88R3380 KKR-D
	By: Rose	H.B. No. 1481

	A BILL TO BE ENTITLED
	AN ACT
	relating to sickle cell disease health care improvement and the
	sickle cell task force.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Subchapter A, Chapter 533, Government Code, is
	amended by adding Section 533.0091 to read as follows:
	Sec. 533.0091.  SICKLE CELL DISEASE TREATMENT; HEALTH HOMES.
	(a) In this section, "health home" means a primary care provider
	or, if appropriate, a specialty care provider, incorporating into
	patient care several features, including comprehensive care
	coordination, family-centered care, and data management, that are
	focused on improving outcome-based quality of care and increasing
	patient and provider satisfaction.
	(b)  The commission shall:
	(1)  in collaboration with the sickle cell task force
	established under Chapter 52, Health and Safety Code:
	(A)  ensure that health care services provided
	under a managed care plan to recipients diagnosed with sickle cell
	disease align with national clinical practice guidelines and
	protocols for sickle cell disease treatment;
	(B)  consider using sickle cell clinical
	evaluation and treatment guidelines, including those recommended
	by the American Society of Hematology or the Children's Hospital of
	Philadelphia; and
	(C)  increase sickle cell disease education for
	Medicaid providers, including emergency room providers; and
	(2)  use the commission's Texas Healthcare Learning
	Collaborative to identify opportunities for improving health
	outcomes of recipients diagnosed with sickle cell disease by:
	(A)  reducing hospital admissions and
	readmissions; and
	(B)  connecting those recipients to a sickle cell
	disease health home or sickle cell disease expert.
	(c)  The commission shall establish one or more health homes
	in this state for recipients diagnosed with sickle cell disease to:
	(1)  reduce barriers preventing recipients diagnosed
	with sickle cell disease from receiving necessary health care;
	(2)  prevent unnecessary hospitalizations and
	vaso-occlusive crises;
	(3)  avoid duplication of services; and
	(4)  reduce costs associated with sickle cell disease
	treatment.
	(d)  A health home established under this section must:
	(1)  provide to a recipient diagnosed with sickle cell
	disease:
	(A)  comprehensive care management;
	(B)  care coordination;
	(C)  health promotion;
	(D)  comprehensive transitional and follow-up
	care;
	(E)  patient and family support; and
	(F)  referral to community and social support
	services; and
	(2)  use the existing Medicaid managed care delivery
	system in a manner that avoids duplication of services and payment.
	SECTION 2.  Sections 52.0003 and 52.0007, Health and Safety
	Code, are amended to read as follows:
	Sec. 52.0003.  COMPOSITION OF TASK FORCE. The task force is
	composed of the following members appointed by the executive
	commissioner:
	(1)  two members from community-based organizations
	with experience addressing the needs of individuals with sickle
	cell disease;
	(2)  two physicians specializing in hematology;
	(3)  two members of the public, each of whom either has
	sickle cell disease or is a parent of a person with sickle cell
	disease or trait; [and]
	(4)  one representative of a health-related
	institution;
	(5)  one representative of the Texas Education Agency;
	and
	(6)  one representative of the commission.
	Sec. 52.0007.  ANNUAL REPORT. (a) Not later than December 1
	of each year, the task force shall prepare and submit to the
	governor and the legislature an annual written report that
	summarizes the task force's work and includes any recommended
	actions or policy changes endorsed by the task force.
	(b)  The task force shall, in collaboration with the
	commission, include in the task force's annual report
	recommendations for improving sickle cell disease education for
	health care providers.
	SECTION 3.  Subtitle B, Title 2, Health and Safety Code, is
	amended by adding Chapter 52A to read as follows:
	CHAPTER 52A. SICKLE CELL DISEASE CARE EDUCATION AND TREATMENT
	Sec. 52A.001.  DEFINITION. In this chapter, "sickle cell
	task force" means the sickle cell task force established under
	Chapter 52.
	Sec. 52A.002.  SICKLE CELL DISEASE SURVEILLANCE SYSTEM. (a)
	Using grant money awarded by the Centers for Disease Control and
	Prevention's Sickle Cell Data Collection Program, the department
	shall establish and maintain a voluntary sickle cell disease
	surveillance system to determine:
	(1)  the number of individuals with sickle cell disease
	in this state;
	(2)  the manner in which individuals with sickle cell
	disease use health care services; and
	(3)  health outcomes of individuals with sickle cell
	disease.
	(b)  The sickle cell disease surveillance system must
	include:
	(1)  a de-identified record of individuals diagnosed
	with sickle cell disease or sickle cell trait in this state; and
	(2)  any other de-identified information concerning
	cases of sickle cell disease or sickle cell trait that the
	department considers necessary and appropriate.
	(c)  An individual who is diagnosed with sickle cell disease
	or sickle cell trait may voluntarily register with the department
	for inclusion in the sickle cell disease surveillance system.
