| |
|
|
A BILL TO BE ENTITLED
|
|
|
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. |
|
|
|
|
|
* * * * * |