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.