By: Cain H.B. No. 4693
A BILL TO BE ENTITLED
AN ACT
relating to entities that provide services to rural Texans and in
rural counties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 58.093, Agriculture Code, is amended to
read as follows:
Sec. 58.093. AMOUNT OF GRANTS. A grant under the young
farmer grant program may not be less than $5,000 or more than
$35,000 [$20,000].
SECTION 2. Chapter 12, Agriculture Code, Subsection 12.051
is amended to read as follows:
Sec. 12.051. FARMER MENTAL HEALTH AND SUICIDE PREVENTION
PROGRAM.
(a) The department shall establish a farmer mental health
and suicide prevention program to raise awareness among farmers of
issues relating to mental health and suicide prevention.
(b) As part of the program, the department shall:
(1) promote suicide prevention among farmers through a
public awareness campaign;
(2) provide a toll-free telephone hotline for farmer
mental health assistance;
(3) develop a mental wellness plan for farmers
affected by a disaster; [and]
(4) coordinate suicide prevention activities with
other state agencies, including the Department of State Health
Services; [.]
(5) identify counties where farmers reside and where
an inadequate number of mental health providers are located; and
(6) develop strategies to increase the number of
mental health providers located in those counties.
SECTION 3. Subchapter D, Chapter 48, Education Code, is
amended by adding Section 48.114(d) to read as follows:
(d) A mentor teacher who provides services at a rural
campus, as defined by Section 48.112(a) shall be eligible for
compensation in excess of the amounts provided in Subsection (c) if
the district is able to fund such compensation from sources other
than the mentor program allotment.
SECTION 4. Subchapter H, Chapter 301, Occupations Code, is
amended by adding Sections 301.357 and 301.358 to read as follows:
Sec. 301.357. PRACTICE IN RURAL HELTHCARE AREAS BY CERTAIN
ADVANCED PRACTICE REGISTERED NURSES. (a) This section and Section
301.358 apply to a licensed advanced practice registered nurse only
if 85% or more of the nurse's services are provided in a rural
healthcare area.
(b) In this section and Section 301.358:
(1) "advanced practice registered nurse" has the
meaning assigned by Section 301.152(a);
(2) "controlled substance" has the meaning assigned by
Section 481.002, Health and Safety Code;
(3) "dangerous drug" has the meaning assigned by
Section 483.001, Health and Safety Code;
(4) "device" has the meaning assigned by Section
551.003, and includes durable medical equipment;
(5) "licensed rural practitioner" means a licensed
advanced practice registered nurse authorized by the board to
practice under this section and under Section 301.358 in accordance
with standards established and recognized by the board to protect
the public health and safety; and
(6) "nonprescription drug" has the meaning assigned by
Section 551.003; and
(7) "rural healthcare area" has the meaning assigned
by Section 12.052, Agriculture Code.
(c) The board shall authorize the practice under this
section and Section 301.358 of an advanced practice registered
nurse who applies in the manner the board prescribes by rule and who
meets the requirements for authorization. An advanced practice
registered nurse who applies for authorization must file an
affidavit with the board demonstrating that the nurse meets the
requirements of Subsection (a).
(d) The board by rule shall establish:
(1) standards for licensed rural practitioners to
protect the public health and safety; and
(2) guidelines for continuing education for licensed
rural practitioners that are not subject to the limitations of
Section 301.303(b).
(e) The scope of practice of a licensed rural practitioner
includes:
(1) ordering, performing, and interpreting diagnostic
tests;
(2) formulating primary and differential medical
diagnoses and advanced assessments;
(3) treating actual and potential health problems;
(4) prescribing therapeutic and corrective measures,
including nutrition and diagnostic support services, home health
care, hospice care, physical therapy, and occupational therapy, and
delegating and assigning the performance of therapeutic and
corrective measures to assistive personnel;
(5) to the extent authorized by the board under
Section 301.358, prescribing, ordering, procuring, administering,
and dispensing drugs and devices, including blood and blood
products, controlled substances listed in Schedules II, III, IV,
and V, dangerous drugs, and nonprescription drugs;
(6) providing referrals to health care agencies,
health care providers, and community resources;
(7) serving as the primary care provider of record;
and
(8) performing other acts that require education and
training consistent with professional standards and that are
commensurate with the licensed rural practitioner's education,
license, authorization to practice under this section and Section
301.358, and competencies and experience.
(f) A licensed rural practitioner is accountable to
patients, the nursing profession, and the board for:
(1) complying with the requirements of this chapter;
(2) providing quality advanced nursing care;
(3) recognizing the nurse's limits of knowledge;
(4) planning for the management of situations beyond
the nurse's expertise; and
(5) consulting with or referring patients to other
health care providers as appropriate.
(g) This section does not limit or modify the scope of
practice of a nurse who is not authorized to practice under this
section.
(h) A law that authorizes a licensed physician assistant or
advanced practice registered nurse acting on behalf of or under
authority delegated by a physician to take an action is considered
to authorize a licensed rural practitioner to take the action.
Sec. 301.358. PRESCRIBING AND ORDERING AUTHORITY OF
LICENSED RURAL PRACTITIONER. (a) The board by rule may authorize a
licensed rural practitioner to prescribe and order drugs and
devices, including controlled substances listed in Schedules II,
III, IV, and V, dangerous drugs, and nonprescription drugs.
(b) The board may establish the level of demonstrated
proficiency required to take authorized actions under the rules
adopted under Subsection (a).
SECTION 5. Chapter 12, Agriculture Code, is amended by
adding Section 12.052 to read as follows:
Sec. 12.052 RURAL HEALTHCARE AREAS. (a) A "Rural
Healthcare Area" is defined as:
(1) any location in a rural county as defined by
Section 487.301, Government Code;
(2) a Rural Health Facility Capital Improvement
Program defined entity; or
(3) any location where a person whose primary
residence is in a rural county as defined by Section 487.301,
Government Code receives healthcare.
SECTION 6. Section 61.9606, Education Code is amended to
read as follows:
Sec. 61.9606. REPAYMENT. (a) Except as provided by Section
61.9609(a), the board shall provide repayment assistance under this
subchapter in the following amounts:
(1) [60] 75 percent of each payment due on an
attorney's eligible loans during the first 12-month period after
the attorney enters into the agreement under Section 61.9605;
(2) 80 percent of each payment due on an attorney's
eligible loans during the second 12-month period after the attorney
enters into the agreement; and
(3) 100 percent of each payment due on an attorney's
eligible loans during the third 12-month period after the attorney
enters into the agreement.
(b) The board shall deliver any repayment assistance made
under this subchapter in a lump sum payable to the lender and the
attorney and in accordance with any applicable federal law.
(c) Loan repayment assistance received under this
subchapter may be applied to the principal amount of the loan and to
interest that accrues.
SECTION 7. The change in law made by Section 1 applies to a
grant issued on or after the effective date of this Act. A grant
issued before the effective date of this Act is governed by the law
in effect on the date the grant is issued, and the former law is
continued in effect for that purpose.
SECTION 8. Not later than February 1, 2024, the Texas Board
of Nursing shall adopt the rules necessary to implement the changes
in law made by this Act.
SECTION 9. This Act takes effect September 1, 2023.