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