By: Frank, González of El Paso, Noble, H.B. No. 3720       Guillen, Capriglione     A BILL TO BE ENTITLED   AN ACT   relating to interest lists and eligibility criteria for certain   Medicaid waiver programs.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter B, Chapter 531, Government Code, is   amended by adding Sections 531.06011 and 531.06035 to read as   follows:          Sec. 531.06011.  CERTAIN MEDICAID WAIVER PROGRAMS: INTEREST   LIST MANAGEMENT. (a)  This section applies only with respect to the   following waiver programs:                (1)  the community living assistance and support   services (CLASS) waiver program;                (2)  the home and community-based services (HCS) waiver   program;                (3)  the deaf-blind with multiple disabilities (DBMD)   waiver program;                (4)  the Texas home living (TxHmL) waiver program;                (5)  the medically dependent children (MDCP) waiver   program; and                (6)  the STAR+PLUS home and community-based services   (HCBS) program.          (b)  The commission, in consultation with the Intellectual   and Developmental Disability System Redesign Advisory Committee   established under Section 534.053, the state Medicaid managed care   advisory committee, and interested stakeholders, shall develop a   questionnaire to be completed by or on behalf of an individual who   requests to be placed on or is currently on an interest list for a   waiver program.          (c)  The questionnaire developed under Subsection (b) must,   at a minimum, request the following information about an individual   seeking or receiving services under a waiver program:                (1)  contact information for the individual or the   individual's parent or other legally authorized representative;                (2)  the individual's general demographic information;                (3)  the individual's living arrangement;                (4)  the types of assistance the individual requires;                (5)  the individual's current caregiver supports and   circumstances that may cause the individual to lose those supports;   and                (6)  when the delivery of services under a waiver   program should begin to ensure the individual's health and welfare   and that the individual receives services and supports in the least   restrictive setting possible.          (d)  Subject to the availability of funds, the commission   shall require all individuals on an interest list to annually   update the questionnaire developed under Subsection (b).          (e)  If the commission determines that it is feasible, the   commission shall develop an online portal to allow an individual or   an individual's parent or other legally authorized representative   to:                (1)  request placement on a waiver program interest   list; and                (2)  complete and update the questionnaire developed   under Subsection (b).          (f)  If an individual is on a waiver program's interest list   and the individual or the individual's parent or other legally   authorized representative does not respond to a written or verbal   request made by the commission to update information concerning the   individual or otherwise fails to maintain contact with the   commission, the commission:                (1)  shall designate the individual's status on the   interest list as inactive until the individual or the individual's   parent or other legally authorized representative notifies the   commission that the individual is still interested in receiving   services under the waiver program; and                (2)  at the time the individual or the individual's   parent or other legally authorized representative provides notice   to the commission under Subdivision (1), shall designate the   individual's status on the interest list as active and restore the   individual to the position on the list that corresponds with the   date the individual was initially placed on the list.          (g)  The commission's designation of an individual's status   on an interest list as inactive under Subsection (f) may not result   in the removal of the individual from that list or any other waiver   program interest list.          (h)  Not later than September 1 of each year, the commission   shall provide to the Intellectual and Developmental Disability   System Redesign Advisory Committee established under Section   534.053, or, if that advisory committee is abolished, an   appropriate stakeholder advisory committee, as determined by the   executive commissioner, the number of individuals, including   individuals whose status is designated as inactive by the   commission, who are on an interest list to receive services under a   waiver program.          Sec. 531.06035.  MEDICALLY DEPENDENT CHILDREN WAIVER   PROGRAM (MDCP) INTEREST LIST; MEDICAL NECESSITY ASSESSMENT   REQUIRED.  (a)  This section applies only to a child who receives   Supplemental Security Income (SSI) (42 U.S.C. Section 1381 et   seq.).          (b)  If a child's parent or other legally authorized   representative expresses interest in placing the child on the   interest list for the medically dependent children (MDCP) waiver   program, the commission shall conduct a medical necessity   assessment of the child to ensure the child is eligible for services   before placing the child on the program's interest list.          SECTION 2.  Subchapter B, Chapter 32, Human Resources Code,   is amended by adding Section 32.0521 to read as follows:          Sec. 32.0521.  ELIGIBILITY FOR TEXAS HOME LIVING (TxHmL)   WAIVER PROGRAM.  (a)  In this section:                (1)  "Related condition" means, consistent with 42   C.F.R. Section 435.1010, a severe and chronic disability that:                      (A)  is attributed to:                            (i)  cerebral palsy or epilepsy; or                            (ii)  any other condition, other than mental   illness, found to be closely related to intellectual disability   because the condition results in impairment of general intellectual   functioning or adaptive behavior similar to that of individuals   with intellectual disability, and requires treatment or services   similar to those required for individuals with intellectual   disability;                      (B)  is manifested before the individual reaches   22 years of age;                      (C)  is likely to continue indefinitely; and                      (D)  results in substantial functional limitation   in at least three of the following areas of major life activity:                            (i)  self-care;                            (ii)  understanding and use of language;                            (iii)  learning;                            (iv)  mobility;                            (v)  self-direction; and                            (vi)  capacity for independent living.                (2)  "Section 1915(c) waiver program" has the meaning   assigned by Section 531.001, Government Code.          (b)  To the extent allowed by federal law, an individual is   financially eligible to participate in the Texas home living   (TxHmL) waiver program if the individual's income is not more than   the special income limit established by the commission for other   Section 1915(c) waiver programs, including the home and   community-based services (HCS) waiver program.          (c)  To the extent permitted by federal law, the commission   shall expand medical eligibility criteria under the Texas home   living (TxHmL) waiver program to ensure that an individual is   medically eligible to participate in the waiver program if the   individual:                (1)  has a primary diagnosis by a licensed physician of   a related condition that is included on the list of diagnostic codes   for persons with related conditions that are approved by the   commission; and                (2)  has moderate to extreme deficits in adaptive   behavior, as determined by commission rule, obtained by   administering a standardized assessment of adaptive behavior.          SECTION 3.  As soon as practicable after the effective date   of this Act, the Health and Human Services Commission shall:                (1)  develop the questionnaire required by Section   531.06011(b), Government Code, as added by this Act, and, subject   to the availability of funds, implement Subsection (d) of that   section not later than September 1, 2024;                (2)  determine the feasibility of developing an online   portal under Section 531.06011(e), Government Code, as added by   this Act, and if feasible, develop and implement the online portal;   and                (3)  as appropriate, conduct a medical necessity   assessment of each child who is on the interest list for the   medically dependent children (MDCP) waiver program on the effective   date of this Act to ensure the child's eligibility for program   services.          SECTION 4.  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 5.  This Act takes effect September 1, 2021.