H.B. No. 3550
AN ACT
relating to standards for and services provided by prescribed
pediatric extended care centers, including Medicaid reimbursement
for those services.
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 and 248A.105 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 to determine:
(A) in coordination with a minor client's parent,
guardian, or other legally authorized representative, the schedule
of transportation services; and
(B) in coordination with the client's
prescribing physician, the necessary type of provider who must be
present during transportation;
(2) shall permit a minor client's parent, guardian, or
other legally authorized representative to decline a center's
transportation services entirely or only on a specific date; and
(3) 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; or
(B) consider transportation services as nursing
services included in a client's plan of care.
Sec. 248A.105. 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 legally
authorized representative of a minor client to make decisions
regarding the treatment provided to the child.
(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 to a client
by a center must be a [one-to-one] replacement of private duty
nursing or other skilled nursing services provided in a setting
other than a center unless additional nursing services are
medically necessary.
(b) A center may provide nursing services in a group
setting, consistent with appropriate staffing ratios as the
executive commissioner determines.
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. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0287 to read as follows:
Sec. 32.0287. PRESCRIBED PEDIATRIC EXTENDED CARE CENTER
REIMBURSEMENT. (a) In this section, "center" means a prescribed
pediatric extended care center licensed under Chapter 248A, Health
and Safety Code.
(b) In adopting rules governing the reimbursement of a
center for services provided under the medical assistance program,
the executive commissioner shall clearly identify the
documentation a center must obtain and maintain to be eligible for
reimbursement. The rules may not:
(1) authorize a center to combine documentation for
transportation with documentation for other services provided by
the center; or
(2) condition reimbursement of non-transportation
services on:
(A) a recipient's decision to use transportation
services on a specific date or on an ongoing basis; or
(B) a center's obtaining and maintaining
transportation documentation.
SECTION 6. 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 7. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 8. This Act takes effect September 1, 2023.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 3550 was passed by the House on April
28, 2023, by the following vote: Yeas 109, Nays 33, 2 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 3550 on May 26, 2023, by the following vote: Yeas 113, Nays 29,
1 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 3550 was passed by the Senate, with
amendments, on May 24, 2023, by the following vote: Yeas 25, Nays
5.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor