By Tillery H.B. No. 2202
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to health centers on public school campuses.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Chapter 38, Education Code, is amended by adding
1-5 Section 38.011 to read as follows:
1-6 Sec. 38.011. SCHOOL-BASED HEALTH CENTERS. (a) A school
1-7 district in this state may, if the district identifies the need,
1-8 design a model in accordance with this section for the delivery of
1-9 cooperative health care programs for students and their families
1-10 and may compete for grants awarded under this section. The model
1-11 may provide for the delivery of conventional health services and
1-12 disease prevention of emerging health threats that are specific to
1-13 the district.
1-14 (b) On the recommendation of an advisory council established
1-15 under Subsection (g), a school district may establish a
1-16 school-based health center at one or more campuses in the district
1-17 to meet the health care needs of students and their families. A
1-18 district may contract with a person to provide services at a
1-19 school-based health center.
1-20 (c) A school-based health center may provide services to a
1-21 student only if the district or the provider with whom the district
1-22 contracts obtains the written consent of the student's parent,
1-23 guardian, or other person having legal control of the student on a
1-24 consent form developed by the district or provider. The student's
2-1 parent, guardian, or other person having legal control of the
2-2 student may give consent for a student to receive ongoing services
2-3 or may limit consent to one or more services provided on a single
2-4 occasion. The consent form must list every service the
2-5 school-based health center delivers in a format that complies with
2-6 all applicable state and federal laws and allows a person to
2-7 consent to one or more categories of services. The permissible
2-8 categories of services are:
2-9 (1) family and home support;
2-10 (2) health care, including immunizations;
2-11 (3) dental health care;
2-12 (4) health education; and
2-13 (5) preventive health strategies.
2-14 (d) Reproductive services, counseling, or referrals may not
2-15 be provided through a school-based health center using grant funds
2-16 awarded under this section. Any service provided using grant funds
2-17 must be provided by an appropriate professional who is properly
2-18 licensed, certified, or otherwise authorized under state law to
2-19 provide the service.
2-20 (e) The staff of a school-based health center and the person
2-21 whose consent is obtained under Subsection (c) shall jointly
2-22 identify any health-related concerns of a student that may be
2-23 interfering with the student's well-being or ability to succeed in
2-24 school.
2-25 (f) If it is determined that a student is in need of a
2-26 referral for mental health services, the staff of the center shall
2-27 notify the person whose consent is required under Subsection (c)
3-1 verbally and in writing of the basis for the referral. The
3-2 referral may not be provided unless the person provides written
3-3 consent for the type of service to be provided and provides
3-4 specific written consent for each treatment occasion.
3-5 (g) The board of trustees of a school district may establish
3-6 and appoint members to a local health education and health care
3-7 advisory council to make recommendations to the district on the
3-8 establishment of school-based health centers and to assist the
3-9 district in ensuring that local community values are reflected in
3-10 the operation of each center and in the provision of health
3-11 education. A majority of the members of the council must be
3-12 parents of students enrolled in the district. In addition to the
3-13 appointees who are parents of students, the board of trustees shall
3-14 also appoint at least one person from each of the following groups:
3-15 (1) teachers;
3-16 (2) school administrators;
3-17 (3) licensed health care professionals;
3-18 (4) the clergy;
3-19 (5) law enforcement;
3-20 (6) the business community;
3-21 (7) senior citizens; and
3-22 (8) students.
3-23 (h) A school district may seek assistance in establishing
3-24 and operating a school-based health center from any public health
3-25 agency in the community. On request, a public health agency shall
3-26 cooperate with a district and to the extent practicable,
3-27 considering the resources of the agency, may provide assistance. A
4-1 district and a public health agency may, by agreement, jointly
4-2 establish, operate, and fund a school-based health center.
4-3 (i) If a school-based health center is located in an area
4-4 described by Subsection (j), the school district and the advisory
4-5 council established under Subsection (g) shall make a good faith
4-6 effort to identify and coordinate with existing providers to
4-7 preserve and protect existing health care systems and medical
4-8 relationships in the area. The council shall keep a record of
4-9 efforts made to coordinate with existing providers.
4-10 (j) The requirements prescribed by Subsection (i) apply only
4-11 to a school-based health center serving an area that:
4-12 (1) is located in a county with a population not
4-13 greater than 50,000; or
4-14 (2) has been designated under state or federal law as:
4-15 (A) a health professional shortage area;
4-16 (B) a medically underserved area; or
4-17 (C) a medically underserved community by the
4-18 Center for Rural Health Initiatives.
4-19 (k) If a person receiving a medical service from a
4-20 school-based health center has a primary care physician, the staff
4-21 of the center shall provide notice of the service the person
4-22 received to the primary care physician in order to allow the
4-23 physician to maintain a complete medical history of the person.
4-24 (l) The staff of a school-based health center shall, before
4-25 delivering a medical service to a person with a primary care
4-26 physician under the state Medicaid program, a state children's
4-27 health plan program, or a private health insurance or health
5-1 benefit plan, notify the physician for the purpose of sharing
5-2 medical information and obtaining authorization for delivering the
5-3 medical service.
5-4 (m) A school district or the provider with whom the district
5-5 contracts shall seek all available sources of funding to compensate
5-6 the district or provider for services provided by a school-based
5-7 health center, including money available under the state Medicaid
5-8 program, a state children's health plan program, private health
5-9 insurance or health benefit plans, or the ability of those using a
5-10 school-based clinic to pay for the services.
