HB 2129

relating to school-based health services, including the
administration of the school health and related services program
and the provision and Medicaid reimbursement of certain services to
certain public school students.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Subchapter A, Chapter 38, Education Code, is
amended by adding Section 38.042 to read as follows:
Sec. 38.042.  ON-CAMPUS MENTAL HEALTH OR BEHAVIORAL HEALTH
SERVICES.  (a)  A school district may contract with a local mental
health authority to provide mental health or behavioral health
services on a campus of the district.
(b)  At the request of a student's parent or guardian, a
local mental health authority providing on-campus mental health or
behavioral health services that conducts a mental health or
behavioral health assessment of the student or provides mental
health or behavioral health services to the student shall provide
to the student's primary care physician the results of the
assessment conducted and, if applicable, the results of any
SECTION 2.  Subchapter B, Chapter 532, Government Code, as
effective April 1, 2025, is amended by adding Section 532.00551 to
Sec. 532.00551.  SCHOOL HEALTH AND RELATED SERVICES PROGRAM:
INTEGRITY AND AUDIT FUNCTIONS.  (a)  The commission shall make every
effort to ensure the integrity of the school health and related
services program, including by:
(1)  performing risk assessments of every element of
(2)  annually performing desk audits of all local
education agencies participating in the program;
(3)  performing in-depth audits of a sample of local
(4)  ensuring compliance with all applicable federal
standards and guidance regarding the administration of random
moment time studies, coding, and cost claiming;
(5)  considering information provided by the Texas
Education Agency on the agency's audits of local education agencies
that participate in the program;
(6)  coordinating with the Texas Education Agency and
any relevant stakeholders or advisory bodies in the development of
training materials, policies, and technical assistance necessary
to ensure compliance with all applicable state and federal
(7)  evaluating the program based on metrics developed
(b)  The commission may contract with a third party with the
necessary expertise to comply with this section.
(c)  At least once every five years, the commission's office
of inspector general shall evaluate the effectiveness of the
commission's efforts to ensure the integrity of the school health
SECTION 3.  Subchapter C, Chapter 532, Government Code, as
effective April 1, 2025, is amended by adding Section 532.0104 to
Sec. 532.0104.  RETENTION OF CERTAIN MONEY TO ADMINISTER
SCHOOL HEALTH AND RELATED SERVICES PROGRAM.  (a)  This section
applies only to federal money the commission receives to provide
the school health and related services program.
(b)  Subject to Subsection (c), the commission may retain
from the money to which this section applies an amount equal to the
estimated costs necessary, as determined by the commission, to
administer the school health and related services program,
including costs associated with the development of training
materials, compliance monitoring, technical assistance, and audit
(c)  The amount retained by the commission under this section
may not exceed two percent of the total amount received by the
commission during a state fiscal year.
SECTION 4.  Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Sections 32.0271 and 32.04245 to read as
Sec. 32.0271.  REIMBURSEMENT FOR CERTAIN SERVICES PROVIDED
TO MEDICAID-ENROLLED STUDENTS BY LOCAL EDUCATION AGENCIES.  (a)  In
this section, "local education agency" includes a school district
or open-enrollment charter school.
(b)  This section applies only with respect to a child who is
enrolled in Medicaid and is eligible to receive services under the
school health and related services program, regardless of whether
the child has an individualized education program.
(c)  The commission shall ensure that reimbursement under
the school health and related services program is provided to a
local education agency for all mental health and behavioral health
services covered under the program that are provided to a child
(d)  The parent or legal guardian of a child to whom this
section applies must provide written consent for any services
provided to the child under this section.  The parent or legal
guardian may revoke that consent at any time.
(e)  A local education agency that provides mental health or
behavioral health services to a child under this section shall
provide a written summary of each of the child's service visits to:
(1)  if the child is younger than 18 years of age, the
child's parent or legal guardian; and
(2)  if the child's parent or legal guardian provides
consent, the child's primary care provider.
(f)  This section does not require a local education agency
to enroll as a Medicaid provider.
Sec. 32.04245.  SCHOOL HEALTH AND RELATED SERVICES PROGRAM:
THIRD-PARTY INSURERS.  The commission may not provide reimbursement
under the school health and related services program to a
third-party health insurer for any service provided in order to
facilitate the coordination of benefits.
SECTION 5.  As soon as practicable after the effective date
of this Act, the Health and Human Services Commission shall seek any
necessary amendment to the state Medicaid plan or other appropriate
authorization from the Centers for Medicare and Medicaid Services
or other appropriate federal agency to implement Section 32.0271,
Human Resources Code, as added by this Act, and may delay
implementing that section until the amendment or other
SECTION 6.  This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution.  If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2025.