ARIZONA HOUSE OF REPRESENTATIVES

Fifty-fifth Legislature

First Regular Session

House: HHS DP 9-0-0-0

HB 2521: long-term care; health aides

Sponsor:  Representative Osborne, LD 13

House Engrossed

Overview

Establishes licensed health aide services as a covered home and community based service under the Arizona Long-Term Care System (ALTCS). Provides application requirements and fees for a licensed health aide.

History

Established under the Arizona Health Care Cost Containment System (AHCCCS), ALTCS provides acute care, behavioral health, long-term care and case management services to individuals who are elderly, physically disabled or developmentally disabled. The system includes the management and delivery of hospitalization, medical care, institutional services and home and community based services to members through AHCCCS, contractors and providers together with federal participation under the Social Security Act. (A.R.S. § 36-2932)

The Arizona Department of Economic Security (DES) must provide, as a program contractor with AHCCCS, home and community based services to members who have a developmental disability and are determined to need institutional services. Home and community based services may be provided in a member's home, at an alternative residential setting or at other behavioral health alternative residential facilities licensed by the Arizona Department of Health Services (DHS) and approved by the Director of AHCCCS (Director). Under current law, home and community based services include the following: 1) home health nursing and aide; 2) skilled home health aide; 3) homemaker; 4) personal care; 5) day care; 6) habilitation; 7) respite care; 8) transportation; and 9) other services or licensed or certified settings approved by the Director. (A.R.S. § 36-2939(B))

Additionally, home and community based services may be provided in a member's home, in an adult foster care home, in an assisted living home or assisted living center or in a level one or level two behavioral health alternative residential facility approved by the Director by program contractors to all members who do not have a developmental disability and are determined to need institutional services. (A.R.S. § 36-2939(C))

Provisions

1.   ☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal NoteDefines licensed health aide as a person who:

a)   Is licensed to provide or assist in providing nursing-related services for ALTCS;

b)   Is the parent, guardian or family member of the ALTCS member receiving services who may provide licensed health aide services only to that member and only consistent with that member's plan of care; or

c)   Has a scope of practice that is the same as a licensed nursing assistant and may also provide medication administration, tracheotomy care and enteral care and therapy and any other tasks approved by the Board in rule. (Sec. 1)

2.   Establishes the following fees for an applicant to become a licensed health aide:

a)   $50 for issuing a license;

b)   $50 for renewing a license; and

c)   For renewing an expired license, $25 for each year it is expired. (Sec. 2)

3.   Requires a person who wishes to practice as a licensed health aide to file a verified application on a form prescribed by the Board and accompanied by fees set in statute. (Sec. 3)

4.   Requires a person applying to be a licensed health aide to submit proof, satisfactory to the Board, that the applicant meets all the following:

a)   Is a parent, guardian or family member of an individual who is under 21 years old and who is eligible to receive continuous skilled nursing or skilled nursing respite care services;

b)   Satisfactorily completed the basic curriculum of and received a valid certificate from a training program approved by the Board that includes medication administration, tracheostomy care, enteral care and therapy for persons under 21 years old and any other tasks approved by the Board; and

c)   Satisfactorily completed a competency examination approved by the Board. (Sec. 3)

5.   Requires ALTCS contractors to provide licensed health aide services as a home and community based service. (Sec. 4)

6.   Specifies that licensed health aide services mean a home health agency service that is ordered by physician on the member's plan of care and provided by a licensed health aide. (Sec. 4)

7.   Specifies that, subject to approval by the Centers for Medicare and Medicaid Services (Centers), the Director must implement a program under which licensed health aide services may be provided to members who are under 21 years old, including members:

a)   With developmental disabilities; and

b)   Who require continuous skilled nursing or skilled nursing respite care services. (Sec. 4)

8.   Stipulates that the licensed health aid services may be provided only by a parent, guardian or family member who is a licensed health aide employed by a Medicare-certified home health agency service provider. (Sec. 4)

9.   Specifies that within 60 days of the rules implementing the application requirements for licensed health aides being approved, the Director must request any necessary approvals from the Centers. (Sec. 4)

10.  Mandates that the reimbursement rate for licensed health aide services must reflect the special skills needed to meet the health care needs of members and must exceed the reimbursement rate for home health aide services. (Sec. 4)

11.  Exempts the Board from administrative rulemaking requirements for one year after the effective date of the bill. (Sec. 5)

12.  Makes technical and conforming changes. (Sec. 1-4)

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16.                    HB 2521

17.  Initials EB  Page 0 House Engrossed

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