Today's Law As Amended

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AB-523 Program of All-Inclusive Care for the Elderly.(2021-2022)

As Amends the Law Today


 Section 14593.3 is added to the Welfare and Institutions Code, to read:

 (a) The department shall make permanent the following changes in the California Program of All-Inclusive Care for the Elderly (PACE) program the department instituted, on or before January 1, 2021, in response to the state of emergency caused by the 2019 novel coronavirus (COVID-19) by means of all-facility letters, or other similar instructions, which were taken without regulatory action, in the areas described under paragraphs (1) to (5), inclusive:
(1) (A) Telehealth.
(B) A PACE organization may use telehealth, as defined in Section 2290.5 of the Business and Professions Code, to conduct assessments for eligibility for enrollment in the PACE program, or for service modifications, subject to the federal waiver process.
(2) (A) PACE enrollment agreements.
(B) A PACE organization shall be approved to collect and document a verbal agreement of enrollment in lieu of the participant signature normally required to complete the enrollment agreement for the PACE program. A PACE organization shall document the conversation of the verbal agreement and shall obtain a written signature within 14 days of submission of the enrollment agreement.
(3) (A) Adult Day Health Care (ADHC) services provided in the home.
(B) A PACE organization that exclusively serves PACE participants shall not be required to provide all nursing services, as defined in Section 14550.6, at the center. The PACE interdisciplinary team shall have flexibility to determine how to provide those nursing services to participants. Services may be provided via telehealth or other remote methods, including, but not limited to, check-in calls, health screening calls, and video conferencing, taking into account the participant’s medical, physical, emotional, and social needs.
(4) (A) Marketing.
(B) A PACE organization shall have the flexibility to use a broker for marketing purposes as provided by the federal regulations on PACE. A PACE organization may use individuals and entities to market on their behalf, if the individuals or entities have been appropriately trained on PACE program requirements, and, specifically, participant rights, and requirements on participant enrollment and disenrollment.
(5) (A) Discharge planning.
(B) If a discharge planner at a PACE referral source, including, but not limited to, a hospital, emergency room, nursing home, or health plan, determines that a PACE plan would be an appropriate program to facilitate the patient’s discharge and serve the patient’s needs in their home or community, the discharge planner may ask the patient or the patient’s representative if they would prefer to be contacted by a PACE organization. If the patient affirmatively answers, then all of the following apply:
(i) The discharge planner shall document in the patient’s record that the patient or authorized representative consented to be contacted by a PACE organization.
(ii) The discharge planner may inform the PACE organization that the patient consented to being contacted by a PACE organization, and may provide information on how the patient or representative stated they wish to be contacted.
(iii) The PACE organization may directly contact the patient or representative in the manner chosen by the patient or representative. The PACE organization may make one attempt to contact the patient or their representative by various means, including a phone call, email, or mail. If the individual or their representative indicates that the patient is uninterested in the PACE program or does not respond, the PACE organization shall not make further direct contact.
(b) The department shall work with the federal Centers for Medicare and Medicaid Services to determine how to extend PACE program flexibilities approved during the COVID-19 emergency.