By: Nelson S.B. No. 58
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the integration of behavioral health and physical
  health services into the Medicaid managed care program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 533, Government Code, is
  amended by adding Section 533.00255 to read as follows:
         Sec. 533.00255.  BEHAVIORAL HEALTH AND PHYSICAL HEALTH
  SERVICES NETWORK. (a)  In this section, "behavioral health
  services" means mental health and substance abuse disorder
  services, other than those provided through the NorthSTAR
  demonstration project.
         (b)  The commission shall, to the greatest extent possible,
  integrate into the Medicaid managed care program implemented under
  this chapter the following services for Medicaid-eligible persons:
               (1)  behavioral health services, including targeted
  case management and psychiatric rehabilitation services; and
               (2)  physical health services.
         (c)  A managed care organization that contracts with the
  commission under this chapter shall develop a network of public and
  private providers of behavioral health services and ensure
  consumers with serious mental illness have access to a
  comprehensive array of services.
         (d)  In implementing this section, the commission shall
  ensure that:
               (1)  an appropriate assessment tool is used to
  authorize services;
               (2)  providers are well-qualified and able to provide
  an appropriate array of services;
               (3)  appropriate performance and quality outcomes are
  measured;
               (4)  two health home pilot programs are established in
  two health service areas, representing two distinct regions of the
  state, for persons who are diagnosed with:
                     (A)  a serious mental illness; and
                     (B)  at least one other chronic health condition;
               (5)  a health home established under a pilot program
  under Subdivision (4) complies with the principles for
  patient-centered medical homes described in Section 533.0029; and
               (6)  all behavioral health services provided under this
  section are based on an approach to treatment where the expected
  outcome of treatment is recovery.
         (e)  The commission and the Department of State Health
  Services shall establish a Behavioral Health Integration Advisory
  Committee:
               (1)  whose membership must include:
                     (A)  individuals with behavioral health
  conditions who are current or former recipients of publicly funded
  behavioral health services; and
                     (B)  representatives of managed care
  organizations that have expertise in offering behavioral health
  services; and
               (2)  that shall:
                     (A)  meet at least quarterly to address the
  planning and development needs of the behavioral health services
  network established under this section;
                     (B)  seek input from the behavioral health
  community on the implementation of this section; and
                     (C)  issue formal recommendations to the
  commission regarding the implementation of this section.
         (f)  The commission shall provide administrative support to
  facilitate the duties of the advisory committee established under
  Subsection (e).  This subsection and Subsection (e) expire
  September 1, 2017.
         (g)  The commission shall, if the commission determines that
  it is cost-effective and beneficial to recipients, include a peer
  specialist as a benefit to recipients or as a provider type.
         (h)  To the extent of any conflict between this section and
  any other law relating to behavioral health services, this section
  prevails.
         (i)  The executive commissioner shall adopt rules necessary
  to implement this section.
         SECTION 2.  Not later than December 1, 2013, the Health and
  Human Services Commission shall establish the Behavioral Health
  Integration Advisory Committee required by Section 533.00255,
  Government Code, as added by this Act.
         SECTION 3.  Not later than September 1, 2014, the Health and
  Human Services Commission shall complete the integration of
  behavioral health and physical health services required by Section
  533.00255, Government Code, as added by this Act.
         SECTION 4.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 5.  This Act takes effect September 1, 2013.