Texas 2009 - 81st Regular

Texas House Bill HB4173 Compare Versions

Only one version of the bill is available at this time.

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1	1	81R9408 JSC-F
2	2	By: Maldonado H.B. No. 4173
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to providing outreach and behavioral health services to
8	8	certain military service veterans and their families and providing
9	9	for the creation of clinical practice guidelines.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Title 12, Health and Safety Code, is amended by
12	12	designating Chapter 1001, Health and Safety Code, as Subtitle A and
13	13	adding a heading for Subtitle A to read as follows:
14	14	SUBTITLE A. ADMINISTRATION BY DEPARTMENT
15	15	SECTION 2. Title 12, Health and Safety Code, is amended by
16	16	adding Subtitle B to read as follows:
17	17	SUBTITLE B. DEPARTMENT OF STATE HEALTH SERVICES PROGRAMS
18	18	CHAPTER 1022. SERVICES FOR VETERANS
19	19	SUBCHAPTER A. GENERAL PROVISIONS
20	20	Sec. 1022.001. DEFINITIONS. In this chapter:
21	21	(1) "Department" means the Department of State Health
22	22	Services.
23	23	(2) "Program" means the program established under this
24	24	chapter.
25	25	Sec. 1022.002. RULES. The executive commissioner of the
26	26	Health and Human Services Commission shall adopt rules to implement
27	27	this chapter.
28	28	Sec. 1022.003. CREATION AND PURPOSE. The department shall
29	29	establish a program under this chapter to promote the wellness of
30	30	military servicemembers, military veterans, and their families
31	31	through the development, maintenance, and dissemination of
32	32	clinical practice guidelines and other information for the
33	33	effective treatment of psychological trauma and the reintegration
34	34	of military veterans into their communities, families, and
35	35	workplaces, with emphasis on the trauma of war, including
36	36	post-traumatic stress disorder, traumatic brain injury, and sexual
37	37	trauma that occurs in military settings.
38	38	[Sections 1022.004-1022.050 reserved for expansion]
39	39	SUBCHAPTER B. CLINICAL PRACTICE GUIDELINES FOR TRAUMA
40	40	Sec. 1022.051. CLINICAL GUIDELINES. (a) The department
41	41	shall develop evidence-based clinical practice guidelines
42	42	containing recommendations to clinicians and other providers of
43	43	mental health services for the management of trauma, including
44	44	post-traumatic stress disorder, traumatic brain injury, and other
45	45	trauma impacting behavioral health.
46	46	(b) In developing clinical practice guidelines, the
47	47	department shall consider the recommendations and research of the
48	48	National Center for Posttraumatic Stress Disorder of the federal
49	49	Veterans Health Administration, the trauma registry and research
50	50	database of the United States Army Institute of Surgical Research,
51	51	and other appropriate and reputable sources of clinical research
52	52	and information as determined by the department.
53	53	(c) The department shall provide for the ongoing
54	54	maintenance and updating of the clinical practice guidelines in a
55	55	manner that reflects current diagnostic and treatment best
56	56	practices.
57	57	(d) Clinical practice guidelines established under this
58	58	subchapter do not constitute the sole source of guidance in the
59	59	management of trauma. Guidelines are intended to assist clinicians
60	60	by providing a framework for clinical decision making. These
61	61	guidelines do not provide the only appropriate approach to the
62	62	management of trauma or replace other clinical judgment.
63	63	Sec. 1022.052. DISSEMINATION OF GUIDELINES. (a) The
64	64	department shall make the clinical practice guidelines and other
65	65	information developed under this subchapter available to providers
66	66	of physical and behavioral health services.
67	67	(b) The department shall provide the clinical practice
68	68	guidelines and information to the appropriate professional
69	69	associations to be used in continuing education and shall, to the
70	70	extent feasible, enter into agreements or take other action to
71	71	promote the use of the materials for continuing education purposes.
72	72	(c) The department or its designees shall provide training
73	73	and continuing education to clinicians and shall recognize through
74	74	certificates or other means the health care providers that have
75	75	demonstrated knowledge and mastery of the clinical practice
76	76	guidelines and other materials developed by the department for the
77	77	program.
