88R15415 EAS-F
  By: Kolkhorst, et al. S.B. No. 26
  relating to local mental health authority and local behavioral
  health authority audits and mental and behavioral health reporting,
  services, and programs.
         SECTION 1.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Section 531.099915 to read as follows:
  Not later than September 1, 2025, the commission may, in
  consultation with nursing facilities licensed under Chapter 242,
  Health and Safety Code, develop an incentive payment under the
  Quality Incentive Payment Program (QIPP) for providers that
  implement treatment options, such as reserving specifics beds, for
  individuals who require a level of care provided by nursing
  facilities and who require a high level of behavioral health
  supports and services.
         SECTION 2.  Section 531.1025, Government Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  The commission's office of inspector general shall
  conduct performance audits of each local behavioral health
  authority designated under Section 533.0356, Health and Safety
  Code, and local mental health authority, as defined by Section
  531.002, Health and Safety Code. The office shall:
               (1)  establish an audit schedule that ensures each
  authority described by this subsection is audited at least once
  every 10 years; and
               (2)  conduct additional audits as necessary based on
  adverse findings in a previous audit.
         SECTION 3.  Section 534.0535, Health and Safety Code, is
  amended to read as follows:
         Sec. 534.0535.  JOINT DISCHARGE PLANNING.  (a)  The
  executive commissioner shall adopt or amend, and the department
  shall enforce, rules that require continuity of services and
  planning for patient care between department facilities and local
  mental health authorities.
         (b)  At a minimum, the rules must:
               (1)  specify the local mental health authority's
  responsibility for ensuring the successful transition of patients
  who are determined by the facility to be medically appropriate for
  discharge; and
               (2)  require participation by a department facility in 
  joint discharge planning with [between a department facility and] a
  local mental health authority before the [a] facility discharges a
  patient or places the patient on an extended furlough with an intent
  to discharge.
         (c)  The local mental health authority shall plan with the
  department facility to [and] determine the appropriate community
  services for the patient.
         (d)  The local mental health authority shall arrange for the
  provision of the services upon discharge [if department funds are
  to be used and may subcontract with or make a referral to a local
  agency or entity].
         (e)  The commission shall require each facility to designate
  at least one employee to provide transition support services for
  patients who are determined medically appropriate for discharge
  from the facility.
         (f)  Transition support services provided by the local
  mental health authority must be designed to complement joint
  discharge planning efforts and may include:
               (1)  enhanced services and supports for complex or
  high-need patients, including services and supports necessary to
  create viable discharge or outpatient management plans; and
               (2)  post-discharge monitoring for up to one year after
  the discharge date to reduce the likelihood of readmission.
         (g)  The commission shall ensure that each department
  facility concentrates the provision of transition support services
  for patients who have been:
               (1)  admitted to and discharged from a facility
  multiple times during a 30-day period; or
               (2)  in the facility for longer than 365 consecutive
         SECTION 4.  Subtitle A, Title 7, Health and Safety Code, is
  amended by adding Chapter 535 to read as follows:
         Sec. 535.001.  DEFINITIONS. In this chapter:
               (1)  "Inpatient mental health facility" has the meaning
  assigned by Section 571.003.
               (2)  "Program" means the grant program established
  under this chapter.
               (3)  "State hospital" has the meaning assigned by
  Section 552.0011.
         Sec. 535.002.  ESTABLISHMENT OF GRANT PROGRAM. (a)  To the
  extent money is appropriated to the commission for that purpose,
  the commission shall establish a grant program to provide support
  to eligible entities for community-based initiatives that promote
  identification of mental health issues and improve access to early
  intervention and treatment for children and families.  The
  initiatives may:
               (1)  be evidence-based or otherwise demonstrate
  positive outcomes, including:
                     (A)  improved relationship skills;
                     (B)  improved self-esteem;
                     (C)  reduced involvement in the juvenile justice
                     (D)  participation in the relinquishment
  avoidance program under Subchapter E, Chapter 262, Family Code; and
                     (E)  avoidance of emergency room use; and
               (2)  include:
                     (A)  training; and
                     (B)  services and supports for:
                           (i)  community-based initiatives;
                           (ii)  agencies that provide services to
  children and families;
                           (iii)  individuals who work with children or
  caregivers of children showing atypical social or emotional
  development or other challenging behaviors; and
                           (iv)  children in or at risk of placement in
  foster care or the juvenile justice system.
         (b)  The commission may award a grant under the program only
  in accordance with a contract between the commission and a grant
  recipient. The contract must include provisions under which the
  commission is given sufficient control to ensure the public purpose
  of providing mental health prevention services to children and
  families is accomplished and the state receives the return benefit.
  REQUIREMENTS.  (a)  The executive commissioner by rule shall
  establish application and eligibility requirements for an entity to
  be awarded a grant under the program.
