82R2729 SJM-F
By: Zerwas H.B. No. 2244
A BILL TO BE ENTITLED
AN ACT
relating to expanding the use of and funding for promotoras,
patient health navigators, and community health workers in this
state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 48, Health and Safety Code, is amended to
read as follows:
CHAPTER 48. [TRAINING AND REGULATION OF] PROMOTORAS, PATIENT HEALTH
NAVIGATORS, AND COMMUNITY HEALTH WORKERS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 48.001. DEFINITIONS. In this chapter:
(1) "Advisory committee" means the Promotora Program
Development Advisory Committee.
(2) "Commission" means the Health and Human Services
Commission.
(3) "Compensation" includes receiving payment or
receiving reimbursement for expenses.
(4) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(5) [(2)] "Promotora," "patient health navigator," or
"community health worker" means a person who, with or without
compensation, provides a liaison between health care providers and
patients through activities that may include activities such as
assisting in case conferences, providing patient education, making
referrals to health and social services, conducting needs
assessments, distributing surveys to identify barriers to health
care delivery, making home visits, and providing bilingual language
services.
SUBCHAPTER B. TRAINING AND REGULATION OF PROMOTORAS, PATIENT
HEALTH NAVIGATORS, AND COMMUNITY HEALTH WORKERS
Sec. 48.051 [48.002]. PROMOTORA, PATIENT HEALTH NAVIGATOR,
AND COMMUNITY HEALTH WORKER TRAINING PROGRAM. (a) The commission
[department] shall establish and operate a program designed to
train and educate persons who act as promotoras, patient health
navigators, or community health workers. In establishing the
training program, the commission [department], to the extent
possible, shall consider the report and any findings of the
advisory committee and implement any applicable recommendations of
the advisory committee [Promotora Program Development Committee].
(b) Participation in a training and education program
established under this section is voluntary for a promotora,
patient health navigator, or community health worker who provides
services without receiving any compensation and mandatory for a
promotora, patient health navigator, or community health worker who
provides services for compensation. The executive commissioner
[board] may adopt rules to exempt a promotora, patient health
navigator, or community health worker from mandatory training who
has served for three or more years or who has 1,000 or more hours of
experience.
Sec. 48.052 [48.003]. CERTIFICATION PROGRAM FOR
PROMOTORAS, PATIENT HEALTH NAVIGATORS, AND COMMUNITY HEALTH
WORKERS. (a) The commission [department] shall establish and
operate a certification program for persons who act as promotoras,
patient health navigators, or community health workers. In
establishing the program, the executive commissioner [board] shall
adopt rules that provide minimum standards and guidelines,
including participation in the training and education program under
Section 48.051 [48.002], for issuance of a certificate to a person
under this section. In adopting the minimum standards and
guidelines, the executive commissioner [board] shall consider the
report and any findings of the advisory committee and adopt any
applicable recommendations of the advisory committee [Promotora
Program Development Committee].
(b) Receipt of a certificate issued under this section may
not be a requirement for a person to act as a promotora, patient
health navigator, or community health worker without receiving any
compensation and is a requirement for a person to act as a
promotora, patient health navigator, or community health worker for
compensation.
(c) The commission [Health and Human Services Commission]
shall require health and human services agencies to use certified
promotoras to the extent possible in health outreach and education
programs for recipients of medical assistance under Chapter 32,
Human Resources Code.
Sec. 48.053. RULES. The executive commissioner shall adopt
rules for the administration of this subchapter.
SUBCHAPTER C. MAXIMIZING BENEFITS FROM EMPLOYMENT OF
PROMOTORAS, PATIENT HEALTH NAVIGATORS, AND COMMUNITY HEALTH
WORKERS
Sec. 48.101. PROMOTORA PROGRAM DEVELOPMENT ADVISORY
COMMITTEE. (a) The commission shall establish a statewide
Promotora Program Development Advisory Committee composed of
representatives from relevant entities and state agencies
appointed by the executive commissioner. The executive
commissioner shall appoint a member of the advisory committee as
presiding officer of the advisory committee.
(b) The advisory committee shall assist the commission in:
(1) developing the model plan described by Section
48.102;
(2) interpreting, including performing a cost-benefit
analysis, the results of studies and other information related to
the employment and funding of promotoras, patient health
navigators, and community health workers;
(3) developing recommendations for a sustainable
program for promotoras, patient health navigators, and community
health workers consistent with the purposes of this subchapter; and
(4) preparing the report required by Section 48.103.
(c) Chapter 2110, Government Code, applies to the advisory
committee.
Sec. 48.102. MODEL PLAN. The commission shall create and
implement a model plan to:
(1) maximize the employment of and access to
promotoras, patient health navigators, and community health
workers where practicable; and
(2) expand funding and reimbursement for services
provided by promotoras, patient health navigators, and community
health workers.
Sec. 48.103. COMMISSION STUDY. (a) The commission shall:
(1) study the desirability and feasibility of
employing promotoras, patient health navigators, and community
health workers to provide publicly and privately funded health
services in this state; and
(2) explore methods of funding and reimbursing
promotoras, patient health navigators, and community health
workers for the provision of health care services.
(b) In conducting the study required by Subsection (a), the
commission shall consult:
(1) relevant national organizations engaged in the
development of community health worker policy;
(2) the advisory committee; and
(3) other individuals or organizations the commission
considers necessary to prepare and implement the model plan under
Section 48.102.
(c) The commission shall use the findings of the study
required by Subsection (a) in creating and implementing the model
plan under Section 48.102.
(d) On or before December 1, 2012, the commission shall
submit to the legislature a report regarding the impact of the
implementation of the model plan described by Section 48.102 on:
(1) the cost of avoidable health care expenses in this
state;
(2) the efficiency and quality of health care services
provided in this state; and
(3) the access of individuals in this state to health
care services.
(e) This section expires December 31, 2012.
SECTION 2. The heading to Subtitle B, Title 2, Health and
Safety Code, is amended to read as follows:
SUBTITLE B. [TEXAS DEPARTMENT OF] HEALTH PROGRAMS
SECTION 3. Not later than December 31, 2011, the Health and
Human Services Commission shall:
(1) establish the Promotora Program Development
Advisory Committee as required by Section 48.101, Health and Safety
Code, as added by this Act;
(2) adopt the rules required by Section 48.053, Health
and Safety Code, as added by this Act; and
(3) implement the model plan required by Section
48.102, Health and Safety Code, as added by this Act.
SECTION 4. (a) On September 1, 2011, the promotora, patient
health navigator, and community health worker training program
described by Section 48.051, Health and Safety Code, as added by
this Act, and the certification program for promotoras, patient
health navigators, and community health workers described by
Section 48.052, Health and Safety Code, as added by this Act, are
transferred from the Department of State Health Services to the
Health and Human Services Commission.
(b) The rules of the promotora, patient health navigator,
and community health worker training program and certification
program for promotoras, patient health navigators, and community
health workers are continued in effect until superseded by rules
adopted by the executive commissioner of the Health and Human
Services Commission.
SECTION 5. 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 6. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2011.