88R3380 KKR-D
By: Rose H.B. No. 1481
A BILL TO BE ENTITLED
AN ACT
relating to sickle cell disease health care improvement and the
sickle cell task force.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.0091 to read as follows:
Sec. 533.0091. SICKLE CELL DISEASE TREATMENT; HEALTH HOMES.
(a) In this section, "health home" means a primary care provider
or, if appropriate, a specialty care provider, incorporating into
patient care several features, including comprehensive care
coordination, family-centered care, and data management, that are
focused on improving outcome-based quality of care and increasing
patient and provider satisfaction.
(b) The commission shall:
(1) in collaboration with the sickle cell task force
established under Chapter 52, Health and Safety Code:
(A) ensure that health care services provided
under a managed care plan to recipients diagnosed with sickle cell
disease align with national clinical practice guidelines and
protocols for sickle cell disease treatment;
(B) consider using sickle cell clinical
evaluation and treatment guidelines, including those recommended
by the American Society of Hematology or the Children's Hospital of
Philadelphia; and
(C) increase sickle cell disease education for
Medicaid providers, including emergency room providers; and
(2) use the commission's Texas Healthcare Learning
Collaborative to identify opportunities for improving health
outcomes of recipients diagnosed with sickle cell disease by:
(A) reducing hospital admissions and
readmissions; and
(B) connecting those recipients to a sickle cell
disease health home or sickle cell disease expert.
(c) The commission shall establish one or more health homes
in this state for recipients diagnosed with sickle cell disease to:
(1) reduce barriers preventing recipients diagnosed
with sickle cell disease from receiving necessary health care;
(2) prevent unnecessary hospitalizations and
vaso-occlusive crises;
(3) avoid duplication of services; and
(4) reduce costs associated with sickle cell disease
treatment.
(d) A health home established under this section must:
(1) provide to a recipient diagnosed with sickle cell
disease:
(A) comprehensive care management;
(B) care coordination;
(C) health promotion;
(D) comprehensive transitional and follow-up
care;
(E) patient and family support; and
(F) referral to community and social support
services; and
(2) use the existing Medicaid managed care delivery
system in a manner that avoids duplication of services and payment.
SECTION 2. Sections 52.0003 and 52.0007, Health and Safety
Code, are amended to read as follows:
Sec. 52.0003. COMPOSITION OF TASK FORCE. The task force is
composed of the following members appointed by the executive
commissioner:
(1) two members from community-based organizations
with experience addressing the needs of individuals with sickle
cell disease;
(2) two physicians specializing in hematology;
(3) two members of the public, each of whom either has
sickle cell disease or is a parent of a person with sickle cell
disease or trait; [and]
(4) one representative of a health-related
institution;
(5) one representative of the Texas Education Agency;
and
(6) one representative of the commission.
Sec. 52.0007. ANNUAL REPORT. (a) Not later than December 1
of each year, the task force shall prepare and submit to the
governor and the legislature an annual written report that
summarizes the task force's work and includes any recommended
actions or policy changes endorsed by the task force.
(b) The task force shall, in collaboration with the
commission, include in the task force's annual report
recommendations for improving sickle cell disease education for
health care providers.
SECTION 3. Subtitle B, Title 2, Health and Safety Code, is
amended by adding Chapter 52A to read as follows:
CHAPTER 52A. SICKLE CELL DISEASE CARE EDUCATION AND TREATMENT
Sec. 52A.001. DEFINITION. In this chapter, "sickle cell
task force" means the sickle cell task force established under
Chapter 52.
Sec. 52A.002. SICKLE CELL DISEASE SURVEILLANCE SYSTEM. (a)
Using grant money awarded by the Centers for Disease Control and
Prevention's Sickle Cell Data Collection Program, the department
shall establish and maintain a voluntary sickle cell disease
surveillance system to determine:
(1) the number of individuals with sickle cell disease
in this state;
(2) the manner in which individuals with sickle cell
disease use health care services; and
(3) health outcomes of individuals with sickle cell
disease.
(b) The sickle cell disease surveillance system must
include:
(1) a de-identified record of individuals diagnosed
with sickle cell disease or sickle cell trait in this state; and
(2) any other de-identified information concerning
cases of sickle cell disease or sickle cell trait that the
department considers necessary and appropriate.
(c) An individual who is diagnosed with sickle cell disease
or sickle cell trait may voluntarily register with the department
for inclusion in the sickle cell disease surveillance system.
