Bill Text: TX SB200 | 2015-2016 | 84th Legislature | Enrolled

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Bill Title: Relating to the continuation and functions of the Health and Human Services Commission and the provision of health and human services in this state.

Spectrum: Slight Partisan Bill (Republican 7-3)

Status: (Passed) 2015-06-17 - See remarks for effective date [SB200 Detail]

Download: Texas-2015-SB200-Enrolled.html

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S.B. No. 200

AN ACT
relating to the continuation and functions of the Health and Human
Services Commission and the provision of health and human services
in this state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1. CONSOLIDATION OF HEALTH AND HUMAN SERVICES SYSTEM
SECTION 1.01. (a) Chapter 531, Government Code, is amended
by adding Subchapter A-1 to read as follows:
SUBCHAPTER A-1. CONSOLIDATION OF HEALTH AND HUMAN SERVICES SYSTEM
Sec. 531.02001. CONSOLIDATION OF HEALTH AND HUMAN SERVICES
SYSTEM GENERALLY. In accordance with this subchapter, the
functions of the health and human services system described under
Sections 531.0201, 531.02011, and 531.02012 are consolidated
through a phased transfer of those functions under which:
(1) the initial transfers required under Section
531.0201 occur:
(A) on or after the date on which the executive
commissioner submits the transition plan to the required persons
under Section 531.0204(e); and
(B) not later than September 1, 2016;
(2) the final transfers required under Section
531.02011 occur:
(A) on or after September 1, 2016; and
(B) not later than September 1, 2017; and
(3) transfers of administrative support services
functions occur in accordance with Section 531.02012.
Sec. 531.02002. MEANING OF FUNCTION IN RELATION TO
TRANSFERS. For purposes of the transfers mandated by this
subchapter, "function" includes a power, duty, program, or activity
of a state agency or entity.
Sec. 531.0201. PHASE ONE: INITIAL TRANSFERS. (a) On the
dates specified in the transition plan required under Section
531.0204, the following functions are transferred to the commission
as provided by this subchapter:
(1) all functions, including any remaining
administrative support services functions, of each state agency and
entity subject to abolition under Section 531.0202(a); and
(2) except as provided by Section 531.02013, all
client services of the health and human services system, including
client services functions performed by the following:
(A) the state agency and entity subject to
abolition under Section 531.0202(b);
(B) the Department of Family and Protective
Services; and
(C) the Department of State Health Services.
(b) On the dates specified in the transition plan required
under Section 531.0204, all functions in the health and human
services system related to prevention and early intervention
services, including the Nurse-Family Partnership Competitive Grant
Program under Subchapter C, Chapter 265, Family Code, are
transferred to the Department of Family and Protective Services.
Sec. 531.02011. PHASE TWO: FINAL TRANSFERS TO COMMISSION.
On the dates specified in the transition plan required under
Section 531.0204, the following functions are transferred to the
commission as provided by this subchapter:
(1) all functions of each state agency and entity
subject to abolition under Section 531.0202(b) that remained with
the agency or entity after the initial transfer of functions under
Section 531.0201 or a transfer of administrative support services
functions under Section 531.02012;
(2) regulatory functions and functions related to
state-operated institutions of the Department of State Health
Services; and
(3) regulatory functions of the Department of Family
and Protective Services.
Sec. 531.02012. TRANSFER AND CONSOLIDATION OF
ADMINISTRATIVE SUPPORT SERVICES FUNCTIONS. (a) In this section,
"administrative support services" has the meaning assigned under
Section 531.00553.
(b) As soon as practicable after the first day of the period
prescribed by Section 531.02001(1) and not later than the last day
of the period prescribed by Section 531.02001(2), in accordance
with and on the dates specified in the transition plan required
under Section 531.0204, the executive commissioner shall, after
consulting with affected state agencies and divisions, transfer and
consolidate within the commission administrative support services
functions of the health and human services system to the extent
consolidation of those support services functions is feasible and
contributes to the effective performance of the system.
Consolidation of an administrative support services function under
this section must be conducted in accordance with the principles
and requirements for organization of administrative support
services under Section 531.00553(c).
(c) Consultation with affected state agencies and divisions
under Subsection (b) must be conducted in a manner that ensures
client services are, at most, only minimally affected, and must
result in a memorandum of understanding or other agreement between
the commission and each affected agency or division that:
(1) details measurable performance goals that the
commission is expected to meet;
(2) identifies a means by which the agency or division
may seek permission from the executive commissioner to find an
alternative way to address the needs of the agency or division, as
appropriate;
(3) identifies steps to ensure that programs under the
health and human services system, whether large or small, receive
administrative support services that are adequate to meet the
program's needs; and
(4) if appropriate, specifies that staff responsible
for providing administrative support services consolidated within
the commission are located in the area where persons requiring
those services are located to ensure the staff understands related
program needs and can respond to those needs in a timely manner.
Sec. 531.02013. FUNCTIONS REMAINING WITH CERTAIN AGENCIES.
The following functions are not subject to transfer under Sections
531.0201 and 531.02011:
(1) the functions of the Department of Family and
Protective Services, including the statewide intake of reports and
other information, related to the following:
(A) child protective services, including
services that are required by federal law to be provided by this
state's child welfare agency;
(B) adult protective services, other than
investigations of the alleged abuse, neglect, or exploitation of an
elderly person or person with a disability:
(i) in a facility operated, or in a facility
or by a person licensed, certified, or registered, by a state
agency; or
(ii) by a provider that has contracted to
provide home and community-based services; and
(C) prevention and early intervention services;
and
(2) the public health functions of the Department of
State Health Services, including health care data collection and
maintenance of the Texas Health Care Information Collection
program.
Sec. 531.02014. RELATED TRANSFERS; EFFECT OF
CONSOLIDATION. (a) All of the following that relate to a function
that is transferred under Section 531.0201, 531.02011, or 531.02012
are transferred to the commission or the Department of Family and
Protective Services, as applicable, on the date the related
function is transferred as specified in the transition plan
required under Section 531.0204:
(1) all obligations and contracts, including
obligations and contracts related to a grant program;
(2) all property and records in the custody of the
state agency or entity from which the function is transferred;
(3) all funds appropriated by the legislature and
other money; and
(4) all complaints, investigations, or contested
cases that are pending before the state agency or entity from which
the function is transferred or a governing person or entity of the
state agency or entity, without change in status.
(b) A rule, policy, or form adopted by or on behalf of a
state agency or entity from which functions are transferred under
Section 531.0201, 531.02011, or 531.02012 that relates to a
function that is transferred under one of those sections becomes a
rule, policy, or form of the receiving state agency upon transfer of
the related function and remains in effect:
(1) until altered by the commission or other receiving
state agency, as applicable; or
(2) unless it conflicts with a rule, policy, or form of
the receiving state agency.
(c) A license, permit, or certification in effect that was
issued by a state agency or entity from which functions are
transferred under Section 531.0201 or 531.02011 that relates to a
function that is transferred under either of those sections is
continued in effect as a license, permit, or certification of the
commission upon transfer of the related function until the license,
permit, or certification expires, is suspended or revoked, or
otherwise becomes invalid.
Sec. 531.0202. ABOLITION OF STATE AGENCIES AND ENTITIES;
EFFECT OF TRANSFERS. (a) Each of the following state agencies and
entities is abolished on a date that is within the period prescribed
by Section 531.02001(1), that is specified in the transition plan
required under Section 531.0204 for the abolition of the agency or
entity, and that occurs after all of the agency's or entity's
functions have been transferred in accordance with Section
531.0201:
(1) the Department of Assistive and Rehabilitative
Services;
(2) the Health and Human Services Council;
(3) the Aging and Disability Services Council;
(4) the Assistive and Rehabilitative Services
Council;
(5) the Family and Protective Services Council;
(6) the State Health Services Council; and
(7) the Texas Council on Autism and Pervasive
Developmental Disorders.
(b) The following state agency and entity are abolished on a
date that is within the period prescribed by Section 531.02001(2),
that is specified in the transition plan required under Section
531.0204 for the abolition of the state agency or entity, and that
occurs after all of the state agency's or entity's functions have
been transferred to the commission in accordance with Sections
531.0201 and 531.02011:
(1) the Department of Aging and Disability Services;
and
(2) the Office for the Prevention of Developmental
Disabilities.
(c) The abolition of a state agency or entity listed in
Subsection (a) or (b) and the transfer of its functions and related
obligations, rights, contracts, records, property, and funds as
provided by this subchapter and the transfer of functions and
related obligations, rights, contracts, records, property, and
funds to or from the Department of Family and Protective Services
and from the Department of State Health Services as provided by this
subchapter do not affect or impair an act done, any obligation,
right, order, permit, certificate, rule, criterion, standard, or
requirement existing, or any penalty accrued under former law, and
that law remains in effect for any action concerning those matters.
Sec. 531.0203. HEALTH AND HUMAN SERVICES TRANSITION
LEGISLATIVE OVERSIGHT COMMITTEE. (a) In this section,
"committee" means the Health and Human Services Transition
Legislative Oversight Committee established under this section.
(b) The Health and Human Services Transition Legislative
Oversight Committee is created to facilitate the transfer of
functions under Sections 531.0201, 531.02011, and 531.02012 with
minimal negative effect on the delivery of services to which those
functions relate.
(c) The committee is composed of 11 voting members, as
follows:
(1) four members of the senate, appointed by the
lieutenant governor;
(2) four members of the house of representatives,
appointed by the speaker of the house of representatives; and
(3) three members of the public, appointed by the
governor.
(d) The executive commissioner serves as an ex officio,
nonvoting member of the committee.
(e) A member of the committee serves at the pleasure of the
appointing official.
(f) The lieutenant governor and the speaker of the house of
representatives shall each designate a presiding co-chair from
among their respective appointments.
(g) A member of the committee may not receive compensation
for serving on the committee but is entitled to reimbursement for
travel expenses incurred by the member while conducting the
business of the committee as provided by the General Appropriations
Act.
(h) The committee shall:
(1) facilitate the transfer of functions under
Sections 531.0201, 531.02011, and 531.02012 with minimal negative
effect on the delivery of services to which those functions relate;
(2) with assistance from the commission and the state
agencies and entities from which functions are transferred under
Sections 531.0201, 531.02011, and 531.02012, advise the executive
commissioner concerning:
(A) the functions to be transferred under this
subchapter and the funds and obligations that are related to the
functions;
(B) the transfer of the functions and related
records, property, funds, and obligations by the state agencies and
entities as provided by this subchapter; and
(C) the reorganization of the commission's
administrative structure in accordance with this subchapter,
Sections 531.0055, 531.00553, 531.00561, 531.00562, and 531.008,
and other provisions enacted by the 84th Legislature that become
law; and
(3) meet:
(A) during the period between the establishment
of the committee and September 1, 2017, at least quarterly at the
call of either chair, in addition to meeting at other times as
determined appropriate by either chair;
(B) during the period between September 2, 2017,
and December 31, 2019, at least semiannually at the call of either
chair, in addition to meeting at other times as determined
appropriate by either chair; and
(C) during the period between January 1, 2020,
and August 31, 2023, at least annually at the call of either chair,
in addition to meeting at other times as determined appropriate by
either chair.
(i) Chapter 551 applies to the committee.
(j) The committee shall submit a report to the governor,
lieutenant governor, speaker of the house of representatives, and
legislature not later than December 1 of each even-numbered year.
The report must include an update on the progress of and issues
related to:
(1) the transfer of functions under Sections 531.0201,
531.02011, and 531.02012 to the commission and the Department of
Family and Protective Services, including the need for any
additional statutory changes required to complete the transfer of
prevention and early intervention services functions to the
department in accordance with this subchapter; and
(2) the reorganization of the commission's
administrative structure in accordance with this subchapter,
Sections 531.0055, 531.00553, 531.00561, 531.00562, and 531.008,
and other provisions enacted by the 84th Legislature that become
law.
(k) The committee is abolished September 1, 2023.
Sec. 531.02031. STUDY ON CONTINUING NEED FOR CERTAIN STATE
AGENCIES. (a) Not later than September 1, 2018, the executive
commissioner shall conduct a study and submit a report and
recommendation to the Health and Human Services Transition
Legislative Oversight Committee regarding the need to continue the
Department of Family and Protective Services and the Department of
State Health Services as state agencies separate from the
commission.
(b) Not later than December 1, 2018, the Health and Human
Services Transition Legislative Oversight Committee shall review
the report and recommendation submitted under Subsection (a) and
submit a report and recommendation to the legislature regarding the
need to continue the Department of Family and Protective Services
and the Department of State Health Services as state agencies
separate from the commission.
(c) The Health and Human Services Transition Legislative
Oversight Committee shall include the following in the report
submitted to the legislature under Subsection (b):
(1) an evaluation of the transfer of prevention and
early intervention services functions to the Department of Family
and Protective Services as provided by this subchapter, including
an evaluation of:
(A) any increased coordination and efficiency in
the operation of the programs achieved as a result of the transfer;
(B) the department's coordination with other
state agency programs providing similar prevention and early
intervention services; and
(C) the department's interaction with
stakeholders and other interested parties in performing the
department's functions; and
(2) any recommendations concerning the transfer of
prevention and early intervention services functions of the
department to another state agency.
Sec. 531.0204. TRANSITION PLAN FOR IMPLEMENTATION OF
CONSOLIDATION. (a) The transfers of functions under Sections
531.0201, 531.02011, and 531.02012 must be accomplished in
accordance with a transition plan developed by the executive
commissioner that ensures that the transfers and provision of
health and human services in this state are accomplished in a
careful and deliberative manner. The transition plan must:
(1) include an outline of the commission's reorganized
structure, including its divisions, in accordance with this
subchapter, Sections 531.00561, 531.00562, and 531.008, and other
provisions enacted by the 84th Legislature that become law;
(2) include details regarding movement of functions
and a timeline that, subject to the periods prescribed by Section
531.02001, specifies the dates on which:
(A) the transfers under Sections 531.0201,
531.02011, and 531.02012 are to be made;
(B) each state agency or entity subject to
abolition under Section 531.0202 is abolished; and
(C) each division of the commission is created
and the division's director is appointed;
(3) for purposes of Sections 531.0201, 531.02011, and
531.02013, define:
(A) client services functions;
(B) regulatory functions;
(C) public health functions; and
(D) functions related to:
(i) state-operated institutions;
(ii) child protective services;
(iii) adult protective services; and
(iv) prevention and early intervention
services; and
(4) include an evaluation and determination of the
feasibility and potential effectiveness of consolidating
administrative support services into the commission in accordance
with Section 531.02012, including a report of:
(A) the specific support services that will be
consolidated within the commission;
(B) a timeline that details when specific support
services will be consolidated, including a description of the
support services that will transfer by the last day of each period
prescribed by Section 531.02001; and
(C) measures the commission will take to ensure
information resources and contracting support services continue to
operate properly across the health and human services system under
any consolidation of administrative support services.
(b) In defining the transferred functions under Subsection
(a)(3), the executive commissioner shall ensure that:
(1) not later than the last day of the period
prescribed by Section 531.02001(1), all functions of a state agency
or entity subject to abolition under Section 531.0202(a) are
transferred to the commission or the Department of Family and
Protective Services, as applicable;
(2) the transferred prevention and early intervention
services functions to the Department of Family and Protective
Services include:
(A) prevention and early intervention services
as defined under Section 265.001, Family Code; and
(B) programs that:
(i) provide parent education;
(ii) promote healthier parent-child
relationships; or
(iii) prevent family violence; and
(3) not later than the last day of the period
prescribed by Section 531.02001(2), all functions of the state
agency and entity subject to abolition under Section 531.0202(b)
are transferred to the commission.
(c) In developing the transition plan, the executive
commissioner shall, before submitting the plan to the Health and
Human Services Transition Legislative Oversight Committee, the
governor, and the Legislative Budget Board as required by
Subsection (e):
(1) hold public hearings in various geographic areas
in this state regarding the plan; and
(2) solicit and consider input from appropriate
stakeholders.
(d) Within the periods prescribed by Section 531.02001:
(1) the commission shall begin administering the
respective functions assigned to the commission under Sections
531.0201 and 531.02011, as applicable; and
(2) the Department of Family and Protective Services
shall begin administering the functions assigned to the department
under Section 531.0201.
(d-1) The assumption of the administration of the functions
transferred to the commission and the Department of Family and
Protective Services under Sections 531.0201 and 531.02011, as
applicable, must be accomplished in accordance with the transition
plan.
(e) The executive commissioner shall submit the transition
plan to the Health and Human Services Transition Legislative
Oversight Committee, the governor, and the Legislative Budget Board
not later than March 1, 2016. The Health and Human Services
Transition Legislative Oversight Committee shall comment on and
make recommendations to the executive commissioner regarding any
concerns or adjustments to the transition plan the committee
determines appropriate. The executive commissioner may not
finalize the transition plan until the executive commissioner has
reviewed and considered the comments and recommendations of the
committee regarding the transition plan.
(f) The executive commissioner shall publish in the Texas
Register:
(1) the transition plan developed under this section;
(2) any adjustments to the transition plan recommended
by the Health and Human Services Transition Legislative Oversight
Committee;
(3) a statement regarding whether the executive
commissioner adopted or otherwise incorporated the recommended
adjustments; and
(4) if the executive commissioner did not adopt a
recommended adjustment, the justification for not adopting the
adjustment.
Sec. 531.02041. REQUIRED REPORTS AFTER TRANSITION PLAN
SUBMISSION. If, at any time after the executive commissioner
submits the transition plan in accordance with Section 531.0204(e),
the executive commissioner proposes to make a substantial
organizational change to the health and human services system that
was not included in the transition plan, the executive commissioner
shall, before implementing the proposed change, submit a report
detailing the proposed change to the Health and Human Services
Transition Legislative Oversight Committee.
Sec. 531.0205. APPLICABILITY OF FORMER LAW. An action
brought or proceeding commenced before the date of a transfer
prescribed by this subchapter in accordance with the transition
plan required under Section 531.0204, including a contested case or
a remand of an action or proceeding by a reviewing court, is
governed by the laws and rules applicable to the action or
proceeding before the transfer.
Sec. 531.0206. LIMITED-SCOPE SUNSET REVIEW. (a) The
Sunset Advisory Commission shall conduct a limited-scope review of
the commission during the state fiscal biennium ending August 31,
2023, in the manner provided by Chapter 325 (Texas Sunset Act). The
review must provide:
(1) an update on the commission's progress with
respect to the consolidation of the health and human services
system mandated by this subchapter, including the commission's
compliance with the transition plan required under Section
531.0204;
(2) an evaluation and recommendations regarding the
need to continue the Department of Family and Protective Services
and the Department of State Health Services as state agencies
separate from the commission; and
(3) any additional information the Sunset Advisory
Commission determines appropriate, including information regarding
any additional organizational changes the Sunset Advisory
Commission recommends.
(b) The commission is not abolished solely because the
commission is not explicitly continued following the review
required by this section.
Sec. 531.0207. EXPIRATION OF SUBCHAPTER. This subchapter
expires September 1, 2023.
(b) Not later than October 1, 2015:
(1) the lieutenant governor, the speaker of the house
of representatives, and the governor shall make the appointments to
the Health and Human Services Transition Legislative Oversight
Committee as required by Section 531.0203(c), Government Code, as
added by this article; and
(2) the lieutenant governor and the speaker of the
house of representatives shall each designate a presiding co-chair
of the Health and Human Services Transition Legislative Oversight
Committee in accordance with Section 531.0203(f), Government Code,
as added by this article.
(c) As soon as appropriate under the consolidation under
Subchapter A-1, Chapter 531, Government Code, as added by this
article, and in a manner that minimizes disruption of services, the
Health and Human Services Commission shall take appropriate action
to be designated as the state agency responsible under federal law
for any state or federal program that is transferred to the
commission in accordance with that subchapter and for which federal
law requires the designation of a responsible state agency.
(d) Notwithstanding Section 531.0201, 531.02011, or
531.02012, Government Code, as added by this article, a power,
duty, program, function, or activity of the Department of Assistive
and Rehabilitative Services may not be transferred to the Health
and Human Services Commission under that section if:
(1) H.B. No. 3294 or S.B. No. 208, 84th Legislature,
Regular Session, 2015, or similar legislation of the 84th
Legislature, Regular Session, 2015, is enacted, becomes law, and
provides for the transfer of the power, duty, program, function, or
activity to the Texas Workforce Commission subject to receipt of
any necessary federal approval or other authorization for the
transfer to occur; and
(2) the Department of Assistive and Rehabilitative
Services or the Texas Workforce Commission receives the necessary
federal approval or other authorization to enable the transfer to
occur not later than September 1, 2016.
(e) If neither the Department of Assistive and
Rehabilitative Services nor the Texas Workforce Commission
receives the federal approval or other authorization described by
Subsection (d) of this section to enable the transfer of the power,
duty, program, function, or activity to the Texas Workforce
Commission to occur not later than September 1, 2016, as provided by
the legislation described by Subsection (d) of this section, the
power, duty, program, function, or activity of the Department of
Assistive and Rehabilitative Services transfers to the Health and
Human Services Commission in accordance with Section 531.0201,
Government Code, as added by this article, and the transition plan
required under Section 531.0204, Government Code, as added by this
article.
