86R5769 KKR-D
 
  By: Perry S.B. No. 1093
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the eligibility of children and prioritization of
  persons on waiting lists for certain Medicaid long-term care
  services waiver programs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Sections 531.0601 and 531.0602 to read as
  follows:
         Sec. 531.0601.  LONG-TERM CARE SERVICES WAIVER PROGRAM
  INTEREST LISTS.  (a)  This section applies only to a child who
  becomes ineligible for services under the medically dependent
  children (MDCP) waiver program because the child no longer meets:
               (1)  the level of care criteria for medical necessity
  for nursing facility care; or
               (2)  the age requirement for the program.
         (b)  A legally authorized representative of a child who is
  notified by the commission that the child is no longer eligible for
  the medically dependent children (MDCP) waiver program may request
  that the commission:
               (1)  return the child to the interest list for the
  program unless the child is ineligible due to the child's age; or
               (2)  place the child on the interest list for another
  Section 1915(c) waiver program.
         (c)  At the time a child's legally authorized representative
  makes a request under Subsection (b), the commission shall:
               (1)  for a child who becomes ineligible for the reason
  described by Subsection (a)(1), place the child:
                     (A)  on the interest list for the medically
  dependent children (MDCP) waiver program in the first position on
  the list; or
                     (B)  except as provided by Subdivision (3), on the
  interest list for another Section 1915(c) waiver program in a
  position relative to other persons on the list that is based on the
  date the child was initially placed on the interest list for the
  medically dependent children (MDCP) waiver program;
               (2)  except as provided by Subdivision (3), for a child
  who becomes ineligible for the reason described by Subsection
  (a)(2), place the child on the interest list for another Section
  1915(c) waiver program in a position relative to other persons on
  the list that is based on the date the child was initially placed on
  the interest list for the medically dependent children (MDCP)
  waiver program; or
               (3)  for a child who becomes ineligible for a reason
  described by Subsection (a) and who is already on an interest list
  for another Section 1915(c) waiver program, move the child to a
  position on the interest list relative to other persons on the list
  that is based on the date the child was initially placed on the
  interest list for the medically dependent children (MDCP) waiver
  program, if that date is earlier than the date the child was
  initially placed on the interest list for the other waiver program.
         (d)  At the time the commission provides notice to a legally
  authorized representative that a child is no longer eligible for
  the medically dependent children (MDCP) waiver program, the
  commission shall inform the representative in writing about the
  options under this section for placing the child on an interest
  list.
         Sec. 531.0602.  MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER
  PROGRAM REASSESSMENTS.  (a)  To the extent allowed by federal law,
  the commission shall require that a child participating in the
  medically dependent children (MDCP) waiver program be reassessed to
  determine whether the child meets the level of care criteria for
  medical necessity for nursing facility care only if the child has a
  significant change in function that may affect the medical
  necessity for that level of care instead of requiring that the
  reassessment be made annually.
         (b)  If federal law requires that a reassessment of a child
  participating in the medically dependent children (MDCP) waiver
  program to determine whether the child meets the level of care
  criteria for medical necessity for nursing facility care be made
  annually, the commission shall allow the reassessment to be made on
  an expedited basis.
         SECTION 2.  As soon as possible after the effective date of
  this Act, the Health and Human Services Commission shall identify
  each child who became ineligible for services under the medically
  dependent children (MDCP) waiver program on or after July 1, 2016,
  and before January 1, 2019, based on the child's level of care
  assessment.  The commission shall, on request of the parent or
  legally authorized representative of an identified child, reassess
  the child to determine whether the child meets the level of care
  criteria for medical necessity for nursing facility care required
  to participate in the medically dependent children (MDCP) waiver
  program.
         SECTION 3.  Not later than December 1, 2019, the executive
  commissioner of the Health and Human Services Commission shall
  adopt rules necessary to implement Sections 531.0601 and 531.0602,
  Government Code, as added by this Act.
         SECTION 4.  Section 531.0601, Government Code, as added by
  this Act, applies only to a child who becomes ineligible for the
  medically dependent children (MDCP) waiver program on or after
  December 1, 2019.
         SECTION 5.  Section 531.0602, Government Code, as added by
  this Act, applies only to a reassessment of a child's eligibility
  for the medically dependent children (MDCP) waiver program made on
  or after December 1, 2019.
         SECTION 6.  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 7.  This Act takes effect September 1, 2019.