78	78	Sec. 1022.053. TRAINING AND EDUCATIONAL MATERIALS. In
79	79	addition to clinical practice guidelines, the department shall
80	80	develop, with the advice of and in consultation with the Texas
81	81	Veterans Commission, training and educational materials for the use
82	82	of the Texas Veterans Commission, veterans county service officers,
83	83	and other service providers. The materials must promote the
84	84	understanding and effective treatment of trauma affecting
85	85	behavioral health and other health-related information pertaining
86	86	to the reintegration of military servicemembers into their
87	87	communities, families, and workplaces.
88	88	[Sections 1022.054-1022.100 reserved for expansion]
89	89	SUBCHAPTER C. BEHAVIORAL HEALTH SERVICES AND SERVICE COORDINATION
90	90	Sec. 1022.101. SERVICE COORDINATION. (a) The department,
91	91	in consultation with the United States Department of Veterans
92	92	Affairs, the Texas Military Forces, the Texas Information and
93	93	Referral Network, the Texas Veterans Commission, and the General
94	94	Land Office, shall provide service coordination for veterans and
95	95	their families in all geographic regions of the state to connect
96	96	them to behavioral health services that may be available through
97	97	the United States Department of Veterans Affairs or available under
98	98	this chapter.
99	99	(b) In geographic areas in this state in which services are
100	100	not yet available or accessible through the United States
101	101	Department of Veterans Affairs, the department shall provide
102	102	service coordination for veterans to connect them to behavioral
103	103	health services that may be available through community mental
104	104	health centers or other community resources with which the
105	105	department contracts until federal services are available.
106	106	(c) The department shall provide military servicemembers,
107	107	military veterans, and their families current, accurate, and
108	108	complete information about behavioral health services and
109	109	resources through existing Internet-based resource programs and
110	110	through:
111	111	(1) the directory of services for military personnel
112	112	and their families disseminated through the Texas Information and
113	113	Referral Network under Subchapter U, Chapter 161; and
114	114	(2) the service referral program under Section
115	115	431.0291, Government Code, as added by Chapter 1381 (S.B. 1058),
116	116	Acts of the 80th Legislature, Regular Session, 2007.
117	117	Sec. 1022.102. BEHAVIORAL HEALTH SERVICES. (a) The
118	118	department shall provide behavioral health services in accordance
119	119	with this section for veterans who meet eligibility and medical
120	120	necessity criteria established by the department and cannot obtain
121	121	immediate access to behavioral health services through the United
122	122	States Department of Veterans Affairs. The behavioral health
123	123	services provided under this section may include:
124	124	(1) crisis services in all geographic regions of the
125	125	state; and
126	126	(2) short-term behavioral health services in areas of
127	127	the state in which existing federal and state behavioral health
128	128	services are determined by the department to be inadequate or
129	129	inaccessible.
130	130	(b) The behavioral health services provided under
131	131	Subsection (a)(2) must to the greatest extent possible be provided
132	132	in a peer-based treatment environment and may include:
133	133	(1) screening assessments;
134	134	(2) individual, family, and group therapy;
135	135	(3) substance abuse early intervention and
136	136	detoxification services; and
137	137	(4) substance abuse medication-assisted treatment.
138	138	(c) The behavioral health services provided under
139	139	Subsection (a)(2) shall be available only until a veteran is able to
140	140	access and obtain adequate behavioral health services through the
141	141	United States Department of Veterans Affairs.
142	142	(d) The provision of services by the department under this
143	143	section must be based on medical necessity criteria established by
144	144	department rule.
145	145	(e) The department shall seek reimbursement for the costs of
146	146	services provided under this section from the United States
147	147	Department of Veterans Affairs and from other governmental agencies
148	148	that may provide behavioral health services or payments for such
149	149	services to veterans and their family members.
150	150	(f) In order to enhance service coordination and assess the
151	151	needs of veterans and their families, the department shall provide
152	152	an opportunity for veterans to disclose military status when
153	153	accessing local behavioral health services that receive funding
154	154	from the department.
