By: Hull, Harless, Slawson, Rose, Frank	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 who provides case management services under the case
	management for children and pregnant women program under Section
	531.653(4), 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.