80R10359 BEF-D

By: Davis of Harris H.B. No. 3677

A BILL TO BE ENTITLED

AN ACT

relating to fiscal matters involving health and human services programs.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

ARTICLE 1. BEHAVIORAL HEALTH SERVICES FOR CHILDREN

SECTION 1.01. Section 531.251, Government Code, is amended to read as follows:

Sec. 531.251. TEXAS INTEGRATED FUNDING INITIATIVE PILOT PROJECT [CONSORTIUM]; DEFINITION; EXPANSION PLAN. (a) In this subchapter, "council" means the Children's Behavioral Health Council established under Section 531.425.

(a-1) The council [commission] shall [form a consortium to] develop criteria for and implement the expansion of the Texas Integrated Funding Initiative pilot project and [to] develop local mental health care systems in communities for minors who are receiving residential mental health services or who are at risk of residential placement to receive mental health services. [The consortium must include representatives of the Texas Department of Mental Health and Mental Retardation, Department of Protective and Regulatory Services, Texas Education Agency, Texas Youth Commission, Texas Juvenile Probation Commission, and Texas Commission on Alcohol and Drug Abuse and an equal number of family advocates.]

(b) The commission and the council [consortium] shall:

(1) develop a model and guidelines for the delivery of mental health services and support to a minor, initiated before the person's 18th birthday, including best practices in the financing, administration, governance, and delivery of those services;

(2) establish a plan to expand the Texas Integrated Funding Initiative so that the initiative may operate in up to six communities; and

(3) identify appropriate sources of state and federal funding to finance mental health services under the initiative from a central fund for expansion communities.

SECTION 1.02. Section 531.252(b), Government Code, is amended to read as follows:

(b) The commission and the council [consortium] shall develop criteria to evaluate proposals for selecting expansion communities to participate in the expanded initiative. The criteria must:

(1) reflect the underlying principles of the Texas Integrated Funding Initiative;

(2) emphasize services that are culturally competent, family-centered, and seamless;

(3) identify populations to be served under the proposals;

(4) establish for the expansion communities service outcome goals related to minors who are receiving residential mental health services or who are at risk of residential placement to receive mental health services, including:

(A) decreasing incidents of abuse or neglect of the minors;

(B) reducing recidivism rates of juvenile offenders;

(C) increasing school attendance and progress of the minors;

(D) reducing the rate of placement of the minors in residential treatment;

(E) increasing the rate of reunification of the minors with their families;

(F) improving the emotional, behavioral, and social adjustment of the minors; and

(G) improving the stability of placements of the minors;

(5) provide for locations of participating communities in urban, suburban, and rural settings; and

(6) specify information that must be provided in a proposal for a community, including:

(A) information on the costs of the activities proposed; and

(B) the characteristics of minors in the community who are in residential care for mental health services or who are at risk of being placed in residential care to receive mental health services.

SECTION 1.03. Section 531.253, Government Code, is amended to read as follows:

Sec. 531.253. SELECTION OF EXPANSION COMMUNITIES. The commission and the council [consortium] shall review proposals for expansion communities and approve participation of not more than six communities to participate in the initiative. The selected communities must be those that best meet the criteria developed under Section 531.252.

SECTION 1.04. Section 531.254, Government Code, is amended to read as follows:

Sec. 531.254. SYSTEM DEVELOPMENT COLLABORATION. The commission, the council [consortium], and the expansion communities shall collaborate to develop and shall share technical assistance and training resources to aid communities in developing local systems for delivering mental health services to minors.

SECTION 1.05. Sections 531.255(a), (b), and (c), Government Code, are amended to read as follows:

(a) The commission and the council [Texas Department of Mental Health and Mental Retardation] jointly shall monitor the progress of the expansion communities.

(b) The commission, the council [consortium], and the expansion communities shall collaborate to develop a system to evaluate the success of the expansion communities in achieving outcome goals for the minors the communities serve, including outcome goals developed under Section 531.252. An evaluation under the system must include information on cost avoidance and net savings that result from participation in the initiative.

(c) Each expansion community shall identify the baseline information to compare with the information on outcomes in evaluating the achievements of the community. A community is responsible for collecting and reporting outcome information to the commission and the council in accordance with the requirements of the evaluation system developed under Subsection (b).

