Texas 2023 - 88th Regular

Texas Senate Bill SB26 Compare Versions

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1	1	S.B. No. 26
2	2
3	3
4	4	AN ACT
5	5	relating to local mental health authority and local behavioral
6	6	health authority audits and mental and behavioral health reporting,
7	7	services, and programs.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 8.151, Education Code, is amended to
10	10	read as follows:
11	11	Sec. 8.151. DEFINITIONS. In this subchapter:
12	12	(1) "Executive commissioner" means the executive
13	13	commissioner of the Health and Human Services Commission.
14	14	(2) "Local[, "local] mental health authority" and
15	15	"non-physician mental health professional" have the meanings
16	16	assigned by Section 571.003, Health and Safety Code.
17	17	SECTION 2. Section 8.152, Education Code, is amended by
18	18	adding Subsections (c) and (d) to read as follows:
19	19	(c) If a local mental health authority is unable to employ a
20	20	professional who qualifies as a non-physician mental health
21	21	professional, the authority may request a waiver from the executive
22	22	commissioner for approval to employ, for purposes of performing the
23	23	functions and duties of a non-physician mental health professional
24	24	under this subchapter, a person who:
25	25	(1) is a licensed master social worker, as defined by
26	26	Section 505.002, Occupations Code; or
27	27	(2) has been issued a licensed professional counselor
28	28	associate license by the Texas State Board of Examiners of
29	29	Professional Counselors.
30	30	(d) A person approved under a waiver under Subsection (c)
31	31	shall carry out the functions and duties required of a
32	32	non-physician mental health professional under this subchapter in
33	33	the same manner as a non-physician mental health professional
34	34	employed under Subsection (a) or (b).
35	35	SECTION 3. Subchapter B, Chapter 531, Government Code, is
36	36	amended by adding Section 531.09915 to read as follows:
37	37	Sec. 531.09915. INNOVATION MATCHING GRANT PROGRAM FOR
38	38	MENTAL HEALTH EARLY INTERVENTION AND TREATMENT. (a) In this
39	39	section:
40	40	(1) "Inpatient mental health facility" has the meaning
41	41	assigned by Section 571.003, Health and Safety Code.
42	42	(2) "Program" means the grant program established
43	43	under this section.
44	44	(3) "State hospital" has the meaning assigned by
45	45	Section 552.0011, Health and Safety Code.
46	46	(b) To the extent money is appropriated to the commission
47	47	for that purpose, the commission shall establish a matching grant
48	48	program to provide support to eligible entities for community-based
49	49	initiatives that promote identification of mental health issues and
50	50	improve access to early intervention and treatment for children and
51	51	families. The initiatives may:
52	52	(1) be evidence-based or otherwise demonstrate
53	53	positive outcomes, including:
54	54	(A) improved relationship skills;
55	55	(B) improved self-esteem;
56	56	(C) reduced involvement in the juvenile justice
57	57	system;
58	58	(D) participation in the relinquishment
59	59	avoidance program under Subchapter E, Chapter 262, Family Code; and
60	60	(E) avoidance of emergency room use; and
61	61	(2) include:
62	62	(A) training; and
63	63	(B) services and supports for:
64	64	(i) community-based initiatives;
65	65	(ii) agencies that provide services to
66	66	children and families;
67	67	(iii) individuals who work with children or
68	68	caregivers of children showing atypical social or emotional
69	69	development or other challenging behaviors; and
70	70	(iv) children in or at risk of placement in
71	71	foster care or the juvenile justice system.
72	72	(c) The commission may award a grant under the program only
73	73	in accordance with a contract between the commission and a grant
74	74	recipient. The contract must include provisions under which the
75	75	commission is given sufficient control to ensure the public purpose
76	76	of providing mental health prevention services to children and
77	77	families is accomplished and the state receives the return benefit.
78	78	(d) The executive commissioner by rule shall establish
79	79	application and eligibility requirements for an entity to be
80	80	awarded a grant under the program.
