H.B. No. 3793
 
 
 
 
AN ACT
  relating to powers, duties, and services of entities serving
  counties and county residents.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 21.054, Education Code, is amended by
  adding Subsection (d) to read as follows:
         (d)  The board shall adopt rules that allow an educator to
  fulfill up to 12 hours of continuing education by participating in a
  mental health first aid training program offered by a local mental
  health authority under Section 1001.203, Health and Safety Code.  
  The number of hours of continuing education an educator may fulfill
  under this subsection may not exceed the number of hours the
  educator actually spends participating in a mental health first aid
  training program.
         SECTION 2.  Section 533.0354, Health and Safety Code, is
  amended by adding Subsections (a-1), (a-2), and (b-1) to read as
  follows:
         (a-1)  In addition to the services required under Subsection
  (a) and using money appropriated for that purpose or money received
  under the Texas Health Care Transformation and Quality Improvement
  Program 1115 waiver, a local mental health authority may ensure, to
  the extent feasible, the provision of assessment services, crisis
  services, and intensive and comprehensive services using disease
  management practices for children with serious emotional,
  behavioral, or mental disturbance not described by Subsection (a)
  and adults with severe mental illness who are experiencing
  significant functional impairment due to a mental health disorder
  not described by Subsection (a) that is defined by the Diagnostic
  and Statistical Manual of Mental Disorders, 5th Edition (DSM-5),
  including:
               (1)  major depressive disorder, including single
  episode or recurrent major depressive disorder;
               (2)  post-traumatic stress disorder;
               (3)  schizoaffective disorder, including bipolar and
  depressive types;
               (4)  obsessive compulsive disorder;
               (5)  anxiety disorder;
               (6)  attention deficit disorder;
               (7)  delusional disorder;
               (8)  bulimia nervosa, anorexia nervosa, or other eating
  disorders not otherwise specified; or
               (9)  any other diagnosed mental health disorder.
         (a-2)  The local mental health authority shall ensure that
  individuals described by Subsection (a-1) are engaged with
  treatment services in a clinically appropriate manner.
         (b-1)  The department shall require each local mental health
  authority to incorporate jail diversion strategies into the
  authority's disease management practices to reduce the involvement
  of the criminal justice system in managing adults with the
  following disorders as defined by the Diagnostic and Statistical
  Manual of Mental Disorders, 5th Edition (DSM-5), who are not
  described by Subsection (b):
               (1)  post-traumatic stress disorder;
               (2)  schizoaffective disorder, including bipolar and
  depressive types;
               (3)  anxiety disorder; or
               (4)  delusional disorder.
         SECTION 3.  Subchapter B, Chapter 533, Health and Safety
  Code, is amended by adding Sections 533.051, 533.052, and 533.053
  to read as follows:
         Sec. 533.051.  ALLOCATION OF OUTPATIENT MENTAL HEALTH
  SERVICES AND BEDS IN STATE HOSPITALS.  (a)  To ensure the
  appropriate and timely provision of mental health services to
  patients who voluntarily receive those services or who are ordered
  by a court to receive those services in civil or criminal
  proceedings, the department, in conjunction with the commission,
  shall plan for the proper and separate allocation of outpatient or
  community-based mental health services provided by secure and
  nonsecure outpatient facilities that provide residential care
  alternatives and mental health services and for the proper and
  separate allocation of beds in the state hospitals for the
  following two groups of patients:
               (1)  patients who are voluntarily receiving outpatient
  or community-based mental health services, voluntarily admitted to
  a state hospital under Chapter 572, admitted to a state hospital for
  emergency detention under Chapter 573, or ordered by a court under
  Chapter 574 to receive inpatient mental health services at a state
  hospital or outpatient mental health services from an outpatient
  facility that provides residential care alternatives and mental
  health services; and
               (2)  patients who are ordered to participate in an
  outpatient treatment program to attain competency to stand trial
  under Chapter 46B, Code of Criminal Procedure, or committed to a
  state hospital or other facility to attain competency to stand
  trial under Chapter 46B, Code of Criminal Procedure, or to receive
  inpatient mental health services following an acquittal by reason
  of insanity under Chapter 46C, Code of Criminal Procedure.
         (b)  The plan developed by the department under Subsection
  (a) must include:
               (1)  a determination of the needs for outpatient mental
  health services of the two groups of patients described by
  Subsection (a);
               (2)  a determination of the minimum number of beds that
  the state hospital system must maintain to adequately serve the two
  groups of patients;
               (3)  a statewide plan for and the allocation of
  sufficient funds for meeting the outpatient mental health service
  needs of and for the maintenance of beds by the state hospitals for
  the two groups of patients; and
               (4)  a process to address and develop, without adverse
  impact to local service areas, the accessibility and availability
  of sufficient outpatient mental health services provided to and
  beds provided by the state hospitals to the two groups of patients
  based on the success of contractual outcomes with mental health
  service providers and facilities under Sections 533.034 and
  533.052.
         (c)  To assist in the development of the plan under
  Subsection (a), the department shall establish and meet at least
  monthly with an advisory panel composed of the following persons:
               (1)  one representative designated by the Texas
  Department of Criminal Justice;
               (2)  one representative designated by the Texas
  Association of Counties;
               (3)  two representatives designated by the Texas
  Council of Community Centers, including one representative of an
  urban local service area and one representative of a rural local
  service area;
               (4)  two representatives designated by the County
  Judges and Commissioners Association of Texas, including one
  representative who is the presiding judge of a court with
  jurisdiction over mental health matters;
               (5)  one representative designated by the Sheriffs'
  Association of Texas;
               (6)  two representatives designated by the Texas
  Municipal League, including one representative who is a municipal
  law enforcement official;
               (7)  one representative designated by the Texas
  Conference of Urban Counties;
               (8)  two representatives designated by the Texas
  Hospital Association, including one representative who is a
  physician;
               (9)  one representative designated by the Texas
  Catalyst for Empowerment; and
               (10)  four representatives designated by the
  Department of State Health Services' Council for Advising and
  Planning for the Prevention and Treatment of Mental and Substance
  Use Disorders, including:
                     (A)  the chair of the council;
                     (B)  one representative of the council's members
  who is a consumer of or advocate for mental health services;
                     (C)  one representative of the council's members
  who is a consumer of or advocate for substance abuse treatment; and
                     (D)  one representative of the council's members
  who is a family member of or advocate for persons with mental health
  and substance abuse disorders.
