Bill Text: TX HB26 | 2011 | 82nd Legislature 1st Special | Engrossed
Bill Title: Relating to the containment of costs incurred in the correctional health care system and to studies regarding delivery of health care services by certain nurses.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2011-06-22 - Received from the House [HB26 Detail]
Download: Texas-2011-HB26-Engrossed.html
By: Madden | H.B. No. 26 |
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relating to the containment of costs incurred in the correctional | ||
health care system and to studies regarding delivery of health care | ||
services by certain nurses. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter C, Chapter 499, Government Code, is | ||
amended by adding Section 499.055 to read as follows: | ||
Sec. 499.055. POPULATION MANAGEMENT BASED ON INMATE HEALTH. | ||
The department shall adopt policies designed to manage inmate | ||
population based on similar health conditions suffered by inmates. | ||
The policies adopted under this section must maximize | ||
organizational efficiencies and reduce health care costs to the | ||
department by housing inmates with similar health conditions in the | ||
same unit or units that are, if possible, served by or located near | ||
one or more specialty health care providers most likely to be needed | ||
for the treatment of the health condition. | ||
SECTION 2. (a) Section 501.063, Government Code, is | ||
amended to read as follows: | ||
Sec. 501.063. INMATE FEE [ |
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CARE [ |
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or under contract with the department, other than a halfway house, | ||
who initiates a visit to a health care provider shall pay a health | ||
care services fee [ |
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of $100 [ |
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(2) The fee imposed under Subdivision (1) covers all | ||
visits to a health care provider that the inmate initiates until the | ||
first anniversary of the imposition of the fee. | ||
(3) The inmate shall pay [ |
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out of the inmate's trust fund. If the balance in the fund is | ||
insufficient to cover the fee [ |
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deposit to the fund shall be applied toward the balance owed until | ||
the total amount owed is paid. | ||
(b) [ |
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before any deductions are made from an inmate's trust fund under | ||
this section [ |
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required by Subsection (a). | ||
(c) [ |
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health care as a result of the inmate's failure or inability to pay | ||
a fee under this section [ |
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(d) [ |
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this section in an account in the general revenue fund that may be | ||
used only to pay the cost of correctional health care | ||
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year, the comptroller shall transfer any surplus from the preceding | ||
fiscal year to the state treasury to the credit of the general | ||
revenue fund. | ||
(b) Effective September 1, 2015, Section 501.063, | ||
Government Code, is amended to read as follows: | ||
Sec. 501.063. INMATE COPAYMENTS FOR CERTAIN HEALTH CARE | ||
VISITS. (a) An inmate confined in a facility operated by or under | ||
contract with the department, other than a halfway house, who | ||
initiates a visit to a health care provider shall make a copayment | ||
to the department in the amount of $3. The inmate shall make the | ||
copayment out of the inmate's trust fund. If the balance in the | ||
fund is insufficient to cover the copayment, 50 percent of each | ||
deposit to the fund shall be applied toward the balance owed until | ||
the total amount owed is paid. | ||
(b) The department may not charge a copayment for health | ||
care: | ||
(1) provided in response to a life-threatening or | ||
emergency situation affecting the inmate's health; | ||
(2) initiated by the department; | ||
(3) initiated by the health care provider or | ||
consisting of routine follow-up, prenatal, or chronic care; or | ||
(4) provided under a contractual obligation that is | ||
established under the Interstate Corrections Compact or under an | ||
agreement with another state that precludes assessing a copayment. | ||
(c) The department shall adopt policies to ensure that | ||
before an inmate initiates a visit to a health care provider, the | ||
inmate is informed that a $3 copayment will be deducted from the | ||
inmate's trust fund as required by Subsection (a). | ||
(d) The department may not deny an inmate access to health | ||
care as a result of the inmate's failure or inability to make a | ||
copayment. | ||
(e) The department shall deposit money received under this | ||
section in an account in the general revenue fund that may be used | ||
only to pay the cost of administering this section. At the | ||
beginning of each fiscal year, the comptroller shall transfer any | ||
surplus from the preceding fiscal year to the state treasury to the | ||
credit of the general revenue fund. | ||
SECTION 3. Subchapter B, Chapter 501, Government Code, is | ||
amended by adding Section 501.067 to read as follows: | ||
Sec. 501.067. AVAILABILITY OF CERTAIN MEDICATION. (a) In | ||
this section, "over-the-counter medication" means medication that | ||
may legally be sold and purchased without a prescription. | ||
(b) The department shall make over-the-counter medication | ||
available for purchase by inmates in each inmate commissary | ||
operated by or under contract with the department. | ||