81	81	(e) The following entities are eligible for a grant awarded
82	82	under the program:
83	83	(1) a hospital licensed under Chapter 241, Health and
84	84	Safety Code;
85	85	(2) a mental hospital licensed under Chapter 577,
86	86	Health and Safety Code;
87	87	(3) a hospital district;
88	88	(4) a local mental health authority;
89	89	(5) a child-care facility, as defined by Chapter 42,
90	90	Human Resources Code;
91	91	(6) a county or municipality; and
92	92	(7) a nonprofit organization that is exempt from
93	93	federal income taxation under Section 501(a), Internal Revenue Code
94	94	of 1986, by being listed as an exempt entity under Section 501(c)(3)
95	95	of that code.
96	96	(f) In awarding grants under the program, the commission
97	97	shall prioritize entities that work with children and family
98	98	members of children with a high risk of experiencing a crisis or
99	99	developing a mental health condition to reduce:
100	100	(1) the need for future intensive mental health
101	101	services;
102	102	(2) the number of children at risk of placement in
103	103	foster care or the juvenile justice system; or
104	104	(3) the demand for placement in state hospitals,
105	105	inpatient mental health facilities, and residential behavioral
106	106	health facilities.
107	107	(g) The commission shall condition each grant awarded under
108	108	the program on the grant recipient providing matching money in an
109	109	amount that is equal to at least 10 percent of the grant amount.
110	110	(h) A grant recipient may only use grant money awarded under
111	111	the program and matching money provided by the recipient to develop
112	112	innovative strategies that provide:
113	113	(1) resiliency;
114	114	(2) coping and social skills;
115	115	(3) healthy social and familial relationships; and
116	116	(4) parenting skills and behaviors.
117	117	(i) A grant recipient may not use grant money awarded under
118	118	the program or matching money provided by the recipient to:
119	119	(1) reimburse an expense or pay a cost that another
120	120	source, including the Medicaid program, is obligated to reimburse
121	121	or pay by law or under a contract; or
122	122	(2) supplant or be a substitute for money awarded to
123	123	the recipient from a non-Medicaid federal funding source, including
124	124	federal grant funding.
125	125	(j) A Medicaid provider's receipt of a grant under the
126	126	program does not affect any legal or contractual duty of the
127	127	provider to comply with requirements under the Medicaid program.
128	128	(k) The commission may use a reasonable amount of the money
129	129	appropriated by the legislature for the purposes of the program,
130	130	not to exceed five percent, to pay the administrative costs of
131	131	implementing and administering the program.
132	132	SECTION 4. Subchapter B, Chapter 531, Government Code, is
133	133	amended by adding Section 531.09991 to read as follows:
134	134	Sec. 531.09991. PLAN FOR THE TRANSITION OF CARE OF CERTAIN
135	135	INDIVIDUALS. (a) Not later than January 1, 2025, the commission
136	136	shall, in consultation with nursing facilities licensed under
137	137	Chapter 242, Health and Safety Code, develop a plan for
138	138	transitioning from a hospital that primarily provides behavioral
139	139	health services to a nursing facility individuals who require:
140	140	(1) a level of care provided by nursing facilities;
141	141	and
142	142	(2) a high level of behavioral health supports and
143	143	services.
144	144	(b) The plan must include:
145	145	(1) recommendations for providing incentives to
146	146	providers for the provision of services to individuals described by
147	147	Subsection (a), including an assessment of the feasibility of
148	148	including incentive payments under the Quality Incentive Payment
149	149	Program (QIPP) for those providers;
150	150	(2) recommendations for methods to create bed
151	151	capacity, including reserving specific beds; and
152	152	(3) a fiscal estimate, including estimated costs to
153	153	nursing facilities and savings to hospitals that will result from
154	154	transitioning individuals under Subsection (a).
155	155	(c) The commission may implement the plan, including
156	156	recommendations under the plan, only if the commission determines
157	157	that implementing the plan would increase the amount of available
158	158	state general revenue.
159	159	(d) This section expires September 1, 2025.
160	160	SECTION 5. Section 531.1025, Government Code, is amended by
161	161	adding Subsection (c) to read as follows:
162	162	(c) The commission's office of inspector general shall
163	163	conduct performance audits and require financial audits to be
164	164	conducted of each local behavioral health authority designated
165	165	under Section 533.0356, Health and Safety Code, and local mental
166	166	health authority, as defined by Section 531.002, Health and Safety
167	167	Code. The office shall:
168	168	(1) establish a performance audit schedule that
169	169	ensures the office audits each authority described by this
170	170	subsection at least once every five years;
171	171	(2) establish a financial audit schedule that ensures
172	172	each authority described by this subsection:
173	173	(A) undergoes a financial audit conducted by an
174	174	independent auditor at least once every three years; and
175	175	(B) submits to the office the results of the
176	176	financial audit; and
177	177	(3) require additional audits to be conducted as
178	178	necessary based on adverse findings in a previous audit or as
179	179	requested by the commission.
