Texas 2025 - 89th Regular

Texas House Bill HB18 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	89R22438 MPF-F
2		-	By: VanDeaver, Lambert, et al. H.B. No. 18
3		-	Substitute the following for H.B. No. 18:
4		-	By: VanDeaver C.S.H.B. No. 18
	1	+	89R15143 MPF-F
	2	+	By: VanDeaver H.B. No. 18
5	3
6	4
7	5
8	6
9	7		A BILL TO BE ENTITLED
10	8		AN ACT
11	9		relating to the establishment and administration of certain
12	10		programs and services providing health care services to rural
13	11		counties.
14	12		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
15	13		SECTION 1. This Act may be cited as the Rural Health
16	14		Stabilization and Innovation Act.
17		-	SECTION 2. Sections 526.0301(b) and (c), Government Code,
18		-	are amended to read as follows:
	15	+	SECTION 2. Section 526.0301, Government Code, as effective
	16	+	April 1, 2025, is amended to read as follows:
	17	+	Sec. 526.0301. STRATEGIC PLAN FOR RURAL HOSPITAL SERVICES;
	18	+	REPORT. (a) The commission shall develop and implement a strategic
	19	+	plan to ensure that the citizens in this state residing in rural
	20	+	areas have access to hospital services. The commission shall
	21	+	consult with the State Office of Rural Hospital Finance established
	22	+	under Section 526.0304 when developing and implementing the
	23	+	strategic plan.
19	24		(b) The strategic plan must include:
20	25		(1) a proposal for using at least one of the following
21	26		methods to ensure access to hospital services in the rural areas of
22	27		this state:
23	28		(A) an enhanced cost reimbursement methodology
24	29		for the payment of rural hospitals participating in the Medicaid
25	30		managed care program in conjunction with a supplemental payment
26	31		program for rural hospitals to cover costs incurred in providing
27	32		services to recipients;
28	33		(B) a hospital rate enhancement program
29	34		applicable only to rural hospitals;
30	35		(C) a reduction of punitive actions under
31	36		Medicaid that require reimbursement for Medicaid payments made to a
32	37		rural hospital provider, a reduction of the frequency of payment
33	38		reductions under Medicaid made to rural hospitals, and an
34	39		enhancement of payments made under merit-based programs or similar
35	40		programs for rural hospitals;
36	41		(D) a reduction of state regulatory-related
37	42		costs related to the commission's review of rural hospitals; or
38	43		(E) in accordance with rules the Centers for
39	44		Medicare and Medicaid Services adopts, the establishment of a
40	45		minimum fee schedule that applies to payments made to rural
41	46		hospitals by Medicaid managed care organizations; [and]
42	47		(2) target dates for achieving goals related to the
43	48		proposal described by Subdivision (1); and
44	49		(3) a rural hospital financial needs assessment and
45	50		financial vulnerability index quantifying the likelihood that a
46	51		rural hospital, during the next two-year period, will be able to:
47	52		(A) maintain the types of patient services the
48	53		hospital currently offers at the same level of service;
49	54		(B) meet the hospital's current financial
50	55		obligations; and
51	56		(C) remain operational.
52	57		(c) Not later than December [November] 1 of each
53	58		even-numbered year, the State Office of Rural Hospital Finance
54		-	established under Section 526.0304 [commission] shall submit a
55		-	report regarding the [commission's] development and implementation
56		-	of the strategic plan to:
	59	+	[commission] shall submit a report regarding the [commission's]
	60	+	development and implementation of the strategic plan to:
57	61		(1) the legislature;
58	62		(2) the governor; and
59	63		(3) the Legislative Budget Board.
60		-	SECTION 3. Subchapter G, Chapter 526, Government Code, is
61		-	amended by adding Sections 526.0304 and ~~526.0305 to read as~~
62		-	follows:
	64	+	SECTION 3. Subchapter G, Chapter 526, Government Code, as
	65	+	effective April 1, 2025, is amended by adding Sections 526.0304 and
	66	+	526.0305 to read as follows:
63	67		Sec. 526.0304. STATE OFFICE OF RURAL HOSPITAL FINANCE. The
64	68		commission shall establish and maintain the State Office of Rural
65		-	Hospital Finance within the commission to provide technical
66		-	assistance for rural hospitals and health care systems in rural
67		-	areas of this state that participate or are seeking to participate
68		-	in state or federal financial programs, including Medicaid.
	69	+	Hospital Finance as a division within the commission to provide
	70	+	technical assistance for rural hospitals and health care systems in
	71	+	rural areas of this state that participate or are seeking to
	72	+	participate in state or federal financial programs, including
	73	+	Medicaid.
69	74		Sec. 526.0305. TEXAS RURAL HOSPITAL OFFICERS ACADEMY. (a)
70	75		In this section:
71	76		(1) "Institution of higher education" has the meaning
72	77		assigned by Section 61.003, Education Code.
