| 1 | 1 | | 83R17744 KKR-F |
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| 2 | 2 | | By: Guillen H.B. No. 1267 |
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| 3 | 3 | | Substitute the following for H.B. No. 1267: |
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| 4 | 4 | | By: Raymond C.S.H.B. No. 1267 |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to certain Medicaid home and community-based services |
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| 10 | 10 | | waiver programs. |
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| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 12 | 12 | | SECTION 1. This Act shall be known as Daniel's Law. |
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| 13 | 13 | | SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
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| 14 | 14 | | is amended by adding Sections 32.0521 and 32.0522 to read as |
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| 15 | 15 | | follows: |
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| 16 | 16 | | Sec. 32.0521. HOSPITAL LEVEL OF CARE WAIVER PROGRAM FOR |
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| 17 | 17 | | MEDICALLY FRAGILE INDIVIDUALS. (a) The department shall develop |
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| 18 | 18 | | and apply for a waiver under Section 1915(c), Social Security Act |
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| 19 | 19 | | (42 U.S.C. Section 1396n(c)), to provide the state with the |
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| 20 | 20 | | flexibility to provide medical assistance services outside the |
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| 21 | 21 | | scope, amount, or duration of nonwaiver services available to |
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| 22 | 22 | | medically fragile individuals who are at least 21 years of age and |
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| 23 | 23 | | who require a hospital level of care under the medical assistance |
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| 24 | 24 | | program, if the department determines that implementation of a |
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| 25 | 25 | | hospital level of care waiver program is cost-effective and |
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| 26 | 26 | | efficient. |
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| 27 | 27 | | (b) The hospital level of care waiver program under this |
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| 28 | 28 | | section must include coverage for: |
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| 29 | 29 | | (1) advanced supportive and restorative services; |
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| 30 | 30 | | (2) case management services; |
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| 31 | 31 | | (3) environmental modifications; |
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| 32 | 32 | | (4) home-delivered meals; |
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| 33 | 33 | | (5) hospice care; |
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| 34 | 34 | | (6) occupational therapy; |
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| 35 | 35 | | (7) personal care; |
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| 36 | 36 | | (8) prescribed drugs; |
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| 37 | 37 | | (9) personal emergency response systems; |
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| 38 | 38 | | (10) physical therapy; |
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| 39 | 39 | | (11) private duty nursing; |
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| 40 | 40 | | (12) respiratory therapy; |
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| 41 | 41 | | (13) respite care; |
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| 42 | 42 | | (14) skilled nursing; |
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| 43 | 43 | | (15) specialized medical equipment and supplies; and |
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| 44 | 44 | | (16) speech therapy. |
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| 45 | 45 | | (c) The department may not require that a medically fragile |
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| 46 | 46 | | or technology-dependent individual who meets the eligibility |
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| 47 | 47 | | criteria for the hospital level of care waiver program be placed in |
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| 48 | 48 | | an alternative institutional living arrangement as a condition for |
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| 49 | 49 | | receiving services under the program. |
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| 50 | 50 | | (d) To ensure that services subject to this section are cost |
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| 51 | 51 | | neutral and not duplicative of other services provided under the |
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| 52 | 52 | | medical assistance program, the department shall coordinate the |
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| 53 | 53 | | provision of services subject to this section with services |
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| 54 | 54 | | provided under other federal waiver programs. |
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| 55 | 55 | | Sec. 32.0522. LEVELS OF NEED IN HOME AND COMMUNITY-BASED |
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| 56 | 56 | | SERVICES WAIVER PROGRAM. (a) The department shall develop and |
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| 57 | 57 | | apply for a waiver under Section 1915(c), Social Security Act (42 |
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| 58 | 58 | | U.S.C. Section 1396n(c)), to establish a level of need for use in |
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| 59 | 59 | | the Home and Community-based Services waiver program to assess |
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| 60 | 60 | | individuals who are at least 21 years of age and may require |
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| 61 | 61 | | continuous, intensive, and specialized medical support to ensure |
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| 62 | 62 | | that those individuals may receive that support, if the department |
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| 63 | 63 | | determines that implementation of that level of need is |
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| 64 | 64 | | cost-effective and efficient. |
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| 65 | 65 | | (b) The individual cost limit for an individual assigned the |
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| 66 | 66 | | level of need established under this section must be equal to or |
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| 67 | 67 | | greater than the individual cost limit for an individual assigned a |
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| 68 | 68 | | level of need that includes the receipt of the most intensive |
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| 69 | 69 | | behavioral health support under the Home and Community-based |
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| 70 | 70 | | Services waiver program. |
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| 71 | 71 | | SECTION 3. If before implementing any provision of this Act |
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| 72 | 72 | | a state agency determines that a waiver, an amendment to an existing |
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| 73 | 73 | | waiver, or another authorization from a federal agency is necessary |
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| 74 | 74 | | for implementation of that provision, the agency affected by the |
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| 75 | 75 | | provision shall request the waiver, amendment to the existing |
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| 76 | 76 | | waiver, or other authorization and may delay implementing that |
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| 77 | 77 | | provision until the waiver, amendment, or authorization is granted. |
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| 78 | 78 | | SECTION 4. This Act takes effect September 1, 2013. |
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