SECTION 1.06. Section 531.421, Government Code, is amended by adding Subdivision (3-a) to read as follows:

(3-a) "Council" means the Children's Behavioral Health Council established under Section 531.425.

SECTION 1.07. Section 531.422(c), Government Code, is amended to read as follows:

(c) Each community resource coordination group shall submit the report described by Subsection (b) to the council [consortium]. The council [consortium] shall provide a deadline to each group for submitting the reports. The time frame for completing the reports must be coordinated with any regional reviews by the commission of the delivery of related services.

SECTION 1.08. Section 531.423, Government Code, is amended to read as follows:

Sec. 531.423. SUMMARY REPORT BY COUNCIL [TEXAS INTEGRATED FUNDING INITIATIVE CONSORTIUM]. (a) The council [consortium] shall create a summary report based on the evaluations in the reports submitted to the council [consortium] by community resource coordination groups under Section 531.422. The council's [consortium's] report must include recommendations for policy and statutory changes at each agency that is involved in the provision of systems of care services and the outcome expected from implementing each recommendation.

(b) The council [consortium] shall coordinate, where appropriate, the recommendations in the report created under this section with recommendations in the assessment developed under Chapter 23 [S.B. No. 491], Acts of the 78th Legislature, Regular Session, 2003, and with the continuum of care developed under Section 533.040(d), Health and Safety Code [S.B. No. 490, Acts of the 78th Legislature, Regular Session, 2003].

(c) The council [consortium] may include in the report created under this section recommendations for the statewide expansion of sites participating in the Texas Integrated Funding Initiative under Subchapter G-1 [G, Chapter 531, as added by Chapter 446, Acts of the 76th Legislature, Regular Session, 1999,] and the integration of services provided at those sites with services provided by community resource coordination groups.

(d) The council [consortium] shall provide a copy of the report created under this section to each agency for which the report makes a recommendation and to other agencies as appropriate.

SECTION 1.09. Subchapter L, Chapter 531, Government Code, is amended by adding Sections 531.425 through 531.428 to read as follows:

Sec. 531.425. CHILDREN'S BEHAVIORAL HEALTH COUNCIL. (a) The Children's Behavioral Health Council is established to provide a coordinated, comprehensive, interagency approach to the development and delivery of behavioral health services to children.

(b) The council is composed of one representative from each of the following state agencies, appointed by the chief administrative officer of the respective agency:

(1) the Health and Human Services Commission;

(2) the Department of State Health Services;

(3) the Department of Family and Protective Services;

(4) the Department of Assistive and Rehabilitative Services;

(5) the Department of Aging and Disability Services;

(6) the Texas Education Agency;

(7) the Texas Correctional Office on Offenders with Medical or Mental Impairments;

(8) the Texas Juvenile Probation Commission; and

(9) the Texas Youth Commission.

(c) The members of the council shall annually elect one member to serve as chairperson.

(d) The council, with the advice of the advisory committee established under Section 531.426, shall:

(1) develop and implement coordinated state policies to improve the behavioral health of children;

(2) develop a coordinated system for planning and budgeting that establishes priorities and strategies for the coordinated delivery of behavioral health services to children;

(3) develop a coordinated system to track and report spending on behavioral health services for children by agencies represented by a member of the council;

(4) administer state grants for development of local systems of care services;

(5) develop a plan to support the statewide expansion of local systems of care services;

(6) provide technical assistance and training to local providers of systems of care services;

(7) design an integrated funding structure for the provision of behavioral health services for children in accordance with Section 531.427; and

(8) assess the provision of behavioral health services to children to eliminate duplication of efforts and identify opportunities to consolidate those efforts.

(e) The council is administratively attached to the commission. The commission shall provide administrative support and resources to the council as necessary to enable the council to perform its duties.

(f) The council is not subject to Chapter 2110.

Sec. 531.426. CHILDREN'S BEHAVIORAL HEALTH ADVISORY COMMITTEE. (a) The commission shall establish the Children's Behavioral Health Advisory Committee to assist the council in the performance of its duties.

(b) The governor shall appoint to the advisory committee representatives from advocacy groups and organizations with expertise in behavioral health issues involving children and from other family advocates. The governor shall appoint as many members to the advisory committee as the council considers necessary to assist the council in performing its duties, but not less than the number of agency representatives on the council.

