Amend CSHB 3859 by adding the following appropriately  
numbered SECTION and renumbering subsequent SECTIONS accordingly:
	SECTION ____.  (a)  Subchapter B, Chapter 531, Government 
Code, is amended by adding Section 531.0525 to read as follows:
	Sec. 531.0525.  PILOT PROJECT TO ESTABLISH COMPREHENSIVE 
SINGLE POINT OF ENTRY FOR LONG-TERM SERVICES AND SUPPORTS.  (a)  In 
this section:
		(1)  "Aging and disability resource center" means a 
center established under the Aging and Disability Resource Center 
grant program jointly sponsored by the federal Administration on 
Aging and the Centers for Medicare and Medicaid Services.
		(2)  "Colocated long-term services and supports staff 
members" means:
			(A)  long-term services and supports staff 
members who are located in the same physical office; or
			(B)  long-term services and supports staff 
members who are not located in the same physical office but who work 
collaboratively through the use of the telephone or other 
technologies.
		(3)  "Department of Aging and Disability Services staff 
members" includes the department's access and intake staff members  
and the department's community care for the aged and disabled staff 
members.
		(4)  "Expedited service authorization" means 
authorization of services within seven calendar days based on a 
screening of applicants and tentative eligibility for receipt of 
services and initiation of those services as soon as possible.
		(5)  "Long-term services and supports" means long-term 
assistance or care provided to older persons and persons with 
physical disabilities through the Medicaid program or other 
programs.  The term includes assistance or care provided through 
the following programs:
			(A)  the primary home care program;                                   
			(B)  the community attendant services program;                        
			(C)  the community-based alternatives program;                        
			(D)  the day activity and health services program;                    
			(E)  the promoting independence program;                              
			(F)  a program funded through the Older Americans 
Act of 1965 (42 U.S.C. Section 3001 et seq.);
			(G)  a community care program funded through Title 
XX of the federal Social Security Act (42 U.S.C. Section 301 et 
seq.);
			(H)  the program of all-inclusive care for the 
elderly (PACE), if the program is available in the area served by 
the pilot project;
			(I)  the in-home and family support program; and                      
			(J)  a nursing facility program.                                      
		(6)  "Long-term services and supports staff" means:                    
			(A)  one or more of the commission's Medicaid 
eligibility determination staff members;
			(B)  one or more Department of Aging and 
Disability Services staff members; and
			(C)  one or more local area agency on aging staff 
members.          
		(7)  "Pilot project site" means a location in an area 
served by the pilot project established under this section where 
colocated long-term services and supports staff members work 
collaboratively to provide information and authorize and initiate 
long-term services and supports.
		(8)  "Tentative eligibility," with respect to receipt 
of services, means a process by which eligibility for services is 
provisionally determined based on a standard screening tool that 
assesses both functional and financial program eligibility for 
receipt of services.
	(b)  Subject to availability of funds, the commission shall 
develop and implement in not more than three geographic areas of 
this state a pilot project to establish a comprehensive single 
point of entry system for long-term services and supports in which 
colocated long-term services and supports staff members work in 
collaboration to provide all necessary services in connection with 
long-term services and supports from the intake process to the 
start of service delivery.  The pilot project must require that, at 
a minimum, the staff members work collaboratively to:
		(1)  inform and educate older persons, persons with 
physical disabilities, and their family members and other 
caregivers about long-term services and supports for which they may 
qualify;
		(2)  screen older persons and persons with physical 
disabilities requesting long-term services and supports;
		(3)  establish tentative eligibility for long-term 
services and supports;
		(4)  support and provide expedited service 
authorization for older persons and persons with physical 
disabilities requesting long-term services and supports for which 
there are no interest lists; and
		(5)  make final determinations of financial 
eligibility for long-term services and supports after a period of 
tentative eligibility for receipt of those services and supports.
