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.