86R8924 JG-D
 
  By: Thompson of Harris H.B. No. 10
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to grants and programs for researching and treating
  behavioral health and psychiatric issues.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 58A.024, Education Code, is amended by
  adding Subsection (a-1) to read as follows:
         (a-1)  The board shall award a supplemental grant to a new or
  existing graduate medical education program to enable the program
  to increase the number of residency positions, including fellowship
  positions, leading to a medical specialty in the diagnosis and
  treatment of psychiatric and associated behavioral health issues
  affecting children and adolescents.
         SECTION 2.  Section 58A.0245(a), Education Code, is amended
  to read as follows:
         (a)  If the board determines that the number of first-year
  residency positions proposed by eligible applicants under Sections
  58A.023 and 58A.024 exceeds the number of first-year residency
  positions for which grant funding under those sections is
  appropriated, in awarding grants under those sections the board may
  not award a supplemental grant described by Section 58A.024(a-1)
  but shall otherwise prioritize the awarding of new grants to
  medical specialties determined by the board to be at critical
  shortage levels.
         SECTION 3.  Chapter 61, Education Code, is amended by adding
  Subchapter LL to read as follows:
  SUBCHAPTER LL. CHILD AND ADOLESCENT
  PSYCHIATRIC NURSING GRANT PROGRAM
         Sec. 61.9851.  DEFINITIONS. In this subchapter:
               (1)  "Advanced practice registered nurse" has the
  meaning assigned to that term by Section 301.152, Occupations Code.
               (2)  "Advanced practice registered nursing program" or
  "nursing program" means an educational program offered by a public
  or private institution of higher education to prepare students for
  board certification as advanced practice registered nurses.
               (3)  "Child-adolescent psychiatrist" means a licensed
  physician who specializes in the diagnosis and treatment of
  psychiatric and associated behavioral health issues affecting
  children and adolescents.
               (4)  "Grant program" means the child and adolescent
  psychiatric nursing grant program established under this
  subchapter.
         Sec. 61.9852.  ESTABLISHMENT; PURPOSE. (a) A child and
  adolescent psychiatric nursing grant program is established.
         (b)  The board shall administer the grant program to award
  grants to advanced practice registered nursing programs to enable
  those programs to:
               (1)  support the salaries of a program's faculty and
  staff;
               (2)  increase the number of enrollments and graduations
  of students who seek to become advanced practice registered nurses
  specializing in child and adolescent psychiatric nursing;
               (3)  recruit child-adolescent psychiatrists to help
  provide the clinical instruction necessary for those students to
  prepare for board certification in that specialty; or
               (4)  establish or expand the number of postgraduate
  residency and fellowship training positions for advanced practice
  registered nurses to receive specialized training in child and
  adolescent psychiatric nursing.
         Sec. 61.9853.  GRANTS. (a) A grant awarded to a nursing
  program under this subchapter:
               (1)  must be expended exclusively on costs related to
  the purpose for which the grant is awarded under Section
  61.9852(b);
               (2)  is contingent on the advanced practice registered
  nursing program's having been approved as an advanced practice
  registered nursing program by the board or the Texas Board of
  Nursing, as appropriate; and
               (3)  is contingent on the nursing program's being in
  good standing with the Texas Board of Nursing or other accrediting
  body.
         (b)  In addition to the requirements of Subsection (a), a
  grant awarded for a purpose described by Section 61.9852(b)(2) is
  contingent on the nursing program's ability to enroll and graduate
  additional students, including having the necessary classroom
  space and clinical slots.
         (c)  The nursing program shall return to the board any money
  not expended exclusively on the costs described by Subsection
  (a)(1).
         Sec. 61.9854.  APPLICATION PROCESS. (a) The board by rule
  shall establish a process under which a public or private
  institution of higher education that offers an advanced practice
  registered nursing program may apply for a grant under this
  subchapter and the board, contingent on appropriations of money for
  the grants, selects one or more applicants to receive a grant based
  on criteria established by board rule.  The criteria must include
  the institution's agreement that the institution's nursing program
  will use the grant money for the purpose for which the grant is
  awarded under Section 61.9852(b).
