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A BILL TO BE ENTITLED
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AN ACT
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relating to sickle cell disease health care improvement and the |
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sickle cell task force. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 533, Government Code, is |
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amended by adding Section 533.0091 to read as follows: |
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Sec. 533.0091. SICKLE CELL DISEASE TREATMENT; HEALTH HOMES. |
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(a) In this section, "health home" means a primary care provider |
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or, if appropriate, a specialty care provider, incorporating into |
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patient care several features, including comprehensive care |
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coordination, family-centered care, and data management, that are |
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focused on improving outcome-based quality of care and increasing |
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patient and provider satisfaction. |
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(b) The commission shall: |
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(1) in collaboration with the sickle cell task force |
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established under Chapter 52, Health and Safety Code: |
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(A) ensure that health care services provided |
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under a managed care plan to recipients diagnosed with sickle cell |
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disease align with national clinical practice guidelines and |
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protocols for sickle cell disease treatment; |
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(B) consider using sickle cell clinical |
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evaluation and treatment guidelines, including those recommended |
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by the American Society of Hematology or the Children's Hospital of |
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Philadelphia; and |
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(C) increase sickle cell disease education for |
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Medicaid providers, including emergency room providers; and |
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(2) use the commission's Texas Healthcare Learning |
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Collaborative to identify opportunities for improving health |
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outcomes of recipients diagnosed with sickle cell disease by: |
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(A) reducing hospital admissions and |
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readmissions; and |
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(B) connecting those recipients to a sickle cell |
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disease health home or sickle cell disease expert. |
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(c) The commission shall establish one or more health homes |
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in this state for recipients diagnosed with sickle cell disease to: |
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(1) reduce barriers preventing recipients diagnosed |
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with sickle cell disease from receiving necessary health care; |
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(2) prevent unnecessary hospitalizations and |
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vaso-occlusive crises; |
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(3) avoid duplication of services; and |
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(4) reduce costs associated with sickle cell disease |
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treatment. |
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(d) A health home established under this section must: |
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(1) provide to a recipient diagnosed with sickle cell |
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disease: |
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(A) comprehensive care management; |
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(B) care coordination; |
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(C) health promotion; |
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(D) comprehensive transitional and follow-up |
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care; |
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(E) patient and family support; and |
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(F) referral to community and social support |
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services; and |
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(2) use the existing Medicaid managed care delivery |
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system in a manner that avoids duplication of services and payment. |
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SECTION 2. Sections 52.0003 and 52.0007, Health and Safety |
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Code, are amended to read as follows: |
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Sec. 52.0003. COMPOSITION OF TASK FORCE. The task force is |
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composed of the following members appointed by the executive |
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commissioner: |
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(1) two members from community-based organizations |
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with experience addressing the needs of individuals with sickle |
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cell disease; |
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(2) two physicians specializing in hematology; |
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(3) two members of the public, each of whom either has |
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sickle cell disease or is a parent of a person with sickle cell |
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disease or trait; [and] |
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(4) one representative of a health-related |
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institution; |
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(5) one representative of the Texas Education Agency; |
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and |
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(6) one representative of the commission. |
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Sec. 52.0007. ANNUAL REPORT. (a) Not later than December 1 |
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of each year, the task force shall prepare and submit to the |
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governor and the legislature an annual written report that |
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summarizes the task force's work and includes any recommended |
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actions or policy changes endorsed by the task force. |
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(b) The task force shall, in collaboration with the |
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commission, include in the task force's annual report |
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recommendations for improving sickle cell disease education for |
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health care providers. |
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SECTION 3. Subtitle B, Title 2, Health and Safety Code, is |
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amended by adding Chapter 52A to read as follows: |
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CHAPTER 52A. SICKLE CELL DISEASE CARE EDUCATION AND TREATMENT |
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Sec. 52A.001. DEFINITION. In this chapter, "sickle cell |
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task force" means the sickle cell task force established under |
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Chapter 52. |
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Sec. 52A.002. SICKLE CELL DISEASE SURVEILLANCE SYSTEM. (a) |
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Using grant money awarded by the Centers for Disease Control and |
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Prevention's Sickle Cell Data Collection Program, the department |
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shall establish and maintain a voluntary sickle cell disease |
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surveillance system to determine: |
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(1) the number of individuals with sickle cell disease |
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in this state; |
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(2) the manner in which individuals with sickle cell |
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disease use health care services; and |
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(3) health outcomes of individuals with sickle cell |
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disease. |
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(b) The sickle cell disease surveillance system must |
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include: |
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(1) a de-identified record of individuals diagnosed |
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with sickle cell disease or sickle cell trait in this state; and |
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(2) any other de-identified information concerning |
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cases of sickle cell disease or sickle cell trait that the |
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department considers necessary and appropriate. |