(c) The advisory committee shall elect one member to serve as chairperson, and shall meet in accordance with commission rules.

(d) A member of the advisory committee may not receive compensation for serving on the committee, but is entitled to reimbursement for travel expenses incurred while conducting the business of the committee, as provided by the General Appropriations Act.

(e) The commission shall provide administrative support and resources to the advisory committee as necessary to enable the committee to perform its duties.

(f) The committee is not subject to Chapter 2110.

Sec. 531.427. INTEGRATED FUNDING STRUCTURE FOR CERTAIN BEHAVIORAL HEALTH SERVICES. (a) The council shall design an integrated cross-agency funding structure for the provision of behavioral health services to children.

(b) In creating the funding structure, the council shall consider:

(1) the use of existing categorical or noncategorical federal, state, and local funds;

(2) the use of blended or braided funding arrangements;

(3) which funds should be included in the funding structure and how the funds should be structured; and

(4) the persons that should control and manage the funds, including managed care financing structures.

(c) The council may hire a consultant to assist with designing the funding structure.

(d) Not later than June 1, 2008, the council shall submit a report to the governor and the Legislative Budget Board that:

(1) describes the funding structure designed by the council; and

(2) identifies the steps necessary to implement the structure, including identification of necessary statutory changes or federal approvals.

(e) Subsection (d) and this subsection expire September 1, 2008.

Sec. 531.428. HOME AND COMMUNITY SERVICES FOR CHILDREN WITH SEVERE EMOTIONAL DISTURBANCES. (a) The commission shall maximize funding for home and community-based services for children with severe emotional disturbances by providing those services, to the greatest extent possible, through a Section 1915(c) waiver program or other Medicaid program. Not later than September 1, 2008, the commission shall identify each service the commission anticipates could be delivered cost-effectively in that manner using existing resources and seek federal approval as necessary to permit the delivery of services in that manner.

(b) Notwithstanding any other provision of this section, the commission may implement maximization financing strategies at a location providing systems of care services.

SECTION 1.10. Section 531.421(3), Government Code, is repealed.

SECTION 1.11. Not later than October 1, 2007, the chief administrative officer of each agency listed in Section 531.425(b), Government Code, as added by this article, shall appoint the agency's representative to the Children's Behavioral Health Council established by that section.

SECTION 1.12. (a) Not later than November 1, 2007, the governor shall appoint the initial members of the Children's Behavioral Health Advisory Committee created by Section 531.426, Government Code, as added by this article.

(b) In making initial appointments, the governor must include the public members serving immediately before the effective date of this article on the Texas Integrated Funding Initiative Consortium, as formed under Section 531.251, Government Code, as that section existed before amendment by this article, provided that those members wish to continue to serve.

SECTION 1.13. The changes in law made by this article to Subchapter G-1, Chapter 531, Government Code, do not affect the funding for or provision of services by a community participating in the Texas Integrated Funding Initiative under that subchapter before the effective date of this article.

ARTICLE 2. PARTICIPATION IN CERTAIN TANF EMPLOYMENT PROGRAMS

SECTION 2.01. Subchapter A, Chapter 31, Human Resources Code, is amended by adding Section 31.0021 to read as follows:

Sec. 31.0021. DEFINITION OF NONRECIPIENT PARENT. (a) Except as provided by Subsection (b), in this chapter, "nonrecipient parent" means an adult or minor parent who is not a recipient of financial assistance but who is living with the person's child who is a recipient of financial assistance.

(b) "Nonrecipient parent" does not include:

(1) a minor parent who is not the head of household;

(2) a person who is ineligible for financial assistance because of the person's immigration status; or

(3) a parent who cares for a disabled family member living in the home if the family member does not attend school full-time and the need for the care is supported by medical documentation.

SECTION 2.02. Section 31.0033(d), Human Resources Code, is amended to read as follows:

(d) The department by rule shall establish criteria for good cause failure to cooperate and guidelines for what constitutes a good faith effort on behalf of a recipient under this section, except that the Texas Workforce Commission shall establish criteria for good cause failure to cooperate with regard to work or employment activities in accordance with Section 31.012(b).

SECTION 2.03. The heading to Section 31.012, Human Resources Code, is amended to read as follows:

Sec. 31.012. MANDATORY WORK OR PARTICIPATION IN EMPLOYMENT ACTIVITIES [THROUGH THE JOB OPPORTUNITIES AND BASIC SKILLS PROGRAM].

