81R9408 JSC-F
By: Maldonado H.B. No. 4173
A BILL TO BE ENTITLED
AN ACT
relating to providing outreach and behavioral health services to
certain military service veterans and their families and providing
for the creation of clinical practice guidelines.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Title 12, Health and Safety Code, is amended by
designating Chapter 1001, Health and Safety Code, as Subtitle A and
adding a heading for Subtitle A to read as follows:
SUBTITLE A. ADMINISTRATION BY DEPARTMENT
SECTION 2. Title 12, Health and Safety Code, is amended by
adding Subtitle B to read as follows:
SUBTITLE B. DEPARTMENT OF STATE HEALTH SERVICES PROGRAMS
CHAPTER 1022. SERVICES FOR VETERANS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 1022.001. DEFINITIONS. In this chapter:
(1) "Department" means the Department of State Health
Services.
(2) "Program" means the program established under this
chapter.
Sec. 1022.002. RULES. The executive commissioner of the
Health and Human Services Commission shall adopt rules to implement
this chapter.
Sec. 1022.003. CREATION AND PURPOSE. The department shall
establish a program under this chapter to promote the wellness of
military servicemembers, military veterans, and their families
through the development, maintenance, and dissemination of
clinical practice guidelines and other information for the
effective treatment of psychological trauma and the reintegration
of military veterans into their communities, families, and
workplaces, with emphasis on the trauma of war, including
post-traumatic stress disorder, traumatic brain injury, and sexual
trauma that occurs in military settings.
[Sections 1022.004-1022.050 reserved for expansion]
SUBCHAPTER B. CLINICAL PRACTICE GUIDELINES FOR TRAUMA
Sec. 1022.051. CLINICAL GUIDELINES. (a) The department
shall develop evidence-based clinical practice guidelines
containing recommendations to clinicians and other providers of
mental health services for the management of trauma, including
post-traumatic stress disorder, traumatic brain injury, and other
trauma impacting behavioral health.
(b) In developing clinical practice guidelines, the
department shall consider the recommendations and research of the
National Center for Posttraumatic Stress Disorder of the federal
Veterans Health Administration, the trauma registry and research
database of the United States Army Institute of Surgical Research,
and other appropriate and reputable sources of clinical research
and information as determined by the department.
(c) The department shall provide for the ongoing
maintenance and updating of the clinical practice guidelines in a
manner that reflects current diagnostic and treatment best
practices.
(d) Clinical practice guidelines established under this
subchapter do not constitute the sole source of guidance in the
management of trauma. Guidelines are intended to assist clinicians
by providing a framework for clinical decision making. These
guidelines do not provide the only appropriate approach to the
management of trauma or replace other clinical judgment.
Sec. 1022.052. DISSEMINATION OF GUIDELINES. (a) The
department shall make the clinical practice guidelines and other
information developed under this subchapter available to providers
of physical and behavioral health services.
(b) The department shall provide the clinical practice
guidelines and information to the appropriate professional
associations to be used in continuing education and shall, to the
extent feasible, enter into agreements or take other action to
promote the use of the materials for continuing education purposes.
(c) The department or its designees shall provide training
and continuing education to clinicians and shall recognize through
certificates or other means the health care providers that have
demonstrated knowledge and mastery of the clinical practice
guidelines and other materials developed by the department for the
program.
Sec. 1022.053. TRAINING AND EDUCATIONAL MATERIALS. In
addition to clinical practice guidelines, the department shall
develop, with the advice of and in consultation with the Texas
Veterans Commission, training and educational materials for the use
of the Texas Veterans Commission, veterans county service officers,
and other service providers. The materials must promote the
understanding and effective treatment of trauma affecting
behavioral health and other health-related information pertaining
to the reintegration of military servicemembers into their
communities, families, and workplaces.
[Sections 1022.054-1022.100 reserved for expansion]
SUBCHAPTER C. BEHAVIORAL HEALTH SERVICES AND SERVICE COORDINATION
Sec. 1022.101. SERVICE COORDINATION. (a) The department,
in consultation with the United States Department of Veterans
Affairs, the Texas Military Forces, the Texas Information and
Referral Network, the Texas Veterans Commission, and the General
Land Office, shall provide service coordination for veterans and
their families in all geographic regions of the state to connect
them to behavioral health services that may be available through
the United States Department of Veterans Affairs or available under
this chapter.
