Texas 2009 - 81st Regular

Texas Senate Bill SB1648 Compare Versions

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1	1	81R33511 JSC-D
2	2	By: Van de Putte, et al. S.B. No. 1648
3	3	Substitute the following for S.B. No. 1648:
4	4	By: Kolkhorst C.S.S.B. No. 1648
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to providing outreach services, service coordination for
10	10	behavioral health services and other health care services related
11	11	to mental health, and related information to members and veterans
12	12	of the armed forces and their families, creating a pilot program for
13	13	provision of related behavioral health services, and providing for
14	14	the creation of related clinical practice guidelines.
15	15	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
16	16	SECTION 1. Title 12, Health and Safety Code, is amended by
17	17	designating Chapter 1001, Health and Safety Code, as Subtitle A and
18	18	adding a heading for Subtitle A to read as follows:
19	19	SUBTITLE A. ADMINISTRATION BY DEPARTMENT
20	20	SECTION 2. Title 12, Health and Safety Code, is amended by
21	21	adding Subtitle B to read as follows:
22	22	SUBTITLE B. DEPARTMENT OF STATE HEALTH SERVICES PROGRAMS
23	23	CHAPTER 1022. SERVICES FOR SERVICEMEMBERS
24	24	SUBCHAPTER A. GENERAL PROVISIONS
25	25	Sec. 1022.001. DEFINITIONS. In this chapter:
26	26	(1) "Department" means the Department of State Health
27	27	Services.
28	28	(2) "Post-traumatic stress disorder" means a
29	29	psychiatric disorder that can occur in people who have experienced
30	30	or witnessed life-threatening events, including natural disasters,
31	31	serious accidents, terrorist incidents, war, or violent personal
32	32	assaults.
33	33	(3) "Program" means the program established under this
34	34	chapter.
35	35	(4) "Servicemember" has the meaning assigned by
36	36	Section 161.551.
37	37	(5) "Traumatic brain injury" means an acquired injury
38	38	to the brain, including brain injuries caused by anoxia due to near
39	39	drowning. The term does not include brain dysfunction caused by
40	40	congenital or degenerative disorders or birth trauma.
41	41	Sec. 1022.002. RULES. The executive commissioner of the
42	42	Health and Human Services Commission shall adopt rules to implement
43	43	this chapter.
44	44	Sec. 1022.003. CREATION AND PURPOSE. The department shall
45	45	establish a program under this chapter to promote the wellness of
46	46	servicemembers and their families through the development,
47	47	maintenance, and dissemination of clinical practice guidelines and
48	48	other information for the effective treatment of psychological
49	49	trauma and the reintegration of servicemembers into their
50	50	communities, families, and workplaces, with emphasis on the trauma
51	51	of war, including post-traumatic stress disorder, traumatic brain
52	52	injury, and sexual trauma that occurs in military settings.
53	53	[Sections 1022.004-1022.050 reserved for expansion]
54	54	SUBCHAPTER B. CLINICAL PRACTICE GUIDELINES FOR TRAUMA
55	55	Sec. 1022.051. CLINICAL GUIDELINES. (a) The department
56	56	shall develop evidence-based clinical practice guidelines
57	57	containing recommendations to clinicians and other providers of
58	58	mental health services for the management of trauma, including
59	59	post-traumatic stress disorder, traumatic brain injury, and other
60	60	trauma impacting behavioral health.
61	61	(b) In developing clinical practice guidelines, the
62	62	department shall consider the recommendations and research of the
63	63	National Center for Posttraumatic Stress Disorder of the federal
64	64	Veterans Health Administration, the trauma registry and research
65	65	database of the United States Army Institute of Surgical Research,
66	66	and other appropriate and reputable sources of clinical research
67	67	and information as determined by the department.
68	68	(c) The department shall provide for the ongoing
69	69	maintenance and updating of the clinical practice guidelines in a
70	70	manner that reflects current diagnostic and treatment best
71	71	practices.
72	72	(d) Clinical practice guidelines established under this
73	73	subchapter do not constitute the sole source of guidance in the
74	74	management of trauma. Guidelines are intended to assist clinicians
75	75	by providing a framework for clinical decision making. These
76	76	guidelines do not provide the only appropriate approach to the
77	77	management of trauma or replace other clinical judgment.
