Texas 2011 - 82nd Regular

Texas Senate Bill SB1878 Compare Versions

The same version is selected twice. Please select two different versions to compare.

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	By: Deuell, Rodriguez, Uresti S.B. No. 1878
2	2	(Zerwas)
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the program of all-inclusive care for the elderly.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 32.053, Human Resources Code, is amended
10	10	by amending Subsections (a), (b), and (e) and adding Subsections
11	11	(f), (g), and (h) to read as follows:
12	12	(a) The department, as an integral [a] part of the medical
13	13	assistance program, shall develop and implement a program of
14	14	all-inclusive care for the elderly (PACE) in accordance with
15	15	Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No.
16	16	105-33), as amended. The department shall provide medical
17	17	assistance to a participant in the PACE program in the manner and to
18	18	the extent authorized by federal law.
19	19	(b) The executive commissioner of the Health and Human
20	20	Services Commission [department] shall adopt rules as necessary to
21	21	implement this section. In adopting rules, the executive
22	22	commissioner [department] shall:
23	23	(1) use the Bienvivir Senior Health Services of El
24	24	Paso initiative as a model for the program; [and]
25	25	(2) ensure that a person is not required to hold a
26	26	certificate of authority as a health maintenance organization under
27	27	Chapter 843, Insurance Code, [the Texas Health Maintenance
28	28	Organization Act (Chapter 20A, Vernon's Texas Insurance Code)] to
29	29	provide services under the PACE program;
30	30	(3) ensure that participation in the PACE program is
31	31	available as an alternative to enrollment in a Medicaid managed
32	32	care plan under Chapter 533, Government Code, for eligible
33	33	recipients, including recipients eligible for assistance under
34	34	both the medical assistance and Medicare programs;
35	35	(4) ensure that managed care organizations that
36	36	contract under Chapter 533, Government Code, consider the
37	37	availability of the PACE program when considering whether to refer
38	38	a recipient to a nursing home or other long-term care facility; and
39	39	(5) establish protocols for the referral of eligible
40	40	persons to the PACE program.
41	41	(e) The [department, with the cooperation of the Texas]
42	42	Department of [on] Aging and Disability Services and area agencies
43	43	on aging[,] shall develop and implement a coordinated plan to
44	44	promote PACE program sites operating under this section. The
45	45	department shall adopt policies and procedures, including
46	46	operating guidelines, to ensure that caseworkers and any other
47	47	appropriate department staff discuss the benefits of participating
48	48	in the PACE program with long-term care clients.
49	49	(f) The department shall consider the PACE program as a
50	50	community-based service option under any "Money Follows the Person"
51	51	demonstration project or other initiative that is designed to
52	52	eliminate barriers or mechanisms that prevent or restrict the
53	53	flexible use of funds under the medical assistance program to
54	54	enable a recipient to receive long-term services or supports in a
55	55	setting of the recipient's choice.
56	56	(g) A PACE program site may coordinate with entities that
57	57	are eligible to obtain discount prescription drug prices under
58	58	Section 340B, Public Health Service Act (42 U.S.C. Section 256b),
59	59	as necessary to enable the PACE program site to obtain those
60	60	discounts.
61	61	(h) The Health and Human Services Commission shall adopt a
62	62	reimbursement methodology for the payment of the providers of
63	63	services under the PACE program for purposes of encouraging a
64	64	natural increase in the number of PACE program sites throughout the
65	65	state.
66	66	SECTION 2. Subchapter B, Chapter 32, Human Resources Code,
67	67	is amended by adding Section 32.0531 to read as follows:
68	68	Sec. 32.0531. PACE PROGRAM TEAM. (a) The Department of
69	69	Aging and Disability Services shall establish a PACE program team
70	70	composed of experienced personnel. The team is responsible for:
71	71	(1) increasing public attention and awareness of the
72	72	availability of PACE program sites;
73	73	(2) increasing the number of PACE program sites
74	74	operating in this state; and
75	75	(3) serving as a liaison with the state and federal
76	76	agencies responsible for administering the PACE program,
77	77	participants in the program, and PACE program sites.
78	78	(b) The PACE program team shall conduct a study to evaluate
79	79	the feasibility of implementing a statewide standard reimbursement
80	80	rate for all providers of services under the PACE program. Not
81	81	later than September 1, 2012, the PACE program team shall submit to
82	82	the Health and Human Services Commission a written report
83	83	containing the findings of the study conducted under this
84	84	subsection and the team's recommendations. This subsection expires
85	85	September 2, 2012.
86	86	SECTION 3. If before implementing any provision of this Act
87	87	a state agency determines that a waiver or authorization from a
88	88	federal agency is necessary for implementation of that provision,
89	89	the agency affected by the provision shall request the waiver or
90	90	authorization and may delay implementing that provision until the
91	91	waiver or authorization is granted.
92	92	SECTION 4. This Act takes effect September 1, 2011.