SECTION 2.04. Section 31.012, Human Resources Code, is amended by amending Subsections (a) through (d) and adding Subsections (c-1) and (g) to read as follows:

(a) The Health and Human Services Commission [department] shall require that, during any one-month period in which an adult is receiving or the child of a nonrecipient parent is receiving financial assistance under this chapter, the adult or nonrecipient parent shall during that period:

(1) work not less than 30 hours a week; or

(2) participate for not less than 20 hours a week in an activity established under a Temporary Assistance for Needy Families employment program under Part A, Subchapter IV, Social Security Act (42 U.S.C. Section 601 et seq.) [the job opportunities and basic skills (JOBS) training program under Part F, Subchapter IV, Social Security Act (42 U.S.C. Section 682)].

(b) The Texas Workforce Commission [department] by rule shall establish criteria for good cause failure to cooperate and for notification procedures regarding participation in work or employment activities under this section.

(c) An adult recipient providing care for a disabled family member living in the home, if the family member does not attend school full-time, [A person who is the caretaker of a physically or mentally disabled child who requires the caretaker's presence] is not required to participate in a program under this section. A single person who is the caretaker of a child is not required to participate in a program under this section [exempt] until the caretaker's youngest child at the time the caretaker first became eligible for assistance reaches the age of one. Notwithstanding Sections 31.0035(b) and 32.0255(b), the department shall provide to a person who is not required to participate in a program [exempt] under this subsection and who voluntarily participates in a program under Subsection (a)(2) six months of transitional benefits in addition to the applicable limit prescribed by Section 31.0065.

(c-1) Notwithstanding Section 531.0055, Government Code, the executive commissioner of the Health and Human Services Commission may not adopt rules that provide exceptions to a person's required participation in work or employment activities that are in addition to the exceptions provided by Subsection (c).

(d) A state program operated under this section shall be administered by the division of workforce development of the Texas Workforce Commission [when the program is transferred to that commission].

(g) A nonrecipient parent who receives Supplemental Security Income (SSI) benefits under 42 U.S.C. Section 1381 et seq., as amended, is not subject to the requirements of this section. The Texas Workforce Commission may provide services to the nonrecipient parent under this chapter in accordance with commission rules.

SECTION 2.05. Section 31.014(a), Human Resources Code, is amended to read as follows:

(a) The Health and Human Services Commission [department] shall provide financial assistance, in accordance with [department] rules adopted by the executive commissioner of the Health and Human Services Commission, to a two-parent family if the primary wage earner parent, other than a nonrecipient parent described by Section 31.012(g), is registered with a Temporary Assistance for Needy Families employment program under Part A, Subchapter IV, Social Security Act (42 U.S.C. Section 601 et seq.) [in the job opportunities and basic skills (JOBS) training program under Part F, Subchapter IV, Social Security Act (42 U.S.C. Section 682)], or is registered with the Texas Workforce [Employment] Commission.

SECTION 2.06. Sections 31.0126(c) and 31.014(c), Human Resources Code, are repealed.

SECTION 2.07. The changes in law made by this article apply to a person receiving financial assistance, including a nonrecipient parent, as defined by Section 31.0021, Human Resources Code, as added by this article, on or after the effective date of this article, regardless of the date the determination of eligibility for that assistance was made.

ARTICLE 3. HEALTH INSURANCE PREMIUM PAYMENT REIMBURSEMENT PROGRAM

FOR MEDICAID RECIPIENTS

SECTION 3.01. Section 32.0422, Human Resources Code, is amended by adding Subsections (m-1) and (m-2) to read as follows:

(m-1) The Health and Human Services Commission, in consultation with the Texas Department of Insurance, shall provide training to agents who hold a general life, accident, and health license under Chapter 4054, Insurance Code, regarding the health insurance premium payment reimbursement program and the eligibility requirements for participation in the program. Participation in a training program established under this subsection is voluntary, and a general life, accident, and health agent who successfully completes the training is entitled to receive continuing education credit under Subchapter B, Chapter 4004, Insurance Code, in accordance with rules adopted by the commissioner of insurance.

(m-2) The Health and Human Services Commission may pay a referral fee, in an amount determined by the commission, to each general life, accident, and health agent who, after completion of the training program established under Subsection (m-1), successfully refers an eligible individual to the department for enrollment in a group health benefit plan under this section.

