Texas 2009 - 81st Regular

Texas Senate Bill SB943 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R388 CLG-D
2	2	By: Zaffirini S.B. No. 943
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a pilot project to establish a comprehensive single
8	8	point of entry for long-term services and supports provided to the
9	9	aged and physically disabled individuals.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subchapter B, Chapter 531, Government Code, is
12	12	amended by adding Section 531.0525 to read as follows:
13	13	Sec. 531.0525. PILOT PROJECT TO ESTABLISH COMPREHENSIVE
14	14	SINGLE POINT OF ENTRY FOR LONG-TERM SERVICES AND SUPPORTS. (a) In
15	15	this section:
16	16	(1) "Aging and disability resource center" means a
17	17	center established under the Aging and Disability Resource Center
18	18	grant program jointly sponsored by the federal Administration on
19	19	Aging and the Centers for Medicare and Medicaid Services.
20	20	(2) "Department of Aging and Disability Services staff
21	21	members" includes the department's access and intake staff members
22	22	and the department's community care for the aged and disabled staff
23	23	members.
24	24	(3) "Expedited service authorization" means
25	25	authorization of services within seven calendar days based on a
26	26	screening of applicants and tentative eligibility for receipt of
27	27	services and initiation of those services as soon as possible.
28	28	(4) "Long-term services and supports" means long-term
29	29	assistance or care provided to the aged or physically disabled
30	30	individuals through the Medicaid program or other programs. The
31	31	term includes assistance or care provided through the following
32	32	programs:
33	33	(A) the primary home care program;
34	34	(B) the community attendant services program;
35	35	(C) the community-based alternatives program;
36	36	(D) the day activity and health services program;
37	37	(E) the promoting independence program;
38	38	(F) a program funded through the Older Americans
39	39	Act of 1965 (42 U.S.C. Section 3001 et seq.);
40	40	(G) a community care program funded through Title
41	41	XX of the federal Social Security Act (42 U.S.C. Section 301 et
42	42	seq.);
43	43	(H) the program of all-inclusive care for the
44	44	elderly (PACE), if the program is available in the area served by
45	45	the pilot project;
46	46	(I) the in-home and family support program; and
47	47	(J) a nursing facility program.
48	48	(5) "Long-term services and supports staff" means:
49	49	(A) one or more of the commission's Medicaid
50	50	eligibility determination staff members;
51	51	(B) one or more Department of Aging and
52	52	Disability Services staff members; and
53	53	(C) one or more local area agency on aging staff
54	54	members.
55	55	(6) "Physically colocated staff members" means
56	56	long-term services and supports staff members who are located in
57	57	the same physical office.
58	58	(7) "Pilot project site" means a location in an area
59	59	served by the pilot project established under this section where
60	60	physically colocated staff members work collaboratively to
61	61	authorize and initiate long-term services and supports. The term
62	62	does not include a location where staff members work together
63	63	solely by means of virtual communication, such as e-mail or the
64	64	Internet, or by telephone.
65	65	(8) "Tentative eligibility," with respect to receipt
66	66	of services, means a process by which eligibility for services is
67	67	provisionally determined based on a standard screening tool that
68	68	assesses both functional and financial program eligibility for
69	69	receipt of services.
70	70	(b) The commission shall develop and implement in not more
71	71	than three geographic areas of this state a pilot project to
72	72	establish a comprehensive single point of entry system for
73	73	long-term services and supports in which long-term services and
74	74	supports staff members located in the same physical office work in
75	75	collaboration to provide all necessary services in connection with
76	76	long-term services and supports from the intake process to the
77	77	start of service delivery. The pilot project must require that, at
78	78	a minimum, physically colocated staff members work collaboratively
79	79	to:
80	80	(1) screen the aged and physically disabled
81	81	individuals requesting long-term services and supports;
82	82	(2) establish tentative eligibility for long-term
83	83	services and supports;
84	84	(3) support and provide expedited service
85	85	authorization for the aged and physically disabled individuals
86	86	requesting long-term services and supports for which there are no
87	87	waiting lists; and
88	88	(4) make final determinations of financial
89	89	eligibility for long-term services and supports after a period of
90	90	tentative eligibility for receipt of those services and supports.
