82R9351 SJM-D

By: Shelton H.B. No. 3279

A BILL TO BE ENTITLED

AN ACT

relating to the creation of the Santa Rosa grant program.

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

SECTION 1. Chapter 531, Government Code, is amended by adding Subchapter Q-1 to read as follows:

SUBCHAPTER Q-1. SANTA ROSA GRANT PROGRAM

Sec. 531.671. DEFINITIONS. (a) In this subchapter:

(1) "Advance directive" has the meaning assigned by Section 166.002, Health and Safety Code.

(2) "Chronic illness" means a medical condition that traditionally requires frequent use of hospital services, including:

(A) tumors of the central nervous system;

(B) trauma to the central nervous system;

(C) cerebral palsy; and

(D) multiple complications due to premature birth.

(3) "Grant program" means the Santa Rosa grant program established under this subchapter.

(4) "Hospital" means a general hospital, pediatric and adolescent hospital, or special hospital, as those terms are defined by Section 241.003, Health and Safety Code.

(5) "Palliative care" has the meaning assigned by Section 142.001, Health and Safety Code.

(b) The executive commissioner by rule shall define "low-income" and may further define "chronic illness" for purposes of this subchapter.

Sec. 531.672. ESTABLISHMENT OF SANTA ROSA GRANT PROGRAM. The commission shall establish the Santa Rosa grant program to award grants to hospitals for the purpose of:

(1) reducing the number of unnecessary emergency room visits by chronically ill, low-income children through the establishment of a primary care environment;

(2) decreasing the need for the long-term hospitalization of chronically ill, low-income children by maximizing the use of outpatient services; and

(3) reducing the costs associated with providing medical care to chronically ill, low-income children.

Sec. 531.673. AWARDING OF GRANTS; ADVISORY COMMITTEE. (a) Subject to Section 531.674, the executive commissioner or the executive commissioner's designee shall award grants under this subchapter.

(b) The executive commissioner may establish an advisory committee to make recommendations on establishing the grant program and making awards under the grant program. If the executive commissioner establishes an advisory committee under this subsection, the executive commissioner may appoint any of the following persons to the advisory committee:

(1) representatives of appropriate public or private entities, including state agencies concerned with health care management;

(2) physicians;

(3) members of the legislature;

(4) representatives of the health insurance industry; and

(5) any other persons the executive commissioner determines appropriate.

(c) An advisory committee created under this section is not subject to Chapter 2110.

Sec. 531.674. ELIGIBILITY. To be eligible to receive an award under the grant program, a hospital must have the facilities and staff necessary to provide or facilitate the provision of the following services to a chronically ill child:

(1) a primary care physician who must, to the extent possible:

(A) see the child at each elective visit to the hospital or clinic affiliated with the hospital;

(B) coordinate the child's consultants, medications, and hospitalizations; and

(C) if the child is hospitalized:

(i) act as the child's attending physician; and

(ii) see the child at least five of every seven days that the child is hospitalized;

(2) pastoral services;

(3) planning services related to creating an advance directive;

(4) assistance in identifying and enrolling in community-based service programs as an alternative to hospitalization; and

(5) palliative care.

Sec. 531.675. ADDITIONAL CONSIDERATIONS IN AWARDING GRANTS. (a) Subject to Subsection (b), the executive commissioner or the executive commissioner's designee may make an award under the grant program to a hospital regardless of whether the hospital provides medical care to children under the Medicaid program or the child health plan program, or whether the care is paid for out-of-pocket or by private health insurance.

(b) In awarding grants, the executive commissioner or the executive commissioner's designee shall give preference to hospitals that:

(1) frequently provide services to chronically ill children under the Medicaid and child health plan programs; and

(2) cooperate with affiliated community-based support services organizations.

Sec. 531.676. STATE FUNDS, GIFTS, GRANTS, AND DONATIONS. The commission may use appropriated funds from the state and may solicit and accept gifts, grants, and donations from any public or private source to fund the grant program.

Sec. 531.677. REPORT. The commission annually shall submit to the standing committees of the senate and house of representatives having primary jurisdiction over health and human services, the governor, and the Legislative Budget Board a report regarding the operation of the grant program. The report must include:

(1) a summary of the grant program's impact on:

(A) reducing the number of unnecessary emergency room visits by chronically ill, low-income children;

(B) decreasing the need for the long-term hospitalization of chronically ill, low-income children; and

(C) reducing the costs associated with providing medical care to chronically ill, low-income children; and

(2) recommendations regarding changes to the grant program to achieve better outcomes.

Sec. 531.678. RULES. The executive commissioner may adopt rules as necessary to implement this subchapter.

SECTION 2. (a) Not later than January 1, 2012, the Health and Human Services Commission shall establish and implement the Santa Rosa grant program required by Subchapter Q-1, Chapter 531, Government Code, as added by this Act.

(b) Not later than January 1, 2013, the Health and Human Services Commission shall submit the initial report required under Section 531.677, Government Code, as added by this Act.

SECTION 3. This Act takes effect September 1, 2011.