155	155	[Sections 1022.103-1022.150 reserved for expansion]
156	156	SUBCHAPTER D. BEHAVIORAL HEALTH OUTREACH
157	157	Sec. 1022.151. OUTREACH ACTIVITIES. (a) Through a public
158	158	outreach program, the department shall provide to veterans, members
159	159	of the military, and their families information about accessing
160	160	services through the Texas Information and Referral Network and
161	161	through other organizations participating in memoranda of
162	162	understanding maintained by the Texas Military Forces.
163	163	(b) The department's outreach activities must describe
164	164	programs administered by health and human services agencies that
165	165	could be of interest to veterans and their families, including
166	166	early childhood intervention services, state vocational
167	167	rehabilitation services, and higher education benefits and support
168	168	services.
169	169	(c) The department's outreach efforts must be:
170	170	(1) conducted on a statewide basis;
171	171	(2) conducted through a contract or contracts with
172	172	local community-based organizations with experience in statewide
173	173	outreach to the military; and
174	174	(3) staffed by individuals with demonstrated
175	175	experience in working with the military and military service
176	176	organizations.
177	177	(d) Outreach methods must include direct personal contacts
178	178	with military servicemembers and veterans and outreach using
179	179	communications media and printed materials. As a component of the
180	180	department's outreach activities, the department shall maintain or
181	181	support an existing interactive Internet-based resource program
182	182	that:
183	183	(1) allows individuals to access comprehensive
184	184	information, advocacy resources, and other resources regarding
185	185	public and private behavioral health services, crisis and emergency
186	186	services, and early intervention and prevention programs; and
187	187	(2) enables the public and private health care
188	188	communities to work together to address the problems related to
189	189	obtaining access to behavioral health services and other
190	190	reintegration services for military servicemembers, veterans, and
191	191	their families.
192	192	(e) The interactive Internet-based program established
193	193	under Subsection (d) shall be developed or maintained by the
194	194	department with the advice of and in consultation with the Texas
195	195	Military Forces. The department shall collaborate with state
196	196	agencies and the Texas Military Forces to develop strategies to use
197	197	existing interactive Internet-based resources that serve military
198	198	members and their families.
199	199	SECTION 3. Section 434.007, Government Code, is amended to
200	200	read as follows:
201	201	Sec. 434.007. DUTIES. (a) The commission shall:
202	202	(1) compile federal, state, and local laws enacted to
203	203	benefit members of the armed forces, veterans, and their families
204	204	and dependents;
205	205	(2) collect information relating to services and
206	206	facilities available to veterans;
207	207	(3) cooperate with veterans service agencies in the
208	208	state;
209	209	(4) inform members and veterans of the armed forces,
210	210	their families and dependents, and military and civilian
211	211	authorities about the existence or availability of:
212	212	(A) educational training and retraining
213	213	facilities;
214	214	(B) health, medical, rehabilitation, and housing
215	215	services and facilities;
216	216	(C) employment and reemployment services;
217	217	(D) provisions of federal, state, and local law
218	218	affording rights, privileges, and benefits to members and veterans
219	219	of the armed forces and their families and dependents; and
220	220	(E) other similar, related, or appropriate
221	221	matters;
222	222	(5) assist veterans and their families and dependents
223	223	in presenting, proving, and establishing claims, privileges,
224	224	rights, and benefits they may have under federal, state, or local
225	225	law, including establishing eligibility for health care services
226	226	and treatments from the federal Veterans Health Administration and
227	227	for services provided through the Department of State Health
228	228	Services;
229	229	(6) cooperate with all government and private agencies
230	230	securing services or benefits to veterans and their families and
231	231	dependents;
232	232	(7) investigate, and if possible correct, abuses or
233	233	exploitation of veterans or their families or dependents, and
234	234	recommend necessary legislation for full correction;
235	235	(8) coordinate the services and activities of state
236	236	departments and divisions having services and resources affecting
237	237	veterans or their families or dependents;
238	238	(9) provide training and certification of veterans
239	239	county service officers and assistant veterans county service
240	240	officers in accordance with Section 434.038; and
241	241	(10) through surveys or other reasonable and accurate
242	242	methods of estimation, collect and maintain for each county in the
243	243	state the number of servicemembers and veterans residing in the
244	244	county and annually update and publish the information on the
245	245	commission's website.
