Texas 2023 - 88th Regular

Texas House Bill HB1575 Compare Versions

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Version 2 (New)

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1	1	H.B. No. 1575
2	2
3	3
4	4	AN ACT
5	5	relating to improving health outcomes for pregnant women under
6	6	Medicaid and certain other public benefits programs.
7	7	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	8	SECTION 1. It is the intent of the legislature to improve
9	9	health outcomes for pregnant women and their children through the
10	10	case management for children and pregnant women program. In
11	11	recognizing that nonmedical factors impact health outcomes, this
12	12	legislation, in part, authorizes Medicaid to provide case
13	13	management services for nonmedical needs that will improve health
14	14	outcomes for pregnant women and their children.
15	15	SECTION 2. Subchapter B, Chapter 531, Government Code, is
16	16	amended by adding Section 531.024183 to read as follows:
17	17	Sec. 531.024183. STANDARDIZED SCREENING QUESTIONS FOR
18	18	ASSESSING NONMEDICAL HEALTH-RELATED NEEDS OF CERTAIN PREGNANT
19	19	WOMEN; INFORMED CONSENT. (a) In this section, "alternatives to
20	20	abortion program" means the program established by the commission
21	21	to enhance and increase resources that promote childbirth for women
22	22	facing unplanned pregnancy, or a successor program.
23	23	(b) The commission shall adopt standardized screening
24	24	questions designed to screen for, identify, and aggregate data
25	25	regarding the nonmedical health-related needs of pregnant women
26	26	eligible for benefits under a public benefits program administered
27	27	by the commission or another health and human services agency,
28	28	including:
29	29	(1) Medicaid; and
30	30	(2) the alternatives to abortion program.
31	31	(c) Subject to Subsection (d), the standardized screening
32	32	questions must be used by Medicaid managed care organizations and
33	33	providers participating in the alternatives to abortion program.
34	34	(d) A managed care organization or provider participating
35	35	in a public benefits program described by Subsection (b), including
36	36	the alternatives to abortion program, may not perform a screening
37	37	of a pregnant woman using the standardized screening questions
38	38	required by this section unless the organization or provider:
39	39	(1) informs the woman:
40	40	(A) about the type of data that will be collected
41	41	during the screening and the purposes for which the data will be
42	42	used; and
43	43	(B) that the collected data will become part of
44	44	the woman's medical record or service plan; and
45	45	(2) obtains the woman's informed consent to perform
46	46	the screening.
47	47	(e) A managed care organization or provider participating
48	48	in a public benefits program described by Subsection (b), including
49	49	the alternatives to abortion program, must provide to the
50	50	commission, in the form and manner prescribed by the commission,
51	51	data the organization or provider collects using the standardized
52	52	screening questions required by this section.
53	53	(f) Not later than December 1 of each even-numbered year,
54	54	the commission shall prepare and submit to the legislature a report
55	55	that, using de-identified information, summarizes the data
56	56	collected and provided to the commission under Subsection (e)
57	57	during the previous biennium. In accordance with Section 531.014,
58	58	the commission may consolidate the report required under this
59	59	subsection with any other report to the legislature required under
60	60	this chapter or another law that relates to the same subject matter.
61	61	SECTION 3. Chapter 531, Government Code, is amended by
62	62	adding Subchapter Q to read as follows:
63	63	SUBCHAPTER Q. CASE MANAGEMENT SERVICES FOR CERTAIN PREGNANT WOMEN
64	64	Sec. 531.651. DEFINITIONS. In this subchapter:
65	65	(1) "Case management for children and pregnant women
66	66	program" means the "children and pregnant women program," as
67	67	defined by Section 533.002555.
68	68	(2) "Nonmedical health-related needs screening" means
69	69	a screening performed using the standardized screening questions
70	70	required under Section 531.024183.
71	71	(3) "Program services" means case management services
72	72	provided under the case management for children and pregnant women
73	73	program, including assistance provided to a Medicaid managed care
74	74	organization in coordinating the provision of benefits to a
75	75	recipient enrolled in the organization's managed care plan in a
76	76	manner that is consistent with the recipient's plan of care.
