81R9880 ALB-D

By: Nichols S.B. No. 2116

A BILL TO BE ENTITLED

AN ACT

relating to a pilot program to provide community-based alternatives under the Medicaid program for certain individuals diagnosed with Alzheimer's disease.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter D, Chapter 161, Human Resources Code, is amended by adding Section 161.083 to read as follows:

Sec. 161.083. ALZHEIMER'S ASSISTED LIVING FACILITY OR RESIDENTIAL CARE PILOT PROGRAM. (a) In this section, "pilot program" means the Alzheimer's Assisted Living Facility or Residential Care pilot program established under this section.

(b) The department shall establish a pilot program to provide community-based alternatives and assisted living and residential care and support services under the Medicaid program to individuals who are diagnosed with Alzheimer's disease.

(c) An individual may be eligible for the pilot program if the individual:

(1) has been diagnosed with Alzheimer's disease;

(2) meets financial eligibility requirements specified by the executive commissioner;

(3) does not meet the medical necessity requirements under the Medicaid program for entry into a nursing facility; and

(4) has a plan of care the costs of which do not exceed the average daily nursing facility payment under the Medicaid program.

(d) The executive commissioner shall adopt rules necessary to implement this section.

(e) Rules adopted under Subsection (d) must permit a residential facility at which pilot program services are offered to operate under the direction of a physician acting on a volunteer basis, provided that a registered nurse is available at the facility at all times.

(f) Not later than December 1, 2014, the department shall submit a report to the legislature regarding the effectiveness of the pilot program, including a cost-benefit analysis that compares the costs of treating an individual through the pilot program to the costs incurred by the state of treating an individual in a nursing facility.

(g) This section expires September 1, 2015.

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, 2009.