91	91	(c) In developing and implementing the pilot project, the
92	92	commission shall ensure that:
93	93	(1) each pilot project site serves as a comprehensive
94	94	single point of entry for the aged and physically disabled
95	95	individuals to access long-term services and supports in the site's
96	96	service area;
97	97	(2) each pilot project site is designed and operated
98	98	in accordance with best practices adopted by the executive
99	99	commissioner after the commission reviews best practices for
100	100	similar initiatives in other states and professional policy-based
101	101	research describing best practices for successful initiatives;
102	102	(3) the physically colocated staff members at each
103	103	pilot project site include:
104	104	(A) one or more full-time commission staff
105	105	members who determine eligibility for the Medicaid program and who:
106	106	(i) have full access to the Texas
107	107	Integrated Eligibility Redesign System (TIERS) or the System of
108	108	Application, Verification, Eligibility, Referral, and Reporting
109	109	(SAVERR);
110	110	(ii) have previously made Medicaid
111	111	long-term care eligibility determinations; and
112	112	(iii) are dedicated primarily to making
113	113	eligibility determinations for incoming clients at the site;
114	114	(B) sufficient Department of Aging and
115	115	Disability Services staff members to carry out the screening and
116	116	expedited service authorization functions at the site;
117	117	(C) sufficient area agency on aging staff members
118	118	to:
119	119	(i) assist with the performance of
120	120	screening functions and service coordination for services funded
121	121	under the Older Americans Act of 1965 (42 U.S.C. Section 3001 et
122	122	seq.), such as meals programs; and
123	123	(ii) identify other locally funded and
124	124	supported services that will enable the aged or physically disabled
125	125	individuals to continue to reside in the community to the extent
126	126	reasonable; and
127	127	(D) any available staff members from local
128	128	service agencies; and
129	129	(4) the physically colocated staff members of a pilot
130	130	project site:
131	131	(A) use a standardized screening tool that:
132	132	(i) assesses both functional and financial
133	133	program eligibility; and
134	134	(ii) provides sufficient information to
135	135	make a tentative eligibility determination for receipt of services;
136	136	(B) process requests for long-term services and
137	137	supports in person or by telephone or through the Internet;
138	138	(C) perform all screening and assessment,
139	139	eligibility determination, and service authorization functions
140	140	necessary to promptly initiate appropriate service delivery;
141	141	(D) closely coordinate with local hospital
142	142	discharge planners and staff members of extended rehabilitation
143	143	units of local hospitals and nursing homes;
144	144	(E) give first priority to individuals who
145	145	urgently need services; and
146	146	(F) inform individuals about community-based
147	147	services available in the area served by the pilot project.
148	148	(d) An area in which the pilot project will be implemented
149	149	may consist of a single county or a multicounty region, as
150	150	determined by the commission. At least one of the areas must have a
151	151	pilot project site located within an aging and disability resource
152	152	center. If the commission finds that there is no aging and
153	153	disability resource center that is willing or able to accomodate a
154	154	pilot project site on the date the pilot project is to be
155	155	implemented, the pilot project site may be located at a local
156	156	Department of Aging and Disability Services office, an area agency
157	157	on aging office, or another appropriate location.
158	158	(e) Not later than January 31, 2011, the commission shall
159	159	submit a report concerning the pilot project to the presiding
160	160	officers of the standing committees of the senate and house of
161	161	representatives having primary jurisdiction over health and human
162	162	services. The report must:
163	163	(1) be prepared by a person not associated with the
164	164	pilot project or the commission;
165	165	(2) contain, for each area of this state in which the
166	166	pilot project is being implemented, an evaluation of the operation
167	167	of the pilot project in that area;
168	168	(3) contain an evaluation of the pilot project's
169	169	benefits for individuals who received services;
170	170	(4) contain a calculation of the costs and cost
171	171	savings that can be attributed to implementation of the pilot
172	172	project;
173	173	(5) include a recommendation regarding adopting
174	174	improved policies and procedures concerning long-term services and
175	175	supports with statewide applicability, as determined from
176	176	information obtained in operating the pilot project;
177	177	(6) include a recommendation regarding the
178	178	feasibility of expanding the pilot project to other areas of this
179	179	state or statewide; and
180	180	(7) contain the perspectives of service providers of
181	181	programs listed in Subsection (a)(4) who are operating in the area
182	182	served by a pilot project site.
183	183	(f) This section expires September 1, 2013.
184	184	SECTION 2. Not later than December 31, 2009, the Health and
185	185	Human Services Commission shall ensure that at least one pilot
186	186	project site is in operation under the pilot project required by
187	187	Section 531.0525, Government Code, as added by this Act.
188	188	SECTION 3. If before implementing any provision of this Act
189	189	a state agency determines that a waiver or authorization from a
190	190	federal agency is necessary for implementation of that provision,
191	191	the agency affected by the provision shall request the waiver or
192	192	authorization and may delay implementing that provision until the
193	193	waiver or authorization is granted.
194	194	SECTION 4. This Act takes effect immediately if it receives
195	195	a vote of two-thirds of all the members elected to each house, as
196	196	provided by Section 39, Article III, Texas Constitution. If this
197	197	Act does not receive the vote necessary for immediate effect, this
198	198	Act takes effect September 1, 2009.