Texas 2023 - 88th Regular

Texas House Bill HB4693 Compare Versions

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1	1	By: Cain H.B. No. 4693
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to entities that provide services to rural Texans and in
7	7	rural counties.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 58.093, Agriculture Code, is amended to
10	10	read as follows:
11	11	Sec. 58.093. AMOUNT OF GRANTS. A grant under the young
12	12	farmer grant program may not be less than $5,000 or more than
13	13	$35,000 [$20,000].
14	14	SECTION 2. Chapter 12, Agriculture Code, Subsection 12.051
15	15	is amended to read as follows:
16	16	Sec. 12.051. FARMER MENTAL HEALTH AND SUICIDE PREVENTION
17	17	PROGRAM.
18	18	(a) The department shall establish a farmer mental health
19	19	and suicide prevention program to raise awareness among farmers of
20	20	issues relating to mental health and suicide prevention.
21	21	(b) As part of the program, the department shall:
22	22	(1) promote suicide prevention among farmers through a
23	23	public awareness campaign;
24	24	(2) provide a toll-free telephone hotline for farmer
25	25	mental health assistance;
26	26	(3) develop a mental wellness plan for farmers
27	27	affected by a disaster; [and]
28	28	(4) coordinate suicide prevention activities with
29	29	other state agencies, including the Department of State Health
30	30	Services; [.]
31	31	(5) identify counties where farmers reside and where
32	32	an inadequate number of mental health providers are located; and
33	33	(6) develop strategies to increase the number of
34	34	mental health providers located in those counties.
35	35	SECTION 3. Subchapter D, Chapter 48, Education Code, is
36	36	amended by adding Section 48.114(d) to read as follows:
37	37	(d) A mentor teacher who provides services at a rural
38	38	campus, as defined by Section 48.112(a) shall be eligible for
39	39	compensation in excess of the amounts provided in Subsection (c) if
40	40	the district is able to fund such compensation from sources other
41	41	than the mentor program allotment.
42	42	SECTION 4. Subchapter H, Chapter 301, Occupations Code, is
43	43	amended by adding Sections 301.357 and 301.358 to read as follows:
44	44	Sec. 301.357. PRACTICE IN RURAL HELTHCARE AREAS BY CERTAIN
45	45	ADVANCED PRACTICE REGISTERED NURSES. (a) This section and Section
46	46	301.358 apply to a licensed advanced practice registered nurse only
47	47	if 85% or more of the nurse's services are provided in a rural
48	48	healthcare area.
49	49	(b) In this section and Section 301.358:
50	50	(1) "advanced practice registered nurse" has the
51	51	meaning assigned by Section 301.152(a);
52	52	(2) "controlled substance" has the meaning assigned by
53	53	Section 481.002, Health and Safety Code;
54	54	(3) "dangerous drug" has the meaning assigned by
55	55	Section 483.001, Health and Safety Code;
56	56	(4) "device" has the meaning assigned by Section
57	57	551.003, and includes durable medical equipment;
58	58	(5) "licensed rural practitioner" means a licensed
59	59	advanced practice registered nurse authorized by the board to
60	60	practice under this section and under Section 301.358 in accordance
61	61	with standards established and recognized by the board to protect
62	62	the public health and safety; and
63	63	(6) "nonprescription drug" has the meaning assigned by
64	64	Section 551.003; and
65	65	(7) "rural healthcare area" has the meaning assigned
66	66	by Section 12.052, Agriculture Code.
67	67	(c) The board shall authorize the practice under this
68	68	section and Section 301.358 of an advanced practice registered
69	69	nurse who applies in the manner the board prescribes by rule and who
70	70	meets the requirements for authorization. An advanced practice
71	71	registered nurse who applies for authorization must file an
72	72	affidavit with the board demonstrating that the nurse meets the
73	73	requirements of Subsection (a).
74	74	(d) The board by rule shall establish:
75	75	(1) standards for licensed rural practitioners to
76	76	protect the public health and safety; and
77	77	(2) guidelines for continuing education for licensed
78	78	rural practitioners that are not subject to the limitations of
79	79	Section 301.303(b).