         (d)  In developing the plan under Subsection (a), the
  department and advisory panel shall consider:
               (1)  needs for outpatient mental health services of the
  two groups of patients described by Subsection (a);
               (2)  the frequency of use of beds and the historical
  patterns of use of beds in the state hospitals and other facilities
  by the two groups of patients;
               (3)  local needs and demands for outpatient mental
  health services by the two groups of patients;
               (4)  local needs and demands for beds in the state
  hospitals and other facilities for the two groups of patients;
               (5)  the availability of outpatient mental health
  service providers and inpatient mental health facilities that may
  be contracted with to provide outpatient mental health services and
  beds for the two groups of patients;
               (6)  the differences between the two groups of patients
  with regard to:
                     (A)  admission to and discharge from a state
  hospital or outpatient facility;
                     (B)  rapid stabilization and discharge to the
  community;
                     (C)  length of stay in a state hospital or
  outpatient facility;
                     (D)  disputes arising from the determination of a
  patient's length of stay in a state hospital by a health maintenance
  organization or a managed care organization;
                     (E)  third-party billing; and
                     (F)  legal challenges or requirements related to
  the examination and treatment of the patients; and
               (7)  public input provided to the department or
  advisory panel in a form and at a time and place that is effective
  and appropriate and in a manner that complies with any applicable
  laws, including administrative rules.
         (e)  The department shall update the plan biennially.
         (f)  Not later than December 31, 2013, the department, in
  conjunction with the advisory panel, shall develop the initial
  version of the plan required by Subsection (a).
         (g)  Not later than August 31, 2014, the department shall:
               (1)  identify standards and methodologies for the
  implementation of the plan required by Subsection (a); and
               (2)  begin implementing the plan.
         (h)  Not later than December 1, 2014, the department shall
  submit a report to the legislature and governor that includes the
  initial version of the plan, the status of the plan's
  implementation, and the impact of the plan on the delivery of
  services.
         (i)  While the plan required by Subsection (a) is being
  developed and implemented, the department may not, pursuant to any
  rule, contract, or directive, impose a sanction, penalty, or fine
  on a local mental health authority for the authority's
  noncompliance with any methodology or standard adopted or applied
  by the department relating to the allocation of beds by authorities
  for the two groups of patients described by Subsection (a).
         Sec. 533.052.  CONTRACTING WITH CERTAIN MENTAL HEALTH
  SERVICE PROVIDERS AND FACILITIES TO PROVIDE SERVICES AND BEDS FOR
  CERTAIN PERSONS.  The department shall make every effort, through
  collaboration and contractual arrangements with local mental
  health authorities, to contract with and use a broad base of local
  community outpatient mental health service providers and inpatient
  mental health facilities, as appropriate, to make available a
  sufficient and appropriately located amount of outpatient mental
  health services and a sufficient and appropriately located number
  of beds in inpatient mental health facilities, as specified in the
  plan developed by the department under Section 533.051, to ensure
  the appropriate and timely provision of mental health services to
  the two groups of patients described by Section 533.051(a).
         Sec. 533.053.  INFORMING COURTS OF COMMITMENT OPTIONS. The
  department shall develop and implement a procedure through which a
  court that has the authority to commit a person who is incompetent
  to stand trial or who has been acquitted by reason of insanity under
  Chapters 46B and 46C, Code of Criminal Procedure, is aware of all of
  the commitment options for the person, including jail diversion and
  community-based programs.
         SECTION 4.  Chapter 1001, Health and Safety Code, is amended
  by adding Subchapter H to read as follows:
  SUBCHAPTER H.  MENTAL HEALTH FIRST AID TRAINING
         Sec. 1001.201.  DEFINITIONS. In this subchapter:
               (1)  "Educator" means a person who is required to hold a
  certificate issued under Subchapter B, Chapter 21, Education Code.
               (2)  "Local mental health authority" has the meaning
  assigned by Section 531.002 and includes the local behavioral
  health authority for the NorthSTAR Behavioral Health Program.
               (3)  "Regional education service center" means a
  regional education service center established under Chapter 8,
  Education Code.
         Sec. 1001.202.  GRANTS FOR TRAINING OF MENTAL HEALTH FIRST
  AID TRAINERS.  (a)  To the extent funds are appropriated to the
  department for that purpose, the department shall make grants to
  local mental health authorities to contract with persons approved
  by the department to train employees or contractors of the
  authorities as mental health first aid trainers.
         (b)  Except as provided by Subsection (c), the department
  shall make each grant to a local mental health authority under this
  section in an amount equal to $1,000 times the number of employees
  or contractors of the authority whose training as mental health
  first aid trainers will be paid by the grant.
         (c)  For each state fiscal year, the total amount the
  department may grant to a local mental health authority under this
  section may not exceed the lesser of $30,000 or three percent of the
  funds appropriated to the department for making grants under this
  section.