         (b)  A grant application under this subchapter must require
  the institution applying for a grant to:
               (1)  identify benchmarks for determining adequate and
  timely progress toward achieving the purpose for which the grant is
  awarded under Section 61.9852(b);
               (2)  as applicable, state:
                     (A)  with respect to students who seek to become
  advanced practice registered nurses specializing in child and
  adolescent psychiatric nursing, the number of additional students
  that the institution's nursing program intends to enroll and the
  number of additional students that the program intends to graduate;
                     (B)  the number of child-adolescent psychiatrists
  the institution intends to recruit to help provide the clinical
  instruction necessary for students described by Paragraph (A); or
                     (C)  the number of postgraduate residency or
  fellowship positions for specialized training in child or
  adolescent psychiatric nursing that the institution's nursing
  program intends to establish or expand for advanced practice
  registered nurses; and
               (3)  state the amount of grant money requested.
         (c)  The board may negotiate changes to the application
  before approving the application.
         (d)  If the board determines that a nursing program has
  failed to make adequate and timely progress toward achieving the
  purpose for which the grant was awarded, the board may:
               (1)  require the institution offering the nursing
  program to return any unearned grant money awarded to that program
  under this subchapter;
               (2)  withhold future grant awards that would otherwise
  be made under this subchapter in accordance with the approved
  application;
               (3)  renegotiate the terms of the approved application;
  or
               (4)  rescind approval of the application.
         Sec. 61.9855.  ADMINISTRATION. The board shall adopt rules
  for the administration of the grant program.
         Sec. 61.9856.  GRANTS, GIFTS, AND DONATIONS. In addition to
  funds appropriated by the legislature, the board may solicit,
  receive, and spend grants, gifts, and donations from public or
  private sources for the purposes of this subchapter.
         Sec. 61.9857.  ANNUAL REPORT. Each institution of higher
  education that has an advanced practice registered nursing program
  shall submit an annual report to the board detailing its strategy
  for achieving the purpose for which the grant was awarded.
         Sec. 61.9858.  DISBURSEMENT AND ACCOUNTING OF APPROPRIATED
  FUNDS. (a) The board shall adopt procedures for assuring that
  grants awarded under this subchapter are:
               (1)  distributed in a timely manner, including the
  forfeiture and reallocation of money if an institution fails to
  provide in a timely manner the information required for the money to
  be disbursed and if that failure prevents the timely disbursement
  of money to other institutions; and
               (2)  expended on the advanced practice registered
  nursing program by institutions receiving the money.
         (b)  The procedures adopted under Subsection (a) must
  require each advanced practice registered nursing program that
  receives money to file an annual report with the board accounting
  for all money received.
         Sec. 61.9859.  ADMINISTRATIVE COSTS. A reasonable amount,
  not to exceed five percent, of the money appropriated by the
  legislature for the purposes of this subchapter may be used by the
  board to pay administrative costs of implementing this subchapter.
         SECTION 4.  Subtitle E, Title 2, Health and Safety Code, is
  amended by adding Chapter 104A to read as follows:
  CHAPTER 104A. TEXAS BEHAVIORAL HEALTH RESEARCH INSTITUTE
         Sec. 104A.001.  DEFINITIONS. In this chapter:
               (1)  "Child-adolescent psychiatrist" means a physician
  who specializes in the diagnosis and treatment of psychiatric and
  associated behavioral health issues affecting children and
  adolescents.
               (2)  "Child psychiatry access line" means a telephonic
  or other electronic system operated to connect health care
  professionals with child-adolescent psychiatrists for peer-to-peer
  consultation regarding the treatment of children with behavioral
  health concerns through telepsychiatry.
               (3)  "Direct care provider" means a health care
  professional, including a primary care physician, who is providing
  in-person health care services to a child.
               (4)  "Institute" means the Texas Behavioral Health
  Research Institute.
               (5)  "Social-emotional learning" means the process
  through which children develop and apply the knowledge, attitudes,
  and skills to understand and manage emotions, resolve conflicts,
  set and achieve goals, feel and show empathy for others, establish
  and maintain positive relationships, and make responsible
  decisions.
               (6)  "Telepsychiatry" means the remote diagnosis and
  treatment of patients for psychiatric problems through
  videoconferencing or through various other means of electronic
  communication.
