HBA-DMD H.B. 2148 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2148 By: Maxey Human Services 3/15/1999 Introduced BACKGROUND AND PURPOSE Under current federal law, states are allowed to apply for waivers of certain Medicaid requirements. Legislation passed by the 75th legislature required the Health and Human Services Commission (commission) to study and make recommendations regarding the feasibility and advisability of consolidating the state's Medicaid long-term care 1915(c) waiver programs, which allow states to provide home and community-based services to individuals who qualify for care in an institution. Currently, Texas operates eight 1915(c) waivers. H.B. 2148 requires the commission to develop and implement a plan to make uniform certain functions which relate to the administration and delivery of federally funded Medicaid programs at certain state agencies. This bill requires the commission, by rule, to develop and implement a pilot program in which populations served by Medicaid programs are provided services under a single waiver program. This bill requires the commission to submit a report to the legislature on the effectiveness of the pilot program and authorizes a state agency to obtain authorization from a federal agency if the state agency determines that such authorization is needed in order to implement any provision of this Act. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Health and Human Services Commission in SECTION 2 of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter B, Chapter 531, Government Code, by adding Section 531.0218, as follows: Sec. 531.0218. LONG-TERM CARE MEDICAID PROGRAMS. (a) Requires the Health and Human Services Commission (commission) to develop and implement a plan to make uniform rate setting, procurement methods and procedures, the applicability and use of definitions in the provision of services, quality assurance standards, and intake data elements, relating to the administration and delivery of federally funded Medicaid programs supporting long-term care services at the Texas Department of Human Services, Texas Department of Mental Health and Mental Retardation, Texas Rehabilitation Commission, and Texas Department of Health under a federal waiver or authorization. (b) Sets forth requirements for the commission when developing the plan. SECTION 2. PILOT PROGRAM. (a) Requires the commission, by rule, to develop and implement a pilot program in which populations served by federally funded Medicaid programs that support long-term care services administered by the Texas Department of Human Services, Texas Department of Mental Health and Mental Retardation, Texas Rehabilitation Commission, and Texas Department of Health under a federal waiver or authorization are provided services under a single waiver program or authorization granted under Section 1915(c) of the federal Social Security Act (42 U.S.C. Section 1396n(c)). (b) Sets forth requirements for the commission when developing the pilot program. (c) Requires the commission to conduct the pilot program using a test population that is representative of some or all of the populations who are enrolled in or seek enrollment in: (1) the community-based alternatives program administered by the Texas Department of Human Services; (2) the community living assistance support and services program administered by the Texas Department of Human Services; (3) the home and community services program and the home and community services program under the Omnibus Budget Reconciliation Act (OBRA), Nursing Home Reform Amendments of 1987, administered by the Texas Department of Mental Health and Mental Retardation; (4) the deaf and blind services program administered by the Texas Rehabilitation Commission; or (5) the medically dependent children program administered by the Texas Department of Health. (d) Requires the commission, no later than September 1, 2003, to contract with a private entity to evaluate the pilot program that is authorized under this section and to prepare a report of its findings. Specifies the contents of the report. SECTION 3. REPORT TO LEGISLATURE. Requires the commission, no later than January 1, 2004, to submit to the legislature a report concerning the effectiveness of the pilot program required by SECTION 2 of this Act. SECTION 4. FEDERAL WAIVER OR AUTHORIZATION. Requires a state agency, if before implementing any provision of this Act the state agency determines that a waiver or authorization from a federal agency is necessary for implementation, to request the waiver or authorization and authorizes the state agency to delay implementing that provision until the waiver or authorization is granted. SECTION 5. DEVELOPMENT AND IMPLEMENTATION. (a) Requires the commission, as soon as possible after the effective date of this Act, to develop and implement the plan required by Section 531.0218, Government Code, as added by this Act. (b) Requires the commission, no later than September 1, 2001, to implement the pilot program required by SECTION 2 of this Act. SECTION 6. Sets forth that SECTIONS 2, 3, 4, and 5 of this Act expire September 1, 2004. SECTION 7.Effective date: September 1, 1999. SECTION 8.Emergency clause.