73	78		(2) "Rural county" means a county with a population of
74	79		68,750 or less.
75	80		(3) "Rural hospital" has the meaning assigned by
76	81		Section 548.0351.
77	82		(b) To the extent money is appropriated to the commission
78	83		for the purpose, the commission shall contract with at least two but
79		-	not more than four institutions of higher education to ~~administer~~
80		-	an academy to provide professional development and ~~continuing~~
81		-	education programs for the officers of rural hospitals ~~and other~~
82		-	health care providers located in rural counties. The ~~academy must~~
83		-	offer at least 100 hours of coursework each year that ~~consists of~~
84		-	courses and technical training on matters that impact ~~the financial~~
85		-	stability of rural hospitals and rural health care ~~systems,~~
86		-	including:
	84	+	not more than four institutions of higher education to establish
	85	+	and administer an academy to provide professional development and
	86	+	continuing education programs for the officers of rural hospitals
	87	+	and other health care providers located in rural counties. The
	88	+	academy must offer at least 100 hours of coursework each year that
	89	+	consists of courses and technical training on matters that impact
	90	+	the financial stability of rural hospitals and rural health care
	91	+	systems, including:
87	92		(1) relevant state and federal regulations;
88	93		(2) relevant state and federal financial programs;
89	94		(3) business administration, including revenue
90	95		maximization;
91	96		(4) organizational management; and
92	97		(5) other topics applicable to the financial stability
93	98		of rural hospitals and rural health care systems.
94		-	(b-1) The commission shall establish an interagency
	99	+	(b-1) An institution of higher education that establishes
	100	+	an academy under Subsection (b) shall establish an interagency
95	101		advisory committee to oversee the development of the academy's
96	102		curriculum. The advisory committee is composed of the following
97		-	members appointed by the executive commissioner:
	103	+	members appointed by the president of the establishing institution
	104	+	of higher education:
98	105		(1) a representative of the commission;
99		-	(2) a representative of ~~two~~ or more institutions of
	106	+	(2) a representative of one or more institutions of
100	107		higher education;
101	108		(3) a representative of the Department of State Health
102	109		Services;
103	110		(4) a representative of the Texas Department of
104	111		Insurance;
105	112		(5) a representative of the state auditor's office;
106		-	~~(6) a representative of a rural hospital;~~ and
107		-	(7) a representative of any state agency the ~~executive~~
108		-	~~commissioner~~ determines is appropriate.
	113	+	and
	114	+	(6) a representative of any other state agency the
	115	+	president determines is appropriate.
109	116		(b-2) The advisory committee established under Subsection
110	117		(b-1) is abolished on the earlier of:
111	118		(1) the date the advisory committee adopts a
112	119		curriculum; or
113	120		(2) September 1, 2027.
114	121		(b-3) This subsection and Subsections (b-1) and (b-2)
115	122		expire September 1, 2028.
116		-	(c) The commission shall establish criteria for the
117		-	screening and selection of applicants for admission to an academy
118		-	and include the criteria in each contract entered into under
119		-	Subsection (b). An institution of higher education that receives a
120		-	contract to administer an academy under Subsection (b) shall notify
121		-	the commission when the institution completes the applicant
122		-	selection process and provide information to the commission
123		-	regarding the qualifications of the applicants.
	123	+	(c) An institution of higher education that establishes an
	124	+	academy under Subsection (b) shall:
	125	+	(1) appoint a panel that consists of at least five but
	126	+	not more than 11 representatives from the entities from which
	127	+	members of the advisory committee established by the institution
	128	+	under Subsection (b-1) are appointed to establish a competitive
	129	+	application process and selection criteria for academy
	130	+	participants; and
	131	+	(2) subject to Subsection (d), select academy
	132	+	participants using the competitive application process developed
	133	+	under Subdivision (1).
124	134		(d) Participation in an academy is limited to individuals
125	135		who are responsible for, or who anticipate becoming responsible
126	136		for, the financial stability of a rural hospital or rural health
127	137		care system in this state.
128		-	(e) An institution of higher education that receives a
129		-	contract to administer an academy under Subsection (b):
	138	+	(e) The panelists appointed under Subsection (c) shall
	139	+	review applications for the academy and provide recommendations to
	140	+	the establishing institution of higher education regarding
	141	+	participant admission.
	142	+	(f) An institution of higher education that establishes an
	143	+	academy under Subsection (b):
130	144		(1) shall accept new participants for the academy each
131	145		year;
132	146		(2) shall offer to reimburse academy participants for
133	147		travel and related expenses; and
134	148		(3) may not claim or charge a participant for
135	149		admission to or participation in the academy or any associated
136	150		services.
