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Amend CSHB 2292 by adding the following appropriately
numbered section to the bill and renumbering subsequent sections
accordingly:
SECTION ____. Subchapter B, Chapter 533, Health and Safety
Code, is amended by adding Section 533.0355 to read as follows:
Sec. 533.0355. ALLOCATION OF DUTIES UNDER CERTAIN MEDICAID
WAIVER PROGRAMS. (a) In this section, "waiver program" means the
mental retardation local authority waiver program established
under the state Medicaid program.
(b) A provider of services under the waiver program shall:
(1) develop a person directed plan and an individual
program plan for each person who receives services from the
provider under the waiver program;
(2) perform justification and implementation functions
for the plans described by Subdivision (1);
(3) conduct case management under the waiver program,
other than case management under Subsection (c)(4), in accordance
with applicable state and federal laws; and
(4) plan, coordinate, and review the provision of
services to all persons who receive services from the service
provider under the waiver program.
(c) A local mental retardation authority shall:
(1) manage any waiting lists for services under the
waiver program;
(2) screen and assess persons who may receive services
under the waiver program and perform any functions relating to
inventory for those persons and agency planning assessments;
(3) perform functions relating to consumer choice and
enrollment for persons who receive services under the waiver
program;
(4) conduct case management under the waiver program
relating to funding disputes between a service provider and the
local mental retardation authority; and
(5) manage an appeals process relating to decisions
that affect a person receiving services under the waiver program.
(d) The department shall perform all administrative
functions under the waiver program that are not assigned to a
service provider under Subsection (b) or to a local mental
retardation authority under Subsection (c). Administrative
functions performed by the department include any surveying,
certification, and utilization review functions required under the
waiver program.
(e) The department shall review case management fees paid
under the waiver program to a community center and administrative
fees paid under the waiver program to a service provider. The
review must include a comparison of fees paid before the
implementation of this section with fees paid after the
implementation of this section. The department may adjust fees
paid based on that review.
(f) The department shall allocate the portion of the gross
reimbursement funds paid to a local authority and a service
provider for client services for the case management function in
accordance with this section and to the extent allowed by law.
(g) The department may adopt rules governing the functions of
a local mental retardation authority or service provider under this
section.