By: Zaffirini S.B. No. 2165

A BILL TO BE ENTITLED

AN ACT

relating to day habilitation services for individuals with an intellectual disability; imposing an administrative penalty.

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

SECTION 1. Chapter 161, Human Resources Code, is amended by adding Subchapter J to read as follows:

SUBCHAPTER J. DAY HABILITATION REGISTRATION AND REGULATION

Sec. 161.401. DEFINITIONS. In this subchapter:

(1) "Day habilitation services" means services provided in a nonresidential setting to assist persons with intellectual and developmental disabilities in acquiring, retaining, and improving the self-help, socialization, and adaptive skills necessary to reside successfully in the community.

(2) "Day habilitation services provider" means a person who contracts with a community-based intellectual and developmental disabilities services provider or intermediate care facility to provide federally funded Medicaid day habilitation services authorized under Section 1915(c) of the federal Social Security Act (42 U.S.C. Section 1396n(c).

(3) "Medicaid waiver participant" means an individual who receives services through a Medicaid waiver program authorized under 42 U.S.C. Section 1369n(c).

(4) "Medicaid waiver program" means services under the state Medicaid home and community-based services waiver program for persons with an intellectual disability adopted in accordance with 42 U.S.C. Section 1369n(c).

(5) "Service planning team" means a group of persons convened to develop a plan of services and supports for a Medicaid waiver participant, including the participant, appropriate staff members and professional personnel, and other persons selected by the participant's legally authorized representative.

Sec. 161.402. COMMISSION REGISTRATION PROGRAM. (a) The executive commissioner by rule shall establish a registration process by which a day habilitation services provider may register with the commission if the provider demonstrates to the commission that the provider:

(1) follows safety guidelines and minimum service requirements established by the executive commissioner; and

(2) meets the minimum qualifications for a person or entity providing services to an individual participating in the consumer-directed service option under Section 531.051, Government Code.

(b) The guidelines established under Subsection (a) shall include a requirement that the setting and services provided by the day habilitation services provider meet the federal requirements established under 42 C.F.R. Sections 441.301(c)(4) and 441.530(a).

Sec. 161.403. DUTIES OF MEDICAID WAIVER PROGRAM PROVIDER. (a) A Medicaid waiver program provider shall make a good faith effort to provide employment services or day habilitation services to a Medicaid waiver participant who wishes to participate in employment services or day habilitation.

(b) A Medicaid waiver program provider may not contract with a day habilitation services provider who provides day habilitation services to a Medicaid waiver participant as part of the Medicaid waiver program unless the provider is registered with the commission under Section 161.402.

(c) A Medicaid waiver program provider shall develop and implement a procedure by which a Medicaid waiver participant may pool Medicaid funds dedicated for day services with one or more other participants to pay for access to day services as a group.

(d) The commission may impose an administrative penalty against a Medicaid waiver program provider who violates this section.

Sec. 161.404. DUTY OF SERVICE PLANNING TEAM. A Medicaid waiver participant's service planning team shall inform the participant that employment services or day habilitation services are optional and the participant can choose to participate or not to participate in employment services or day habilitation services.

Sec. 161.405. CERTAIN LOCATIONS FOR DAY HABILITATION SERVICES PROHIBITED. A day habilitation services provider may not provide services at the same location as:

(1) a sheltered workshop; or

(2) an employment setting in which participants are paid less than minimum wage.

Sec. 161.406. CERTAIN DAY HABILITATION SERVICES PROVIDERS PROHIBITED. An employer of record of a Medicaid waiver participant may not provide day habilitation services to the participant.

SECTION 2. Not later than December 1, 2017, the Health and Human Services Commission shall adopt rules required by Section 161.402, Human Resources Code, as added by this Act.

SECTION 3. This Act takes effect September 1, 2017.