| 1 | 1 | | 81R9880 ALB-D |
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| 2 | 2 | | By: Nichols S.B. No. 2116 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to a pilot program to provide community-based alternatives |
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| 8 | 8 | | under the Medicaid program for certain individuals diagnosed with |
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| 9 | 9 | | Alzheimer's disease. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Subchapter D, Chapter 161, Human Resources Code, |
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| 12 | 12 | | is amended by adding Section 161.083 to read as follows: |
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| 13 | 13 | | Sec. 161.083. ALZHEIMER'S ASSISTED LIVING FACILITY OR |
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| 14 | 14 | | RESIDENTIAL CARE PILOT PROGRAM. (a) In this section, "pilot |
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| 15 | 15 | | program" means the Alzheimer's Assisted Living Facility or |
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| 16 | 16 | | Residential Care pilot program established under this section. |
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| 17 | 17 | | (b) The department shall establish a pilot program to |
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| 18 | 18 | | provide community-based alternatives and assisted living and |
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| 19 | 19 | | residential care and support services under the Medicaid program to |
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| 20 | 20 | | individuals who are diagnosed with Alzheimer's disease. |
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| 21 | 21 | | (c) An individual may be eligible for the pilot program if |
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| 22 | 22 | | the individual: |
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| 23 | 23 | | (1) has been diagnosed with Alzheimer's disease; |
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| 24 | 24 | | (2) meets financial eligibility requirements |
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| 25 | 25 | | specified by the executive commissioner; |
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| 26 | 26 | | (3) does not meet the medical necessity requirements |
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| 27 | 27 | | under the Medicaid program for entry into a nursing facility; and |
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| 28 | 28 | | (4) has a plan of care the costs of which do not exceed |
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| 29 | 29 | | the average daily nursing facility payment under the Medicaid |
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| 30 | 30 | | program. |
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| 31 | 31 | | (d) The executive commissioner shall adopt rules necessary |
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| 32 | 32 | | to implement this section. |
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| 33 | 33 | | (e) Rules adopted under Subsection (d) must permit a |
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| 34 | 34 | | residential facility at which pilot program services are offered to |
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| 35 | 35 | | operate under the direction of a physician acting on a volunteer |
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| 36 | 36 | | basis, provided that a registered nurse is available at the |
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| 37 | 37 | | facility at all times. |
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| 38 | 38 | | (f) Not later than December 1, 2014, the department shall |
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| 39 | 39 | | submit a report to the legislature regarding the effectiveness of |
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| 40 | 40 | | the pilot program, including a cost-benefit analysis that compares |
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| 41 | 41 | | the costs of treating an individual through the pilot program to the |
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| 42 | 42 | | costs incurred by the state of treating an individual in a nursing |
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| 43 | 43 | | facility. |
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| 44 | 44 | | (g) This section expires September 1, 2015. |
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| 45 | 45 | | SECTION 2. If before implementing any provision of this Act |
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| 46 | 46 | | a state agency determines that a waiver or authorization from a |
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| 47 | 47 | | federal agency is necessary for implementation of that provision, |
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| 48 | 48 | | the agency affected by the provision shall request the waiver or |
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| 49 | 49 | | authorization and may delay implementing that provision until the |
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| 50 | 50 | | waiver or authorization is granted. |
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| 51 | 51 | | SECTION 3. This Act takes effect September 1, 2009. |
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