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SENATE FLOOR VERSION
February 28, 2024
COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 1419 By: Gollihare of the Senate
and
Boatman of the House
[ home care - program - tasks - reimbursement - rules
- application - Home Care Act – State Commissioner of
Health - codification - effective date -
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 5013.2 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. As used in this section:
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 equivalen t 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 Statut es.
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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 Hea lth 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 req uire 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
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 li mited to, the Home Care Act and
rules promulgated by the State Commissioner of Health .
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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 stan dards 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 certified 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.
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
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this section and to secure federal financial par ticipation 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 pursuan t to the Home Care A ct for home health
aides and home care agency administrato rs;
3. “Department” means the State Department of Health;
4. “Healthcare “Health care provider” means a physician,
physician assistant or Advanc ed 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 organization which
administers, offers or provid es home care service s, 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 se rvices, provided
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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 Organizations
(ISO) to provide federal Intern al 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, training,
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 place of residence
for a fee;
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:
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a. a trained Respiratory Therapist/Technician or by
respiratory therapist /technician,
b. a person currently li censed 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 pur pose 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 hom e health
aide;
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 a ssistance 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, Sect ion 1-1964, is
amended to read as follows:
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Section 1-1964. The State Commissioner of Health shall
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 certification
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 responsibilities;
5. Establishing continuing education requirements for re newal
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
provider operations including, but 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;
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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 Medi caid program;
9. For the exclusive purpose of the program established 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;
10. Restrictions on any agency, agency employee, or agency
contractor soliciting, coercing, or harassing a consumer of home
care services or who m ay need home care services; and
10. 11. Standards or other provisions which 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.
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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 take effect and
be in full force from and aft er its passage and a pproval.
COMMITTEE REPORT BY: COMMITTEE ON APPROPRIATIONS
February 28, 2024 - DO PASS