By: Deuell, Rodriguez, Uresti S.B. No. 1878
A BILL TO BE ENTITLED
AN ACT
relating to the program of all-inclusive care for the elderly.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 32.053, Human Resources Code, is amended
by amending Subsections (a), (b), and (e) and adding Subsections
(f), (g), and (h) to read as follows:
(a) The department, as an integral [a] part of the medical
assistance program, shall develop and implement a program of
all-inclusive care for the elderly (PACE) in accordance with
Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No.
105-33), as amended. The department shall provide medical
assistance to a participant in the PACE program in the manner and to
the extent authorized by federal law.
(b) The executive commissioner of the Health and Human
Services Commission [department] shall adopt rules as necessary to
implement this section. In adopting rules, the executive
commissioner [department] shall:
(1) use the Bienvivir Senior Health Services of El
Paso initiative as a model for the program; [and]
(2) ensure that a person is not required to hold a
certificate of authority as a health maintenance organization under
Chapter 843, Insurance Code, [the Texas Health Maintenance
Organization Act (Chapter 20A, Vernon's Texas Insurance Code)] to
provide services under the PACE program;
(3) ensure that participation in the PACE program is
available as an alternative to enrollment in a Medicaid managed
care plan under Chapter 533, Government Code, for eligible
recipients, including recipients eligible for assistance under
both the medical assistance and Medicare programs;
(4) ensure that managed care organizations that
contract under Chapter 533, Government Code, consider the
availability of the PACE program when considering whether to refer
a recipient to a nursing home or other long-term care facility; and
(5) establish protocols for the referral of eligible
persons to the PACE program.
(e) The [department, with the cooperation of the Texas]
Department of [on] Aging and Disability Services and area agencies
on aging[,] shall develop and implement a coordinated plan to
promote PACE program sites operating under this section. The
department shall adopt policies and procedures, including
operating guidelines, to ensure that caseworkers and any other
appropriate department staff discuss the benefits of participating
in the PACE program with long-term care clients.
(f) The department shall consider the PACE program as a
community-based service option under any "Money Follows the Person"
demonstration project or other initiative that is designed to
eliminate barriers or mechanisms that prevent or restrict the
flexible use of funds under the medical assistance program to
enable a recipient to receive long-term services or supports in a
setting of the recipient's choice.
(g) A PACE program site may coordinate with entities that
are eligible to obtain discount prescription drug prices under
Section 340B, Public Health Service Act (42 U.S.C. Section 256b),
as necessary to enable the PACE program site to obtain those
discounts.
(h) The Health and Human Services Commission shall adopt a
reimbursement methodology for the payment of the providers of
services under the PACE program for purposes of encouraging a
natural increase in the number of PACE program sites throughout the
state.
SECTION 2. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0531 to read as follows:
Sec. 32.0531. PACE PROGRAM TEAM. (a) The Department of
Aging and Disability Services shall establish a PACE program team
composed of experienced personnel. The team is responsible for:
(1) increasing public attention and awareness of the
availability of PACE program sites;
(2) increasing the number of PACE program sites
operating in this state; and
(3) serving as a liaison with the state and federal
agencies responsible for administering the PACE program,
participants in the program, and PACE program sites.
(b) The PACE program team shall conduct a study to evaluate
the feasibility of implementing a statewide standard reimbursement
rate for all providers of services under the PACE program. Not
later than September 1, 2012, the PACE program team shall submit to
the Health and Human Services Commission a written report
containing the findings of the study conducted under this
subsection and the team's recommendations. This subsection expires
September 2, 2012.
SECTION 3. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 4. This Act takes effect September 1, 2011.