77	77	Sec. 531.652. MEDICAID MANAGED CARE ORGANIZATION SERVICE
78	78	COORDINATION BENEFITS NOT AFFECTED. The provision of program
79	79	services to a recipient does not preempt or otherwise affect a
80	80	Medicaid managed care organization's obligation to provide service
81	81	coordination benefits to the recipient.
82	82	Sec. 531.653. CASE MANAGEMENT FOR CHILDREN AND PREGNANT
83	83	WOMEN PROGRAM: PROVIDER QUALIFICATIONS. Program services may be
84	84	provided only by a provider who completes the standardized case
85	85	management training required by the commission under Section
86	86	531.654 and who is:
87	87	(1) an advanced practice nurse who holds a license,
88	88	other than a provisional or temporary license, under Chapter 301,
89	89	Occupations Code;
90	90	(2) a registered nurse who holds a license, other than
91	91	a provisional or temporary license, under Chapter 301, Occupations
92	92	Code, and:
93	93	(A) completed a baccalaureate degree program in
94	94	nursing; or
95	95	(B) completed an associate degree program in
96	96	nursing and has:
97	97	(i) at least two years of cumulative paid
98	98	full-time work experience; or
99	99	(ii) at least two years of cumulative,
100	100	supervised full-time educational internship or practicum
101	101	experience obtained in the last 10 years that included assessing
102	102	the psychosocial and health needs of and making community referrals
103	103	of:
104	104	(a) children who are 21 years of age
105	105	or younger; or
106	106	(b) pregnant women;
107	107	(3) a social worker who holds a license, other than a
108	108	provisional or temporary license, under Chapter 505, Occupations
109	109	Code, appropriate for the individual's practice, including the
110	110	practice of independent social work;
111	111	(4) a community health worker as defined by Section
112	112	48.001, Health and Safety Code, who is certified by the Department
113	113	of State Health Services; or
114	114	(5) a doula who is certified by a recognized national
115	115	certification program, as determined by the commission, unless the
116	116	doula qualifies as a certified community health worker under
117	117	Subdivision (4).
118	118	Sec. 531.654. CASE MANAGEMENT FOR CHILDREN AND PREGNANT
119	119	WOMEN PROGRAM: PROVIDER TRAINING. The commission shall require
120	120	that each provider of program services complete training prescribed
121	121	by the commission. The training must be trauma-informed and include
122	122	instruction on:
123	123	(1) social services provided by this state and local
124	124	governments in this state;
125	125	(2) community assistance programs, including programs
126	126	providing:
127	127	(A) nutrition and housing assistance;
128	128	(B) counseling and parenting services;
129	129	(C) substance use disorder treatment; and
130	130	(D) domestic violence assistance and shelter;
131	131	(3) domestic violence and coercive control dynamics;
132	132	(4) methods for explaining and eliciting an eligible
133	133	recipient's informed consent to receive:
134	134	(A) program services screening; and
135	135	(B) any services that may be offered as a result
136	136	of the screening; and
137	137	(5) procedures for:
138	138	(A) an eligible recipient to:
139	139	(i) decline program services screening; or
140	140	(ii) withdraw consent for offered services;
141	141	and
142	142	(B) ensuring that the recipient is not subject to
143	143	any retaliatory action for declining or discontinuing any
144	144	screenings or services.
145	145	Sec. 531.655. INITIAL MEDICAL AND NONMEDICAL
146	146	HEALTH-RELATED SCREENINGS OF CERTAIN RECIPIENTS. (a) A Medicaid
147	147	managed care organization that provides health care services to a
148	148	pregnant woman under the STAR Medicaid managed care program shall
149	149	conduct an initial health needs screening and nonmedical
150	150	health-related needs screening of each pregnant recipient to
151	151	determine, regardless of whether the recipient is considered to
152	152	have a high-risk pregnancy, if the recipient:
153	153	(1) is eligible for service coordination benefits to
154	154	be provided by the managed care organization; or
155	155	(2) should be referred for program services.
156	156	(b) Service coordination benefits described by Subsection
157	157	(a) must include identifying and coordinating the provision of
158	158	non-covered services, community supports, and other resources the
159	159	Medicaid managed care organization determines will improve the
160	160	recipient's health outcomes.