(b) In geographic areas in this state in which services are
not yet available or accessible through the United States
Department of Veterans Affairs, the department shall provide
service coordination for veterans to connect them to behavioral
health services that may be available through community mental
health centers or other community resources with which the
department contracts until federal services are available.
(c) The department shall provide military servicemembers,
military veterans, and their families current, accurate, and
complete information about behavioral health services and
resources through existing Internet-based resource programs and
through:
(1) the directory of services for military personnel
and their families disseminated through the Texas Information and
Referral Network under Subchapter U, Chapter 161; and
(2) the service referral program under Section
431.0291, Government Code, as added by Chapter 1381 (S.B. 1058),
Acts of the 80th Legislature, Regular Session, 2007.
Sec. 1022.102. BEHAVIORAL HEALTH SERVICES. (a) The
department shall provide behavioral health services in accordance
with this section for veterans who meet eligibility and medical
necessity criteria established by the department and cannot obtain
immediate access to behavioral health services through the United
States Department of Veterans Affairs. The behavioral health
services provided under this section may include:
(1) crisis services in all geographic regions of the
state; and
(2) short-term behavioral health services in areas of
the state in which existing federal and state behavioral health
services are determined by the department to be inadequate or
inaccessible.
(b) The behavioral health services provided under
Subsection (a)(2) must to the greatest extent possible be provided
in a peer-based treatment environment and may include:
(1) screening assessments;
(2) individual, family, and group therapy;
(3) substance abuse early intervention and
detoxification services; and
(4) substance abuse medication-assisted treatment.
(c) The behavioral health services provided under
Subsection (a)(2) shall be available only until a veteran is able to
access and obtain adequate behavioral health services through the
United States Department of Veterans Affairs.
(d) The provision of services by the department under this
section must be based on medical necessity criteria established by
department rule.
(e) The department shall seek reimbursement for the costs of
services provided under this section from the United States
Department of Veterans Affairs and from other governmental agencies
that may provide behavioral health services or payments for such
services to veterans and their family members.
(f) In order to enhance service coordination and assess the
needs of veterans and their families, the department shall provide
an opportunity for veterans to disclose military status when
accessing local behavioral health services that receive funding
from the department.
[Sections 1022.103-1022.150 reserved for expansion]
SUBCHAPTER D. BEHAVIORAL HEALTH OUTREACH
Sec. 1022.151. OUTREACH ACTIVITIES. (a) Through a public
outreach program, the department shall provide to veterans, members
of the military, and their families information about accessing
services through the Texas Information and Referral Network and
through other organizations participating in memoranda of
understanding maintained by the Texas Military Forces.
(b) The department's outreach activities must describe
programs administered by health and human services agencies that
could be of interest to veterans and their families, including
early childhood intervention services, state vocational
rehabilitation services, and higher education benefits and support
services.
(c) The department's outreach efforts must be:
(1) conducted on a statewide basis;
(2) conducted through a contract or contracts with
local community-based organizations with experience in statewide
outreach to the military; and
(3) staffed by individuals with demonstrated
experience in working with the military and military service
organizations.
(d) Outreach methods must include direct personal contacts
with military servicemembers and veterans and outreach using
communications media and printed materials. As a component of the
department's outreach activities, the department shall maintain or
support an existing interactive Internet-based resource program
that:
(1) allows individuals to access comprehensive
information, advocacy resources, and other resources regarding
public and private behavioral health services, crisis and emergency
services, and early intervention and prevention programs; and
(2) enables the public and private health care
communities to work together to address the problems related to
obtaining access to behavioral health services and other
reintegration services for military servicemembers, veterans, and
their families.
(e) The interactive Internet-based program established
under Subsection (d) shall be developed or maintained by the
department with the advice of and in consultation with the Texas
Military Forces. The department shall collaborate with state
agencies and the Texas Military Forces to develop strategies to use
existing interactive Internet-based resources that serve military
members and their families.
