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  88R22200 KKR-F
 
  By: Hull, Harless, Slawson, Rose, Frank H.B. No. 1575
 
  Substitute the following for H.B. No. 1575:
 
  By:  Harless C.S.H.B. No. 1575
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to improving health outcomes for pregnant women under
  Medicaid and certain other public benefits programs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  It is the intent of the legislature to improve
  health outcomes for pregnant women and their children through the
  case management for children and pregnant women program. In
  recognizing that nonmedical factors impact health outcomes, this
  legislation, in part, authorizes Medicaid to provide case
  management services for nonmedical needs that will improve health
  outcomes for pregnant women and their children.
         SECTION 2.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Section 531.024183 to read as follows:
         Sec. 531.024183.  STANDARDIZED SCREENING QUESTIONS FOR
  ASSESSING NONMEDICAL HEALTH-RELATED NEEDS OF CERTAIN PREGNANT
  WOMEN; INFORMED CONSENT. (a) In this section, "alternatives to
  abortion program" means the program established by the commission
  to enhance and increase resources that promote childbirth for women
  facing unplanned pregnancy, or a successor program.
         (b)  The commission shall adopt standardized screening
  questions designed to screen for, identify, and aggregate data
  regarding the nonmedical health-related needs of pregnant women
  eligible for benefits under a public benefits program administered
  by the commission or another health and human services agency,
  including:
               (1)  Medicaid; and
               (2)  the alternatives to abortion program.
         (c)  Subject to Subsection (d), the standardized screening
  questions must be used by Medicaid managed care organizations and
  providers participating in the alternatives to abortion program.
         (d)  A managed care organization or provider participating
  in a public benefits program described by Subsection (b), including
  the alternatives to abortion program, may not perform a screening
  of a pregnant woman using the standardized screening questions
  required by this section unless the organization or provider:
               (1)  informs the woman:
                     (A)  about the type of data that will be collected
  during the screening and the purposes for which the data will be
  used; and
                     (B)  that the collected data will become part of
  the woman's medical record or service plan; and
               (2)  obtains the woman's informed consent to perform
  the screening.
         (e)  A managed care organization or provider participating
  in a public benefits program described by Subsection (b), including
  the alternatives to abortion program, must provide to the
  commission, in the form and manner prescribed by the commission,
  data the organization or provider collects using the standardized
  screening questions required by this section.
         (f)  Not later than December 1 of each even-numbered year,
  the commission shall prepare and submit to the legislature a report
  that, using de-identified information, summarizes the data
  collected and provided to the commission under Subsection (e)
  during the previous biennium. In accordance with Section 531.014,
  the commission may consolidate the report required under this
  subsection with any other report to the legislature required under
  this chapter or another law that relates to the same subject matter.
         SECTION 3.  Chapter 531, Government Code, is amended by
  adding Subchapter Q to read as follows:
  SUBCHAPTER Q.  CASE MANAGEMENT SERVICES FOR CERTAIN PREGNANT WOMEN
         Sec. 531.651.  DEFINITIONS. In this subchapter:
               (1)  "Case management for children and pregnant women
  program" means the "children and pregnant women program," as
  defined by Section 533.002555.
               (2)  "Nonmedical health-related needs screening" means
  a screening performed using the standardized screening questions
  required under Section 531.024183.
               (3)  "Program services" means case management services
  provided under the case management for children and pregnant women
  program, including assistance provided to a Medicaid managed care
  organization in coordinating the provision of benefits to a
  recipient enrolled in the organization's managed care plan in a
  manner that is consistent with the recipient's plan of care.
         Sec. 531.652.  MEDICAID MANAGED CARE ORGANIZATION SERVICE
  COORDINATION BENEFITS NOT AFFECTED. The provision of program
  services to a recipient does not preempt or otherwise affect a
  Medicaid managed care organization's obligation to provide service
  coordination benefits to the recipient.
         Sec. 531.653.  CASE MANAGEMENT FOR CHILDREN AND PREGNANT
  WOMEN PROGRAM: PROVIDER QUALIFICATIONS.  Program services may be
  provided only by a provider who completes the standardized case
  management training required by the commission under Section
  531.654 and who is:
               (1)  an advanced practice nurse who holds a license,
  other than a provisional or temporary license, under Chapter 301,
  Occupations Code;
               (2)  a registered nurse who holds a license, other than
  a provisional or temporary license, under Chapter 301, Occupations
  Code, and:
                     (A)  completed a baccalaureate degree program in
  nursing; or
                     (B)  completed an associate degree program in
  nursing and has:
                           (i)  at least two years of cumulative paid
  full-time work experience; or
                           (ii)  at least two years of cumulative,
  supervised full-time educational internship or practicum
  experience obtained in the last 10 years that included assessing
  the psychosocial and health needs of and making community referrals
  of:
                                 (a)  children who are 21 years of age
  or younger; or
                                 (b)  pregnant women;
               (3)  a social worker who holds a license, other than a