         (d)  The executive commissioner shall adopt rules to
  establish the requirements for a person to be approved by the
  department to train employees or contractors of a local mental
  health authority as mental health first aid trainers.  The rules
  must ensure that a person who is approved by the department is
  qualified to provide training in:
               (1)  the potential risk factors and warning signs for
  various mental illnesses, including depression, anxiety, trauma,
  psychosis, eating disorders, substance abuse disorders, and
  self-injury;
               (2)  the prevalence of various mental illnesses in the
  United States and the need to reduce the stigma associated with
  mental illness;
               (3)  an action plan for use by the employees or
  contractors that involves the use of skills, resources, and
  knowledge to assess a situation and develop and implement an
  appropriate intervention to help an individual experiencing a
  mental health crisis obtain appropriate professional care; and
               (4)  the evidence-based professional, peer, social,
  and self-help resources available to help individuals with mental
  illness.
         (e)  Two or more local mental health authorities may
  collaborate and share resources to provide training for employees
  or contractors of the authorities under this section.
         Sec. 1001.203.  GRANTS FOR TRAINING CERTAIN EDUCATORS IN
  MENTAL HEALTH FIRST AID.  (a)  To the extent funds are appropriated
  to the department for that purpose, the department shall make
  grants to local mental health authorities to provide an approved
  mental health first aid training program, administered by mental
  health first aid trainers, at no cost to educators.
         (b)  For each state fiscal year, the total amount the
  department may grant to a local mental health authority under this
  section may not exceed the lesser of $40,000 or three percent of the
  funds appropriated to the department for making grants under this
  section.
         (c)  Subject to the limit provided by Subsection (b), out of
  the funds appropriated to the department for making grants under
  this section, the department shall grant $100 to a local mental
  health authority for each educator who successfully completes a
  mental health first aid training program provided by the authority
  under this section.
         (d)  A mental health first aid training program provided by a
  local mental health authority under this section must:
               (1)  be conducted by a person trained as a mental health
  first aid trainer;
               (2)  provide participants with the skills necessary to
  help an individual experiencing a mental health crisis until the
  individual is able to obtain appropriate professional care; and
               (3)  include:
                     (A)  instruction in a five-step strategy for
  helping an individual experiencing a mental health crisis,
  including assessing risk, listening respectfully to and supporting
  the individual, and identifying professional help and other
  supports for the individual;
                     (B)  an introduction to the risk factors and
  warning signs for mental illness and substance abuse problems;
                     (C)  experiential activities to increase
  participants' understanding of the impact of mental illness on
  individuals and families; and
                     (D)  a presentation of evidence-supported
  treatment and self-help strategies.
         (e)  A local mental health authority may contract with a
  regional education service center to provide a mental health first
  aid training program to educators under this section.
         (f)  Two or more local mental health authorities may
  collaborate and share resources to develop and operate a mental
  health first aid training program under this section.
         Sec. 1001.204.  PLANS FOR MENTAL HEALTH FIRST AID TRAINING
  PROGRAMS.  (a)  Not later than October 1 of each state fiscal year
  for which a local mental health authority will seek a grant from the
  department under Section 1001.203, the authority shall submit to
  the department a plan demonstrating the manner in which grants made
  to the authority under that section will be used:
               (1)  to train individuals in mental health first aid
  throughout the authority's local service area to maximize the
  number of children who have direct contact with an individual who
  has successfully completed a mental health first aid training
  program provided by the authority;
               (2)  to meet the greatest needs of the authority's local
  service area, as identified by the authority; and
               (3)  to complement existing resources and not duplicate
  established mental health first aid training efforts.
         (b)  The department may not make a grant to a local mental
  health authority under Section 1001.203 unless the department has
  evaluated a plan submitted by the authority under this section.
         Sec. 1001.205.  REPORTS.  (a)  Not later than July 1 of each
  year, a local mental health authority shall provide to the
  department the number of:
               (1)  employees and contractors of the authority who
  were trained as mental health first aid trainers under Section
  1001.202;
               (2)  educators who completed a mental health first aid
  training program offered by the authority under Section 1001.203
  during the preceding calendar year; and
               (3)  individuals who are not educators who completed a
  mental health first aid training program offered by the authority
  during the preceding calendar year.
         (b)  Not later than August 1 of each year, the department
  shall compile the information submitted by local mental health
  authorities as required by Subsection (a) and submit a report to the
  legislature containing the number of:
               (1)  authority employees and contractors trained as
  mental health first aid trainers;
               (2)  educators who completed a mental health first aid
  training program provided by an authority during the preceding
  calendar year; and
               (3)  individuals who are not educators who completed a
  mental health first aid training program provided by an authority
  during the preceding calendar year.
         Sec. 1001.206.  LIABILITY.  A person who has completed a
  mental health first aid training program offered by a local mental
  health authority under this subchapter and who in good faith
  attempts to assist an individual experiencing a mental health
  crisis is not liable in civil damages for an act performed in
  attempting to assist the individual unless the act is wilfully or
  wantonly negligent.
         SECTION 5.  Subtitle A, Title 3, Special District Local Laws
  Code, is amended by adding Chapter 1122 to read as follows:
  CHAPTER 1122.  HIDALGO COUNTY HOSPITAL DISTRICT
  SUBCHAPTER A.  GENERAL PROVISIONS
         Sec. 1122.001.  DEFINITIONS. In this chapter:
               (1)  "Board" means the board of directors of the
  district.
               (2)  "Director" means a member of the board.
               (3)  "District" means the Hidalgo County Hospital
  District.
         Sec. 1122.002.  DISTRICT AUTHORIZATION. The Hidalgo County
  Hospital District may be created and, if created, operates and is
  financed as provided by Section 9, Article IX, Texas Constitution,
  and by this chapter.
         Sec. 1122.003.  ESSENTIAL PUBLIC FUNCTION. The district is
  a public entity performing an essential public function.
         Sec. 1122.004.  DISTRICT TERRITORY.  The boundaries of the
  district are coextensive with the boundaries of Hidalgo County.
         Sec. 1122.005.  DISTRICT SUPPORT AND MAINTENANCE NOT STATE
  OBLIGATION. The state may not be obligated for the support or
  maintenance of the district.