180	180	SECTION 6. Section 534.0535, Health and Safety Code, is
181	181	amended to read as follows:
182	182	Sec. 534.0535. JOINT DISCHARGE PLANNING. (a) The
183	183	executive commissioner shall adopt or amend, and the department
184	184	shall enforce, rules that require continuity of services and
185	185	planning for patient care between department facilities and local
186	186	mental health authorities.
187	187	(b) At a minimum, the rules must:
188	188	(1) specify the local mental health authority's
189	189	responsibility for ensuring the successful transition of patients
190	190	who are determined by the facility to be medically appropriate for
191	191	discharge; and
192	192	(2) require participation by a department facility in
193	193	joint discharge planning with [between a department facility and] a
194	194	local mental health authority before the [a] facility discharges a
195	195	patient or places the patient on an extended furlough with an intent
196	196	to discharge.
197	197	(c) The local mental health authority shall plan with the
198	198	department facility to [and] determine the appropriate community
199	199	services for the patient.
200	200	(d) The local mental health authority shall arrange for the
201	201	provision of the services upon discharge [if department funds are
202	202	to be used and may subcontract with or make a referral to a local
203	203	agency or entity].
204	204	(e) The commission shall require each facility to designate
205	205	at least one employee to provide transition support services for
206	206	patients who are determined medically appropriate for discharge
207	207	from the facility.
208	208	(f) Transition support services provided by the local
209	209	mental health authority must be designed to complement joint
210	210	discharge planning efforts and may include:
211	211	(1) enhanced services and supports for complex or
212	212	high-need patients, including services and supports necessary to
213	213	create viable discharge or outpatient management plans; and
214	214	(2) post-discharge monitoring for up to one year after
215	215	the discharge date to reduce the likelihood of readmission.
216	216	(g) The commission shall ensure that each department
217	217	facility concentrates the provision of transition support services
218	218	for patients who have been:
219	219	(1) admitted to and discharged from a facility
220	220	multiple times during a 30-day period; or
221	221	(2) in the facility for longer than 365 consecutive
222	222	days.
223	223	SECTION 7. Chapter 572, Health and Safety Code, is amended
224	224	by adding Section 572.0026 to read as follows:
225	225	Sec. 572.0026. VOLUNTARY ADMISSION RESTRICTIONS. The
226	226	facility administrator of an inpatient mental health facility or
227	227	the administrator's designee may only approve the admission of a
228	228	person for whom a proper request for voluntary inpatient services
229	229	is filed if, at the time the request is filed, there is available
230	230	space at the inpatient mental health facility.
231	231	SECTION 8. Section 1001.084, Health and Safety Code, as
232	232	redesignated by Chapter 1236 (S.B. 1296), Acts of the 84th
233	233	Legislature, Regular Session, 2015, is amended by amending
234	234	Subsections (a), (b), (c), and (d) and adding Subsections (d-1),
235	235	(d-2), and (g) to read as follows:
236	236	(a) The department, in collaboration with the commission,
237	237	shall establish and maintain a public reporting system of
238	238	performance and outcome measures relating to mental health and
239	239	substance use [abuse] services established by the [Legislative
240	240	Budget Board, the department, and the] commission. The system must
241	241	allow external users to view and compare the performance[,
242	242	outputs,] and outcomes of:
243	243	(1) local mental health authorities [community
244	244	centers established under Subchapter A, Chapter 534, that provide
245	245	mental health services];
246	246	(2) local behavioral health authorities [Medicaid
247	247	managed care pilot programs that provide mental health services];
248	248	and
249	249	(3) local intellectual and developmental disability
250	250	authorities [agencies, organizations, and persons that contract
251	251	with the state to provide substance abuse services].
