83R4298 JSC-D
	By: Kolkhorst	H.B. No. 15

	A BILL TO BE ENTITLED
	AN ACT
	relating to level of care designations for hospitals that provide
	neonatal and maternal services.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Chapter 241, Health and Safety Code, is amended
	by adding Subchapter H to read as follows:
	SUBCHAPTER H. HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL AND
	MATERNAL CARE
	Sec. 241.181.  DEFINITIONS. In this subchapter:
	(1)  "Department" means the Department of State Health
	Services.
	(2)  "Executive commissioner" means the executive
	commissioner of the Health and Human Services Commission.
	Sec. 241.182.  LEVEL OF CARE DESIGNATIONS. (a) The
	executive commissioner shall assign level of care designations to
	each hospital based on the neonatal and maternal services provided
	at the hospital.
	(b)  A hospital may receive different level designations for
	neonatal and maternal care, respectively.
	Sec. 241.183.  RULES. (a) The executive commissioner shall
	adopt rules:
	(1)  establishing the levels of care for neonatal and
	maternal care to be assigned to hospitals;
	(2)  prescribing criteria for designating levels of
	neonatal and maternal care, respectively, including specifying the
	minimum requirements to qualify for each level designation;
	(3)  establishing a process for the assignment of
	levels of care to a hospital for neonatal and maternal care,
	respectively;
	(4)  dividing the state into neonatal and maternal care
	regions;
	(5)  establishing neonatal and maternal care regional
	advisory councils and prescribing processes for the councils; and
	(6)  detailing confidential reporting requirements.
	(b)  Each level of care designation must require the hospital
	to:
	(1)  actively participate in the appropriate neonatal
	and maternal care regional advisory council; and
	(2)  regularly submit outcome and other data to the
	department as required or requested.
	(c)  The criteria a hospital must achieve to receive each
	level of care designation must be posted on the department's
	Internet website.
	Sec. 241.184.  ASSIGNMENT OF LEVEL OF CARE DESIGNATION. (a)
	The executive commissioner in consultation with the department
	shall assign the appropriate level of care designation to each
	hospital that meets the minimum standards for that level of care.
	The executive commissioner shall evaluate separately the neonatal
	and maternal services provided at the hospital and assign the
	respective level of care designations accordingly.
	(b)  Biennially, the executive commissioner and the
	department shall review the levels of care designations assigned to
	each hospital and, as necessary, assign a hospital a different
	level of care designation or remove the hospital's level of care
	designation.
	Sec. 241.185.  HOSPITAL FAILING TO ACHIEVE MINIMUM LEVELS OF
	CARE. A hospital that does not meet the minimum requirements for
	any level of care designation for neonatal or maternal services:
	(1)  may not receive a level of care designation for
	those services; and
	(2)  is not eligible to receive reimbursement through
	the Medicaid program for neonatal or maternal services, as
	applicable.
	SECTION 2.  (a) In this section:
	(1)  "Department" means the Department of State Health
	Services.
	(2)  "Executive commissioner" means the executive
	commissioner of the Health and Human Services Commission.
	(3)  "Task force" means the Perinatal Facility
	Designation Implementation Task Force established under this
	section.
	(b)  The task force consists of 14 members appointed by the
	executive commissioner as follows:
	(1)  four neonatologists, at least two of whom must
	practice in a Level IIIC neonatal intensive care unit;
	(2)  one general pediatrician;
	(3)  two general obstetrician-gynecologists;
	(4)  two maternal fetal medicine specialists;
	(5)  one family practice physician who provides
	obstetrical care and practices in a rural community;
	(6)  one representative from a children's hospital;
	(7)  one representative from a hospital with a Level II
	neonatal intensive care unit;
	(8)  one representative from a rural hospital; and
	(9)  one representative from a general hospital.
	(c)  To the extent possible, the executive commissioner
	shall appoint members to the task force who previously served on the
	Neonatal Intensive Care Unit Council established under Chapter 818
	(H.B. 2636), Acts of the 82nd Legislature, Regular Session, 2011.
	(d)  A member of the task force serves without compensation
	but is entitled to reimbursement for actual and necessary travel
	expenses related to the performance of task force duties.
	(e)  The Health and Human Services Commission, the
	department, and the task force shall work together to develop a
	process for the designation of levels of neonatal and maternal care
	at hospitals in accordance with Subchapter H, Chapter 241, Health
	and Safety Code, as added by this Act.
	(f)  The task force shall:
	(1)  develop criteria for designating levels of
	neonatal and maternal care, respectively, including specifying the
	minimum requirements to qualify for each level designation;
	(2)  develop a process for the assignment of levels of
	care to a hospital for neonatal and maternal care, respectively;
	(3)  make recommendations for the division of the state
	into neonatal and maternal care regions;
	(4)  develop processes for neonatal and maternal care
	regional advisory councils; and
	(5)  develop confidential reporting requirements.
	(g)  In developing the criteria for the levels of neonatal
	and maternal care, the task force shall consider:
	(1)  any recommendations or publications of the
	American Academy of Pediatrics and the American Congress of
	Obstetricians and Gynecologists, including the Guidelines for
	Perinatal Care; and
	(2)  the geographic and varied needs of citizens of
	this state.
	(h)  Each level of care designation must comply with Section
	241.183(b), Health and Safety Code, as added by this Act.
	(i)  The task force shall submit a report detailing the task
	force's determinations and recommendations to the department and
	the executive commissioner not later than September 1, 2015.
	(j)  The task force is abolished August 31, 2016.
	SECTION 3.  (a) Not later than December 1, 2013, the
	executive commissioner of the Health and Human Services Commission
	shall appoint the members of the Perinatal Facility Designation
	Implementation Task Force as required by Section 2 of this Act.
	(b)  Not later than March 1, 2016, after consideration of the
	report of the Perinatal Facility Designation Implementation Task
	Force, the executive commissioner of the Health and Human Services
	Commission shall adopt the initial rules required by Section
	241.183, Health and Safety Code, as added by this Act.
	(c)  Not later than August 31, 2016, the executive
	commissioner of the Health and Human Services Commission shall
	complete the neonatal and maternal level of care designation
	assignments for each hospital in this state.
	(d)  Notwithstanding Section 241.185, Health and Safety
	Code, as added by this Act, a hospital is not required to have a
	level of care designation as a condition of reimbursement through
	the Medicaid program before September 1, 2016.
	SECTION 4.  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 5.  This Act takes effect September 1, 2013.