137	151		SECTION 4. Chapter 526, Government Code, as effective April
138	152		1, 2025, is amended by adding Subchapter G-1 to read as follows:
139	153		SUBCHAPTER G-1. GRANT PROGRAMS FOR RURAL HOSPITALS, HOSPITAL
140	154		DISTRICTS, AND HOSPITAL AUTHORITIES
141	155		Sec. 526.0321. DEFINITIONS. In this subchapter:
142	156		(1) "Hospital district" means a hospital district
143	157		created under the authority of Sections 4 through 11, Article IX,
144	158		Texas Constitution.
145	159		(2) "Office" means the State Office of Rural Hospital
146	160		Finance established under Section 526.0304.
147	161		(3) "Rural county" means a county with a population of
148	162		68,750 or less.
149	163		(4) "Rural hospital" has the meaning assigned by
150	164		Section 548.0351.
151	165		(5) "Rural hospital authority" means a hospital
152	166		authority located in a rural county.
153	167		(6) "Rural hospital district" means a hospital
154	168		district located in a rural county.
155		-	(7) "Rural hospital organization" means a statewide
156		-	nonprofit organization that provides services to rural hospitals.
157	169		Sec. 526.0322. FINANCIAL STABILIZATION GRANT PROGRAM. (a)
158		-	The commission shall establish a financial stabilization grant
159		-	program to award grants to support and improve the financial
	170	+	To the extent money is appropriated to the commission for the
	171	+	purpose, the commission may establish a financial stabilization
	172	+	grant program to award grants to support and improve the financial
160	173		stability of rural hospitals, rural hospital districts, and rural
161	174		hospital authorities that are determined to be at a moderate or high
162		-	risk of financial instability.
	175	+	risk of financial instability. If the commission establishes a
	176	+	financial stabilization grant program under this section, the
	177	+	office shall administer the grant program for the commission.
163	178		(b) The determination of whether a grant applicant is at a
164	179		moderate or high risk of financial instability shall be made using
165	180		the hospital financial needs assessment and financial
166	181		vulnerability index developed as part of the strategic plan
167	182		required under Section 526.0301.
168	183		(b-1) Notwithstanding Subsection (b), for a grant
169	184		application received before December 1, 2026, the office shall
170	185		determine whether the applicant is at a moderate or high risk of
171	186		financial instability by evaluating data published by the
172	187		commission regarding the financial stability of rural hospitals,
173	188		rural hospital districts, and rural hospital authorities. This
174	189		subsection expires September 1, 2027.
175		-	(c) The office shall develop a formula to allocate the money
	190	+	(c) The office shall develop an application process and
	191	+	eligibility and selection criteria for grant applicants under this
	192	+	section.
	193	+	(d) The office may award a grant under this section only in
	194	+	accordance with the terms of a contract between the office and the
	195	+	grant recipient. The contract must include provisions under which
	196	+	the office is granted sufficient control to ensure that:
	197	+	(1) grant funds are spent in a manner that is
	198	+	consistent with the public purpose of providing adequate access to
	199	+	quality health care in all areas of this state; and
	200	+	(2) both this state and the grant recipient are
	201	+	benefited by the award of the grant.
	202	+	(e) The office shall develop a formula to allocate the money
176	203		available to the commission for grants under this section to rural
177		-	hospitals, rural hospital districts, and rural ~~hospital~~
178		-	~~authorities~~ that are determined to be at a moderate or high risk of
179		-	~~financial~~ instability. The formula ~~may~~ consider:
	204	+	hospitals, rural hospital districts, and rural health authorities
	205	+	that are determined to be at a moderate or high risk of financial
	206	+	instability. The formula must consider:
180	207		(1) the degree of financial vulnerability of the
181	208		applicant as determined using the hospital financial needs
182	209		assessment and financial vulnerability index developed under
183	210		Section 526.0301;
184	211		(2) whether the applicant is the sole provider of
185	212		hospital services in the county in which the applicant is located;
186	213		(3) whether a hospital is located within 35 miles of
187	214		the applicant's facilities; and
188	215		(4) any other factors the office determines are
189	216		relevant to assessing the financial stability of rural hospitals,
190		-	rural hospital districts, and rural hospital authorities.
191		-	Sec. 526.0323. EMERGENCY HARDSHIP GRANT PROGRAM. (a) The
192		-	commission shall establish an emergency hardship grant program.
	217	+	rural hospital districts, and rural health authorities.
	218	+	Sec. 526.0323. EMERGENCY HARDSHIP GRANT PROGRAM. (a) To
	219	+	the extent money is appropriated to the commission for the purpose,
	220	+	the commission may establish an emergency hardship grant program.
	221	+	If the commission establishes an emergency hardship grant program
	222	+	under this section, the office shall administer the grant program
	223	+	for the commission.