         Sec. 104A.002.  ESTABLISHMENT; PURPOSE. The institute is
  established to create a centralized direction and vision for
  addressing child and adolescent behavioral health needs and to
  provide grants for researching and treating behavioral health
  issues.
         Sec. 104A.003.  COMPOSITION OF INSTITUTE. (a) The
  institute is composed of the following members:
               (1)  one representative from the commission, appointed
  by the governor;
               (2)  one member of the public who represents
  pediatricians, appointed by the governor;
               (3)  one member of the public who represents nonprofit
  organizations in this state that focus on mental health issues,
  appointed by the governor; and
               (4)  the chair of the academic department of psychiatry
  from each of the following health-related institutions of higher
  education or a person designated to serve by the chair in the
  chair's place:
                     (A)  The University of Texas Health Science Center
  at Houston; 
                     (B)  The University of Texas Health Science Center
  at San Antonio;
                     (C)  The University of Texas Southwestern Medical
  Center;
                     (D)  The University of Texas Medical Branch at
  Galveston;
                     (E)  The University of Texas M. D. Anderson Cancer
  Center;
                     (F)  The University of Texas Health Science Center
  at Tyler;
                     (G)  The Texas A&M University Health Science
  Center;
                     (H)  the University of North Texas Health Science
  Center at Fort Worth;
                     (I)  the Texas Tech University Health Sciences
  Center;
                     (J)  the Texas Tech University Health Sciences
  Center at El Paso;
                     (K)  the Dell Medical School at The University of
  Texas at Austin;
                     (L)  The University of Texas Rio Grande Valley
  School of Medicine; and
                     (M)  Baylor College of Medicine.
         (b)  Service on the institute by a public officer or employee
  is an additional duty of the office or employment.
         (c)  The institute shall elect a presiding member from among
  its membership.
         (d)  The institute shall establish a schedule of regular
  meetings.
         Sec. 104A.004.  POWERS AND DUTIES. (a) The institute shall
  undertake to improve the quality and accessibility of care in local
  communities by:
               (1)  providing grants or other funding to the
  health-related institutions of higher education listed in Section
  104A.003(a)(4) and community mental health providers to provide
  direct mental health care services and treatment;
               (2)  establishing child psychiatry access lines for
  peer-to-peer consultation support for direct care providers who use
  telepsychiatry; 
               (3)  establishing partnerships between behavioral
  health professionals from the health-related institutions of
  higher education listed in Section 104A.003(a)(4) and direct care
  providers to encourage the use of child psychiatry access lines;
               (4)  educating direct care providers about services and
  supports that child-adolescent psychiatrists provide;
               (5)  creating a program to provide students access to
  telepsychiatry through the use of child psychiatry access lines to
  support public school personnel who are assisting students with
  behavioral health concerns; and
               (6)  providing grants under the grant programs
  established under Sections 104A.005 and 104A.006.
         (b)  The institute shall create a statewide plan to address
  behavioral health issues in schools that includes:
               (1)  best practices in anti-bullying efforts;
               (2)  best practices in social-emotional learning;
               (3)  best practices for screening and triaging at-risk
  youth for behavioral health concerns;
               (4)  suicide prevention programming;
               (5)  opportunities for restorative justice; and
               (6)  community education programs for parents,
  students, and the community that address behavioral health
  concerns.
         (c)  The institute shall develop funding mechanisms that
  promote collaborative planning, implementation, workforce
  development, and research to ensure quality services for youth and
  families.
         (d)  The institute shall prioritize the development of
  specific behavioral health services for high-risk populations,
  including: 
               (1)  children exposed to severe trauma, neglect, or
  loss;
               (2)  victims of sex trafficking;
               (3)  children and youth in foster care;
               (4)  children at risk of adjudication; and
               (5)  children with intellectual or developmental
  disabilities.
