HBA-NLM S.B. 1586 76(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 1586 By: Zaffirini Human Services 5/14/1999 Engrossed BACKGROUND AND PURPOSE Currently, Texas is piloting a voucher program for payment of certain services for persons with disabilities. Such a program has been recommended by the Comptroller's Texas Performance Review. S.B. 1586 requires the Health and Human Services Commission (commission) to develop and oversee the implementation of a program in which the use of vouchers is established as a payment option for the delivery of certain state-funded and Medicaid-funded services to persons with disabilities. In addition, S.B. 1586 provides for the creation of a work group to assist the commission in developing and implementing the voucher payment program. 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 1 (Section 531.051, Government Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter B, Chapter 531, Government Code, by adding Sections 531.051 and 531.052, as follows: Sec. 531.051. VOUCHER PROGRAM FOR PAYMENT OF CERTAIN SERVICES FOR PERSONS WITH DISABILITIES. (a) Defines "consumer" and "personal assistance services." (b) Requires the Health and Human Services Commission (commission) to develop and oversee the implementation of a program in which the use of vouchers is established as a payment option for the delivery of certain state-funded and Medicaid-funded services to persons with disabilities. (c) Requires the commission, in adopting rules for the voucher payment program, to ensure that the program: _includes the delivery to persons with disabilities of personal assistance services, respite services, supported employment services, and other services that the commission with assistance from the work group established under Section 531.052, determines are appropriate and applicable and may be provided with available funding; and provision of durable medical equipment and assistive technology to persons with disabilities to the extent funds are available for that purpose; _works in conjunction with the comptroller and appropriate health and human services agencies to develop the program; _is designed in a manner in which, for certain programs considered appropriate by the commission, with assistance from the work group established under Section 531.052 (Voucher Payment Program Work Group), a private entity or local governmental entity applies with and is approved by the Internal Revenue Service to act as the agent for a consumer for certain purposes; _ensures that the program is designed to comply with federal and state tax laws; _ensures that a consumer is the employer of and retains control over the selection, management, and dismissal of an individual providing health care services covered by the program; _establishes a system to ensure that a potential consumer has adequate and appropriate information, including the responsibilities of a consumer under each payment option, to make an informed choice among the payment options; _requires each consumer to sign a statement acknowledging receipt of the information required by this subsection; _develops a system to monitor the program; _ensures that a consumer may contract with a service provider acting as the consumer's agent to obtain any necessary services, including services not being provided to the consumer under the program; and _works in conjunction with the work group established under Section 531.052 to set a timetable to implement and complete the program. (d) Authorizes the voucher payment program developed under this section to be implemented only in appropriate programs of the Texas Department of Human Services, the Texas Department of Mental Health and Mental Retardation, the Texas Rehabilitation Commission, and the Texas Department of Health. (e) Requires each health and human services agency in which the voucher payment program is implemented and the comptroller to provide information to the commission as necessary to facilitate the development and implementation of the program. Sec. 531.052. VOUCHER PAYMENT PROGRAM WORK GROUP. Provides that a work group is created to assist the commission in developing and implementing the voucher payment program under Section 531.051. Establishes that the work group is composed of certain state agency representatives and other specified persons. Specifies that a majority of the members of the work group must be composed of consumers, advocates, or providers described by this section. Provides that a member of the work group serves at the will of the appointing agency and receives no additional compensation for serving on the work group. Requires the commissioner of health and human services to appoint a member of the work group to serve as presiding officer, and members of the work group to elect any other necessary officers. Requires the work group to meet at the call of the presiding officer. Specifies that the work group is not subject to Chapter 2110 (State Agency Advisory Committees). Provides that this section expires September 1, 2003. SECTION 2. Requires the commission, as soon as practicable after the effective date of this Act, to develop outcome measures to determine the cost-effectiveness of the voucher payment program required by Section 531.051, Government Code, as added by this Act. Requires the commission to submit to the legislature a report on its findings and recommendations not later than September 1, 2002. SECTION 3. Requires the commission or other state agency, if before implementing Section 531.051, Government Code, as added by this Act, the commission or another state agency determines that a waiver or authorization from a federal agency is necessary for implementation, to request the waiver or authorization, and provides that the commission or state agency may delay implementing that provision until the waiver or authorization is granted. SECTION 4. Emergency clause. Effective date: upon passage.