By:  Delisi (Senate Sponsor - Nelson)                           H.C.R. No. 56 
	(In the Senate - Received from the House April 10, 2003; 
April 14, 2003, read first time and referred to Committee on Health 
and Human Services; May 2, 2003, reported adversely, with 
favorable Committee Substitute by the following vote:  Yeas 8, Nays 
0; May 2, 2003, sent to printer.)


COMMITTEE SUBSTITUTE FOR H.C.R. No. 56                                   By:  Nelson


HOUSE CONCURRENT RESOLUTION

	WHEREAS, State Medicaid spending currently accounts for 
approximately 22 percent of total state spending; and
	WHEREAS, 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; and
	WHEREAS, 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; and
	WHEREAS, 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; and
	WHEREAS, The Congressional Budget Office projects that 
Medicaid spending under the current system will more than double by 
the year 2012; and
	WHEREAS, Section 1115 of 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 which are 
likely to promote the objectives of the program; and
	WHEREAS, Section 1115 demonstration waivers allow states to 
change provisions of their Medicaid or 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; and
	WHEREAS, The State of Florida has successfully experimented 
with the "cash and counsel" program, a consumer directed care model 
for the purchase of attendant care and other community care 
services under a Section 1115 demonstration waiver; and
	WHEREAS, In early 2002, both houses of the legislature of the 
State of Florida voted unanimously to continue with a consumer 
directed care approach for the purchase of attendant care and other 
community care services; now, therefore, be it
	RESOLVED, That the 78th Legislature of the State of Texas 
hereby 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 State of Texas for the purposes of implementing a 
consumer directed care program for the purchase of attendant care 
and other community care services under the state Medicaid program; 
and, be it further
	RESOLVED, That 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.



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