SECTION 1.02. Subchapter A, Chapter 531, Government Code,
is amended by adding Sections 531.0011 and 531.0012 to read as
follows:
Sec. 531.0011. REFERENCES IN LAW MEANING COMMISSION OR
APPROPRIATE DIVISION. (a) In this code or in any other law, a
reference to any of the following state agencies or entities in
relation to a function transferred to the commission under Section
531.0201, 531.02011, or 531.02012, as applicable, means the
commission or the division of the commission performing the
function previously performed by the state agency or entity before
the transfer, as appropriate:
(1) health and human services agency;
(2) the Department of State Health Services;
(3) the Department of Aging and Disability Services;
(4) the Department of Family and Protective Services;
or
(5) the Department of Assistive and Rehabilitative
Services.
(b) In this code or in any other law and notwithstanding any
other law, a reference to any of the following state agencies or
entities in relation to a function transferred to the commission
under Section 531.0201, 531.02011, or 531.02012, as applicable,
from the state agency that assumed the relevant function in
accordance with Chapter 198 (H.B. 2292), Acts of the 78th
Legislature, Regular Session, 2003, means the commission or the
division of the commission performing the function previously
performed by the agency that assumed the function before the
transfer, as appropriate:
(1) the Texas Department on Aging;
(2) the Texas Commission on Alcohol and Drug Abuse;
(3) the Texas Commission for the Blind;
(4) the Texas Commission for the Deaf and Hard of
Hearing;
(5) the Texas Department of Health;
(6) the Texas Department of Human Services;
(7) the Texas Department of Mental Health and Mental
Retardation;
(8) the Texas Rehabilitation Commission;
(9) the Texas Health Care Information Council; or
(10) the Interagency Council on Early Childhood
Intervention.
(c) In this code or in any other law and notwithstanding any
other law, a reference to the Department of Protective and
Regulatory Services in relation to a function transferred under
Section 531.0201, 531.02011, or 531.02012, as applicable, from the
Department of Family and Protective Services means the commission
or the division of the commission performing the function
previously performed by the Department of Family and Protective
Services before the transfer.
(d) This section applies notwithstanding Section
531.001(4).
Sec. 531.0012. REFERENCES IN LAW MEANING EXECUTIVE
COMMISSIONER OR DESIGNEE. (a) In this code or in any other law, a
reference to any of the following persons in relation to a function
transferred to the commission under Section 531.0201, 531.02011, or
531.02012, as applicable, means the executive commissioner, the
executive commissioner's designee, or the director of the division
of the commission performing the function previously performed by
the state agency from which it was transferred and that the person
represented, as appropriate:
(1) the commissioner of aging and disability services;
(2) the commissioner of assistive and rehabilitative
services;
(3) the commissioner of state health services; or
(4) the commissioner of the Department of Family and
Protective Services.
(b) In this code or in any other law and notwithstanding any
other law, a reference to any of the following persons or entities
in relation to a function transferred to the commission under
Section 531.0201, 531.02011, or 531.02012, as applicable, from the
state agency that assumed or continued to perform the function in
accordance with Chapter 198 (H.B. 2292), Acts of the 78th
Legislature, Regular Session, 2003, means the executive
commissioner or the director of the division of the commission
performing the function performed before the enactment of Chapter
198 (H.B. 2292) by the state agency that was abolished or renamed by
Chapter 198 (H.B. 2292) and that the person or entity represented:
(1) an executive director or other chief
administrative officer of a state agency listed in Section
531.0011(b) or of the Department of Protective and Regulatory
Services; or
(2) the governing body of a state agency listed in
Section 531.0011(b) or of the Department of Protective and
Regulatory Services.
(c) A reference to any of the following councils means the
executive commissioner or the executive commissioner's designee,
as appropriate, and a function of any of the following councils is a
function of that appropriate person:
(1) the Health and Human Services Council;
(2) the Aging and Disability Services Council;
(3) the Assistive and Rehabilitative Services
Council;
(4) the Family and Protective Services Council; or
(5) the State Health Services Council.
SECTION 1.03. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0051 to read as follows:
Sec. 531.0051. HEALTH AND HUMAN SERVICES COMMISSION
EXECUTIVE COUNCIL. (a) The Health and Human Services Commission
Executive Council is established to receive public input and advise
the executive commissioner regarding the operation of the
commission. The council shall seek and receive public comment on:
(1) proposed rules;
(2) recommendations of advisory committees;
(3) legislative appropriations requests or other
documents related to the appropriations process;
(4) the operation of health and human services
programs; and
(5) other items the executive commissioner determines
appropriate.
(b) The council does not have authority to make
administrative or policy decisions.
(c) The council is composed of:
(1) the executive commissioner;
(2) the director of each division established by the
executive commissioner under Section 531.008(c);
(3) the commissioner of a health and human services
agency; and
(4) other individuals appointed by the executive
commissioner as the executive commissioner determines necessary.
(c-1) To the extent the executive commissioner appoints
members to the council under Subsection (c)(4), the executive
commissioner shall make every effort to ensure that those
appointments result in a council membership that includes:
(1) a balanced representation of a broad range of
health and human services industry and consumer interests; and
(2) representation from broad geographic regions of
this state.
(d) The executive commissioner serves as the chair of the
council and shall adopt rules for the operation of the council.
(e) Members of the council appointed under Subsection
(c)(4):
(1) are subject to the restrictions applicable to
service on the council provided by Section 531.006(a-1); and
(2) serve at the pleasure of the executive
commissioner.
(f) The council shall meet at the call of the executive
commissioner at least quarterly. The executive commissioner may
call additional meetings as the executive commissioner determines
necessary.
(g) The council shall give public notice of the date, time,
and place of each meeting held by the council. A live video
transmission of each meeting must be publicly available through the
Internet.
(h) A majority of the members of the council constitute a
quorum for the transaction of business.
(i) A council member appointed under Subsection (c)(4) may
not receive compensation for service as a member of the council but
is entitled to reimbursement for travel expenses incurred by the
member while conducting the business of the council as provided by
the General Appropriations Act.
(j) The executive commissioner shall develop and implement
policies that provide the public with a reasonable opportunity to
appear before the council which may include holding meetings in
various geographic areas across this state, or through allowing
public comment at teleconferencing centers in various geographic
areas across this state and to speak on any issue under the
jurisdiction of the commission.
(k) A meeting of individual members of the council that
occurs in the ordinary course of commission operation is not a
meeting of the council, and the requirements of Subsection (g) do
not apply.
(l) This section does not limit the authority of the
executive commissioner to establish additional advisory committees
or councils.
(m) Chapters 551 and 2110 do not apply to the council.
(b) As soon as possible after the executive commissioner of
the Health and Human Services Commission appoints division
directors in accordance with Section 531.00561, Government Code, as
added by this article, the Health and Human Services Commission
Executive Council established under Section 531.0051, Government
Code, as added by this article, shall begin operation.
SECTION 1.04. The heading to Section 531.0055, Government
Code, is amended to read as follows:
Sec. 531.0055. EXECUTIVE COMMISSIONER: GENERAL
RESPONSIBILITY FOR HEALTH AND HUMAN SERVICES SYSTEM [AGENCIES].
SECTION 1.05. Section 531.0055, Government Code, is amended
by amending Subsection (b), as amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, and amending Subsections (d),
(e), (f), (g), (h), (k), and (l) to read as follows:
(b) The commission shall:
(1) supervise the administration and operation of
Medicaid, including the administration and operation of the
Medicaid managed care system in accordance with Section 531.021;
(2) perform information systems planning and
management for the health and human services system [agencies]
under Section 531.0273, with:
(A) the provision of information technology
services for the [at] health and human services system [agencies]
considered to be a centralized administrative support service
either performed by commission personnel or performed under a
contract with the commission; and
(B) an emphasis on research and implementation on
a demonstration or pilot basis of appropriate and efficient uses of
new and existing technology to improve the operation of the health
and human services system [agencies] and delivery of health and
human services;
(3) monitor and ensure the effective use of all
federal funds received for the [by a] health and human services
system [agency] in accordance with Section 531.028 and the General
Appropriations Act;
(4) implement Texas Integrated Enrollment Services as
required by Subchapter F, except that notwithstanding Subchapter F,
determining eligibility for benefits under the following programs
is the responsibility of and must be centralized by the commission:
(A) the child health plan program;
(B) the financial assistance program under
Chapter 31, Human Resources Code;
(C) Medicaid;
(D) the supplemental nutrition assistance
program under Chapter 33, Human Resources Code;
(E) long-term care services, as defined by
Section 22.0011, Human Resources Code;
(F) community-based support services identified
or provided in accordance with Section 531.02481; and
(G) other health and human services programs, as
appropriate; and
(5) implement programs intended to prevent family
violence and provide services to victims of family violence.
(d) After implementation of the commission's duties under
Subsections (b) and (c), the commission shall implement the powers
and duties given to the commission under Section 531.0248. Nothing
in the priorities established by this section is intended to limit
the authority of the commission to work simultaneously to achieve
the multiple tasks assigned to the commission in this section, when
such an approach is beneficial in the judgment of the commission.
The commission shall plan and implement an efficient and effective
centralized system of administrative support services for the
health and human services system in accordance with Section
531.00553 [agencies]. [The performance of administrative support
services for health and human services agencies is the
responsibility of the commission. The term "administrative support
services" includes, but is not limited to, strategic planning and
evaluation, audit, legal, human resources, information resources,
purchasing, contract management, financial management, and
accounting services.]
(e) Notwithstanding any other law, the executive
commissioner shall adopt rules and policies for the operation of
and provision of health and human services by the health and human
services system [agencies]. In addition, the executive
commissioner, as necessary to perform the functions described by
Subsections (b), (c), and (d) and Section 531.00553 in
implementation of applicable policies established for a health and
human services system [an] agency or division, as applicable, by
the executive commissioner, shall:
(1) manage and direct the operations of each [health
and human services] agency or division, as applicable;
(2) supervise and direct the activities of each agency
or division director, as applicable; and
(3) be responsible for the administrative supervision
of the internal audit program for the [all] health and human
services system agencies, including:
(A) selecting the director of internal audit;
(B) ensuring that the director of internal audit
reports directly to the executive commissioner; and
(C) ensuring the independence of the internal
audit function.
(f) The operational authority and responsibility of the
executive commissioner for purposes of Subsection (e) for [at] each
health and human services system agency or division, as applicable,
includes authority over and responsibility for the:
(1) management of the daily operations of the agency
or division, including the organization and management of the
agency or division and its [agency] operating procedures;
(2) allocation of resources within the agency or
division, including use of federal funds received by the agency or
division;
(3) personnel and employment policies;
(4) contracting, purchasing, and related policies,
subject to this chapter and other laws relating to contracting and
purchasing by a state agency;
(5) information resources systems used by the agency
or division;
(6) location of [agency] facilities; and
(7) coordination of agency or division activities with
activities of other components of the health and human services
system and state agencies[, including other health and human
services agencies].
(g) Notwithstanding any other law, the operational
authority and responsibility of the executive commissioner for
purposes of Subsection (e) for [at] each health and human services
system agency or division, as applicable, includes the authority
and responsibility to adopt or approve, subject to applicable
limitations, any rate of payment or similar provision required by
law to be adopted or approved by a health and human services system
[the] agency.
(h) For each health and human services system agency and
division, as applicable, the executive commissioner shall
implement a program to evaluate and supervise [the] daily
operations [of the agency]. The program must include measurable
performance objectives for each agency or division director and
adequate reporting requirements to permit the executive
commissioner to perform the duties assigned to the executive
commissioner under this section.
(k) The executive commissioner and each agency director
shall enter into a memorandum of understanding in the manner
prescribed by Section 531.0163 that:
(1) clearly defines the responsibilities of the agency
director and the executive commissioner, including:
(A) the responsibility of the agency director to
report to the governor and to report to and implement policies of
the executive commissioner; and
(B) the extent to which the agency director acts
as a liaison between the agency and the commission;
(2) establishes the program of evaluation and
supervision of daily operations required by Subsection (h); [and]
(3) describes each delegation of a power or duty made
to an agency director; and
(4) ensures that the commission and each health and
human services agency has access to databases or other information
maintained or kept by each other agency that is necessary for the
operation of a function performed by the commission or the health
and human services agency, to the extent not prohibited by other law
[under Subsection (i) or other law].
(l) Notwithstanding any other law, the executive
commissioner has the authority to adopt policies and rules
governing the delivery of services to persons who are served by the
[each] health and human services system [agency] and the rights and
duties of persons who are served or regulated by the system [each
agency].
SECTION 1.06. Subchapter A, Chapter 531, Government Code,
is amended by adding Section 531.00553 to read as follows:
Sec. 531.00553. ADMINISTRATIVE SUPPORT SERVICES. (a) In
this section, the term "administrative support services" includes
strategic planning and evaluation, audit, legal, human resources,
information resources, purchasing, contracting, financial
management, and accounting services.
(b) Subject to Subsection (c), the executive commissioner
shall plan and implement an efficient and effective centralized
system of administrative support services for the health and human
services system. The performance of administrative support
services for the health and human services system is the
responsibility of the commission.
(c) The executive commissioner shall plan and implement the
centralized system of administrative support services in
accordance with the following principles and requirements:
(1) the executive commissioner shall consult with the
commissioner of each agency and with the director of each division
within the health and human services system to ensure the
commission is responsive to and addresses agency or division needs;
(2) consolidation of staff providing the support
services must be done in a manner that ensures each agency or
division within the health and human services system that loses
staff as a result of the centralization of support services has
adequate resources to carry out functions of the agency or
division, as appropriate; and
(3) the commission and each agency or division within
the health and human services system shall, as appropriate, enter
into a memorandum of understanding or other written agreement for
the purpose of ensuring accountability for the provision of
administrative services by clearly detailing:
(A) the responsibilities of each agency or
division and the commission;
(B) the points of contact for each agency or
division and the commission;
(C) the transfer of personnel among each agency
or division and the commission;
(D) the budgetary effect the agreement has on
each agency or division and the commission; and
(E) any other item determined by the executive
commissioner to be critical for maintaining accountability.
(d) The memorandum of understanding or other agreement
required under Subsection (c), if appropriate, may be combined with
the memorandum of understanding required under Section
531.0055(k).
SECTION 1.07. Section 531.0056, Government Code, is amended
by adding Subsection (g) to read as follows:
(g) The requirements of this section apply with respect to a
state agency listed in Section 531.001(4) only until the agency is
abolished under Section 531.0202.
SECTION 1.08. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Sections 531.00561 and 531.00562 to read
as follows:
Sec. 531.00561. APPOINTMENT AND QUALIFICATIONS OF DIVISION
DIRECTORS. (a) The executive commissioner shall appoint a
director for each division established within the commission under
Section 531.008, except that the director of the office of
inspector general is appointed in accordance with Section
531.102(a-1).
(b) The executive commissioner shall:
(1) develop clear qualifications for the director of
each division appointed under this section that ensure that an
individual appointed director has:
(A) demonstrated experience in fields relevant
to the director position; and
(B) executive-level administrative and
leadership experience; and
(2) ensure the qualifications developed under
Subdivision (1) are publicly available.
Sec. 531.00562. DIVISION DIRECTOR DUTIES. (a) The
executive commissioner shall clearly define the duties and
responsibilities of a division director and develop clear policies
for the delegation of specific decision-making authority,
including budget authority, to division directors.
(b) The delegation of decision-making authority should be
significant enough to ensure the efficient administration of the
commission's programs and services.
(b) The executive commissioner of the Health and Human
Services Commission shall implement Sections 531.00561 and
531.00562, Government Code, as added by this article, on the date
specified in the transition plan required under Section 531.0204,
Government Code, as added by this article.
SECTION 1.09. (a) Section 531.008, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 531.008. DIVISIONS OF COMMISSION. (a) The [Subject
to Subsection (c), the] executive commissioner shall [may]
establish divisions within the commission along functional lines as
necessary for effective administration and for the discharge of the
commission's functions.
(b) The [Subject to Subsection (c), the] executive
commissioner may allocate and reallocate functions among the
commission's divisions.
(c) Notwithstanding Subsections (a) and (b), the [The]
executive commissioner shall establish the following divisions and
offices within the commission:
(1) a medical and social services division [the
eligibility services division to make eligibility determinations
for services provided through the commission or a health and human
services agency related to:
[(A) the child health plan program;
[(B) the financial assistance program under
Chapter 31, Human Resources Code;
[(C) Medicaid;
[(D) the supplemental nutrition assistance
program under Chapter 33, Human Resources Code;
[(E) long-term care services, as defined by
Section 22.0011, Human Resources Code;
[(F) community-based support services identified
or provided in accordance with Section 531.02481; and
[(G) other health and human services programs, as
appropriate];
(2) the office of inspector general to perform fraud
and abuse investigation and enforcement functions as provided by
Subchapter C and other law;
(3) a regulatory division [the office of the ombudsman
to:
[(A) provide dispute resolution services for the
commission and the health and human services agencies; and
[(B) perform consumer protection functions
related to health and human services];
(4) an administrative division [a purchasing division
as provided by Section 531.017]; and
(5) a facilities division for the purpose of
administering state facilities, including state hospitals and
state supported living centers [an internal audit division to
conduct a program of internal auditing in accordance with Chapter
2102].
(d) Subsection (c) does not prohibit the executive
commissioner from establishing additional divisions under
Subsection (a) as the executive commissioner determines
appropriate. This subsection and Subsection (c) expire September
1, 2023.
(b) The executive commissioner of the Health and Human
Services Commission shall establish divisions within the
commission as required under Section 531.008, Government Code, as
amended by this article, on the date specified in the transition
plan required under Section 531.0204, Government Code, as added by
this article.
SECTION 1.10. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0083 to read as follows:
Sec. 531.0083. OFFICE OF POLICY AND PERFORMANCE. (a) In
this section, "office" means the office of policy and performance
established by this section.
(b) The executive commissioner shall establish the office
of policy and performance as an executive-level office designed to
coordinate policy and performance efforts across the health and
human services system. To coordinate those efforts, the office
shall:
(1) develop a performance management system;
(2) take the lead in supporting and providing
oversight for the implementation of major policy changes and in
managing organizational changes; and
(3) act as a centralized body of experts within the
commission that offers program evaluation and process improvement
expertise.
(c) In developing a performance management system under
Subsection (b)(1), the office shall:
(1) gather, measure, and evaluate performance
measures and accountability systems used by the health and human
services system;
(2) develop new and refined performance measures as
appropriate; and
(3) establish targeted, high-level system metrics
that are capable of measuring and communicating overall performance
and achievement of goals by the health and human services system to
both internal and public audiences through various mechanisms,
including the Internet.
(d) In providing support and oversight for the
implementation of policy or organizational changes within the
health and human services system under Subsection (b)(2), the
office shall:
(1) ensure individuals receiving services from or
participating in programs administered through the health and human
services system do not lose visibility or attention during the
implementation of any new policy or organizational change by:
(A) establishing timelines and milestones for
any transition;
(B) supporting staff of the health and human
services system in any change between service delivery methods; and
(C) providing feedback to executive management
on technical assistance and other support needed to achieve a
successful transition;
(2) address cultural differences among staff of the
health and human services system; and
(3) track and oversee changes in policy or
organization mandated by legislation or administrative rule.
(e) In acting as a centralized body of experts under
Subsection (b)(3), the office shall:
(1) for the health and human services system, provide
program evaluation and process improvement guidance both generally
and for specific projects identified with executive or stakeholder
input or through risk analysis; and
(2) identify and monitor cross-functional efforts
involving different administrative components within the health
and human services system and the establishment of cross-functional
teams when necessary to improve the coordination of services
provided through the system.
(f) The executive commissioner may otherwise develop the
office's structure and duties as the executive commissioner
determines appropriate.
(b) As soon as practicable after the effective date of this
article but not later than October 1, 2015, the executive
commissioner of the Health and Human Services Commission shall
establish the office of policy and performance as an executive
office within the commission as required under Section 531.0083,
Government Code, as added by this article.
(c) The office of policy and performance required under
Section 531.0083, Government Code, as added by this article, shall
assist the Health and Human Services Transition Legislative
Oversight Committee created under Section 531.0203, Government
Code, as added by this article, by performing the functions
required of the office under Section 531.0083(b)(2), Government
Code, as added by this article, with respect to the consolidation
mandated by Subchapter A-1, Chapter 531, Government Code, as added
by this article.
SECTION 1.11. Section 531.017, Government Code, is amended
to read as follows:
Sec. 531.017. PURCHASING UNIT [DIVISION]. (a) The
commission shall establish a purchasing unit [division] for the
management of administrative activities related to the purchasing
functions within [of the commission and] the health and human
services system [agencies].
(b) The purchasing unit [division] shall:
(1) seek to achieve targeted cost reductions, increase
process efficiencies, improve technological support and customer
services, and enhance purchasing support within the [for each]
health and human services system [agency]; and
(2) if cost-effective, contract with private entities
to perform purchasing functions for the [commission and the] health
and human services system [agencies].