ARTICLE 4. LONG-TERM CARE

SECTION 4.01. Chapter 32, Human Resources Code, is amended by adding Subchapter C to read as follows: SUBCHAPTER C. PARTNERSHIP FOR LONG-TERM CARE PROGRAM

Sec. 32.101. DEFINITIONS. In this subchapter:

(1) "Approved plan" means a long-term care benefit plan that is approved by the Texas Department of Insurance under Subchapter C, Chapter 1651, Insurance Code.

(2) "Asset disregard" means the total equity value of assets and resources not exempt under rules governing the medical assistance program that are disregarded in determining eligibility for the medical assistance program and in determining estate recovery obligations.

(3) "Asset protection" means the right extended to a plan holder of an approved plan to dollar-for-dollar asset disregard under the medical assistance program.

(4) "Dollar-for-dollar asset disregard" means an asset disregard in which the amount of the disregard is equal to the sum of qualifying benefit payments made on behalf of the qualified plan holder.

(5) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

(6) "Partnership for long-term care program" means the program established under this subchapter and Subchapter C, Chapter 1651, Insurance Code.

Sec. 32.102. PARTNERSHIP FOR LONG-TERM CARE PROGRAM. The partnership for long-term care program is administered as part of the medical assistance program by the department with the assistance of the Texas Department of Insurance. The program must be consistent with provisions governing the expansion of a state long-term care partnership program established under the federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171).

Sec. 32.103. ASSET DISREGARD. (a) To the extent allowed by the federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171) and other federal law, the executive commissioner, in adopting rules and standards governing the medical assistance program, shall allow for dollar-for-dollar asset disregard to provide medical assistance to an individual receiving long-term care services if the individual is or was covered by a long-term care benefit plan providing coverage for long-term care that meets the applicable minimum benefit standards of the commissioner of the Texas Department of Insurance under Subchapter C, Chapter 1651, Insurance Code, and other requirements for approval under the partnership for long-term care program.

(b) The department may not consider the resources of an individual who has used all or part of the individual's benefits under an approved plan to the extent those resources are the subject of a dollar-for-dollar asset disregard in determining:

(1) eligibility for medical assistance under the medical assistance program;

(2) the amount of medical assistance provided; or

(3) any subsequent recovery by this state from the individual's estate for medical assistance provided to the individual.

(c) The department may not provide to an individual eligible for medical assistance under this section those medical assistance services covered under the medical assistance program that are also covered by the individual's benefits under the approved plan until the individual has fully exhausted the individual's benefits under the plan.

Sec. 32.104. RECIPROCAL AGREEMENTS. The department may enter into reciprocal agreements with other states to extend asset protection to a resident of this state who purchased a long-term care benefit plan in another state that has a substantially similar asset disregard program.

Sec. 32.105. TECHNICAL ASSISTANCE AND INFORMATION. The Health and Human Services Commission shall provide information and technical assistance to the Texas Department of Insurance regarding that department's role in ensuring that each individual who sells a long-term care benefit plan under the partnership for long-term care program receives training and demonstrates evidence of an understanding of these plans and how the plans relate to other public and private coverage of long-term care.

Sec. 32.106. RULES. (a) The executive commissioner shall adopt rules as necessary to administer the partnership for long-term care program and to implement this subchapter.

(b) In adopting rules under this section, the executive commissioner shall:

(1) provide for dollar-for-dollar asset disregard and asset protection for purchasers of an approved plan; and

(2) count benefits paid under the approved plan toward the dollar-for-dollar asset disregard to the extent the benefits are provided for covered services under the approved plan.

SECTION 4.02. Chapter 1651, Insurance Code, is amended by adding Subchapter C to read as follows: SUBCHAPTER C. PARTNERSHIP FOR LONG-TERM CARE PROGRAM

Sec. 1651.101. DEFINITIONS. In this subchapter:

(1) "Approved plan" means a long-term care benefit plan that is approved by the department under this subchapter.

(2) "Dollar-for-dollar asset disregard" and "asset protection" have the meanings assigned by Section 32.101, Human Resources Code.

(3) "Medical assistance program" means the medical assistance program established under Chapter 32, Human Resources Code.