78	78	Sec. 1022.052. DISSEMINATION OF GUIDELINES. (a) The
79	79	department shall make the clinical practice guidelines and other
80	80	information developed under this subchapter available to providers
81	81	of physical and behavioral health services.
82	82	(b) The department shall provide the clinical practice
83	83	guidelines and information to the appropriate professional
84	84	associations to be used in continuing education and shall, to the
85	85	extent feasible, enter into agreements or take other action to
86	86	promote the use of the materials for continuing education purposes.
87	87	(c) The department or its designees shall provide training
88	88	and continuing education to clinicians and shall recognize through
89	89	certificates or other means the health care providers that have
90	90	demonstrated knowledge and mastery of the clinical practice
91	91	guidelines and other materials developed by the department for the
92	92	program.
93	93	Sec. 1022.053. TRAINING AND EDUCATIONAL MATERIALS. In
94	94	addition to clinical practice guidelines, the department shall
95	95	develop, with the advice of and in consultation with the Texas
96	96	Veterans Commission, training and educational materials for the use
97	97	of the Texas Veterans Commission, veterans county service officers,
98	98	and other service providers. The materials must promote the
99	99	understanding and effective treatment of trauma affecting
100	100	behavioral health and other health-related information pertaining
101	101	to the reintegration of servicemembers into their communities,
102	102	families, and workplaces.
103	103	[Sections 1022.054-1022.100 reserved for expansion]
104	104	SUBCHAPTER C. SERVICE COORDINATION FOR BEHAVIORAL
105	105	HEALTH SERVICES
106	106	Sec. 1022.101. SERVICE COORDINATION. (a) The department,
107	107	in consultation with the United States Department of Veterans
108	108	Affairs, the Texas military forces, the Texas Information and
109	109	Referral Network, the Texas Veterans Commission, and the General
110	110	Land Office, shall provide service coordination for servicemembers
111	111	and their families in all geographic regions of the state to connect
112	112	them to behavioral health services that may be available through
113	113	the United States Department of Veterans Affairs or available under
114	114	this chapter.
115	115	(b) In geographic areas in this state in which services are
116	116	not yet available or accessible through the United States
117	117	Department of Veterans Affairs, the department shall negotiate
118	118	contracts with the United States Department of Veterans Affairs for
119	119	behavioral health services provided through community mental
120	120	health centers or other community resources with which the
121	121	department contracts until federal services are available.
122	122	(c) The department shall provide servicemembers and their
123	123	families current, accurate, and complete information about
124	124	behavioral health services and resources through existing
125	125	Internet-based resource programs and through:
126	126	(1) the directory of services for military personnel
127	127	and their families disseminated through the Texas Information and
128	128	Referral Network under Subchapter U, Chapter 161; and
129	129	(2) the service referral program under Section
130	130	431.0291, Government Code, as added by Chapter 1381 (S.B. 1058),
131	131	Acts of the 80th Legislature, Regular Session, 2007.
132	132	(d) The department shall seek reimbursement for the costs of
133	133	services provided under this section from the United States
134	134	Department of Veterans Affairs and from other governmental agencies
135	135	that may provide behavioral health services or payments for such
136	136	services to servicemembers and their families.
137	137	(e) In order to enhance service coordination and assess the
138	138	needs of servicemembers and their families, the department shall
139	139	provide an opportunity for servicemembers to disclose military
140	140	status when accessing local behavioral health services that receive
141	141	funding from the department.
142	142	[Sections 1022.102-1022.150 reserved for expansion]
143	143	SUBCHAPTER D. BEHAVIORAL HEALTH SERVICES PILOT PROGRAMS
144	144	Sec. 1022.151. ESTABLISHMENT OF PILOT PROGRAMS. (a) The
145	145	department shall establish pilot programs in El Paso and Bexar
146	146	Counties to evaluate the effectiveness of a program to provide
147	147	behavioral health services to eligible servicemembers.
148	148	(b) The department shall contract with the local mental
149	149	health authorities in El Paso and Bexar Counties to administer the
150	150	pilot programs.