SECTION 1.12. Chapter 265, Family Code, is amended by
designating Sections 265.001 through 265.004 as Subchapter A and
adding a subchapter heading to read as follows:
SUBCHAPTER A. PREVENTION AND EARLY INTERVENTION SERVICES
SECTION 1.13. Section 265.002, Family Code, is amended to
read as follows:
Sec. 265.002. PREVENTION AND EARLY INTERVENTION SERVICES
DIVISION. (a) The department shall operate a division to provide
services for children in at-risk situations and for the families of
those children and to achieve the consolidation of prevention and
early intervention services within the jurisdiction of a single
agency in order to avoid fragmentation and duplication of services
and to increase the accountability for the delivery and
administration of these services. The division shall be called the
prevention and early intervention services division and shall have
the following duties:
(1) to plan, develop, and administer a comprehensive
and unified delivery system of prevention and early intervention
services to children and their families in at-risk situations;
(2) to improve the responsiveness of services for
at-risk children and their families by facilitating greater
coordination and flexibility in the use of funds by state and local
service providers;
(3) to provide greater accountability for prevention
and early intervention services in order to demonstrate the impact
or public benefit of a program by adopting outcome measures; and
(4) to assist local communities in the coordination
and development of prevention and early intervention services in
order to maximize federal, state, and local resources.
(b) The department's prevention and early intervention
services division must be organizationally separate from the
department's divisions performing child protective services and
adult protective services functions.
SECTION 1.14. Subchapter A, Chapter 265, Family Code, as
added by this article, is amended by adding Section 265.006 to read
as follows:
Sec. 265.006. PROHIBITION ON USE OF AGENCY NAME OR LOGO.
The department may not allow the use of the department's name or
identifying logo or insignia on forms or other materials related to
the department's prevention and early intervention services that
are:
(1) provided by the department's contractors; or
(2) distributed by the department's contractors to the
department's clients.
SECTION 1.15. (a) Subchapter Q, Chapter 531, Government
Code, including provisions amended by S.B. No. 219, Acts of the 84th
Legislature, Regular Session, 2015, is transferred to Chapter 265,
Family Code, redesignated as Subchapter C, Chapter 265, Family
Code, and amended to read as follows:
SUBCHAPTER C [Q]. NURSE-FAMILY PARTNERSHIP COMPETITIVE
GRANT PROGRAM
Sec. 265.101 [531.651]. DEFINITIONS. In this subchapter:
(1) "Competitive grant program" means the
nurse-family partnership competitive grant program established
under this subchapter.
(2) "Partnership program" means a nurse-family
partnership program.
Sec. 265.102 [531.652]. OPERATION OF NURSE-FAMILY
PARTNERSHIP COMPETITIVE GRANT PROGRAM. (a) The department
[commission] shall operate a nurse-family partnership competitive
grant program through which the department [commission] will award
grants for the implementation of nurse-family partnership
programs, or the expansion of existing programs, and for the
operation of those programs for a period of not less than two years.
(b) The department [commission] shall award grants under
the program to applicants, including applicants operating existing
programs, in a manner that ensures that the partnership programs
collectively:
(1) operate in multiple communities that are
geographically distributed throughout this state; and
(2) provide program services to approximately 2,000
families.
Sec. 265.103 [531.653]. PARTNERSHIP PROGRAM REQUIREMENTS.
A partnership program funded through a grant awarded under this
subchapter must:
(1) strictly adhere to the program model developed by
the Nurse-Family Partnership National Service Office, including
any clinical, programmatic, and data collection requirements of
that model;
(2) require that registered nurses regularly visit the
homes of low-income, first-time mothers participating in the
program to provide services designed to:
(A) improve pregnancy outcomes;
(B) improve child health and development;
(C) improve family economic self-sufficiency and
stability; and
(D) reduce the incidence of child abuse and
neglect;
(3) require that nurses who provide services through
the program:
(A) receive training from the office of the
attorney general at least once each year on procedures by which a
person may voluntarily acknowledge the paternity of a child and on
the availability of child support services from the office;
(B) provide a mother with information about the
rights, responsibilities, and benefits of establishing the
paternity of her child, if appropriate;
(C) provide assistance to a mother and the
alleged father of her child if the mother and alleged father seek to
voluntarily acknowledge paternity of the child, if appropriate; and
(D) provide information to a mother about the
availability of child support services from the office of the
attorney general; and
(4) require that the regular nurse visits described by
Subdivision (2) begin not later than a mother's 28th week of
gestation and end when her child reaches two years of age.
Sec. 265.104 [531.654]. APPLICATION. (a) A public or
private entity, including a county, municipality, or other
political subdivision of this state, may apply for a grant under
this subchapter.
(b) To apply for a grant, an applicant must submit a written
application to the department [commission] on a form prescribed by
the department [commission] in consultation with the Nurse-Family
Partnership National Service Office.
(c) The application prescribed by the department
[commission] must:
(1) require the applicant to provide data on the
number of low-income, first-time mothers residing in the community
in which the applicant proposes to operate or expand a partnership
program and provide a description of existing services available to
those mothers;
(2) describe the ongoing monitoring and evaluation
process to which a grant recipient is subject under Section 265.109
[531.659], including the recipient's obligation to collect and
provide information requested by the department [commission] under
Section 265.109(c) [531.659(c)]; and
(3) require the applicant to provide other relevant
information as determined by the department [commission].
Sec. 265.105 [531.655]. ADDITIONAL CONSIDERATIONS IN
AWARDING GRANTS. In addition to the factors described by Sections
265.102(b) [531.652(b)] and 265.103 [531.653], in determining
whether to award a grant to an applicant under this subchapter, the
department [commission] shall consider:
(1) the demonstrated need for a partnership program in
the community in which the applicant proposes to operate or expand
the program, which may be determined by considering:
(A) the poverty rate, the crime rate, the number
of births to Medicaid recipients, the rate of poor birth outcomes,
and the incidence of child abuse and neglect during a prescribed
period in the community; and
(B) the need to enhance school readiness in the
community;
(2) the applicant's ability to participate in ongoing
monitoring and performance evaluations under Section 265.109
[531.659], including the applicant's ability to collect and provide
information requested by the department [commission] under Section
265.109(c) [531.659(c)];
(3) the applicant's ability to adhere to the
partnership program standards adopted under Section 265.106
[531.656];
(4) the applicant's ability to develop broad-based
community support for implementing or expanding a partnership
program, as applicable; and
(5) the applicant's history of developing and
sustaining innovative, high-quality programs that meet the needs of
families and communities.
Sec. 265.106 [531.656]. PARTNERSHIP PROGRAM STANDARDS.
The executive commissioner, with the assistance of the Nurse-Family
Partnership National Service Office, shall adopt standards for the
partnership programs funded under this subchapter. The standards
must adhere to the Nurse-Family Partnership National Service Office
program model standards and guidelines that were developed in
multiple, randomized clinical trials and have been tested and
replicated in multiple communities.
Sec. 265.107 [531.657]. USE OF AWARDED GRANT FUNDS. The
grant funds awarded under this subchapter may be used only to cover
costs related to implementing or expanding and operating a
partnership program, including costs related to:
(1) administering the program;
(2) training and managing registered nurses who
participate in the program;
(3) paying the salaries and expenses of registered
nurses who participate in the program;
(4) paying for facilities and equipment for the
program; and
(5) paying for services provided by the Nurse-Family
Partnership National Service Office to ensure a grant recipient
adheres to the organization's program model.
Sec. 265.108 [531.658]. STATE NURSE CONSULTANT. Using
money appropriated for the competitive grant program, the
department [commission] shall hire or contract with a state nurse
consultant to assist grant recipients with implementing or
expanding and operating the partnership programs in the applicable
communities.
Sec. 265.109 [531.659]. PROGRAM MONITORING AND EVALUATION;
ANNUAL COMMITTEE REPORTS. (a) The department [commission], with
the assistance of the Nurse-Family Partnership National Service
Office, shall:
(1) adopt performance indicators that are designed to
measure a grant recipient's performance with respect to the
partnership program standards adopted by the executive
commissioner under Section 265.106 [531.656];
(2) use the performance indicators to continuously
monitor and formally evaluate on an annual basis the performance of
each grant recipient; and
(3) prepare and submit an annual report, not later
than December 1 of each year, to the Senate Health and Human
Services Committee, or its successor, and the House Human Services
Committee, or its successor, regarding the performance of each
grant recipient during the preceding state fiscal year with respect
to providing partnership program services.
(b) The report required under Subsection (a)(3) must
include:
(1) the number of low-income, first-time mothers to
whom each grant recipient provided partnership program services
and, of that number, the number of mothers who established the
paternity of an alleged father as a result of services provided
under the program;
(2) the extent to which each grant recipient made
regular visits to mothers during the period described by Section
265.103(4) [531.653(4)]; and
(3) the extent to which each grant recipient adhered
to the Nurse-Family Partnership National Service Office's program
model, including the extent to which registered nurses:
(A) conducted home visitations comparable in
frequency, duration, and content to those delivered in Nurse-Family
Partnership National Service Office clinical trials; and
(B) assessed the health and well-being of mothers
and children participating in the partnership programs in
accordance with indicators of maternal, child, and family health
defined by the department [commission] in consultation with the
Nurse-Family Partnership National Service Office.
(c) On request, each grant recipient shall timely collect
and provide data and any other information required by the
department [commission] to monitor and evaluate the recipient or to
prepare the report required by this section.
Sec. 265.110 [531.660]. COMPETITIVE GRANT PROGRAM FUNDING.
(a) The department [commission] shall actively seek and apply for
any available federal funds, including federal Medicaid and
Temporary Assistance for Needy Families (TANF) funds, to assist in
financing the competitive grant program established under this
subchapter.
(b) The department [commission] may use appropriated funds
from the state government and may accept gifts, donations, and
grants of money from the federal government, local governments,
private corporations, or other persons to assist in financing the
competitive grant program.
(b) Notwithstanding the transfer of Subchapter Q, Chapter
531, Government Code, to Chapter 265, Family Code, and
redesignation as Subchapter C of that chapter, the Health and Human
Services Commission shall continue to administer the Nurse-Family
Partnership Competitive Grant Program under that subchapter until
the date the program transfers to the Department of Family and
Protective Services in accordance with Section 531.0201,
Government Code, as added by this article, and the transition plan
under Section 531.0204, Government Code, as added by this article.
SECTION 1.16. Effective September 1, 2017, Section
1001.002, Health and Safety Code, is amended to read as follows:
Sec. 1001.002. AGENCY AND AGENCY FUNCTIONS. (a) In this
section, "function" includes a power, duty, program, or activity
and an administrative support services function associated with the
power, duty, program, or activity, unless consolidated under
Section 531.02012, Government Code.
(b) The department is an agency of the state.
(c) In accordance with Subchapter A-1, Chapter 531,
Government Code, and notwithstanding any other law, the department
performs only functions related to public health, including health
care data collection and maintenance of the Texas Health Care
Information Collection program.
SECTION 1.17. Effective September 1, 2017, Subchapter A,
Chapter 1001, Health and Safety Code, is amended by adding Sections
1001.004 and 1001.005 to read as follows:
Sec. 1001.004. REFERENCES IN LAW MEANING DEPARTMENT. In
this code or any other law, a reference to the department in
relation to a function described by Section 1001.002(c) means the
department. A reference in law to the department in relation to any
other function has the meaning assigned by Section 531.0011,
Government Code.
Sec. 1001.005. REFERENCES IN LAW MEANING COMMISSIONER OR
DESIGNEE. In this code or in any other law, a reference to the
commissioner in relation to a function described by Section
1001.002(c) means the commissioner. A reference in law to the
commissioner in relation to any other function has the meaning
assigned by Section 531.0012, Government Code.
SECTION 1.18. Effective September 1, 2017, Section
40.002(b), Human Resources Code, as amended by S.B. 219, Acts of the
84th Legislature, Regular Session, 2015, is amended to read as
follows:
(b) Except as provided by Section 40.0025 [Notwithstanding
any other law], the department shall:
(1) provide protective services for children and
elderly persons and persons with disabilities, including
investigations of alleged abuse, neglect, or exploitation in
facilities of the Department of State Health Services and the
Department of Aging and Disability Services or the successor agency
for either of those agencies;
(2) provide family support and family preservation
services that respect the fundamental right of parents to control
the education and upbringing of their children;
(3) license, register, and enforce regulations
applicable to child-care facilities, child-care administrators,
and child-placing agency administrators; and
(4) implement and manage programs intended to provide
early intervention or prevent at-risk behaviors that lead to child
abuse, delinquency, running away, truancy, and dropping out of
school.
SECTION 1.19. Effective September 1, 2017, Subchapter A,
Chapter 40, Human Resources Code, is amended by adding Sections
40.0025, 40.0026, and 40.0027 to read as follows:
Sec. 40.0025. AGENCY FUNCTIONS. (a) In this section,
"function" includes a power, duty, program, or activity and an
administrative support services function associated with the
power, duty, program, or activity, unless consolidated under
Section 531.02012, Government Code.
(b) In accordance with Subchapter A-1, Chapter 531,
Government Code, and notwithstanding any other law, the department
performs only functions, including the statewide intake of reports
and other information, related to the following services:
(1) child protective services, including services
that are required by federal law to be provided by this state's
child welfare agency;
(2) adult protective services, other than
investigations of the alleged abuse, neglect, or exploitation of an
elderly person or person with a disability:
(A) in a facility operated, or in a facility or by
a person licensed, certified, or registered, by a state agency; or
(B) by a provider that has contracted to provide
home and community-based services; and
(3) prevention and early intervention services
functions, including:
(A) prevention and early intervention services
as defined under Section 265.001, Family Code; and
(B) programs that:
(i) provide parent education;
(ii) promote healthier parent-child
relationships; or
(iii) prevent family violence.
Sec. 40.0026. REFERENCES IN LAW MEANING DEPARTMENT. In
this code or any other law, a reference to the department in
relation to a function described by Section 40.0025(b) means the
department. A reference in law to the department in relation to any
other function has the meaning assigned by Section 531.0011,
Government Code.
Sec. 40.0027. REFERENCES IN LAW MEANING COMMISSIONER OR
DESIGNEE. In this code or in any other law, a reference to the
commissioner in relation to a function described by Section
40.0025(b) means the commissioner. A reference in law to the
commissioner in relation to any other function has the meaning
assigned by Section 531.0012, Government Code.
SECTION 1.20. Sections 40.0515(d) and (e), Human Resources
Code, are amended to read as follows:
(d) A performance review conducted under Subsection (b)(3)
is considered a performance evaluation for purposes of Section
40.032(c) of this code or Section 531.009(c), Government Code, as
applicable. The department shall ensure that disciplinary or other
corrective action is taken against a supervisor or other managerial
employee who is required to conduct a performance evaluation for
adult protective services personnel under Section 40.032(c) of this
code or Section 531.009(c), Government Code, as applicable, or a
performance review under Subsection (b)(3) and who fails to
complete that evaluation or review in a timely manner.
(e) The annual performance evaluation required under
Section 40.032(c) of this code or Section 531.009(c), Government
Code, as applicable, of the performance of a supervisor in the adult
protective services division must:
(1) be performed by an appropriate program
administrator; and
(2) include:
(A) an evaluation of the supervisor with respect
to the job performance standards applicable to the supervisor's
assigned duties; and
(B) an evaluation of the supervisor with respect
to the compliance of employees supervised by the supervisor with
the job performance standards applicable to those employees'
assigned duties.
SECTION 1.21. (a) The heading to Subchapter C, Chapter
112, Human Resources Code, is amended to read as follows:
SUBCHAPTER C. [OFFICE FOR THE] PREVENTION OF DEVELOPMENTAL
DISABILITIES
(b) Section 112.042, Human Resources Code, is amended by
amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
read as follows:
(1) "Commission" means the Health and Human Services
Commission.
(1-a) "Developmental disability" means a severe,
chronic disability that:
(A) is attributable to a mental or physical
impairment or to a combination of a mental and physical impairment;
(B) is manifested before a person reaches the age
of 22;
(C) is likely to continue indefinitely;
(D) results in substantial functional
limitations in three or more major life activities, including:
(i) self-care;
(ii) receptive and expressive language;
(iii) learning;
(iv) mobility;
(v) self-direction;
(vi) capacity for independent living; and
(vii) economic sufficiency; and
(E) reflects the person's needs for a combination
and sequence of special interdisciplinary or generic care,
treatment, or other lifelong or extended services that are
individually planned and coordinated.
(1-b) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(c) Subchapter C, Chapter 112, Human Resources Code, is
amended by adding Sections 112.0421 and 112.0431 to read as
follows:
Sec. 112.0421. APPLICABILITY AND EXPIRATION OF CERTAIN
PROVISIONS. (a) Sections 112.041(a), 112.043, 112.045, 112.0451,
112.0452, 112.0453, 112.0454, 112.046, 112.047, 112.0471, and
112.0472 apply only until the date the executive commissioner
begins to administer this subchapter and the commission assumes the
duties and functions of the Office for the Prevention of
Developmental Disabilities in accordance with Section 112.0431.
(b) On the date the provisions listed in Subsection (a)
cease to apply, the executive committee under Section 112.045 and
the board of advisors under Section 112.046 are abolished.
(c) This section and Sections 112.041(a), 112.043, 112.045,
112.0451, 112.0452, 112.0453, 112.0454, 112.046, 112.047,
112.0471, and 112.0472 expire on the last day of the period
prescribed by Section 531.02001(2), Government Code.
Sec. 112.0431. ADMINISTRATION OF SUBCHAPTER; CERTAIN
REFERENCES. (a) Notwithstanding any other provision in this
subchapter, the executive commissioner shall administer this
subchapter beginning on the date specified in the transition plan
under Section 531.0204, Government Code, and the commission shall
perform the duties and functions of the Office for the Prevention of
Developmental Disabilities in the organizational form the
executive commissioner determines appropriate.
(b) Following the assumption of the administration of this
subchapter by the executive commissioner and the duties and
functions by the commission in accordance with Subsection (a):
(1) a reference in this subchapter to the office, the
Office for the Prevention of Developmental Disabilities, or the
executive committee of that office means the commission, the
division or other organizational unit within the commission
designated by the executive commissioner, or the executive
commissioner, as appropriate; and
(2) a reference in any other law to the Office for the
Prevention of Developmental Disabilities has the meaning assigned
by Subdivision (1).
(d) Section 112.044, Human Resources Code, is amended to
read as follows:
Sec. 112.044. DUTIES. The office shall:
(1) educate the public and attempt to promote sound
public policy regarding the prevention of developmental
disabilities;
(2) identify, collect, and disseminate information
and data concerning the causes, frequency of occurrence, and
preventability of developmental disabilities;
(3) work with appropriate divisions within the
commission, state agencies, and other entities to develop a
coordinated long-range plan to effectively monitor and reduce the
incidence or severity of developmental disabilities;
(4) promote and facilitate the identification,
development, coordination, and delivery of needed prevention
services;
(5) solicit, receive, and spend grants and donations
from public, private, state, and federal sources;
(6) identify and encourage establishment of needed
reporting systems to track the causes and frequencies of occurrence
of developmental disabilities;
(7) develop, operate, and monitor programs created
under Section 112.048 addressing [task forces to address] the
prevention of specific targeted developmental disabilities;
(8) monitor and assess the effectiveness of divisions
within the commission and of state agencies in preventing [to
prevent] developmental disabilities;
(9) recommend the role each division within the
commission and each state agency should have with regard to
prevention of developmental disabilities;
(10) facilitate coordination of state agency
prevention services and activities within the commission and among
appropriate state agencies; and
(11) encourage cooperative, comprehensive, and
complementary planning among public, private, and volunteer
individuals and organizations engaged in prevention activities,
providing prevention services, or conducting related research.
(e) Sections 112.048 and 112.049, Human Resources Code, are
amended to read as follows:
Sec. 112.048. PREVENTION PROGRAMS FOR TARGETED
DEVELOPMENTAL DISABILITIES [TASK FORCES]. (a) The executive
committee shall establish guidelines for:
(1) selecting targeted disabilities;
(2) assessing prevention services needs; and
(3) reviewing [task force] plans, budgets, and
operations for programs under this section.
(b) The executive committee shall [create task forces made
up of members of the board of advisors to] plan and implement
prevention programs for specifically targeted developmental
disabilities. [A task force operates as an administrative division
of the office and can be abolished when it is ineffective or is no
longer needed.]
(c) A program under this section [task force shall]:
(1) must include [develop] a plan designed to reduce
the incidence of a specifically targeted disability;
(2) must include [prepare] a budget for implementing a
plan;
(3) must be funded [arrange for funds] through:
(A) contracts for services from participating
agencies;
(B) grants and gifts from private persons and
consumer and advocacy organizations; and
(C) foundation support; and
(4) must be approved by [submit the plan, budget, and
evidence of funding commitments to] the executive committee [for
approval].
[(d) A task force shall regularly report to the executive
committee, as required by the committee, the operation, progress,
and results of the task force's prevention plan.]
