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No. 3667 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 58th Legislature (2022) COMMITTEE SUBSTITUTE FOR SENATE BILL 1577 By: Kidd COMMITTEE SUBSTITUTE An Act relating to long-term care; defining terms; designating the Oklahoma Health Care Authority as the state administering agency for PACE program agreements; authorizing the Authority to enter into PACE program agreements ; requiring enforcement of certain federal laws and regulations; authorizing the Authority to enter into certain agreements with the State Department of Health; directing the Department to create and issue certain license; stating minimum licensure requirements; directing monitoring of PACE organizations; prohibiting certain regulation; authorizing certain action for noncompliance ; directing promulgation of rules; amending 63 O.S. 2021, Section 1-872, which relates to definitions used in the Adult Day Care Act; amending 63 O.S. 2021, Section 1-1961, which relates to definitions used in the Home Care Act; modifying definitions; providing for codification; and providing an effective date. BE IT ENACTED BY THE PEOPLE OF T HE STATE OF OKLAHOMA: SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1017.7 of Title 56, unless there is created a duplication in numbering, reads as follows: A. As used in this section : Req. No. 3667 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. “PACE” stands for program of all-inclusive care for the elderly; and 2. The terms “PACE program agreement”, “PACE organization”, and “state administering ag ency” have the same meaning as provided by 42 C.F.R., Section 460.6. B. 1. The Oklahoma Health Care Authority shall serve as the state administering agency responsible for administering PACE program agreements under 42 C.F.R., Part 460, Subpart C . The Authority may enter into PACE program agreements with PACE organizations and the Centers for Medicare and M edicaid Services. 2. The Authority shall enforce applicable federal laws and regulations governing PACE organizations including but not limited to regulations of the Centers for Medicare and M edicaid Services codified at 42 C.F.R. , Part 460. The Authority may enter into an agreement with the State Department of Health to carry out any duties or functions of the state administering agency under 42 C.F.R., Part 460 or other applicable federal laws or regulations. C. 1. The State Department of H ealth shall create and issue to qualifying applicants a license for PACE organizations. Qualifying PACE organizations s hall at a minimum meet all requirements of 42 C.F.R., Part 460, Subpart B. 2. The Department shall perform onsite visits and other necessary monitoring of PACE organizations under 42 C.F.R., Part Req. No. 3667 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 460, Subpart K and as provided by the agreement with the Authority described in paragraph 2 of subsection B of this section. 3. The Department shall not license or regulate PACE organizations under the Home Care Act, the Adult Day Care Act, or any other act that governs a different type of facility or provider. 4. The Department may, in cooperation with the Centers for Medicare and Medicaid Services and as provided by the agreement with the Authority described in paragraph 2 of subsection B of this section, take action against noncompliant PACE organizations under 42 C.F.R., Part 460, Subpart D. D. The Oklahoma Health Care Authority Board and the State Commissioner of Health shall promulgate rules to imple ment this section. SECTION 2. AMENDATORY 63 O.S. 2021, Section 1 -872, is amended to read as follows: Section 1-872. As used in the Adult Day Care Act: 1. “Adult day care center ” or “center” means a facility which provides basic day care services to unrelated impaired adults for more than four (4) hours in a twenty -four-hour period. A center shall be a distinct entity, either freestanding or a separate program of a larger organization. A center shal l have a separately verifiable staff, space, budge t and participant record system . The terms “adult day care center ” or “center” shall not include Req. No. 3667 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 retirement centers and, senior citizen centers, or PACE organizations as defined by 42 C.F.R. , Section 460.6; 2. “Basic day care services ” means supervised health, social supportive, and recreational services in a structured daytime program which serves functionally impaired adults who continue to live in their own homes, usually with the aid of family care givers; 3. “Department” means the State Department of Health; and 4. “Participant” means any person attending an adult day care center. SECTION 3. AMENDATORY 63 O.S. 2021, Section 1-1961, is amended to read as follows: Section 1-1961. As used in the Home Care Act: 1. “Board” means the State Board of Health; 2. “Certification” means verification of appropriate traini ng and competence established by the Sta te Commissioner of Health by rules promulgated pursuan t to the Home Care Act for home health aides and home care agency administrators; 3. “Department” means the State Department of Health; 4. “Healthcare provider” means a physician, physician assistant or Advanced Practice Registered Nurse recognized by th e Oklahoma Board of Nursing as a Certified Nurse Practitioner or a Clinical Nurse Specialist; 5. “Home care agency” means any sole proprietorship, partnership, association, corporation or other organiz ation which Req. No. 3667 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 administers, offers or provides home care services, for a fee or pursuant to a contract for such services, to clients in their place of residence. The term “home care agency” shall not include: a. individuals who contract with the Department o f Human Services to provide personal care services, pr ovided such individuals shall not be exempt from certification as home health aides, b. organizations that contract with the Oklahoma Health Care Authority as Int ermediary Services Organizations (ISO) to provide federal Internal Revenue Service fiscal and supportive services to Consumer -Directed Personal Assistance Supports and Services (CD -PASS) waiver program participants who have employer responsibility for hiri ng, training, directing and managing an individual personal care attendant, or c. CD-PASS waiver program employer participants , or d. PACE organizations as defined by 42 C.F.R. , Section 460.6; 6. “Home care services” means skilled or pers onal care services provided to clients in their pl ace of residence for a fee; 7. “Home health aide” means an individual who provides personal care to clients in their temporar y or permanent place of residence for a fee; Req. No. 3667 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 8. “Home care agency administrator ” means a person who operates, manages, or supervi ses, or is in charge of a home care agency; 9. “Personal care” means assistance with dressing, bathing, ambulation, exercise or other personal needs; 10. “Skilled care” means home care services performed on a regular basis by a trained Respiratory Therap ist/Technician or by a person currently licensed by this state including but not limited to a Licensed Practical Nurse, Regist ered Nurse, Physical Therapist, Occupational Therapist, Speech Therapist, or Soc ial Worker; 11. “Standby assistance” means supervision of client directed activities with verbal prompting and infrequent, incidental hands -on intervention only; and 12. “Supportive home assistant ” means an individual employed by a home care agency who p rovides standby assistance to ambulatory clients, in conjunction with other companionship or homemaker services, in the temporary or permanent place of residence of the client for a fee. SECTION 4. This act shall become effective November 1, 2022. 58-2-3667 DC 2/28/2022 3:18:19 PM