(c) The department may not deny an inmate access to | ||
over-the-counter medications as a result of the inmate's inability | ||
to pay for the medication. The department shall pay for the cost of | ||
over-the-counter medication for inmates who are unable to pay for | ||
the medication out of the profits of inmate commissaries operated | ||
by or under contract with the department. | ||
(d) The department may adopt policies concerning the sale | ||
and purchase of over-the-counter medication under this section as | ||
necessary to ensure the safety and security of inmates in the | ||
custody of, and employees of, the department, including policies | ||
concerning the quantities and types of over-the-counter medication | ||
that may be sold and purchased under this section. | ||
SECTION 4. Section 501.147(d), Government Code, is amended | ||
to read as follows: | ||
(d) Notwithstanding Subsection (c) or any other provision | ||
of this subchapter [ |
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may [ |
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contracts [ |
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confined by the department. | ||
SECTION 5. Subchapter E, Chapter 501, Government Code, is | ||
amended by adding Section 501.1485 to read as follows: | ||
Sec. 501.1485. CORRECTIONS MEDICATION AIDES. (a) The | ||
department, in cooperation with The University of Texas Medical | ||
Branch at Galveston and the Texas Tech University Health Sciences | ||
Center, shall develop and implement a training program for | ||
corrections medication aides that uses a curriculum specific to | ||
administering medication in a correctional setting. | ||
(b) In developing the curriculum for the training program, | ||
the department, The University of Texas Medical Branch at | ||
Galveston, and the Texas Tech University Health Sciences Center | ||
shall: | ||
(1) consider the content of the curriculum developed | ||
by the American Correctional Association for certified corrections | ||
nurses; and | ||
(2) modify as appropriate the content of the | ||
curriculum developed under Chapter 242, Health and Safety Code, for | ||
medication aides administering medication in convalescent and | ||
nursing homes and related institutions to produce content suitable | ||
for administering medication in a correctional setting. | ||
(c) The department shall submit an application for the | ||
approval of a training program developed under this section, | ||
including the curriculum, to the Department of Aging and Disability | ||
Services in the manner established by the executive commissioner of | ||
the Health and Human Services Commission under Section 161.083, | ||
Human Resources Code. | ||
SECTION 6. Section 251.012, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 251.012. EXEMPTIONS FROM LICENSING REQUIREMENT. The | ||
following facilities are not required to be licensed under this | ||
chapter: | ||
(1) a home and community support services agency | ||
licensed under Chapter 142 with a home dialysis designation; | ||
(2) a hospital licensed under Chapter 241 that | ||
provides dialysis only to individuals receiving: | ||
(A) [ |
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from the hospital; or | ||
(B) [ |
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due to a disaster declared by the governor or a federal disaster | ||
declared by the president of the United States occurring in this | ||
state or another state during the term of the disaster declaration; | ||
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(3) a hospital operated by or on behalf of the state as | ||
part of the managed health care provider network established under | ||
Chapter 501, Government Code, that provides dialysis only to | ||
individuals receiving: | ||
(A) inpatient services from the hospital; or | ||
(B) outpatient services while serving a term of | ||
confinement in a facility operated by or under contract with the | ||
Texas Department of Criminal Justice; | ||
(4) an end stage renal disease facility operated by or | ||
on behalf of the state as part of the managed health care provider | ||
network established under Chapter 501, Government Code, that | ||
provides dialysis only to individuals receiving those services | ||
while serving a term of confinement in a facility operated by or | ||
under contract with the Texas Department of Criminal Justice; or | ||
(5) the office of a physician unless the office is used | ||
primarily as an end stage renal disease facility. | ||
SECTION 7. Subchapter D, Chapter 161, Human Resources Code, | ||
is amended by adding Section 161.083 to read as follows: | ||
Sec. 161.083. CORRECTIONS MEDICATION AIDES. (a) The | ||
executive commissioner shall establish: | ||
(1) minimum standards and procedures for the approval | ||
of corrections medication aide training programs, including | ||
curricula, developed under Section 501.1485, Government Code; | ||
(2) minimum requirements for the issuance, denial, | ||
renewal, suspension, and revocation of a permit to a corrections | ||
medication aide, including the payment of an application or renewal | ||
fee in an amount necessary to cover the costs incurred by the | ||
department in administering this section; and | ||
(3) the acts and practices that are within and outside | ||
the scope of a permit issued under this section. | ||
(b) Not later than the 90th day after receipt of an | ||
application for approval of a corrections medication aide training | ||
program developed under Section 501.1485, Government Code, the | ||
department shall: | ||
(1) approve the program, if the program meets the | ||
minimum standards and procedures established under Subsection | ||
(a)(1); or | ||
(2) provide notice to the Texas Department of Criminal | ||
