88R15415 EAS-F     By: Kolkhorst, et al. S.B. No. 26       A BILL TO BE ENTITLED   AN ACT   relating to local mental health authority and local behavioral   health authority audits and mental and behavioral health reporting,   services, and programs.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter B, Chapter 531, Government Code, is   amended by adding Section 531.099915 to read as follows:          Sec. 531.099915.  INCENTIVE PAYMENTS FOR CERTAIN PROVIDERS.   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   days.          SECTION 4.  Subtitle A, Title 7, Health and Safety Code, is   amended by adding Chapter 535 to read as follows:   CHAPTER 535. INNOVATION GRANT PROGRAM FOR MENTAL HEALTH EARLY   INTERVENTION AND TREATMENT          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   system;                      (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.          Sec. 535.003.  GRANT APPLICATION AND ELIGIBILITY   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   appropriate.          (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];   and                (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   served;                (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.