By: Deuell, Rodriguez	S.B. No. 1878
	(In the Senate - Filed March 16, 2011; March 28, 2011, read
	first time and referred to Committee on Health and Human Services;
	April 26, 2011, reported adversely, with favorable Committee
	Substitute by the following vote:  Yeas 9, Nays 0; April 26, 2011,
	sent to printer.)
	COMMITTEE SUBSTITUTE FOR S.B. No. 1878	By:  Rodriguez

	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 Health and Human Services Commission shall adopt a
	reimbursement methodology for the payment of the providers of
	services under the PACE program 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 providers of services under the PACE program.  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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