80	80	(e) The scope of practice of a licensed rural practitioner
81	81	includes:
82	82	(1) ordering, performing, and interpreting diagnostic
83	83	tests;
84	84	(2) formulating primary and differential medical
85	85	diagnoses and advanced assessments;
86	86	(3) treating actual and potential health problems;
87	87	(4) prescribing therapeutic and corrective measures,
88	88	including nutrition and diagnostic support services, home health
89	89	care, hospice care, physical therapy, and occupational therapy, and
90	90	delegating and assigning the performance of therapeutic and
91	91	corrective measures to assistive personnel;
92	92	(5) to the extent authorized by the board under
93	93	Section 301.358, prescribing, ordering, procuring, administering,
94	94	and dispensing drugs and devices, including blood and blood
95	95	products, controlled substances listed in Schedules II, III, IV,
96	96	and V, dangerous drugs, and nonprescription drugs;
97	97	(6) providing referrals to health care agencies,
98	98	health care providers, and community resources;
99	99	(7) serving as the primary care provider of record;
100	100	and
101	101	(8) performing other acts that require education and
102	102	training consistent with professional standards and that are
103	103	commensurate with the licensed rural practitioner's education,
104	104	license, authorization to practice under this section and Section
105	105	301.358, and competencies and experience.
106	106	(f) A licensed rural practitioner is accountable to
107	107	patients, the nursing profession, and the board for:
108	108	(1) complying with the requirements of this chapter;
109	109	(2) providing quality advanced nursing care;
110	110	(3) recognizing the nurse's limits of knowledge;
111	111	(4) planning for the management of situations beyond
112	112	the nurse's expertise; and
113	113	(5) consulting with or referring patients to other
114	114	health care providers as appropriate.
115	115	(g) This section does not limit or modify the scope of
116	116	practice of a nurse who is not authorized to practice under this
117	117	section.
118	118	(h) A law that authorizes a licensed physician assistant or
119	119	advanced practice registered nurse acting on behalf of or under
120	120	authority delegated by a physician to take an action is considered
121	121	to authorize a licensed rural practitioner to take the action.
122	122	Sec. 301.358. PRESCRIBING AND ORDERING AUTHORITY OF
123	123	LICENSED RURAL PRACTITIONER. (a) The board by rule may authorize a
124	124	licensed rural practitioner to prescribe and order drugs and
125	125	devices, including controlled substances listed in Schedules II,
126	126	III, IV, and V, dangerous drugs, and nonprescription drugs.
127	127	(b) The board may establish the level of demonstrated
128	128	proficiency required to take authorized actions under the rules
129	129	adopted under Subsection (a).
130	130	SECTION 5. Chapter 12, Agriculture Code, is amended by
131	131	adding Section 12.052 to read as follows:
132	132	Sec. 12.052 RURAL HEALTHCARE AREAS. (a) A "Rural
133	133	Healthcare Area" is defined as:
134	134	(1) any location in a rural county as defined by
135	135	Section 487.301, Government Code;
136	136	(2) a Rural Health Facility Capital Improvement
137	137	Program defined entity; or
138	138	(3) any location where a person whose primary
139	139	residence is in a rural county as defined by Section 487.301,
140	140	Government Code receives healthcare.
141	141	SECTION 6. Section 61.9606, Education Code is amended to
142	142	read as follows:
143	143	Sec. 61.9606. REPAYMENT. (a) Except as provided by Section
144	144	61.9609(a), the board shall provide repayment assistance under this
145	145	subchapter in the following amounts:
146	146	(1) [60] 75 percent of each payment due on an
147	147	attorney's eligible loans during the first 12-month period after
148	148	the attorney enters into the agreement under Section 61.9605;
149	149	(2) 80 percent of each payment due on an attorney's
150	150	eligible loans during the second 12-month period after the attorney
151	151	enters into the agreement; and
152	152	(3) 100 percent of each payment due on an attorney's
153	153	eligible loans during the third 12-month period after the attorney
154	154	enters into the agreement.
155	155	(b) The board shall deliver any repayment assistance made
156	156	under this subchapter in a lump sum payable to the lender and the
157	157	attorney and in accordance with any applicable federal law.
158	158	(c) Loan repayment assistance received under this
159	159	subchapter may be applied to the principal amount of the loan and to
160	160	interest that accrues.
161	161	SECTION 7. The change in law made by Section 1 applies to a
162	162	grant issued on or after the effective date of this Act. A grant
163	163	issued before the effective date of this Act is governed by the law
164	164	in effect on the date the grant is issued, and the former law is
165	165	continued in effect for that purpose.
166	166	SECTION 8. Not later than February 1, 2024, the Texas Board
167	167	of Nursing shall adopt the rules necessary to implement the changes
168	168	in law made by this Act.
169	169	SECTION 9. This Act takes effect September 1, 2023.