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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
COMMITTEE SUBSTITUTE
FOR
SENATE BILL 1419 By: Gollihare
COMMITTEE SUBSTITUTE
An Act relating to home care; defining terms;
directing the Oklahoma Health Care Authority to
establish certain program subject to c ertain
conditions; stating qualification criteria for
program; requiring certain compliance with laws and
rules; authorizing and limiting performance of
skilled care tasks; directing certain reimbursement
of home care services; requiring certain agencies to
coordinate for implementation; directing promulgation
of rules; requiring application for certain federal
approval; amending 63 O.S. 2021, Section 1 -1961,
which relates to definitions used in the Home Care
Act; modifying definition; amending 63 O.S. 2021,
Section 1-1964, which relates to rules promulgated
under the Home Care Act; requiring rules to include
certain scope of practice standards and restrictions ;
requiring State Commissioner of Health to consider
certain advice; updating statutory la nguage;
providing for codification; providi ng an effective
date; 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 codif ied
in the Oklahoma Statutes as Section 5013.2 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. As used in this section:
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1. “Family member” means a child, parent, parent -in-law,
sibling, grandparent, grandchild, s pouse, or any other individu al
related by blood, and any other individual with a close associat ion
that is the equivalent of a family relationship; and
2. “Home care agency”, “home care services”, “home health
aide”, and “skilled care” have the same meaning s as provided by
Section 1-1961 of Title 63 of the Oklahoma Statutes .
B. No later than one year after the effective date of this act
and subject to receipt of federal approval for the program, the
Oklahoma Health Care Authority shall establish a program under which
a family member of a Medicaid enrollee may be certified as a home
health aide by the State Department of Health and, after receiving
such certification, may, under the direction and supervision of a
registered nurse or licensed practical nurse, provide home care
services to the enrollee through a licensed home care agency under
the reimbursement rates established und er subsection F of this
section, provided that the enrollee qualifies for such services
under the state Medicaid program .
C. The program established under this section shall require the
family member to complete:
1. A criminal history background check under Section 1-1950.1
of Title 63 of the Okl ahoma Statutes; and
2. All the training, competency evaluation , and other
qualification criteria provided by law or rule for certification as
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a home health aide including, but not limit ed to, qualification
criteria established under the Home Care Act.
D. 1. Upon certification as a home health aide, the family
member shall comply with all laws and rules applicable to home
health aides including, but not limited to, the H ome Care Act and
rules promulgated by the State Commissioner of Health .
2. A licensed home care agency participating in the program
established under thi s section shall comply with all laws and rules
applicable to home care agencies including, but not limited to, the
Home Care Act and rules promulgated by the Commissioner.
E. Home care services provided by a family member certified as
a home health aide under this section m ay include skilled care
tasks, subject to the scope of practice standards and restrictions
established by the Commissioner under Section 1-1964 of Title 63 of
the Oklahoma Statutes and all other requirements and limitations
prescribed by law or rule. The home health aide may only perform
skilled care tasks for his or her family member who is a Medicaid
enrollee and for whom the home health aide is receiving or will
receive reimbursement under subsection F of this section.
F. Home care services provided by a family member of a Medicaid
enrollee who becomes cer tified as a home health aide under the
program established under this section shall be reimbursed to a home
care agency at a rate established by the Authority.
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G. 1. The Authority and the Department shall coordinate and
share information as necessary to implement this section.
2. The Oklahoma Health Care Authority Board and the
Commissioner shall promulgate rules as necessary to implement this
section.
3. The Administrator of the Authority shall apply for such
state plan amendments or waivers as may be necessary to implement
this section and to secure federal financial participation for state
Medicaid expenditures under the federal Medi caid program.