193	224		(b) The office may award emergency hardship grants to rural
194	225		hospitals, rural hospital districts, and rural hospital
195	226		authorities that have experienced:
196	227		(1) a man-made or natural disaster resulting in a loss
197	228		of assets; or
198	229		(2) an unforeseeable or unmitigable circumstance
199	230		likely to result in:
200	231		(A) the closure of the entity's facilities during
201	232		the 180-day period beginning on the date the entity submits an
202	233		application for a grant under this section; or
203	234		(B) an inability to fund payroll expenditures for
204	235		the entity's staff during the 180-day period beginning on the date
205	236		the entity submits an application for a grant under this section.
206		-	Sec. 526.0324. INNOVATION GRANT PROGRAM. (a) The
207		-	commission shall establish an innovation grant program to provide
	237	+	(c) The office shall develop an application process and
	238	+	eligibility and selection criteria for grant applicants under this
	239	+	section.
	240	+	(d) The office may award a grant under this section only in
	241	+	accordance with the terms of a contract between the office and the
	242	+	grant recipient. The contract must include provisions under which
	243	+	the office is granted sufficient control to ensure that:
	244	+	(1) grant funds are spent in a manner that is
	245	+	consistent with the public purpose of providing adequate access to
	246	+	quality health care in all areas of this state; and
	247	+	(2) both this state and the grant recipient are
	248	+	benefited by the award of the grant.
	249	+	Sec. 526.0324. INNOVATION GRANT PROGRAM. (a) To the extent
	250	+	money is appropriated to the commission for the purpose, the
	251	+	commission may establish an innovation grant program to provide
208	252		support to rural hospitals, rural hospital districts, and rural
209		-	hospital authorities that undertake initiatives:
210		-	(1) to provide access to health care and improve the
	253	+	hospital authorities that undertake initiatives that:
	254	+	(1) provide access to health care and improve the
211	255		quality of health care provided to residents of a rural county;
212		-	(2) ~~that~~ are likely to improve the financial stability
213		-	of the grant recipient; and
214		-	(3) ~~that~~ are estimated to become sustainable and be
	256	+	(2) are likely to improve the financial stability of
	257	+	the grant recipient; and
	258	+	(3) are estimated to become sustainable and be
215	259		maintained without additional state funding after the award of a
216	260		grant under this section.
217		-	(b) In awarding grants under this section, the office shall
	261	+	(b) If the commission establishes an innovation grant
	262	+	program under this section, the office shall administer the grant
	263	+	program for the commission.
	264	+	(c) In awarding grants under this section, the office may
218	265		prioritize initiatives focused on improving health care facilities
219	266		or services for:
220	267		(1) women who are pregnant or recently gave birth;
221	268		(2) individuals under the age of 20;
222	269		(3) older adults residing in a rural county; or
223	270		(4) individuals who are uninsured.
224		-	Sec. 526.0325. RURAL HOSPITAL SUPPORT GRANT PROGRAM. The
225		-	commission shall establish a rural hospital support grant program
226		-	to award support grants to rural hospitals, rural hospital
227		-	districts, rural hospital authorities, and rural hospital
228		-	organizations to improve the financial stability, continue the
229		-	operations, and support the long-term viability of the grant
230		-	recipient.
	271	+	(d) The office shall develop an application process and
	272	+	eligibility and selection criteria for grant applicants under this
	273	+	section.
	274	+	(e) The office may award a grant under this section only in
	275	+	accordance with the terms of a contract between the office and the
	276	+	grant recipient. The contract must include provisions under which
	277	+	the office is granted sufficient control to ensure that:
	278	+	(1) grant funds are spent in a manner that is
	279	+	consistent with the public purpose of providing adequate access to
	280	+	quality health care in all areas of this state; and
	281	+	(2) both this state and the grant recipient are
	282	+	benefited by the award of the grant.
	283	+	(f) A grant recipient may not use the proceeds of a grant
	284	+	awarded under this section to:
	285	+	(1) reimburse an expense or pay a cost that another
	286	+	source, including Medicaid, is obligated to reimburse or pay by law
	287	+	or under a contract; or
	288	+	(2) supplant, or be used as a substitute for, money
	289	+	awarded to the recipient from a non-Medicaid federal funding
	290	+	source, including a federal grant.
	291	+	Sec. 526.0325. RURAL HOSPITAL SUPPORT GRANT PROGRAM. (a)
	292	+	To the extent money is appropriated to the commission for the
	293	+	purpose, the commission may establish a rural hospital support
	294	+	grant program to award support grants to rural hospitals, rural
	295	+	hospital districts, and rural hospital authorities to improve the
	296	+	financial stability, continue the operations, and support the
	297	+	long-term viability of the grant recipient. If the commission
	298	+	establishes a rural hospital support grant program under this
	299	+	section, the office shall administer the grant program for the
	300	+	commission.
	301	+	(b) The office shall develop an application process and
	302	+	eligibility and selection criteria for grant applicants under this
	303	+	section.