SECTION 3. Section 434.007, Government Code, is amended to
read as follows:
Sec. 434.007. DUTIES. (a) The commission shall:
(1) compile federal, state, and local laws enacted to
benefit members of the armed forces, veterans, and their families
and dependents;
(2) collect information relating to services and
facilities available to veterans;
(3) cooperate with veterans service agencies in the
state;
(4) inform members and veterans of the armed forces,
their families and dependents, and military and civilian
authorities about the existence or availability of:
(A) educational training and retraining
facilities;
(B) health, medical, rehabilitation, and housing
services and facilities;
(C) employment and reemployment services;
(D) provisions of federal, state, and local law
affording rights, privileges, and benefits to members and veterans
of the armed forces and their families and dependents; and
(E) other similar, related, or appropriate
matters;
(5) assist veterans and their families and dependents
in presenting, proving, and establishing claims, privileges,
rights, and benefits they may have under federal, state, or local
law, including establishing eligibility for health care services
and treatments from the federal Veterans Health Administration and
for services provided through the Department of State Health
Services;
(6) cooperate with all government and private agencies
securing services or benefits to veterans and their families and
dependents;
(7) investigate, and if possible correct, abuses or
exploitation of veterans or their families or dependents, and
recommend necessary legislation for full correction;
(8) coordinate the services and activities of state
departments and divisions having services and resources affecting
veterans or their families or dependents;
(9) provide training and certification of veterans
county service officers and assistant veterans county service
officers in accordance with Section 434.038; and
(10) through surveys or other reasonable and accurate
methods of estimation, collect and maintain for each county in the
state the number of servicemembers and veterans residing in the
county and annually update and publish the information on the
commission's website.
(b) The commission shall enter into a memorandum of
understanding with the Department of State Health Services to
develop training materials for veterans county service officers and
veterans service organizations that promote the understanding and
effective treatment of trauma affecting behavioral health and other
health-related information that promotes the reintegration of
military members into their communities, families, and workplaces.
The commission shall:
(1) disseminate training and educational materials
for the development of clinical practice guidelines and other
training and educational materials that it receives from the
department;
(2) enter into a contract or other agreement for the
development of the training and educational materials with the
department;
(3) reimburse the department for costs of preparing
the materials from appropriations or other amounts available to the
commission; and
(4) enter into relationships with established
training programs for the purpose of providing peer support
training and certification for veterans county service officers.
SECTION 4. Section 434.0078(a), Government Code, is amended
to read as follows:
(a) The commission shall adopt procedures for administering
claims assistance services under Section 434.007(5). Claims
assistance services shall be provided for establishing eligibility
for health care services and treatments from the federal Veterans
Health Administration. The procedures shall include:
(1) criteria for determining when a veteran's initial
claim is substantially complete and basic eligibility requirements
are met as provided by federal law;
(2) a process for expediting a claim based on
hardship, including whether the veteran:
(A) is in immediate need;
(B) is terminally ill;
(C) has a verifiable financial hardship; or
(D) has a disability that presents an undue
burden;
(3) a procedure for counseling veterans on the
potential merits or drawbacks of pursuing a claim;
(4) a process to ensure adequate documentation and
development of a claim or appeal, including early client
involvement, collection of needed evidence and records, and
analysis of actions necessary to pursue and support a claim or
appeal;
(5) criteria for evaluating whether a decision of the
United States Department of Veterans Affairs contains sufficient
cause for filing an appeal;
(6) a requirement that a claims counselor report to
the United States Department of Veterans Affairs if the counselor
has direct knowledge that a claim contains false or deceptive
information; and
(7) a procedure for prioritizing a claim, when
appropriate, or providing an alternative source for obtaining
claims assistance services when it is not appropriate to
prioritize.
SECTION 5. The Department of State Health Services shall
conduct an immediate analysis of the behavioral health needs of
veterans and their families and submit a preliminary report of its
findings and recommendations to the legislature and the governor on
or before December 1, 2009, and a final report of its findings and
recommendations on or before December 1, 2010. The report shall:
(1) identify the gaps in behavioral health services
available to veterans and their families;
(2) identify impediments to the ability of veterans
and their families to access the behavioral health services that
are available, particularly in the state's rural areas;
(3) evaluate collaboration among organizations and
entities that provide behavioral health services to veterans and
their families;
(4) make recommendations with respect to improving
outreach to veterans and their families in need of behavioral
health services;
(5) include a specific plan of action to promote
federal and state collaboration to maximize funding and access to
resources for the behavioral health needs of veterans and their
families;
(6) make recommendations with respect to building
provider capacity and increasing provider training to meet the
behavioral health needs of veterans and their families through peer
support treatment methodologies; and
(7) make recommendations with respect to improving the
coordination of behavioral health services for veterans and their
families.
SECTION 6. This Act takes effect September 1, 2009.