78R6168 CLG-D

By:  Delisi                                                       H.B. No. 3182



A BILL TO BE ENTITLED

AN ACT

relating to establishment of a consumer-directed care 
demonstration 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 32.057 to read as follows:
	Sec. 32.057.  CONSUMER-DIRECTED CARE DEMONSTRATION PROGRAM.  
(a)  In this section:
		(1)  "Consumer" means a participant in the 
demonstration program established under this section who receives a 
stipend under the program.
		(2)  "Home and community-based services" include:                      
			(A)  personal care services;                                          
			(B)  a home modification and assistive device that 
may increase the consumer's independence;
			(C)  respite services, as defined by Section 
142.001, Health and Safety Code; and
			(D)  personal assistance services, as defined by 
Section 142.001, Health and Safety Code.
		(3)  "Medical assistance waiver program" means:                        
			(A)  the community-based alternatives program;                        
			(B)  the community living assistance and support 
services program;  
			(C)  the deaf-blind/multiple disabilities 
program;                  
			(D)  the consolidated waiver pilot program; or                        
			(E)  the medically dependent children program.                        
	(b)  The department by rule shall establish a demonstration 
program in which certain individuals enrolled in a medical 
assistance waiver program are given a monthly stipend to direct the 
delivery of home and community-based services provided to the 
individual under the waiver program.
	(c)  The department shall  work in conjunction with the Texas 
Rehabilitation Commission, the comptroller, and any other 
appropriate agency to develop the demonstration program.
	(d)  In establishing the demonstration program, the 
department shall: 
		(1)  ensure that the amount of a consumer's stipend is 
based on the assessed functional needs of a consumer and the 
financial resources available to the medical assistance waiver 
program providing services to the consumer;
		(2)  develop purchasing guidelines to assist consumers 
in using the stipend to purchase necessary and cost-effective home 
and community-based services;
		(3)  design the program in a manner in which a private 
entity or local governmental entity applies with and is approved by 
the department and the Internal Revenue Service to act as the fiscal 
intermediary for a consumer for the limited purpose of:
			(A)  managing the consumer's stipend;                                 
			(B)  computing federal and state employment 
taxes;                  
			(C)  preparing and filing income tax forms and 
reports; and         
			(D)  distributing money to a service provider;                        
		(4)  ensure that a consumer is the employer of and 
retains control over the selection, management, and dismissal of an 
individual providing home and community-based services; and
		(5)  develop a system to monitor the program to ensure:                
			(A)  adherence to existing applicable program 
standards;            
			(B)  appropriate use of funds; and                                    
			(C)  consumer satisfaction with the delivery of 
services.           
	(e)  The Texas Rehabilitation Commission and comptroller 
shall provide information to the department as necessary to 
facilitate the development and implementation of the demonstration 
program.
	(f)  The department shall operate the demonstration program 
in each of the Medicaid managed care service delivery areas.
	(g)  Not later than February 1 of each year, the department 
shall submit to the governor, lieutenant governor, and the clerks 
of the standing committees of the senate and house of 
representatives with primary jurisdiction over long-term care 
services a report on the effectiveness, including the 
cost-effectiveness, of the demonstration program.  The report must 
include recommendations for improvements to the program and for the 
implementation of the program in additional counties or statewide, 
as appropriate.
	(h)  This section expires September 1, 2007.                            
	SECTION 2.  The state agency responsible for implementing 
the demonstration program required by Section 32.057, 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 program not later than January 1, 
2004.  The agency may delay implementing the program until the 
necessary waivers or authorizations are granted.
	SECTION 3.  This Act takes effect September 1, 2003.