87R4872 SCL-F
By: Howard H.B. No. 2333
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of the home nursing visitation for
newborn caregivers competitive grant program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 32, Health and Safety Code, is amended by
adding Subchapter G to read as follows:
SUBCHAPTER G. HOME NURSING VISITATION FOR NEWBORN CAREGIVERS GRANT
PROGRAM
Sec. 32.201. DEFINITIONS. In this subchapter:
(1) "Program" means the home nursing visitation for
newborn caregivers grant program established under this
subchapter.
(2) "Service provider" means an entity that offers
free of charge home nursing visits for newborn caregivers.
Sec. 32.202. ESTABLISHMENT OF PROGRAM; RULES. (a) The
commission shall establish and administer a competitive grant
program under which the commission awards grants to eligible
service providers to provide or expand home nursing visitation
services for newborn caregivers.
(b) The commission shall award grants under the program to
eligible service providers in a manner that ensures the grant
recipients:
(1) operate in multiple communities that are
geographically distributed throughout this state;
(2) have the capacity to offer home nursing visitation
services to all newborn caregivers within a defined service area,
including a birthing hospital service area, a municipality, or a
county; and
(3) commit to continuing ongoing work to ultimately
serve the communities' entire newborn population to have the
maximum possible health impact on that population.
(c) The executive commissioner shall adopt rules as
necessary to implement this subchapter.
Sec. 32.203. SERVICE REQUIREMENTS. Home nursing visitation
services funded by a grant awarded under this subchapter must:
(1) be offered free of charge to all newborn
caregivers, including foster and adoptive families, within the
grant recipient's defined service area;
(2) be voluntary and not impose negative consequences
on a newborn caregiver that chooses not to participate;
(3) be provided by registered nurses in the newborn
caregiver's home whenever possible, using telehealth services when
necessary and feasible;
(4) include an evidence-based assessment of the
physical, social, and emotional factors affecting the health and
safety of the newborn caregiver's family;
(5) include at least one registered nurse visit to the
newborn caregiver not later than six weeks postpartum or six weeks
after the newborn is discharged from a newborn intensive care unit,
whichever is later, with the opportunity for up to three total
registered nurse visits as determined by the nurse's professional
judgment;
(6) provide information and referrals to a newborn
caregiver that are tailored to the caregiver's needs, as identified
by a home nursing visit, and support the caregiver in navigating
needed services;
(7) include a follow-up call to the newborn caregiver
not later than three months after the last home nursing visit to
assess success in referrals and family satisfaction and to close
the case;
(8) strictly adhere to an evidence-based service
delivery model, according to criteria set by the United States
Department of Health and Human Services for an early childhood home
visiting service delivery model, that is selected by the
commission, including any clinical, programmatic, and data
collection requirements of the model;
(9) aim to improve outcomes in one or more of the
following categories:
(A) reduction of child abuse and neglect;
(B) child health;
(C) maternal health;
(D) reduction of family violence;
(E) child development;
(F) family economic self-sufficiency;
(G) completion of maternal follow-up and
well-child visits with health care providers;
(H) appropriate use of a health care facility's
emergency department; and
(I) increase in positive parenting practices;
(10) require that home nursing visits:
(A) are offered in partnership with the newborn
caregiver's attending obstetrician or gynecologist, maternal
health provider, or birthing hospital, if applicable; and
(B) begin not later than the later of six weeks
postpartum or six weeks after a newborn is discharged from a newborn
intensive care unit; and
(11) be provided for a period of at least two years.
Sec. 32.204. APPLICATION REQUIREMENTS. (a) A public or
private entity, including a county, municipality, or other
political subdivision of this state, may apply for a grant under
this subchapter.
(b) To apply for a grant, an applicant must submit a written
application to the commission on a form prescribed by executive
commissioner rule in accordance with this section.
(c) The application form must:
(1) require the applicant to provide:
(A) data on the number of births by hospital
located in the defined service area in which the applicant proposes
to operate; and
(B) a description of existing services available
to newborn caregivers in the community;
(2) describe the processes the commission uses to
monitor and evaluate grant recipients on an ongoing basis under
Section 32.208, including the grant recipient's obligations to:
(A) collect and provide information requested by
the commission; and
(B) adhere to the evidence-based model selected
by the commission;
(3) require the applicant to outline the applicant's
plan to collaborate and strengthen relationships with health care
and social service providers to ensure the applicant's ability to
effectively connect newborn caregivers and the caregivers'
families to other community services when needed; and
(4) describe the applicant's plan for enrolling
newborn caregivers, including how the applicant will partner with
birthing hospitals and local maternal health care and pediatric
health care providers.
