By: McReynolds H.B. No. 3917

A BILL TO BE ENTITLED

AN ACT

relating to the provision of diabetes self-management training under the state Medicaid program and the child health plan program.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is amended by adding Section 32.076 to read as follows:

Sec. 32.076. DIABETES SELF-MANAGEMENT TRAINING. (a) Notwithstanding Section 32.057 and to the extent allowed by federal law, the medical assistance program must provide diabetes self-management training in accordance with Section 1358.055, Insurance Code, to a recipient of medical assistance diagnosed with diabetes.

(b) In implementing this section, the Health and Human Services Commission shall ensure that:

(1) an assessment of a recipient for the diabetes self-management training includes a review of the recipient's medical history, risk factors, health status, resource utilization, knowledge and skill level, and cultural barriers to effective diabetes self-management;

(2) a recipient receives a minimum of:

(A) 10 hours of initial self-management training with a diabetes educator; and

(B) three hours of initial nutrition education with a registered dietitian;

(3) after receipt of the initial self-management training, the recipient receives a minimum of two hours of training each year with a diabetes educator and two hours of training each year with a registered dietitian;

(4) if diabetes self-management training is provided in group sessions, the recipient has direct, face-to-face interaction with the educator and is offered a sufficient number of individual sessions to meet the recipient's cultural and educational needs; and

(5) the recipient may repeat all or part of the self-management training as necessary, regardless of whether the recipient is diagnosed with a new health condition or experiences a change in health status.

SECTION 2. Subchapter D, Chapter 62, Health and Safety Code, is amended by adding Section 62.160 to read as follows:

Sec. 62.160. DIABETES SELF-MANAGEMENT TRAINING. (a) Notwithstanding Section 62.159 and to the extent allowed by federal law, in providing disease management services required by Section 62.159, the child health plan must provide diabetes self-management training in accordance with Section 1358.055, Insurance Code, to an enrolled child diagnosed with diabetes in a developmentally appropriate manner.

(b) In implementing this section, the commission shall ensure that:

(1) an assessment of an enrolled child for the diabetes self-management training includes a review of the child's medical history, risk factors, health status, resource utilization, knowledge and skill level, and cultural barriers to effective diabetes self-management;

(2) an enrolled child, when developmentally appropriate, receives a minimum of:

(A) 10 hours of initial self-management training with a diabetes educator; and

(B) three hours of initial nutrition education with a registered dietitian;

(3) after receipt of the initial self-management training, the child receives a minimum of two hours of training each year with a diabetes educator and two hours of training each year with a registered dietitian;

(4) if diabetes self-management training is provided in group sessions, the child has direct, face-to-face interaction with the educator and is offered a sufficient number of individual sessions to meet the child's cultural and educational needs; and

(5) the child may repeat all or part of the self-management training as necessary, regardless of whether the child is diagnosed with a new health condition or experiences a change in health status.

SECTION 3. Subchapter A, Chapter 533, Government Code, is amended by adding Section 533.0091 to read as follows:

Sec. 533.0091. DIABETES SELF-MANAGEMENT TRAINING. Notwithstanding Section 533.009 and to the extent allowed by federal law, the commission shall ensure that a managed care organization under contract with the commission to provide health care services to a recipient provides diabetes self-management training to a recipient diagnosed with diabetes. The training must meet the requirements of:

(1) Section 1358.055, Insurance Code; and

(2) Section 32.076(b), Human Resources Code.

SECTION 4. 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 5. This Act takes effect September 1, 2007.