	304	+	(c) The office may award a grant under this section only in
	305	+	accordance with the terms of a contract between the office and the
	306	+	grant recipient. The contract must include provisions under which
	307	+	the office is granted sufficient control to ensure that:
	308	+	(1) the grant funds are spent in a manner that is
	309	+	consistent with the public purpose of providing adequate access to
	310	+	quality health care in all areas of this state; and
	311	+	(2) both this state and the grant recipient are
	312	+	benefited by the award of the grant.
231	313		Sec. 526.0326. GENERAL GRANT PROVISIONS. (a) Chapter 783
232	314		does not apply to the solicitation of applicants for a grant under
233	315		this subchapter.
234	316		(b) To the extent practicable, the office shall award a
235	317		grant under this subchapter not later than the 180th day after the
236	318		date the office receives the recipient's grant application.
237	319		(c) A Medicaid provider's receipt of a grant under this
238	320		subchapter does not affect any legal or contractual duty of the
239	321		provider to comply with any applicable Medicaid requirements.
240		-	(d) The office shall administer the grant programs
241		-	established under this subchapter.
242		-	(e) The office may award a grant under this subchapter only
243		-	in accordance with the terms of a contract between the office and
244		-	the grant recipient. The contract must include provisions under
245		-	which the office is granted sufficient control to ensure that:
246		-	(1) the grant funds are spent in a manner that is
247		-	consistent with the public purpose of providing adequate access to
248		-	quality health care; and
249		-	(2) both this state and the grant recipient are
250		-	benefited by the award of the grant.
251		-	(f) The office shall develop an application process and
252		-	eligibility and selection criteria for persons applying for a grant
253		-	under this subchapter.
254		-	(g) A grant recipient may not use the proceeds of a grant
255		-	awarded under this subchapter to:
256		-	(1) reimburse an expense or pay a cost that another
257		-	source, including Medicaid, is obligated to reimburse or pay by law
258		-	or under a contract; or
259		-	(2) supplant, or be used as a substitute for, money
260		-	awarded to the recipient from a non-Medicaid federal funding
261		-	source, including a federal grant.
262		-	Sec. 526.0327. APPROPRIATION CONTINGENCY. The commission
263		-	is required to implement a provision of this subchapter only if the
264		-	legislature appropriates money specifically for that purpose.
265		-	SECTION 5. Section 532.0155, Government Code, is amended by
266		-	amending Subsection (b) and adding Subsection (g) to read as
	322	+	SECTION 5. Section 532.0155, Government Code, as effective
	323	+	April 1, 2025, is amended by adding Subsection (g) to read as
267	324		follows:
268		-	(b) To the extent allowed by federal law [and subject to
269		-	limitations on appropriations], the executive commissioner by rule
270		-	shall adopt a prospective reimbursement methodology for the payment
271		-	of rural hospitals participating in Medicaid that ensures the rural
272		-	hospitals are reimbursed on an individual basis for providing
273		-	inpatient and general outpatient services to recipients by using
274		-	the hospitals' most recent cost information concerning the costs
275		-	incurred for providing the services. The commission shall
276		-	calculate the prospective cost-based reimbursement rates once
277		-	every two years.
278		-	(g) To the extent allowed by federal law, the executive
279		-	commissioner, in addition to the cost-based reimbursement rate
280		-	calculated by the executive commissioner under Subsection (b),
281		-	shall develop and calculate an add-on reimbursement rate for rural
282		-	hospitals that have a department of obstetrics and gynecology. The
283		-	executive commissioner shall calculate the rate required by this
284		-	subsection annually.
285		-	SECTION 6. Section 548.0351, Government Code, is amended by
286		-	adding Subdivisions (6-a) and (6-b) to read as follows:
287		-	(6-a) "Rural health clinic" has the meaning assigned
288		-	by Section 113.0001, Health and Safety Code.
289		-	(6-b) "Rural hospital" means a health care facility
	325	+	(g) To the extent allowed by federal law and subject to
	326	+	available appropriations, the executive commissioner, in addition
	327	+	to the cost-based reimbursement rate calculated by the executive
	328	+	commissioner under Subsection (b), shall develop and calculate an
	329	+	add-on reimbursement rate for rural hospitals that have a
	330	+	department of obstetrics and gynecology. The executive
	331	+	commissioner shall calculate the rate required by this subsection
	332	+	annually.
	333	+	SECTION 6. Section 548.0351, Government Code, as effective
	334	+	April 1, 2025, is amended by adding Subdivision (6-a) to read as
	335	+	follows:
	336	+	(6-a) "Rural hospital" means a health care facility
290	337		licensed under Chapter 241, Health and Safety Code, that:
291	338		(A) is located in a county with a population of
292	339		68,750 or less; or
293	340		(B) has been designated by the Centers for
294	341		Medicare and Medicaid Services as a critical access hospital, rural
295	342		referral center, or sole community hospital and:
296	343		(i) is not located in a metropolitan
297	344		statistical area; or
298	345		(ii) if the hospital has 100 or fewer beds,
299	346		is located in a metropolitan statistical area.