151	151	Sec. 1022.152. ELIGIBILITY. (a) To qualify for behavioral
152	152	health services under Section 1022.153, a servicemember must:
153	153	(1) reside in El Paso or Bexar County;
154	154	(2) be younger than 65 years of age;
155	155	(3) have served for at least 180 days of duty after the
156	156	servicemember's initial training;
157	157	(4) not be an inmate of a public institution;
158	158	(5) not be a resident of a nursing facility;
159	159	(6) not have health care coverage that provides
160	160	diagnostic review and treatment for post-traumatic stress
161	161	disorder, traumatic brain injury, or other trauma occurring in a
162	162	military setting that impacts behavioral health; and
163	163	(7) be ineligible for services from the United States
164	164	Department of Veterans Affairs or be unable to access those
165	165	services because:
166	166	(A) the servicemember does not have
167	167	transportation to a service provider; or
168	168	(B) the servicemember must wait more than 30 days
169	169	for an appointment with a service provider.
170	170	(b) A servicemember who does not meet the eligibility
171	171	requirements for services under this section shall be referred to
172	172	an appropriate service provider for follow-up care.
173	173	(c) To receive behavioral health services under Section
174	174	1022.153, an eligible servicemember must enroll with the local
175	175	mental health authority in the pilot program. Following expiration
176	176	of the term of a servicemember's enrollment in the pilot program,
177	177	the servicemember may reenroll for services under the pilot program
178	178	if the local mental health authority determines that the
179	179	servicemember continues to qualify for treatment for
180	180	post-traumatic stress disorder, traumatic brain injury, or other
181	181	trauma occurring in a military setting that impacts behavioral
182	182	health.
183	183	(d) A family member of an enrolled servicemember may receive
184	184	behavioral health services under the pilot program as described by
185	185	Section 1022.153.
186	186	Sec. 1022.153. BEHAVIORAL HEALTH SERVICES PILOT PROGRAMS.
187	187	(a) The department through contracts with the local mental health
188	188	authorities in El Paso and Bexar Counties shall establish pilot
189	189	programs to provide behavioral health services in accordance with
190	190	this section for eligible servicemembers under Section 1022.152.
191	191	The behavioral health services provided under this section may
192	192	include:
193	193	(1) crisis services; and
194	194	(2) behavioral health services.
195	195	(b) The behavioral health services provided under
196	196	Subsection (a)(2) must to the greatest extent possible be provided
197	197	in a peer-based treatment environment and may include:
198	198	(1) screening assessments;
199	199	(2) individual, family, and group therapy;
200	200	(3) substance abuse early intervention and
201	201	detoxification services; and
202	202	(4) substance abuse medication-assisted treatment.
203	203	(c) The provision of services by the local mental health
204	204	authority under this section must be based on medical necessity
205	205	criteria established by department rule.
206	206	(d) The department shall seek reimbursement for the costs of
207	207	services provided under this section from the United States
208	208	Department of Veterans Affairs and from other governmental agencies
209	209	that may provide behavioral health services or payments for such
210	210	services to servicemembers and their families.
211	211	Sec. 1022.154. REPORT. Not later than December 1, 2010, the
212	212	department shall submit a report to the governor, lieutenant
213	213	governor, and speaker of the house of representatives that
214	214	includes:
215	215	(1) an analysis of the effectiveness of the pilot
216	216	program under this subchapter; and
217	217	(2) recommendations regarding continuation or
218	218	expansion of the pilot program.
219	219	Sec. 1022.155. EXPIRATION. This subchapter expires
220	220	September 1, 2011.
221	221	[Sections 1022.156-1022.200 reserved for expansion]
222	222	SUBCHAPTER E. BEHAVIORAL HEALTH OUTREACH
223	223	Sec. 1022.201. OUTREACH ACTIVITIES. (a) Through a public
224	224	outreach program, the department shall provide to servicemembers
225	225	and their families information on accessing services through the
226	226	Texas Information and Referral Network and through other
227	227	organizations participating in memoranda of understanding
228	228	maintained by the Texas military forces.
229	229	(b) The department's outreach activities must describe
230	230	programs administered by health and human services agencies that
231	231	could be of interest to servicemembers and their families,
232	232	including early childhood intervention services, state vocational
233	233	rehabilitation services, and higher education benefits and support
234	234	services.
235	235	(c) The department's outreach efforts must be:
236	236	(1) conducted on a statewide basis;
237	237	(2) conducted through a contract or contracts with
238	238	statewide or local community-based organizations with experience
239	239	in statewide outreach to the military; and
240	240	(3) staffed by individuals with demonstrated
241	241	experience in working with the military and military service
242	242	organizations.
