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ENGROSSED SENATE AMENDMENT
TO
ENGROSSED HOUSE
BILL NO. 3238 By: Lawson of the House
and
Garvin of the Senate
An Act relating to poor persons; defining terms;
designating the Oklahoma Health Care Authority as the
state administering agency for PA CE 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 the Adult Day
Care Act; modifying definition ; amending 63 O.S.
2021, Section 1-1961, which relates to the Home Care
Act; modifying definition; updating statutory
language; providing for codification; and provi ding
an effective date.
AUTHOR: Add the following House Coauthor: Waldron
AMENDMENT NO. 1. Page 1, strike the title, enacting clause and
entire bill and insert
“An Act relating to long -term care; defining terms;
designating the Oklahoma Health Care Authority 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 ; providing
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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, Section
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:
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 the 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.
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D. PACE organizations shall be exempt from licensure by the
State Department of Health under the Home Care Act, the 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 organ ization 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.
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 Da y 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
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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 impaire d 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 training
and competence establish ed 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 physi cian,
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, co rporation or other organization which
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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 aides,
b. organizations that contract with the Oklahoma Health
Care Authority as Intermediary Services Organizations
(ISO) to provide federal Internal Revenue Service
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 defined by 42 C.F.R., Section
460.6;
6. “Home care services” means skilled or p ersonal care services
provided to clients in their place of residence for a fee;
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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 administra tor” 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 perform ed 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 Therapist,
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 pl ace of residence of the
client for a fee.
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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. ”
Passed the Senate the 22nd day of April, 2024.
Presiding Officer of the Senate
Passed the House of Representatives the ____ day of __________,
2024.
Presiding Officer of the House
of Representatives
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ENGROSSED HOUSE
BILL NO. 3238 By: Lawson of the House
and
Garvin of the Senate
An Act relating to poor persons; defining terms;
designating the Oklahoma Health Care Authority as the
state administering agency for P ACE 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 nonc ompliance;
directing promulgation of rules; amending 63 O.S.
2021, Section 1-872, which relates to the Adult Day
Care Act; modifying definition; amending 63 O.S.
2021, Section 1-1961, which relates to the Home Care
Act; modifying definition; updating statutory
language; providing for codification; and providing
an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 5. 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 :
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1. “PACE” shall mean the program of all-inclusive care for the
elderly; and
2. The terms “PACE program agreement”, “PACE organization”, and
“state administering agency” shall have the same meaning as pro vided
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 Me dicare and Medicaid Services
codified at 42 C.F.R. , Part 460. The Authority may enter into an
agreement with the State Depart ment of Health to carry out any
duties or functions of the state administering agenc y 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 shall 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
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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 6. 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
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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 hea lth, social
supportive, and recreational services in a st ructured 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 7. 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 training
and competence established by the Sta te Commissioner of Health by
rules promulgated pursuant to the Home Care Act for home health
aides and home care agency administ rators;
3. “Department” means the State Department of He alth;
4. “Healthcare 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 Clinica l
Nurse Specialist;
5. “Home care agency” means any sole proprietorship,
partnership, association, corporation or other organiz ation which
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administers, offers or provides home care services, for a fee or
pursuant to a contract for such services, to client s 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 per sonal care services, provided
such individuals shall not be exempt from
certification as home health aides,
b. organizations that contract wit h the Oklahoma Health
Care Authority as Intermediary Services Organizations
(ISO) to provide federal Internal Reve nue Service
fiscal and supportive services to Consumer -Directed
Personal Assistance Supports and Services (CD -PASS)
waiver program participant s who have employer
responsibility for hiring, training, directing and
managing an individual personal care attend ant, 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 personal 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 temporary or permanent place of r esidence
for a fee;
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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 , Registered Nurse, Physical Ther apist,
Occupational Therapist , Speech Therapist, or 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 b y
a home care agency who provides standby assistance to ambulatory
clients, in conjunction with other companionshi p or homemaker
services, in the temporary or permanent place of residence of the
client for a fee.
SECTION 8. This act shall become effective November 1, 2024.
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Passed the House of Representatives the 5th day of March, 2024.
Presiding Officer of the House
of Representatives
Passed the Senate the ___ day of __________, 2024.
Presiding Officer of the Senate