Amend CSHB 2292 as follows:                                                  
	SECTION 1.  Subchapter C, Chapter 487, Government Code, is 
amended by adding Section 487.059 to read as follows:
(a)  In this section:
		(1)  "Primary health services provider" means:                                
			(A)  an allopathic or osteopathic primary care 
physician, which includes:  
				(i)  a family practitioner;                                                 
				(ii)  an internist;                                                         
				(iii)  a pediatrician;                                                      
				(iv)  an obstetrician or gynecologist; and                                  
				(v)  a general psychiatrist;                                                
			(B)  a primary care nurse practitioner;                                      
			(C)  a certified nurse midwife;                                              
			(D)  a certified midwife;                                                    
			(E)  a primary care physician assistant;                                     
			(F)  a general practice dentist;                                             
			(G)  a registered clinical dental hygienist;                                 
			(H)  a clinical or counseling psychologist;                                  
			(I)  a clinical social worker;                                               
			(J)  a psychiatric nurse specialist;                                         
			(K)  a mental health counselor;                                              
			(L)  a licensed professional counselor; and                                  
			(M)  a marriage or family therapist.                                         
		(2)  "Rural county" has the definition assigned by 
Section 487.301.         
		(3)  "Rural community" means a community in a rural 
	(b)  The office, with cooperation from the Texas Department 
of Health, the Health and Human Services Commission, the statewide 
rural health care system designated under Chapter 845, Insurance 
Code, public health departments in rural counties, and professional 
health care associations, shall assess the health care needs of 
each rural community and the pattern of use of health care services 
in each of those communities.
	(c)  The agencies shall use the information collected under 
Subsection (b) to collaborate with the rural community to determine 
a comprehensive access point for health care to coordinate the 
delivery of health care, including delivery of services offered 
under the medical assistance program under Chapter 32, Human 
Resources Code, and the state child health plan under Chapter 62, 
Health and Safety Code, to residents of the rural community.
	(d)  Each agency listed in Subsection (b) shall provide 
services covered by programs of the agency to residents of rural 
communities from the comprehensive access points for health care.  
Each agency shall implement working arrangements with primary 
health services providers to work from or through each access point 
to provide services to residents of the rural communities served by 
the access point.  Primary health services providers providing 
services at an access point must be eligible to serve residents who 
are enrolled in federal and agency programs, including:
		(1)  the federal special supplemental nutrition 
program for women, infants, and children under 42 U.S.C. Section 
1786, as amended;
		(2)  the state child health plan under Chapter 62, 
Health and Safety Code;  
		(3)  the medical assistance program under Chapter 32, 
Human Resources Code; and
		(4)  the Medicare program.                                                    
	(e)  The office shall report to the legislature regarding the 
efficacy of comprehensive access points for health care as part of 
the office's report to the legislature under Section 487.056.
	SECTION 2.  (a)  Not later than January 1, 2004, the Office 
of Rural Community Affairs, after ensuring approval from local 
communities, shall choose three or four sites to serve as 
comprehensive access points for health care as required by Section 
487.059, Government Code, as added by this Act.
	(b)  The Office of Rural Community Affairs may designate 
additional sites as comprehensive access points for health care if 
the office determines, as reported in its annual report delivered 
to the legislature on January 1, 2005, that the access points are 
effective in coordinating health care services to residents of 
rural counties.
	SECTION 3.  This Act takes effect September 1, 2003.