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A BILL TO BE ENTITLED
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AN ACT
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relating to the integration of behavioral health and physical |
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health services into the Medicaid managed care program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 533, Government Code, is |
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amended by adding Section 533.00255 to read as follows: |
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Sec. 533.00255. BEHAVIORAL HEALTH AND PHYSICAL HEALTH |
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SERVICES NETWORK. (a) In this section, "behavioral health |
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services" means mental health and substance abuse disorder |
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services, other than those provided through the NorthSTAR |
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demonstration project. |
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(b) The commission shall, to the greatest extent possible, |
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integrate into the Medicaid managed care program implemented under |
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this chapter the following services for Medicaid-eligible persons: |
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(1) behavioral health services, including targeted |
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case management and psychiatric rehabilitation services; and |
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(2) physical health services. |
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(c) A managed care organization that contracts with the |
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commission under this chapter shall develop a network of public and |
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private providers of behavioral health services and ensure |
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consumers with serious mental illness have access to a |
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comprehensive array of services. |
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(d) In implementing this section, the commission shall |
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ensure that: |
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(1) an appropriate assessment tool is used to |
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authorize services; |
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(2) providers are well-qualified and able to provide |
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an appropriate array of services; |
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(3) appropriate performance and quality outcomes are |
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measured; |
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(4) two health home pilot programs are established in |
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two health service areas, representing two distinct regions of the |
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state, for persons who are diagnosed with: |
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(A) a serious mental illness; and |
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(B) at least one other chronic health condition; |
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(5) a health home established under a pilot program |
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under Subdivision (4) complies with the principles for |
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patient-centered medical homes described in Section 533.0029; and |
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(6) all behavioral health services provided under this |
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section are based on an approach to treatment where the expected |
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outcome of treatment is recovery. |
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(e) The commission and the Department of State Health |
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Services shall establish a Behavioral Health Integration Advisory |
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Committee: |
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(1) whose membership must include: |
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(A) individuals with behavioral health |
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conditions who are current or former recipients of publicly funded |
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behavioral health services; and |
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(B) representatives of managed care |
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organizations that have expertise in offering behavioral health |
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services; and |
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(2) that shall: |
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(A) meet at least quarterly to address the |
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planning and development needs of the behavioral health services |
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network established under this section; |
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(B) seek input from the behavioral health |
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community on the implementation of this section; and |
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(C) issue formal recommendations to the |
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commission regarding the implementation of this section. |
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(f) The commission shall provide administrative support to |
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facilitate the duties of the advisory committee established under |
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Subsection (e). This subsection and Subsection (e) expire |
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September 1, 2017. |
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(g) The commission shall, if the commission determines that |
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it is cost-effective and beneficial to recipients, include a peer |
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specialist as a benefit to recipients or as a provider type. |
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(h) To the extent of any conflict between this section and |
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any other law relating to behavioral health services, this section |
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prevails. |
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(i) The executive commissioner shall adopt rules necessary |
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to implement this section. |
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SECTION 2. Not later than December 1, 2013, the Health and |
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Human Services Commission shall establish the Behavioral Health |
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Integration Advisory Committee required by Section 533.00255, |
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Government Code, as added by this Act. |
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SECTION 3. Not later than September 1, 2014, the Health and |
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Human Services Commission shall complete the integration of |
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behavioral health and physical health services required by Section |
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533.00255, Government Code, as added by this Act. |
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SECTION 4. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 5. This Act takes effect September 1, 2013. |
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