Sec. 112.049. EVALUATION. (a) The office shall identify
or encourage the establishment of needed statistical bases for each
targeted group against which the office can measure how effectively
a [task force] program under Section 112.048 is reducing the
frequency or severity of a targeted developmental disability.
(b) The executive committee shall regularly monitor and
evaluate the results of [task force prevention] programs under
Section 112.048.
(f) The heading to Section 112.050, Human Resources Code, is
amended to read as follows:
Sec. 112.050. GRANTS AND OTHER FUNDING.
(g) Section 112.050, Human Resources Code, is amended by
amending Subsection (c) and adding Subsection (d) to read as
follows:
(c) The executive committee may not submit a legislative
appropriation request for general revenue funds for purposes of
this subchapter.
(d) In addition to funding under Subsection (a), the office
may accept and solicit gifts, donations, and grants of money from
public and private sources, including the federal government, local
governments, and private entities, to assist in financing the
duties and functions of the office. The commission shall support
office fund-raising efforts authorized by this subsection. Funds
raised under this subsection may only be spent in furtherance of a
duty or function of the office or in accordance with rules
applicable to the office.
(h) Section 112.051, Human Resources Code, is amended to
read as follows:
Sec. 112.051. REPORTS TO LEGISLATURE. The office shall
submit by February 1 of each odd-numbered year biennial reports to
the legislature detailing findings of the office and the results of
[task force prevention] programs under Section 112.048 and
recommending improvements in the delivery of developmental
disability prevention services.
(i) Notwithstanding the changes in law made by this section,
the Office for the Prevention of Developmental Disabilities and any
administrative entity of the Office for the Prevention of
Developmental Disabilities shall continue to operate under the law
as it existed before the effective date of this article, and that
law is continued in effect for that purpose, until the executive
commissioner of the Health and Human Services Commission begins
administering Subchapter C, Chapter 112, Human Resources Code, as
amended by this article, and the commission begins performing the
duties and functions of the Office for the Prevention of
Developmental Disabilities as required by Section 112.0431, Human
Resources Code, as added by this article, on the date specified in
the transition plan required under Section 531.0204, Government
Code, as added by this article.
(j) The executive commissioner of the Health and Human
Services Commission shall begin administering Subchapter C,
Chapter 112, Human Resources Code, as amended by this article, and
the commission shall begin performing the duties and functions of
the Office for the Prevention of Developmental Disabilities as
required by Section 112.0431, Human Resources Code, as added by
this article, on the date specified in the transition plan required
under Section 531.0204, Government Code, as added by this article.
SECTION 1.22. (a) The heading to Chapter 114, Human
Resources Code, is amended to read as follows:
CHAPTER 114. [TEXAS COUNCIL ON] AUTISM AND PERVASIVE DEVELOPMENTAL
DISORDERS
(b) Section 114.002, Human Resources Code, is amended by
adding Subdivisions (1-a) and (3) to read as follows:
(1-a) "Commission" means the Health and Human Services
Commission.
(3) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(c) Chapter 114, Human Resources Code, is amended by adding
Sections 114.0021 and 114.0031 to read as follows:
Sec. 114.0021. APPLICABILITY AND EXPIRATION OF CERTAIN
PROVISIONS. (a) Sections 114.001, 114.003, 114.004, 114.005,
114.007(a), and 114.010(d) apply only until the date the executive
commissioner begins to administer this chapter and the commission
assumes the duties and functions of the Texas Council on Autism and
Pervasive Developmental Disorders in accordance with Section
114.0031.
(b) On the date the provisions listed in Subsection (a)
cease to apply, the Texas Council on Autism and Pervasive
Developmental Disorders is abolished.
(c) This section and Sections 114.001, 114.003, 114.004,
114.005, 114.007(a), and 114.010(d) expire on the last day of the
period prescribed by Section 531.02001(1), Government Code.
Sec. 114.0031. ADMINISTRATION OF CHAPTER; CERTAIN
REFERENCES. (a) Notwithstanding any other provision in this
chapter, the executive commissioner shall administer this chapter
beginning on the date specified in the transition plan under
Section 531.0204, Government Code, and the commission shall perform
the duties and functions of the Texas Council on Autism and
Pervasive Developmental Disorders in the organizational form the
executive commissioner determines appropriate.
(b) Following the assumption of the administration of this
chapter by the executive commissioner and the duties and functions
by the commission in accordance with Subsection (a):
(1) a reference in this chapter to the council, the
Texas Council on Autism and Pervasive Developmental Disorders, or
an agency represented on the council means the commission, the
division or other organizational unit within the commission
designated by the executive commissioner, or the executive
commissioner, as appropriate; and
(2) a reference in any other law to the Texas Council
on Autism and Pervasive Developmental Disorders has the meaning
assigned by Subdivision (1).
(d) Section 114.006(b), Human Resources Code, is amended to
read as follows:
(b) The council shall make written recommendations on the
implementation of this chapter. If the council considers a
recommendation that will affect another state [an] agency [not
represented on the council], the council shall seek the advice and
assistance of the agency before taking action on the
recommendation. On approval of the governing body of the agency,
each agency affected by a council recommendation shall implement
the recommendation. If an agency does not have sufficient funds to
implement a recommendation, the agency shall request funds for that
purpose in its next budget proposal.
(e) Sections 114.007(b) and (c), Human Resources Code, are
amended to read as follows:
(b) The council with [the advice of the advisory task force
and] input from people with autism and other pervasive
developmental disorders, their families, and related advocacy
organizations shall address contemporary issues affecting services
available to persons with autism or other pervasive developmental
disorders in this state, including:
(1) successful intervention and treatment strategies,
including transitioning;
(2) personnel preparation and continuing education;
(3) referral, screening, and evaluation services;
(4) day care, respite care, or residential care
services;
(5) vocational and adult training programs;
(6) public awareness strategies;
(7) contemporary research;
(8) early identification strategies;
(9) family counseling and case management; and
(10) recommendations for monitoring autism service
programs.
(c) The council with [the advice of the advisory task force
and] input from people with autism and other pervasive
developmental disorders, their families, and related advocacy
organizations shall advise the legislature on legislation that is
needed to develop further and to maintain a statewide system of
quality intervention and treatment services for all persons with
autism or other pervasive developmental disorders. The council may
develop and recommend legislation to the legislature or comment on
pending legislation that affects those persons.
(f) Section 114.008, Human Resources Code, is amended to
read as follows:
Sec. 114.008. REPORT. (a) [The agencies represented on
the council and the public members shall report to the council any
requirements identified by the agency or person to provide
additional or improved services to persons with autism or other
pervasive developmental disorders.] Not later than November 1 of
each even-numbered year, the council shall:
(1) prepare a report summarizing requirements the
council identifies and recommendations for providing additional or
improved services to persons with autism or other pervasive
developmental disorders; and
(2) deliver the report to the executive commissioner
[of the Health and Human Services Commission], the governor, the
lieutenant governor, and the speaker of the house of
representatives [a report summarizing the recommendations].
(b) The council shall develop a strategy for establishing
new programs to meet the requirements identified through the
council's review and assessment and from input from [the task
force,] people with autism and related pervasive developmental
disorders, their families, and related advocacy organizations.
(g) Section 114.013, Human Resources Code, is amended to
read as follows:
Sec. 114.013. COORDINATION OF RESOURCES FOR INDIVIDUALS
WITH AUTISM SPECTRUM DISORDERS [RESOURCE CENTER]. (a) The
commission [Health and Human Services Commission] shall [establish
and administer an autism spectrum disorders resource center to]
coordinate resources for individuals with autism and other
pervasive developmental disorders and their families. In
coordinating those resources [establishing and administering the
center], the commission [Health and Human Services Commission]
shall consult with [the council and coordinate with] appropriate
state agencies[, including each agency represented on the council].
(b) As part of coordinating resources under Subsection (a),
the commission [The Health and Human Services Commission] shall
[design the center to]:
(1) collect and distribute information and research
regarding autism and other pervasive developmental disorders;
(2) conduct training and development activities for
persons who may interact with an individual with autism or another
pervasive developmental disorder in the course of their employment,
including school, medical, or law enforcement personnel;
(3) coordinate with local entities that provide
services to an individual with autism or another pervasive
developmental disorder; and
(4) provide support for families affected by autism
and other pervasive developmental disorders.
(h) Notwithstanding the changes in law made by this section,
the Texas Council on Autism and Pervasive Developmental Disorders
and any administrative entity of the Texas Council on Autism and
Pervasive Developmental Disorders shall continue to operate under
the law as it existed before the effective date of this article, and
that law is continued in effect for that purpose, until the
executive commissioner of the Health and Human Services Commission
begins administering Chapter 114, Human Resources Code, as amended
by this article, and the commission begins performing the duties
and functions of the Texas Council on Autism and Pervasive
Developmental Disorders as required by Section 114.0031, Human
Resources Code, as added by this article, on the date specified in
the transition plan required under Section 531.0204, Government
Code, as added by this article.
(i) The executive commissioner of the Health and Human
Services Commission shall begin administering Chapter 114, Human
Resources Code, as amended by this article, and the commission
shall begin performing the duties and functions of the Texas
Council on Autism and Pervasive Developmental Disorders as required
by Section 114.0031, Human Resources Code, as added by this
article, on the date specified in the transition plan required
under Section 531.0204, Government Code, as added by this article.
SECTION 1.23. (a) Effective September 1, 2016, the
following provisions of the Government Code, including provisions
amended by S.B. No. 219, Acts of the 84th Legislature, Regular
Session, 2015, are repealed:
(1) Section 531.0235; and
(2) Subchapter K, Chapter 531.
(b) Effective September 1, 2016, the following provisions
of the Health and Safety Code are repealed:
(1) Section 1001.021;
(2) Section 1001.022;
(3) Section 1001.023;
(4) Section 1001.024;
(5) Section 1001.025;
(6) Section 1001.026; and
(7) Section 1001.027.
(c) Effective September 1, 2016, the following provisions
of the Human Resources Code, including provisions added or amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015,
are repealed:
(1) Section 40.021;
(2) Section 40.022;
(3) Section 40.0226;
(4) Section 40.024;
(5) Section 40.025;
(6) Section 40.026;
(7) Section 117.002;
(8) Section 117.021;
(9) Section 117.022;
(10) Section 117.023;
(11) Section 117.024;
(12) Section 117.025;
(13) Section 117.026;
(14) Section 117.027;
(15) Section 117.028;
(16) Section 117.029;
(17) Section 117.030;
(18) Section 117.032;
(19) Section 117.051;
(20) Section 117.052;
(21) Section 117.053;
(22) Section 117.054;
(23) Section 117.055;
(24) Section 117.056;
(25) Section 117.0711;
(26) Section 117.0712;
(27) Section 117.072;
(28) Section 161.021;
(29) Section 161.022;
(30) Section 161.023;
(31) Section 161.024;
(32) Section 161.025;
(33) Section 161.026;
(34) Section 161.027;
(35) Section 161.028;
(36) Section 161.029; and
(37) Section 161.030.
(d) Effective September 1, 2017, Section 531.0055(i),
Government Code, is repealed.
(e) Effective September 1, 2017, the following provisions
of the Human Resources Code, including provisions added or amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015,
are repealed:
(1) Section 161.002;
(2) Section 161.032;
(3) Section 161.051;
(4) Section 161.052;
(5) Section 161.053;
(6) Section 161.054;
(7) Section 161.055;
(8) Section 161.056;
(9) Section 161.0711;
(10) Section 161.0712; and
(11) Section 161.072.
(f) Notwithstanding Subsections (a), (b), (c), (d), and (e)
of this section, the implementation of a provision repealed by one
of those subsections ceases on the date the responsible state
agency or entity listed in Section 531.0202, Government Code, as
added by this article, is abolished as provided by Subchapter A-1,
Chapter 531, Government Code, as added by this article.
ARTICLE 2. HEALTH AND HUMAN SERVICES SYSTEM OPERATIONS
SECTION 2.01. Section 531.001, Government Code, is amended
by adding Subdivision (3-a) to read as follows:
(3-a) "Health and human services system" means the
system for providing or otherwise administering health and human
services in this state by the commission, including through an
office or division of the commission or through another entity
under the administrative and operational control of the executive
commissioner.
SECTION 2.02. Subchapter A, Chapter 531, Government Code,
is amended by adding Section 531.00552 to read as follows:
Sec. 531.00552. CONSOLIDATED INTERNAL AUDIT PROGRAM.
(a) Notwithstanding Section 2102.005, the commission shall
operate the internal audit program required under Chapter 2102 for
the commission and each health and human services agency as a
consolidated internal audit program.
(b) For purposes of this section, a reference in Chapter
2102 to the administrator of a state agency with respect to a health
and human services agency means the executive commissioner.
SECTION 2.03. Section 531.006, Government Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
Sec. 531.006. ELIGIBILITY FOR APPOINTMENT AS EXECUTIVE
COMMISSIONER; EMPLOYEE RESTRICTIONS. (a) In this section, "Texas
trade association" means a cooperative and voluntarily joined
statewide association of business or professional competitors in
this state designed to assist its members and its industry or
profession in dealing with mutual business or professional problems
and in promoting their common interest.
(a-1) A person may not be appointed [is not eligible for
appointment] as executive commissioner, may not serve on the
commission's executive council, and may not be a commission
employee employed in a "bona fide executive, administrative, or
professional capacity," as that phrase is used for purposes of
establishing an exemption to the overtime provisions of the federal
Fair Labor Standards Act of 1938 (29 U.S.C. Section 201 et seq.) if:
(1) the person is an officer, employee, or paid
consultant of a Texas trade association in the field of health and
human services; or
(2) the person's spouse is an [employee,] officer,
manager, or paid consultant of a Texas trade association in the [a]
field of health and human services [under the commission's
jurisdiction].
(b) A person may not be appointed as executive commissioner
or act as general counsel of the commission if the person [who] is
required to register as a lobbyist under Chapter 305 because of the
person's activities for compensation [in or] on behalf of a
profession related to the operation of the commission [a field
under the commission's jurisdiction may not serve as executive
commissioner].
(c) A person may not be appointed [is not eligible for
appointment] as executive commissioner if the person has a
financial interest in a corporation, organization, or association
under contract with:
(1) the commission or a health and human services
agency [Department of State Health Services, if the contract
involves mental health services];
(2) [the Department of Aging and Disability Services,
if the contract involves intellectual and developmental disability
services;
[(3)] a local mental health or intellectual and
developmental disability authority; or
(3) [(4)] a community center.
SECTION 2.04. Section 531.0161, Government Code, is amended
by adding Subsection (c) to read as follows:
(c) The commission shall:
(1) coordinate the implementation of the policy
developed under Subsection (a);
(2) provide training as needed to implement the
procedures for negotiated rulemaking or alternative dispute
resolution; and
(3) collect data concerning the effectiveness of those
procedures.
SECTION 2.05. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0164 to read as follows:
Sec. 531.0164. HEALTH AND HUMAN SERVICES SYSTEM INTERNET
WEBSITE COORDINATION. The commission shall establish a process to
ensure Internet websites across the health and human services
system are developed and maintained according to standard criteria
for uniformity, efficiency, and technical capabilities. Under the
process, the commission shall:
(1) develop and maintain an inventory of all health
and human services system Internet websites;
(2) on an ongoing basis, evaluate the inventory
maintained under Subdivision (1) to:
(A) determine whether any of the Internet
websites should be consolidated to improve public access to those
websites' content; and
(B) ensure the Internet websites comply with the
standard criteria; and
(3) if appropriate, consolidate the websites
identified under Subdivision (2)(A).
(b) As soon as possible after the effective date of this
article, the Health and Human Services Commission shall implement
Section 531.0164, Government Code, as added by this article.
(c) As soon as possible after a function is transferred in
accordance with Section 531.0201, 531.02011, or 531.02012,
Government Code, as added by this Act, the Health and Human Services
Commission shall, in accordance with Section 531.0164, Government
Code, as added by this article, ensure that an Internet website
related to the transferred function is updated, transferred, or
consolidated to reflect the consolidation mandated by Subchapter
A-1, Chapter 531, Government Code, as added by this Act.
SECTION 2.06. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0171 to read as follows:
Sec. 531.0171. OFFICE OF OMBUDSMAN. (a) The executive
commissioner shall establish the commission's office of the
ombudsman with authority and responsibility over the health and
human services system in performing the following functions:
(1) providing dispute resolution services for the
health and human services system;
(2) performing consumer protection and advocacy
functions related to health and human services, including assisting
a consumer or other interested person with:
(A) raising a matter within the health and human
services system that the person feels is being ignored; and
(B) obtaining information regarding a filed
complaint; and
(3) collecting inquiry and complaint data related to
the health and human services system.
(b) The office of the ombudsman does not have the authority
to provide a separate process for resolving complaints or appeals.
(c) The executive commissioner shall develop a standard
process for tracking and reporting received inquiries and
complaints within the health and human services system. The
process must provide for the centralized tracking of inquiries and
complaints submitted to field, regional, or other local health and
human services system offices.
(d) Using the process developed under Subsection (c), the
office of the ombudsman shall collect inquiry and complaint data
from all offices, agencies, divisions, and other entities within
the health and human services system. To assist with the collection
of data under this subsection, the office may access any system or
process for recording inquiries and complaints used or maintained
within the health and human services system.
(b) As soon as possible after the effective date of this
article, the executive commissioner of the Health and Human
Services Commission shall implement Section 531.0171, Government
Code, as added by this article.
(c) Notwithstanding any other provision of state law but
except as provided by Subsection (d) of this section:
(1) each office of an ombudsman established before the
effective date of this section that performs ombudsman duties for a
state agency or entity subject to abolition under Section 531.0202,
Government Code, as added by this Act, is abolished on the date the
state agency or entity for which the office performs ombudsman
duties is abolished in accordance with the transition plan under
Section 531.0204, Government Code, as added by this Act; and
(2) each office of an ombudsman established before the
effective date of this section that performs ombudsman duties for
the Department of Family and Protective Services or the Department
of State Health Services is abolished on the date specified in the
transition plan under Section 531.0204, Government Code, as added
by this Act.
(d) The following offices of an ombudsman are not abolished
under Subsection (c) of this section and continue in existence:
(1) the office of independent ombudsman for state
supported living centers established under Subchapter C, Chapter
555, Health and Safety Code;
(2) the office of the state long-term care ombudsman;
and
(3) any other ombudsman office serving all or part of
the health and human services system that is required by federal
law.
(e) The executive commissioner of the Health and Human
Services Commission shall certify which offices of ombudsman are
abolished, and which are exempt from abolition, under Subsection
(d) of this section and shall publish that certification in the
Texas Register not later than September 1, 2016.
SECTION 2.07. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0192 to read as follows:
Sec. 531.0192. HEALTH AND HUMAN SERVICES SYSTEM HOTLINE AND
CALL CENTER COORDINATION. (a) The commission shall establish a
process to ensure all health and human services system hotlines and
call centers are necessary and appropriate. Under the process, the
commission shall:
(1) develop criteria for use in assessing whether a
hotline or call center serves an ongoing purpose;
(2) develop and maintain an inventory of all system
hotlines and call centers;
(3) use the inventory and assessment criteria
developed under this subsection to periodically consolidate
hotlines and call centers along appropriate functional lines;
(4) develop an approval process designed to ensure
that a newly established hotline or call center, including the
telephone system and contract terms for the hotline or call center,
meets policies and standards established by the commission; and
(5) develop policies and standards for hotlines and
call centers that include both quality and quantity performance
measures and benchmarks and may include:
(A) client satisfaction with call resolution;
(B) accuracy of information provided;
(C) the percentage of received calls that are
answered;
(D) the amount of time a caller spends on hold;
and
(E) call abandonment rates.
(a-1) In developing policies and standards under Subsection
(a)(5), the commission may allow varied performance measures and
benchmarks for a hotline or call center based on factors affecting
the capacity of the hotline or call center, including factors such
as staffing levels and funding.
(b) In consolidating hotlines and call centers under
Subsection (a)(3), the commission shall seek to maximize the use
and effectiveness of the commission's 2-1-1 telephone number.
(b) As soon as possible after the effective date of this
article, the Health and Human Services Commission shall implement
Section 531.0192, Government Code, as added by this article.
(c) Not later than March 1, 2016, the Health and Human
Services Commission shall complete an initial assessment and
consolidation of hotlines and call centers, as required by Section
531.0192, Government Code, as added by this article.
(d) As soon as possible after a function is transferred in
accordance with Section 531.0201 or 531.02011, Government Code, as
added by this Act, the Health and Human Services Commission shall,
in accordance with Section 531.0192, Government Code, as added by
this article, ensure a hotline or call center related to the
transferred function is transferred or consolidated to reflect the
consolidation mandated by Subchapter A-1, Chapter 531, Government
Code, as added by this Act.
