87R19826 KKR-F
By: Howard, Rose, Guerra 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) "Commissioner" means the commissioner of the
Department of Family and Protective Services.
(2) "Department" means the Department of Family and
Protective Services.
(3) "Program" means the home nursing visitation for
newborn caregivers grant program established under this
subchapter.
(4) "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
department shall establish and administer within the department's
prevention and early intervention services division a competitive
grant program through which the department awards grants to
eligible service providers to provide or expand home nursing
visitation services for newborn caregivers.
(b) The department shall award grants under the program to
eligible service providers in a manner that ensures the grant
recipients:
(1) operate in multiple communities 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 providing ongoing services to ultimately
serve the communities' entire newborn population and provide the
maximum possible health impact on that population.
(c) The 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 may 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,
with the opportunity to receive not more than three registered
nurse visits as determined by the nurse's professional judgment;
(6) provide to a newborn caregiver information and
referrals 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 selected by the department in accordance with
criteria set by the United States Department of Health and Human
Services for an early childhood home visiting service delivery
model, including any clinical, programmatic, and data collection
requirements under the model;
(9) strive 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) increased positive parenting practices;
(10) require the home nursing visits to:
(A) be 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 six weeks postpartum or
six weeks after a newborn is discharged from a newborn intensive
care unit; and
(11) continue 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 department on a form prescribed by commissioner
rule in accordance with this section.
(c) The application form must:
(1) require the applicant to provide:
(A) information 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 department uses to
continually monitor and evaluate grant recipients under Section
32.208, including the grant recipient's obligations to:
(A) collect and provide information requested by
the department; and
(B) adhere to the evidence-based model selected
by the department;
(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 the applicant's partnerships 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
department 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 continued monitoring and
performance evaluations under Section 32.208, including the
applicant's ability to collect and provide information requested by
the department;
(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, 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
department 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 department 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 commissioner or the department; 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
department.
Sec. 32.208. GRANT RECIPIENT MONITORING AND EVALUATION;
ANNUAL REPORT. (a) The department shall:
(1) adopt performance indicators designed to measure a
grant recipient's performance with respect to the program standards
adopted by commissioner rule that align with the evidence-based
model selected by the department; and
(2) use the performance indicators to continuously
monitor and formally evaluate at least annually the performance of
each grant recipient.
(b) Not later than December 1 of each year, the department
shall prepare and submit a written report to the standing
committees of the legislature with primary jurisdiction over the
department 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
department 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 department 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 department 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 Department of Family and Protective Services
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. If federal money is not available for
that purpose and notwithstanding any provision of this Act, the
department shall delay implementation of Subchapter G, Chapter 32,
Health and Safety Code, as added by this Act, until federal money
becomes available.
(b) Not later than September 1, 2022, the Department of
Family and Protective Services 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 commissioner of
the Department of Family and Protective Services 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 Department of
Family and Protective Services shall submit a written report to the
standing committees of the legislature with primary jurisdiction
over the department 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 Department of
Family and Protective Services 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.