By: Zerwas, et al. (Senate Sponsor - Deuell) H.B. No. 2903
         (In the Senate - Received from the House May 6, 2011;
  May 9, 2011, read first time and referred to Committee on Health
  and Human Services; May 18, 2011, reported adversely, with
  favorable Committee Substitute by the following vote:  Yeas 9,
  Nays 0; May 18, 2011, sent to printer.)
 
  COMMITTEE SUBSTITUTE FOR H.B. No. 2903 By:  Deuell
 
 
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 (a), (b), and (e) and adding Subsections
  (f), (g), and (h) to read as follows:
         (a)  The department, as an integral [a] part of the medical
  assistance program, shall develop and implement a program of
  all-inclusive care for the elderly (PACE) 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 PACE program in the manner and to
  the extent authorized by federal law.
         (b)  The executive commissioner of the Health and Human
  Services Commission [department] shall adopt rules as necessary to
  implement this section. In adopting rules, the executive
  commissioner [department] shall:
               (1)  use the Bienvivir Senior Health Services of El
  Paso initiative as a model for the program; [and]
               (2)  ensure that a person is not required to hold a
  certificate of authority as a health maintenance organization under
  Chapter 843, Insurance Code, [the Texas Health Maintenance
  Organization Act (Chapter 20A, Vernon's Texas 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 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 home or other long-term care facility; and
               (5)  establish protocols for the referral of eligible
  persons to the PACE program.
         (e)  The [department, with the cooperation of the Texas]
  Department of [on] 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
  department 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.
         (f)  The department shall consider the PACE program as a
  community-based service option under any "Money Follows the Person"
  demonstration project or other initiative that is designed to
  eliminate barriers or mechanisms that prevent or restrict the
  flexible use of funds under the medical assistance program to
  enable a recipient to receive long-term services or supports in a
  setting of the recipient's choice.
         (g)  A PACE program site may coordinate with entities that
  are eligible to obtain discount prescription drug prices under
  Section 340B, Public Health Service Act (42 U.S.C. Section 256b),
  as necessary to enable the PACE program site to obtain those
  discounts.
         (h)  The commission shall adopt a standard reimbursement
  methodology for the payment of all PACE organizations for purposes
  of encouraging a natural increase in the number of PACE program
  sites throughout the state.
         SECTION 2.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.0531 to read as follows:
         Sec. 32.0531.  PACE PROGRAM TEAM. (a) The Department of
  Aging and Disability Services shall establish a PACE program team
  composed of experienced personnel. The team is responsible for:
               (1)  increasing public attention and awareness of the
  availability of PACE program sites;
               (2)  increasing the number of PACE program sites
  operating in this state; and
               (3)  serving as a liaison with the state and federal
  agencies responsible for administering the PACE program,
  participants in the program, and PACE program sites.
         (b)  The PACE program team shall conduct a study to evaluate
  the feasibility of implementing a statewide standard reimbursement
  rate for all PACE organizations. Not later than September 1, 2012,
  the PACE program team shall submit to the Health and Human Services
  Commission a written report containing the findings of the study
  conducted under this subsection and the team's recommendations.
  This subsection expires September 2, 2012.
         SECTION 3.  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 4.  This Act takes effect September 1, 2011.
 
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