Justice that the program is not approved and include in the notice a | ||
description of the actions that are required for the program to be | ||
approved. | ||
(c) The department shall issue a permit to or renew the | ||
permit of an applicant who meets the minimum requirements | ||
established under Subsection (a)(2). The department shall | ||
coordinate with the Texas Department of Criminal Justice in the | ||
performance of the department's duties and functions under this | ||
subsection. | ||
SECTION 8. INTERIM STUDY OF INDEPENDENT PRESCRIPTIVE | ||
AUTHORITY FOR ADVANCED PRACTICE REGISTERED NURSES. (a) The | ||
speaker of the house and the lieutenant governor shall create and | ||
appoint a joint interim committee composed of a combination of | ||
legislators, state officials and citizen members to conduct a joint | ||
study as described by Subsection (b). | ||
(b) The study shall examine the independent authority of | ||
advanced practice registered nurses to diagnose and prescribe drugs | ||
and medical devices within the scope of the health care providers' | ||
practice and license, including the impact on inmate health in | ||
Texas Department of Criminal Justice facilities, including any the | ||
potential cost savings and other foreseeable consequences of | ||
expanding the authority in the Nursing Practice Act of advanced | ||
practice registered nurses in Texas Department of Criminal Justice | ||
facilities to prescribe medication to patients without statutory | ||
requirements for physician delegation or collaboration. | ||
(c) Not later than January 1, 2013, the committees shall | ||
report the committees' finding and recommendations to the | ||
lieutenant governor, the speaker of the house of representatives, | ||
and the governor. The committees shall include in their | ||
recommendations specific changes to statutes and agency rules that | ||
may be necessary according to the results of the committees' study | ||
conducted under this section. | ||
(d) Not later than November 1, 2011, the lieutenant governor | ||
and the speaker of the house of representatives shall issue the | ||
joint interim charge required by this section. | ||
(e) This section expires January 1, 2013. | ||
SECTION 9. (a) The Institute for Health Policy at the | ||
School of Public Health at The University of Texas Health Science | ||
Center at Houston shall study, with respect to patients who receive | ||
health care services from an advanced practice nurse, as that term | ||
is defined in Section 301.152, Occupations Code, patient safety and | ||
outcomes, including quality of care, health care costs, access to | ||
health care, and any other measures determined by the institute. | ||
(b) Not later than October 15, 2012, the Institute for | ||
Health Policy shall report its findings to the governor, the | ||
lieutenant governor, the speaker of the house of representatives, | ||
the Senate Health and Human Services Committee or its successor, | ||
and the House Public Health Committee or its successor and the joint | ||
interim committee created and appointed to study independent | ||
prescriptive authority for advanced practice registered nurses. | ||
(c) This section expires September 1, 2013. | ||
SECTION 10. (a) The change in law made by this Act to | ||
Section 501.147(d), Government Code, does not affect a contract | ||
executed before the effective date of this Act. Such a contract is | ||
governed by the law as it existed immediately before the effective | ||
date of this Act, and that law is continued in effect for that | ||
purpose. | ||
(b) The amendment of Section 501.147(d), Government Code, | ||
by this Act prevails over any conflicting amendment of that section | ||
by S.B. No. 1 of the 82nd Legislature, 1st Called Session, 2011, | ||
regardless of the relative dates of enactment. | ||
SECTION 11. (a) The Texas Department of Criminal Justice, | ||
in cooperation with The University of Texas Medical Branch at | ||
Galveston, the Texas Tech University Health Sciences Center, or a | ||
successor correctional managed health care provider, shall develop | ||
the training program required by Section 501.1485, Government Code, | ||
as added by this Act, and the department shall submit an application | ||
for approval of that program, as required by Subsection (c) of that | ||
section, not later than January 1, 2012. If after the effective | ||
date of this Act and before the date the department develops the | ||
training program described by this subsection The University of | ||
Texas Medical Branch at Galveston and the Texas Tech University | ||
Health Sciences Center are no longer represented on the | ||
Correctional Managed Health Care Committee, or no longer serve as | ||
correctional managed health care providers, the executive director | ||
of the department shall request and receive the cooperation of any | ||
other state agency determined by the executive director to be an | ||
appropriate resource in the development of the program. | ||
(b) The change in law made by this Act in amending Section | ||
251.012, Health and Safety Code, applies only to dialysis services | ||
provided on or after the effective date of this Act. Dialysis | ||
services provided before the effective date of this Act are covered | ||
by the law in effect immediately before that date, and the former | ||
law is continued in effect for that purpose. | ||
(c) The executive commissioner of the Health and Human | ||
Services Commission shall establish the minimum standards and | ||
requirements and the acts and practices allowed or prohibited, as | ||
required by Section 161.083, Human Resources Code, as added by this | ||
Act, not later than January 1, 2012. | ||
SECTION 12. This Act takes effect on the 91st day after the | ||
last day of the legislative session. |