         Sec. 1122.006.  RESTRICTION ON STATE FINANCIAL ASSISTANCE.
  The legislature may not make a direct appropriation for the
  construction, maintenance, or improvement of a district facility.
  SUBCHAPTER A-1.  TEMPORARY PROVISIONS
         Sec. 1122.021.  CREATION ELECTION; ORDERING ELECTION. (a)  
  The district may be created and a tax may be authorized only if the
  creation and the tax are approved by a majority of the registered
  voters of the territory of the proposed district voting at an
  election called and held for that purpose.
         (b)  The Hidalgo County Commissioners Court shall order an
  election for the registered voters of Hidalgo County on the
  question of creation of the Hidalgo County Hospital District if the
  commissioners court receives a petition requesting an election that
  is signed by at least 50 registered voters who are residents of
  Hidalgo County.
         (c)  The order calling an election under this section must
  state:
               (1)  the nature of the election, including the
  proposition that is to appear on the ballot;
               (2)  the date of the election;
               (3)  the hours during which the polls will be open; and
               (4)  the location of the polling places.
         (d)  Section 41.001(a), Election Code, does not apply to an
  election ordered under this section.
         (e)  The Hidalgo County Commissioners Court shall give
  notice of an election under this section by publishing a
  substantial copy of the election order in a newspaper with general
  circulation in Hidalgo County once a week for two consecutive
  weeks.  The first publication must appear not later than the 30th
  day before the date set for the election.
         (f)  The ballot for an election under this section must be
  printed to permit voting for or against the proposition: "The
  creation of the Hidalgo County Hospital District, providing for the
  imposition of an ad valorem tax at a rate not to exceed 75 cents on
  each $100 valuation on all taxable property in the district."
         (g)  The Hidalgo County Commissioners Court shall find that
  the Hidalgo County Hospital District is created if a majority of the
  voters voting in the election held under this section favor the
  creation of the district.
  SUBCHAPTER B.  DISTRICT ADMINISTRATION
         Sec. 1122.051.  DIRECTORS; TERM.  (a)  If the creation of the
  district is approved at the election held under Section 1122.021,
  the district shall be governed by a nine-member board of directors,
  appointed as follows:
               (1)  the Hidalgo County Commissioners Court shall
  appoint four directors;
               (2)  the governing body of the municipality with the
  largest population in Hidalgo County shall appoint two directors;
               (3)  the governing body of the municipality with the
  second largest population in Hidalgo County shall appoint one
  director;
               (4)  the governing body of a municipality with the
  third largest population in Hidalgo County shall appoint one
  director; and
               (5)  the governing body of a municipality with the
  fourth largest population in Hidalgo County shall appoint one
  director.
         (b)  Directors serve staggered four-year terms, with as near
  as possible to one-fourth of the directors' terms expiring each
  year.  The terms of the initial directors are as follows:
               (1)  the directors appointed by the governing bodies of
  the municipalities in Hidalgo County described by Subsection (a)
  shall draw lots to determine which two directors serve a one-year
  term, which director serves a two-year term, which director serves
  a three-year term, and which director serves a four-year term; and
               (2)  the directors appointed by the Hidalgo County
  Commissioners Court shall draw lots to determine which director
  serves a one-year term, which director serves a two-year term,
  which director serves a three-year term, and which director serves
  a four-year term.
         (c)  A director may not serve more than two consecutive
  four-year terms.
         Sec. 1122.052.  QUALIFICATIONS.  The Hidalgo County
  Commissioners Court shall by order provide for the qualifications
  of appointees to the board. The qualifications must provide that a
  person is not eligible for appointment to the board if the person
  is:
               (1)  an employee of Hidalgo County;
               (2)  a district employee; or
               (3)  related within the third degree of consanguinity
  or affinity, as determined under Subchapter B, Chapter 573,
  Government Code, to a member of the commissioners court or to a
  person described by Subdivision (1) or (2).
         Sec. 1122.053.  OFFICERS.  (a)  The board shall elect from
  among the directors:
               (1)  a chairman; and
               (2)  a vice-chairman to preside in the chairman's
  absence.
         (b)  The board shall elect a director or the district
  administrator to serve as secretary.
         Sec. 1122.054.  COMPENSATION; REIMBURSEMENT.  A director or
  officer serves without compensation but may be reimbursed for
  actual expenses incurred in the performance of official duties.
  The expenses must be:
               (1)  reported in the district's records; and
               (2)  approved by the board.
         Sec. 1122.055.  DIRECTOR'S BOND.  (a)  Before assuming the
  duties of office, each director must execute a bond in the amount of
  $5,000 payable to the district and conditioned on the faithful
  performance of the director's duties.
         (b)  The bond shall be kept in the permanent records of the
  district.
         (c)  The board may pay for a director's bond with district
  money.
         Sec. 1122.056.  BOARD VACANCY.  If a vacancy occurs in the
  office of director, the remaining directors shall appoint a
  director for the remainder of the unexpired term.
         Sec. 1122.057.  VOTING REQUIREMENT.  A concurrence of a
  majority of the directors voting is necessary in matters relating
  to district business.
         Sec. 1122.058.  DISTRICT ADMINISTRATOR; ADMINISTRATOR'S
  BOND.  (a)  The board may appoint a qualified person as district
  administrator.
         (b)  The district administrator serves at the will of the
  board.
         (c)  The district administrator is entitled to compensation
  determined by the board.
         (d)  Before assuming the duties of district administrator,
  the administrator must execute a bond payable to the district in an
  amount not less than $5,000, as determined by the board,
  conditioned on the faithful performance of the administrator's
  duties.
         (e)  The board may pay for the bond with district money.
         Sec. 1122.059.  GENERAL DUTIES OF DISTRICT ADMINISTRATOR.
