83R1304 EES-D
	By: Zaffirini	S.B. No. 41

	A BILL TO BE ENTITLED
	AN ACT
	relating to the administration and provision of consumer-directed
	services under certain health and human services programs.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  The heading to Section 531.051, Government Code,
	is amended to read as follows:
	Sec. 531.051.  CONSUMER DIRECTION OF CERTAIN SERVICES FOR
	CERTAIN PERSONS [WITH DISABILITIES AND ELDERLY PERSONS].
	SECTION 2.  Section 531.051(a), Government Code, is amended
	by amending Subdivision (2) and adding Subdivisions (4-a) and (5-a)
	to read as follows:
	(2)  "Consumer direction" or "consumer direction
	model" means a service delivery model under which a consumer or the
	consumer's legally authorized representative exercises control
	over the development and implementation of the consumer's
	individual service plan or over the persons delivering the services
	directly to the consumer.  The term includes the consumer-directed
	service option, the service responsibility option, the
	individualized budget option, the purchasing option, and other
	types of service delivery models developed by the commission under
	this section.
	(4-a)  "Individualized budget option" means a type of
	consumer direction model in which:
	(A)  a consumer-directed services agency
	assesses the needs of a consumer and assists the consumer in
	developing an individual budget expressed in dollars and based on
	the anticipated cost of services and supports appropriate for the
	consumer for the purchase of the goods and services necessary to
	meet the consumer's needs;
	(B)  the consumer and, if appropriate, a person
	who provides support or counseling services to the consumer develop
	a spending plan for how and when the consumer will spend the money
	in accordance with the consumer's individual budget;
	(C)  a consumer-directed services agency monitors
	the consumer's individual budget;
	(D)  the consumer receives financial management
	services through the consumer-directed services agency that
	developed or monitors the consumer's individual budget; and
	(E)  the consumer does not directly receive cash
	in relation to the consumer's individual budget but is instead
	provided with a variety of tracking methods to manage and monitor
	the consumer's individual budget.
	(5-a)  "Purchasing option" means a type of consumer
	direction model in which a consumer is allocated money to purchase
	goods and services that:
	(A)  are permissible under applicable federal and
	state laws;
	(B)  address the needs identified in the
	consumer's individual service plan;
	(C)  the consumer can afford without compromising
	the consumer's health or safety; and
	(D)  are directly for the consumer's benefit.
	SECTION 3.  Section 531.051, Government Code, is amended by
	amending Subsections (b) and (c) and adding Subsection (c-1) to
	read as follows:
	(b)  The commission shall develop and oversee the
	implementation of consumer direction models under which a person
	with a disability or an elderly person who is receiving certain
	state-funded or Medicaid-funded services, a person who is receiving
	public mental health services under a program administered by the
	Department of State Health Services, or the [person's] legally
	authorized representative of one of those persons [,] exercises
	control over the development and implementation of the person's
	individual service plan or over the persons who directly deliver
	the services.
	(c)  In adopting rules for the consumer direction models, the
	executive commissioner [commission] shall:
	(1)  with assistance from the work group established
	under Section 531.052 and subject to Subsection (c-1), determine
	which services are appropriate and suitable for delivery through
	consumer direction;
	(2)  ensure that each consumer direction model is
	designed to comply with applicable federal and state laws;
	(3)  maintain procedures to ensure that a potential
	consumer or the consumer's legally authorized representative has
	adequate and appropriate information, including the
	responsibilities of a consumer or representative under each service
	delivery option, to make an informed choice among the types of
	consumer direction models;
	(4)  require each consumer or the consumer's legally
	authorized representative to sign a statement acknowledging
	receipt of the information required by Subdivision (3);
	(5)  maintain procedures to monitor delivery of
	services through consumer direction to ensure:
	(A)  adherence to existing applicable program
	standards;
	(B)  appropriate use of funds; and
	(C)  consumer satisfaction with the delivery of
	services;
	(6)  ensure that authorized program services that are
	not being delivered to a consumer through consumer direction are
	provided by a provider agency chosen by the consumer or the
	consumer's legally authorized representative; and
	(7)  work in conjunction with the work group
	established under Section 531.052 to set a timetable to complete
	the implementation of the consumer direction models.
	(c-1)  In adopting rules regarding what services are
	appropriate and suitable for delivery through consumer direction
	under Subsection (c)(1), the executive commissioner shall ensure
	that:
	(1)  included in the services eligible for
	consumer-directed delivery are all home and community-based
	services provided under the Medicaid state plan, including services
	provided under the STAR + PLUS Medicaid managed care program and
	Medicaid waiver programs, including waiver programs authorized
	under Sections 1915 and 1115 of the federal Social Security Act (42
	U.S.C. Sections 1396n and 1315); and
	(2)  consumers are provided case management and service
	coordination when available.
	SECTION 4.  Not later than December 1, 2013, the executive
	commissioner of the Health and Human Services Commission shall
	adopt the rules necessary to develop and implement the consumer
	direction models described in Sections 531.051(a)(4-a) and (5-a),
	Government Code, as added by this Act, and the rules required by
	Section 531.051(c-1), Government Code, as added by this Act.
	SECTION 5.  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 6.  This Act takes effect September 1, 2013.