Bill Text: TX HB1575 | 2023-2024 | 88th Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.
Spectrum: Slight Partisan Bill (Republican 9-3)
Status: (Passed) 2023-06-02 - Effective on 9/1/23 [HB1575 Detail]
Download: Texas-2023-HB1575-Comm_Sub.html
Bill Title: Relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.
Spectrum: Slight Partisan Bill (Republican 9-3)
Status: (Passed) 2023-06-02 - Effective on 9/1/23 [HB1575 Detail]
Download: Texas-2023-HB1575-Comm_Sub.html
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 |
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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. |