1-1 By: Shapleigh S.B. No. 908 1-2 (In the Senate - Filed February 23, 2001; February 27, 2001, 1-3 read first time and referred to Committee on Health and Human 1-4 Services; April 3, 2001, reported favorably by the following vote: 1-5 Yeas 6, Nays 0; April 3, 2001, sent to printer.) 1-6 A BILL TO BE ENTITLED 1-7 AN ACT 1-8 relating to the establishment of a program of all-inclusive care 1-9 for the elderly (PACE). 1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-11 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, 1-12 is amended by adding Section 32.053 to read as follows: 1-13 Sec. 32.053. PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY 1-14 (PACE). (a) The department, as a part of the medical assistance 1-15 program, shall develop and implement a program of all-inclusive 1-16 care for the elderly (PACE) in accordance with Section 4802 of the 1-17 Balanced Budget Act of 1997 (Pub. L. No. 105-33), as amended. The 1-18 department shall provide medical assistance to a participant in the 1-19 PACE program in the manner and to the extent authorized by federal 1-20 law. 1-21 (b) The department shall adopt rules as necessary to 1-22 implement this section. In adopting rules, the department shall: 1-23 (1) use the Bienvivir Senior Health Services of El 1-24 Paso initiative as a model for the program; and 1-25 (2) ensure that a person is not required to hold a 1-26 certificate of authority as a health maintenance organization under 1-27 the Texas Health Maintenance Organization Act (Chapter 20A, 1-28 Vernon's Texas Insurance Code) to provide services under the PACE 1-29 program. 1-30 (c) The department may not contract with a person to provide 1-31 services under the PACE program unless the person: 1-32 (1) purchases reinsurance in an amount determined by 1-33 the department that is sufficient to ensure the person's continued 1-34 solvency; or 1-35 (2) has the financial resources sufficient to cover 1-36 expenses in the event of the person's insolvency. 1-37 (d) To demonstrate sufficiency of financial resources for 1-38 purposes of Subsection (c)(2), a person may use cash reserves, a 1-39 letter of credit, a guarantee of a company affiliated with the 1-40 person, or a combination of those arrangements. The amount of a 1-41 person's financial arrangement must be at least equal to the sum 1-42 of: 1-43 (1) the total capitation revenue for one month; and 1-44 (2) the average monthly payment of operating expenses. 1-45 (e) The department, with the cooperation of the Texas 1-46 Department on Aging and area agencies on aging, shall develop and 1-47 implement a coordinated plan to promote PACE program sites 1-48 operating under this section. The department shall adopt policies 1-49 and procedures to ensure that caseworkers and any other appropriate 1-50 department staff discuss the benefits of participating in the PACE 1-51 program with long-term care clients. 1-52 SECTION 2. The state agency administering the program of 1-53 all-inclusive care for the elderly (PACE) implemented under Section 1-54 32.053, Human Resources Code, as added by this Act, shall use its 1-55 best efforts to have in operation six PACE program sites for the 1-56 state fiscal year beginning September 1, 2001, 11 PACE program 1-57 sites for the state fiscal year beginning September 1, 2002, and 1-58 16 PACE program sites for the state fiscal year beginning September 1-59 1, 2003. 1-60 SECTION 3. (a) In this section, "PACE program" means a 1-61 program of all-inclusive care for the elderly (PACE) established in 1-62 accordance with Section 4802 of the Balanced Budget Act of 1997 1-63 (Pub. L. No. 105-33), as amended. 1-64 (b) If before June 1, 2004, the state does not receive 2-1 federal approval for the operation of all PACE program sites for 2-2 which the state has applied solely because the federal limit on the 2-3 number of new PACE program sites allowed nationwide per year has 2-4 been attained, the Health and Human Services Commission and Texas 2-5 Department of Human Services, not later than September 1, 2004, 2-6 shall examine federal laws and regulations regarding PACE programs 2-7 and identify changes to law that would result in an increased 2-8 number of PACE programs in this state. 2-9 (c) Not later than December 1, 2004, the commissioner of 2-10 health and human services shall submit to the legislature a written 2-11 report concerning the results of the examination conducted under 2-12 Subsection (b) of this section. The report must include any 2-13 recommendations for memorializing the Congress of the United States 2-14 to request changes to federal laws or regulations. 2-15 SECTION 4. As soon as practicable after the effective date 2-16 of this Act, the Health and Human Services Commission shall submit 2-17 an amendment to the state's Medicaid plan authorizing the state to 2-18 implement the program of all-inclusive care for the elderly (PACE) 2-19 established under Section 32.053, Human Resources Code, as added by 2-20 this Act. The commission is not required to submit an additional 2-21 amendment to the state's Medicaid plan each time the state agency 2-22 administering the PACE program selects and enters into a proposed 2-23 agreement with a provider to deliver services under the program. 2-24 SECTION 5. If before implementing any provision of this Act, 2-25 a state agency determines that a waiver or authorization from a 2-26 federal agency is necessary for implementation, the state agency 2-27 shall request the waiver or authorization and may delay 2-28 implementing that provision until the waiver or authorization is 2-29 granted. 2-30 SECTION 6. This Act takes effect September 1, 2001. 2-31 * * * * *