87R19826 KKR-F
 
  By: Howard, Rose, Guerra H.B. No. 2333
 
  Substitute the following for H.B. No. 2333:
 
  By:  Klick C.S.H.B. No. 2333
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the establishment of the home nursing visitation for
  newborn caregivers competitive grant program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 32, Health and Safety Code, is amended by
  adding Subchapter G to read as follows:
  SUBCHAPTER G. HOME NURSING VISITATION FOR NEWBORN CAREGIVERS GRANT
  PROGRAM
         Sec. 32.201.  DEFINITIONS. In this subchapter:
               (1)  "Commissioner" means the commissioner of the
  Department of Family and Protective Services.
               (2)  "Department" means the Department of Family and
  Protective Services.
               (3)  "Program" means the home nursing visitation for
  newborn caregivers grant program established under this
  subchapter.
               (4)  "Service provider" means an entity that offers
  free of charge home nursing visits for newborn caregivers.
         Sec. 32.202.  ESTABLISHMENT OF PROGRAM; RULES. (a) The
  department shall establish and administer within the department's
  prevention and early intervention services division a competitive
  grant program through which the department awards grants to
  eligible service providers to provide or expand home nursing
  visitation services for newborn caregivers.
         (b)  The department shall award grants under the program to
  eligible service providers in a manner that ensures the grant
  recipients:
               (1)  operate in multiple communities geographically
  distributed throughout this state; 
               (2)  have the capacity to offer home nursing visitation
  services to all newborn caregivers within a defined service area,
  including a birthing hospital service area, a municipality, or a
  county; and
               (3)  commit to providing ongoing services to ultimately
  serve the communities' entire newborn population and provide the
  maximum possible health impact on that population.
         (c)  The commissioner shall adopt rules as necessary to
  implement this subchapter.
         Sec. 32.203.  SERVICE REQUIREMENTS. Home nursing visitation
  services funded by a grant awarded under this subchapter must:
               (1)  be offered free of charge to all newborn
  caregivers, including foster and adoptive families, within the
  grant recipient's defined service area;
               (2)  be voluntary and may not impose negative
  consequences on a newborn caregiver that chooses not to
  participate;
               (3)  be provided by registered nurses in the newborn
  caregiver's home whenever possible, using telehealth services when
  necessary and feasible;
               (4)  include an evidence-based assessment of the
  physical, social, and emotional factors affecting the health and
  safety of the newborn caregiver's family;
               (5)  include at least one registered nurse visit to the
  newborn caregiver not later than six weeks postpartum or six weeks
  after the newborn is discharged from a newborn intensive care unit,
  with the opportunity to receive not more than three registered
  nurse visits as determined by the nurse's professional judgment;
               (6)  provide to a newborn caregiver information and
  referrals tailored to the caregiver's needs, as identified by a
  home nursing visit, and support the caregiver in navigating needed
  services;
               (7)  include a follow-up call to the newborn caregiver
  not later than three months after the last home nursing visit to
  assess success in referrals and family satisfaction and to close
  the case;
               (8)  strictly adhere to an evidence-based service
  delivery model selected by the department in accordance with
  criteria set by the United States Department of Health and Human
  Services for an early childhood home visiting service delivery
  model, including any clinical, programmatic, and data collection
  requirements under the model;
               (9)  strive to improve outcomes in one or more of the
  following categories:
                     (A)  reduction of child abuse and neglect;
                     (B)  child health;
                     (C)  maternal health;
                     (D)  reduction of family violence;
                     (E)  child development;
                     (F)  family economic self-sufficiency;
                     (G)  completion of maternal follow-up and
  well-child visits with health care providers;
                     (H)  appropriate use of a health care facility's
  emergency department; and
                     (I)  increased positive parenting practices; 
               (10)  require the home nursing visits to:
                     (A)  be offered in partnership with the newborn
  caregiver's attending obstetrician or gynecologist, maternal
  health provider, or birthing hospital, if applicable; and 
                     (B)  begin not later than six weeks postpartum or
  six weeks after a newborn is discharged from a newborn intensive
  care unit; and
               (11)  continue for a period of at least two years.
         Sec. 32.204.  APPLICATION REQUIREMENTS. (a) A public or
  private entity, including a county, municipality, or other
  political subdivision of this state, may apply for a grant under
  this subchapter.
         (b)  To apply for a grant, an applicant must submit a written
  application to the department on a form prescribed by commissioner
  rule in accordance with this section. 
         (c)  The application form must:
               (1)  require the applicant to provide:
                     (A)  information on the number of births by
  hospital located in the defined service area in which the applicant
  proposes to operate; and
                     (B)  a description of existing services available
  to newborn caregivers in the community;
               (2)  describe the processes the department uses to
  continually monitor and evaluate grant recipients under Section
  32.208, including the grant recipient's obligations to:
                     (A)  collect and provide information requested by
  the department; and 
                     (B)  adhere to the evidence-based model selected
  by the department;
               (3)  require the applicant to outline the applicant's
  plan to collaborate and strengthen relationships with health care