243	243	(d) Outreach methods must include direct personal contacts
244	244	with servicemembers and outreach using communications media and
245	245	printed materials. As a component of the department's outreach
246	246	activities, the department shall maintain or support an existing
247	247	interactive Internet-based resource program that:
248	248	(1) allows individuals to access comprehensive
249	249	information, advocacy resources, and other resources regarding
250	250	public and private behavioral health services, crisis and emergency
251	251	services, and early intervention and prevention programs; and
252	252	(2) enables the public and private health care
253	253	communities to work together to address the problems related to
254	254	obtaining access to behavioral health services and other
255	255	reintegration services for servicemembers and their families.
256	256	(e) The interactive Internet-based program established
257	257	under Subsection (d) shall be developed or maintained by the
258	258	department with the advice of and in consultation with the Texas
259	259	military forces. The department shall collaborate with state
260	260	agencies and the Texas military forces to develop strategies to use
261	261	existing interactive Internet-based resources that serve
262	262	servicemembers and their families.
263	263	SECTION 3. Subchapter A, Chapter 431, Government Code, is
264	264	amended by adding Section 431.0186 to read as follows:
265	265	Sec. 431.0186. SCREENING FOR TRAUMATIC BRAIN INJURY.
266	266	(a) The adjutant general shall require each member of the Texas
267	267	National Guard who served during Operation Enduring Freedom or
268	268	Operation Iraqi Freedom to be screened for traumatic brain injury.
269	269	(b) The adjutant general shall assist a member of the Texas
270	270	National Guard who tests positive for traumatic brain injury in
271	271	obtaining appropriate medical care.
272	272	SECTION 4. Section 434.007, Government Code, is amended to
273	273	read as follows:
274	274	Sec. 434.007. DUTIES. (a) The commission shall:
275	275	(1) compile federal, state, and local laws enacted to
276	276	benefit members of the armed forces, veterans, and their families
277	277	and dependents;
278	278	(2) collect information relating to services and
279	279	facilities available to veterans;
280	280	(3) cooperate with veterans service agencies in the
281	281	state;
282	282	(4) inform members and veterans of the armed forces,
283	283	their families and dependents, and military and civilian
284	284	authorities about the existence or availability of:
285	285	(A) educational training and retraining
286	286	facilities;
287	287	(B) health, medical, rehabilitation, and housing
288	288	services and facilities;
289	289	(C) employment and reemployment services;
290	290	(D) provisions of federal, state, and local law
291	291	affording rights, privileges, and benefits to members and veterans
292	292	of the armed forces and their families and dependents; and
293	293	(E) other similar, related, or appropriate
294	294	matters;
295	295	(5) assist veterans and their families and dependents
296	296	in presenting, proving, and establishing claims, privileges,
297	297	rights, and benefits they may have under federal, state, or local
298	298	law, including establishing eligibility for health care services
299	299	and treatments from the federal Veterans Health Administration and
300	300	for services provided through the Department of State Health
301	301	Services;
302	302	(6) cooperate with all government and private agencies
303	303	securing services or benefits to veterans and their families and
304	304	dependents;
305	305	(7) investigate, and if possible correct, abuses or
306	306	exploitation of veterans or their families or dependents, and
307	307	recommend necessary legislation for full correction;
308	308	(8) coordinate the services and activities of state
309	309	departments and divisions having services and resources affecting
310	310	veterans or their families or dependents;
311	311	(9) provide training and certification of veterans
312	312	county service officers and assistant veterans county service
313	313	officers in accordance with Section 434.038; and
314	314	(10) through surveys or other reasonable and accurate
315	315	methods of estimation, collect and maintain for each county in the
316	316	state the number of servicemembers and veterans residing in the
317	317	county and annually update and publish the information on the
318	318	commission's website.
