By: Rose, Jetton, et al. H.B. No. 3550
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to standards for and services provided by prescribed
  pediatric extended care centers.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 248A.101(b), Health and Safety Code, is
  amended to read as follows:
         (b)  To protect the health and safety of the public and
  ensure the health, safety, and comfort of the minors served by a
  center, the rules must establish minimum center standards,
  including:
               (1)  standards relating to the issuance, renewal,
  denial, suspension, probation, and revocation of a license to
  operate a center;
               (2)  standards relating to the provision of
  family-centered basic services that include individualized
  medical, developmental, and family training services;
               (3)  based on the size of the building and the number of
  minors served, building construction and renovation standards,
  including standards for plumbing, electrical, glass, manufactured
  buildings, accessibility for persons with physical disabilities,
  and fire protection;
               (4)  based on the size of the building and the number of
  minors served, building maintenance conditions relating to
  plumbing, heating, lighting, ventilation, adequate space, fire
  protection, and other conditions;
               (5)  standards relating to the minimum number of and
  qualifications required for personnel who provide personal care or
  basic services to the minors served;
               (6)  standards relating to the sanitary conditions
  within a center and its surroundings, including water supply,
  sewage disposal, food handling, and general hygiene;
               (7)  standards relating to the programs offered by the
  center to promote and maintain the health and development of the
  minors served and to meet the training needs of the minors' parents
  or legal guardians;
               (8)  standards relating to physician-prescribed
  supportive services;
               (9)  standards relating to transportation services and
  as required by Section 248A.1015; and
               (10)  standards relating to maintenance of patient
  medical records and program records in accordance with other law
  and with accepted professional standards and practices.
         SECTION 2.  Subchapter C, Chapter 248A, Health and Safety
  Code, is amended by adding Sections 248A.1015, 248A.105, and
  248A.106 to read as follows:
         Sec. 248A.1015.  TRANSPORTATION STANDARDS. The executive
  commissioner by rule shall establish minimum standards for
  transportation services as required under Section 248A.101(b)(9).
  In adopting rules under this section, the executive commissioner:
               (1)  shall authorize a center, in coordination with a
  client's parent, guardian, or other responsible adult, to determine
  the schedule of transportation services and determine by provider
  type whether a provider must be present to supervise the client
  during transportation; and
               (2)  may not:
                     (A)  require a plan of care or physician's order
  to document a client's need for transportation services to access a
  center's services;
                     (B)  require the center to obtain:
                           (i)  the signature of a client's parent,
  guardian, or other responsible adult on each occasion the client
  boards or deboards the transportation; or
                           (ii)  any confirmation of the exact time the
  client boards or deboards the transportation; or
                     (C)  prohibit a client from declining
  transportation offered by a center, including declining
  transportation entirely or only on a specific date.
         Sec. 248A.105.  REIMBURSEMENT FOR SERVICES. (a)  The
  executive commissioner by rule shall establish a reimbursement rate
  for services a center provides to clients, including transportation
  service to and from the center. The executive commissioner shall
  clearly identify the documentation a center must obtain and
  maintain to be eligible for reimbursement.
         (b)  In adopting rules under Subsection (a), the executive
  commissioner may not:
               (1)  authorize a center to combine documentation for
  transportation with documentation for other services provided by
  the center;
               (2)  condition reimbursement for transportation
  services on:
                     (A)  obtaining the signature of a client's parent,
  guardian, or other responsible adult on each occasion the client
  boards or deboards the transportation; or
                     (B)  obtaining any confirmation of the exact time
  the client boards or deboards the transportation; or
               (3)  condition reimbursement of non-transportation
  services on:
                     (A)  a client's decision to use transportation
  services on a specific date or on an ongoing basis; or
                     (B)  a center's obtaining and maintaining
  transportation documentation.
         Sec. 248A.106.  INTERFERENCE WITH RIGHTS TO DETERMINE
  TREATMENT. (a) Except as provided by Subsection (b), any rules the
  executive commissioner adopts under this subchapter may not
  interfere with the authority of a parent, guardian, or other
  responsible adult of a minor client to make decisions regarding the
  treatment provided to the child, including by:
               (1)  requiring the center and the parent, guardian, or
  other responsible adult of a minor client to adhere to a set
  schedule of treatment determined in advance;
               (2)  conditioning payment to a center on the parent,
  guardian, or other responsible adult of a minor client providing an
  explanation of any discrepancies between the treatment scheduled
  and treatment provided; and
               (3)  preventing the center and the parent, guardian, or
  other responsible adult of a minor client from modifying the
  treatment and schedule of treatment consistent with the changing
  medical needs of the client.
         (b)  The executive commissioner, by rule, may limit the
  maximum amount of authorized services provided to a client.
         SECTION 3.  Section 248A.158, Health and Safety Code, is
  amended to read as follows:
         Sec. 248A.158.  RELATION TO NURSING SERVICES.  (a) Subject
  to Subsection (b), nursing [Nursing] services provided by a center
  must be a [one-to-one] replacement of private duty nursing or other
  skilled nursing services unless additional nursing services are
  medically necessary.
         (b)  A center may provide nursing services in a group
  setting, consistent with appropriate staffing ratios.
         SECTION 4.  Subchapter D, Chapter 248A, Health and Safety
  Code, is amended by adding Section 248A.159 to read as follows:
         Sec. 248A.159.  ADMISSION FORMS. (a) Before admission to a
  center, the center may obtain all required parent or legal guardian
  signatures for a patient on one consent document.
         (b)  The consent document must illustrate the involvement of
  the parent or legal guardian in developing and establishing the
  care and treatment to be provided to the patient in the center.
         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)  adopt the rules necessary to implement the changes
  in law made by this Act; and
               (2)  update any relevant procedure manuals, including
  the Children's Services Handbook, to conform to the changes in law
  made by this Act.
         SECTION 6.  This Act takes effect September 1, 2023.