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A BILL TO BE ENTITLED
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AN ACT
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relating to the eligibility of children and prioritization of |
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persons on waiting lists for certain Medicaid long-term care |
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services waiver programs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Sections 531.0601 and 531.0602 to read as |
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follows: |
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Sec. 531.0601. LONG-TERM CARE SERVICES WAIVER PROGRAM |
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INTEREST LISTS. (a) This section applies only to a child who |
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becomes ineligible for services under the medically dependent |
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children (MDCP) waiver program because the child no longer meets: |
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(1) the level of care criteria for medical necessity |
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for nursing facility care; or |
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(2) the age requirement for the program. |
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(b) A legally authorized representative of a child who is |
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notified by the commission that the child is no longer eligible for |
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the medically dependent children (MDCP) waiver program may request |
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that the commission: |
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(1) return the child to the interest list for the |
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program unless the child is ineligible due to the child's age; or |
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(2) place the child on the interest list for another |
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Section 1915(c) waiver program. |
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(c) At the time a child's legally authorized representative |
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makes a request under Subsection (b), the commission shall: |
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(1) for a child who becomes ineligible for the reason |
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described by Subsection (a)(1), place the child: |
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(A) on the interest list for the medically |
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dependent children (MDCP) waiver program in the first position on |
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the list; or |
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(B) except as provided by Subdivision (3), on the |
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interest list for another Section 1915(c) waiver program in a |
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position relative to other persons on the list that is based on the |
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date the child was initially placed on the interest list for the |
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medically dependent children (MDCP) waiver program; |
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(2) except as provided by Subdivision (3), for a child |
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who becomes ineligible for the reason described by Subsection |
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(a)(2), place the child on the interest list for another Section |
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1915(c) waiver program in a position relative to other persons on |
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the list that is based on the date the child was initially placed on |
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the interest list for the medically dependent children (MDCP) |
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waiver program; or |
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(3) for a child who becomes ineligible for a reason |
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described by Subsection (a) and who is already on an interest list |
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for another Section 1915(c) waiver program, move the child to a |
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position on the interest list relative to other persons on the list |
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that is based on the date the child was initially placed on the |
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interest list for the medically dependent children (MDCP) waiver |
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program, if that date is earlier than the date the child was |
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initially placed on the interest list for the other waiver program. |
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(d) At the time the commission provides notice to a legally |
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authorized representative that a child is no longer eligible for |
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the medically dependent children (MDCP) waiver program, the |
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commission shall inform the representative in writing about the |
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options under this section for placing the child on an interest |
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list. |
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Sec. 531.0602. MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER |
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PROGRAM REASSESSMENTS. (a) To the extent allowed by federal law, |
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the commission shall require that a child participating in the |
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medically dependent children (MDCP) waiver program be reassessed to |
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determine whether the child meets the level of care criteria for |
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medical necessity for nursing facility care only if the child has a |
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significant change in function that may affect the medical |
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necessity for that level of care instead of requiring that the |
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reassessment be made annually. |
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(b) If federal law requires that a reassessment of a child |
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participating in the medically dependent children (MDCP) waiver |
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program to determine whether the child meets the level of care |
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criteria for medical necessity for nursing facility care be made |
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annually, the commission shall allow the reassessment to be made on |
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an expedited basis. |
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SECTION 2. As soon as possible after the effective date of |
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this Act, the Health and Human Services Commission shall identify |
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each child who became ineligible for services under the medically |
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dependent children (MDCP) waiver program on or after July 1, 2016, |
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and before January 1, 2019, based on the child's level of care |
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assessment. The commission shall, on request of the parent or |
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legally authorized representative of an identified child, reassess |
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the child to determine whether the child meets the level of care |
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criteria for medical necessity for nursing facility care required |
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to participate in the medically dependent children (MDCP) waiver |
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program. |
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SECTION 3. Not later than December 1, 2019, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt rules necessary to implement Sections 531.0601 and 531.0602, |
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Government Code, as added by this Act. |
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SECTION 4. Section 531.0601, Government Code, as added by |
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this Act, applies only to a child who becomes ineligible for the |
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medically dependent children (MDCP) waiver program on or after |
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December 1, 2019. |
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SECTION 5. Section 531.0602, Government Code, as added by |
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this Act, applies only to a reassessment of a child's eligibility |
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for the medically dependent children (MDCP) waiver program made on |
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or after December 1, 2019. |
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SECTION 6. 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 7. This Act takes effect September 1, 2019. |