  Subject to the limitations prescribed by the board, the district
  administrator shall:
               (1)  supervise the work and activities of the district;
  and
               (2)  direct the general affairs of the district.
         Sec. 1122.060.  ASSISTANT DISTRICT ADMINISTRATOR; ATTORNEY.
  (a)  The board may appoint qualified persons as assistant district
  administrator and attorney for the district.
         (b)  The assistant district administrator and attorney for
  the district serve at the will of the board.
         (c)  The assistant district administrator and attorney for
  the district are entitled to compensation determined by the board.
         Sec. 1122.061.  EMPLOYEES.  (a)  The district may employ
  nurses, technicians, fiscal agents, accountants, architects,
  additional attorneys, and other necessary employees.
         (b)  The board may delegate to the district administrator the
  authority to employ persons for the district.
         Sec. 1122.062.  RECRUITMENT OF MEDICAL STAFF AND EMPLOYEES.
  The board may spend district money, enter into agreements, and take
  other necessary actions to recruit physicians and other persons to
  serve as medical staff members or district employees.  The actions
  may include:
               (1)  advertising and marketing;
               (2)  paying travel, recruitment, and relocation
  expenses;
               (3)  providing a loan or scholarship to a physician or a
  person currently enrolled in health care education courses at an
  institution of higher education who contracts to become a medical
  staff member or district employee; or
               (4)  contracting with a full-time medical student or
  other student in a health occupation who is enrolled in and in good
  standing at an accredited medical school, college, or university to
  pay the student's tuition or other expenses for the consideration
  of the student agreeing to serve as an employee or independent
  contractor for the district.
         Sec. 1122.063.  APPOINTMENT AND REMOVAL OF MEDICAL STAFF.
  The board may:
               (1)  appoint to the medical staff any doctor the board
  considers necessary for the efficient operation of the district;
               (2)  remove any doctor from the medical staff, after
  due process, if the board considers the doctor's removal necessary
  for the efficient operation of the district; and
               (3)  make temporary appointments to the medical staff
  as the board considers necessary.
         Sec. 1122.064.  RETIREMENT BENEFITS.  The board may provide
  retirement benefits for district employees by:
               (1)  establishing or administering a retirement
  program; or
               (2)  participating in:
                     (A)  the Texas County and District Retirement
  System; or
                     (B)  another statewide retirement system in which
  the district is eligible to participate.
  SUBCHAPTER C.  POWERS AND DUTIES
         Sec. 1122.101.  DISTRICT RESPONSIBILITY.  The district has
  full responsibility for operating hospital facilities and
  providing medical and hospital care for the district's needy
  residents.
         Sec. 1122.102.  MANAGEMENT, CONTROL, AND ADMINISTRATION.
  The board shall manage, control, and administer the hospital system
  and the money and resources of the district.
         Sec. 1122.103.  RULES.  The board may adopt rules governing:
               (1)  the operation of the hospital and hospital system;
  and
               (2)  the duties, functions, and responsibilities of
  district staff and employees.
         Sec. 1122.104.  PURCHASING AND ACCOUNTING PROCEDURES.  The
  board may prescribe:
               (1)  the method of making purchases and expenditures by
  and for the district; and
               (2)  accounting and control procedures for the
  district.
         Sec. 1122.105.  PROVISION OF CERTAIN HEALTH SERVICES. (a)  
  The district may operate or provide for the operation of a mobile
  emergency medical service.
         (b)  The district may operate or provide for home health
  services, long-term care, skilled nursing care, intermediate
  nursing care, or hospice care.
         Sec. 1122.106.  DISTRICT PROPERTY, FACILITIES, AND
  EQUIPMENT.  (a)  The board shall determine:
               (1)  the type, number, and location of buildings
  required to maintain an adequate hospital system; and
               (2)  the type of equipment necessary for hospital care.
         (b)  The board may:
               (1)  acquire property, facilities, and equipment for
  the district for use in the hospital system;
               (2)  mortgage or pledge the property, facilities, or
  equipment as security for payment of the purchase price;
               (3)  sell or otherwise dispose of property, facilities,
  or equipment for the district; or
               (4)  lease hospital facilities for the district.
         Sec. 1122.107.  OPERATING AND MANAGEMENT CONTRACTS.  The
  board may enter into operating or management contracts relating to
  hospital facilities for the district.
         Sec. 1122.108.  SERVICE CONTRACTS.  (a)  The board may
  contract with a public or private hospital, a political subdivision
  of the state, or a state or federal agency for the district to
  provide a mobile emergency medical service or other health care
  services needed to provide for the investigatory or welfare needs
  of residents of the district.
         (b)  The board may contract with a person to receive or
  supply the services the board considers necessary for the effective
  operation of the district.
         Sec. 1122.109.  EMINENT DOMAIN.  (a)  The district may
  exercise the power of eminent domain to acquire a fee simple or
  other interest in property located in district territory if the
  interest is necessary for the district to exercise the rights or
  authority conferred by this chapter.
         (b)  The district must exercise the power of eminent domain
  in the manner provided by Chapter 21, Property Code, except that the
  district is not required to deposit with the trial court money or a
  bond as provided by Section 21.021(a), Property Code.
         (c)  In a condemnation proceeding brought by the district,
  the district is not required to:
               (1)  pay in advance or provide bond or other security
  for costs in the trial court;
               (2)  provide bond for the issuance of a temporary
  restraining order or a temporary injunction; or
               (3)  provide a bond for costs or a supersedeas bond on
  an appeal or petition for review.
         Sec. 1122.110.  COST OF RELOCATING OR ALTERING PROPERTY. In
  exercising the power of eminent domain, if the board requires
  relocating, raising, lowering, rerouting, changing the grade, or
  altering the construction of any railroad, highway, pipeline, or
  electric transmission and electric distribution, telegraph, or
  telephone line, conduit, pole, or facility, the district shall pay
  the actual cost of that activity to provide a comparable
  replacement, without enhancement of facilities, after deducting
  the net salvage value derived from the old facility.