	(c)  In developing and implementing the pilot project, the 
commission shall ensure that:
		(1)  at least one pilot project site has only colocated 
long-term services and supports staff members who are located in 
the same physical office;
		(2)  each pilot project site serves as a comprehensive 
single point of entry for older persons and persons with physical 
disabilities to obtain information about long-term services and 
supports for which they may qualify and access long-term services 
and supports in the site's service area;
		(3)  each pilot project site is designed and operated 
in accordance with best practices adopted by the executive 
commissioner after the commission reviews best practices for 
similar initiatives in other states and professional policy-based 
research describing best practices for successful initiatives;
		(4)  the colocated long-term services and supports 
staff members supporting each pilot project site include:
			(A)  one or more full-time commission staff 
members who determine eligibility for the Medicaid program and who:
				(i)  have full access to the Texas 
Integrated Eligibility Redesign System (TIERS);
				(ii)  have previously made Medicaid 
long-term care eligibility determinations; and
				(iii)  are dedicated primarily to making 
eligibility determinations for incoming clients at the site;
			(B)  sufficient Department of Aging and 
Disability Services staff members to carry out the screening and 
expedited service authorization functions at the site;
			(C)  sufficient area agency on aging staff members 
to:              
				(i)  assist with the performance of 
screening functions and service coordination for services funded 
under the Older Americans Act of 1965 (42 U.S.C. Section 3001 et 
seq.), such as meals programs; and
				(ii)  identify other locally funded and 
supported services that will enable older persons and persons with 
physical disabilities to continue to reside in the community to the 
extent reasonable; and
			(D)  any available staff members from local 
service agencies; and   
		(5)  the colocated long-term services and supports 
staff members of a pilot project site:
			(A)  use a standardized screening tool that:                          
				(i)  assesses both functional and financial 
program eligibility; and
				(ii)  provides sufficient information to 
make a tentative eligibility determination for receipt of services;
			(B)  process requests for long-term services and 
supports in person or by telephone or through the Internet;
			(C)  perform all screening and assessment, 
eligibility determination, and service authorization functions 
necessary to promptly initiate appropriate service delivery;
			(D)  closely coordinate with local hospital 
discharge planners and staff members of extended rehabilitation 
units of local hospitals and nursing homes;
			(E)  give first priority to persons who urgently 
need services; and 
			(F)  inform persons about community-based 
services available in the area served by the pilot project.
	(d)  An area in which the pilot project will be implemented 
may consist of a single county or a multicounty region, as 
determined by the commission.  At least one of the areas must have a 
pilot project site located within an aging and disability resource 
center.  If the commission finds that there is no aging and 
disability resource center that is willing or able to accommodate a 
pilot project site on the date the pilot project is to be 
implemented, the pilot project site may be located at a local 
Department of Aging and Disability Services office, an area agency 
on aging office, or another appropriate location.
	(e)  Not later than January 31, 2011, the commission shall 
submit a report concerning the pilot project to the presiding 
officers of the standing committees of the senate and house of 
representatives having primary jurisdiction over health and human 
services.  The report must:
		(1)  be prepared by a person not associated with the 
pilot project or the commission;
		(2)  contain, for each area of this state in which the 
pilot project is being implemented, an evaluation of the operation 
of the pilot project in that area;
		(3)  contain an evaluation of the pilot project's 
benefits for persons who received services;
		(4)  contain a calculation of the costs and cost 
savings that can be attributed to implementation of the pilot 
project;
		(5)  include a recommendation regarding adopting 
improved policies and procedures concerning long-term services and 
supports with statewide applicability, as determined from 
information obtained in operating the pilot project;
		(6)  include a recommendation regarding the 
feasibility of expanding the pilot project to other areas of this 
state or statewide; and
		(7)  contain the perspectives of service providers of 
programs listed in Subsection (a)(5) who are operating in the area 
served by a pilot project site.
	(f)  This section expires September 1, 2013.                            
	(b)  Not later than December 31, 2009, the Health and Human 
Services Commission shall ensure that at least one pilot project 
site is in operation under the pilot project required by Section 
531.0525, Government Code, as added by this section, subject to 
availability of funds for that purpose.