Texas 2009 - 81st Regular

Texas House Bill HB1398 Compare Versions

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1	1	81R16562 CLG-D
2	2	By: Guillen, Naishtat, Hughes H.B. No. 1398
3	3	Substitute the following for H.B. No. 1398:
4	4	By: Rose C.S.H.B. No. 1398
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to a pilot project to establish a comprehensive single
10	10	point of entry for long-term services and supports provided to
11	11	older persons and persons with physical disabilities.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Subchapter B, Chapter 531, Government Code, is
14	14	amended by adding Section 531.0525 to read as follows:
15	15	Sec. 531.0525. PILOT PROJECT TO ESTABLISH COMPREHENSIVE
16	16	SINGLE POINT OF ENTRY FOR LONG-TERM SERVICES AND SUPPORTS. (a) In
17	17	this section:
18	18	(1) "Aging and disability resource center" means a
19	19	center established under the Aging and Disability Resource Center
20	20	grant program jointly sponsored by the federal Administration on
21	21	Aging and the Centers for Medicare and Medicaid Services.
22	22	(2) "Colocated long-term services and supports staff
23	23	members" means:
24	24	(A) long-term services and supports staff
25	25	members who are located in the same physical office; or
26	26	(B) long-term services and supports staff
27	27	members who are not located in the same physical office but who work
28	28	collaboratively through the use of the telephone or other
29	29	technologies.
30	30	(3) "Department of Aging and Disability Services staff
31	31	members" includes the department's access and intake staff members
32	32	and the department's community care for the aged and disabled staff
33	33	members.
34	34	(4) "Expedited service authorization" means
35	35	authorization of services within seven calendar days based on a
36	36	screening of applicants and tentative eligibility for receipt of
37	37	services and initiation of those services as soon as possible.
38	38	(5) "Long-term services and supports" means long-term
39	39	assistance or care provided to older persons and persons with
40	40	physical disabilities through the Medicaid program or other
41	41	programs. The term includes assistance or care provided through
42	42	the following programs:
43	43	(A) the primary home care program;
44	44	(B) the community attendant services program;
45	45	(C) the community-based alternatives program;
46	46	(D) the day activity and health services program;
47	47	(E) the promoting independence program;
48	48	(F) a program funded through the Older Americans
49	49	Act of 1965 (42 U.S.C. Section 3001 et seq.);
50	50	(G) a community care program funded through Title
51	51	XX of the federal Social Security Act (42 U.S.C. Section 301 et
52	52	seq.);
53	53	(H) the program of all-inclusive care for the
54	54	elderly (PACE), if the program is available in the area served by
55	55	the pilot project;
56	56	(I) the in-home and family support program; and
57	57	(J) a nursing facility program.
58	58	(6) "Long-term services and supports staff" means:
59	59	(A) one or more of the commission's Medicaid
60	60	eligibility determination staff members;
61	61	(B) one or more Department of Aging and
62	62	Disability Services staff members; and
63	63	(C) one or more local area agency on aging staff
64	64	members.
65	65	(7) "Pilot project site" means a location in an area
66	66	served by the pilot project established under this section where
67	67	colocated long-term services and supports staff members work
68	68	collaboratively to provide information and authorize and initiate
69	69	long-term services and supports.
70	70	(8) "Tentative eligibility," with respect to receipt
71	71	of services, means a process by which eligibility for services is
72	72	provisionally determined based on a standard screening tool that
73	73	assesses both functional and financial program eligibility for
74	74	receipt of services.
75	75	(b) The commission shall develop and implement in not more
76	76	than three geographic areas of this state a pilot project to
77	77	establish a comprehensive single point of entry system for
78	78	long-term services and supports in which colocated long-term
79	79	services and supports staff members work in collaboration to
80	80	provide all necessary services in connection with long-term
81	81	services and supports from the intake process to the start of
82	82	service delivery. The pilot project must require that, at a
83	83	minimum, the staff members work collaboratively to:
84	84	(1) inform and educate older persons, persons with
85	85	physical disabilities, and their family members and other
86	86	caregivers about long-term services and supports for which they may
87	87	qualify;
88	88	(2) screen older persons and persons with physical
89	89	disabilities requesting long-term services and supports;
90	90	(3) establish tentative eligibility for long-term
91	91	services and supports;
92	92	(4) support and provide expedited service
93	93	authorization for older persons and persons with physical
94	94	disabilities requesting long-term services and supports for which
95	95	there are no interest lists; and
96	96	(5) make final determinations of financial
97	97	eligibility for long-term services and supports after a period of
98	98	tentative eligibility for receipt of those services and supports.
