bill to pay family members as home health aides

The text as introduced · 1,124 words

90R2014 KKR-D

By: Bucy
H.B. No. 420

A BILL TO BE ENTITLED

AN ACT

relating to establishing a family health aide program to enable

parents, legal guardians, or family members of certain Medicaid

recipients to provide home health services to those recipients in

coordination with private duty nursing services; requiring an

occupational license.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Chapter 546, Government Code, is amended by

adding Subchapter P to read as follows:

SUBCHAPTER P. FAMILY HEALTH AIDE PROGRAM

Sec. 546.0751. DEFINITIONS. (a) In this subchapter:

(1) "Home and community support services agency" means

a person licensed under Chapter 142, Health and Safety Code.

(2) "Licensed health aide" means an individual who is:

(A) the parent, legal guardian, or family member

of a recipient participating in the program;

(B) licensed under the program to assist in

providing private duty nursing services; and

(C) employed by the home and community support

services agency providing services to the recipient.

(3) "Private duty nursing services" means nursing

services provided under the Texas Health Steps comprehensive care

program to a recipient enrolled in the STAR Kids Medicaid managed

care program.

(4) "Program" means the family health aide program

established under this subchapter.

Sec. 546.0752. FAMILY HEALTH AIDE PROGRAM. The commission,

in consultation with the Texas Board of Nursing and the state

Medicaid Managed Care Advisory Committee, shall develop and

implement a family health aide program to enable a parent, legal

guardian, or family member of a recipient receiving private duty

nursing services in a home setting to assist in providing those

services as a licensed health aide.

Sec. 546.0753. PROGRAM ELIGIBILITY. An individual is

eligible to participate in the program if:

(1) the recipient is:

(A) enrolled in the STAR Kids Medicaid managed

care program; and

(B) eligible to receive private duty nursing

services under the Texas Health Steps comprehensive care program;

(2) the recipient's parent, legal guardian, or family

member, as defined by commission rule, elects to participate in the

program; and

(3) the home and community support services agency

that employs the professional registered nurse providing private

duty nursing services to the recipient agrees to employ the

recipient's parent, legal guardian, or family member.

Sec. 546.0754. RECIPIENT SCREENING AND NOTIFICATION. The

commission shall:

(1) add criteria to any screening tool or other

instrument used to conduct an assessment or reassessment of a

recipient under the STAR Kids Medicaid managed care program to

identify recipients who are eligible to participate in the program;

and

(2) notify the parent or legally authorized

representative of the recipient of the potential availability of

the program.

Sec. 546.0755. HEALTH AIDE LICENSE REQUIRED. (a) To assist

in providing private duty nursing services to a recipient under the

program, a parent, legal guardian, or other family member of the

recipient must hold a license under this subchapter. An applicant

for a license under this subchapter must:

(1) submit an application to the commission in the

form and manner the commission prescribes; and

(2) satisfy all training, testing, and other minimum

qualification standards the commission establishes.

(b) Notwithstanding any other law, the executive

commissioner shall, in consultation with the Texas Board of

Nursing, adopt rules and procedures for issuing a license and for

renewing, suspending, or revoking a license issued under this

subchapter. The rules must:

(1) provide that the commission establish minimum

qualification standards and, subject to Section 546.0756, training

requirements for obtaining and maintaining the license;

(2) provide that the commission issue the license

under this subchapter; and

(3) prescribe procedures for accepting complaints and

conducting investigations of alleged violations of the terms of the

licensure by license holders.

Sec. 546.0756. TRAINING PROGRAM. (a) The commission shall

develop or approve a health aide training program. The program must

include instruction on:

(1) transferring;

(2) positioning;

(3) ambulation;

(4) feeding;

(5) personal care;

(6) catheter care;

(7) range of motion;

(8) vital signs;

(9) blood pressure;

(10) medication administration;

(11) tracheostomy care;

(12) enteral care and therapy;

(13) administering enteral feedings;

(14) formula types and preparation; and

(15) other tasks the commission approves.

(b) The commission may not impose a fee on an applicant for

the training required by this subchapter.

Sec. 546.0757. LICENSE RESTRICTED; LIMITED SCOPE OF

SERVICES. (a) A license holder under this subchapter:

(1) may only provide health aide services to a

recipient who is:

(A) related to the license holder; and

(B) enrolled in the program; and

(2) must be employed by the home and community support

services agency that employs the nurse providing private duty

nursing services to the recipient.

(b) A licensed health aide may only provide health services

to a recipient if the services are:

(1) delegated to the health aide by the professional

registered nurse providing private duty nursing services to the

recipient;

(2) performed under the supervision of that nurse;

(3) consistent with Texas Board of Nursing rules

governing the delegation of nursing tasks by a registered

professional nurse and federal law and regulations governing the

provision of private duty nursing services under Medicaid,

including 42 C.F.R. Section 440.80;

(4) consistent with the recipient's plan of care; and

(5) authorized by commission rules.

Sec. 546.0758. LICENSED HEALTH AIDE REGISTRY. The

commission shall establish and maintain a registry of health aides

licensed under this subchapter.

Sec. 546.0759. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES

OUTREACH. The commission shall:

(1) provide information about the program to home and

community support services agencies that provide private duty

nursing services under the STAR Kids Medicaid managed care program;

and

(2) encourage agencies to employ health aides licensed

under this subchapter.

Sec. 546.0760. REIMBURSEMENT FOR LICENSED HEALTH AIDE

SERVICES. (a) The commission shall ensure a home and community

support services agency is reimbursed for services provided to a

recipient by a licensed health aide under this subchapter at a rate

that is at least equal to the current Medicare low utilization

payment adjustment visit rates for this state. Reimbursement for

the services is subject to an enhanced reimbursement rate of a

certified nursing assistant.

(b) Reimbursement under this section must be based on

billing units.

Sec. 546.0761. RULES. The executive commissioner shall

adopt rules necessary to implement this subchapter.

SECTION 2. The commission shall implement the family health

aide program established under Subchapter P, Chapter 546,

Government Code, as added by this Act, not later than September 1,

2028.

SECTION 3. 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 4. This Act takes effect September 1, 2027.