1-1 By: Madla S.B. No. 982 1-2 (In the Senate - Filed March 8, 1999; March 9, 1999, read 1-3 first time and referred to Committee on Health Services; 1-4 April 15, 1999, reported adversely, with favorable Committee 1-5 Substitute by the following vote: Yeas 5, Nays 0; April 15, 1999, 1-6 sent to printer.) 1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 982 By: Nixon 1-8 A BILL TO BE ENTITLED 1-9 AN ACT 1-10 relating to persons authorized to provide diabetes self-management 1-11 training. 1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-13 SECTION 1. Section 4, Article 21.53G, Insurance Code, is 1-14 amended to read as follows: 1-15 Sec. 4. Diabetes Self-Management Training. (a) Diabetes 1-16 self-management training under this article must be provided by a 1-17 health care practitioner or provider who is licensed, registered, 1-18 or certified in this state to provide appropriate health care 1-19 services, acting within the scope of practice authorized by the 1-20 license, registration, or certification of the practitioner or 1-21 provider. Self-management training includes: 1-22 (1) training provided to a qualified insured after the 1-23 initial diagnosis of diabetes in the care and management of that 1-24 condition, including nutritional counseling and proper use of 1-25 diabetes equipment and supplies; 1-26 (2) additional training authorized on the diagnosis of 1-27 a physician or other health care practitioner of a significant 1-28 change in the qualified insured's symptoms or condition that 1-29 requires changes in the qualified insured's self-management regime; 1-30 and 1-31 (3) periodic or episodic continuing education training 1-32 when prescribed by an appropriate health care practitioner as 1-33 warranted by the development of new techniques and treatments for 1-34 diabetes. 1-35 (b) A health benefit plan shall provide diabetes 1-36 self-management training or coverage for diabetes self-management 1-37 training for which a physician or practitioner has written an order 1-38 to each insured or the caretaker of the insured from: 1-39 (1) a diabetes self-management training program 1-40 recognized by the American Diabetes Association; 1-41 (2) a multidisciplinary team, coordinated by a 1-42 Certified Diabetes Educator who is certified by the National 1-43 Certification Board for Diabetes Educators or a person who has 1-44 completed at least 24 hours of approved continuing education that 1-45 includes a combination of diabetes education, educational 1-46 principles, and behavioral strategies, consisting of at least a 1-47 dietitian and a nurse educator who collaborate routinely and which 1-48 may include a pharmacist and a social worker, and each member of 1-49 which, other than a social worker, must have recent didactic and 1-50 experiential preparation in diabetes clinical and educational 1-51 issues; 1-52 (3) a Certified Diabetes Educator who is certified by 1-53 the National Certification Board for Diabetes Educators; 1-54 (4) a licensed health care practitioner, including a 1-55 physician, a physician assistant, a registered nurse, a licensed 1-56 dietitian, or a pharmacist, who has been determined by the 1-57 practitioner's licensing board to have recent didactic and 1-58 experiential preparation in diabetes clinical and educational 1-59 issues; or 1-60 (5) the following licensed health care practitioners 1-61 or providers, who may provide a component or components of a 1-62 diabetes self-management training program: 1-63 (A) a licensed dietitian, who may provide any 1-64 nutritional counseling component; 2-1 (B) a pharmacist, who may provide any 2-2 pharmaceutical component; or 2-3 (C) a physician, a physician assistant, a 2-4 registered nurse, or an advanced practice nurse, who may provide 2-5 any other component of the training. 2-6 (c) In this section, the term "nutritional counseling" has 2-7 the meaning assigned the term "nutrition counseling" in Section 2-8 2(12), Licensed Dietitian Act (Article 4512h, Vernon's Texas Civil 2-9 Statutes). 2-10 (d) In consultation with the Texas Diabetes Council, the 2-11 appropriate licensing board of practitioners or providers 2-12 authorized to provide diabetes self-management training in 2-13 accordance with this section shall by rule determine the recent 2-14 didactic and experiential preparation in diabetes clinical and 2-15 educational issues required by this section to qualify licensees of 2-16 the board to provide the training and shall by rule determine and 2-17 define the component or components of diabetes self-management 2-18 training authorized by Subsections (b)(5)(B) and (C) of this 2-19 section. 2-20 SECTION 2. This Act takes effect September 1, 1999, and 2-21 applies only to a health benefit plan that is delivered, issued for 2-22 delivery, or renewed on or after January 1, 2000. A health benefit 2-23 plan that is delivered, issued for delivery, or renewed before 2-24 January 1, 2000, is governed by the law as it existed immediately 2-25 before the effective date of this Act, and that law is continued in 2-26 effect for that purpose. 2-27 SECTION 3. The importance of this legislation and the 2-28 crowded condition of the calendars in both houses create an 2-29 emergency and an imperative public necessity that the 2-30 constitutional rule requiring bills to be read on three several 2-31 days in each house be suspended, and this rule is hereby suspended. 2-32 * * * * *