         Sec. 1122.111.  GIFTS AND ENDOWMENTS. The board may accept
  for the district a gift or endowment to be held in trust for any
  purpose and under any direction, limitation, or provision in
  writing by the donor that is consistent with the proper management
  of the district.
         Sec. 1122.112.  PAYMENT FOR TREATMENT; PROCEDURES.  (a)  
  When a person who resides in the district is admitted as a patient
  to a district facility, the district administrator may have an
  inquiry made into the financial circumstances of:
               (1)  the patient; and
               (2)  a relative of the patient who is legally
  responsible for the patient's support.
         (b)  To the extent that the patient or a relative of the
  patient who is legally responsible for the patient's support cannot
  pay for care and treatment provided by the district, the district
  shall supply the care and treatment without charging the patient or
  the patient's relative.
         (c)  On determining that the patient or a relative legally
  responsible for the patient's support can pay for all or part of the
  care and treatment provided by the district, the district
  administrator shall report that determination to the board, and the
  board shall issue an order directing the patient or the relative to
  pay the district a specified amount each week.  The amount must be
  based on the person's ability to pay.
         (d)  The district administrator may collect money owed to the
  district from the patient's estate or from that of a relative
  legally responsible for the patient's support in the manner
  provided by law for the collection of expenses in the last illness
  of a deceased person.
         (e)  If there is a dispute relating to a person's ability to
  pay or if the district administrator has any doubt concerning a
  person's ability to pay, the board shall call witnesses, hear and
  resolve the question, and issue a final order.  The order may be
  appealed to a district court in any county in which the district is
  located.  The substantial evidence rule applies to an appeal under
  this subsection.
         Sec. 1122.113.  REIMBURSEMENT FOR SERVICES.  (a)  The board
  shall require a county, municipality, or public hospital located
  outside of the district to reimburse the district for the
  district's care and treatment of a sick or injured person of that
  county, municipality, or hospital, as provided by Chapter 61,
  Health and Safety Code.
         (b)  The board shall require the sheriff of Hidalgo County to
  reimburse the district for the district's care and treatment of a
  person who is confined in a jail facility of Hidalgo County and is
  not a resident of the district.
         (c)  On behalf of the district, the board may contract with
  the state or federal government for that government to reimburse
  the district for treatment of a sick or injured person.
         Sec. 1122.114.  NONPROFIT CORPORATION.  (a)  The district
  may create and sponsor a nonprofit corporation under the Business
  Organizations Code and may contribute money to or solicit money for
  the corporation.
         (b)  A corporation created under this section may use money
  contributed by the district only to provide health care or other
  services the district is authorized to provide under this chapter.
         (c)  The corporation may invest the corporation's money in
  any manner in which the district may invest the district's money,
  including investing money as authorized by Chapter 2256, Government
  Code.
         (d)  The board shall establish controls to ensure that the
  corporation uses its money as required by this section.
         Sec. 1122.115.  LOANS AND GRANTS FOR ECONOMIC DEVELOPMENT
  PURPOSES. Under the authority granted by Section 52-a, Article
  III, Texas Constitution, the district may loan or grant money to any
  person for the development of medical education and research in the
  district.
         Sec. 1122.116.  AUTHORITY TO SUE AND BE SUED.  The board may
  sue and be sued on behalf of the district.
         Sec. 1122.117.  CONSTRUCTION CONTRACTS; ADVERTISING FOR
  CERTAIN CONSTRUCTION CONTRACTS.  (a)  The board may enter into a
  construction contract on the district's behalf.
         (b)  The board may enter into a construction contract only
  after competitive bidding as provided by Subchapter B, Chapter 271,
  Local Government Code, if the amount of the contract is greater than
  the amount provided by Section 271.024 of that code.
  SUBCHAPTER D.  GENERAL FINANCIAL PROVISIONS
         Sec. 1122.151.  BUDGET.  (a)  The district administrator
  shall prepare a proposed annual budget for the district.
         (b)  The proposed budget must contain a complete financial
  statement, including a statement of:
               (1)  the outstanding obligations of the district;
               (2)  the amount of cash on hand to the credit of each
  fund of the district;
               (3)  the amount of money received by the district from
  all sources during the previous year;
               (4)  the amount of money available to the district from
  all sources during the ensuing year;
               (5)  the amount of the balances expected at the end of
  the year in which the budget is being prepared;
               (6)  the estimated amount of revenues and balances
  available to cover the proposed budget; and
               (7)  the estimated tax rate required.
         Sec. 1122.152.  NOTICE; HEARING; ADOPTION OF BUDGET. (a)  
  The board shall hold a public hearing on the proposed budget.
         (b)  The board shall publish notice of the hearing in a
  newspaper with general circulation in the district not later than
  the 10th day before the date of the hearing.
         (c)  Any district resident is entitled to be present and
  participate at the hearing.
         (d)  At the conclusion of the hearing, the board shall adopt
  a budget by acting on the budget proposed by the district
  administrator.  The board may make a change in the proposed budget
  that the board determines to be in the interests of the taxpayers.
         (e)  The budget is effective only after adoption by the
  board.
         Sec. 1122.153.  AMENDMENT OF BUDGET.  After the budget is
  adopted, the budget may be amended on the board's approval.
         Sec. 1122.154.  FISCAL YEAR.  (a)  The district operates
  according to a fiscal year established by the board.
         (b)  The fiscal year may not be changed:
               (1)  during a period in which revenue bonds of the
  district are outstanding; or
               (2)  more than once in a 24-month period.
         Sec. 1122.155.  ANNUAL AUDIT.  The board shall have an annual
  audit made of the financial condition of the district.
