|
|
A BILL TO BE ENTITLED
|
|
AN ACT
|
|
relating to expansion of the use of consumer direction for delivery |
|
of certain services to persons with disabilities and elderly |
|
persons. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. The heading to Section 531.051, Government Code, |
|
is amended to read as follows: |
|
Sec. 531.051. CONSUMER DIRECTION [VOUCHER PROGRAM FOR
|
|
PAYMENT] OF CERTAIN SERVICES FOR PERSONS WITH DISABILITIES AND |
|
ELDERLY PERSONS. |
|
SECTION 2. Sections 531.051(a), (b), (c), and (d), |
|
Government Code, are amended to read as follows: |
|
(a) In this section: |
|
(1) "Consumer" means a person who receives services |
|
through a consumer direction model [under the program] established |
|
by the commission under this section. |
|
(2) "Consumer direction" or "consumer direction |
|
model" means a service delivery model under which a consumer or the |
|
consumer's legally authorized representative exercises control |
|
over the development and implementation of the consumer's |
|
individual service plan or over the persons delivering the services |
|
directly to the consumer. The term includes the consumer-directed |
|
service option, the service responsibility option, and other types |
|
of service delivery models developed by the commission under this |
|
section. |
|
(3) "Consumer-directed service option" means a type of |
|
consumer direction model in which: |
|
(A) a consumer or the consumer's legally |
|
authorized representative, as the employer, exercises control |
|
over: |
|
(i) the recruitment, hiring, management, or |
|
dismissal of persons providing services directly to the consumer; |
|
and |
|
(ii) the retention of contractors or |
|
vendors for other authorized program services; and |
|
(B) the provider agency serves as fiscal agent |
|
and performs employer-related administrative functions for the |
|
consumer or the consumer's legally authorized representative, |
|
including payroll and the filing of tax and related reports. |
|
(4) "Legally authorized representative" means: |
|
(A) a parent or legal guardian if the person is a |
|
minor; |
|
(B) a legal guardian if the person has been |
|
adjudicated as incapacitated to manage the person's personal |
|
affairs; or |
|
(C) any other person authorized or required by |
|
law to act on behalf of the person with regard to the person's care. |
|
(5) "Service responsibility option" means a type of |
|
consumer direction model in which: |
|
(A) a consumer or the consumer's legally |
|
authorized representative participates in the selection of, |
|
trains, and manages persons providing services directly to the |
|
consumer; and |
|
(B) the provider agency, as the employer, |
|
performs employer-related administrative functions for the |
|
consumer or the consumer's legally authorized representative, |
|
including the hiring and dismissal of persons providing services |
|
directly to the consumer ["Personal assistance services" and
|
|
"respite services" have the meanings assigned by Section 142.001,
|
|
Health and Safety Code]. |
|
(b) The commission shall develop and oversee the |
|
implementation of consumer direction models under which a person |
|
with a disability or an elderly person who is receiving certain |
|
state-funded or Medicaid-funded services, or the person's legally |
|
authorized representative, exercises control over the development |
|
and implementation of the person's individual service plan or over |
|
the persons who directly deliver the services [a program in which
|
|
the use of vouchers is established as a payment option for the
|
|
delivery of certain state-funded and Medicaid-funded services to
|
|
persons with disabilities]. |
|
(c) In adopting rules for the consumer direction models |
|
[voucher payment program], the commission shall: |
|
(1) with assistance from the work group established |
|
under Section 531.052, determine which services are appropriate and |
|
suitable for delivery through consumer direction [ensure that the
|
|
program includes the:
|
|
[(A) delivery to persons with disabilities of
|
|
personal assistance services, respite services, supported
|
|
employment services, and other services that the commission with
|
|
assistance from the work group established under Section 531.052,
|
|
determines are appropriate and applicable and may be provided with
|
|
available funding; and
|
|
[(B) provision of durable medical equipment and
|
