project, 
including whether the preventive drug treatments and related 
services provided under the project offset future long-term care 
costs for project participants.  If the results of the evaluation 
indicate that the project is cost-effective, the department shall 
incorporate a request for funding for the continuation of the 
program in the department's budget request for the next state 
fiscal biennium.
	(j)  This section expires September 1, 2011.                            
	SECTION 2.  The state agency responsible for implementing 
the demonstration project required by Section 32.061, Human 
Resources Code, as added by this Act, 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 demonstration project not later 
than September 1, 2004.  The agency may delay implementing the 
demonstration project until the necessary waivers or 
authorizations are granted.
	SECTION 3.  This Act takes effect immediately if it receives 
a vote of two-thirds of all the members elected to each house, as 
provided by Section 39, Article III, Texas Constitution.  If this 
Act does not receive the vote necessary for immediate effect, this 
Act takes effect September 1, 2003.