Amend CSSB 1188 (House Committee Printing) in SECTION 5(a) of 
the bill by striking added Section 531.083, Government Code (page 
11, line 23, through page 12, line 15), and substituting the 
following:
	Sec. 531.083. MEDICAID LONG-TERM CARE SYSTEM.  The commission 
shall ensure that the Medicaid long-term care system provides the 
broadest array of choices possible for recipients while ensuring 
that the services are delivered in a manner that is cost-effective 
and makes the best use of available funds.  The commission shall 
also make every effort to improve the quality of care for recipients 
of Medicaid long-term care services by:
		(1)  evaluating the need for expanding the provider base 
for consumer-directed services and, if the commission identifies a 
demand for that expansion, encouraging area agencies on aging, 
independent living centers, and other potential long-term care 
providers to become providers through contracts with the Department 
of Aging and Disability Services;
		(2)  ensuring that each recipient who resides in a 
nursing facility and the person responsible for making health care 
decisions for the recipient are provided information about 
end-of-life care options and the importance of planning for 
end-of-life care, including the need for an advanced directive, as 
defined by Section 166.002, Health and Safety Code;
		(3)  developing policies to encourage a recipient who 
resides in a nursing facility to receive treatment at that facility 
whenever possible, while ensuring that the recipient receives an 
appropriate continuum of care; and
		(4)  ensuring that each recipient who resides in a 
nursing facility receives Medicaid long-term care coverage for the 
cost of a transfer to a willing provider and continued available 
life-sustaining treatment until the transfer is completed and, 
notwithstanding Sections 166.045 and 166.046, Health and Safety 
Code, is provided available life-sustaining treatment, if:
			(A)  the recipient's attending physician or 
nursing facility decides to deny the treatment under Section 
166.045 or 166.046, Health and Safety Code;
			(B)  the recipient, the recipient's advanced 
directive, as defined by Section 166.002, Health and Safety Code, 
or the person responsible for making health care decisions for the 
recipient directs that the treatment be provided; and
			(C)  denial of the treatment, in reasonable 
medical judgment, would likely result in the recipient's death.