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House Interim Committee on Public Health

LABORATORY SCIENTIST LICENSURE

Charge

Study whether public protection or public services could be enhanced by the registration or licensing of clinical laboratory scientists.
Recommendations

  • Maintain the status quo. The federal Clinical Laboratory Improvement Act (CLIA) regulates clinical laboratories in Texas, and most other licensed health professionals are not held to the same type of stringent standards within the workplace.

  • Continue to monitor potential changes at the federal level regarding the CLIA regulation of provider operated laboratories (POLs) in Texas.

    NURSE AIDE RATIO STUDY
    Charge

    Review the benefits, costs, and possibility of mandating a specific ratio of certified nurse aides to nursing home residents.
    Background

    Although there is no imposed ratio of nurse aides in Texas, several states have implemented ratios as a way of ensuring higher quality of care in nursing homes. Disturbed by gross negligence at some nursing home facilities, advocates of nursing homes conclude that a mandatory ratio will improve conditions in nursing homes statewide. Industry representatives, however, cite cost and implementation problems and remain cautious of any hasty solutions.
    Recommendations

  • The Department of Human Services Division of Long-term Care should use existing information and enforcement techniques available to identify and remedy facilities with inadequate staff.

  • Texas nursing facilities should institute measures to increase nurse aide retention, including educational and career incentives and nurse aide participation in discussions of resident care.

  • Pay particular attention to the Board of Nursing Facility Administrators in order to safeguard Texas' nursing home residents. The membership of the board should be reviewed to determine whether the current representation is serving the needs of the state.

  • Explore a cost reimbursement system that rewards quality of care without impacting overall cost to the state.

    REVIEW OF MEDICAL SCHOOL FUNDS
    Charge

    Review the ways in which medical schools use funds generated by their family practice programs.
    Recommendations

  • Account for medical school revenue and funds in the appropriations process.

  • Create a graduate medical education fund (GME fund).

  • Direct the Higher Education Coordinating Board to create an outcome-based formula for the distribution of these funds, if any additional funds are appropriated to the medical schools for GME after this GME fund is created. This formula would be based on the state's physician workforce needs.

    IMPROVING ACCESS TO HEALTH CARE FOR CHILDREN IN TEXAS
    Charge

    Study the possibilities of improving access to health care for children, including a review of the Chronically Ill and Disabled Children's program. In developing proposals, the committee must consult the Legislative Budget Board to ensure the recommendations have no fiscal implications for the state.
    Recommendations

  • Continue to support the current Medicaid 1115(a) waiver application to expand health care services to children up to 133 percent of the federal poverty level.

  • Create a nonprofit corporation under the Texas Non-Profit Corporation Act to administer a statewide children's health insurance program through qualified insurers.

  • Reinvest existing state and local funds by pooling its general revenue appropriations for children's health services to finance a children's health insurance plan.

  • Require non-custodial parents who are required by law to provide health insurance coverage for their children to select either an employer-based plan with comparable coverage or participate in the Texas Healthy Kids Corporation.

  • Identify barriers to access, such as transportation, education, cost, and provider availability. Removing these barriers will be integral to the success of a children's health insurance program.

  • Current CIDC eligible clients up to age 18 should retain their existing level of benefits either through Medicaid coverage or another comparable health care arrangement, as well as access any new benefits that might be available through such coverage.

  • Require certain coverage safeguards for children with special health care needs in managed systems.

    AGENCY OVERSIGHT
    Charge

    Conduct active oversight of agencies under the committee's jurisdiction.
    Recommendations

    None.