SECTION 2.08. (a) Section 531.02111(b), Government Code,
as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(b) The report must include:
(1) for each state agency described by Subsection (a):
(A) a description of each of the components of
Medicaid operated by the agency; and
(B) an accounting of all funds related to
Medicaid received and disbursed by the agency during the period
covered by the report, including:
(i) the amount of any federal Medicaid
funds allocated to the agency for the support of each of the
Medicaid components operated by the agency;
(ii) the amount of any funds appropriated
by the legislature to the agency for each of those components; and
(iii) the amount of Medicaid payments and
related expenditures made by or in connection with each of those
components; and
(2) for each Medicaid component identified in the
report:
(A) the amount and source of funds or other
revenue received by or made available to the agency for the
component; [and]
(B) the amount spent on each type of service or
benefit provided by or under the component;
(C) the amount spent on component operations,
including eligibility determination, claims processing, and case
management; and
(D) the amount spent on any other administrative
costs [information required by Section 531.02112(b)].
(b) The following provisions, including provisions amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015,
are repealed:
(1) Section 531.02112, Government Code;
(2) Sections 531.03131(f) and (g), Government Code;
(3) Section 2155.144(o), Government Code; and
(4) Section 22.0251(b), Human Resources Code.
SECTION 2.09. Subchapter B, Chapter 531, Government Code,
is amended by adding Section 531.02114 to read as follows:
Sec. 531.02114. DENTAL DIRECTOR. The executive
commissioner shall appoint for Medicaid a dental director who is a
licensed dentist under Subtitle D, Title 3, Occupations Code, and
rules adopted under that subtitle by the State Board of Dental
Examiners.
SECTION 2.10. (a) Subchapter B, Chapter 531, Government
Code, is amended by adding Section 531.02118 to read as follows:
Sec. 531.02118. STREAMLINING MEDICAID PROVIDER ENROLLMENT
AND CREDENTIALING PROCESSES. (a) The commission shall streamline
provider enrollment and credentialing processes under Medicaid.
(b) In streamlining the Medicaid provider enrollment
process, the commission shall establish a centralized Internet
portal through which providers may enroll in Medicaid. The
commission may use the Internet portal created under this
subsection to create a single, consolidated Medicaid provider
enrollment and credentialing process.
(c) In streamlining the Medicaid provider credentialing
process under this section, the commission may designate a
centralized credentialing entity and may:
(1) share information in the database established
under Subchapter C, Chapter 32, Human Resources Code, with the
centralized credentialing entity; and
(2) require all managed care organizations
contracting with the commission to provide health care services to
Medicaid recipients under a managed care plan issued by the
organization to use the centralized credentialing entity as a hub
for the collection and sharing of information.
(d) If cost-effective, the commission may contract with a
third party to develop the single, consolidated Medicaid provider
enrollment and credentialing process authorized under Subsection
(b).
(b) The Health and Human Services Commission shall
streamline provider enrollment and credentialing processes as
required under Section 531.02118, Government Code, as added by this
article, not later than September 1, 2016.
SECTION 2.11. (a) Section 531.02141, Government Code, is
amended by adding Subsections (c), (d), and (e) to read as follows:
(c) The commission shall regularly evaluate data submitted
by managed care organizations that contract with the commission
under Chapter 533 to determine whether:
(1) the data continues to serve a useful purpose; and
(2) additional data is needed to oversee contracts or
evaluate the effectiveness of Medicaid.
(d) The commission shall collect Medicaid managed care data
that effectively captures the quality of services received by
Medicaid recipients.
(e) The commission shall develop a dashboard for agency
leadership that is designed to assist leadership with overseeing
Medicaid and comparing the performance of managed care
organizations participating in Medicaid. The dashboard must
identify a concise number of important Medicaid indicators,
including key data, performance measures, trends, and problems.
(b) Not later than March 1, 2016, the Health and Human
Services Commission shall develop the dashboard required by Section
531.02141(e), Government Code, as added by this article.
SECTION 2.12. Subchapter B, Chapter 531, Government Code,
is amended by adding Section 531.02221 to read as follows:
Sec. 531.02221. WOMEN'S HEALTH ADVISORY COMMITTEE.
(a) The executive commissioner shall establish a women's health
advisory committee to provide recommendations to the commission on
the consolidation of women's health programs.
(b) The executive commissioner shall appoint members to the
advisory committee and ensure that a majority of the members are
health care providers who:
(1) are participating in women's health programs of
various sizes;
(2) are located in separate geographic areas of this
state; and
(3) have experience in operating women's health
programs.
(c) The executive commissioner may appoint a member not
described by Subsection (b) to the women's health advisory
committee who represents the women's health industry and is
knowledgeable on the best practices for women's health programs.
(d) The executive commissioner shall establish the women's
health advisory committee not later than October 15, 2015.
(e) The women's health advisory committee is abolished and
this section expires September 1, 2017.
SECTION 2.13. Subchapter B, Chapter 531, Government Code,
is amended by adding Section 531.02731 to read as follows:
Sec. 531.02731. REPORT OF INFORMATION RESOURCES MANAGER TO
COMMISSION. Notwithstanding Section 2054.075(b), the information
resources manager of a health and human services agency shall
report directly to the executive commissioner or a deputy executive
commissioner designated by the executive commissioner.
SECTION 2.14. Section 531.102, Government Code, is amended
by adding Subsections (p) and (q) to read as follows:
(p) In accordance with Section 533.015(b), the office shall
consult with the executive commissioner regarding the adoption of
rules defining the office's role in and jurisdiction over, and the
frequency of, audits of managed care organizations participating in
Medicaid that are conducted by the office and the commission.
(q) The office shall coordinate all audit and oversight
activities, including the development of audit plans, risk
assessments, and findings, with the commission to minimize the
duplication of activities. In coordinating activities under this
subsection, the office shall:
(1) on an annual basis, seek input from the commission
and consider previous audits and onsite visits made by the
commission for purposes of determining whether to audit a managed
care organization participating in Medicaid; and
(2) request the results of any informal audit or
onsite visit performed by the commission that could inform the
office's risk assessment when determining whether to conduct, or
the scope of, an audit of a managed care organization participating
in Medicaid.
SECTION 2.15. (a) Section 531.1031(a), Government Code,
as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(a) In this section and Sections 531.1032, 531.1033, and
531.1034:
(1) "Health care professional" means a person issued a
license[, registration, or certification] to engage in a health
care profession.
(1-a) "License" means a license, certificate,
registration, permit, or other authorization that:
(A) is issued by a licensing authority; and
(B) must be obtained before a person may practice
or engage in a particular business, occupation, or profession.
(1-b) "Licensing authority" means a department,
commission, board, office, or other agency of the state that issues
a license.
(1-c) "Office" means the commission's office of
inspector general unless a different meaning is plainly required by
the context in which the term appears.
(2) "Participating agency" means:
(A) the Medicaid fraud enforcement divisions of
the office of the attorney general;
(B) each licensing authority [board or agency]
with authority to issue a license to[, register, regulate, or
certify] a health care professional or managed care organization
that may participate in Medicaid; and
(C) the [commission's] office [of inspector
general].
(3) "Provider" has the meaning assigned by Section
531.1011(10)(A).
(b) Subchapter C, Chapter 531, Government Code, is amended
by adding Sections 531.1032, 531.1033, and 531.1034 to read as
follows:
Sec. 531.1032. OFFICE OF INSPECTOR GENERAL: CRIMINAL
HISTORY RECORD INFORMATION CHECK. (a) The office and each
licensing authority that requires the submission of fingerprints
for the purpose of conducting a criminal history record information
check of a health care professional shall enter into a memorandum of
understanding to ensure that only persons who are licensed and in
good standing as health care professionals participate as providers
in Medicaid. The memorandum under this section may be combined with
a memorandum authorized under Section 531.1031(c-1) and must
include a process by which:
(1) the office may confirm with a licensing authority
that a health care professional is licensed and in good standing for
purposes of determining eligibility to participate in Medicaid; and
(2) the licensing authority immediately notifies the
office if:
(A) a provider's license has been revoked or
suspended; or
(B) the licensing authority has taken
disciplinary action against a provider.
(b) The office may not, for purposes of determining a health
care professional's eligibility to participate in Medicaid as a
provider, conduct a criminal history record information check of a
health care professional who the office has confirmed under
Subsection (a) is licensed and in good standing. This subsection
does not prohibit the office from performing a criminal history
record information check of a provider that is required or
appropriate for other reasons, including for conducting an
investigation of fraud, waste, or abuse.
(c) For purposes of determining eligibility to participate
in Medicaid and subject to Subsection (d), the office, after
seeking public input from various geographic areas across this
state, either in person or through teleconferencing centers, shall
establish and the executive commissioner by rule shall adopt
guidelines for the evaluation of criminal history record
information of providers and potential providers. The guidelines
must outline conduct, by provider type, that may be contained in
criminal history record information that will result in exclusion
of a person from Medicaid as a provider, taking into consideration:
(1) the extent to which the underlying conduct relates
to the services provided under Medicaid;
(2) the degree to which the person would interact with
Medicaid recipients as a provider; and
(3) any previous evidence that the person engaged in
fraud, waste, or abuse under Medicaid.
(d) The guidelines adopted under Subsection (c) may not
impose stricter standards for the eligibility of a person to
participate in Medicaid than a licensing authority described by
Subsection (a) requires for the person to engage in a health care
profession without restriction in this state.
(e) The office and the commission shall use the guidelines
adopted under Subsection (c) to determine whether a provider
participating in Medicaid continues to be eligible to participate
in Medicaid as a provider.
(f) The provider enrollment contractor, if applicable, and
a managed care organization participating in Medicaid shall defer
to the office regarding whether a person's criminal history record
information precludes the person from participating in Medicaid as
a provider.
Sec. 531.1033. MONITORING OF CERTAIN FEDERAL DATABASES.
The office shall routinely check appropriate federal databases,
including databases referenced in 42 C.F.R. Section 455.436, to
ensure that a person who is excluded from participating in Medicaid
or in the Medicare program by the federal government is not
participating as a provider in Medicaid.
Sec. 531.1034. TIME TO DETERMINE PROVIDER ELIGIBILITY;
PERFORMANCE METRICS. (a) Not later than the 10th day after the
date the office receives the complete application of a health care
professional seeking to participate in Medicaid, the office shall
inform the commission or the health care professional, as
appropriate, of the office's determination regarding whether the
health care professional should be denied participation in Medicaid
based on:
(1) information concerning the licensing status of the
health care professional obtained as described by Section
531.1032(a);
(2) information contained in the criminal history
record information check that is evaluated in accordance with
guidelines adopted under Section 531.1032(c);
(3) a review of federal databases under Section
531.1033;
(4) the pendency of an open investigation by the
office; or
(5) any other reason the office determines
appropriate.
(b) Completion of an on-site visit of a health care
professional during the period prescribed by Subsection (a) is not
required.
(c) The office shall develop performance metrics to measure
the length of time for conducting a determination described by
Subsection (a) with respect to applications that are complete when
submitted and all other applications.
(c) Not later than September 1, 2016, the executive
commissioner of the Health and Human Services Commission shall
adopt the guidelines required under Section 531.1032(c),
Government Code, as added by this section.
SECTION 2.16. (a) Section 531.251, Government Code, as
amended by S.B. No. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
Sec. 531.251. TEXAS SYSTEM OF CARE FRAMEWORK [CONSORTIUM].
(a) In this section:
(1) "Minor" means an individual younger than 18 years
of age.
(2) "Serious emotional disturbance" means a mental,
behavioral, or emotional disorder of sufficient duration to result
in functional impairment that substantially interferes with or
limits a person's role or ability to function in family, school, or
community activities.
(3) "System of care framework" means a framework for
collaboration among state agencies, minors who have a serious
emotional disturbance or are at risk of developing a serious
emotional disturbance, and the families of those minors that
improves access to services and delivers effective community-based
services that are family-driven, youth- or young adult-guided, and
culturally and linguistically competent.
(b) The commission shall implement [form a consortium to
have responsibility for and oversight over] a [state] system of
care framework to develop local mental health systems of care in
communities for minors who are receiving residential mental health
services and supports or inpatient mental health hospitalization,
have or are at risk of developing a serious emotional disturbance,
or [who] are at risk of being removed from the minor's home and
placed in a more restrictive environment to receive mental health
services and supports, including an inpatient mental health
hospital, a residential treatment facility, or a facility or
program operated by the Department of Family and Protective
Services or an agency that is part of the juvenile justice system.
(c) [(a-1) The consortium must include:
[(1) representatives of the Department of State Health
Services, Department of Family and Protective Services,
commission's Medicaid program, Texas Education Agency, Texas
Juvenile Justice Department, and Texas Correctional Office on
Offenders with Medical or Mental Impairments; and
[(2) one member who is:
[(A) a youth or young adult who has a serious
emotional disturbance and has received mental health services and
supports; or
[(B) a family member of a youth or young adult
described by Paragraph (A).
[(a-2) The consortium may coordinate with the Children's
Policy Council for the purposes of including the representation
required by Subsection (a-1)(2).
[(b)] The commission [and the consortium] shall:
(1) maintain a comprehensive plan for the delivery of
mental health services and supports to a minor and a minor's family
using a system of care framework, including best practices in the
financing, administration, governance, and delivery of those
services;
(2) enter memoranda of understanding with the
Department of State Health Services, the Department of Family and
Protective Services, the Texas Education Agency, the Texas Juvenile
Justice Department, and the Texas Correctional Office on Offenders
with Medical or Mental Impairments that specify the roles and
responsibilities of each agency in implementing the comprehensive
plan described by Subdivision (1) [implement strategies to expand
the use of system of care practices in the planning and delivery of
services throughout the state];
(3) identify appropriate local, state, and federal
funding sources to finance infrastructure and mental health
services and supports needed to support state and local system of
care framework efforts; [and]
(4) develop an evaluation system to measure
cross-system performance and outcomes of state and local system of
care framework efforts; and
(5) in implementing the provisions of this section,
consult with stakeholders, including:
(A) minors who have or are at risk of developing a
serious emotional disturbance or young adults who received mental
health services and supports as a minor with or at risk of
developing a serious emotional disturbance; and
(B) family members of those minors or young
adults.
[(b-1) Not later than November 1 of each even-numbered year,
the consortium shall submit a report to the legislature and the
Council on Children and Families that contains an evaluation of the
outcomes of the Texas System of Care and recommendations on
strengthening state policies and practices that support local
systems of care, including recommendations relating to:
[(1) methods to increase access to effective and
coordinated services and supports;
[(2) methods to increase community capacity to
implement local systems of care through training and technical
assistance;
[(3) use of cross-system performance and outcome data
to make informed decisions at individual and system levels; and
[(4) strategies to maximize public and private funding
at the local, state, and federal levels.]
(b) Section 531.255, Government Code, is amended to read as
follows:
Sec. 531.255. EVALUATION. [(a)] The commission [and the
Department of State Health Services jointly] shall monitor the
implementation of a system of care framework under Section 531.251
and adopt rules as necessary to facilitate or adjust that
implementation [progress of the communities that implement a local
system of care, including monitoring cost avoidance and the net
savings that result from implementing a local system of care].
SECTION 2.17. (a) Chapter 531, Government Code, is amended
by adding Subchapter M to read as follows:
SUBCHAPTER M. COORDINATION OF QUALITY INITIATIVES
Sec. 531.451. OPERATIONAL PLAN TO COORDINATE INITIATIVES.
(a) The commission shall develop and implement a comprehensive,
coordinated operational plan to ensure a consistent approach across
the major quality initiatives of the health and human services
system for improving the quality of health care.
(b) The operational plan developed under this section must
include broad goals for the improvement of the quality of health
care in this state, including health care services provided through
Medicaid.
(c) The operational plan under this section may evaluate:
the Delivery System Reform Incentive Payment (DSRIP) program under
the Texas Health Care Transformation and Quality Improvement
Program waiver issued under Section 1115 of the federal Social
Security Act (42 U.S.C. Section 1315), enhancing funding to
disproportionate share hospitals in the state, Section 1332 of 42
U.S.C. Section 18052, enhancing uncompensated care pool payments to
hospitals in the state under the Texas Health Care Transformation
and Quality Improvement Program waiver issued under Section 1115 of
the federal Social Security Act (42 U.S.C. Section 1315), home and
community-based services state plan options under Section 1915(i)
of the federal Social Security Act (42 U.S.C. Section 1396n), and a
contingency plan in the event the commission does not obtain an
extension or renewal of the uncompensated care pool provisions or
any other provisions of the Texas Health Care Transformation and
Quality Improvement Program waiver issued under Section 1115 of the
federal Social Security Act (42 U.S.C. Section 1315).
Sec. 531.452. REVISION OF MAJOR INITIATIVES.
Notwithstanding any other law, the commission shall revise major
quality initiatives of the health and human services system in
accordance with the operational plan and health care quality
improvement goals developed under Section 531.451. To the extent
it is possible, the commission shall ensure that outcome measure
data is collected and reported consistently across all major
quality initiatives to improve the evaluation of the initiatives'
statewide impact.
Sec. 531.453. INCENTIVES FOR INITIATIVE COORDINATION. The
commission shall consider and, if the commission determines it
appropriate, develop incentives that promote coordination among
the various major quality initiatives in accordance with this
subchapter, including projects and initiatives approved under the
Texas Health Care Transformation and Quality Improvement Program
waiver issued under Section 1115 of the federal Social Security Act
(42 U.S.C. Section 1315).
Sec. 531.454. RENEWAL OF FEDERAL AUTHORIZATION FOR MEDICAID
REFORM. (a) When the commission seeks to renew the Texas Health
Care Transformation and Quality Improvement Program waiver issued
under Section 1115 of the federal Social Security Act (42 U.S.C.
Section 1315), the commission shall, to the extent permitted under
federal law:
(1) seek to reduce the number of approved project
options that may be funded under the waiver using delivery system
reform incentive payments to include only those projects that are:
(A) the most critical for improving the quality
of health care, including behavioral health services; and
(B) consistent with the operational plan and
health care quality improvement goals developed under Section
531.451; and
(2) allow a delivery system reform incentive payment
project that, as a result of Subdivision (1), is no longer an option
under the waiver, to continue operating as long as the project meets
funding requirements and outcome objectives.
(b) In reducing the number of approved project options under
Subsection (a), the commission shall take into consideration the
diversity of local and regional health care needs in this state.
(c) This section expires September 1, 2017.
(b) As soon as possible after the effective date of this
article, the Health and Human Services Commission shall develop the
operational plan and perform the other actions corresponding with
the operational plan as required under Subchapter M, Chapter 531,
Government Code, as added by this article.
SECTION 2.18. Section 533.00255(a), Government Code, is
amended to read as follows:
(a) In this section, "behavioral health services" means
mental health and substance abuse disorder services[, other than
those provided through the NorthSTAR demonstration project].
SECTION 2.19. Section 533.00255, Government Code, is
amended by adding Subsection (a-1) to read as follows:
(a-1) Notwithstanding Subsection (a), for purposes of this
section, the term "behavioral health services" does not include
mental health and substance disorder services provided through the
NorthSTAR demonstration project. This subsection expires on the
later of the following dates:
(1) January 1, 2017; or
(2) the last day of the transition deadline for the
cessation of the NorthSTAR Behavioral Health Services model if that
deadline is extended in accordance with provisions of H.B. No. 1,
Acts of the 84th Legislature, Regular Session, 2015 (the General
Appropriations Act), by written approval of the Legislative Budget
Board or the governor.
SECTION 2.20. Subchapter A, Chapter 533, Government Code,
is amended by adding Section 533.002551 to read as follows:
Sec. 533.002551. MONITORING OF COMPLIANCE WITH BEHAVIORAL
HEALTH INTEGRATION. (a) In this section, "behavioral health
services" has the meaning assigned by Section 533.00255.
(b) In monitoring contracts the commission enters into with
managed care organizations under this chapter, the commission
shall:
(1) ensure managed care organizations fully integrate
behavioral health services into a recipient's primary care
coordination;
(2) use performance audits and other oversight tools
to improve monitoring of the provision and coordination of
behavioral health services; and
(3) establish performance measures that may be used to
determine the effectiveness of the integration of behavioral health
services.
(c) In monitoring a managed care organization's compliance
with behavioral health services integration requirements under
this section, the commission shall give particular attention to a
managed care organization that provides behavioral health services
through a contract with a third party.
SECTION 2.21. Subchapter A, Chapter 533, Government Code,
is amended by adding Section 533.0061 to read as follows:
Sec. 533.0061. FREQUENCY OF PROVIDER CREDENTIALING. A
managed care organization that contracts with the commission to
provide health care services to Medicaid recipients under a managed
care plan issued by the organization shall formally recredential a
physician or other provider with the frequency required by the
single, consolidated Medicaid provider enrollment and
credentialing process, if that process is created under Section
531.02118. The required frequency of recredentialing may be less
frequent than once in any three-year period, notwithstanding any
other law.
SECTION 2.22. Subchapter A, Chapter 533, Government Code,
is amended by adding Section 533.0077 to read as follows:
Sec. 533.0077. STATEWIDE EFFORT TO PROMOTE MAINTENANCE OF
ELIGIBILITY. (a) The commission shall develop and implement a
statewide effort to assist recipients who satisfy Medicaid
eligibility requirements and who receive Medicaid services through
a managed care organization with maintaining eligibility and
avoiding lapses in coverage under Medicaid.
