HBA-CMT S.B. 908 77(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 908 By: Shapleigh Human Services 5/15/2001 Engrossed BACKGROUND AND PURPOSE The Program for All-Inclusive Care for the Elderly (PACE) is a nationwide, fully-integrated, managed care system that provides an alternative to nursing home care for the elderly. PACE programs are authorized in the federal Balanced Budget Act of 1997 to provide states with cost-effective options under state Medicaid plans. PACE enables the elderly to remain as healthy as possible at home in their communities, and maintain their independence, dignity, and quality of life. Those who are older than 55, medically frail, and eligible for nursing home placement are eligible for the PACE program. Health care provided by the PACE program includes everything from prescription drugs and rehabilitations services to hospitalization. The program also provides the elderly with recreational therapists, home health aides, dieticians, and drivers. PACE programs cost the state less than traditional Medicaid payments for those who are eligible for nursing home placement. Currently, the only PACE program site in Texas is Bienvivir in El Paso. Since 1986, this site has provided comprehensive care for the frail elderly in their community. Senate Bill 908 requires the Texas Department of Human Services to implement and expand the PACE program throughout Texas. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Health and Human Services Commission in SECTION 1 (Section 32.053, Human Resources Code) of this bill. ANALYSIS Senate Bill 908 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to develop and implement, as a part of the medical assistance program, a program of all-inclusive care for the elderly (PACE). The bill requires HHSC to provide medical assistance to a participant in the PACE program in the manner and to the extent authorized by federal law. The bill requires HHSC to adopt rules as necessary to implement the PACE program and in doing so to use the Bienvivir Senior Health Services of El Paso initiative as a model and to ensure that a person is not required to hold a certificate of authority as a health maintenance organization (HMO) under the Texas Health Maintenance Organization Act to provide services under the PACE program. The bill prohibits HHSC from contracting with a person to provide services under the PACE program unless the person purchases reinsurance in an amount sufficient to ensure the person's continued solvency or has the financial resources sufficient to cover expenses in the event of insolvency. The bill sets forth methods by which a person may demonstrate sufficiency of financial resources. The bill requires HHSC, with the cooperation of the Texas Department on Aging and area agencies on aging, to develop and implement a coordinated plan to promote PACE program sites. HHSC is required to adopt policies and procedures to ensure that caseworkers and other appropriate HHSC staff discuss the benefits of participating in the PACE program with long-term care clients. The bill establishes a time-table for implementation of the provisions of the bill. EFFECTIVE DATE September 1, 2001.