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.