(b) As part of its effort under Subsection (a), the
commission shall:
(1) require each managed care organization providing
health care services to recipients to assist those recipients with
maintaining eligibility;
(2) if the commission determines it is cost-effective,
develop specific strategies for assisting recipients who receive
Supplemental Security Income (SSI) benefits under 42 U.S.C. Section
1381 et seq. with maintaining eligibility; and
(3) ensure information that is relevant to a
recipient's eligibility status is provided to the managed care
organization through which the recipient receives Medicaid
services.
SECTION 2.23. (a) Section 533.015, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 533.015. COORDINATION OF EXTERNAL OVERSIGHT
ACTIVITIES. (a) To the extent possible, the commission shall
coordinate all external oversight activities to minimize
duplication of oversight of managed care plans under Medicaid and
disruption of operations under those plans.
(b) The executive commissioner, after consulting with the
commission's office of inspector general, shall, by rule, define
the commission's and office's roles in and jurisdiction over, and
frequency of, audits of managed care organizations participating in
Medicaid that are conducted by the commission and the commission's
office of inspector general.
(c) In accordance with Section 531.102(q), the commission
shall share with the commission's office of inspector general, at
the request of the office, the results of any informal audit or
onsite visit that could inform that office's risk assessment when
determining whether to conduct, or the scope of, an audit of a
managed care organization participating in Medicaid.
(b) Not later than September 1, 2016, the executive
commissioner of the Health and Human Services Commission shall
adopt rules required by Section 533.015(b), Government Code, as
added by this article.
SECTION 2.24. Section 533.041(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) The executive commissioner shall appoint a state
Medicaid managed care advisory committee. The advisory committee
consists of representatives of:
(1) hospitals;
(2) managed care organizations and participating
health care providers;
(3) primary care providers and specialty care
providers;
(4) state agencies;
(5) low-income recipients or consumer advocates
representing low-income recipients;
(6) recipients with disabilities, including
recipients with an intellectual or developmental disability or with
physical disabilities, or consumer advocates representing those
recipients;
(7) parents of children who are recipients;
(8) rural providers;
(9) advocates for children with special health care
needs;
(10) pediatric health care providers, including
specialty providers;
(11) long-term services and supports providers,
including nursing facility providers and direct service workers;
(12) obstetrical care providers;
(13) community-based organizations serving low-income
children and their families;
(14) community-based organizations engaged in
perinatal services and outreach;
(15) recipients who are 65 years of age or older;
(16) recipients with mental illness;
(17) nonphysician mental health providers
participating in the Medicaid managed care program; and
(18) entities with responsibilities for the delivery
of long-term services and supports or other Medicaid service
delivery, including:
(A) independent living centers;
(B) area agencies on aging;
(C) aging and disability resource centers
established under the Aging and Disability Resource Center
initiative funded in part by the federal Administration on Aging
and the Centers for Medicare and Medicaid Services; and
(D) community mental health and intellectual
disability centers[; and
[(E) the NorthSTAR Behavioral Health Program
provided under Chapter 534, Health and Safety Code].
SECTION 2.25. (a) Chapter 533, Government Code, is amended
by adding Subchapter E to read as follows:
SUBCHAPTER E. PILOT PROGRAM TO INCREASE INCENTIVE-BASED PROVIDER
PAYMENTS
Sec. 533.081. DEFINITION. In this subchapter, "pilot
program" means the pilot program to increase incentive-based
provider payments established under Section 533.082.
Sec. 533.082. PILOT PROGRAM TO INCREASE INCENTIVE-BASED
PROVIDER PAYMENTS. The commission shall develop a pilot program to
increase the use and effectiveness of incentive-based provider
payments by managed care organizations providing services under the
Medicaid managed care program. The commission and the managed care
organizations providing those services in at least one managed care
service delivery area shall work with health care providers and
professional associations composed of health care providers to
develop common payment incentive methodologies for the pilot
program that:
(1) are structured to reward appropriate, quality
care;
(2) align outcomes of the pilot program with the
commission's Medicaid managed care quality-based payment programs;
(3) are not intended to supplant existing
incentive-based contracts between the managed care organizations
and providers;
(4) are structured to encourage formal arrangements
among providers to work together to provide better patient care;
(5) are adopted by all managed care organizations
providing services under the Medicaid managed care program through
the same managed care service delivery model so that similar
incentive methodologies apply to all participating providers under
the same model; and
(6) are voluntarily agreed to by the participating
providers.
Sec. 533.083. ASSESSMENT AND IMPLEMENTATION OF PILOT
PROGRAM FINDINGS. Not later than September 1, 2018, and
notwithstanding any other law, the commission shall:
(1) based on the results of the pilot program,
identify which types of incentive-based provider payment goals and
outcome measures are most appropriate for statewide implementation
and the services that can be provided using those goals and outcome
measures; and
(2) require that a managed care organization that has
contracted with the commission to provide health care services to
recipients implement the payment goals and outcome measures
identified under Subdivision (1).
Sec. 533.084. EXPIRATION. Sections 533.081 and 533.082 and
this section expire September 1, 2018.
(b) As soon as possible after the effective date of this
article, the Health and Human Services Commission shall develop the
pilot program required under Subchapter E, Chapter 533, Government
Code, as added by this article.
(c) The Health and Human Services Commission, in a contract
between the commission and a managed care organization under
Chapter 533, Government Code, that is entered into or renewed on or
after September 1, 2018, shall require that the managed care
organization implement the incentive-based provider payment goals
and outcome measures identified by the commission under Section
533.083, Government Code, as added by this article.
(d) The Health and Human Services Commission shall seek to
amend contracts entered into with managed care organizations under
Chapter 533, Government Code, before September 1, 2018, to require
that those managed care organizations implement the
incentive-based provider payment goals and outcome measures
identified by the commission under Section 533.083, Government
Code, as added by this article. To the extent of a conflict between
that section and a provision of a contract with a managed care
organization entered into before September 1, 2018, the contract
provision prevails.
SECTION 2.26. Subchapter A, Chapter 552, Health and Safety
Code, is amended by adding Section 552.0012 to read as follows:
Sec. 552.0012. STUDY REGARDING NEW LOCATION FOR AUSTIN
STATE HOSPITAL. (a) The commission, in coordination with the
department, the General Land Office, and the Texas Facilities
Commission, shall conduct a study to determine the feasibility,
costs, and benefits of transferring operation of the Austin State
Hospital from the hospital's facilities as of January 1, 2015, to a
new facility at a new location.
(b) The study conducted under this section must consider
potential locations and facilities for the operation of the Austin
State Hospital that are owned by the state and that are not owned by
the state. For each potential location, the study must consider:
(1) property and facility costs, including costs
associated with purchasing or leasing facilities;
(2) ease of public access by main roads and public
transportation; and
(3) capacity to accommodate the complete operation of
the Austin State Hospital without overcrowding or interference in
the delivery of services to patients.
(c) In considering property and facility costs of a
potential location for the Austin State Hospital under Subsection
(b)(1), the study must assume that proceeds from the sale or lease
of the Austin State Hospital's facilities as of January 1, 2015,
would be used for the payment of property and facility costs of a
new location.
(d) The commission, in conducting the study, shall obtain
input from appropriate stakeholders and from the public at public
hearings held in locations across the geographic area served by the
Austin State Hospital.
(e) Not later than September 1, 2016, the commission shall
compile a report containing results from the study and submit the
report to:
(1) each legislative standing committee with primary
jurisdiction over health and human services;
(2) the Sunset Advisory Commission; and
(3) the Legislative Budget Board.
(f) This section expires September 1, 2017.
SECTION 2.27. Section 1001.080(b), Health and Safety Code,
is amended to read as follows:
(b) This section applies to health or mental health
benefits, services, or assistance provided by the department that
the department anticipates will be impacted by a health insurance
exchange as defined by Section 1001.081(a), including:
(1) community primary health care services provided
under Chapter 31;
(2) women's and children's health services provided
under Chapter 32;
(3) services for children with special health care
needs provided under Chapter 35;
(4) epilepsy program assistance provided under
Chapter 40;
(5) hemophilia program assistance provided under
Chapter 41;
(6) kidney health care services provided under Chapter
42;
(7) human immunodeficiency virus infection and
sexually transmitted disease prevention programs and services
provided under Chapter 85;
(8) immunization programs provided under Chapter 161;
(9) programs and services provided by the Rio Grande
State Center under Chapter 252;
(10) mental health services for adults provided under
Chapter 534;
(11) mental health services for children provided
under Chapter 534;
(12) [the NorthSTAR Behavioral Health Program
provided under Chapter 534;
[(13)] programs and services provided by community
mental health hospitals under Chapter 552;
(13) [(14)] programs and services provided by state
mental health hospitals under Chapter 552; and
(14) [(15)] any other health or mental health program
or service designated by the department.
SECTION 2.28. Section 1001.201(2), Health and Safety Code,
as added by Chapter 1306 (H.B. 3793), Acts of the 83rd Legislature,
Regular Session, 2013, is amended to read as follows:
(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].
SECTION 2.29. Subchapter A, Chapter 33, Human Resources
Code, is amended by adding Section 33.018 to read as follows:
Sec. 33.018. SNAP ELIGIBILITY FOLLOWING CERTAIN CRIMINAL
CONVICTIONS. (a) As authorized by 21 U.S.C. Section 862a(d)(1)
and except as provided by this section, 21 U.S.C. Section
862a(a)(2) does not apply in determining the eligibility of any
person for the supplemental nutrition assistance program.
(b) 21 U.S.C. Section 862a(a)(2) applies in determining the
eligibility for the supplemental nutrition assistance program of a
person who has been convicted of, and released on parole or placed
on community supervision for, any felony offense that has as an
element the possession, use, or distribution of a controlled
substance, as defined in 21 U.S.C. Section 802, if the person
violates any condition of that parole or community supervision. A
person described by this subsection is ineligible for the
supplemental nutrition assistance program only for a two-year
period beginning on the date the person is found to have violated
the condition of parole or community supervision, as authorized by
21 U.S.C. Section 862a(d)(1)(B).
(c) A person convicted of an offense described by Subsection
(b) who is receiving supplemental nutrition assistance program
benefits and who is convicted of a subsequent felony offense,
regardless of the elements of the offense, is ineligible for the
supplemental nutrition assistance program.
SECTION 2.30. The changes in law made by this Act apply only
to a determination of eligibility of a person for supplemental
nutrition assistance benefits made on or after the effective date
of this Act. A determination of eligibility made before the
effective date of this Act is governed by the law in effect on the
date the determination was made, and the former law is continued in
effect for that purpose.
SECTION 2.31. (a) The Health and Human Services Commission
shall develop a strategic plan to significantly reduce morbidity
and mortality from chronic respiratory disease, including asthma
and chronic obstructive pulmonary disease.
(b) In developing the strategic plan, the Health and Human
Services Commission shall collaborate with the Department of State
Health Services, including the Chronic Disease Prevention Division
and may convene any necessary workgroups. The members of a
workgroup may include health care providers, medical school and
academic experts, nonprofit and community organizations, and other
people the department determines necessary specializing in asthma
and chronic obstructive pulmonary disease prevention, screening,
treatment, or research.
(c) In developing the strategic plan, the Health and Human
Service Commission shall:
(1) identify barriers to effective prevention,
screening, medication adherence, and treatment for asthma and
chronic obstructive pulmonary disease;
(2) identify methods to increase awareness of the risk
factors and symptoms associated with asthma and chronic obstructive
pulmonary disease;
(3) identify methods to increase the use of regular
evidence-based screening for asthma and chronic obstructive
pulmonary disease;
(4) review current technologies and best practices for
chronic respiratory disease diagnosis, management, and treatment;
(5) develop methods for creating partnerships with
public and private entities to increase awareness of asthma and
chronic obstructive pulmonary disease;
(6) review current prevention, screening, treatment,
and other related activities in this state for asthma and chronic
obstructive pulmonary disease and identify areas in which the
health care services provided through those activities are lacking;
(7) estimate the annual direct and indirect state
health care costs attributable to asthma and chronic obstructive
pulmonary disease; and
(8) make recommendations to the legislature on state
policy changes and funding needed to implement the strategic plan.
(d) Not later than December 31, 2016, the Department of
State Health Services shall deliver to the governor and members of
the legislature the strategic plan and recommendations on goal
implementation and schedule compliance related to the strategic
plan developed as required by this section.
(e) This section expires January 1, 2017.
SECTION 2.32. (a) The Health and Human Services Commission
shall develop a strategic plan to significantly reduce morbidity
and mortality from human papillomavirus-associated cancer.
(b) In developing the strategic plan, the Health and Human
Services Commission shall collaborate with the Department of State
Health Services and the Cancer Prevention and Research Institute of
Texas and may convene any necessary workgroups. The members of a
workgroup may include:
(1) health care providers specializing in human
papillomavirus-associated cancer prevention, screening,
treatment, or research;
(2) physicians specializing in primary care,
pediatrics, or obstetrics and gynecology;
(3) mid-level health care practitioners;
(4) cancer epidemologists;
(5) representatives of general academic teaching
institutions as defined by Section 61.003, Education Code, medical
and dental units as defined by Section 61.003, Education Code, and
medical schools as defined by Section 61.501, Education Code;
(6) middle school, high school, or college health
educators;
(7) human papillomavirus-associated cancer survivors;
(8) representatives from geographic areas or other
population groups at higher risk of human
papillomavirus-associated cancer;
(9) public advocates concerned with issues related to
vaccine-preventable diseases;
(10) representatives of community-based and
faith-based organizations involved in providing education,
awareness, or support relating to human papillomavirus-associated
cancer; or
(11) other people the department determines are
necessary.
(c) In developing the strategic plan, the Department of
State Health Services shall:
(1) identify barriers to effective prevention,
screening, and treatment for human papillomavirus-associated
cancer, including specific barriers affecting providers and
patients;
(2) identify methods, other than a mandate, to
increase the number of people vaccinated against human
papillomavirus;
(3) identify methods to increase use of evidence-based
screening to enhance the number of people screened regularly for
human papillomavirus-associated cancer;
(4) review current technologies and best practices for
human papillomavirus-associated cancer screening;
(5) review technology available to diagnose and
prevent infection by human papillomavirus;
(6) develop methods for creating partnerships with
public and private entities to increase awareness of human
papillomavirus-associated cancer and of the importance of
vaccination education and regular screening;
(7) review current prevention, screening, treatment,
and related activities in this state and identify areas in which the
services for those activities are lacking;
(8) estimate the annual direct and indirect state
health care costs attributable to human papillomavirus-associated
cancers;
(9) identify actions necessary to increase
vaccination and screening rates and reduce the morbidity and
mortality from human papillomavirus-associated cancer and
establish a schedule for implementing those actions; and
(10) make recommendations to the legislature on policy
changes and funding needed to implement the strategic plan.
(d) Not later than December 31, 2016, the Health and Human
Services Commission shall deliver to the governor and members of
the legislature the strategic plan and recommendations on goal
implementation and schedule compliance related to the strategic
plan.
(e) This section expires January 1, 2017.
ARTICLE 3. HEALTH AND HUMAN SERVICES SYSTEM ADVISORY ENTITIES
SECTION 3.01. Section 262.353(d), Family Code, is amended
to read as follows:
(d) Not later than September 30, 2014, the department and
the Department of State Health Services shall file a report with the
legislature [and the Council on Children and Families] on the
results of the study required by Subsection (a). The report must
include:
(1) each option to prevent relinquishment of parental
custody that was considered during the study;
(2) each option recommended for implementation, if
any;
(3) each option that is implemented using existing
resources;
(4) any policy or statutory change needed to implement
a recommended option;
(5) the fiscal impact of implementing each option, if
any;
(6) the estimated number of children and families that
may be affected by the implementation of each option; and
(7) any other significant information relating to the
study.
SECTION 3.02. (a) Section 531.012, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 531.012. ADVISORY COMMITTEES. (a) The executive
commissioner shall establish and maintain [may appoint] advisory
committees to consider issues and solicit public input across all
major areas of the health and human services system which may be
from various geographic areas across the state, which may be done
either in person or through teleconferencing centers, including
relating to the following issues:
(1) Medicaid and other social services programs;
(2) managed care under Medicaid and the child health
plan program;
(3) health care quality initiatives;
(4) aging;
(5) persons with disabilities, including persons with
autism;
(6) rehabilitation, including for persons with brain
injuries;
(7) children;
(8) public health;
(9) behavioral health;
(10) regulatory matters;
(11) protective services; and
(12) prevention efforts.
(b) Chapter 2110 applies to an advisory committee
established under this section.
(c) The executive commissioner shall adopt rules:
(1) in compliance with Chapter 2110 to govern an
advisory committee's purpose, tasks, reporting requirements, and
date of abolition; and
(2) related to an advisory committee's:
(A) size and quorum requirements;
(B) membership, including:
(i) qualifications to be a member,
including any experience requirements;
(ii) required geographic representation;
(iii) appointment procedures; and
(iv) terms of members; and
(C) duty to comply with the requirements for open
meetings under Chapter 551.
(d) An advisory committee established under this section
shall:
(1) report any recommendations to the executive
commissioner at a meeting of the Health and Human Services
Commission Executive Council established under Section 531.0051;
and
(2) submit a written report to the legislature of any
policy recommendations made to the executive commissioner under
Subdivision (1) [as needed].
(b) Not later than March 1, 2016, the executive commissioner
of the Health and Human Services Commission shall adopt rules under
Section 531.012, Government Code, as amended by this article. This
subsection takes effect September 1, 2015.
SECTION 3.03. Subchapter A, Chapter 531, Government Code,
is amended by adding Section 531.0121 to read as follows:
Sec. 531.0121. PUBLIC ACCESS TO ADVISORY COMMITTEE
MEETINGS. (a) This section applies to an advisory committee
established under Section 531.012.
(b) The commission shall create a master calendar that
includes all advisory committee meetings across the health and
human services system.
(c) The commission shall make available on the commission's
Internet website:
(1) the master calendar;
(2) all meeting materials for an advisory committee
meeting; and
(3) streaming live video of each advisory committee
meeting.
(d) The commission shall provide Internet access in each
room used for a meeting that appears on the master calendar.
SECTION 3.04. Section 531.0216(b), Government Code, is
amended to read as follows:
(b) In developing the system, the executive commissioner by
rule shall:
(1) review programs and pilot projects in other states
to determine the most effective method for reimbursement;
(2) establish billing codes and a fee schedule for
services;
(3) provide for an approval process before a provider
can receive reimbursement for services;
(4) consult with the Department of State Health
Services [and the telemedicine and telehealth advisory committee]
to establish procedures to:
(A) identify clinical evidence supporting
delivery of health care services using a telecommunications system;
and
(B) annually review health care services,
considering new clinical findings, to determine whether
reimbursement for particular services should be denied or
authorized;
(5) establish a separate provider identifier for
telemedicine medical services providers, telehealth services
providers, and home telemonitoring services providers; and
(6) establish a separate modifier for telemedicine
medical services, telehealth services, and home telemonitoring
services eligible for reimbursement.
SECTION 3.05. Section 531.02441(j), Government Code, is
amended to read as follows:
(j) The task force is abolished and this [This] section
expires September 1, 2017.
SECTION 3.06. Section 531.051(c), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(c) In adopting rules for the consumer direction models, the
executive commissioner shall:
(1) [with assistance from the work group established
under Section 531.052,] determine which services are appropriate
and suitable for delivery through consumer direction;
(2) ensure that each consumer direction model is
designed to comply with applicable federal and state laws;
(3) maintain procedures to ensure that a potential
consumer or the consumer's legally authorized representative has
adequate and appropriate information, including the
responsibilities of a consumer or representative under each service
delivery option, to make an informed choice among the types of
consumer direction models;
(4) require each consumer or the consumer's legally
authorized representative to sign a statement acknowledging
receipt of the information required by Subdivision (3);
(5) maintain procedures to monitor delivery of
services through consumer direction to ensure:
(A) adherence to existing applicable program
standards;
(B) appropriate use of funds; and
(C) consumer satisfaction with the delivery of
services;
(6) ensure that authorized program services that are
not being delivered to a consumer through consumer direction are
provided by a provider agency chosen by the consumer or the
consumer's legally authorized representative; and
(7) [work in conjunction with the work group
established under Section 531.052 to] set a timetable to complete
the implementation of the consumer direction models.
SECTION 3.07. Section 531.067, Government Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
Sec. 531.067. PROGRAM TO IMPROVE AND MONITOR CERTAIN
OUTCOMES OF RECIPIENTS UNDER CHILD HEALTH PLAN PROGRAM AND MEDICAID
[PUBLIC ASSISTANCE HEALTH BENEFIT REVIEW AND DESIGN COMMITTEE].
The [(a) The commission shall appoint a Public Assistance Health
Benefit Review and Design Committee. The committee consists of
nine representatives of health care providers participating in
Medicaid or the child health plan program, or both. The committee
membership must include at least three representatives from each
program.
