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A BILL TO BE ENTITLED
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AN ACT
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relating to the administration and provision of consumer-directed |
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services under certain health and human services programs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Section 531.051, Government Code, |
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is amended to read as follows: |
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Sec. 531.051. CONSUMER DIRECTION OF CERTAIN SERVICES FOR |
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CERTAIN PERSONS [WITH DISABILITIES AND ELDERLY PERSONS]. |
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SECTION 2. Section 531.051(a), Government Code, is amended |
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by amending Subdivision (2) and adding Subdivisions (4-a) and (5-a) |
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to read as follows: |
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(2) "Consumer direction" or "consumer direction |
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model" means a service delivery model under which a consumer or the |
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consumer's legally authorized representative exercises control |
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over the development and implementation of the consumer's |
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individual service plan or over the persons delivering the services |
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directly to the consumer. The term includes the consumer-directed |
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service option, the service responsibility option, the |
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individualized budget option, the purchasing option, and other |
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types of service delivery models developed by the commission under |
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this section. |
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(4-a) "Individualized budget option" means a type of |
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consumer direction model in which: |
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(A) a consumer-directed services agency |
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assesses the needs of a consumer and assists the consumer in |
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developing an individual budget expressed in dollars and based on |
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the anticipated cost of services and supports appropriate for the |
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consumer for the purchase of the goods and services necessary to |
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meet the consumer's needs; |
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(B) the consumer and, if appropriate, a person |
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who provides support or counseling services to the consumer develop |
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a spending plan for how and when the consumer will spend the money |
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in accordance with the consumer's individual budget; |
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(C) a consumer-directed services agency monitors |
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the consumer's individual budget; |
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(D) the consumer receives financial management |
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services through the consumer-directed services agency that |
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developed or monitors the consumer's individual budget; and |
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(E) the consumer does not directly receive cash |
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in relation to the consumer's individual budget but is instead |
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provided with a variety of tracking methods to manage and monitor |
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the consumer's individual budget. |
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(5-a) "Purchasing option" means a type of consumer |
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direction model in which a consumer is allocated money to purchase |
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goods and services that: |
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(A) are permissible under applicable federal and |
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state laws; |
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(B) address the needs identified in the |
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consumer's individual service plan; |
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(C) the consumer can afford without compromising |
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the consumer's health or safety; and |
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(D) are directly for the consumer's benefit. |
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SECTION 3. Section 531.051, Government Code, is amended by |
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amending Subsections (b) and (c) and adding Subsection (c-1) to |
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read as follows: |
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(b) The commission shall develop and oversee the |
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implementation of consumer direction models under which a person |
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with a disability or an elderly person who is receiving certain |
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state-funded or Medicaid-funded services, a person who is receiving |
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public mental health services under a program administered by the |
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Department of State Health Services, or the [person's] legally |
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authorized representative of one of those persons [,] exercises |
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control over the development and implementation of the person's |
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individual service plan or over the persons who directly deliver |
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the services. |
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(c) In adopting rules for the consumer direction models, the |
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executive commissioner [commission] shall: |
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(1) with assistance from the work group established |
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under Section 531.052 and subject to Subsection (c-1), determine |
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which services are appropriate and suitable for delivery through |
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consumer direction; |
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(2) ensure that each consumer direction model is |
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designed to comply with applicable federal and state laws; |
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(3) maintain procedures to ensure that a potential |
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consumer or the consumer's legally authorized representative has |
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adequate and appropriate information, including the |
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responsibilities of a consumer or representative under each service |
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delivery option, to make an informed choice among the types of |
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consumer direction models; |
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(4) require each consumer or the consumer's legally |
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authorized representative to sign a statement acknowledging |
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receipt of the information required by Subdivision (3); |
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(5) maintain procedures to monitor delivery of |
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services through consumer direction to ensure: |
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(A) adherence to existing applicable program |
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standards; |
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(B) appropriate use of funds; and |
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(C) consumer satisfaction with the delivery of |
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services; |
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(6) ensure that authorized program services that are |
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not being delivered to a consumer through consumer direction are |
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provided by a provider agency chosen by the consumer or the |
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consumer's legally authorized representative; and |
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(7) work in conjunction with the work group |
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established under Section 531.052 to set a timetable to complete |
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the implementation of the consumer direction models. |
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(c-1) In adopting rules regarding what services are |
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appropriate and suitable for delivery through consumer direction |
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under Subsection (c)(1), the executive commissioner shall ensure |
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that: |
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(1) included in the services eligible for |
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consumer-directed delivery are all home and community-based |
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services provided under the Medicaid state plan, including services |
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provided under the STAR + PLUS Medicaid managed care program and |
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Medicaid waiver programs, including waiver programs authorized |
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under Sections 1915 and 1115 of the federal Social Security Act (42 |
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U.S.C. Sections 1396n and 1315); and |
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(2) consumers are provided case management and service |
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coordination when available. |
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SECTION 4. Not later than December 1, 2013, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt the rules necessary to develop and implement the consumer |
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direction models described in Sections 531.051(a)(4-a) and (5-a), |
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Government Code, as added by this Act, and the rules required by |
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Section 531.051(c-1), Government Code, as added by this Act. |
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SECTION 5. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 6. This Act takes effect September 1, 2013. |