83R1304 EES-D
By: Zaffirini S.B. No. 41
A BILL TO BE ENTITLED
AN ACT
relating to the administration and provision of consumer-directed
services under certain health and human services programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Section 531.051, Government Code,
is amended to read as follows:
Sec. 531.051. CONSUMER DIRECTION OF CERTAIN SERVICES FOR
CERTAIN PERSONS [WITH DISABILITIES AND ELDERLY PERSONS].
SECTION 2. Section 531.051(a), Government Code, is amended
by amending Subdivision (2) and adding Subdivisions (4-a) and (5-a)
to read as follows:
(2) "Consumer direction" or "consumer direction
model" means a service delivery model under which a consumer or the
consumer's legally authorized representative exercises control
over the development and implementation of the consumer's
individual service plan or over the persons delivering the services
directly to the consumer. The term includes the consumer-directed
service option, the service responsibility option, the
individualized budget option, the purchasing option, and other
types of service delivery models developed by the commission under
this section.
(4-a) "Individualized budget option" means a type of
consumer direction model in which:
(A) a consumer-directed services agency
assesses the needs of a consumer and assists the consumer in
developing an individual budget expressed in dollars and based on
the anticipated cost of services and supports appropriate for the
consumer for the purchase of the goods and services necessary to
meet the consumer's needs;
(B) the consumer and, if appropriate, a person
who provides support or counseling services to the consumer develop
a spending plan for how and when the consumer will spend the money
in accordance with the consumer's individual budget;
(C) a consumer-directed services agency monitors
the consumer's individual budget;
(D) the consumer receives financial management
services through the consumer-directed services agency that
developed or monitors the consumer's individual budget; and
(E) the consumer does not directly receive cash
in relation to the consumer's individual budget but is instead
provided with a variety of tracking methods to manage and monitor
the consumer's individual budget.
(5-a) "Purchasing option" means a type of consumer
direction model in which a consumer is allocated money to purchase
goods and services that:
(A) are permissible under applicable federal and
state laws;
(B) address the needs identified in the
consumer's individual service plan;
(C) the consumer can afford without compromising
the consumer's health or safety; and
(D) are directly for the consumer's benefit.
SECTION 3. Section 531.051, Government Code, is amended by
amending Subsections (b) and (c) and adding Subsection (c-1) to
read as follows:
(b) The commission shall develop and oversee the
implementation of consumer direction models under which a person
with a disability or an elderly person who is receiving certain
state-funded or Medicaid-funded services, a person who is receiving
public mental health services under a program administered by the
Department of State Health Services, or the [person's] legally
authorized representative of one of those persons [,] exercises
control over the development and implementation of the person's
individual service plan or over the persons who directly deliver
the services.
(c) In adopting rules for the consumer direction models, the
executive commissioner [commission] shall:
(1) with assistance from the work group established
under Section 531.052 and subject to Subsection (c-1), determine
which services are appropriate and suitable for delivery through
consumer direction;
(2) ensure that each consumer direction model is
designed to comply with applicable federal and state laws;
(3) maintain procedures to ensure that a potential
consumer or the consumer's legally authorized representative has
adequate and appropriate information, including the
responsibilities of a consumer or representative under each service
delivery option, to make an informed choice among the types of
consumer direction models;
(4) require each consumer or the consumer's legally
authorized representative to sign a statement acknowledging
receipt of the information required by Subdivision (3);
(5) maintain procedures to monitor delivery of
services through consumer direction to ensure:
(A) adherence to existing applicable program
standards;
(B) appropriate use of funds; and
(C) consumer satisfaction with the delivery of
services;
(6) ensure that authorized program services that are
not being delivered to a consumer through consumer direction are
provided by a provider agency chosen by the consumer or the
consumer's legally authorized representative; and
(7) work in conjunction with the work group
established under Section 531.052 to set a timetable to complete
the implementation of the consumer direction models.
(c-1) In adopting rules regarding what services are
appropriate and suitable for delivery through consumer direction
under Subsection (c)(1), the executive commissioner shall ensure
that:
(1) included in the services eligible for
consumer-directed delivery are all home and community-based
services provided under the Medicaid state plan, including services
provided under the STAR + PLUS Medicaid managed care program and
Medicaid waiver programs, including waiver programs authorized
under Sections 1915 and 1115 of the federal Social Security Act (42
U.S.C. Sections 1396n and 1315); and
(2) consumers are provided case management and service
coordination when available.
SECTION 4. Not later than December 1, 2013, the executive
commissioner of the Health and Human Services Commission shall
adopt the rules necessary to develop and implement the consumer
direction models described in Sections 531.051(a)(4-a) and (5-a),
Government Code, as added by this Act, and the rules required by
Section 531.051(c-1), Government Code, as added by this Act.
SECTION 5. 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 6. This Act takes effect September 1, 2013.