300		-	SECTION 7. Section 548.0352, Government Code, ~~is amended to~~
301		-	read as follows:
	347	+	SECTION 7. Section 548.0352, Government Code, as effective
	348	+	April 1, 2025, is amended to read as follows:
302	349		Sec. 548.0352. ESTABLISHMENT OF PEDIATRIC
303	350		TELE-CONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS. The commission
304	351		with any necessary assistance of pediatric tele-specialty
305	352		providers shall establish a pediatric tele-connectivity resource
306		-	program for rural Texas to award grants to rural hospitals ~~and rural~~
307		-	~~health clinics~~ [nonurban health care facilities] to connect the
308		-	~~hospitals and clinics [the~~ facilities] with pediatric specialists
309		-	~~and pediatric~~ subspecialists who provide telemedicine medical
310		-	~~services or with an~~ institution of higher education that is a member
311		-	~~of the Texas Child~~ Mental Health Care Consortium established under
312		-	~~Chapter 113, Health~~ and Safety Code.
313		-	SECTION 8. Section 548.0353, Government Code, ~~is amended to~~
314		-	read as follows:
315		-	Sec. 548.0353. USE OF PROGRAM GRANT. A rural hospital or
316		-	~~rural health clinic~~ [nonurban health care facility] awarded a grant
317		-	~~under this~~ subchapter may use grant money to:
	353	+	program for rural Texas to award grants to rural hospitals
	354	+	[nonurban health care facilities] to connect the hospitals [the
	355	+	facilities] with pediatric specialists and pediatric
	356	+	subspecialists who provide telemedicine medical services or with an
	357	+	institution of higher education that is a member of the Texas Child
	358	+	Mental Health Care Consortium established under Chapter 113, Health
	359	+	and Safety Code.
	360	+	SECTION 8. Section 548.0353, Government Code, as effective
	361	+	April 1, 2025, is amended to read as follows:
	362	+	Sec. 548.0353. USE OF PROGRAM GRANT. A rural hospital
	363	+	[nonurban health care facility] awarded a grant under this
	364	+	subchapter may use grant money to:
318	365		(1) purchase equipment necessary for implementing a
319	366		telemedicine medical service;
320		-	(2) modernize the hospital's ~~or clinic's~~ [facility's]
321		-	~~information~~ technology infrastructure and secure information
322		-	~~technology~~ support to ensure an uninterrupted two-way video signal
323		-	~~that is~~ compliant with the Health Insurance Portability and
324		-	~~Accountability~~ Act of 1996 (Pub. L. No. 104-191);
	367	+	(2) modernize the hospital's [facility's] information
	368	+	technology infrastructure and secure information technology
	369	+	support to ensure an uninterrupted two-way video signal that is
	370	+	compliant with the Health Insurance Portability and Accountability
	371	+	Act of 1996 (Pub. L. No. 104-191);
325	372		(3) pay a service fee to a pediatric tele-specialty
326	373		provider under an annual contract with the provider; or
327	374		(4) pay for other activities, services, supplies,
328	375		facilities, resources, and equipment the commission determines
329		-	necessary for the hospital ~~or clinic~~ [facility] to use a
330		-	~~telemedicine medical~~ service.
331		-	SECTION 9. Section 548.0354, Government Code, ~~is amended to~~
332		-	read as follows:
	376	+	necessary for the hospital [facility] to use a telemedicine medical
	377	+	service.
	378	+	SECTION 9. Section 548.0354, Government Code, as effective
	379	+	April 1, 2025, is amended to read as follows:
333	380		Sec. 548.0354. SELECTION OF PROGRAM GRANT RECIPIENTS. (a)
334	381		The commission [with any necessary assistance of pediatric
335	382		tele-specialty providers] may select [an] eligible rural hospitals
336		-	~~and rural health clinics~~ [nonurban health care facility] to receive
337		-	~~a grant under this~~ subchapter.
338		-	(b) To be eligible for a grant, a rural hospital ~~or rural~~
339		-	~~health clinic [nonurban~~ health care facility] must maintain [have:
	383	+	[nonurban health care facility] to receive a grant under this
	384	+	subchapter.
	385	+	(b) To be eligible for a grant, a rural hospital [nonurban
	386	+	health care facility] must maintain [have:
340	387		[(1) a quality assurance program that measures the
341	388		compliance of the facility's health care providers with the
342	389		facility's medical protocols;
343	390		[(2) on staff at least one full-time equivalent
344	391		physician who has training and experience in pediatrics and one
345	392		individual who is responsible for ongoing nursery and neonatal
346	393		support and care;
347	394		[(3) a designated neonatal intensive care unit or an
348	395		emergency department;
349	396		[(4) a commitment to obtaining neonatal or pediatric
350	397		education from a tertiary facility to expand the facility's depth
351	398		and breadth of telemedicine medical service capabilities; and
352	399		[(5) the capability of maintaining] records and
353	400		produce [producing] reports that measure the effectiveness of a
354		-	[the] grant received by the hospital ~~or clinic~~ under this
355		-	~~subchapter~~ [facility would receive].
