Texas 2025 - 89th Regular

Texas House Bill HB4371 Compare Versions

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1	1		By: Harris Davila H.B. No. 4371
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4	6		A BILL TO BE ENTITLED
5	7		AN ACT
6	8		relating to the provision of services by certain persons in the
7	9		private duty nursing program.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. Chapter 531, Government Code, is amended by
10	12		adding Subchapter T to read as follows:
11	13		SUBCHAPTER T. COMPLEX CARE AIDE
12	14		Sec. 531.801. DEFINITIONS. (a) In this subchapter:
13	15		(1) "Home and community support services agency" means
14	16		a person licensed under Chapter 142, Health and Safety Code.
15	17		(2) "Certified complex care aide" means a person who
16	18		is:
17	19		(A) the parent, legal guardian, or family member
18	20		of a recipient participating in the program;
19	21		(B) certified under the program to assist in
20	22		providing certain private duty nursing services; and
21	23		(C) employed by the home and community support
22	24		services agency providing services to the recipient.
23	25		(3) "Private duty nursing services" means nursing
24	26		services provided under the Texas Health Steps comprehensive care
25	27		program to a recipient enrolled in the STAR Kids Medicaid managed
26	28		care program.
27	29		Sec. 531.802. CERTIFIED COMPLEX CARE AIDE. The commission
28	30		shall develop policies to enable a parent, legal guardian, or
29	31		family member of a recipient receiving private duty nursing
30	32		services in a home setting to assist in providing those services as
31	33		a complex care aide.
32	34		Sec. 531.803. ELIGIBILITY. (a) An individual is eligible
33	35		to receive services from a certified complex care aide if:
34	36		(1) the recipient is:
35	37		(A) enrolled in the STAR Kids Medicaid managed
36	38		care program; and
37	39		(B) eligible to receive private duty nursing
38	40		services under the Texas Health Steps comprehensive care program;
39	41		(2) the recipient's parent, legal guardian, or family
40	42		member, as defined by commission rule, elects to become a certified
41	43		complex care aide;
42	44		(3) The recipient's parent, legal guardian, or family
43	45		member, completes all required training necessary to be certified
44	46		as a complex care aide; and
45	47		(4) the home and community support services agency
46	48		that employs the professional registered nurses providing private
47	49		duty nursing services to the recipient agrees to employ the
48	50		recipient's parent, legal guardian, or family member.
49	51		Sec. 531.804. RECIPIENT SCREENING AND NOTIFICATION. (a)
50	52		The commission shall:
51	53		(1) add criteria to any screening tool or other
52	54		instrument used to conduct an assessment or reassessment of a
53	55		recipient under the STAR Kids Medicaid managed care program to
54	56		identify recipients who are eligible to participate in the program;
55	57		and
56	58		(2) notify the parent or legally authorized
57	59		representative of the recipient of the potential availability of
58	60		the service option.
59	61		(b) The parent or legally authorized representative of
60	62		the recipient has the sole choice of whether to utilize the service
61	63		option.
62	64		Sec. 531.805. COMPLEX CARE AIDE CERTIFICATION REQUIRED.
63	65		(a) To assist in providing private duty nursing services to a
64	66		recipient under the program, a parent, legal guardian, or other
65	67		family member of the recipient must be certified as a complex care
66	68		aide. A person seeking certification as a complex care aide must
67	69		satisfy all training, testing, and other minimum qualification
68	70		standards the commission establishes.
69	71		Sec. 531.806. TRAINING PROGRAM. (a) The commission shall
70	72		approve family health aide training programs that meet all of the
71	73		requirements under 42 CFR 484.80. The training program must
72	74		include instruction on:
73	75		(1) transferring;
74	76		(2) positioning;
75	77		(3) ambulation;
76	78		(4) feeding;
77	79		(5) personal care;
78	80		(6) catheter care;
79	81		(7) range of motion;
80	82		(8) vital signs;
81	83		(9) blood pressure;
82	84		(10) medication administration;
83	85		(11) enteral care and therapy;
84	86		(12) administering enteral feedings;
85	87		(13) formula types and preparation; and
86	88		(14) other tasks the commission approves except for
87	89		tracheostomy care.
88	90		(b) The home and community support services agency
89	91		must also provide ten hours of training in addition to the training
90	92		required under (a) regarding tasks and skills specific to the needs
91	93		of the recipient.
92	94		(c) The home and community support services agency may not
93	95		impose a fee on an applicant for the training required by this
94	96		subchapter.
95	97		Sec. 531.807. CERTIFICATION RESTRICTED; LIMITED SCOPE OF
96	98		PRACTICE. (a) A certified complex care aide under this subchapter:
97	99		(1) may only provide complex care services to a
98	100		recipient who is:
99	101		(A) related to the license holder; and
100	102		(B) enrolled in the program; and
101	103		(2) must be employed by the home and community support
102	104		services agency that employs the nurse providing private duty
103	105		nursing services to the recipient.
104	106		(b) A certified complex care aide may only provide health
105	107		services to a recipient if the services are:
106	108		(1) delegated to the certified complex care aide by
107	109		the professional registered nurse providing private duty nursing
108	110		services to the recipient;
109	111		(2) performed under the supervision of that nurse;
110	112		(3) consistent with Texas Board of Nursing rules
111	113		governing the delegation of nursing tasks by a registered
112	114		professional nurse and federal law and regulations governing the
113	115		provision of private duty nursing services under Medicaid,
114	116		including 42 C.F.R. Section 440.80 except for tracheostomy care;
115	117		(4) consistent with the recipient's plan of care; and
116	118		(5) authorized by commission rules.
117	119		Sec. 531.808. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
118	120		OUTREACH. The commission shall:
119	121		(1) provide information about the program to home and
120	122		community support services agencies that provide private duty
121	123		nursing services under the STAR Kids Medicaid managed care program;
122	124		and
123	125		(2) encourage agencies to employ certified complex
124	126		care aides that are qualified to provide services under this
125	127		subchapter.
126	128		Sec. 531.809. REIMBURSEMENT FOR CERTIFIED COMPLEX CARE AIDE
127	129		SERVICES. (a) The commission shall reimburse a home and community
128	130		support services agency for services provided to a recipient by a
129	131		certified complex care aide under this subchapter at a rate that is
130	132		no less than ninety percent of the licensed vocational nurse rate
131	133		for private duty nursing services. The commission shall administer
132	134		reimbursement based on billing units.
133	135		(b) A recipient's parent, legal guardian, or family member
134	136		is not eligible for reimbursement as a certified complex care aide
135	137		if they:
136	138		(1) do not meet all of the requirements under 531.806;
137	139		(2) provide more than 40 hours per week of services to an
138	140		eligible recipient.
139	141		Sec. 531.811. RULES. The executive commissioner shall
140	142		adopt rules necessary to implement this subchapter.
141	143		SECTION 2. The commission shall allow the provision of
142	144		services by certified complex care aides established under
143	145		Subchapter T, Chapter 531, Government Code, as added by this Act,
144	146		not later than September 1, 2026.
145	147		SECTION 3. If before implementing any provision of this Act
146	148		a state agency determines that a waiver or authorization from a
147	149		federal agency is necessary for implementation of that provision,
148	150		the agency affected by the provision shall request the waiver or
149	151		authorization and may delay implementing that provision until the
150	152		waiver or authorization is granted.
151	153		SECTION 4. This Act takes effect September 1, 2025.