87R17013 KKR-F
By: Minjarez H.B. No. 3368
Substitute the following for H.B. No. 3368:
By: Klick C.S.H.B. No. 3368
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 (b) and (e) and adding Subsections (b-1)
and (e-1) to read as follows:
(b) The executive commissioner shall adopt rules as
necessary to implement this section. In adopting rules, the
executive commissioner shall:
(1) use the Bienvivir Senior Health Services of El
Paso initiative as a model for the program;
(2) ensure that a person is not required to hold a
certificate of authority as a health maintenance organization under
Chapter 843, 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 the commission's enrollment broker
complies with the requirement under Subsection (b-1) to notify
recipients about the PACE program and refer those recipients, as
appropriate, to corresponding program sites;
(5) ensure that qualified eligible recipients who
choose to participate in the PACE program are allowed to enroll in
the program [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 facility
or other long-term care facility];
(6) [and
[(5)] establish protocols for the referral of eligible
persons to the PACE program; and
(7) ensure that the PACE enrollment census in existing
and future corresponding PACE program sites is allowed to grow
naturally based on need as determined by the enrollment census.
(b-1) The commission's enrollment broker shall:
(1) at the time a Medicaid recipient, including a
recipient enrolled in a managed care plan under Chapter 533,
Government Code, is determined eligible for nursing facility care,
if the recipient resides in a PACE program service area:
(A) notify the recipient that the recipient may:
(i) request an eligibility assessment to
participate in the PACE program; and
(ii) choose to enroll in the PACE program as
an alternative to enrolling in a managed care plan under Chapter
533, Government Code; and
(B) provide with the notification required by
Paragraph (A) educational materials described by Subsection (e-1);
and
(2) on a monthly basis and by electronic means, refer
each recipient described by Subdivision (1) to the PACE program
site in the corresponding service area.
(e) The commission [Department of 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 executive commissioner 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.
(e-1) The commission shall develop educational materials
about the PACE program, including:
(1) the benefits of receiving acute care services and
long-term care services through the program;
(2) contact information for each program service area
site; and
(3) a statement that reads as follows: "YOU ARE
ELIGIBLE TO RECEIVE MEDICAL SERVICES IN OUR HOME THROUGH THE PACE
PROGRAM IN YOUR COMMUNITY. PLEASE CONTACT THE TELEPHONE NUMBER
BELOW: (telephone number)".
SECTION 2. 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 3. This Act takes effect September 1, 2021.