87R4872 SCL-F
 
  By: Howard 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)  "Program" means the home nursing visitation for
  newborn caregivers grant program established under this
  subchapter.
               (2)  "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
  commission shall establish and administer a competitive grant
  program under which the commission awards grants to eligible
  service providers to provide or expand home nursing visitation
  services for newborn caregivers.
         (b)  The commission shall award grants under the program to
  eligible service providers in a manner that ensures the grant
  recipients:
               (1)  operate in multiple communities that are
  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 continuing ongoing work to ultimately
  serve the communities' entire newborn population to have the
  maximum possible health impact on that population.
         (c)  The executive 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 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,
  whichever is later, with the opportunity for up to three total
  registered nurse visits as determined by the nurse's professional
  judgment;
               (6)  provide information and referrals to a newborn
  caregiver that are 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, according to criteria set by the United States
  Department of Health and Human Services for an early childhood home
  visiting service delivery model, that is selected by the
  commission, including any clinical, programmatic, and data
  collection requirements of the model;
               (9)  aim 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)  increase in positive parenting practices; 
               (10)  require that home nursing visits:
                     (A)  are 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 the later of six weeks
  postpartum or six weeks after a newborn is discharged from a newborn
  intensive care unit; and
               (11)  be provided 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 commission on a form prescribed by executive
  commissioner rule in accordance with this section. 
         (c)  The application form must:
               (1)  require the applicant to provide:
                     (A)  data 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 commission uses to
  monitor and evaluate grant recipients on an ongoing basis under
  Section 32.208, including the grant recipient's obligations to:
                     (A)  collect and provide information requested by
  the commission; and 
                     (B)  adhere to the evidence-based model selected
  by the commission;
               (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 how the applicant will partner 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
  commission 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 ongoing monitoring and
  performance evaluations under Section 32.208, including the
  applicant's ability to collect and provide information requested by
  the commission;
                     (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, high-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
  commission 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 commission 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 executive commissioner or the commission; 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
  commission.
         Sec. 32.208.  GRANT RECIPIENT MONITORING AND EVALUATION;
  ANNUAL REPORT. (a) The commission shall:
               (1)  adopt performance indicators designed to measure a
  grant recipient's performance with respect to the program standards
  adopted by executive commissioner rule that align with the
  evidence-based model selected by the commission; and
               (2)  use the performance indicators to continuously
  monitor and formally evaluate on an annual basis the performance of
  each grant recipient.
         (b)  Not later than December 1 of each year, the commission
  shall prepare and submit a written report to the standing
  committees of the legislature with primary jurisdiction over the
  commission 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
  commission 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 commission 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 commission 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 Health and Human Services Commission 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.
         (b)  Not later than September 1, 2022, the Health and Human
  Services Commission 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 executive
  commissioner of the Health and Human Services Commission 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 Health and Human
  Services Commission shall submit a written report to the standing
  committees of the legislature with primary jurisdiction over the
  commission 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 Health and Human
  Services Commission 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.