83R1902 EES-D

By: Zerwas H.B. No. 3251

A BILL TO BE ENTITLED

AN ACT

relating to the assessment of the long-term care needs of certain persons with intellectual and developmental disabilities and a resource allocation system for certain Medicaid program services provided to those persons.

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

SECTION 1. Subchapter D, Chapter 161, Human Resources Code, is amended by adding Sections 161.087 and 161.088 to read as follows:

Sec. 161.087. ASSESSMENT TOOL FOR PERSONS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. (a) In this section:

(1) "ICF/IID" has the meaning assigned to "ICF-MR" by Section 531.002, Health and Safety Code.

(2) "Section 1915(c) waiver program" has the meaning assigned by Section 531.001, Government Code.

(b) The department shall, in accordance with this section, implement an automated functional assessment tool for use in assessing the needs of persons with intellectual and developmental disabilities who:

(1) receive long-term care services and supports, including services and supports provided under a Section 1915(c) waiver program, from the state; or

(2) are on an interest list for a program, including a Section 1915(c) waiver program, under which the state provides long-term care services and supports.

(c) The department may elect to use a national standardized assessment tool or develop a state-based automated functional assessment tool under this section. The department shall consult with stakeholders in selecting the automated functional assessment tool required under this section.

(d) The department shall establish a procedure through which a person whose needs are assessed by the department using the automated functional assessment tool implemented under this section may request an informal hearing to contest the department's determination of the person's level of need.

(e) Not later than August 31, 2014, the department shall prepare and submit to the governor and the Legislative Budget Board a report containing:

(1) a description of the automated functional assessment tool that the department develops or selects under this section; and

(2) a plan for the implementation of the tool.

(f) Not later than January 1, 2018, the department shall implement, in the most cost-effective manner possible and in the following phases, the automated functional assessment tool selected under this section:

(1) an initial phase, during which the department uses the tool to assess persons receiving services under the home and community-based services (HCS) waiver program;

(2) an expansion phase, during which the department uses the tool to assess persons receiving services under the:

(A) community living assistance and support services (CLASS) waiver program;

(B) deaf, blind, and multiple disabilities (DBMD) waiver program; and

(C) Texas home living (TxHmL) waiver program; and

(3) a final phase, during which the department uses the tool to assess:

(A) residents of ICF/IID facilities, including residents of state supported living centers;

(B) persons served by other programs or facilities that provide safety-net services to persons with intellectual and developmental disabilities and are funded through appropriations by the legislature from the general revenue fund; and

(C) persons on an interest list for a waiver program described in Subdivision (1) or (2).

(g) Not later than August 31 of each year, the department shall prepare and submit to the governor and the Legislative Budget Board a report that:

(1) summarizes the department's progress in implementing the automated functional assessment tool required under this section; and

(2) analyzes the needs of the persons described in Subsection (f) to the extent that their needs have been assessed using the automated functional assessment tool required under this section.

(h) This subsection and Subsections (e), (f), and (g) expire January 1, 2020.

Sec. 161.088. RESOURCE ALLOCATION SYSTEM FOR HOME AND COMMUNITY-BASED SERVICES WAIVER PROGRAM. (a) The department shall develop and implement a resource allocation system for use in the home and community-based services (HCS) waiver program that:

(1) is based on a reliable assessment of the types and levels of need of persons receiving and seeking services under the program; and

(2) ensures that persons receiving services under the program only receive services:

(A) that are appropriate and medically necessary; and

(B) at the appropriate funding levels.

(b) The department shall ensure that the resource allocation system implemented under this section includes a process through which a person assessed under the system may request a reassessment of the person's level of need if the person believes that the services that the person is receiving are insufficient due to a change in the person's diagnosis or available supports.

(c) The department may contract with a third party who has experience developing resource allocation systems to aid in the implementation of the allocation system developed under this section.

SECTION 2. The Department of Aging and Disability Services shall develop and implement the resource allocation system required by Section 161.088, Human Resources Code, as added by this Act, not later than August 31, 2015.

SECTION 3. 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.

SECTION 4. This Act takes effect September 1, 2013.