319	319	(b) The commission shall enter into a memorandum of
320	320	understanding with the Department of State Health Services to
321	321	develop training materials for veterans county service officers and
322	322	veterans service organizations that promote the understanding and
323	323	effective treatment of trauma affecting behavioral health and other
324	324	health-related information that promotes the reintegration of
325	325	members and veterans of the armed forces into their communities,
326	326	families, and workplaces. The commission shall:
327	327	(1) disseminate training and educational materials
328	328	for the development of clinical practice guidelines and other
329	329	training and educational materials that it receives from the
330	330	department;
331	331	(2) enter into a contract or other agreement for the
332	332	development of the training and educational materials with the
333	333	department;
334	334	(3) reimburse the department for costs of preparing
335	335	the materials from appropriations or other amounts available to the
336	336	commission; and
337	337	(4) enter into relationships with established
338	338	training programs for the purpose of providing peer support
339	339	training and certification for veterans county service officers.
340	340	SECTION 5. Subsection (a), Section 434.0078, Government
341	341	Code, is amended to read as follows:
342	342	(a) The commission shall adopt procedures for administering
343	343	claims assistance services under Section 434.007(5). Claims
344	344	assistance services shall be provided for establishing eligibility
345	345	for health care services and treatments from the federal Veterans
346	346	Health Administration. The procedures shall include:
347	347	(1) criteria for determining when a veteran's initial
348	348	claim is substantially complete and basic eligibility requirements
349	349	are met as provided by federal law;
350	350	(2) a process for expediting a claim based on
351	351	hardship, including whether the veteran:
352	352	(A) is in immediate need;
353	353	(B) is terminally ill;
354	354	(C) has a verifiable financial hardship; or
355	355	(D) has a disability that presents an undue
356	356	burden;
357	357	(3) a procedure for counseling veterans on the
358	358	potential merits or drawbacks of pursuing a claim;
359	359	(4) a process to ensure adequate documentation and
360	360	development of a claim or appeal, including early client
361	361	involvement, collection of needed evidence and records, and
362	362	analysis of actions necessary to pursue and support a claim or
363	363	appeal;
364	364	(5) criteria for evaluating whether a decision of the
365	365	United States Department of Veterans Affairs contains sufficient
366	366	cause for filing an appeal;
367	367	(6) a requirement that a claims counselor report to
368	368	the United States Department of Veterans Affairs if the counselor
369	369	has direct knowledge that a claim contains false or deceptive
370	370	information; and
371	371	(7) a procedure for prioritizing a claim, when
372	372	appropriate, or providing an alternative source for obtaining
373	373	claims assistance services when it is not appropriate to
374	374	prioritize.
375	375	SECTION 6. The Department of State Health Services shall
376	376	conduct an immediate analysis of the behavioral health needs of
377	377	servicemembers and their families and submit a preliminary report
378	378	of its findings and recommendations to the legislature and the
379	379	governor on or before December 1, 2009, and a final report of its
380	380	findings and recommendations on or before December 1, 2010. The
381	381	report shall:
382	382	(1) identify the gaps in behavioral health services
383	383	available to servicemembers and their families;
384	384	(2) identify impediments to the ability of
385	385	servicemembers and their families to access the behavioral health
386	386	services that are available, particularly in the state's rural
387	387	areas;
388	388	(3) evaluate collaboration among organizations and
389	389	entities that provide behavioral health services to servicemembers
390	390	and their families;
391	391	(4) make recommendations with respect to improving
392	392	outreach to servicemembers and their families in need of behavioral
393	393	health services;
394	394	(5) include a specific plan of action to promote
395	395	federal and state collaboration to maximize funding and access to
396	396	resources for the behavioral health needs of servicemembers and
397	397	their families;
398	398	(6) make recommendations with respect to building
399	399	provider capacity and increasing provider training to meet the
400	400	behavioral health needs of servicemembers and their families
401	401	through peer support treatment methodologies; and
402	402	(7) make recommendations with respect to improving the
403	403	coordination of behavioral health services for servicemembers and
404	404	their families.
405	405	SECTION 7. Not later than January 1, 2010, the executive
406	406	commissioner of the Health and Human Services Commission shall
407	407	adopt rules as necessary to administer Chapter 1022, Health and
408	408	Safety Code, as added by this Act.
409	409	SECTION 8. This Act does not make an appropriation. This
410	410	Act takes effect only if a specific appropriation for the
411	411	implementation of the Act is provided in a general appropriations
412	412	act of the 81st Legislature.
413	413	SECTION 9. Except as provided by Section 8 of this Act, this
414	414	Act takes effect September 1, 2009.