[(b) The executive commissioner shall designate one member
to serve as presiding officer for a term of two years.
[(c) The committee shall meet at the call of the presiding
officer.
[(d) The committee shall review and provide recommendations
to the commission regarding health benefits and coverages provided
under Medicaid, the child health plan program, and any other
income-based health care program administered by the commission or
a health and human services agency. In performing its duties under
this subsection, the committee must:
[(1) review benefits provided under each of the
programs; and
[(2) review procedures for addressing high
utilization of benefits by recipients.
[(e) The commission shall provide administrative support
and resources as necessary for the committee to perform its duties
under this section.
[(f) Section 2110.008 does not apply to the committee.
[(g) In performing the duties under this section, the]
commission may design and implement a program to improve and
monitor clinical and functional outcomes of a recipient of services
under Medicaid or the state child health plan program. The program
may use financial, clinical, and other criteria based on pharmacy,
medical services, and other claims data related to Medicaid or the
child health plan program. [The commission must report to the
committee on the fiscal impact, including any savings associated
with the strategies utilized under this section.]
SECTION 3.08. (a) Section 531.0691, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is redesignated as Section 531.0735, Government Code, to read
as follows:
Sec. 531.0735 [531.0691]. MEDICAID DRUG UTILIZATION REVIEW
PROGRAM: DRUG USE REVIEWS AND ANNUAL REPORT. (a) In this section:
(1) "Medicaid Drug Utilization Review Program" means
the program operated by the vendor drug program to improve the
quality of pharmaceutical care under Medicaid.
(2) "Prospective drug use review" means the review of
a patient's drug therapy and prescription drug order or medication
order before dispensing or distributing a drug to the patient.
(3) "Retrospective drug use review" means the review
of prescription drug claims data to identify patterns of
prescribing.
(b) The commission shall provide for an increase in the
number and types of retrospective drug use reviews performed each
year under the Medicaid Drug Utilization Review Program, in
comparison to the number and types of reviews performed in the state
fiscal year ending August 31, 2009.
(c) In determining the number and types of drug use reviews
to be performed, the commission shall:
(1) allow for the repeat of retrospective drug use
reviews that address ongoing drug therapy problems and that, in
previous years, improved client outcomes and reduced Medicaid
spending;
(2) consider implementing disease-specific
retrospective drug use reviews that address ongoing drug therapy
problems in this state and that reduced Medicaid prescription drug
use expenditures in other states; and
(3) regularly examine Medicaid prescription drug
claims data to identify occurrences of potential drug therapy
problems that may be addressed by repeating successful
retrospective drug use reviews performed in this state and other
states.
(d) In addition to any other information required by federal
law, the commission shall include the following information in the
annual report regarding the Medicaid Drug Utilization Review
Program:
(1) a detailed description of the program's
activities; and
(2) estimates of cost savings anticipated to result
from the program's performance of prospective and retrospective
drug use reviews.
(e) The cost-saving estimates for prospective drug use
reviews under Subsection (d) must include savings attributed to
drug use reviews performed through the vendor drug program's
electronic claims processing system and clinical edits screened
through the prior authorization system implemented under Section
531.073.
(f) The commission shall post the annual report regarding
the Medicaid Drug Utilization Review Program on the commission's
website.
(b) Subchapter B, Chapter 531, Government Code, is amended
by adding Section 531.0736 to read as follows:
Sec. 531.0736. DRUG UTILIZATION REVIEW BOARD. (a) In this
section, "board" means the Drug Utilization Review Board.
(b) In addition to performing any other duties required by
federal law, the board shall:
(1) develop and submit to the commission
recommendations for preferred drug lists adopted by the commission
under Section 531.072;
(2) suggest to the commission restrictions or clinical
edits on prescription drugs;
(3) recommend to the commission educational
interventions for Medicaid providers;
(4) review drug utilization across Medicaid; and
(5) perform other duties that may be specified by law
and otherwise make recommendations to the commission.
(c) The executive commissioner shall determine the
composition of the board, which must:
(1) comply with applicable federal law, including 42
C.F.R. Section 456.716;
(2) include two representatives of managed care
organizations as nonvoting members, one of whom must be a physician
and one of whom must be a pharmacist;
(3) include at least 17 physicians and pharmacists
who:
(A) provide services across the entire
population of Medicaid recipients and represent different
specialties, including at least one of each of the following types
of physicians:
(i) a pediatrician;
(ii) a primary care physician;
(iii) an obstetrician and gynecologist;
(iv) a child and adolescent psychiatrist;
and
(v) an adult psychiatrist; and
(B) have experience in either developing or
practicing under a preferred drug list; and
(4) include a consumer advocate who represents
Medicaid recipients.
(c-1) The executive commissioner by rule shall develop and
implement a process by which a person may apply to become a member
of the board and shall post the application and information
regarding the application process on the commission's Internet
website.
(d) Members appointed under Subsection (c)(2) may attend
quarterly and other regularly scheduled meetings, but may not:
(1) attend executive sessions; or
(2) access confidential drug pricing information.
(e) Members of the board serve staggered four-year terms.
(f) The voting members of the board shall elect from among
the voting members a presiding officer. The presiding officer must
be a physician.
(g) The board shall hold a public meeting quarterly at the
call of the presiding officer and shall permit public comment
before voting on any changes in the preferred drug lists, the
adoption of or changes to drug use criteria, or the adoption of
prior authorization or drug utilization review proposals. The
location of the quarterly public meeting may rotate among different
geographic areas across this state, or allow for public input
through teleconferencing centers in various geographic areas
across this state. The board shall hold public meetings at other
times at the call of the presiding officer. Minutes of each meeting
shall be made available to the public not later than the 10th
business day after the date the minutes are approved. The board may
meet in executive session to discuss confidential information as
described by Subsection (i).
(h) In developing its recommendations for the preferred
drug lists, the board shall consider the clinical efficacy, safety,
and cost-effectiveness of and any program benefit associated with a
product.
(i) The executive commissioner shall adopt rules governing
the operation of the board, including rules governing the
procedures used by the board for providing notice of a meeting and
rules prohibiting the board from discussing confidential
information described by Section 531.071 in a public meeting. The
board shall comply with the rules adopted under this subsection and
Subsection (j).
(j) In addition to the rules under Subsection (i), the
executive commissioner by rule shall require the board or the
board's designee to present a summary of any clinical efficacy and
safety information or analyses regarding a drug under consideration
for a preferred drug list that is provided to the board by a private
entity that has contracted with the commission to provide the
information. The board or the board's designee shall provide the
summary in electronic form before the public meeting at which
consideration of the drug occurs. Confidential information
described by Section 531.071 must be omitted from the summary. The
summary must be posted on the commission's Internet website.
(k) To the extent feasible, the board shall review all drug
classes included in the preferred drug lists adopted under Section
531.072 at least once every 12 months and may recommend inclusions
to and exclusions from the lists to ensure that the lists provide
for a range of clinically effective, safe, cost-effective, and
medically appropriate drug therapies for the diverse segments of
the Medicaid population, children receiving health benefits
coverage under the child health plan program, and any other
affected individuals.
(l) The commission shall provide administrative support and
resources as necessary for the board to perform its duties.
(m) Chapter 2110 does not apply to the board.
(n) The commission or the commission's agent shall publicly
disclose, immediately after the board's deliberations conclude,
each specific drug recommended for or against preferred drug list
status for each drug class included in the preferred drug list for
the Medicaid vendor drug program. The disclosure must be posted on
the commission's Internet website not later than the 10th business
day after the date of conclusion of board deliberations that result
in recommendations made to the executive commissioner regarding the
placement of drugs on the preferred drug list. The public
disclosure must include:
(1) the general basis for the recommendation for each
drug class; and
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070.
(c) Section 531.0692, Government Code, is redesignated as
Section 531.0737, Government Code, and amended to read as follows:
Sec. 531.0737 [531.0692]. [MEDICAID] DRUG UTILIZATION
REVIEW BOARD: CONFLICTS OF INTEREST. (a) A voting member of the
[board of the Medicaid] Drug Utilization Review Board [Program] may
not have a contractual relationship, ownership interest, or other
conflict of interest with a pharmaceutical manufacturer or labeler
or with an entity engaged by the commission to assist in the
development of the preferred drug lists or in the administration of
the Medicaid Drug Utilization Review Program.
(b) The executive commissioner may implement this section
by adopting rules that identify prohibited relationships and
conflicts or requiring the board to develop a conflict-of-interest
policy that applies to the board.
(d) Sections 531.072(c) and (e), Government Code, are
amended to read as follows:
(c) In making a decision regarding the placement of a drug
on each of the preferred drug lists, the commission shall consider:
(1) the recommendations of the Drug Utilization Review
Board [Pharmaceutical and Therapeutics Committee established]
under Section 531.0736 [531.074];
(2) the clinical efficacy of the drug;
(3) the price of competing drugs after deducting any
federal and state rebate amounts; and
(4) program benefit offerings solely or in conjunction
with rebates and other pricing information.
(e) In this subsection, "labeler" and "manufacturer" have
the meanings assigned by Section 531.070. The commission shall
ensure that:
(1) a manufacturer or labeler may submit written
evidence supporting the inclusion of a drug on the preferred drug
lists before a supplemental agreement is reached with the
commission; and
(2) any drug that has been approved or has had any of
its particular uses approved by the United States Food and Drug
Administration under a priority review classification will be
reviewed by the Drug Utilization Review Board [Pharmaceutical and
Therapeutics Committee] at the next regularly scheduled meeting of
the board [committee]. On receiving notice from a manufacturer or
labeler of the availability of a new product, the commission, to the
extent possible, shall schedule a review for the product at the next
regularly scheduled meeting of the board [committee].
(e) Section 531.073(b), Government Code, is amended to read
as follows:
(b) The commission shall establish procedures for the prior
authorization requirement under the Medicaid vendor drug program to
ensure that the requirements of 42 U.S.C. Section 1396r-8(d)(5) and
its subsequent amendments are met. Specifically, the procedures
must ensure that:
(1) a prior authorization requirement is not imposed
for a drug before the drug has been considered at a meeting of the
Drug Utilization Review Board [Pharmaceutical and Therapeutics
Committee established] under Section 531.0736 [531.074];
(2) there will be a response to a request for prior
authorization by telephone or other telecommunications device
within 24 hours after receipt of a request for prior authorization;
and
(3) a 72-hour supply of the drug prescribed will be
provided in an emergency or if the commission does not provide a
response within the time required by Subdivision (2).
(f) Section 531.0741, Government Code, is amended to read as
follows:
Sec. 531.0741. PUBLICATION OF INFORMATION REGARDING
COMMISSION DECISIONS ON PREFERRED DRUG LIST PLACEMENT. The
commission shall publish on the commission's Internet website any
decisions on preferred drug list placement, including:
(1) a list of drugs reviewed and the commission's
decision for or against placement on a preferred drug list of each
drug reviewed;
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070; and
(3) the rationale for any departure from a
recommendation of the Drug Utilization Review Board
[pharmaceutical and therapeutics committee established] under
Section 531.0736 [531.074].
(g) Section 531.074, Government Code, as amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
(h) The term of a member serving on the Medicaid Drug
Utilization Review Board on January 1, 2016, expires on February
29, 2016. Not later than March 1, 2016, the executive commissioner
of the Health and Human Services Commission shall appoint the
initial members to the Drug Utilization Review Board in accordance
with Section 531.0736, Government Code, as added by this article,
for terms beginning March 1, 2016. In making the initial
appointments and notwithstanding Section 531.0736(e), Government
Code, as added by this article, the executive commissioner shall
designate as close to one-half as possible of the members to serve
for terms expiring March 1, 2018, and the remaining members to serve
for terms expiring March 1, 2020.
(i) Not later than February 1, 2016, and before making
initial appointments to the Drug Utilization Review Board as
provided by Subsection (h) of this section, the executive
commissioner of the Health and Human Services Commission shall
adopt and implement the application process required under Section
531.0736(c-1), Government Code, as added by this article.
(j) Not later than May 1, 2016, and except as provided by
Subsection (i) of this section, the executive commissioner of the
Health and Human Services Commission shall adopt or amend rules as
necessary to reflect the changes in law made to the Drug Utilization
Review Board under Section 531.0736, Government Code, as added by
this article, including rules that reflect the changes to the
board's functions and composition.
SECTION 3.09. The heading to Subchapter D, Chapter 531,
Government Code, is amended to read as follows:
SUBCHAPTER D. PLAN TO SUPPORT GUARDIANSHIPS [GUARDIANSHIP ADVISORY
BOARD]
SECTION 3.10. Section 531.124, Government Code, is amended
to read as follows:
Sec. 531.124. COMMISSION DUTIES. The [(a) With the advice
of the advisory board, the] commission shall develop and, subject
to appropriations, implement a plan to:
(1) ensure that each incapacitated individual in this
state who needs a guardianship or another less restrictive type of
assistance to make decisions concerning the incapacitated
individual's own welfare and financial affairs receives that
assistance; and
(2) foster the establishment and growth of local
volunteer guardianship programs.
[(b) The advisory board shall biennially review and comment
on the minimum standards adopted under Section 111.041 and the plan
implemented under Subsection (a) and shall include its conclusions
in the report submitted under Section 531.1235.]
SECTION 3.11. Section 531.907(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Based on [the recommendations of the advisory committee
established under Section 531.904 and] feedback provided by
interested parties, the commission in stage two of implementing the
health information exchange system may expand the system by:
(1) providing an electronic health record for each
child enrolled in the child health plan program;
(2) including state laboratory results information in
an electronic health record, including the results of newborn
screenings and tests conducted under the Texas Health Steps
program, based on the system developed for the health passport
under Section 266.006, Family Code;
(3) improving data-gathering capabilities for an
electronic health record so that the record may include basic
health and clinical information in addition to available claims
information, as determined by the executive commissioner;
(4) using evidence-based technology tools to create a
unique health profile to alert health care providers regarding the
need for additional care, education, counseling, or health
management activities for specific patients; and
(5) continuing to enhance the electronic health record
created for each Medicaid recipient as technology becomes available
and interoperability capabilities improve.
SECTION 3.12. Section 531.909, Government Code, is amended
to read as follows:
Sec. 531.909. INCENTIVES. The commission [and the advisory
committee established under Section 531.904] shall develop
strategies to encourage health care providers to use the health
information exchange system, including incentives, education, and
outreach tools to increase usage.
SECTION 3.13. Section 533.00251(c), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(c) Subject to Section 533.0025 and notwithstanding any
other law, the commission[, in consultation with the advisory
committee,] shall provide benefits under Medicaid to recipients who
reside in nursing facilities through the STAR + PLUS Medicaid
managed care program. In implementing this subsection, the
commission shall ensure:
(1) that the commission is responsible for setting the
minimum reimbursement rate paid to a nursing facility under the
managed care program, including the staff rate enhancement paid to
a nursing facility that qualifies for the enhancement;
(2) that a nursing facility is paid not later than the
10th day after the date the facility submits a clean claim;
(3) the appropriate utilization of services
consistent with criteria established by the commission;
(4) a reduction in the incidence of potentially
preventable events and unnecessary institutionalizations;
(5) that a managed care organization providing
services under the managed care program provides discharge
planning, transitional care, and other education programs to
physicians and hospitals regarding all available long-term care
settings;
(6) that a managed care organization providing
services under the managed care program:
(A) assists in collecting applied income from
recipients; and
(B) provides payment incentives to nursing
facility providers that reward reductions in preventable acute care
costs and encourage transformative efforts in the delivery of
nursing facility services, including efforts to promote a
resident-centered care culture through facility design and
services provided;
(7) the establishment of a portal that is in
compliance with state and federal regulations, including standard
coding requirements, through which nursing facility providers
participating in the STAR + PLUS Medicaid managed care program may
submit claims to any participating managed care organization;
(8) that rules and procedures relating to the
certification and decertification of nursing facility beds under
Medicaid are not affected; and
(9) that a managed care organization providing
services under the managed care program, to the greatest extent
possible, offers nursing facility providers access to:
(A) acute care professionals; and
(B) telemedicine, when feasible and in
accordance with state law, including rules adopted by the Texas
Medical Board.
SECTION 3.14. Section 533.00253, Government Code, is
amended by amending Subsection (b), as amended by S.B. 219, Acts of
the 84th Legislature, Regular Session, 2015, and Subsection (f) to
read as follows:
(b) Subject to Section 533.0025, the commission shall, in
consultation with the [advisory committee and the] Children's
Policy Council established under Section 22.035, Human Resources
Code, establish a mandatory STAR Kids capitated managed care
program tailored to provide Medicaid benefits to children with
disabilities. The managed care program developed under this
section must:
(1) provide Medicaid benefits that are customized to
meet the health care needs of recipients under the program through a
defined system of care;
(2) better coordinate care of recipients under the
program;
(3) improve the health outcomes of recipients;
(4) improve recipients' access to health care
services;
(5) achieve cost containment and cost efficiency;
(6) reduce the administrative complexity of
delivering Medicaid benefits;
(7) reduce the incidence of unnecessary
institutionalizations and potentially preventable events by
ensuring the availability of appropriate services and care
management;
(8) require a health home; and
(9) coordinate and collaborate with long-term care
service providers and long-term care management providers, if
recipients are receiving long-term services and supports outside of
the managed care organization.
(f) The commission shall seek ongoing input from the
Children's Policy Council regarding the establishment and
implementation of the STAR Kids managed care program. This
subsection expires on the date the Children's Policy Council is
abolished under Section 22.035(n), Human Resources Code.
SECTION 3.15. Section 533.00254(f), Government Code, is
amended to read as follows:
(f) On the first anniversary of the date the commission
completes implementation of the STAR Kids Medicaid managed care
program under Section 533.00253 [September 1, 2016]:
(1) the advisory committee is abolished; and
(2) this section expires.
SECTION 3.16. Section 533.00256(a), Government Code, is
amended to read as follows:
(a) In consultation with [the Medicaid and CHIP
Quality-Based Payment Advisory Committee established under Section
536.002 and other] appropriate stakeholders with an interest in the
provision of acute care services and long-term services and
supports under the Medicaid managed care program, the commission
shall:
(1) establish a clinical improvement program to
identify goals designed to improve quality of care and care
management and to reduce potentially preventable events, as defined
by Section 536.001; and
(2) require managed care organizations to develop and
implement collaborative program improvement strategies to address
the goals.
SECTION 3.17. Section 534.053(g), Government Code, is
amended to read as follows:
(g) On the one-year anniversary of the date the commission
completes implementation of the transition required under Section
534.202 [January 1, 2024]:
(1) the advisory committee is abolished; and
(2) this section expires.
SECTION 3.18. Section 535.053, Government Code, is amended
by amending Subsection (a) and adding Subsection (a-1) to read as
follows:
(a) The interagency coordinating group for faith- and
community-based initiatives is composed of each faith- and
community-based liaison designated under Section 535.051 and a
liaison from the State Commission on National and Community
Service. [The commission shall provide administrative support to
the interagency coordinating group.]
(a-1) Service on the interagency coordinating group is an
additional duty of the office or position held by each person
designated as a liaison under Section 535.051(b). The state
agencies described by Section 535.051(b) shall provide
administrative support for the interagency coordinating group as
coordinated by the presiding officer.
SECTION 3.19. Sections 535.055(a) and (b), Government Code,
are amended to read as follows:
(a) The Texas Nonprofit Council is established to help
direct the interagency coordinating group in carrying out the
group's duties under this section. The state agencies of the
interagency coordinating group described by Section 535.051(b)
[commission] shall provide administrative support to the council as
coordinated by the presiding officer of the interagency
coordinating group.
(b) The governor [executive commissioner], in consultation
with the presiding officer of the interagency coordinating group,
shall appoint as members of the council two representatives from
each of the following groups and entities to represent each group's
and entity's appropriate sector:
(1) statewide nonprofit organizations;
(2) local governments;
(3) faith-based groups, at least one of which must be a
statewide interfaith group;
(4) community-based groups;
(5) consultants to nonprofit corporations; and
(6) statewide associations of nonprofit
organizations.
SECTION 3.20. Section 535.104(a), Government Code, is
amended to read as follows:
(a) The commission shall:
(1) contract with the State Commission on National and
Community Service to administer funds appropriated from the account
in a manner that:
(A) consolidates the capacity of and strengthens
national service and community and faith- and community-based
initiatives; and
(B) leverages public and private funds to benefit
this state;
(2) develop a competitive process to be used in
awarding grants from account funds that is consistent with state
law and includes objective selection criteria;
(3) oversee the delivery of training and other
assistance activities under this subchapter;
(4) develop criteria limiting awards of grants under
Section 535.105(1)(A) to small and medium-sized faith- and
community-based organizations that provide charitable services to
persons in this state;
(5) establish general state priorities for the
account;
(6) establish and monitor performance and outcome
measures for persons to whom grants are awarded under this
subchapter; and
(7) establish policies and procedures to ensure that
any money appropriated from the account to the commission that is
allocated to build the capacity of a faith-based organization or
for a faith-based initiative[, including money allocated for the
establishment of the advisory committee under Section 535.108,] is
not used to advance a sectarian purpose or to engage in any form of
proselytization.