(4) "Partnership for long-term care program" means the program established under Subchapter C, Chapter 32, Human Resources Code, and this subchapter.

Sec. 1651.102. APPLICABILITY. Except to the extent of a conflict, Subchapters A and B apply to a plan issued in accordance with this subchapter.

Sec. 1651.103. ASSISTANCE OF DEPARTMENT. The department shall assist the Health and Human Services Commission as necessary for the commission to perform its duties and functions with respect to the administration of the partnership for long-term care program.

Sec. 1651.104. LONG-TERM CARE INSURANCE POLICY FOR PARTNERSHIP FOR LONG-TERM CARE PROGRAM. The commissioner, in consultation with the Health and Human Services Commission, shall adopt minimum standards for a long-term care benefit plan that may qualify as an approved plan under the partnership for long-term care program. The standards must be consistent with provisions governing the expansion of a state long-term care partnership program established under the federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171).

Sec. 1651.105. EFFECT OF DISCONTINUATION OF PROGRAM ON POLICY. If the partnership for long-term care program is discontinued, an individual who purchased an approved plan before the date the program is discontinued remains eligible to receive dollar-for-dollar asset disregard and asset protection under the medical assistance program.

Sec. 1651.106. RULES. The commissioner may adopt rules as necessary to implement this subchapter.

SECTION 4.03. The Health and Human Services Commission shall amend this state's Medicaid plan as necessary to allow for dollar-for-dollar asset disregard and asset protection for purchasers of an approved policy under the partnership for long-term care program established under Subchapter C, Chapter 32, Human Resources Code, as added by this article.

ARTICLE 5. LIFESPAN RESPITE SERVICES PILOT PROGRAM

SECTION 5.01. Subchapter D, Chapter 161, Human Resources Code, is amended by adding Section 161.075 to read as follows:

Sec. 161.075. LIFESPAN RESPITE SERVICES PILOT PROGRAM. (a) In this section, "respite services" means support services, including in-home services, adult day-care services, and facility-based services, that are provided for the purpose of temporarily giving relief to a primary caregiver who provides ongoing care to an individual with a chronic illness or disability.

(b) The department shall develop and implement the lifespan respite services pilot program to promote the provision of respite services. As part of the pilot program, the executive commissioner shall contract with community-based organizations or local governmental entities selected by the department to provide respite services or to facilitate access to local respite services.

(c) A community-based organization or local governmental entity that receives a contract under this section to facilitate access to local respite services may:

(1) recruit and train respite services providers;

(2) maintain a registry of respite services providers;

(3) connect caregivers with available respite services providers or programs;

(4) identify, coordinate, and develop community resources for respite services;

(5) build local partnerships with respect to respite services;

(6) implement public awareness activities regarding respite services; and

(7) subject to the availability of funds, provide vouchers for respite services to eligible primary caregivers, as determined by rule of the executive commissioner, who are not eligible for respite services provided through other programs.

(d) In implementing the pilot program, the department shall:

(1) provide technical assistance to community-based organizations and local governmental entities that receive a contract under this section;

(2) provide policy and program development support for organizations and entities described by Subdivision (1);

(3) monitor the activities for which the executive commissioner contracts under this section; and

(4) select the areas of this state in which to implement the pilot program.

(e) The executive commissioner shall adopt rules necessary to implement the pilot program, including:

(1) selection criteria for the award of contracts to community-based organizations and local governmental entities; and

(2) guidelines for contract monitoring and reporting.

(f) In developing the pilot program and adopting rules under this section, the department and executive commissioner, respectively, shall review similar initiatives in other states.

(g) This section expires September 1, 2011.

SECTION 5.02. Not later than November 1, 2010, the executive commissioner of the Health and Human Services Commission, in consultation with the Department of Aging and Disability Services, shall submit a report to the governor and the Legislative Budget Board regarding the lifespan respite services pilot program established under Section 161.075, Human Resources Code, as added by this article. The report must include an evaluation of the effect of the pilot program on:

(1) access to respite services by primary caregivers of persons with chronic illnesses or disabilities; and

(2) Medicaid expenditures for long-term care services provided in institutional care settings.

ARTICLE 6. WAIVER

SECTION 6.01. 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.

ARTICLE 7. EFFECTIVE DATE

SECTION 7.01. This Act takes effect September 1, 2007.