Sec. 533A.0335.  COMPREHENSIVE ASSESSMENT AND RESOURCE ALLOCATION PROCESS.

Text of subsection effective until April 01, 2025

  (a)  In this section:
(1)  "Advisory committee" means the Intellectual and Developmental Disability System Redesign Advisory Committee established under Section 534.053, Government Code.
(2)   "Functional need," "ICF-IID program," and "Medicaid waiver program" have the meanings assigned those terms by Section 534.001, Government Code.

Text of subsection effective on April 01, 2025

(a)  In this section:
(1)  "Advisory committee" means the Intellectual and Developmental Disability System Redesign Advisory Committee established under Section 542.0052, Government Code.
(2)  "Functional need," "ICF-IID program," and "Medicaid waiver program" have the meanings assigned those terms by Section 542.0001, Government Code.
(b)  Subject to the availability of federal funding, the department shall develop and implement a comprehensive assessment instrument and a resource allocation process for individuals with intellectual and developmental disabilities as needed to ensure that each individual with an intellectual or developmental disability receives the type, intensity, and range of services that are both appropriate and available, based on the functional needs of that individual, if the individual receives services through one of the following:
(1)  a Medicaid waiver program;
(2)  the ICF-IID program; or
(3)  an intermediate care facility operated by the state and providing services for individuals with intellectual and developmental disabilities.
(c)  The department, in consultation with the advisory committee, shall establish a prior authorization process for requests for supervised living or residential support services available in the home and community-based services (HCS) Medicaid waiver program.  The process must ensure that supervised living or residential support services available in the home and community-based services (HCS) Medicaid waiver program are available only to individuals for whom a more independent setting is not appropriate or available.
(d)  The department shall cooperate with the advisory committee to establish the prior authorization process required by Subsection (c).  This subsection expires January 1, 2024.
Added by Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1335, eff. April 2, 2015.
Amended by: 
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.61, eff. April 1, 2025.