SECTION 3.21. Section 536.001(20), Government Code, is
amended to read as follows:
(20) "Potentially preventable readmission" means a
return hospitalization of a person within a period specified by the
commission that may have resulted from deficiencies in the care or
treatment provided to the person during a previous hospital stay or
from deficiencies in post-hospital discharge follow-up. The term
does not include a hospital readmission necessitated by the
occurrence of unrelated events after the discharge. The term
includes the readmission of a person to a hospital for:
(A) the same condition or procedure for which the
person was previously admitted;
(B) an infection or other complication resulting
from care previously provided;
(C) a condition or procedure that indicates that
a surgical intervention performed during a previous admission was
unsuccessful in achieving the anticipated outcome; or
(D) another condition or procedure of a similar
nature, as determined by the executive commissioner [after
consulting with the advisory committee].
SECTION 3.22. Section 536.003(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) The commission[, in consultation with the advisory
committee,] shall develop quality-based outcome and process
measures that promote the provision of efficient, quality health
care and that can be used in the child health plan program and
Medicaid to implement quality-based payments for acute care
services and long-term services and supports across all delivery
models and payment systems, including fee-for-service and managed
care payment systems. Subject to Subsection (a-1), the commission,
in developing outcome and process measures under this section, must
include measures that are based on potentially preventable events
and that advance quality improvement and innovation. The
commission may change measures developed:
(1) to promote continuous system reform, improved
quality, and reduced costs; and
(2) to account for managed care organizations added to
a service area.
SECTION 3.23. Section 536.004(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Using quality-based outcome and process measures
developed under Section 536.003 and subject to this section, the
commission, after consulting with [the advisory committee and
other] appropriate stakeholders with an interest in the provision
of acute care and long-term services and supports under the child
health plan program and Medicaid, shall develop quality-based
payment systems, and require managed care organizations to develop
quality-based payment systems, for compensating a physician or
other health care provider participating in the child health plan
program or Medicaid that:
(1) align payment incentives with high-quality,
cost-effective health care;
(2) reward the use of evidence-based best practices;
(3) promote the coordination of health care;
(4) encourage appropriate physician and other health
care provider collaboration;
(5) promote effective health care delivery models; and
(6) take into account the specific needs of the child
health plan program enrollee and Medicaid recipient populations.
SECTION 3.24. Section 536.006(a), Government Code, is
amended to read as follows:
(a) The commission [and the advisory committee] shall:
(1) ensure transparency in the development and
establishment of:
(A) quality-based payment and reimbursement
systems under Section 536.004 and Subchapters B, C, and D,
including the development of outcome and process measures under
Section 536.003; and
(B) quality-based payment initiatives under
Subchapter E, including the development of quality of care and
cost-efficiency benchmarks under Section 536.204(a) and efficiency
performance standards under Section 536.204(b);
(2) develop guidelines establishing procedures for
providing notice and information to, and receiving input from,
managed care organizations, health care providers, including
physicians and experts in the various medical specialty fields, and
other stakeholders, as appropriate, for purposes of developing and
establishing the quality-based payment and reimbursement systems
and initiatives described under Subdivision (1);
(3) in developing and establishing the quality-based
payment and reimbursement systems and initiatives described under
Subdivision (1), consider that as the performance of a managed care
organization or physician or other health care provider improves
with respect to an outcome or process measure, quality of care and
cost-efficiency benchmark, or efficiency performance standard, as
applicable, there will be a diminishing rate of improved
performance over time; and
(4) develop web-based capability to provide managed
care organizations and health care providers with data on their
clinical and utilization performance, including comparisons to
peer organizations and providers located in this state and in the
provider's respective region.
SECTION 3.25. Section 536.052(b), Government Code, is
amended to read as follows:
(b) The commission[, after consulting with the advisory
committee,] shall develop quality of care and cost-efficiency
benchmarks, including benchmarks based on a managed care
organization's performance with respect to reducing potentially
preventable events and containing the growth rate of health care
costs.
SECTION 3.26. Section 536.102(a), Government Code, is
amended to read as follows:
(a) Subject to this subchapter, the commission[, after
consulting with the advisory committee,] may develop and implement
quality-based payment systems for health homes designed to improve
quality of care and reduce the provision of unnecessary medical
services. A quality-based payment system developed under this
section must:
(1) base payments made to a participating enrollee's
health home on quality and efficiency measures that may include
measurable wellness and prevention criteria and use of
evidence-based best practices, sharing a portion of any realized
cost savings achieved by the health home, and ensuring quality of
care outcomes, including a reduction in potentially preventable
events; and
(2) allow for the examination of measurable wellness
and prevention criteria, use of evidence-based best practices, and
quality of care outcomes based on the type of primary or specialty
care provider practice.
SECTION 3.27. Section 536.152(a), Government Code, is
amended to read as follows:
(a) Subject to Subsection (b), using the data collected
under Section 536.151 and the diagnosis-related groups (DRG)
methodology implemented under Section 536.005, if applicable, the
commission[, after consulting with the advisory committee,] shall
to the extent feasible adjust child health plan and Medicaid
reimbursements to hospitals, including payments made under the
disproportionate share hospitals and upper payment limit
supplemental payment programs, based on the hospital's performance
with respect to exceeding, or failing to achieve, outcome and
process measures developed under Section 536.003 that address the
rates of potentially preventable readmissions and potentially
preventable complications.
SECTION 3.28. Section 536.202(a), Government Code, is
amended to read as follows:
(a) The commission shall[, after consulting with the
advisory committee,] establish payment initiatives to test the
effectiveness of quality-based payment systems, alternative
payment methodologies, and high-quality, cost-effective health
care delivery models that provide incentives to physicians and
other health care providers to develop health care interventions
for child health plan program enrollees or Medicaid recipients, or
both, that will:
(1) improve the quality of health care provided to the
enrollees or recipients;
(2) reduce potentially preventable events;
(3) promote prevention and wellness;
(4) increase the use of evidence-based best practices;
(5) increase appropriate physician and other health
care provider collaboration;
(6) contain costs; and
(7) improve integration of acute care services and
long-term services and supports, including discharge planning from
acute care services to community-based long-term services and
supports.
SECTION 3.29. Section 536.204(a), Government Code, is
amended to read as follows:
(a) The executive commissioner shall[:
[(1) consult with the advisory committee to] develop
quality of care and cost-efficiency benchmarks and measurable goals
that a payment initiative must meet to ensure high-quality and
cost-effective health care services and healthy outcomes[; and
[(2) approve benchmarks and goals developed as
provided by Subdivision (1)].
SECTION 3.30. Section 536.251(a), Government Code, is
amended to read as follows:
(a) Subject to this subchapter, the commission, after
consulting with [the advisory committee and other] appropriate
stakeholders representing nursing facility providers with an
interest in the provision of long-term services and supports, may
develop and implement quality-based payment systems for Medicaid
long-term services and supports providers designed to improve
quality of care and reduce the provision of unnecessary services. A
quality-based payment system developed under this section must base
payments to providers on quality and efficiency measures that may
include measurable wellness and prevention criteria and use of
evidence-based best practices, sharing a portion of any realized
cost savings achieved by the provider, and ensuring quality of care
outcomes, including a reduction in potentially preventable events.
SECTION 3.31. Section 538.052(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Subject to Subsection (b), the commission shall solicit
and accept suggestions for clinical initiatives, in either written
or electronic form, from:
(1) a member of the state legislature;
(2) the executive commissioner;
(3) the commissioner of aging and disability services;
(4) the commissioner of state health services;
(5) the commissioner of the Department of Family and
Protective Services;
(6) the commissioner of assistive and rehabilitative
services;
(7) the medical care advisory committee established
under Section 32.022, Human Resources Code; and
(8) the physician payment advisory committee created
under Section 32.022(d), Human Resources Code[; and
[(9) the Electronic Health Information Exchange
System Advisory Committee established under Section 531.904].
SECTION 3.32. Section 98.1046(a), Health and Safety Code,
is amended to read as follows:
(a) The [In consultation with the Texas Institute of Health
Care Quality and Efficiency under Chapter 1002, the] department,
using data submitted under Chapter 108, shall publicly report for
hospitals in this state risk-adjusted outcome rates for those
potentially preventable complications and potentially preventable
readmissions that the department[, in consultation with the
institute,] has determined to be the most effective measures of
quality and efficiency.
SECTION 3.33. Section 98.1047(a), Health and Safety Code,
is amended to read as follows:
(a) The [In consultation with the Texas Institute of Health
Care Quality and Efficiency under Chapter 1002, the] department
shall study which adverse health conditions commonly occur in
long-term care facilities and, of those health conditions, which
are potentially preventable.
SECTION 3.34. Section 98.1065, Health and Safety Code, is
amended to read as follows:
Sec. 98.1065. STUDY OF INCENTIVES AND RECOGNITION FOR
HEALTH CARE QUALITY. The department[, in consultation with the
Texas Institute of Health Care Quality and Efficiency under Chapter
1002,] shall conduct a study on developing a recognition program to
recognize exemplary health care facilities for superior quality of
health care and make recommendations based on that study.
SECTION 3.35. Section 22.035, Human Resources Code, is
amended by adding Subsection (n) to read as follows:
(n) The work group is abolished and this section expires
September 1, 2017.
SECTION 3.36. (a) Section 32.022(b), Human Resources
Code, as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(b) The executive commissioner shall appoint the committee
in compliance with the requirements of the federal agency
administering medical assistance. The appointments shall:
(1) provide for a balanced representation of the
general public, providers, consumers, and other persons, state
agencies, or groups with knowledge of and interest in the
committee's field of work; and
(2) include one member who is the representative of a
managed care organization.
(b) Not later than January 1, 2016, the executive
commissioner of the Health and Human Services Commission shall
appoint an additional member to the medical care advisory committee
in accordance with Section 32.022(b)(2), Human Resources Code, as
added by this article.
SECTION 3.37. Section 32.0641(a), Human Resources Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) To the extent permitted under and in a manner that is
consistent with Title XIX, Social Security Act (42 U.S.C. Section
1396 et seq.) and any other applicable law or regulation or under a
federal waiver or other authorization, the executive commissioner
shall adopt[, after consulting with the Medicaid and CHIP
Quality-Based Payment Advisory Committee established under Section
536.002, Government Code,] cost-sharing provisions that encourage
personal accountability and appropriate utilization of health care
services, including a cost-sharing provision applicable to a
recipient who chooses to receive a nonemergency medical service
through a hospital emergency room.
SECTION 3.38. Section 1352.004(b), Insurance Code, is
amended to read as follows:
(b) The commissioner by rule shall require a health benefit
plan issuer to provide adequate training to personnel responsible
for preauthorization of coverage or utilization review under the
plan. The purpose of the training is to prevent denial of coverage
in violation of Section 1352.003 and to avoid confusion of medical
benefits with mental health benefits. The commissioner[, in
consultation with the Texas Traumatic Brain Injury Advisory
Council,] shall prescribe by rule the basic requirements for the
training described by this subsection.
SECTION 3.39. Section 1352.005(b), Insurance Code, is
amended to read as follows:
(b) The commissioner[, in consultation with the Texas
Traumatic Brain Injury Advisory Council,] shall prescribe by rule
the specific contents and wording of the notice required under this
section.
SECTION 3.40. (a) The following provisions of the
Government Code, including provisions amended by S.B. 219, Acts of
the 84th Legislature, Regular Session, 2015, are repealed:
(1) Section 531.0217(j);
(2) Section 531.02172;
(3) Section 531.02173(c);
(4) Section 531.052;
(5) Section 531.0571;
(6) Section 531.068;
(7) Sections 531.121(1), (5), and (6);
(8) Section 531.122;
(9) Section 531.123;
(10) Section 531.1235;
(11) Section 531.251;
(12) Subchapters R and T, Chapter 531;
(13) Section 531.904;
(14) Section 533.00251(a)(1);
(15) Section 533.00252;
(16) Sections 533.00255(e) and (f);
(17) Section 533.00285;
(18) Subchapters B and C, Chapter 533;
(19) Section 535.055(f);
(20) Section 535.108;
(21) Section 536.001(1);
(22) Section 536.002; and
(23) Section 536.007(b).
(b) The following provisions of the Health and Safety Code,
including provisions amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, are repealed:
(1) Subchapter C, Chapter 32;
(2) Section 62.151(e);
(3) Section 62.1571(c);
(4) Section 81.010;
(5) Section 92.011;
(6) Subchapter B, Chapter 92;
(7) Chapter 115; and
(8) Chapter 1002.
(c) Section 32.022(e), Human Resources Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
(d) Section 848.001(7), Insurance Code, is repealed.
SECTION 3.41. On the effective date of this article, the
following advisory committees are abolished:
(1) the advisory committee on Medicaid and child
health plan program rate and expenditure disparities;
(2) the Advisory Committee on Qualifications for
Health Care Translators and Interpreters;
(3) the Behavioral Health Integration Advisory
Committee;
(4) the Consumer Direction Work Group;
(5) the Council on Children and Families;
(6) the Electronic Health Information Exchange System
Advisory Committee;
(7) the Guardianship Advisory Board;
(8) the hospital payment advisory committee;
(9) the Interagency Coordinating Council for HIV and
Hepatitis;
(10) the Medicaid and CHIP Quality-Based Payment
Advisory Committee;
(11) each Medicaid managed care advisory committee
appointed for a health care service region under Subchapter B,
Chapter 533, Government Code;
(12) the Public Assistance Health Benefit Review and
Design Committee;
(13) the renewing our communities account advisory
committee;
(14) the STAR + PLUS Nursing Facility Advisory
Committee;
(15) the STAR + PLUS Quality Council;
(16) the state Medicaid managed care advisory
committee;
(17) the task force on domestic violence;
(18) the Interagency Task Force for Children With
Special Needs;
(19) the telemedicine and telehealth advisory
committee;
(20) the Texas Institute of Health Care Quality and
Efficiency;
(21) the Texas System of Care Consortium;
(22) the Texas Traumatic Brain Injury Advisory
Council; and
(23) the volunteer advocate program advisory
committee.
SECTION 3.42. (a) Not later than November 1, 2015, the
executive commissioner of the Health and Human Services Commission
shall publish in the Texas Register:
(1) a list of the new advisory committees established
or to be established as a result of this article, including the
advisory committees required under Section 531.012(a), Government
Code, as amended by this article; and
(2) a list that identifies the advisory committees
listed in Section 3.41 of this article:
(A) that will not be continued in any form; or
(B) whose functions will be assumed by a new
advisory committee established under Section 531.012(a),
Government Code, as amended by this article.
(b) The executive commissioner of the Health and Human
Services Commission shall ensure that an advisory committee
established under Section 531.012(a), Government Code, as amended
by this article, begins operations immediately on its establishment
to ensure ongoing public input and engagement.
(c) This section takes effect September 1, 2015.
SECTION 3.43. Except as otherwise provided by this article,
this article takes effect January 1, 2016.
ARTICLE 4. CONTINUATION OF HEALTH AND HUMAN SERVICES POWERS AND
DUTIES
SECTION 4.01. Section 531.004, Government Code, is amended
to read as follows:
Sec. 531.004. SUNSET PROVISION. The Health and Human
Services Commission is subject to Chapter 325 (Texas Sunset Act).
Unless continued in existence as provided by that chapter, the
commission is abolished and this chapter expires September 1, 2027
[2015].
SECTION 4.02. Section 108.016, Health and Safety Code, is
amended to read as follows:
Sec. 108.016. SUNSET REVIEW. Unless the department is
continued in existence in accordance with Chapter 325, Government
Code (Texas Sunset Act), after the review required by Section
1001.003 [11.003(b)], this chapter expires on the date the
department is abolished under that section [September 1, 2015].
SECTION 4.03. Section 1001.003, Health and Safety Code, is
amended to read as follows:
Sec. 1001.003. SUNSET PROVISION. The Department of State
Health Services is subject to Chapter 325, Government Code (Texas
Sunset Act). Unless continued in existence as provided by that
chapter, the department is abolished and this chapter expires
September 1, 2023 [2015].
SECTION 4.04. Section 40.003, Human Resources Code, is
amended to read as follows:
Sec. 40.003. SUNSET PROVISION. The Department of Family
and Protective Services is subject to Chapter 325, Government Code
(Texas Sunset Act). Unless continued in existence as provided by
that chapter, the department is abolished and this chapter expires
September 1, 2023 [2015].
SECTION 4.05. Section 117.003, Human Resources Code, is
amended to read as follows:
Sec. 117.003. SUNSET PROVISION. Unless the commission is
[The Department of Assistive and Rehabilitative Services is subject
to Chapter 325, Government Code (Texas Sunset Act). Unless]
continued in existence as provided by Chapter 325, Government Code
[that chapter], after the review required by Section 531.004,
Government Code, [the department is abolished and] this chapter
expires on the date the commission is abolished under that section
[September 1, 2015].
SECTION 4.06. Section 161.003, Human Resources Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 161.003. SUNSET PROVISION. Unless the commission is
[The department is subject to Chapter 325, Government Code (Texas
Sunset Act). Unless] continued in existence as provided by Chapter
325, Government Code [that chapter], after the review required by
Section 531.004, Government Code, [the department is abolished and]
this chapter expires on the date the commission is abolished under
that section [September 1, 2015].
ARTICLE 5. VITAL STATISTICS
SECTION 5.01. Subchapter A, Chapter 191, Health and Safety
Code, is amended by adding Section 191.0031 to read as follows:
Sec. 191.0031. CERTIFIED COPIES BY MAIL. The state
registrar or a local registrar may not issue a certified copy of a
record under this chapter to a person who has applied for the record
by mail unless the person has provided notarized proof of identity
in accordance with rules adopted by the executive commissioner of
the Health and Human Services Commission. The rules may require the
issuer of the certified copy to verify the notarization using the
records of the secretary of state under Section 406.012, Government
Code.
SECTION 5.02. Section 191.022, Health and Safety Code, is
amended by adding Subsection (g) to read as follows:
(g) Each local registrar shall annually submit a
self-assessment report to the state registrar. The department
shall prescribe the information that must be included in the report
to allow a thorough desk audit of a local registrar.
SECTION 5.03. Chapter 191, Health and Safety Code, is
amended by adding Subchapter D to read as follows:
SUBCHAPTER D. ACCESS TO RECORDS
Sec. 191.071. CRIMINAL BACKGROUND CHECK REQUIRED. (a) A
person may not access vital records maintained by the department
under this chapter and may not access the department's vital
records electronic registration system unless the department, or
another person acting on behalf of the department, has conducted a
fingerprint-based criminal background check, using state and
federal databases, on the person in accordance with department
policy and the person's record is satisfactory as determined under
department policy.
(b) The department may adopt a policy waiving the
requirement of a fingerprint-based background check for a person
who previously submitted to a fingerprint-based background check as
a condition of licensure by a state agency.
SECTION 5.04. Section 411.110(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) The Department of State Health Services is entitled to
obtain from the department criminal history record information
maintained by the department that relates to:
(1) a person who is:
(A) an applicant for a license or certificate
under the Emergency Health Care Act (Chapter 773, Health and Safety
Code);
(B) an owner or manager of an applicant for an
emergency medical services provider license under that Act; or
(C) the holder of a license or certificate under
that Act;
(2) an applicant for a license or a license holder
under Subchapter N, Chapter 431, Health and Safety Code;
(3) an applicant for a license, the owner or manager of
an applicant for a massage establishment license, or a license
holder under Chapter 455, Occupations Code;
(4) an applicant for employment at or current employee
of:
(A) a public health hospital as defined by
Section 13.033, Health and Safety Code; or
(B) the South Texas Health Care System; [or]
(5) an applicant for employment at, current employee
of, or person who contracts or may contract to provide goods or
services with[:
[(A) the vital statistics unit of the Department
of State Health Services; or
[(B)] the Council on Sex Offender Treatment or
other division or component of the Department of State Health
Services that monitors sexually violent predators as described by
Section 841.003(a), Health and Safety Code; or
(6) a person authorized to access vital records or the
vital records electronic registration system under Chapter 191,
Health and Safety Code, including an employee of or contractor for
the Department of State Health Services, a local registrar, a
medical professional, or a funeral director.
SECTION 5.05. In prescribing the initial requirements for
local registrar self-assessment reports under Section 191.022(g),
Health and Safety Code, as added by this article, the Department of
State Health Services shall solicit comment from local registrars
in this state.
SECTION 5.06. The Department of State Health Services shall
prescribe policies necessary to implement Subchapter D, Chapter
191, Health and Safety Code, as added by this article, to take
effect March 1, 2016.
ARTICLE 6. FEDERAL AUTHORIZATION AND EFFECTIVE DATE
SECTION 6.01. 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 6.02. Except as otherwise provided by this Act,
this Act takes effect September 1, 2015.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 200 passed the Senate on
April 15, 2015, by the following vote: Yeas 31, Nays 0; and that
the Senate concurred in House amendments on May 28, 2015, by the
following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 200 passed the House, with
amendments, on May 25, 2015, by the following vote: Yeas 143,
Nays 1, one present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor