SENATE FLOOR VERSION - HB3238 SFLR Page 1 (Bold face denotes Committee Amendments) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SENATE FLOOR VERSION April 11, 2024 COMMITTEE SUBSTITUTE FOR ENGROSSED HOUSE BILL NO. 3238 By: Lawson and Waldron of the House and Garvin of the Senate An Act relating to long -term care; defining terms; designating the Oklahoma Health Care Aut hority as the state administering agency for programs of all - inclusive care for the elderly (PACE) agreements; requiring enforcement of certain federal regulations; providing certain powers and duties; exempting PACE organizations from certain licensure; p roviding certain construction; authorizing certain interagency agreement; authorizing promulgation of rules; amending 63 O.S. 2021, Section 1 -872, which relates to definitions used in the Adult Day Care Act; modifying definition; amending 63 O.S. 2021, Sec tion 1-1961, which relates to definitions used in the Home Care Act; modifying definition; updating statutory language; providing for codification; and declaring an emergency. BE IT ENACTED BY THE PEOPLE OF THE 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: SENATE FLOOR VERSION - HB3238 SFLR Page 2 (Bold face denotes Committee Amendments) 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 programs of all -inclusive care for the elderly; and 2. The terms “PACE program agreement ”, “PACE organization”, “participant” and “state administering agency ” have the same meaning as provided by 42 C.F.R., Section 460.6. B. The Oklahoma Health Care Authority shall serve as t he state administering agency responsible for administering PACE program agreements under 42 C.F.R., Part 460, Subpart C. C. The Authority shall enforce the federal regulations of the Centers for Medicare and Medicaid Services governing PACE codified at 42 C.F.R., Part 460. The Authority shall have all the powers and duties provided to the state administering agency under 42 C.F.R., Part 460. D. PACE organizations shall be e xempt from licensure by the State Department of Health under the Home Care Act, t he Adult Day Care Act, or any other act that governs a different type of facility or provider. This subsection shall not be construed to prevent the Department from enforcing such acts with respect to facilities or providers contracted by the PACE organiz ation to provide services to PACE program participants. E. The Authority may, as necessary, execute an interagency agreement with the State Department of Health to carry out any of the functions of the state administering agency under 42 C.F.R., Part 460. SENATE FLOOR VERSION - HB3238 SFLR Page 3 (Bold face denotes Committee Amendments) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 F. The Oklahoma Health Care Authority Board may promulgate rules as necessary to implement 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 shall have a separately verifiable staff, space, budget and participant record system. The terms “adult day care center ” adult day care center or “center” center shall not include 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 recreati onal 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: SENATE FLOOR VERSION - HB3238 SFLR Page 4 (Bold face denotes Committee Amendments) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Section 1-1961. As used in the Home Care Act: 1. “Board” means the State Board of Health; 2. “Certification” means verification of appropriate training and competence established by the State Commissioner of Health by rules promulgated pursuant to the Home Care Act for home health aides and home care agency administrators; 3. “Department” means the State Department of Health; 4. “Healthcare “Health care provider” means a physician, physician assistant or Advanced Practice Registered Nurse recognized by the Oklahoma Board of Nursing as a Certified Nurse Practitioner or a Clinical Nurse Specialist; 5. “Home care agency” means any sole proprietorship, partnership, association, corp oration or other organization which 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” home care agency shall not include: a. individuals who contract with the Department of Human Services to provide personal care services, provided such individuals shall not be exempt from certification as home health ai des, b. organizations that contract with the Oklahoma Health Care Authority as In termediary Services Organizations (ISO) to provide federal Internal Revenue Service SENATE FLOOR VERSION - HB3238 SFLR Page 5 (Bold face denotes Committee Amendments) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 fiscal and supportive services to Oklahoma Consumer- Directed Personal Assistance Supports and Support Services (CD-PASS) waiver program participants who have employer responsibility for hiring, training, directing and managing an individual personal care attendant, or c. CD-PASS waiver program employer participants , or d. PACE organizations as d efined by 42 C.F.R., Section 460.6; 6. “Home care services” means skilled or per sonal care services provided to clients in their place of residence for a fee; 7. “Home health aide” means an individual who provides personal care to clients in their temporary or permanent place of residence for a fee; 8. “Home care agency administrato r” means a person who operates, manages, or supervises, 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 Therapist/Technician respiratory therapist/technician or by a person currently licensed by this state including but not limited to a Licensed Practical Nurse, Registered Nurse, Physical Therapist, Occupational T herapist, SENATE FLOOR VERSION - HB3238 SFLR Page 6 (Bold face denotes Committee Amendments) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Speech Therapist physical therapist, occupational therapist, speech therapist, or Social Worker social 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 provides standby assistance to ambulatory clients, in conjunction with other companionship or homemaker services, in the temporary or permanent plac e of residence of the client for a fee. SECTION 4. It being immediately necessary for the preservation of the public peace, health or safety, an emergency is hereby declared to exist, by reason whereof this act shall take effect and be in full force from and after its passage and approval. COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES April 11, 2024 - DO PASS AS AMENDED BY CS