246	246	(b) The commission shall enter into a memorandum of
247	247	understanding with the Department of State Health Services to
248	248	develop training materials for veterans county service officers and
249	249	veterans service organizations that promote the understanding and
250	250	effective treatment of trauma affecting behavioral health and other
251	251	health-related information that promotes the reintegration of
252	252	military members into their communities, families, and workplaces.
253	253	The commission shall:
254	254	(1) disseminate training and educational materials
255	255	for the development of clinical practice guidelines and other
256	256	training and educational materials that it receives from the
257	257	department;
258	258	(2) enter into a contract or other agreement for the
259	259	development of the training and educational materials with the
260	260	department;
261	261	(3) reimburse the department for costs of preparing
262	262	the materials from appropriations or other amounts available to the
263	263	commission; and
264	264	(4) enter into relationships with established
265	265	training programs for the purpose of providing peer support
266	266	training and certification for veterans county service officers.
267	267	SECTION 4. Section 434.0078(a), Government Code, is amended
268	268	to read as follows:
269	269	(a) The commission shall adopt procedures for administering
270	270	claims assistance services under Section 434.007(5). Claims
271	271	assistance services shall be provided for establishing eligibility
272	272	for health care services and treatments from the federal Veterans
273	273	Health Administration. The procedures shall include:
274	274	(1) criteria for determining when a veteran's initial
275	275	claim is substantially complete and basic eligibility requirements
276	276	are met as provided by federal law;
277	277	(2) a process for expediting a claim based on
278	278	hardship, including whether the veteran:
279	279	(A) is in immediate need;
280	280	(B) is terminally ill;
281	281	(C) has a verifiable financial hardship; or
282	282	(D) has a disability that presents an undue
283	283	burden;
284	284	(3) a procedure for counseling veterans on the
285	285	potential merits or drawbacks of pursuing a claim;
286	286	(4) a process to ensure adequate documentation and
287	287	development of a claim or appeal, including early client
288	288	involvement, collection of needed evidence and records, and
289	289	analysis of actions necessary to pursue and support a claim or
290	290	appeal;
291	291	(5) criteria for evaluating whether a decision of the
292	292	United States Department of Veterans Affairs contains sufficient
293	293	cause for filing an appeal;
294	294	(6) a requirement that a claims counselor report to
295	295	the United States Department of Veterans Affairs if the counselor
296	296	has direct knowledge that a claim contains false or deceptive
297	297	information; and
298	298	(7) a procedure for prioritizing a claim, when
299	299	appropriate, or providing an alternative source for obtaining
300	300	claims assistance services when it is not appropriate to
301	301	prioritize.
302	302	SECTION 5. The Department of State Health Services shall
303	303	conduct an immediate analysis of the behavioral health needs of
304	304	veterans and their families and submit a preliminary report of its
305	305	findings and recommendations to the legislature and the governor on
306	306	or before December 1, 2009, and a final report of its findings and
307	307	recommendations on or before December 1, 2010. The report shall:
308	308	(1) identify the gaps in behavioral health services
309	309	available to veterans and their families;
310	310	(2) identify impediments to the ability of veterans
311	311	and their families to access the behavioral health services that
312	312	are available, particularly in the state's rural areas;
313	313	(3) evaluate collaboration among organizations and
314	314	entities that provide behavioral health services to veterans and
315	315	their families;
316	316	(4) make recommendations with respect to improving
317	317	outreach to veterans and their families in need of behavioral
318	318	health services;
319	319	(5) include a specific plan of action to promote
320	320	federal and state collaboration to maximize funding and access to
321	321	resources for the behavioral health needs of veterans and their
322	322	families;
323	323	(6) make recommendations with respect to building
324	324	provider capacity and increasing provider training to meet the
325	325	behavioral health needs of veterans and their families through peer
326	326	support treatment methodologies; and
327	327	(7) make recommendations with respect to improving the
328	328	coordination of behavioral health services for veterans and their
329	329	families.
330	330	SECTION 6. This Act takes effect September 1, 2009.