         Sec. 1122.156.  INSPECTION OF ANNUAL AUDIT AND DISTRICT
  RECORDS. The annual audit and other district records are open to
  inspection during regular business hours at the principal office of
  the district.
         Sec. 1122.157.  FINANCIAL REPORT.  As soon as practicable
  after the close of each fiscal year, the district administrator
  shall prepare for the board a sworn statement of the amount of
  district money and an account of the disbursement of that money.
         Sec. 1122.158.  SHORT-TERM FINANCING.  The district may
  borrow money through short-term financing.
         Sec. 1122.159.  DEBT LIMITATION.  Except as provided by this
  chapter and Chapter 1207, Government Code, the district may not
  incur a debt payable from district revenue other than revenue
  available in the current fiscal year and the immediately following
  fiscal year of the district.
         Sec. 1122.160.  DEPOSITORY.  (a)  The board shall select at
  least one bank to serve as a depository for district money.
         (b)  The board may solicit bids from local financial
  institutions to determine which institution may serve as a
  depository for district money.
         (c)  District money, other than money invested as provided by
  Section 1122.161 and money transmitted to a bank for payment of
  bonds or obligations issued or assumed by the district, shall be
  deposited as received with the depository bank and shall remain on
  deposit.  This subsection does not limit the board's power to place
  part of the district's money on time deposit or to purchase
  certificates of deposit.
         Sec. 1122.161.  RESTRICTION ON INVESTMENT.  The board may
  invest operating, depreciation, or building reserves only in funds
  or securities specified by Chapter 2256, Government Code.
  SUBCHAPTER E.  BONDS
         Sec. 1122.201.  GENERAL OBLIGATION BONDS. If authorized by
  an election, the board may issue and sell general obligation bonds
  in the name and on the faith and credit of the district to:
               (1)  purchase, construct, acquire, repair, or renovate
  buildings or improvements;
               (2)  equip buildings or improvements for hospital
  purposes; or
               (3)  acquire and operate a mobile emergency medical
  service.
         Sec. 1122.202.  TAX TO PAY GENERAL OBLIGATION BONDS. (a)  At
  the time general obligation bonds are issued by the district under
  Section 1122.201, the board shall impose an ad valorem tax in an
  amount sufficient to create an interest and sinking fund to pay the
  principal of and interest on the bonds as the bonds mature.
         (b)  The tax required by this section together with any other
  tax the district imposes in any year may not exceed the limit
  approved by the voters at the election authorizing the imposition
  of taxes.
         Sec. 1122.203.  GENERAL OBLIGATION BOND ELECTION.  (a)  The
  district may issue general obligation bonds only if the bonds are
  authorized by a majority of the voters voting in an election held
  for that purpose.
         (b)  The board may order a bond election.  The order calling
  the election must specify:
               (1)  the nature and date of the election;
               (2)  the hours during which the polls will be open;
               (3)  the location of polling places;
               (4)  the amounts of the bonds to be authorized; and
               (5)  the maximum maturity of the bonds.
         (c)  Notice of a bond election must be given as provided by
  Chapter 1251, Government Code.
         (d)  The board shall declare the results of the election.
         Sec. 1122.204.  REVENUE BONDS.  (a)  The board may issue
  revenue bonds to:
               (1)  acquire, purchase, construct, repair, renovate,
  or equip buildings or improvements for hospital purposes;
               (2)  acquire sites to be used for hospital purposes; or
               (3)  acquire and operate a mobile emergency medical
  service to assist the district in carrying out its hospital
  purposes.
         (b)  The bonds must be payable from and secured by a pledge of
  all or part of the revenues derived from the operation of the
  district's hospital system.
         (c)  The bonds may be additionally secured by a mortgage or
  deed of trust lien on all or part of the district property.
         (d)  The bonds must be issued in the manner provided by
  Sections 264.042, 264.043, 264.046, 264.047, 264.048, and 264.049,
  Health and Safety Code, for issuance of revenue bonds by county
  hospital authorities.
         Sec. 1122.205.  MATURITY.  District bonds must mature not
  later than 40 years after the date of their issuance.
         Sec. 1122.206.  EXECUTION OF BONDS.  (a)  The board president
  shall execute district bonds in the district's name.
         (b)  The board secretary shall countersign the bonds in the
  manner provided by Chapter 618, Government Code.
         Sec. 1122.207.  BONDS NOT SUBJECT TO TAXATION.  The
  following are not subject to taxation by the state or by a political
  subdivision of the state:
               (1)  bonds issued by the district;
               (2)  any transaction relating to the bonds; and
               (3)  profits made in the sale of the bonds.
  SUBCHAPTER F.  AD VALOREM TAX
         Sec. 1122.251.  IMPOSITION OF AD VALOREM TAX.  (a)  The board
  shall impose a tax on all property in the district subject to
  hospital district taxation.
         (b)  The tax may be used to pay:
               (1)  indebtedness issued or assumed by the district;
  and
               (2)  the maintenance and operating expenses of the
  district.
         (c)  The district may not impose a tax to pay the principal of
  or interest on revenue bonds issued under this chapter.
         Sec. 1122.252.  TAX RATE.  (a)  The tax rate on all taxable
  property in the district for all purposes may not exceed 75 cents on
  each $100 valuation of the property according to the most recent
  certified tax appraisal roll of the district.
         (b)  In setting the tax rate, the board shall consider
  district income from sources other than taxation.
         Sec. 1122.253.  TAX ASSESSOR-COLLECTOR.  The board may
  provide for the appointment of a tax assessor-collector for the
  district or may contract for the assessment and collection of taxes
  as provided by the Tax Code.
  SUBCHAPTER G. DISSOLUTION
         Sec. 1122.301.  DISSOLUTION; ELECTION.  (a)  The district
  may be dissolved only on approval of a majority of the voters voting
  in an election held for that purpose.