  and social service providers to ensure the applicant's ability to
  effectively connect newborn caregivers and the caregivers'
  families to other community services when needed; and
               (4)  describe the applicant's plan for enrolling
  newborn caregivers, including the applicant's partnerships with
  birthing hospitals and local maternal health care and pediatric
  health care providers.
         Sec. 32.205.  GRANT AWARD REQUIREMENTS. In determining
  whether to award a grant to an applicant under this subchapter, the
  department shall consider the applicant's demonstrated capacity to
  provide home nursing visitation services to newborn caregivers in
  the defined service area in which the applicant proposes to provide
  services, which may be determined by considering:
               (1)  the applicant's ability to:
                     (A)  participate in continued monitoring and
  performance evaluations under Section 32.208, including the
  applicant's ability to collect and provide information requested by
  the department;
                     (B)  comply with program standards; and
                     (C)  develop broad-based community support and
  leverage philanthropic support to implement or expand home nursing
  visitation services for newborn caregivers; and
               (2)  the applicant's history of developing and
  sustaining innovative, quality home nursing visitation services
  for newborn caregivers that meet the needs of families and
  communities.
         Sec. 32.206.  WRITTEN AGREEMENT WITH GRANT RECIPIENT
  REQUIRED. Before awarding a grant under this subchapter, the
  department shall enter into a written agreement with each applicant
  to be awarded a grant that requires the grant recipient to repay
  this state, in accordance with terms specified in the agreement,
  if:
               (1)  the department determines the grant recipient has
  not complied with the minimum standards and reporting requirements
  prescribed by this subchapter or rules adopted under this
  subchapter or with any other applicable rules or standards
  prescribed by the commissioner or the department; or
               (2)  the grant recipient fails to use the grant money
  for the purposes for which the grant was awarded, in accordance with
  Section 32.207.
         Sec. 32.207.  USE OF GRANT MONEY. Grant money awarded under
  this subchapter may be used only to cover costs related to the grant
  recipient administering, implementing, or expanding home nursing
  visitation services for newborn caregivers, including costs
  related to:
               (1)  administering the home nursing visitation
  services;
               (2)  training and managing registered nurses and other
  staff who participate in providing the home nursing visitation
  services;
               (3)  paying the salaries and expenses of registered
  nurses and other required staff members who are essential to
  delivering the home nursing visitation services;
               (4)  paying for facilities and equipment for providing
  the home nursing visitation services; and
               (5)  paying for technical assistance to ensure a grant
  recipient adheres to the evidence-based model selected by the
  department.
         Sec. 32.208.  GRANT RECIPIENT MONITORING AND EVALUATION;
  ANNUAL REPORT. (a) The department shall:
               (1)  adopt performance indicators designed to measure a
  grant recipient's performance with respect to the program standards
  adopted by commissioner rule that align with the evidence-based
  model selected by the department; and
               (2)  use the performance indicators to continuously
  monitor and formally evaluate at least annually the performance of
  each grant recipient.
         (b)  Not later than December 1 of each year, the department
  shall prepare and submit a written report to the standing
  committees of the legislature with primary jurisdiction over the
  department regarding the performance of each grant recipient during
  the preceding state fiscal year with respect to providing program
  services and improving outcomes for newborns and their families.
         Sec. 32.209.  COMPETITIVE GRANT PROGRAM FUNDING. (a) The
  department shall seek and apply for any available federal and state
  money, including money available for Medicaid or the Children's
  Health Insurance Program (CHIP), to assist in financing the
  program.
         (b)  The department shall consult, collaborate, and
  coordinate with health benefit plan issuers in this state,
  including Medicaid managed care organizations, to identify
  existing incentives and reimbursement strategies that could expand
  the program.
         (c)  The department may solicit and accept gifts, grants, and
  donations to operate the program.
         SECTION 2.  (a) As soon as practicable after the effective
  date of this Act, the Department of Family and Protective Services
  shall apply for any available federal money to finance the grant
  program established by Subchapter G, Chapter 32, Health and Safety
  Code, as added by this Act.  If federal money is not available for
  that purpose and notwithstanding any provision of this Act, the
  department shall delay implementation of Subchapter G, Chapter 32,
  Health and Safety Code, as added by this Act, until federal money
  becomes available.
         (b)  Not later than September 1, 2022, the Department of
  Family and Protective Services shall establish and implement the
  grant program established by Subchapter G, Chapter 32, Health and
  Safety Code, as added by this Act.
         (c)  Not later than September 1, 2022, the commissioner of
  the Department of Family and Protective Services shall adopt rules
  necessary to implement Subchapter G, Chapter 32, Health and Safety
  Code, as added by this Act.
         (d)  Not later than December 1, 2022, the Department of
  Family and Protective Services shall submit a written report to the
  standing committees of the legislature with primary jurisdiction
  over the department regarding the implementation and status of the
  grant program described by Subchapter G, Chapter 32, Health and
  Safety Code, as added by this Act.
         (e)  Not later than December 1, 2023, the Department of
  Family and Protective Services shall submit the initial report
  required by Section 32.208, Health and Safety Code, as added by this
  Act.
         SECTION 3.  This Act takes effect September 1, 2021.