         Sec. 104A.005.  BEHAVIORAL HEALTH RESEARCH AND TREATMENT
  GRANT PROGRAM. (a) The institute shall establish a behavioral
  health research and treatment grant program to provide grants to
  the health-related institutions of higher education  listed in
  Section 104A.003(a)(4) to support research efforts regarding
  behavioral health issues, including research related to:
               (1)  physical, structural, chemical, electrical, or
  genetic causes of behavioral health issues;
               (2)  external factors that may result in behavioral
  health issues;
               (3)  physical or other health issues that may affect
  behavioral health;
               (4)  public health trends and strategies related to
  behavioral health;
               (5)  new treatments, therapies, pharmaceuticals,
  medical interventions, or other solutions for addressing
  behavioral health issues;
               (6)  substance use and addiction issues, including:
                     (A)  genetic determinants of addiction;
                     (B)  identification of and mitigation of
  substance use and addiction risk factors;
                     (C)  addiction recovery;
                     (D)  pain management strategies; and
                     (E)  prescription practices in this state; and
               (7)  other behavioral health and addiction issues
  identified by the institute.
         (b)  A health-related institution of higher education listed
  in Section 104A.003(a)(4) may apply for a grant under this section
  alone or in partnership with the institute or other state agency or
  another health-related institution of higher education to carry out
  research efforts described by Subsection (a).
         Sec. 104A.006.  ADDICTION CRISIS GRANT PROGRAM. The
  institute shall create an addiction crisis grant program to provide
  grants to health-related institutions of higher education listed in
  Section 104A.003(a)(4) to:
               (1)  research, develop, test, and disseminate new
  standards for prescribing opioid drugs;
               (2)  teach the standards for prescribing opioid drugs
  described by Subdivision (1) at the health-related institutions of
  higher education and at any continuing or community education
  courses provided by the institution;
               (3)  develop a workforce that specializes in substance
  use research and clinical care;
               (4)  conduct research related to identifying:
                     (A)  addiction recovery methods that use new
  substance use treatment strategies, therapies, drugs, or
  telemedicine services;
                     (B)  barriers to the accessibility of
  evidence-based substance use medical treatments;
                     (C)  strategies and new treatment methods to
  reduce the effects of opioid drugs and other controlled substances
  on maternal mortality and morbidity rates in this state;
                     (D)  prevention techniques, policies, and
  outreach methods to reduce the use of opioid drugs and other
  controlled substances;
                     (E)  better pain management strategies for
  persons recovering from a substance use disorder;
                     (F)  ways to obtain better data related to
  substance use and ways to achieve the interoperability of various
  sources of that data;
                     (G)  the most recent pharmacogenetic strategies;
                     (H)  the genetic determinants of addiction; and
                     (I)  whether risk factors for addiction can be
  determined or mitigated;
               (5)  develop a prescriber screening method or tool;
               (6)  research and test new substance use clinical
  treatment approaches;
               (7)  monitor trends in substance use patterns through
  the use of improved toxicology testing; and
               (8)  collaborate with the commission, the Texas State
  Board of Pharmacy, and any other appropriate agency or professional
  board to complete comparative studies of prescribing practices for
  opioid drugs in this state.
         Sec. 104A.007.  FUNDING. In addition to any money
  appropriated to the institute, the institute may solicit and accept
  gifts, grants, and donations from any source for the purpose of
  carrying out this chapter.
         Sec. 104A.008.  COLLABORATION WITH HISTORICALLY BLACK
  COLLEGE OR UNIVERSITY.  A health-related institution of higher
  education may contract with a historically black college or
  university in this state to collaborate with the institution in
  carrying out any part of this chapter.
         Sec. 104A.009.  REPORT. Not later than December 1 of each
  even-numbered year, the institute shall prepare and submit to the
  governor, lieutenant governor, speaker of the house of
  representatives, and members of the legislature a biennial report
  on the institute's activities and legislative recommendations
  based on those activities.
         Sec. 104A.010. APPROPRIATION CONTINGENCY. The institute is
  required to implement a provision of this chapter only if the
  legislature appropriates money specifically for that purpose. If
  the legislature does not appropriate money specifically for that
  purpose, the institute may, but is not required to, implement the
  provision using other money available to the institute for that
  purpose.
         SECTION 5.  The Texas Higher Education Coordinating Board
  shall establish the child and adolescent psychiatric nursing grant
  program under Subchapter LL, Chapter 61, Education Code, as added
  by this Act, not later than December 31, 2019.
         SECTION 6.  Not later than December 1, 2019, the governor
  shall appoint members to the Texas Behavioral Health Research
  Institute in accordance with Section 104A.003, Health and Safety
  Code, as added by this Act.
         SECTION 7.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2019.