HBA-MPM H.B. 2873 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2873 By: Maxey Public Health 3/22/1999 Introduced BACKGROUND AND PURPOSE Many Texas children with disabilities require long term care. Texas has developed and provided Medicaid waivers for those children who would otherwise be forced to enter an institution. The waivers allow individuals with significant support needs to obtain comprehensive services in their communities, including the families of children with disabilities or special health care needs who require a flexible service array to ensure that basic needs for safety, security, and stability are met. These waivers may need to be modified to ensure that services are structured and provided in a manner supportive of families. H.B. 2873 requires the Health and Human Services Commission or an agency operating part of the medical assistance program, as appropriate, in developing and providing services subject to this section, to adopt a specific protocol in the identification of children with disabilities or special needs and methods of providing support services to children and their families. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter B, Chapter 32, Human Resources Code, by adding Section 32.052, as follows: Sec. 32.052. WAIVER PROGRAMS FOR CHILDREN WITH DISABILITIES OR SPECIAL HEALTH CARE NEEDS. (a) Makes this section applicable to services under the medical assistance program (program) provided to children with disabilities or special health care needs under a waiver granted under 42 U.S.C., Section 1396n(c) (Section 1915(c), Social Security Act) (Waiver Respecting Medical Assistance Requirement in State Plan: Scope, etc.). (b) Defines "permanency planning" for purposes of this section as a philosophy and planning process designed to achieve family support through the facilitation of a permanent living arrangement that has as its primary feature an enduring and nurturing parental relationship. (c) Requires the Health and Human Services Commission or an agency operating part of the medical assistance program (department), as appropriate, in developing and providing services subject to this section, to: _assess a child at the time the child applies for assistance to determine all appropriate services for the child under the program, including both waiver and nonwaiver services; _ensure permanency planning implementation to identify and establish the family support necessary to maintain a child's permanent living arrangement with a family; _implement a transition and referral process to prevent gaps in services received by a child that could otherwise result from changes in the delivery system serving the child, changes in the child's needs and eligibility status, or changes in the child's residence; _identify and provide core services addressing a child's developmental needs and the needs of the child's family; _provide for comprehensive coordination and use of available services and resources in a manner that ensures that a child's family is aware of all service options; _ensure that eligibility requirements, assessments for service needs, and other components of service delivery are fair and equitable for all families; and _provide for certain service options and a reasonable choice of service providers. (d) Requires the department to coordinate the provision of services subject to this section with services provided under the Texas Health Steps Comprehensive Care Program (THSCCP) to ensure that the services are cost neutral and that they are not duplicated within the program. (e) Requires the department to establish an advisory committee (committee) to provide recommendations on the delivery of services subject to this section. Provides that the committee must meet regularly and include the parents of children receiving services subject to this section and representatives of appropriate advocacy organizations. Requires the committee to provide recommendations relating to administration and coordination of services, elimination of gaps in service delivery, policy development, and quality and effectiveness evaluation, while eliminating duplication of services provided under THSCCP. SECTION 2. Requires a state agency to request a waiver or authorization and authorizes it to delay implementing a provision until the waiver or authorization is granted, should the agency determine that a waiver or authorization from a federal agency is necessary before implementing any provision of this Act. SECTION 3.Emergency clause. Effective date: upon passage.