(a) In this section:
(1) “Consumer” means a person who receives services through a consumer direction model established by the commission under this section.
(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, and other types of service delivery models developed by the commission under this section.
(3) “Consumer-directed service option” means a type of consumer direction model in which:
(A) a consumer or the consumer’s legally authorized representative, as the employer, exercises control over:
(i) the recruitment, hiring, management, or dismissal of persons providing services directly to the consumer; or
(ii) the retention of contractors or vendors for other authorized program services; and
(B) the consumer-directed services agency serves as fiscal agent and performs employer-related administrative functions for the consumer or the consumer’s legally authorized representative, including payroll and the filing of tax and related reports.
(4) “Designated representative” means an adult volunteer appointed by a consumer or the consumer’s legally authorized representative, as an employer, to perform all or part of the consumer’s or the representative’s duties as employer as approved by the consumer or the representative.
(5) “Legally authorized representative”:
(A) means:
(i) a parent or legal guardian if the person is a minor;
(ii) a legal guardian if the person has been adjudicated as incapacitated to manage the person’s personal affairs; or
(iii) any other person authorized or required by law to act on behalf of the person with regard to the person’s care; and
(B) does not include a designated representative.
(6) “Service responsibility option” means a type of consumer direction model in which:
(A) a consumer or the consumer’s legally authorized representative participates in the selection of, trains, and manages persons providing services directly to the consumer; and
(B) the provider agency, as the employer, performs employer-related administrative functions for the consumer or the consumer’s legally authorized representative, including the hiring and dismissal of persons providing services directly to the consumer.
(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, or the person’s legally authorized representative, 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 shall:
(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) set a timetable to complete the implementation of the consumer direction models.
(d) The consumer direction models established under this section may be implemented in appropriate and suitable programs of the commission or a health and human services agency.
(e) § 301.251(a), Occupations Code, does not apply to delivery of a service for which payment is provided under the consumer-directed service option developed under this section if:
(1) the person who delivers the service:
(A) has not been denied a license under Chapter 301, Occupations Code;
(B) has not been issued a license under Chapter 301, Occupations Code, that is revoked or suspended; and
(C) performs a service that is not expressly prohibited from delegation by the Texas Board of Nursing; and
(2) the consumer who receives the service:
(A) has a disability and the service would have been performed by the consumer or the consumer’s legally authorized representative except for that disability; and
(B) if:
(i) the consumer is capable of training the person in the proper performance of the service, the consumer directs the person to deliver the service; or
(ii) the consumer is not capable of training the person in the proper performance of the service, the consumer’s legally authorized representative is capable of training the person in the proper performance of the service and directs the person to deliver the service.
(f) If the person delivers the service under Subsection (e)(2)(B)(ii), the legally authorized representative must be present when the service is performed or be immediately accessible to the person who delivers the service. If the person will perform the service when the representative is not present, the representative must observe the person performing the service at least once to assure the representative that the person performing the service can competently perform that service.
(g) Repealed by Acts 2007, 80th Leg., R.S., Ch. 576, Sec. 5, eff. September 1, 2007.
(h) Repealed by Acts 2007, 80th Leg., R.S., Ch. 576, Sec. 5, eff. September 1, 2007.

Text of section effective until April 01, 2025