5-11 (n) Subject to the availability of federal or state
5-12 appropriated funds, the commissioner of education and the
5-13 commissioner of public health shall jointly administer a program
5-14 under which grants are awarded to assist school districts with the
5-15 costs of operating school-based health centers in accordance with
5-16 this section. The commissioners, by rules adopted in accordance
5-17 with this section, shall establish procedures for awarding grants.
5-18 (o) A school district may not receive more than $250,000 per
5-19 biennium through grants awarded under this section. To be eligible
5-20 to receive a grant, a district must provide matching funds in
5-21 accordance with rules adopted under Subsection (n). The matching
5-22 funds may be obtained from any source available to the district,
5-23 including in-kind contributions, community or foundation grants,
5-24 individual contributions, and local governmental agency operating
5-25 funds.
5-26 (p) The rules adopted under Subsection (n) must provide
5-27 that:
6-1 (1) grants are awarded to school districts on an
6-2 annual basis through a competitive process; and
6-3 (2) a preference is given to school districts that are
6-4 located in rural areas or that have low property wealth per
6-5 student.
6-6 (q) The commissioner of education and the commissioner of
6-7 public health are partners in administering the grants. The Texas
6-8 Education Agency and the Texas Department of Health shall enter
6-9 into a memorandum of understanding that prescribes the duties of
6-10 each agency and commissioner. The memorandum must provide that:
6-11 (1) the commissioner of public health is responsible
6-12 for administering the state and federal funds used to provide the
6-13 grants;
6-14 (2) the commissioner of public health shall adopt
6-15 rules establishing standards for health care delivery in a
6-16 school-based health center funded through a grant that place
6-17 primary emphasis on delivery of physical health services and
6-18 secondary emphasis on population-based models that prevent emerging
6-19 health threats;
6-20 (3) all programs shall be designed to meet the
6-21 following goals:
6-22 (A) reducing student absenteeism;
6-23 (B) increasing a student's ability to meet the
6-24 student's academic potential; and
6-25 (C) stabilizing the physical well-being of a
6-26 student; and
6-27 (4) the commissioner of education may determine which
7-1 school districts receive grants.
7-2 (r) Based on statistics obtained from every school-based
7-3 health center in this state, the commissioner of education and the
7-4 commissioner of public health shall jointly issue an annual report
7-5 to the legislature about the relative efficacy of services
7-6 delivered by school-based health centers and any increased academic
7-7 success of students at campuses served by those centers, with
7-8 special emphasis on any increased attendance, decreased drop-out
7-9 rates, improved student health, and improved performance on student
7-10 assessment instruments administered under Subchapter B, Chapter 39.
7-11 In obtaining statistics for preparation of the report required by
7-12 this subsection, the commissioners shall ensure that data is
7-13 collected for each county and aggregated appropriately according to
7-14 geographical region.
7-15 (s) The commissioner of education and the commissioner of
7-16 public health shall require client surveys to be conducted in
7-17 school-based health centers funded through grants provided under
7-18 this section, and the results of those surveys must be included in
7-19 the annual report required under Subsection (r).
7-20 SECTION 2. Chapter 38, Education Code, is amended by adding
7-21 Section 38.012 to read as follows:
7-22 Sec. 38.012. NOTICE CONCERNING HEALTH CARE SERVICES. (a)
7-23 Before a school district or school may expand or change the health
7-24 care services available at a school in the district from those that
7-25 were available on January 1, 1999, the board of trustees must:
7-26 (1) hold a public hearing at which the board discloses
7-27 all information on the proposed health care services, including:
8-1 (A) all health care services to be provided;
8-2 (B) whether federal law permits or requires any
8-3 health care service provided to be kept confidential from parents;
8-4 (C) whether a child's medical records will be
8-5 accessible to the child's parent;
8-6 (D) information concerning grant funds to be
8-7 used;
8-8 (E) the titles of persons who will have access
8-9 to the medical records of a student; and
8-10 (F) the security measures that will be used to
8-11 protect the privacy of students' medical records; and
8-12 (2) approve the expansion or change by a record vote.
8-13 (b) A hearing under Subsection (a) must include an
8-14 opportunity for public comment on the proposal.
8-15 (c) If, after January 1, 1999, a school district expands or
8-16 changes the health care services available at a school in the
8-17 district, the district must provide to parents or other persons
8-18 having legal control of students at the school, annually:
8-19 (1) the information specified under Subsection (a);
8-20 and
8-21 (2) a summary of complaints the district has received
8-22 during the preceding year concerning health care services provided
8-23 by the district at the school.
8-24 SECTION 3. Chapter 38, Education Code, is amended by adding
8-25 Section 38.0095 to read as follows:
8-26 Sec. 38.0095. PARENTAL ACCESS TO MEDICAL RECORDS. (a) A
8-27 parent or guardian of a student is entitled to access to the
9-1 student's medical records maintained by a school district.
9-2 (b) On request of a student's parent or guardian, the school
9-3 district shall provide a copy of the student's medical records to
9-4 the parent or guardian. The district may not impose a charge for
9-5 providing the copy that exceeds the charge authorized by Section
9-6 552.261, Government Code, for providing a copy of public
9-7 information.
9-8 SECTION 4. A school district must provide information
9-9 required under Section 38.012(c), Education Code, as added by this
9-10 Act, annually beginning January 1, 2000.
9-11 SECTION 5. The importance of this legislation and the
9-12 crowded condition of the calendars in both houses create an
9-13 emergency and an imperative public necessity that the
9-14 constitutional rule requiring bills to be read on three several
9-15 days in each house be suspended, and this rule is hereby suspended,
9-16 and that this Act take effect and be in force from and after its
9-17 passage, and it is so enacted.