  provisional or temporary license, under Chapter 505, Occupations
  Code, appropriate for the individual's practice, including the
  practice of independent social work;
               (4)  a community health worker as defined by Section
  48.001, Health and Safety Code, who is certified by the Department
  of State Health Services; or
               (5)  a doula who is certified by a recognized national
  certification program, as determined by the commission, unless the
  doula qualifies as a certified community health worker under
  Subdivision (4).
         Sec. 531.654.  CASE MANAGEMENT FOR CHILDREN AND PREGNANT
  WOMEN PROGRAM: PROVIDER TRAINING. The commission shall require
  that each provider of program services complete training prescribed
  by the commission. The training must be trauma-informed and include
  instruction on:
               (1)  social services provided by this state and local
  governments in this state;
               (2)  community assistance programs, including programs
  providing:
                     (A)  nutrition and housing assistance;
                     (B)  counseling and parenting services;
                     (C)  substance use disorder treatment; and
                     (D)  domestic violence assistance and shelter;
               (3)  domestic violence and coercive control dynamics;
               (4)  methods for explaining and eliciting an eligible
  recipient's informed consent to receive:
                     (A)  program services screening; and
                     (B)  any services that may be offered as a result
  of the screening; and
               (5)  procedures for:
                     (A)  an eligible recipient to:
                           (i)  decline program services screening; or
                           (ii)  withdraw consent for offered services;
  and
                     (B)  ensuring that the recipient is not subject to
  any retaliatory action for declining or discontinuing any
  screenings or services.
         Sec. 531.655.  INITIAL MEDICAL AND NONMEDICAL
  HEALTH-RELATED SCREENINGS OF CERTAIN RECIPIENTS. (a) A Medicaid
  managed care organization that provides health care services to a
  pregnant woman under the STAR Medicaid managed care program shall
  conduct an initial health needs screening and nonmedical
  health-related needs screening of each pregnant recipient to
  determine, regardless of whether the recipient is considered to
  have a high-risk pregnancy, if the recipient:
               (1)  is eligible for service coordination benefits to
  be provided by the managed care organization; or
               (2)  should be referred for program services.
         (b)  Service coordination benefits described by Subsection
  (a) must include identifying and coordinating the provision of
  non-covered services, community supports, and other resources the
  Medicaid managed care organization determines will improve the
  recipient's health outcomes.
         (c)  A Medicaid managed care organization must use the
  results of the screenings conducted under Subsection (a) to
  determine if a recipient requires a more comprehensive assessment
  for purposes of determining whether the recipient is eligible for
  service coordination benefits or program services.
         Sec. 531.656.  SCREENING AND PROGRAM SERVICES OPTIONAL. A
  Medicaid managed care organization providing screenings under
  Section 531.655 must inform each pregnant woman who is referred for
  program services or for whom screening is conducted under that
  section that:
               (1)  the woman has a right to decline the screening or
  services or choose to discontinue the screening or services at any
  time; and
               (2)  declining or discontinuing the screening or
  services will not result in retaliatory action against the woman in
  the provision of other services.
         SECTION 4.  Section 32.024, Human Resources Code, is amended
  by adding Subsections (pp) and (qq) to read as follows:
         (pp)  For purposes of enrollment as a provider and
  reimbursement under the medical assistance program, the commission
  shall establish a separate provider type for a community health
  worker, as defined by Section 48.001, Health and Safety Code, who
  provides case management services under the children and pregnant
  women program, as defined by Section 533.002555, Government Code.
         (qq)  For purposes of enrollment as a provider and
  reimbursement under the medical assistance program, the commission
  shall establish a separate provider type for a doula who is
  certified by a recognized national doula certification program
  approved by the commission.
         SECTION 5.  (a) In this section:
               (1)  "Case management for children and pregnant women
  program" has the meaning assigned by Section 531.651, Government
  Code, as added by this Act.
               (2)  "Commission" means the Health and Human Services
  Commission.
         (b)  Not later than December 1, 2024, the commission shall
  prepare and submit to the legislature a status report on the
  implementation of case management services provided to pregnant
  women under the case management for children and pregnant women
  program during the preceding fiscal year. The report must include
  de-identified information about:
               (1)  the nonmedical health-related needs of the women
  receiving case management services;
               (2)  the number and types of referrals made of women to
  nonmedical community assistance programs and providers; and
               (3)  the birth outcomes for the women.
         SECTION 6.  As soon as practicable after the effective date
  of this Act, the Health and Human Services Commission shall:
               (1)  develop the standardized screening questions as
  required by Section 531.024183, Government Code, as added by this
  Act; and
               (2)  revise the commission's standardized case
  management training for children and pregnant women program
  providers to comply with Section 531.654, Government Code, as added
  by this Act.
         SECTION 7.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 8.  This Act takes effect September 1, 2023.