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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision of services by certain persons in the |
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private duty nursing program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 531, Government Code, is amended by |
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adding Subchapter T to read as follows: |
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SUBCHAPTER T. COMPLEX CARE AIDE |
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Sec. 531.801. DEFINITIONS. (a) In this subchapter: |
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(1) "Home and community support services agency" means |
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a person licensed under Chapter 142, Health and Safety Code. |
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(2) "Certified complex care aide" means a person who |
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is: |
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(A) the parent, legal guardian, or family member |
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of a recipient participating in the program; |
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(B) certified under the program to assist in |
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providing certain private duty nursing services; and |
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(C) employed by the home and community support |
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services agency providing services to the recipient. |
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(3) "Private duty nursing services" means nursing |
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services provided under the Texas Health Steps comprehensive care |
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program to a recipient enrolled in the STAR Kids Medicaid managed |
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care program. |
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Sec. 531.802. CERTIFIED COMPLEX CARE AIDE. The commission |
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shall develop policies to enable a parent, legal guardian, or |
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family member of a recipient receiving private duty nursing |
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services in a home setting to assist in providing those services as |
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a complex care aide. |
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Sec. 531.803. ELIGIBILITY. (a) An individual is eligible |
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to receive services from a certified complex care aide if: |
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(1) the recipient is: |
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(A) enrolled in the STAR Kids Medicaid managed |
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care program; and |
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(B) eligible to receive private duty nursing |
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services under the Texas Health Steps comprehensive care program; |
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(2) the recipient's parent, legal guardian, or family |
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member, as defined by commission rule, elects to become a certified |
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complex care aide; |
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(3) The recipient's parent, legal guardian, or family |
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member, completes all required training necessary to be certified |
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as a complex care aide; and |
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(4) the home and community support services agency |
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that employs the professional registered nurses providing private |
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duty nursing services to the recipient agrees to employ the |
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recipient's parent, legal guardian, or family member. |
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Sec. 531.804. RECIPIENT SCREENING AND NOTIFICATION. (a) |
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The commission shall: |
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(1) add criteria to any screening tool or other |
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instrument used to conduct an assessment or reassessment of a |
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recipient under the STAR Kids Medicaid managed care program to |
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identify recipients who are eligible to participate in the program; |
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and |
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(2) notify the parent or legally authorized |
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representative of the recipient of the potential availability of |
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the service option. |
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(b) The parent or legally authorized representative of |
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the recipient has the sole choice of whether to utilize the service |
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option. |
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Sec. 531.805. COMPLEX CARE AIDE CERTIFICATION REQUIRED. |
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(a) To assist in providing private duty nursing services to a |
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recipient under the program, a parent, legal guardian, or other |
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family member of the recipient must be certified as a complex care |
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aide. A person seeking certification as a complex care aide must |
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satisfy all training, testing, and other minimum qualification |
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standards the commission establishes. |
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Sec. 531.806. TRAINING PROGRAM. (a) The commission shall |
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approve family health aide training programs that meet all of the |
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requirements under 42 CFR 484.80. The training program must |
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include instruction on: |
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(1) transferring; |
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(2) positioning; |
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(3) ambulation; |
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(4) feeding; |
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(5) personal care; |
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(6) catheter care; |
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(7) range of motion; |
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(8) vital signs; |
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(9) blood pressure; |
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(10) medication administration; |
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(11) enteral care and therapy; |
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(12) administering enteral feedings; |
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(13) formula types and preparation; and |
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(14) other tasks the commission approves except for |
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tracheostomy care. |
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(b) The home and community support services agency |
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must also provide ten hours of training in addition to the training |
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required under (a) regarding tasks and skills specific to the needs |
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of the recipient. |
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(c) The home and community support services agency may not |
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impose a fee on an applicant for the training required by this |
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subchapter. |
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Sec. 531.807. CERTIFICATION RESTRICTED; LIMITED SCOPE OF |
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PRACTICE. (a) A certified complex care aide under this subchapter: |
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(1) may only provide complex care services to a |
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recipient who is: |
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(A) related to the license holder; and |
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(B) enrolled in the program; and |
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(2) must be employed by the home and community support |
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services agency that employs the nurse providing private duty |
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nursing services to the recipient. |
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(b) A certified complex care aide may only provide health |
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services to a recipient if the services are: |
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(1) delegated to the certified complex care aide by |
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the professional registered nurse providing private duty nursing |
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services to the recipient; |
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(2) performed under the supervision of that nurse; |
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(3) consistent with Texas Board of Nursing rules |
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governing the delegation of nursing tasks by a registered |
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professional nurse and federal law and regulations governing the |
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provision of private duty nursing services under Medicaid, |
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including 42 C.F.R. Section 440.80 except for tracheostomy care; |
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(4) consistent with the recipient's plan of care; and |
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(5) authorized by commission rules. |
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Sec. 531.808. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES |
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OUTREACH. The commission shall: |
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(1) provide information about the program to home and |
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community support services agencies that provide private duty |
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nursing services under the STAR Kids Medicaid managed care program; |
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and |
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(2) encourage agencies to employ certified complex |
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care aides that are qualified to provide services under this |
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subchapter. |
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Sec. 531.809. REIMBURSEMENT FOR CERTIFIED COMPLEX CARE AIDE |
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SERVICES. (a) The commission shall reimburse a home and community |
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support services agency for services provided to a recipient by a |
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certified complex care aide under this subchapter at a rate that is |
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no less than ninety percent of the licensed vocational nurse rate |
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for private duty nursing services. The commission shall administer |
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reimbursement based on billing units. |
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(b) A recipient's parent, legal guardian, or family member |
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is not eligible for reimbursement as a certified complex care aide |
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if they: |
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(1) do not meet all of the requirements under 531.806; |
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(2) provide more than 40 hours per week of services to an |
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eligible recipient. |
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Sec. 531.811. RULES. The executive commissioner shall |
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adopt rules necessary to implement this subchapter. |
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SECTION 2. The commission shall allow the provision of |
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services by certified complex care aides established under |
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Subchapter T, Chapter 531, Government Code, as added by this Act, |
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not later than September 1, 2026. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2025. |