| 1 | 1 | | By: Menéndez S.B. No. 2448 |
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| 2 | 2 | | |
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| 3 | 3 | | |
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| 4 | 4 | | A BILL TO BE ENTITLED |
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| 5 | 5 | | AN ACT |
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| 6 | 6 | | relating to the use of funds appropriated by the Department of State |
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| 7 | 7 | | Health Services to deliver low-dose, at-home racemic ketamine via |
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| 8 | 8 | | telehealth to improve healthcare access and mental health outcomes |
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| 9 | 9 | | across rural and high-risk populations. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Section 1001.203, Health and Safety Code is |
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| 12 | 12 | | amended by adding Section 1001.2032 to read as follows: |
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| 13 | 13 | | (1) The purpose of this Act is to provide for expanded |
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| 14 | 14 | | healthcare access, reduced care costs, improved mental health, |
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| 15 | 15 | | reduced chronic pain, increased workforce productivity, improved |
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| 16 | 16 | | trauma management for first responders and active military, and |
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| 17 | 17 | | improved health rankings for rural and high-risk populations across |
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| 18 | 18 | | Texas by authorizing the Department of State Health Services to |
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| 19 | 19 | | fund low-dose, at-home ketamine using medical technology in the |
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| 20 | 20 | | form of targeted intranasal delivery that can optimize the |
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| 21 | 21 | | effectiveness of and reduce the potential side effects related to |
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| 22 | 22 | | racemic ketamine treatments. |
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| 23 | 23 | | (2) The Department of State Health Services shall direct |
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| 24 | 24 | | funding to treat rural health population, first responders, |
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| 25 | 25 | | veterans, and activity military with a clinical diagnosis of |
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| 26 | 26 | | depression, post-traumatic stress disorder, anxiety, and chronic |
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| 27 | 27 | | pain. The Department of State Health Services shall allocate a |
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| 28 | 28 | | total of $55,000,000 for the purpose of providing funding during |
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| 29 | 29 | | the state fiscal years ending August 31, 2024 and August 31, 2025 |
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| 30 | 30 | | for the treatment of at least 15,000 adults that are designated as |
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| 31 | 31 | | living in a rural area of Texas, at least 8,000 first responders, |
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| 32 | 32 | | and at least 6,000 veterans or active military. |
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| 33 | 33 | | (3) The Department of State Health Services shall transfer |
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| 34 | 34 | | the appropriations through contracts with low-dose, at-home |
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| 35 | 35 | | racemic ketamine service providers that utilize targeted |
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| 36 | 36 | | intranasal drug delivery. When treating mental health and |
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| 37 | 37 | | neurological conditions, which requires the delivery of |
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| 38 | 38 | | pharmaceutical agents to the brain, it is well understood that |
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| 39 | 39 | | using oral administration is the least efficient and problematic |
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| 40 | 40 | | route and intravenous or intramuscular administration prohibits |
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| 41 | 41 | | at-home, self-administration, which is required to maximize access |
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| 42 | 42 | | to care. The most optimized route of administration is intranasal, |
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| 43 | 43 | | where certain regions of the nasal anatomy provide optimized |
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| 44 | 44 | | pathways for drug delivery that can eliminate side effects that can |
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| 45 | 45 | | reduce treatment compliance and maximize potential health |
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| 46 | 46 | | outcomes. The treatment protocol shall not exceed 30 to 60 |
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| 47 | 47 | | milligrams of racemic ketamine per individual treatment and shall |
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| 48 | 48 | | not exceed a total of 180 to 360 milligrams of racemic ketamine for |
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| 49 | 49 | | the entire treatment program, as this sub-anesthetic and low-dose |
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| 50 | 50 | | treatment protocol will minimize the potential for side-effects. |
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| 51 | 51 | | SECTION 2. This Act takes effect immediately if it receives |
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| 52 | 52 | | a vote of two-thirds of all the members elected to each house, as |
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| 53 | 53 | | provided by Section 39, Article III, Texas Constitution, and shall |
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| 54 | 54 | | expire September 1, 2025. |
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| 55 | 55 | | SECTION 3: The Department of State Health Services required |
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| 56 | 56 | | to implement this Act only if the legislature appropriates money |
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| 57 | 57 | | specifically for the purpose stated in SECTION 1 if this Act. If the |
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| 58 | 58 | | legislature does not appropriate money specifically for that |
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| 59 | 59 | | purpose, the Department of State Health Services may, but is not |
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| 60 | 60 | | required to, implement this Act using other appropriations |
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| 61 | 61 | | available for the purpose. |
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| 62 | 62 | | SECTION 4. This Act takes effect September 1, 2023. |
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