By:  Delisi                                                       H.B. No. 3483



A BILL TO BE ENTITLED

AN ACT

relating to certain programs operated under the medical assistance 
program. 
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 32, Human Resources Code, 
is amended by adding Section 32.071 to read as follows:
	Sec. 32.071.  PROGRAM OF ALL-INCLUSIVE CARE FOR CHILDREN 
(PACC).  (a)  The department, as a part of the medical assistance 
program, shall develop and implement a program of all-inclusive 
care for children (PACC) 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 
PACC program in the manner and to the extent authorized by federal 
law.
	(b)  The department shall adopt rules as necessary to 
implement this section.  In adopting rules, the department shall:
		(1)  use the Medically Fragile Children's Program of 
South Carolina as a model for the pilot program,
		(2)  identify medically fragile children within the 
foster care system of the Texas Department of Protective and 
Regulatory Services San Antonio and Austin regions for the pilot 
program; and
		(3)  ensure that a person is not required to hold a 
certificate of authority as a health maintenance organization under 
the Texas Health Maintenance Organization Act (Chapter 20A, 
Vernon's Insurance Code) to provide services under the program of 
all-inclusive care for children (PACC).
	(c)  The department may not contract with a person to provide 
services under the program for all-inclusive care of children 
(PACC) unless the person:
		(1)  purchases reinsurance in an amount determined by 
the department that is sufficient to ensure the person's continued 
solvency; or
		(2)  has the financial resources sufficient to cover 
expenses in the event of the person's insolvency.
	(d)  To demonstrate sufficiency of financial resources for 
purposes of Subsection (c) (2), a person may use cash reserves, a 
letter of credit, a guarantee of a company affiliated with the 
person, or a combination of those arrangements.  The amount of a 
person's financial arrangement must be at least equal to the sum of:
		(1)  the total capitation revenue for one month; and                   
		(2)  the average monthly payment of operating expenses.                
	(e)  The department shall develop and implement a 
coordinated plan to promote the program of all-inclusive care for 
children (PACC) program sites operating under this section.  The 
department shall adopt policies and procedures to ensure that 
caseworkers and any other appropriate department staff discuss the 
benefits of participating in the new program of all-inclusive care 
for children (PACC) with long-term care clients.
	SECTION 2.  The state agency administering the program of 
all-inclusive care for children (PACC) implemented under Section 
32.055, Human Resources Code, as added by this Act, shall have in 
operation one program of all-inclusive care for children (PACC) 
site for the state fiscal year beginning September 1, 2004.
	SECTION 3.  Subchapter B, Chapter 32, Human Resources Code, 
is amended by adding Section 32.073 to read as follows:
	Sec. 32.073.  PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY 
(PACE).  (a)  The commission shall make the PACE program a part of 
the permanent long-term care plan for citizens of the state of Texas 
who are eligible.
	(b)  The commissioner shall promote the PACE program as a 
long-term care initiative.
	(c)  If any funds have lapsed the commission shall direct all 
or part of these funds into the PACE program to promote expansion of 
PACE in Texas.
	SECTION 4.  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, the state agency 
shall request the waiver or authorization and may delay 
implementing that provision until the waiver or authorization is 
granted.
	SECTION 5.  EFFECTIVE DATE.  This Act takes effect 
immediately if it receives a vote of two-thirds of all the members 
elected to each house, as provided by Section 39, Article III, Texas 
Constitution.  If this Act does not receive the vote necessary for 
immediate effect, this Act takes effect September 1, 2003.