Assigned to HHS                                                                                                                     FOR COMMITTEE

ARIZONA STATE SENATE

Fifty-Fourth Legislature, First Regular Session

FACT SHEET FOR H.B. 2706

ALTCS; licensed nursing assistants

Purpose

            Requires the Arizona Health Care Cost Containment System (AHCCCS) to implement a program that provides skilled home health aide services to AHCCCS members who meet prescribed eligibility requirements.

Background

            The Arizona Long Term Care System (ALTCS) provides long term care services, including institutional care at nursing facilities as well as home and community-based services provided by nurses, personal care attendants or spouses, to financially needy individuals that are at risk for institutionalization. AHCCCS serves as the ALTCS administrator for individuals that are elderly and physically disabled while the Department of Economic Security serves as the ALTCS administrator for individuals that are developmentally disabled. A person’s eligibility for ALTCS services is based on: 1) income and resource limits; and 2) medical and functional requirements.

            Statute requires that ALTCS contractors provide the following services to members who are determined to need institutional services: 1) nursing facility services other than services in an institution for tuberculosis or mental disease; 2) behavioral health services; 3) hospice services;
4) case management services; and 5) health and medical services. Additionally, statute permits the provision of home and community-based services in an ALTCS member's home, alternative residential setting or at another behavioral health alternative residential facility licensed by the Department of Health Services and approved by the Director of AHCCCS (Director). Home health includes the provision of: 1) nursing services, 2) home health aide services; 3) medical supplies, equipment and appliances that are provided on a part-time or intermittent basis; 4) physical therapy; and 5) occupational therapy, speech and audiology. Current statute authorizes the Director to implement a demonstration project to provide home and community-based services to special populations, including people with disabilities who are 18 years of age or younger, are medically fragile, reside at home and would be eligible for supplemental security income for the aged, blind or disabled or the State Supplemental Payment Program, with certain exceptions. The Director is authorized to provide for parental contributions for the care of a child in a demonstration project (A.R.S. § 36-2939).

            There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

1. Requires the Director to implement a program under which skilled home health aide services may be provided to members who have developmental disabilities, who are under 18 years of age and who are eligible to receive continuous skilled nursing or skilled nursing respite care services.

2. Allows the provision of skilled home health aide services by a parent, guardian or family member who is a licensed nursing assistant employed by a Medicare-certified home health agency service provider.

3. Requires the Director to request any necessary approvals from the Centers for Medicare and Medicaid Services to implement prescribed requirements and qualify for federal monies available under Title XIX of the Social Security Act or the Section 1115 waiver.

4. Specifies that a skilled home health aide is a home health service ordered by a physician on the member's plan of care and provided by a licensed nursing assistant under the supervision of a registered nurse.

5. Makes technical and conforming changes.

6. Becomes effective on the general effective date.

House Action

HHS                2/21/19      DP       7-1-0-1

3^rd Read          3/4/19                    59-0-1

Prepared by Senate Research

March 18, 2019

CRS/AG/kja