|
assistive technology to persons with disabilities to the extent
|
|
funds are available for that purpose]; |
|
(2) [work in conjunction with the comptroller and
|
|
appropriate health and human services agencies to develop the
|
|
program;
|
|
[(3) design the program in a manner in which, for
|
|
certain programs considered appropriate by the commission, with
|
|
assistance from the work group established under Section 531.052, a
|
|
private entity or local governmental entity applies with and is
|
|
approved by the Internal Revenue Service to act as the agent for a
|
|
consumer for the limited purpose of:
|
|
[(A) computing federal and state employment
|
|
taxes;
|
|
[(B) preparing and filing income tax forms and
|
|
reports; and
|
|
[(C) distributing money to a service provider
|
|
after a deduction for employment taxes;
|
|
[(4)] ensure that each consumer direction model [the
|
|
program] is designed to comply with applicable federal and state |
|
[tax] laws; |
|
(3) maintain procedures [(5) ensure that a consumer
|
|
is the employer of and retains control over the selection,
|
|
management, and dismissal of an individual providing health care
|
|
services covered by the program;
|
|
[(6)establish a system] to ensure that a potential |
|
consumer or the consumer's legally authorized representative has |
|
adequate and appropriate information, including the |
|
responsibilities of a consumer or representative under each service |
|
delivery [payment] option, to make an informed choice among the |
|
types of consumer direction models [payment options]; |
|
(4) [(7)] require each consumer or the consumer's |
|
legally authorized representative to acknowledge [sign a statement
|
|
acknowledging] receipt of the information required by Subdivision |
|
(3) [(6)]; |
|
(5) maintain procedures [(8)develop a system] to |
|
monitor delivery of services through consumer direction [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; |
|
(6) [(9)] ensure that authorized program services |
|
that are not being delivered to a consumer through consumer |
|
direction are provided by a service provider chosen by the consumer |
|
or the consumer's legally authorized representative [a consumer may
|
|
contract with a service provider acting as the consumer's agent
|
|
under Subdivision (3) to obtain any necessary services, including
|
|
services not being provided to the consumer under the program]; and |
|
(7) [(10)] work in conjunction with the work group |
|
established under Section 531.052 to set a timetable to [implement
|
|
and] complete the implementation of the consumer direction models |
|
[program]. |
|
(d) The consumer direction models established [voucher
|
|
payment program developed] under this section may be implemented |
|
[only] in appropriate and suitable programs of the commission or a |
|
health and human services agency [Texas Department of Human
|
|
Services, the Texas Department of Mental Health and Mental
|
|
Retardation, the Texas Rehabilitation Commission, and the Texas
|
|
Department of Health]. |
|
SECTION 3. The heading to Section 531.052, Government Code, |
|
is amended to read as follows: |
|
Sec. 531.052. CONSUMER DIRECTION [DIRECTED SERVICES] WORK |
|
GROUP. |
|
SECTION 4. Section 531.052, Government Code, is amended by |
|
amending Subsections (a), (b), (c), (e), and (g), and adding |
|
Subsection (c-1) to read as follows: |
|
(a) A work group is created to: |
|
(1) advise the commission concerning the delivery of |
|
services through consumer direction in all programs offering |
|
long-term services and supports to ensure that consumers have |
|
access to a service delivery model that enhances a consumer's |
|
ability to have freedom and exercise control and authority over the |
|
consumer's choices, regardless of age or disability; and |
|
(2) assist the commission in developing and |
|
implementing consumer direction models and expanding the delivery |
|
of services through consumer direction [the voucher payment
|
|
program] under Section 531.051. |
|
(b) The work group is composed of: |
|
(1) representatives of the commission, appointed by |
|
the executive commissioner; |
|
(2) representatives of the Department of Aging and |
|
Disability Services [Texas Department of Human Services], |
|
appointed by the commissioner of that agency; |
|
(3) [representatives of the Texas Department of Mental
|
|
Health and Mental Retardation, appointed by the commissioner of
