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.