SECTION 2. 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 State Com missioner of Health by
rules promulgated pursuant to the Home Care Act for home health
aides and home care ag ency 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 Practit ioner
or a Clinical Nurse Specialist ;
5. “Home care agency” means any sole proprietorship,
partnership, association, corporation or other orga nization which
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administers, offers or provides home care services, for a fee or
pursuant to a contract fo r such services, to clients in their place
of residence. The term “home care agency” home care agency shall
not include:
a. individuals who contract w ith the Department of Human
Services to provide personal care services, pr ovided
such individuals sha ll not be exempt from
certification as home health aides,
b. organizations that contract with the Oklahoma Health
Care Authority as Intermediary Services O rganizations
(ISO) to provide federal Internal Revenue Service
fiscal and supportive services to Consumer -Directed
Personal Assistance Supports and Services and Supports
(CD-PASS) waiver program participants who have
employer responsibility for hiring, tra ining,
directing and managing an individual personal care
attendant, or
c. CD-PASS waiver program employer partici pants;
6. “Home care services” means skilled or 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 pla ce of residence
for a fee;
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8. “Home care agency administrator ” 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. a trained Respiratory Therapist/Technician or by
respiratory therapist/technician,
b. a person currently licensed by this state including
but not limited to a Licensed Practical Nurse,
Registered Nurse, Physical Therapist physical
therapist, Occupational Therapist occupational
therapist, Speech Therapist speech therapist, or
Social Worker social worker, or
c. for the exclusive purpose of the program established
under Section 1 of this act and subject to the scope
of practice standards and restrictions established
under Section 1-1964 of this title, a family member of
a Medicaid enrollee who is certified as a home health
aide;
11. “Standby assistance” means supervision of client directed
activities with verbal prompting and infrequent, incidental hands -on
intervention only; and
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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 permanen t place of residence of the
client for a fee.
SECTION 3. AMENDATORY 63 O.S. 2021, Section 1 -1964, is
amended to read as follows:
Section 1-1964. The State Commissioner of Health s hall
promulgate rules necessary to implement the provisions of the Home
Care Act. Such rules shall include, but shall not be limited to:
1. Minimum standards for home care services. In establishing
such standards, the Commissioner shall consider those standards
adopted by state and national home care a ssociations;
2. Requirements for the certification and renewal cert ification
of home health aides and home c are agency administrators;
3. Provisions for transfer of owner ship of a licensed agency;
4. A requirement that each licensed agency create and disclose
to its clients a statement of clients ’ rights and responsibil ities;
5. Establishing continuing education requirements for renewal
of certifications for home care agency administrators;
6. Requirements for financial resources to ensure a home care
agency’s ability to provide adequate home care services;
7. Standards for assessing an applicant ’s business and
professional experience as demonstrated in prior health care
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provider operations including, b ut not limited to, nursing homes,
residential care homes, and home care and in previous compliance
with all lawful orders of suspension, receivership, administrative
penalty or sanction issued by the State Department of Health or by
other administrative agencies in other states with si milar
responsibilities;
8. Restrictions on any agency, agency employee, or agency
contractor providing skilled care o r conducting an in-home
assessment of the need for skilled care unless and until the agency
receives a healthcare health care provider’s order to provide
skilled care or to conduct an in -home assessment of the need for
skilled care; provided, however, such restrictions shall not prevent
an agency from providing personal care to a client without a
healthcare health care provider’s order. Provided further, such
restrictions shall not a pply to in-home assessments of home and
community-based waiver clients in the state Medicaid program;
9. For the exclusive purpose of the program es tablished under
Section 1 of this act, scope of practice standards and restrictions
for skilled care provided to a Medicaid enrollee by a family member
who is certified as a home health aide . In establishing such
standards and restrictions, the Commissioner shall consider the
advice of the Oklahoma Health Care Authority;
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10. Restrictions on any agency, agency employee, or agency
contractor soliciting, coercing, or harassing a consumer of home
care services or who ma y need home care services; and
10. 11. Standards or other provisions whi ch do not conflict
with any federal requirements relating to the federal Medicaid and
Medicare programs.
SECTION 4. This act shall become effe ctive July 1, 2024.
SECTION 5. It being immediately necessary for t he preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall t ake effect and
be in full force from and after its passage and ap proval.
59-2-3510 DC 2/15/2024 11:18:18 AM