161	161	(c) A Medicaid managed care organization must use the
162	162	results of the screenings conducted under Subsection (a) to
163	163	determine if a recipient requires a more comprehensive assessment
164	164	for purposes of determining whether the recipient is eligible for
165	165	service coordination benefits or program services.
166	166	Sec. 531.656. SCREENING AND PROGRAM SERVICES OPTIONAL. A
167	167	Medicaid managed care organization providing screenings under
168	168	Section 531.655 must inform each pregnant woman who is referred for
169	169	program services or for whom screening is conducted under that
170	170	section that:
171	171	(1) the woman has a right to decline the screening or
172	172	services or choose to discontinue the screening or services at any
173	173	time; and
174	174	(2) declining or discontinuing the screening or
175	175	services will not result in retaliatory action against the woman in
176	176	the provision of other services.
177	177	SECTION 4. Section 32.024, Human Resources Code, is amended
178	178	by adding Subsections (pp) and (qq) to read as follows:
179	179	(pp) For purposes of enrollment as a provider and
180	180	reimbursement under the medical assistance program, the commission
181	181	shall establish a separate provider type for a community health
182	182	worker who provides case management services under the case
183	183	management for children and pregnant women program under Section
184	184	531.653(4), Government Code.
185	185	(qq) For purposes of enrollment as a provider and
186	186	reimbursement under the medical assistance program, the commission
187	187	shall establish a separate provider type for a doula who:
188	188	(1) is certified by a recognized national doula
189	189	certification program approved by the commission; and
190	190	(2) provides case management services under the case
191	191	management for children and pregnant women program under Section
192	192	531.653(5), Government Code.
193	193	SECTION 5. (a) In this section:
194	194	(1) "Case management for children and pregnant women
195	195	program" has the meaning assigned by Section 531.651, Government
196	196	Code, as added by this Act.
197	197	(2) "Commission" means the Health and Human Services
198	198	Commission.
199	199	(b) Not later than December 1, 2024, the commission shall
200	200	prepare and submit to the legislature a status report on the
201	201	implementation of case management services provided to pregnant
202	202	women under the case management for children and pregnant women
203	203	program during the preceding fiscal year. The report must include
204	204	de-identified information about:
205	205	(1) the nonmedical health-related needs of the women
206	206	receiving case management services;
207	207	(2) the number and types of referrals made of women to
208	208	nonmedical community assistance programs and providers; and
209	209	(3) the birth outcomes for the women.
210	210	SECTION 6. As soon as practicable after the effective date
211	211	of this Act, the Health and Human Services Commission shall:
212	212	(1) develop the standardized screening questions as
213	213	required by Section 531.024183, Government Code, as added by this
214	214	Act; and
215	215	(2) revise the commission's standardized case
216	216	management training for children and pregnant women program
217	217	providers to comply with Section 531.654, Government Code, as added
218	218	by this Act.
219	219	SECTION 7. If before implementing any provision of this Act
220	220	a state agency determines that a waiver or authorization from a
221	221	federal agency is necessary for implementation of that provision,
222	222	the agency affected by the provision shall request the waiver or
223	223	authorization and may delay implementing that provision until the
224	224	waiver or authorization is granted.
225	225	SECTION 8. This Act takes effect September 1, 2023.
226	226	______________________________ ______________________________
227	227	President of the Senate Speaker of the House
228	228	I certify that H.B. No. 1575 was passed by the House on April
229	229	25, 2023, by the following vote: Yeas 140, Nays 3, 1 present, not
230	230	voting; and that the House concurred in Senate amendments to H.B.
231	231	No. 1575 on May 15, 2023, by the following vote: Yeas 131, Nays 12,
232	232	1 present, not voting.
233	233	______________________________
234	234	Chief Clerk of the House
235	235	I certify that H.B. No. 1575 was passed by the Senate, with
236	236	amendments, on May 11, 2023, by the following vote: Yeas 30, Nays
237	237	0.
238	238	______________________________
239	239	Secretary of the Senate
240	240	APPROVED: __________________
241	241	Date
242	242	__________________
243	243	Governor