         (b)  The following entities are eligible for a grant awarded
  under the program:
               (1)  a hospital licensed under Chapter 241;
               (2)  a mental hospital licensed under Chapter 577;
               (3)  a hospital district;
               (4)  a local mental health authority;
               (5)  a school district;
               (6)  a child-care facility, as defined by Chapter 42,
  Human Resources Code;
               (7)  a county or municipality;
               (8)  a nonprofit organization that is exempt from
  federal income taxation under Section 501(a), Internal Revenue Code
  of 1986, by being listed as an exempt entity under Section 501(c)(3)
  of that code; and
               (9)  any other entity the commission considers
         (c)  In awarding grants under the program, the commission
  shall prioritize entities that work with children and family
  members of children with a high risk of experiencing a crisis or
  developing a mental health condition to reduce:
               (1)  need for future intensive mental health services;
               (2)  the number of children at risk of placement in
  foster care or the juvenile justice system; or
               (3)  the demand for placement in state hospitals,
  inpatient mental health facilities, and residential behavioral
  health facilities.
         Sec. 535.004.  USE OF GRANT MONEY. A grant recipient may use
  grant money awarded under this chapter to develop innovative
  strategies that provide:
               (1)  resiliency;
               (2)  coping and social skills;
               (3)  healthy social and familial relationships; and
               (4)  parenting skills and behaviors.
         SECTION 5.  Section 1001.084, Health and Safety Code, as
  redesignated by Chapter 1236 (S.B. 1296), Acts of the 84th
  Legislature, Regular Session, 2015, is amended by amending
  Subsections (a), (b), (c), and (d) and adding Subsections (d-1) and
  (g) to read as follows:
         (a)  The department, in collaboration with the commission,
  shall establish and maintain a public reporting system of
  performance and outcome measures relating to mental health and
  substance use [abuse] services established by the [Legislative
  Budget Board, the department, and the] commission. The system must
  allow external users to view and compare the performance[,
  outputs,] and outcomes of:
               (1)  local mental health authorities [community
  centers established under Subchapter A, Chapter 534, that provide
  mental health services];
               (2)  local behavioral health authorities [Medicaid
  managed care pilot programs that provide mental health services];
               (3)  local intellectual and developmental disability
  authorities [agencies, organizations, and persons that contract
  with the state to provide substance abuse services].
         (b)  The public reporting system must allow external users to
  view and compare the performance[, outputs,] and outcomes of the
  Medicaid managed care programs that provide mental health services.
         (c)  The department shall post the performance[, output,]
  and outcome measures on the department's Internet website so that
  the information is accessible to the public. The department shall
  post the measures monthly, or as frequently as possible [quarterly
  or semiannually in accordance with when the measures are reported
  to the department].
         (d)  The [department shall consider public input in
  determining the appropriate outcome measures to collect in the]
  public reporting system must[.  To the extent possible, the
  department shall] include outcome measures that capture:
               (1)  inpatient psychiatric care diversion;
               (2)  [,] avoidance of emergency room use;
               (3)  [,] criminal justice diversion;
               (4)  [, and] the numbers of people who are homeless
               (5)  access to timely and adequate screening and rapid
  crisis stabilization services;
               (6)  timely access to and appropriate treatment from
  community-based crisis residential services and hospitalization;
               (7)  improved functioning as a result of
  medication-related and psychosocial rehabilitation services;
               (8)  information related to the number of people
  referred to a state hospital, state supported living center, or
  community-based hospital, the length of time between referral and
  admission, the length of stay, and the length of time between the
  date a person is determined ready for discharge or transition and
  the date of discharge or transition;
               (9)  the rate of denial of services or requests for
  assistance from jails and other entities and the reason for denial;
               (10)  quality of care in community-based mental health
  services and state facilities;
               (11)  the average number of hours of service provided
  to individuals in a full level of care compared to the recommended
  number of hours of service for each level of care; and
               (12)  any other relevant information to determine the
  quality of services provided during the reporting period.
         (d-1)  This subsection and Subsection (d) expire September
  1, 2025.
         (g)  In this section:
               (1)  "Local behavioral health authority" means an
  authority designated by the commission under Section 533.0356.
               (2)  "Local intellectual and developmental disability
  authority" and "local mental health authority" have the meanings
  assigned by Section 531.002.
               (3)  "State hospital" has the meaning assigned by
  Section 552.0011.
               (4)  "State supported living center" has the meaning
  assigned by Section 531.002.
         SECTION 6.  Section 1001.084(e), Health and Safety Code, as
  redesignated by Chapter 1236 (S.B. 1296), Acts of the 84th
  Legislature, Regular Session, 2015, is repealed.
         SECTION 7.  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 8.  This Act takes effect September 1, 2023.