	(d)  After an individual registers with the department under
	Subsection (c), a health care facility or health care provider who
	treats the individual shall provide to the department, in the form
	and manner the department prescribes, data the department considers
	necessary and appropriate concerning cases of sickle cell disease.
	(e)  The executive commissioner by rule shall develop
	guidelines to:
	(1)  obtain information from health care facilities
	regarding cases of sickle cell disease;
	(2)  protect the confidentiality of individuals
	diagnosed with sickle cell disease in accordance with Section
	159.002, Occupations Code; and
	(3)  ensure the sickle cell disease surveillance system
	is developed in a manner consistent with:
	(A)  the Health Insurance Portability and
	Accountability Act of 1996 (Pub. L. No. 104-191);
	(B)  regulations adopted under that Act; and
	(C)  other applicable laws and regulations
	governing disclosure of health information.
	(f)  Information obtained under this section is confidential
	and privileged and:
	(1)  is not subject to disclosure under Chapter 552,
	Government Code;
	(2)  is not subject to subpoena or discovery or
	otherwise compelled to be produced in any administrative, civil,
	criminal, or other proceeding; and
	(3)  may not be introduced into evidence in any
	administrative, civil, criminal, or other proceeding.
	(g)  The department may compile and publish statistical and
	other studies derived from de-identified data obtained under this
	chapter.
	(h)  The executive commissioner shall adopt rules necessary
	to implement this section.
	Sec. 52A.003.  TEXAS HEALTH SERVICE AUTHORITY EMERGENCY
	DEPARTMENT ENCOUNTER NOTIFICATIONS SYSTEM. The Texas Health
	Services Authority established under Chapter 182 shall collect and
	analyze clinical data and use the emergency department encounter
	notifications system to ensure an individual diagnosed with sickle
	cell disease is not incorrectly identified as an individual who
	misuses opioid drugs.
	Sec. 52A.004.  EMERGENCY AND PRIMARY CARE MEDICINE GRADUATE
	MEDICAL EDUCATION PROGRAM CURRICULUM. (a) In this section,
	"graduate medical education program" and "medical school" have the
	meanings assigned by Section 58A.001, Education Code.
	(b)  A medical school in this state that offers an emergency
	medicine, family medicine, or internal medicine residency program
	shall include in the curriculum requirements for the program
	education focused on sickle cell disease and sickle cell trait. The
	medical school may enter into agreements as necessary for the
	purposes of this section.
	Sec. 52A.005.  INFORMATION FOR PUBLIC SCHOOL DISTRICT
	PERSONNEL. (a) The Texas Education Agency shall partner with
	sickle cell disease community-based organizations to provide
	information on sickle cell disease and sickle cell trait to public
	school districts and district staff, including school nurses,
	teachers, and coaches.
	(b)  The commission in collaboration with the sickle cell
	task force shall explore methods for improving sickle cell disease
	education and awareness within the public school system and provide
	recommendations to the Texas Education Agency on the improvement
	methods.
	SECTION 4.  (a) Not later than the second anniversary of the
	date the Health and Human Services Commission establishes a health
	home for Medicaid recipients diagnosed with sickle cell disease in
	accordance with Section 533.0091(c), Government Code, as added by
	this Act, the commission shall submit to the governor and the
	legislature a report on the effects of using a health home for those
	recipients, including:
	(1)  health outcomes of those recipients; and
	(2)  cost savings to this state associated with sickle
	cell disease treatment.
	(b)  The Health and Human Services Commission may include the
	report required under Subsection (a) of this section with the
	annual report the sickle cell task force is required to submit under
	Section 52.0007, Health and Safety Code, as amended by this Act.
	SECTION 5.  As soon as practicable after the effective date
	of this Act, the executive commissioner of the Health and Human
	Services Commission shall:
	(1)  in accordance with Section 1945, Social Security
	Act (42 U.S.C. Section 1396w-4), seek from the appropriate federal
	agency an amendment to the state's Medicaid state plan to implement
	Section 533.0091, Government Code, as added by this Act, and the
	commission may delay implementing that section until the state plan
	amendment is approved;
	(2)  appoint the new members of the sickle cell task
	force as required by Section 52.0003, Health and Safety Code, as
	amended by this Act; and
	(3)  apply for a grant from the Centers for Disease
	Control and Prevention's Sickle Cell Data Collection Program to
	establish a voluntary sickle cell disease surveillance system under
	Section 52A.002, Health and Safety Code, as added by this Act.
	SECTION 6.  Section 52A.004, Health and Safety Code, as
	added by this Act, applies to residents entering an emergency
	medicine, family medicine, or internal residency program at a
	medical school in this state on or after January 1, 2024.
	SECTION 7.  This Act takes effect September 1, 2023.