(d) After an individual registers with the department under
Subsection (c), a health care facility or health care provider who
treats the individual shall provide to the department, in the form
and manner the department prescribes, data the department considers
necessary and appropriate concerning cases of sickle cell disease.
(e) The executive commissioner by rule shall develop
guidelines to:
(1) obtain information from health care facilities
regarding cases of sickle cell disease;
(2) protect the confidentiality of individuals
diagnosed with sickle cell disease in accordance with Section
159.002, Occupations Code; and
(3) ensure the sickle cell disease surveillance system
is developed in a manner consistent with:
(A) the Health Insurance Portability and
Accountability Act of 1996 (Pub. L. No. 104-191);
(B) regulations adopted under that Act; and
(C) other applicable laws and regulations
governing disclosure of health information.
(f) Information obtained under this section is confidential
and privileged and:
(1) is not subject to disclosure under Chapter 552,
Government Code;
(2) is not subject to subpoena or discovery or
otherwise compelled to be produced in any administrative, civil,
criminal, or other proceeding; and
(3) may not be introduced into evidence in any
administrative, civil, criminal, or other proceeding.
(g) The department may compile and publish statistical and
other studies derived from de-identified data obtained under this
chapter.
(h) The executive commissioner shall adopt rules necessary
to implement this section.
Sec. 52A.003. TEXAS HEALTH SERVICE AUTHORITY EMERGENCY
DEPARTMENT ENCOUNTER NOTIFICATIONS SYSTEM. The Texas Health
Services Authority established under Chapter 182 shall collect and
analyze clinical data and use the emergency department encounter
notifications system to ensure an individual diagnosed with sickle
cell disease is not incorrectly identified as an individual who
misuses opioid drugs.
Sec. 52A.004. EMERGENCY AND PRIMARY CARE MEDICINE GRADUATE
MEDICAL EDUCATION PROGRAM CURRICULUM. (a) In this section,
"graduate medical education program" and "medical school" have the
meanings assigned by Section 58A.001, Education Code.
(b) A medical school in this state that offers an emergency
medicine, family medicine, or internal medicine residency program
shall include in the curriculum requirements for the program
education focused on sickle cell disease and sickle cell trait. The
medical school may enter into agreements as necessary for the
purposes of this section.
Sec. 52A.005. INFORMATION FOR PUBLIC SCHOOL DISTRICT
PERSONNEL. (a) The Texas Education Agency shall partner with
sickle cell disease community-based organizations to provide
information on sickle cell disease and sickle cell trait to public
school districts and district staff, including school nurses,
teachers, and coaches.
(b) The commission in collaboration with the sickle cell
task force shall explore methods for improving sickle cell disease
education and awareness within the public school system and provide
recommendations to the Texas Education Agency on the improvement
methods.
SECTION 4. (a) Not later than the second anniversary of the
date the Health and Human Services Commission establishes a health
home for Medicaid recipients diagnosed with sickle cell disease in
accordance with Section 533.0091(c), Government Code, as added by
this Act, the commission shall submit to the governor and the
legislature a report on the effects of using a health home for those
recipients, including:
(1) health outcomes of those recipients; and
(2) cost savings to this state associated with sickle
cell disease treatment.
(b) The Health and Human Services Commission may include the
report required under Subsection (a) of this section with the
annual report the sickle cell task force is required to submit under
Section 52.0007, Health and Safety Code, as amended by this Act.
SECTION 5. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall:
(1) in accordance with Section 1945, Social Security
Act (42 U.S.C. Section 1396w-4), seek from the appropriate federal
agency an amendment to the state's Medicaid state plan to implement
Section 533.0091, Government Code, as added by this Act, and the
commission may delay implementing that section until the state plan
amendment is approved;
(2) appoint the new members of the sickle cell task
force as required by Section 52.0003, Health and Safety Code, as
amended by this Act; and
(3) apply for a grant from the Centers for Disease
Control and Prevention's Sickle Cell Data Collection Program to
establish a voluntary sickle cell disease surveillance system under
Section 52A.002, Health and Safety Code, as added by this Act.
SECTION 6. Section 52A.004, Health and Safety Code, as
added by this Act, applies to residents entering an emergency
medicine, family medicine, or internal residency program at a
medical school in this state on or after January 1, 2024.
SECTION 7. This Act takes effect September 1, 2023.