An Act
ENROLLED HOUSE
BILL NO. 3238 By: Lawson, Waldron, Hefner,
and Pittman of the House
and
Garvin of the Senate
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
certain construction; authorizing ce rtain 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 use d in the Home
Care Act; modifying definition s; providing for
codification; and declaring an emergency.
SUBJECT: Long-term care
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
ENR. H. B. NO. 3238 Page 2
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 res ponsible 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 Authori ty 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 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
centers, or PACE organizations as defined by 42 C.F.R., Section
460.6; ENR. H. B. NO. 3238 Page 3
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
caregivers;
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 Comm issioner 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 provider” “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, co rporation 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 aides,
b. organizations that contract with the Oklahoma Health
Care Authority as Intermediary Services Organizations ENR. H. B. NO. 3238 Page 4
(ISO) to provide federal Internal Revenue Service
fiscal and supportive services to Oklahoma Consumer-
Directed Personal Assistance Supports and Services and
Supports (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 o r personal 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 admin istrator” 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, Occup ational 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 ha nds-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 per manent place of residence of the
client for a fee.
ENR. H. B. NO. 3238 Page 5
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 effec t and
be in full force from and after its passage and approval.
ENR. H. B. NO. 3238 Page 6
Passed the House of Representatives the 7th day of May, 2024.
Presiding Officer of the House
of Representatives
Passed the Senate the 22nd day of April, 2024.
Presiding Officer of the Senate
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Ok lahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this _____ _____
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________