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(c) An individual who is diagnosed with sickle cell disease |
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or sickle cell trait may voluntarily register with the department |
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for inclusion in the sickle cell disease surveillance system. |
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(d) After an individual registers with the department under |
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Subsection (c), a health care facility or health care provider who |
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treats the individual shall provide to the department, in the form |
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and manner the department prescribes, data the department considers |
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necessary and appropriate concerning cases of sickle cell disease. |
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(e) The executive commissioner by rule shall develop |
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guidelines to: |
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(1) obtain information from health care facilities |
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regarding cases of sickle cell disease; |
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(2) protect the confidentiality of individuals |
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diagnosed with sickle cell disease in accordance with Section |
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159.002, Occupations Code; and |
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(3) ensure the sickle cell disease surveillance system |
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is developed in a manner consistent with: |
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(A) the Health Insurance Portability and |
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Accountability Act of 1996 (Pub. L. No. 104-191); |
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(B) regulations adopted under that Act; and |
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(C) other applicable laws and regulations |
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governing disclosure of health information. |
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(f) Information obtained under this section is confidential |
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and privileged and: |
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(1) is not subject to disclosure under Chapter 552, |
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Government Code; |
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(2) is not subject to subpoena or discovery or |
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otherwise compelled to be produced in any administrative, civil, |
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criminal, or other proceeding; and |
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(3) may not be introduced into evidence in any |
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administrative, civil, criminal, or other proceeding. |
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(g) The department may compile and publish statistical and |
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other studies derived from de-identified data obtained under this |
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chapter. |
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(h) The executive commissioner shall adopt rules necessary |
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to implement this section. |
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Sec. 52A.003. TEXAS HEALTH SERVICE AUTHORITY EMERGENCY |
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DEPARTMENT ENCOUNTER NOTIFICATIONS SYSTEM. The Texas Health |
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Services Authority established under Chapter 182 shall collect and |
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analyze clinical data and use the emergency department encounter |
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notifications system to ensure an individual diagnosed with sickle |
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cell disease is not incorrectly identified as an individual who |
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misuses opioid drugs. |
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Sec. 52A.004. EMERGENCY AND PRIMARY CARE MEDICINE GRADUATE |
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MEDICAL EDUCATION PROGRAM CURRICULUM. (a) In this section, |
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"graduate medical education program" and "medical school" have the |
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meanings assigned by Section 58A.001, Education Code. |
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(b) A medical school in this state that offers an emergency |
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medicine, family medicine, or internal medicine residency program |
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shall include in the curriculum requirements for the program |
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education focused on sickle cell disease and sickle cell trait. The |
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medical school may enter into agreements as necessary for the |
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purposes of this section. |
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Sec. 52A.005. INFORMATION FOR PUBLIC SCHOOL DISTRICT |
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PERSONNEL. (a) The Texas Education Agency shall partner with |
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sickle cell disease community-based organizations to provide |
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information on sickle cell disease and sickle cell trait to public |
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school districts and district staff, including school nurses, |
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teachers, and coaches. |
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(b) The commission in collaboration with the sickle cell |
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task force shall explore methods for improving sickle cell disease |
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education and awareness within the public school system and provide |
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recommendations to the Texas Education Agency on the improvement |
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methods. |
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SECTION 4. (a) Not later than the second anniversary of the |
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date the Health and Human Services Commission establishes a health |
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home for Medicaid recipients diagnosed with sickle cell disease in |
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accordance with Section 533.0091(c), Government Code, as added by |
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this Act, the commission shall submit to the governor and the |
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legislature a report on the effects of using a health home for those |
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recipients, including: |
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(1) health outcomes of those recipients; and |
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(2) cost savings to this state associated with sickle |
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cell disease treatment. |
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(b) The Health and Human Services Commission may include the |
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report required under Subsection (a) of this section with the |
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annual report the sickle cell task force is required to submit under |
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Section 52.0007, Health and Safety Code, as amended by this Act. |
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SECTION 5. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission shall: |
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(1) in accordance with Section 1945, Social Security |
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Act (42 U.S.C. Section 1396w-4), seek from the appropriate federal |
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agency an amendment to the state's Medicaid state plan to implement |
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Section 533.0091, Government Code, as added by this Act, and the |
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commission may delay implementing that section until the state plan |
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amendment is approved; |
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(2) appoint the new members of the sickle cell task |
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force as required by Section 52.0003, Health and Safety Code, as |
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amended by this Act; and |
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(3) apply for a grant from the Centers for Disease |
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Control and Prevention's Sickle Cell Data Collection Program to |
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establish a voluntary sickle cell disease surveillance system under |
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Section 52A.002, Health and Safety Code, as added by this Act. |
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SECTION 6. Section 52A.004, Health and Safety Code, as |
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added by this Act, applies to residents entering an emergency |
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medicine, family medicine, or internal residency program at a |
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medical school in this state on or after January 1, 2024. |
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SECTION 7. This Act takes effect September 1, 2023. |