	401	+	[the] grant received by the hospital under this subchapter
	402	+	[facility would receive].
356	403		(c) To the extent practicable, the commission shall award a
357	404		program grant to a grant recipient not later than the 180th day
358	405		after the date the commission receives the recipient's program
359	406		grant application under this section.
360	407		(d) Chapter 783 does not apply to the solicitation of
361	408		applicants for a program grant award under this subchapter.
362		-	SECTION 10. Section 548.0357, Government Code, ~~is amended~~
363		-	to read as follows:
	409	+	SECTION 10. Section 548.0357, Government Code, as effective
	410	+	April 1, 2025, is amended to read as follows:
364	411		Sec. 548.0357. BIENNIAL REPORT. Not later than December 1
365	412		of each even-numbered year, the commission shall submit a report to
366	413		the governor and members of the legislature regarding the
367	414		activities of the program and grant recipients under the program,
368	415		including the results and outcomes of grants awarded under this
369	416		subchapter. The commission may combine the report required by this
370	417		section with the report submitted by the State Office of Rural
371	418		Hospital Finance under Section 526.0301.
372	419		SECTION 11. Section 113.0001, Health and Safety Code, is
373		-	amended by adding Subdivisions (4), (5), and (6) to read as follows:
374		-	(4) "Rural health clinic" means a rural health clinic,
375		-	as defined by 42 C.F.R. Section 491.2, that is:
376		-	(A) accredited by an accreditation organization,
377		-	a participant in the federal Medicare program, or both; and
378		-	(B) located in a county that does not contain a
379		-	general hospital or special hospital, as those terms are defined by
380		-	Section 241.003.
381		-	(5) "Rural hospital" has the meaning assigned by
	420	+	amended by adding Subdivision (4) to read as follows:
	421	+	(4) "Rural hospital" has the meaning assigned by
382	422		Section 548.0351, Government Code.
383		-	(6) "Rural hospital organization" has the meaning
384		-	assigned by Section 526.0321, Government Code.
385	423		SECTION 12. Chapter 113, Health and Safety Code, is amended
386	424		by adding Subchapter D-1 to read as follows:
387	425		SUBCHAPTER D-1. RURAL PEDIATRIC MENTAL HEALTH CARE ACCESS PROGRAM
388	426		Sec. 113.0181. MENTAL HEALTH CARE ACCESS PROGRAM FOR RURAL
389		-	HOSPITALS AND RURAL HEALTH CLINICS. (a) Using the network of
390		-	comprehensive child psychiatry access centers established under
391		-	Section 113.0151, the consortium shall establish or expand provider
392		-	consultation programs to assist health care practitioners
393		-	providing services at rural hospitals or rural health clinics to:
394		-	(1) identify and assess the behavioral health needs of
395		-	pediatric and perinatal patients seeking services at the hospital
396		-	or clinic; and
397		-	(2) identify necessary mental health care services to
398		-	improve access to mental health care services for pediatric and
399		-	perinatal patients seeking services at the hospital or clinic.
400		-	(b) The consortium, in collaboration with a rural hospital
401		-	organization, shall develop a plan to establish, under the
402		-	authority provided in Section 113.0151(b) and not later than
403		-	September 1, 2026, telemedicine or telehealth programs to identify
404		-	and assess behavioral health needs and provide access to mental
405		-	health care services for pediatric patients seeking services at
406		-	rural hospitals or rural health clinics. The plan may include
407		-	limitations on the hours of the day during which services provided
408		-	by the telemedicine or telehealth programs are available. The plan
409		-	shall provide access to mental health care services for pediatric
410		-	patients seeking services at the rural hospital or rural health
411		-	clinic at the same or a substantially similar level as the mental
412		-	health care services provided to students attending school in a
413		-	school district for which the consortium has made available mental
414		-	health care services under this chapter.
415		-	(c) On or after September 1, 2026, and subject to available
416		-	appropriations, the consortium shall establish a program
417		-	establishing or expanding telemedicine or telehealth programs to
418		-	identify and assess behavioral health needs and provide access to
419		-	mental health care services for pediatric patients seeking services
420		-	at rural hospitals or rural health clinics.
	427	+	HOSPITALS. Using the network of comprehensive child psychiatry
	428	+	access centers established under Section 113.0151, the consortium
	429	+	shall establish or expand telemedicine or telehealth programs for
	430	+	identifying and assessing behavioral health needs and providing
	431	+	access to mental health care services for pediatric patients
	432	+	seeking services at a rural hospital.
