76R14439 KKA-F
By Tillery, Naishtat, Coleman, Salinas H.B. No. 2202
Substitute the following for H.B. No. 2202:
By Dunnam C.S.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. An appropriate
2-1 person may give consent for a student to receive ongoing services
2-2 or may limit consent to one or more services provided on a single
2-3 occasion. The consent form must list every service the
2-4 school-based health center delivers in a format that complies with
2-5 all applicable state and federal laws and allows a person to
2-6 consent to one or more categories of services. The permissible
2-7 categories of services are:
2-8 (1) family and home support;
2-9 (2) health care, including immunizations;
2-10 (3) dental health care;
2-11 (4) health education; and
2-12 (5) preventive health strategies.
2-13 (d) Reproductive services or counseling may not be provided
2-14 through a school-based health center using grant funds awarded
2-15 under this section. Any service provided using grant funds must be
2-16 provided by an appropriate professional who is properly licensed,
2-17 certified, or otherwise authorized under state law to provide the
2-18 service.
2-19 (e) The staff of a school-based health center and the person
2-20 whose consent is obtained under Subsection (c) shall jointly
2-21 identify any health-related concerns of a student that may be
2-22 interfering with the student's well-being or ability to succeed in
2-23 school.
2-24 (f) If it is determined that a student is in need of a
2-25 referral for mental health services, the staff of the center shall
2-26 notify the person whose consent is required under Subsection (c)
2-27 verbally and in writing of the basis for the referral. The
3-1 referral may not be provided unless the person provides written
3-2 consent for the type of service to be provided and provides
3-3 specific written consent for each treatment occasion.
3-4 (g) The board of trustees of a school district may establish
3-5 and appoint members to a local health education and health care
3-6 advisory council to make recommendations to the district on the
3-7 establishment of school-based health centers and to assist the
3-8 district in ensuring that local community values are reflected in
3-9 the operation of each center and in the provision of health
3-10 education. A majority of the members of the council must be
3-11 parents of students enrolled in the district. The board of
3-12 trustees shall also appoint at least one person from each of the
3-13 following groups:
3-14 (1) teachers;
3-15 (2) school administrators;
3-16 (3) licensed health care professionals;
3-17 (4) the clergy;
3-18 (5) law enforcement;
3-19 (6) the business community;
3-20 (7) senior citizens; and
3-21 (8) students.
3-22 (h) A school district may seek assistance in establishing
3-23 and operating a school-based health center from any public health
3-24 agency in the community. On request, a public health agency shall
3-25 cooperate with a district and to the extent practicable,
3-26 considering the resources of the agency, may provide assistance. A
3-27 district and a public health agency may, by agreement, jointly
4-1 establish, operate, and fund a school-based health center.
4-2 (i) If a school-based health center is located in an area
4-3 described by Subsection (j):
4-4 (1) the school district and the advisory council
4-5 established under Subsection (g) shall coordinate with existing
4-6 providers to preserve and protect existing health care systems and
4-7 medical relationships in the area; and
4-8 (2) the staff of the center shall, before delivering a
4-9 medical service to a person with a primary care physician under the
4-10 state Medicaid program, a state children's health plan program, or
4-11 a private health insurance or health benefit plan, notify the
4-12 physician for the purpose of sharing medical information and
4-13 obtaining authorization for delivering the medical service.
4-14 (j) The requirements prescribed by Subsection (i) apply only
4-15 to a school-based health center serving an area that:
4-16 (1) is located in a county with a population not
4-17 greater than 50,000; or
4-18 (2) has been designated under state or federal law as:
4-19 (A) a health professional shortage area;
4-20 (B) a medically underserved area; or
4-21 (C) a medically underserved community by the
4-22 Center for Rural Health Initiatives.
4-23 (k) If a person receiving a medical service from a
4-24 school-based health center has a primary care physician, the staff
4-25 of the center shall provide notice of the service the person
4-26 received to the primary care physician in order to allow the
4-27 physician to maintain a complete medical history of the person.
5-1 (l) A school district or the provider with whom the district
5-2 contracts shall seek all available sources of funding to compensate
5-3 the district or provider for services provided by a school-based
5-4 health center, including money available under the state Medicaid
5-5 program, a state children's health plan program, or private health
5-6 insurance or health benefit plans.
5-7 (m) Subject to the availability of federal or state
5-8 appropriated funds, the commissioner of education and the
5-9 commissioner of public health shall jointly administer a program
5-10 under which grants are awarded to assist school districts with the
5-11 costs of operating school-based health centers in accordance with
5-12 this section. The commissioners, by rules adopted in accordance
5-13 with this section, shall establish procedures for awarding grants.
5-14 (n) A school district may not receive more than $250,000 per
5-15 biennium through grants awarded under this section. To be eligible
5-16 to receive a grant, a district must provide matching funds in
5-17 accordance with rules adopted under Subsection (m). The matching
5-18 funds may be obtained from any source available to the district,
5-19 including in-kind contributions, community or foundation grants,
5-20 individual contributions, and local governmental agency operating
5-21 funds.
5-22 (o) The rules adopted under Subsection (m) must provide
5-23 that:
5-24 (1) grants are awarded to school districts on an
5-25 annual basis through a competitive process; and
5-26 (2) a preference is given to school districts that are
5-27 located in rural areas or that have low property wealth per
6-1 student.
6-2 (p) The commissioner of education and the commissioner of
6-3 public health are partners in administering the grants. The Texas
6-4 Education Agency and the Texas Department of Health shall enter
6-5 into a memorandum of understanding that prescribes the duties of
6-6 each agency and commissioner. The memorandum must provide that:
6-7 (1) the commissioner of public health is responsible
6-8 for administering the state and federal funds used to provide the
6-9 grants;
6-10 (2) the commissioner of public health shall adopt
6-11 rules establishing standards for health care delivery in a
6-12 school-based health center funded through a grant that place
6-13 primary emphasis on delivery of physical and mental health services
6-14 and secondary emphasis on population-based models that prevent
6-15 emerging health threats;
6-16 (3) all programs shall be designed to meet the
6-17 following goals:
6-18 (A) reducing student absenteeism;
6-19 (B) increasing a student's ability to meet the
6-20 student's academic potential; and
6-21 (C) stabilizing the physical and mental
6-22 well-being of a student; and
6-23 (4) the commissioner of education shall determine
6-24 which school districts receive grants.
6-25 (q) Based on statistics obtained from every school-based
6-26 health center in this state, the commissioner of education and the
6-27 commissioner of public health shall jointly issue an annual report
7-1 to the legislature about the relative efficacy of services
7-2 delivered by school-based health centers and any increased academic
7-3 success of students at campuses served by those centers, with
7-4 special emphasis on any increased attendance, decreased drop-out
7-5 rates, improved student health, and improved performance on student
7-6 assessment instruments administered under Subchapter B, Chapter 39.
7-7 In obtaining statistics for preparation of the report required by
7-8 this subsection, the commissioners shall ensure that data is
7-9 collected for each county and aggregated appropriately according to
7-10 geographical region.
7-11 (r) The commissioner of education and the commissioner of
7-12 public health shall require client surveys to be conducted in
7-13 school-based health centers funded through grants provided under
7-14 this section, and the results of those surveys must be included in
7-15 the annual report required under Subsection (q).
7-16 SECTION 2. The importance of this legislation and the
7-17 crowded condition of the calendars in both houses create an
7-18 emergency and an imperative public necessity that the
7-19 constitutional rule requiring bills to be read on three several
7-20 days in each house be suspended, and this rule is hereby suspended,
7-21 and that this Act take effect and be in force from and after its
7-22 passage, and it is so enacted.