Sec. 32.205. GRANT AWARD REQUIREMENTS. In determining
whether to award a grant to an applicant under this subchapter, the
commission shall consider the applicant's demonstrated capacity to
provide home nursing visitation services to newborn caregivers in
the defined service area in which the applicant proposes to provide
services, which may be determined by considering:
(1) the applicant's ability to:
(A) participate in ongoing monitoring and
performance evaluations under Section 32.208, including the
applicant's ability to collect and provide information requested by
the commission;
(B) comply with program standards; and
(C) develop broad-based community support and
leverage philanthropic support to implement or expand home nursing
visitation services for newborn caregivers; and
(2) the applicant's history of developing and
sustaining innovative, high-quality home nursing visitation
services for newborn caregivers that meet the needs of families and
communities.
Sec. 32.206. WRITTEN AGREEMENT WITH GRANT RECIPIENT
REQUIRED. Before awarding a grant under this subchapter, the
commission shall enter into a written agreement with each applicant
to be awarded a grant that requires the grant recipient to repay
this state, in accordance with terms specified in the agreement,
if:
(1) the commission determines the grant recipient has
not complied with the minimum standards and reporting requirements
prescribed by this subchapter or rules adopted under this
subchapter or with any other applicable rules or standards
prescribed by the executive commissioner or the commission; or
(2) the grant recipient fails to use the grant money
for the purposes for which the grant was awarded, in accordance with
Section 32.207.
Sec. 32.207. USE OF GRANT MONEY. Grant money awarded under
this subchapter may be used only to cover costs related to the grant
recipient administering, implementing, or expanding home nursing
visitation services for newborn caregivers, including costs
related to:
(1) administering the home nursing visitation
services;
(2) training and managing registered nurses and other
staff who participate in providing the home nursing visitation
services;
(3) paying the salaries and expenses of registered
nurses and other required staff members who are essential to
delivering the home nursing visitation services;
(4) paying for facilities and equipment for providing
the home nursing visitation services; and
(5) paying for technical assistance to ensure a grant
recipient adheres to the evidence-based model selected by the
commission.
Sec. 32.208. GRANT RECIPIENT MONITORING AND EVALUATION;
ANNUAL REPORT. (a) The commission shall:
(1) adopt performance indicators designed to measure a
grant recipient's performance with respect to the program standards
adopted by executive commissioner rule that align with the
evidence-based model selected by the commission; and
(2) use the performance indicators to continuously
monitor and formally evaluate on an annual basis the performance of
each grant recipient.
(b) Not later than December 1 of each year, the commission
shall prepare and submit a written report to the standing
committees of the legislature with primary jurisdiction over the
commission regarding the performance of each grant recipient during
the preceding state fiscal year with respect to providing program
services and improving outcomes for newborns and their families.
Sec. 32.209. COMPETITIVE GRANT PROGRAM FUNDING. (a) The
commission shall seek and apply for any available federal and state
money, including money available for Medicaid or the Children's
Health Insurance Program (CHIP), to assist in financing the
program.
(b) The commission shall consult, collaborate, and
coordinate with health benefit plan issuers in this state,
including Medicaid managed care organizations, to identify
existing incentives and reimbursement strategies that could expand
the program.
(c) The commission may solicit and accept gifts, grants, and
donations to operate the program.
SECTION 2. (a) As soon as practicable after the effective
date of this Act, the Health and Human Services Commission shall
apply for any available federal money to finance the grant program
established by Subchapter G, Chapter 32, Health and Safety Code, as
added by this Act.
(b) Not later than September 1, 2022, the Health and Human
Services Commission shall establish and implement the grant program
established by Subchapter G, Chapter 32, Health and Safety Code, as
added by this Act.
(c) Not later than September 1, 2022, the executive
commissioner of the Health and Human Services Commission shall
adopt rules necessary to implement Subchapter G, Chapter 32, Health
and Safety Code, as added by this Act.
(d) Not later than December 1, 2022, the Health and Human
Services Commission shall submit a written report to the standing
committees of the legislature with primary jurisdiction over the
commission regarding the implementation and status of the grant
program described by Subchapter G, Chapter 32, Health and Safety
Code, as added by this Act.
(e) Not later than December 1, 2023, the Health and Human
Services Commission shall submit the initial report required by
Section 32.208, Health and Safety Code, as added by this Act.
SECTION 3. This Act takes effect September 1, 2021.