88R4150 KKR-D
By: Klick H.B. No. 3807
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of a family health aide program;
requiring an occupational license.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 531, Government Code, is amended by
adding Subchapter T to read as follows:
SUBCHAPTER T. FAMILY HEALTH AIDE PROGRAM
Sec. 531.801. DEFINITIONS. (a) In this subchapter:
(1) "Home and community support services agency" means
a person licensed under Chapter 142, Health and Safety Code.
(2) "Licensed health aide" means a person who is:
(A) the parent, legal guardian, or family member
of a recipient participating in the program;
(B) licensed under the program to assist in
providing private duty nursing services; and
(C) employed by the home and community support
services agency providing services to the recipient.
(3) "Private duty nursing services" means nursing
services provided under the Texas Health Steps comprehensive care
program to a recipient enrolled in the STAR Kids Medicaid managed
care program.
(4) "Program" means the family health aide program
established under this subchapter.
Sec. 531.802. FAMILY HEALTH AIDE PROGRAM. The commission,
in consultation with the Texas Board of Nursing and the STAR Kids
Managed Care Advisory Committee, shall develop and implement a
family health aide program to enable a parent, legal guardian, or
family member of a recipient receiving private duty nursing
services in a home setting to assist in providing those services as
a licensed health aide.
Sec. 531.803. PROGRAM ELIGIBILITY. An individual is
eligible to participate in the program if:
(1) the recipient is:
(A) enrolled in the STAR Kids Medicaid managed
care program; and
(B) eligible to receive private duty nursing
services under the Texas Health Steps comprehensive care program;
(2) the recipient's parent, legal guardian, or family
member, as defined by commission rule, elects to participate in the
program; and
(3) the home and community support services agency
that employs the professional registered nurse providing private
duty nursing services to the recipient agrees to employ the
recipient's parent, legal guardian, or family member.
Sec. 531.804. RECIPIENT SCREENING AND NOTIFICATION. The
commission shall:
(1) add criteria to any screening tool or other
instrument used to conduct an assessment or reassessment of a
recipient under the STAR Kids Medicaid managed care program to
identify recipients who are eligible to participate in the program;
and
(2) notify the parent or legally authorized
representative of the recipient of the potential availability of
the program.
Sec. 531.805. HEALTH AIDE LICENSE REQUIRED. (a) To assist
in providing private duty nursing services to a recipient under the
program, a parent, legal guardian, or other family member of the
recipient must hold a license under this subchapter. An applicant
for a license under this subchapter must:
(1) submit an application to the commission in the
form and manner the commission prescribes; and
(2) satisfy all training, testing, and other minimum
qualification standards the commission establishes.
(b) Notwithstanding any other law, the executive
commissioner shall, in consultation with the Texas Board of
Nursing, adopt rules and procedures for issuing a license and for
renewing, suspending, or revoking a license issued under this
subchapter. The rules must:
(1) provide that the commission establish minimum
qualification standards and, subject to Section 531.806, training
requirements for obtaining and maintaining the license;
(2) provide that the commission issue the license
under this subchapter; and
(3) prescribe procedures for accepting complaints and
conducting investigations of alleged violations of the terms of the
licensure by license holders.
Sec. 531.806. TRAINING PROGRAM. (a) The commission shall
develop or approve a health aide training program. The program must
include instruction on:
(1) transferring;
(2) positioning;
(3) ambulation;
(4) feeding;
(5) personal care;
(6) catheter care;
(7) range of motion;
(8) vital signs;
(9) blood pressure;
(10) medication administration;
(11) tracheostomy care;
(12) enteral care and therapy;
(13) administering enteral feedings;
(14) formula types and preparation; and
(15) other tasks the commission approves.
(b) The commission may not impose a fee on an applicant for
the training required by this subchapter.
Sec. 531.807. LICENSE RESTRICTED; LIMITED SCOPE OF
PRACTICE. (a) A license holder under this subchapter:
(1) may only provide health aide services to a
recipient who is:
(A) related to the license holder; and
(B) enrolled in the program; and
(2) must be employed by the home and community support
services agency that employs the nurse providing private duty
nursing services to the recipient.
(b) A licensed health aide may only provide health services
to a recipient if the services are:
(1) delegated to the health aide by the professional
registered nurse providing private duty nursing services to the
recipient;
(2) performed under the supervision of that nurse;
(3) consistent with Texas Board of Nursing rules
governing the delegation of nursing tasks by a registered
professional nurse and federal law and regulations governing the
provision of private duty nursing services under Medicaid,
including 42 C.F.R. Section 440.80;
(4) consistent with the recipient's plan of care; and
(5) authorized by commission rules.
Sec. 531.808. LICENSED HEALTH AIDE REGISTRY. The
commission shall establish and maintain a registry of health aides
licensed under this subchapter.
Sec. 531.809. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
OUTREACH. The commission shall:
(1) provide information about the program to home and
community support services agencies that provide private duty
nursing services under the STAR Kids Medicaid managed care program;
and
(2) encourage agencies to employ health aides licensed
under this subchapter.
Sec. 531.810. REIMBURSEMENT FOR LICENSED HEALTH AIDE
SERVICES. The commission shall reimburse a home and community
support services agency for services provided to a recipient by a
licensed health aide under this subchapter at a rate that is at
least equal to the current Medicare low utilization payment
adjustment visit rates for this state. Reimbursement for the
services is subject to an enhanced reimbursement rate of a
certified nursing assistant. The commission shall administer
reimbursement based on billing units.
Sec. 531.811. RULES. The executive commissioner shall
adopt rules necessary to implement this subchapter.
SECTION 2. The commission shall implement the family health
aide program established under Subchapter T, Chapter 531,
Government Code, as added by this Act, not later than September 1,
2024.
SECTION 3. 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 4. This Act takes effect September 1, 2023.