79R12288 KLA-F
By: Naishtat H.B. No. 2449
Substitute the following for H.B. No. 2449:
By: Naishtat C.S.H.B. No. 2449
A BILL TO BE ENTITLED
AN ACT
relating to a pilot program for transferring money for certain
persons in institutional care to provide community-based services
to those persons.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.085 to read as follows:
Sec. 531.085. PILOT PROGRAM FOR FUNDING COMMUNITY-BASED
SERVICES. (a) In this section, "ICF-MR" has the meaning assigned
by Section 531.002, Health and Safety Code.
(b) The commission shall direct the Department of Aging and
Disability Services to develop and implement a pilot program to:
(1) quantify the amount of money appropriated by the
legislature that would have been spent during the remainder of a
state fiscal biennium to care for a person who lives in an ICF-MR
facility administered by an ICF-MR provider selected to participate
in the pilot program under this section, but who is leaving that
facility before the end of the biennium to live in the community
with the assistance of community-based services provided through a
medical assistance waiver program; and
(2) notwithstanding any other state law and to the
maximum extent allowed by federal law, transfer within the
department's budget or among the commission and the health and
human services agencies at the time the person leaves the facility
the amount necessary to pay the cost of the community-based
services provided to the person as necessary to comply with this
section.
(c) The amount transferred under this section must be
redirected by the commission or a health and human services agency
to one or more community-based programs to provide community-based
services to the person through a medical assistance waiver program
after the person leaves the ICF-MR facility.
(d) The commission and the Department of Aging and
Disability Services shall jointly determine criteria for selecting
providers of ICF-MR services to participate in the pilot program
under this section and shall jointly select at least one provider,
but not more than five providers, for participation. The criteria
for selecting a provider may relate to any factor the commission and
department consider relevant, including:
(1) the size and number of ICF-MR facilities the
provider administers;
(2) the history of the provider's quality of care;
(3) the specific geographic area in which the provider
provides services; or
(4) whether the provider is willing to convert the
services provided from institutional services to community-based
medical assistance waiver program services.
(e) The executive commissioner may adopt rules under which
the commission may decertify an appropriate Medicaid bed for each
person who leaves an ICF-MR facility and for whom money is
transferred under Subsection (b)(2).
(f) Not later than December 1, 2006, the commission and the
Department of Aging and Disability Services shall submit a joint
report concerning the effectiveness of the pilot program to the
governor and the committees of each house of the legislature that
have primary oversight jurisdiction over health and human services
agencies. The report must include a recommendation regarding the
feasibility of expanding the pilot program statewide, an analysis
of provider and consumer experiences under the program, provider
information related to the feasibility of expanding the program,
and stakeholder recommendations relating to the program. In
preparing the report and recommendations, the commission and
department must:
(1) consider consumer satisfaction with the services
provided under the program;
(2) compare like provider elements, including the
following elements with respect to each provider:
(A) size;
(B) the number of persons served;
(C) financial viability, including rates;
(D) service transition costs;
(E) geographic location; and
(F) type and physical condition of facilities;
and
(3) consider other aspects necessary to provide a
comprehensive analysis of the program.
SECTION 2. Not later than December 1, 2005, the Department
of Aging and Disability Services shall implement the pilot program
under Section 531.085, Government Code, as added by this Act.
SECTION 3. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 4. This Act takes effect September 1, 2005.