| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to certain Medicaid home and community-based services |
|
|
waiver programs. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. This Act shall be known as Daniel's Law. |
|
|
SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
|
|
is amended by adding Sections 32.0521 and 32.0522 to read as |
|
|
follows: |
|
|
Sec. 32.0521. HOSPITAL LEVEL OF CARE WAIVER PROGRAM FOR |
|
|
MEDICALLY FRAGILE INDIVIDUALS. (a) The department shall develop |
|
|
and apply for a waiver under Section 1915(c), Social Security Act |
|
|
(42 U.S.C. Section 1396n(c)), to provide the state with the |
|
|
flexibility to provide medical assistance services outside the |
|
|
scope, amount, or duration of nonwaiver services available to |
|
|
medically fragile individuals who are at least 21 years of age and |
|
|
who require a hospital level of care under the medical assistance |
|
|
program, if the department determines that implementation of a |
|
|
hospital level of care waiver program is cost-effective and |
|
|
efficient. |
|
|
(b) The hospital level of care waiver program under this |
|
|
section must include coverage for: |
|
|
(1) advanced supportive and restorative services; |
|
|
(2) case management services; |
|
|
(3) environmental modifications; |
|
|
(4) home-delivered meals; |
|
|
(5) hospice care; |
|
|
(6) occupational therapy; |
|
|
(7) personal care; |
|
|
(8) prescribed drugs; |
|
|
(9) personal emergency response systems; |
|
|
(10) physical therapy; |
|
|
(11) private duty nursing; |
|
|
(12) respiratory therapy; |
|
|
(13) respite care; |
|
|
(14) skilled nursing; |
|
|
(15) specialized medical equipment and supplies; and |
|
|
(16) speech therapy. |
|
|
(c) The department may not require that a medically fragile |
|
|
or technology-dependent individual who meets the eligibility |
|
|
criteria for the hospital level of care waiver program be placed in |
|
|
an alternative institutional living arrangement as a condition for |
|
|
receiving services under the program. |
|
|
(d) To ensure that services subject to this section are cost |
|
|
neutral and not duplicative of other services provided under the |
|
|
medical assistance program, the department shall coordinate the |
|
|
provision of services subject to this section with services |
|
|
provided under other federal waiver programs. |
|
|
Sec. 32.0522. LEVELS OF NEED IN HOME AND COMMUNITY-BASED |
|
|
SERVICES WAIVER PROGRAM. (a) The department shall develop and |
|
|
apply for a waiver under Section 1915(c), Social Security Act (42 |
|
|
U.S.C. Section 1396n(c)), to establish a level of need for use in |
|
|
the Home and Community-based Services waiver program to assess |
|
|
individuals who are at least 21 years of age and may require |
|
|
continuous, intensive, and specialized medical support to ensure |
|
|
that those individuals may receive that support, if the department |
|
|
determines that implementation of that level of need is |
|
|
cost-effective and efficient. |
|
|
(b) The individual cost limit for an individual assigned the |
|
|
level of need established under this section must be equal to or |
|
|
greater than the individual cost limit for an individual assigned a |
|
|
level of need that includes the receipt of the most intensive |
|
|
behavioral health support under the Home and Community-based |
|
|
Services waiver program. |
|
|
SECTION 3. If before implementing any provision of this Act |
|
|
a state agency determines that a waiver, an amendment to an existing |
|
|
waiver, or another authorization from a federal agency is necessary |
|
|
for implementation of that provision, the agency affected by the |
|
|
provision shall request the waiver, amendment to the existing |
|
|
waiver, or other authorization and may delay implementing that |
|
|
provision until the waiver, amendment, or authorization is granted. |
|
|
SECTION 4. This Act takes effect September 1, 2013. |