By: Nelson S.B. No. 1734
 
 
A BILL TO BE ENTITLED
AN ACT
relating to providing Medicaid services to certain persons with
traumatic brain or spinal cord injuries.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
       SECTION 1.  Subchapter D, Chapter 117, Human Resources Code,
is amended by adding Section 117.075 to read as follows:
       Sec. 117.075.  MEDICAID SERVICES FOR CERTAIN PERSONS WITH
TRAUMATIC BRAIN OR SPINAL CORD INJURIES. (a)  In this section,
"comprehensive rehabilitation services program" means the program
that provides services to persons with traumatic brain or spinal
cord injuries using money appropriated from the comprehensive
rehabilitation fund established under Section 111.060.
       (b)  The department shall determine whether services
provided under the comprehensive rehabilitation services program
could be provided in a more cost-effective manner through the
Medicaid program.  In making that determination, the department
shall evaluate and compare the cost-effectiveness of each of the
following approaches to providing those services under the Medicaid
program:
             (1)  providing the services under a modification to a
previously authorized Section 1915(c) waiver program, as that term
is defined by Section 531.001, Government Code;
             (2)  providing the services under an amendment to the
state Medicaid plan; or
             (3)  providing the services under an additional Section
1915(c) waiver or an alternative home and community-based services
waiver under Section 6086 of the federal Deficit Reduction Act of
2005 (Pub. L. No. 109-171).
       (c)  In evaluating the cost-effectiveness of each approach
to providing Medicaid services under Subsection (b), the department
shall consider:
             (1)  the effect that implementing each approach would
have on the general revenue fund;
             (2)  the amount of additional federal matching funds
this state would receive as a result of implementing each approach;
and
             (3)  the maximum number of persons receiving services
under the comprehensive rehabilitation services program who would
be eligible under the federal income eligibility standards
applicable to each approach.
       (d)  The commission, the Department of Aging and Disability
Services, and the Texas Traumatic Brain Injury Advisory Council
shall assist the department as necessary in performing the
department's duties under Subsections (b) and (c).
       (e)  If the department determines that services provided
under the comprehensive rehabilitation services program could be
provided in a more cost-effective manner through the Medicaid
program, the department shall notify the commission and:
             (1)  the commission shall actively pursue federal
authorization to begin providing those services through the
approach the department determines would be most cost-effective;
and
             (2)  the executive commissioner shall establish
Medicaid eligibility criteria, including income limits, for the
receipt of those services through the Medicaid program as necessary
to maintain cost-effectiveness for this state and maximize federal
matching funds this state will receive.
       (f)  The commission, subject to receipt of any necessary
federal authorization, shall:
             (1)  ensure that services the department determines
could be provided more cost-effectively under the Medicaid program
are provided under that program to eligible persons and that
persons who are ineligible for that program continue to receive
services under the comprehensive rehabilitation services program;
             (2)  ensure that persons receiving services under the
Medicaid program also receive under the comprehensive
rehabilitation services program any service provided under that
program that is not covered under the Medicaid program; and
             (3)  designate and direct the department to:
                   (A)  implement the program to provide the
services, if the department determines that an approach described
by Subsection (b)(2) or (3) is most cost-effective; and
                   (B)  continue to coordinate the provision of
services to all persons with traumatic brain and spinal cord
injuries, regardless of whether the services are provided under the
Medicaid program or the comprehensive rehabilitation services
program.
       SECTION 2.  Not later than November 1, 2008, the Department
of Assistive and Rehabilitative Services shall submit a report to
the governor and the Legislative Budget Board detailing the results
of the department's determinations and actions taken under Section
117.075, Human Resources Code, as added by this Act.
       SECTION 3.  This Act takes effect September 1, 2007.