88R16867 MPF-F
By: Rose, Jetton, et al. H.B. No. 3550
Substitute the following for H.B. No. 3550:
By: Frank C.S.H.B. No. 3550
A BILL TO BE ENTITLED
AN ACT
relating to standards for and services provided by prescribed
pediatric extended care centers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 248A.101(b), Health and Safety Code, is
amended to read as follows:
(b) To protect the health and safety of the public and
ensure the health, safety, and comfort of the minors served by a
center, the rules must establish minimum center standards,
including:
(1) standards relating to the issuance, renewal,
denial, suspension, probation, and revocation of a license to
operate a center;
(2) standards relating to the provision of
family-centered basic services that include individualized
medical, developmental, and family training services;
(3) based on the size of the building and the number of
minors served, building construction and renovation standards,
including standards for plumbing, electrical, glass, manufactured
buildings, accessibility for persons with physical disabilities,
and fire protection;
(4) based on the size of the building and the number of
minors served, building maintenance conditions relating to
plumbing, heating, lighting, ventilation, adequate space, fire
protection, and other conditions;
(5) standards relating to the minimum number of and
qualifications required for personnel who provide personal care or
basic services to the minors served;
(6) standards relating to the sanitary conditions
within a center and its surroundings, including water supply,
sewage disposal, food handling, and general hygiene;
(7) standards relating to the programs offered by the
center to promote and maintain the health and development of the
minors served and to meet the training needs of the minors' parents
or legal guardians;
(8) standards relating to physician-prescribed
supportive services;
(9) standards relating to transportation services and
as required by Section 248A.1015; and
(10) standards relating to maintenance of patient
medical records and program records in accordance with other law
and with accepted professional standards and practices.
SECTION 2. Subchapter C, Chapter 248A, Health and Safety
Code, is amended by adding Sections 248A.1015, 248A.105, and
248A.106 to read as follows:
Sec. 248A.1015. TRANSPORTATION STANDARDS. The executive
commissioner by rule shall establish minimum standards for
transportation services as required under Section 248A.101(b)(9).
In adopting rules under this section, the executive commissioner:
(1) shall authorize a center, in coordination with a
client's parent, guardian, or other responsible adult, to determine
the schedule of transportation services and determine by provider
type whether a provider must be present to supervise the client
during transportation; and
(2) may not:
(A) require a plan of care or physician's order
to document a client's need for transportation services to access a
center's services;
(B) require the center to obtain:
(i) the signature of a client's parent,
guardian, or other responsible adult on each occasion the client
boards or deboards the transportation; or
(ii) any confirmation of the exact time the
client boards or deboards the transportation; or
(C) prohibit a client from declining
transportation offered by a center, including declining
transportation entirely or only on a specific date.
Sec. 248A.105. REIMBURSEMENT FOR SERVICES. (a) The
executive commissioner by rule shall establish a reimbursement rate
for services a center provides to clients, including transportation
service to and from the center. The executive commissioner shall
clearly identify the documentation a center must obtain and
maintain to be eligible for reimbursement.
(b) In adopting rules under Subsection (a), the executive
commissioner:
(1) shall establish a reimbursement rate that, when
converted to an hourly rate, is equal to the average hourly unit
rate for private duty nursing provided under the Texas Health Steps
Comprehensive Care Program; and
(2) may not:
(A) authorize a center to combine documentation
for transportation with documentation for other services provided
by the center;
(B) condition reimbursement for transportation
services on:
(i) obtaining the signature of a client's
parent, guardian, or other responsible adult on each occasion the
client boards or deboards the transportation; or
(ii) obtaining any confirmation of the
exact time the client boards or deboards the transportation; or
(C) condition reimbursement of
non-transportation services on:
(i) a client's decision to use
transportation services on a specific date or on an ongoing basis;
or
(ii) a center's obtaining and maintaining
transportation documentation.
Sec. 248A.106. INTERFERENCE WITH RIGHTS TO DETERMINE
TREATMENT. (a) Except as provided by Subsection (b), any rules the
executive commissioner adopts under this subchapter may not
interfere with the authority of a parent, guardian, or other
responsible adult of a minor client to make decisions regarding the
treatment provided to the child, including by:
(1) requiring the center and the parent, guardian, or
other responsible adult of a minor client to adhere to a set
schedule of treatment determined in advance;
(2) conditioning payment to a center on the parent,
guardian, or other responsible adult of a minor client providing an
explanation of any discrepancies between the treatment scheduled
and treatment provided; and
(3) preventing the center and the parent, guardian, or
other responsible adult of a minor client from modifying the
treatment and schedule of treatment consistent with the changing
medical needs of the client.
(b) The executive commissioner, by rule, may limit the
maximum amount of authorized services provided to a client.
SECTION 3. Section 248A.158, Health and Safety Code, is
amended to read as follows:
Sec. 248A.158. RELATION TO NURSING SERVICES. (a) Subject
to Subsection (b), nursing [Nursing] services provided by a center
must be a [one-to-one] replacement of private duty nursing or other
skilled nursing services unless additional nursing services are
medically necessary.
(b) A center may provide nursing services in a group
setting, consistent with appropriate staffing ratios.
SECTION 4. Subchapter D, Chapter 248A, Health and Safety
Code, is amended by adding Section 248A.159 to read as follows:
Sec. 248A.159. ADMISSION FORMS. (a) Before admission to a
center, the center may obtain all required parent or legal guardian
signatures for a patient on one consent document.
(b) The consent document must illustrate the involvement of
the parent or legal guardian in developing and establishing the
care and treatment to be provided to the patient in the center.
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) adopt the rules necessary to implement the changes
in law made by this Act; and
(2) update any relevant procedure manuals, including
the Children's Services Handbook, to conform to the changes in law
made by this Act.
SECTION 6. This Act takes effect September 1, 2023.