         (b)  The board may order an election on the question of
  dissolving the district and disposing of the district's assets and
  obligations.
         (c)  The board shall order an election if the board receives
  a petition requesting an election that is signed by at least 15
  percent of the district's registered voters.
         (d)  The order calling the election must state:
               (1)  the nature of the election, including the
  proposition that is to appear on the ballot;
               (2)  the date of the election;
               (3)  the hours during which the polls will be open; and
               (4)  the location of the polling places.
         (e)  Section 41.001(a), Election Code, does not apply to an
  election ordered under this section.
         Sec. 1122.302.  NOTICE OF ELECTION.  (a)  The board shall
  give notice of an election under this subchapter by publishing a
  substantial copy of the election order in a newspaper with general
  circulation in the district once a week for two consecutive weeks.
         (b)  The first publication must appear not later than the
  30th day before the date set for the election.
         Sec. 1122.303.  BALLOT.  The ballot for an election under
  this subchapter must be printed to permit voting for or against the
  proposition: "The dissolution of the Hidalgo County Hospital
  District."
         Sec. 1122.304.  ELECTION RESULTS.  (a)  If a majority of the
  votes in an election under this subchapter favor dissolution, the
  board shall order that the district be dissolved.
         (b)  If a majority of the votes in an election under this
  subchapter do not favor dissolution, the board shall continue to
  administer the district, and another election on the question of
  dissolution may not be held before the first anniversary of the date
  of the most recent election to dissolve the district.
         Sec. 1122.305.  TRANSFER OR ADMINISTRATION OF ASSETS. (a)  
  If a majority of the votes in an election under this subchapter
  favor dissolution, the board shall:
               (1)  transfer the land, buildings, improvements,
  equipment, and other assets belonging to the district to Hidalgo
  County or another governmental entity in Hidalgo County; or
               (2)  administer the property, assets, and debts of the
  district until all money has been disposed of and all district debts
  have been paid or settled.
         (b)  If the board makes the transfer under Subsection (a)(1),
  the county or entity assumes all debts and obligations of the
  district at the time of the transfer and the district is dissolved.
         (c)  If Subsection (a)(1) does not apply and the board
  administers the property, assets, and debts of the district under
  Subsection (a)(2), the district is dissolved when all money has
  been disposed of and all district debts have been paid or settled.
         Sec. 1122.306.  IMPOSITION OF TAX AND RETURN OF SURPLUS
  TAXES.  (a)  After the board determines that the district is
  dissolved, the board shall:
               (1)  determine the debt owed by the district; and
               (2)  impose on the property included in the district's
  tax rolls a tax that is in proportion of the debt to the property
  value.
         (b)  On the payment of all outstanding debts and obligations
  of the district, the board shall order the secretary to return to
  each district taxpayer the taxpayer's pro rata share of all unused
  tax money.
         (c)  A taxpayer may request that the taxpayer's share of
  surplus tax money be credited to the taxpayer's county taxes. If a
  taxpayer requests the credit, the board shall direct the secretary
  to transmit the funds to the tax assessor-collector for Hidalgo
  County.
         Sec. 1122.307.  REPORT; DISSOLUTION ORDER.  (a)  After the
  district has paid all its debts and has disposed of all its money
  and other assets as prescribed by this subchapter, the board shall
  file a written report with the Hidalgo County Commissioners Court
  summarizing the board's actions in dissolving the district.
         (b)  Not later than the 10th day after the date the Hidalgo
  County Commissioners Court receives the report and determines that
  the requirements of this subchapter have been fulfilled, the
  commissioners court shall enter an order dissolving the district
  and releasing the board from any further duty or obligation.
         SECTION 6.  (a)  Section 1001.206, Health and Safety Code, as
  added by this Act, applies only to a cause of action that accrues on
  or after the effective date of this Act.  A cause of action that
  accrues before the effective date of this Act is governed by the law
  in effect immediately before that date, and that law is continued in
  effect for that purpose.
         (b)  Not later than May 1, 2014, the executive commissioner
  of the Health and Human Services Commission shall adopt any rules
  necessary to implement Section 533.051, Health and Safety Code, as
  added by this Act, and the rules required by Section 533.053, Health
  and Safety Code, as added by this Act.
         SECTION 7.  Proof of publication of the notice required to
  enact Chapter 1122, Special District Local Laws Code, as added by
  this Act, under the provisions of Section 9, Article IX, Texas
  Constitution, has been made in the manner and form provided by law
  pertaining to the enactment of local and special laws, and the
  notice is found and declared proper and sufficient to satisfy the
  requirement.
         SECTION 8.  (a)  Except as provided by Subsection (b) of this
  section, this Act takes effect September 1, 2013.
         (b)  Section 533.0354, Health and Safety Code, as amended by
  this Act, takes effect January 1, 2014.
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 3793 was passed by the House on May
  10, 2013, by the following vote:  Yeas 138, Nays 5, 2 present, not
  voting; that the House refused to concur in Senate amendments to
  H.B. No. 3793 on May 24, 2013, and requested the appointment of a
  conference committee to consider the differences between the two
  houses; and that the House adopted the conference committee report
  on H.B. No. 3793 on May 26, 2013, by the following vote:  Yeas 113,
  Nays 26, 2 present, not voting.
 
  ______________________________
  Chief Clerk of the House   
 
         I certify that H.B. No. 3793 was passed by the Senate, with
  amendments, on May 22, 2013, by the following vote:  Yeas 31, Nays
  0; at the request of the House, the Senate appointed a conference
  committee to consider the differences between the two houses; and
  that the Senate adopted the conference committee report on H.B. No.
  3793 on May 26, 2013, by the following vote:  Yeas 31, Nays 0.
 
  ______________________________
  Secretary of the Senate   
  APPROVED: __________________
                  Date       
   
           __________________
                Governor