88R3380 KKR-D
 
  By: Rose H.B. No. 1481
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to sickle cell disease health care improvement and the
  sickle cell task force.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 533, Government Code, is
  amended by adding Section 533.0091 to read as follows:
         Sec. 533.0091.  SICKLE CELL DISEASE TREATMENT; HEALTH HOMES.
  (a) In this section, "health home" means a primary care provider
  or, if appropriate, a specialty care provider, incorporating into
  patient care several features, including comprehensive care
  coordination, family-centered care, and data management, that are
  focused on improving outcome-based quality of care and increasing
  patient and provider satisfaction.
         (b)  The commission shall:
               (1)  in collaboration with the sickle cell task force
  established under Chapter 52, Health and Safety Code:
                     (A)  ensure that health care services provided
  under a managed care plan to recipients diagnosed with sickle cell
  disease align with national clinical practice guidelines and
  protocols for sickle cell disease treatment;
                     (B)  consider using sickle cell clinical
  evaluation and treatment guidelines, including those recommended
  by the American Society of Hematology or the Children's Hospital of
  Philadelphia; and
                     (C)  increase sickle cell disease education for
  Medicaid providers, including emergency room providers; and
               (2)  use the commission's Texas Healthcare Learning
  Collaborative to identify opportunities for improving health
  outcomes of recipients diagnosed with sickle cell disease by:
                     (A)  reducing hospital admissions and
  readmissions; and
                     (B)  connecting those recipients to a sickle cell
  disease health home or sickle cell disease expert.
         (c)  The commission shall establish one or more health homes
  in this state for recipients diagnosed with sickle cell disease to:
               (1)  reduce barriers preventing recipients diagnosed
  with sickle cell disease from receiving necessary health care;
               (2)  prevent unnecessary hospitalizations and
  vaso-occlusive crises; 
               (3)  avoid duplication of services; and
               (4)  reduce costs associated with sickle cell disease
  treatment.
         (d)  A health home established under this section must:
               (1)  provide to a recipient diagnosed with sickle cell
  disease:
                     (A)  comprehensive care management;
                     (B)  care coordination;
                     (C)  health promotion;
                     (D)  comprehensive transitional and follow-up
  care;
                     (E)  patient and family support; and
                     (F)  referral to community and social support
  services; and
               (2)  use the existing Medicaid managed care delivery
  system in a manner that avoids duplication of services and payment.
         SECTION 2.  Sections 52.0003 and 52.0007, Health and Safety
  Code, are amended to read as follows:
         Sec. 52.0003.  COMPOSITION OF TASK FORCE. The task force is
  composed of the following members appointed by the executive
  commissioner:
               (1)  two members from community-based organizations
  with experience addressing the needs of individuals with sickle
  cell disease;
               (2)  two physicians specializing in hematology;
               (3)  two members of the public, each of whom either has
  sickle cell disease or is a parent of a person with sickle cell
  disease or trait; [and]
               (4)  one representative of a health-related
  institution;
               (5)  one representative of the Texas Education Agency;
  and
               (6)  one representative of the commission.
         Sec. 52.0007.  ANNUAL REPORT. (a) Not later than December 1
  of each year, the task force shall prepare and submit to the
  governor and the legislature an annual written report that
  summarizes the task force's work and includes any recommended
  actions or policy changes endorsed by the task force.
         (b)  The task force shall, in collaboration with the
  commission, include in the task force's annual report
  recommendations for improving sickle cell disease education for
  health care providers.
         SECTION 3.  Subtitle B, Title 2, Health and Safety Code, is
  amended by adding Chapter 52A to read as follows:
  CHAPTER 52A. SICKLE CELL DISEASE CARE EDUCATION AND TREATMENT
         Sec. 52A.001.  DEFINITION. In this chapter, "sickle cell
  task force" means the sickle cell task force established under
  Chapter 52.
         Sec. 52A.002.  SICKLE CELL DISEASE SURVEILLANCE SYSTEM. (a)
  Using grant money awarded by the Centers for Disease Control and
  Prevention's Sickle Cell Data Collection Program, the department
  shall establish and maintain a voluntary sickle cell disease
  surveillance system to determine:
               (1)  the number of individuals with sickle cell disease
  in this state;
               (2)  the manner in which individuals with sickle cell
  disease use health care services; and
               (3)  health outcomes of individuals with sickle cell
  disease.
         (b)  The sickle cell disease surveillance system must
  include:
               (1)  a de-identified record of individuals diagnosed
  with sickle cell disease or sickle cell trait in this state; and
               (2)  any other de-identified information concerning
  cases of sickle cell disease or sickle cell trait that the
  department considers necessary and appropriate.
         (c)  An individual who is diagnosed with sickle cell disease
  or sickle cell trait may voluntarily register with the department
  for inclusion in the sickle cell disease surveillance system.
         (d)  After an individual registers with the department under
  Subsection (c), a health care facility or health care provider who
  treats the individual shall provide to the department, in the form
  and manner the department prescribes, data the department considers
  necessary and appropriate concerning cases of sickle cell disease.
         (e)  The executive commissioner by rule shall develop
  guidelines to:
               (1)  obtain information from health care facilities
  regarding cases of sickle cell disease;
               (2)  protect the confidentiality of individuals
  diagnosed with sickle cell disease in accordance with Section
  159.002, Occupations Code; and
               (3)  ensure the sickle cell disease surveillance system
  is developed in a manner consistent with:
                     (A)  the Health Insurance Portability and
  Accountability Act of 1996 (Pub. L. No. 104-191);
                     (B)  regulations adopted under that Act; and
                     (C)  other applicable laws and regulations
  governing disclosure of health information.
         (f)  Information obtained under this section is confidential
  and privileged and:
               (1)  is not subject to disclosure under Chapter 552,
  Government Code;
               (2)  is not subject to subpoena or discovery or
  otherwise compelled to be produced in any administrative, civil,
  criminal, or other proceeding; and
               (3)  may not be introduced into evidence in any
  administrative, civil, criminal, or other proceeding.
         (g)  The department may compile and publish statistical and
  other studies derived from de-identified data obtained under this
  chapter.
         (h)  The executive commissioner shall adopt rules necessary
  to implement this section.
         Sec. 52A.003.  TEXAS HEALTH SERVICE AUTHORITY EMERGENCY
  DEPARTMENT ENCOUNTER NOTIFICATIONS SYSTEM. The Texas Health
  Services Authority established under Chapter 182 shall collect and
  analyze clinical data and use the emergency department encounter
  notifications system to ensure an individual diagnosed with sickle
  cell disease is not incorrectly identified as an individual who
  misuses opioid drugs.
         Sec. 52A.004.  EMERGENCY AND PRIMARY CARE MEDICINE GRADUATE
  MEDICAL EDUCATION PROGRAM CURRICULUM. (a) In this section,
  "graduate medical education program" and "medical school" have the
  meanings assigned by Section 58A.001, Education Code.
         (b)  A medical school in this state that offers an emergency
  medicine, family medicine, or internal medicine residency program
  shall include in the curriculum requirements for the program
  education focused on sickle cell disease and sickle cell trait. The
  medical school may enter into agreements as necessary for the
  purposes of this section.
         Sec. 52A.005.  INFORMATION FOR PUBLIC SCHOOL DISTRICT
  PERSONNEL. (a) The Texas Education Agency shall partner with
  sickle cell disease community-based organizations to provide
  information on sickle cell disease and sickle cell trait to public
  school districts and district staff, including school nurses,
  teachers, and coaches.
         (b)  The commission in collaboration with the sickle cell
  task force shall explore methods for improving sickle cell disease
  education and awareness within the public school system and provide
  recommendations to the Texas Education Agency on the improvement
  methods.
         SECTION 4.  (a) Not later than the second anniversary of the
  date the Health and Human Services Commission establishes a health
  home for Medicaid recipients diagnosed with sickle cell disease in
  accordance with Section 533.0091(c), Government Code, as added by
  this Act, the commission shall submit to the governor and the
  legislature a report on the effects of using a health home for those
  recipients, including:
               (1)  health outcomes of those recipients; and
               (2)  cost savings to this state associated with sickle
  cell disease treatment.
         (b)  The Health and Human Services Commission may include the
  report required under Subsection (a) of this section with the
  annual report the sickle cell task force is required to submit under
  Section 52.0007, Health and Safety Code, as amended by this Act.
         SECTION 5.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall:
               (1)  in accordance with Section 1945, Social Security
  Act (42 U.S.C. Section 1396w-4), seek from the appropriate federal
  agency an amendment to the state's Medicaid state plan to implement
  Section 533.0091, Government Code, as added by this Act, and the
  commission may delay implementing that section until the state plan
  amendment is approved;
               (2)  appoint the new members of the sickle cell task
  force as required by Section 52.0003, Health and Safety Code, as
  amended by this Act; and
               (3)  apply for a grant from the Centers for Disease
  Control and Prevention's Sickle Cell Data Collection Program to
  establish a voluntary sickle cell disease surveillance system under
  Section 52A.002, Health and Safety Code, as added by this Act.
         SECTION 6.  Section 52A.004, Health and Safety Code, as
  added by this Act, applies to residents entering an emergency
  medicine, family medicine, or internal residency program at a
  medical school in this state on or after January 1, 2024.
         SECTION 7.  This Act takes effect September 1, 2023.