|
|
that agency;
|
|
[(4)] representatives of the Department of State |
|
Health Services [Texas Department of Health], appointed by the |
|
commissioner of that agency; |
|
(4) [(5)] representatives of the Department of |
|
Assistive and Rehabilitative Services [Texas Rehabilitation
|
|
Commission], appointed by the commissioner of that agency; |
|
(5) [(6)] consumers or potential consumers of the |
|
array of services provided through consumer direction under Section |
|
531.051 [under the voucher payment pilot project under former
|
|
Section 22.0325, Human Resources Code], jointly appointed by the |
|
executive commissioner and the commissioner of the health and human |
|
services agency that administers the program providing the service |
|
[Texas Department of Human Services]; |
|
(6) advocates for elderly persons who are consumers of |
|
the array of services provided to elderly persons through consumer |
|
direction [(7) persons with disabilities, including persons with
|
|
mental illness and persons with mental retardation, who are
|
|
consumers or potential consumers of services provided under the
|
|
voucher payment program], appointed by the executive commissioner; |
|
(7) [(8)] advocates for persons with disabilities who |
|
are consumers of the array of services provided to persons with |
|
disabilities through consumer direction [, including persons with
|
|
mental illness and persons with mental retardation], appointed by |
|
the executive commissioner; |
|
(8) [(9)] providers of services to be provided through |
|
consumer direction [under the voucher payment program], appointed |
|
by the executive commissioner; |
|
(9) [(10)] representatives of the Texas Workforce |
|
Commission, appointed by the executive director of that commission; |
|
[and] |
|
(10) [(11)] representatives of any other state agency |
|
as considered necessary by the executive commissioner, appointed by |
|
the governing body of their respective agency; |
|
(11) representatives of any other state agency as |
|
recommended by the work group and approved by the executive |
|
commissioner, appointed by the governing body of the respective |
|
agency; and |
|
(12) any other public representative appointed by the |
|
executive commissioner. |
|
(c) A majority of the members of the work group must be |
|
composed of consumers and [,] advocates[, or providers] described |
|
by Subsection (b). |
|
(c-1) Duties of the work group created under this section |
|
include: |
|
(1) developing recommendations to: |
|
(A) expand the delivery of services through |
|
consumer direction to other programs serving persons with |
|
disabilities and elderly persons; |
|
(B) expand the array of services delivered |
|
through consumer direction; |
|
(C) increase the use of consumer direction models |
|
by consumers; |
|
(D) optimize the provider base for consumer |
|
direction; and |
|
(E) expand access to support advisors for those |
|
consumers receiving long-term services and supports through |
|
consumer direction; |
|
(2) monitoring national research for best practices in |
|
self-determination and consumer direction; and |
|
(3) developing recommendations and providing |
|
assistance regarding consumer outreach efforts to increase |
|
informed choices, skills, opportunities, and supports as a means to |
|
lead self-determined lives through the use of consumer direction |
|
models. |
|
(e) The executive commissioner shall appoint a member of the |
|
work group to serve as presiding officer, and members of the work |
|
group shall elect any other necessary officers. The presiding |
|
officer may not be a representative of a state agency or provider |
|
organization or be a provider. The work group shall meet at the |
|
call of the presiding officer. |
|
(g) Not later than September 1 of each even-numbered year, |
|
the work group shall report to the legislature regarding the |
|
activities of the work group [This section expires September 1,
|
|
2007]. |
|
SECTION 5. Sections 531.051(e), (f), (g), and (h), |
|
Government Code, are repealed. |
|
SECTION 6. The executive commissioner of the Health and |
|
Human Services Commission shall ensure that not later than January |
|
1, 2008, the membership of the work group established under Section |
|
531.052, Government Code, complies with the requirements of that |
|
section as amended by this Act. |
|
SECTION 7. This Act takes effect September 1, 2007. |