By: Cain H.B. No. 4693       A BILL TO BE ENTITLED   AN ACT   relating to entities that provide services to rural Texans and in   rural counties.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 58.093, Agriculture Code, is amended to   read as follows:          Sec. 58.093.  AMOUNT OF GRANTS. A grant under the young   farmer grant program may not be less than $5,000 or more than   $35,000 [$20,000].          SECTION 2.  Chapter 12, Agriculture Code, Subsection 12.051   is amended to read as follows:          Sec. 12.051.  FARMER MENTAL HEALTH AND SUICIDE PREVENTION   PROGRAM.          (a)  The department shall establish a farmer mental health   and suicide prevention program to raise awareness among farmers of   issues relating to mental health and suicide prevention.          (b)  As part of the program, the department shall:                (1)  promote suicide prevention among farmers through a   public awareness campaign;                (2)  provide a toll-free telephone hotline for farmer   mental health assistance;                (3)  develop a mental wellness plan for farmers   affected by a disaster; [and]                (4)  coordinate suicide prevention activities with   other state agencies, including the Department of State Health   Services; [.]                (5)  identify counties where farmers reside and where   an inadequate number of mental health providers are located; and                (6)  develop strategies to increase the number of   mental health providers located in those counties.          SECTION 3.  Subchapter D, Chapter 48, Education Code, is   amended by adding Section 48.114(d) to read as follows:          (d)  A mentor teacher who provides services at a rural   campus, as defined by Section 48.112(a) shall be eligible for   compensation in excess of the amounts provided in Subsection (c) if   the district is able to fund such compensation from sources other   than the mentor program allotment.          SECTION 4.  Subchapter H, Chapter 301, Occupations Code, is   amended by adding Sections 301.357 and 301.358 to read as follows:          Sec. 301.357.  PRACTICE IN RURAL HELTHCARE AREAS BY CERTAIN   ADVANCED PRACTICE REGISTERED NURSES.  (a)  This section and Section   301.358 apply to a licensed advanced practice registered nurse only   if 85% or more of the nurse's services are provided in a rural   healthcare area.          (b)  In this section and Section 301.358:                (1)  "advanced practice registered nurse" has the   meaning assigned by Section 301.152(a);                (2)  "controlled substance" has the meaning assigned by   Section 481.002, Health and Safety Code;                (3)  "dangerous drug" has the meaning assigned by   Section 483.001, Health and Safety Code;                (4)  "device" has the meaning assigned by Section   551.003, and includes durable medical equipment;                (5)  "licensed rural practitioner" means a licensed   advanced practice registered nurse authorized by the board to   practice under this section and under Section 301.358 in accordance   with standards established and recognized by the board to protect   the public health and safety; and                (6)  "nonprescription drug" has the meaning assigned by   Section 551.003; and                (7)  "rural healthcare area" has the meaning assigned   by Section 12.052, Agriculture Code.          (c)  The board shall authorize the practice under this   section and Section 301.358 of an advanced practice registered   nurse who applies in the manner the board prescribes by rule and who   meets the requirements for authorization. An advanced practice   registered nurse who applies for authorization must file an   affidavit with the board demonstrating that the nurse meets the   requirements of Subsection (a).          (d)  The board by rule shall establish:                (1)  standards for licensed rural practitioners to   protect the public health and safety; and                (2)  guidelines for continuing education for licensed   rural practitioners that are not subject to the limitations of   Section 301.303(b).          (e)  The scope of practice of a licensed rural practitioner   includes:                (1)  ordering, performing, and interpreting diagnostic   tests;                (2)  formulating primary and differential medical   diagnoses and advanced assessments;                (3)  treating actual and potential health problems;                (4)  prescribing therapeutic and corrective measures,   including nutrition and diagnostic support services, home health   care, hospice care, physical therapy, and occupational therapy, and   delegating and assigning the performance of therapeutic and   corrective measures to assistive personnel;                (5)  to the extent authorized by the board under   Section 301.358, prescribing, ordering, procuring, administering,   and dispensing drugs and devices, including blood and blood   products, controlled substances listed in Schedules II, III, IV,   and V, dangerous drugs, and nonprescription drugs;                (6)  providing referrals to health care agencies,   health care providers, and community resources;                (7)  serving as the primary care provider of record;   and                (8)  performing other acts that require education and   training consistent with professional standards and that are   commensurate with the licensed rural practitioner's education,   license, authorization to practice under this section and Section   301.358, and competencies and experience.          (f)  A licensed rural practitioner is accountable to   patients, the nursing profession, and the board for:                (1)  complying with the requirements of this chapter;                (2)  providing quality advanced nursing care;                (3)  recognizing the nurse's limits of knowledge;                (4)  planning for the management of situations beyond   the nurse's expertise; and                (5)  consulting with or referring patients to other   health care providers as appropriate.          (g)  This section does not limit or modify the scope of   practice of a nurse who is not authorized to practice under this   section.          (h)  A law that authorizes a licensed physician assistant or   advanced practice registered nurse acting on behalf of or under   authority delegated by a physician to take an action is considered   to authorize a licensed rural practitioner to take the action.          Sec. 301.358.  PRESCRIBING AND ORDERING AUTHORITY OF   LICENSED RURAL PRACTITIONER. (a) The board by rule may authorize a   licensed rural practitioner to prescribe and order drugs and   devices, including controlled substances listed in Schedules II,   III, IV, and V, dangerous drugs, and nonprescription drugs.          (b)  The board may establish the level of demonstrated   proficiency required to take authorized actions under the rules   adopted under Subsection (a).          SECTION 5.  Chapter 12, Agriculture Code, is amended by   adding Section 12.052 to read as follows:          Sec. 12.052  RURAL HEALTHCARE AREAS. (a)  A "Rural   Healthcare Area" is defined as:                (1)  any location in a rural county as defined by   Section 487.301, Government Code;                (2)  a Rural Health Facility Capital Improvement   Program defined entity; or                (3)  any location where a person whose primary   residence is in a rural county as defined by Section 487.301,   Government Code receives healthcare.          SECTION 6.  Section 61.9606, Education Code is amended to   read as follows:          Sec. 61.9606.  REPAYMENT. (a)  Except as provided by Section   61.9609(a), the board shall provide repayment assistance under this   subchapter in the following amounts:                (1)  [60] 75 percent of each payment due on an   attorney's eligible loans during the first 12-month period after   the attorney enters into the agreement under Section 61.9605;                (2)  80 percent of each payment due on an attorney's   eligible loans during the second 12-month period after the attorney   enters into the agreement; and                (3)  100 percent of each payment due on an attorney's   eligible loans during the third 12-month period after the attorney   enters into the agreement.          (b)  The board shall deliver any repayment assistance made   under this subchapter in a lump sum payable to the lender and the   attorney and in accordance with any applicable federal law.          (c)  Loan repayment assistance received under this   subchapter may be applied to the principal amount of the loan and to   interest that accrues.          SECTION 7.  The change in law made by Section 1 applies to a   grant issued on or after the effective date of this Act.  A grant   issued before the effective date of this Act is governed by the law   in effect on the date the grant is issued, and the former law is   continued in effect for that purpose.          SECTION 8.  Not later than February 1, 2024, the Texas Board   of Nursing shall adopt the rules necessary to implement the changes   in law made by this Act.          SECTION 9.  This Act takes effect September 1, 2023.