252	252	(b) The public reporting system must allow external users to
253	253	view and compare the performance[, outputs,] and outcomes of the
254	254	Medicaid managed care programs that provide mental health services.
255	255	(c) The department shall post the performance[, output,]
256	256	and outcome measures on the department's Internet website so that
257	257	the information is accessible to the public. The department shall
258	258	post the measures monthly, or as frequently as possible [quarterly
259	259	or semiannually in accordance with when the measures are reported
260	260	to the department].
261	261	(d) The [department shall consider public input in
262	262	determining the appropriate outcome measures to collect in the]
263	263	public reporting system must[. To the extent possible, the
264	264	department shall] include outcome measures that capture:
265	265	(1) inpatient psychiatric care diversion;
266	266	(2) [,] avoidance of emergency room use;
267	267	(3) [,] criminal justice diversion;
268	268	(4) [, and] the numbers of people who are homeless
269	269	served;
270	270	(5) access to timely and adequate screening and rapid
271	271	crisis stabilization services;
272	272	(6) timely access to and appropriate treatment from
273	273	community-based crisis residential services and hospitalization;
274	274	(7) improved functioning as a result of
275	275	medication-related and psychosocial rehabilitation services;
276	276	(8) information related to the number of people
277	277	referred to a state hospital, state supported living center, or
278	278	community-based hospital, the length of time between referral and
279	279	admission, the length of stay, and the length of time between the
280	280	date a person is determined ready for discharge or transition and
281	281	the date of discharge or transition;
282	282	(9) the rate of denial of services or requests for
283	283	assistance from jails and other entities and the reason for denial;
284	284	(10) quality of care in community-based mental health
285	285	services and state facilities;
286	286	(11) the average number of hours of service provided
287	287	to individuals in a full level of care compared to the recommended
288	288	number of hours of service for each level of care; and
289	289	(12) any other relevant information to determine the
290	290	quality of services provided during the reporting period.
291	291	(d-1) A local intellectual and developmental disability
292	292	authority is only required to report information described by
293	293	Subsection (d)(8) that is related to a state supported living
294	294	center.
295	295	(d-2) This subsection and Subsections (d) and (d-1) expire
296	296	September 1, 2025.
297	297	(g) In this section:
298	298	(1) "Local behavioral health authority" means an
299	299	authority designated by the commission under Section 533.0356.
300	300	(2) "Local intellectual and developmental disability
301	301	authority" and "local mental health authority" have the meanings
302	302	assigned by Section 531.002.
303	303	(3) "State hospital" has the meaning assigned by
304	304	Section 552.0011.
305	305	(4) "State supported living center" has the meaning
306	306	assigned by Section 531.002.
307	307	SECTION 9. Not later than November 1, 2024, the executive
308	308	commissioner of the Health and Human Services Commission shall by
309	309	rule establish the process for requesting a waiver under Section
310	310	8.152(c), Education Code, as added by this Act.
311	311	SECTION 10. Section 1001.084(e), Health and Safety Code, as
312	312	redesignated by Chapter 1236 (S.B. 1296), Acts of the 84th
313	313	Legislature, Regular Session, 2015, is repealed.
314	314	SECTION 11. If before implementing any provision of this
315	315	Act a state agency determines that a waiver or authorization from a
316	316	federal agency is necessary for implementation of that provision,
317	317	the agency affected by the provision shall request the waiver or
318	318	authorization and may delay implementing that provision until the
319	319	waiver or authorization is granted.
320	320	SECTION 12. This Act takes effect September 1, 2023.
321	321	______________________________ ______________________________
322	322	President of the Senate Speaker of the House
323	323	I hereby certify that S.B. No. 26 passed the Senate on
324	324	April 13, 2023, by the following vote: Yeas 30, Nays 0; and that
325	325	the Senate concurred in House amendments on May 26, 2023, by the
326	326	following vote: Yeas 31, Nays 0.
327	327	______________________________
328	328	Secretary of the Senate
329	329	I hereby certify that S.B. No. 26 passed the House, with
330	330	amendments, on May 23, 2023, by the following vote: Yeas 143,
331	331	Nays 0, two present not voting.
332	332	______________________________
333	333	Chief Clerk of the House
334	334	Approved:
335	335	______________________________
336	336	Date
337	337	______________________________
338	338	Governor