421	433		Sec. 113.0182. CONSENT REQUIRED FOR SERVICES TO MINOR. (a)
422	434		A person may provide mental health care services to a child younger
423	435		than 18 years of age through a program established under this
424	436		subchapter only if the person obtains the written consent of the
425		-	parent or legal guardian of the child or, if the parent or legal
426		-	guardian is not known or available, the adult with whom the child
427		-	primarily resides.
	437	+	parent or legal guardian of the child.
428	438		(b) The consortium shall develop and post on the
429		-	consortium's Internet website a model form for a person to provide
430		-	consent under this section.
	439	+	consortium's Internet website a model form for a parent or legal
	440	+	guardian to provide consent under this section.
	441	+	Sec. 113.0183. REIMBURSEMENT FOR SERVICES. (a) Except as
	442	+	otherwise provided by this section, a child psychiatry access
	443	+	center established under Section 113.0151(a) may not submit an
	444	+	insurance claim or charge a rural hospital, or a health care
	445	+	practitioner providing services at a rural hospital, a fee for
	446	+	providing consultation services or training opportunities under
	447	+	this subchapter.
	448	+	(b) A child psychiatry access center established under
	449	+	Section 113.0151(a) may submit a claim for reimbursement to the
	450	+	commission or a contractor operating a medical assistance program
	451	+	on behalf of the commission if:
	452	+	(1) the provider of the services is enrolled and
	453	+	credentialed as a Medicaid provider; and
	454	+	(2) the individual receiving services by telehealth or
	455	+	telemedicine is eligible and enrolled in the Medicaid program.
	456	+	(c) Reimbursements issued under Subsection (b) shall be
	457	+	paid at the reimbursement rate established by the commission or in
	458	+	accordance with the contractual agreement between the provider and
	459	+	the contractor operating the medical assistance program on behalf
	460	+	of the commission.
431	461		SECTION 13. Section 113.0251, Health and Safety Code, is
432	462		amended to read as follows:
433	463		Sec. 113.0251. BIENNIAL REPORT. Not later than December 1
434	464		of each even-numbered year, the consortium shall prepare and submit
435	465		to the governor, the lieutenant governor, the speaker of the house
436		-	of representatives, [and] the standing committee of each house of
437		-	~~the~~ legislature with primary jurisdiction over behavioral health
438		-	issues~~, and the Legislative Budget Board~~ and post on its Internet
439		-	~~website a written report that~~ outlines:
	466	+	of representatives, and the standing committee of each house of the
	467	+	legislature with primary jurisdiction over behavioral health
	468	+	issues and post on its Internet website a written report that
	469	+	outlines:
440	470		(1) the activities and objectives of the consortium;
441	471		(2) the health-related institutions of higher
442	472		education listed in Section 113.0052(1) that receive funding by the
443		-	executive committee;
444		-	(3) the rural hospitals ~~and rural health clinics to~~
445		-	~~which the program~~ established under Section 113.0181 provided
446		-	~~mental health access~~ services;
	473	+	executive committee; [and]
	474	+	(3) the rural hospitals to which the program
	475	+	established under Section 113.0181 provided mental health access
	476	+	services;
447	477		(4) the cost to maintain the mental health care access
448	478		program established under Subchapter D-1; and
449	479		(5) [(3)] any legislative recommendations based on
450	480		the activities and objectives described by Subdivision (1).
451	481		SECTION 14. The following provisions of the Government Code
452	482		are repealed:
453	483		(1) Section 548.0351(1); and
454	484		(2) Section 548.0356.
455	485		SECTION 15. If before implementing any provision of this
456	486		Act a state agency determines that a waiver or authorization from a
457	487		federal agency is necessary for implementation of that provision,
458	488		the agency affected by the provision shall request the waiver or
459	489		authorization and may delay implementing that provision until the
460	490		waiver or authorization is granted.
461	491		SECTION 16. (a) Not later than December 1, 2025, the Health
462	492		and Human Services Commission shall contract with institutions of
463		-	higher education to ~~administer~~ an academy under Section 526.0305,
	493	+	higher education to establish an academy under Section 526.0305,
464	494		Government Code, as added by this Act.
465		-	(b) Not later than January 1, 2026, the executive
466		-	commissioner of the Health and Human Services Commission shall
	495	+	(b) Not later than January 1, 2026, the president of an
	496	+	institution of higher education establishing an academy under
	497	+	Section 526.0305, Government Code, as added by this Act, shall
467	498		appoint the members of the interagency advisory committee as
468		-	required by Section 526.0305, Government Code, as added by this
469		-	Act.
	499	+	required by that section.
470	500		SECTION 17. This Act takes effect immediately if it
471	501		receives a vote of two-thirds of all the members elected to each
472	502		house, as provided by Section 39, Article III, Texas Constitution.
473	503		If this Act does not receive the vote necessary for immediate
474	504		effect, this Act takes effect September 1, 2025.