99	99	(c) In developing and implementing the pilot project, the
100	100	commission shall ensure that:
101	101	(1) at least one pilot project site has only colocated
102	102	long-term services and supports staff members who are located in
103	103	the same physical office;
104	104	(2) each pilot project site serves as a comprehensive
105	105	single point of entry for older persons and persons with physical
106	106	disabilities to obtain information about long-term services and
107	107	supports for which they may qualify and access long-term services
108	108	and supports in the site's service area;
109	109	(3) each pilot project site is designed and operated
110	110	in accordance with best practices adopted by the executive
111	111	commissioner after the commission reviews best practices for
112	112	similar initiatives in other states and professional policy-based
113	113	research describing best practices for successful initiatives;
114	114	(4) the colocated long-term services and supports
115	115	staff members supporting each pilot project site include:
116	116	(A) one or more full-time commission staff
117	117	members who determine eligibility for the Medicaid program and who:
118	118	(i) have full access to the Texas
119	119	Integrated Eligibility Redesign System (TIERS) or the System of
120	120	Application, Verification, Eligibility, Referral, and Reporting
121	121	(SAVERR);
122	122	(ii) have previously made Medicaid
123	123	long-term care eligibility determinations; and
124	124	(iii) are dedicated primarily to making
125	125	eligibility determinations for incoming clients at the site;
126	126	(B) sufficient Department of Aging and
127	127	Disability Services staff members to carry out the screening and
128	128	expedited service authorization functions at the site;
129	129	(C) sufficient area agency on aging staff members
130	130	to:
131	131	(i) assist with the performance of
132	132	screening functions and service coordination for services funded
133	133	under the Older Americans Act of 1965 (42 U.S.C. Section 3001 et
134	134	seq.), such as meals programs; and
135	135	(ii) identify other locally funded and
136	136	supported services that will enable older persons and persons with
137	137	physical disabilities to continue to reside in the community to the
138	138	extent reasonable; and
139	139	(D) any available staff members from local
140	140	service agencies; and
141	141	(5) the colocated long-term services and supports
142	142	staff members of a pilot project site:
143	143	(A) use a standardized screening tool that:
144	144	(i) assesses both functional and financial
145	145	program eligibility; and
146	146	(ii) provides sufficient information to
147	147	make a tentative eligibility determination for receipt of services;
148	148	(B) process requests for long-term services and
149	149	supports in person or by telephone or through the Internet;
150	150	(C) perform all screening and assessment,
151	151	eligibility determination, and service authorization functions
152	152	necessary to promptly initiate appropriate service delivery;
153	153	(D) closely coordinate with local hospital
154	154	discharge planners and staff members of extended rehabilitation
155	155	units of local hospitals and nursing homes;
156	156	(E) give first priority to persons who urgently
157	157	need services; and
158	158	(F) inform persons about community-based
159	159	services available in the area served by the pilot project.
160	160	(d) An area in which the pilot project will be implemented
161	161	may consist of a single county or a multicounty region, as
162	162	determined by the commission. At least one of the areas must have a
163	163	pilot project site located within an aging and disability resource
164	164	center. If the commission finds that there is no aging and
165	165	disability resource center that is willing or able to accommodate a
166	166	pilot project site on the date the pilot project is to be
167	167	implemented, the pilot project site may be located at a local
168	168	Department of Aging and Disability Services office, an area agency
169	169	on aging office, or another appropriate location.
170	170	(e) Not later than January 31, 2011, the commission shall
171	171	submit a report concerning the pilot project to the presiding
172	172	officers of the standing committees of the senate and house of
173	173	representatives having primary jurisdiction over health and human
174	174	services. The report must:
175	175	(1) be prepared by a person not associated with the
176	176	pilot project or the commission;
177	177	(2) contain, for each area of this state in which the
178	178	pilot project is being implemented, an evaluation of the operation
179	179	of the pilot project in that area;
180	180	(3) contain an evaluation of the pilot project's
181	181	benefits for persons who received services;
182	182	(4) contain a calculation of the costs and cost
183	183	savings that can be attributed to implementation of the pilot
184	184	project;
185	185	(5) include a recommendation regarding adopting
186	186	improved policies and procedures concerning long-term services and
187	187	supports with statewide applicability, as determined from
188	188	information obtained in operating the pilot project;
189	189	(6) include a recommendation regarding the
190	190	feasibility of expanding the pilot project to other areas of this
191	191	state or statewide; and
192	192	(7) contain the perspectives of service providers of
193	193	programs listed in Subsection (a)(5) who are operating in the area
194	194	served by a pilot project site.
195	195	(f) This section expires September 1, 2013.
196	196	SECTION 2. Not later than December 31, 2009, the Health and
197	197	Human Services Commission shall ensure that at least one pilot
198	198	project site is in operation under the pilot project required by
199	199	Section 531.0525, Government Code, as added by this Act.
200	200	SECTION 3. If before implementing any provision of this Act
201	201	a state agency determines that a waiver or authorization from a
202	202	federal agency is necessary for implementation of that provision,
203	203	the agency affected by the provision shall request the waiver or
204	204	authorization and may delay implementing that provision until the
205	205	waiver or authorization is granted.
206	206	SECTION 4. This Act takes effect immediately if it receives
207	207	a vote of two-thirds of all the members elected to each house, as
208	208	provided by Section 39, Article III, Texas Constitution. If this
209	209	Act does not receive the vote necessary for immediate effect, this
210	210	Act takes effect September 1, 2009.