Bill Text: TX HB2304 | 2015-2016 | 84th Legislature | Introduced
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: Bipartisan Bill
Status: (Introduced - Dead) 2015-04-27 - Left pending in committee [HB2304 Detail]
Download: Texas-2015-HB2304-Introduced.html
84R4531 JSL/ADM-D | ||
By: Price | H.B. No. 2304 |
|
||
|
||
relating to the continuation and functions of the Health and Human | ||
Services Commission and the provision of health and human services | ||
in this state. | ||
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. 531.0201. TRANSFERS TO COMMISSION. (a) On the dates | ||
specified in the transition plan required under Section 531.0204, | ||
the powers, duties, functions, programs, and activities of each | ||
state agency or entity abolished by Section 531.0202 are | ||
transferred to the commission as provided by this subchapter. | ||
(b) On the dates described by Subsection (a): | ||
(1) all obligations and contracts of a state agency or | ||
entity abolished by Section 531.0202 are transferred to the | ||
commission; | ||
(2) all property and records in the custody of a state | ||
agency or entity abolished by Section 531.0202 and all funds | ||
appropriated by the legislature to the state agency or entity shall | ||
be transferred to the commission; and | ||
(3) all complaints, investigations, or contested | ||
cases that are pending before a state agency or entity abolished by | ||
Section 531.0202 or a governing person or entity of the state agency | ||
or entity are transferred without change in status to the | ||
commission. | ||
(c) A rule, policy, or form adopted by or on behalf of a | ||
state agency or entity abolished by Section 531.0202 is a rule, | ||
policy, or form of the commission and remains in effect: | ||
(1) until altered by the commission; or | ||
(2) unless it conflicts with a rule, policy, or form of | ||
the commission. | ||
(d) A license, permit, or certification in effect that was | ||
issued by a state agency or entity abolished by Section 531.0202 is | ||
continued in effect as a license, permit, or certification of the | ||
commission. | ||
Sec. 531.0202. ABOLITION OF STATE AGENCIES AND ENTITIES. | ||
(a) On the dates specified in the transition plan required under | ||
Section 531.0204, the following state agencies and entities are | ||
abolished and their respective powers, duties, functions, | ||
programs, and activities are transferred to the commission in | ||
accordance with Section 531.0201: | ||
(1) the Department of Aging and Disability Services; | ||
(2) the Department of Assistive and Rehabilitative | ||
Services; | ||
(3) the Department of Family and Protective Services; | ||
(4) the Department of State Health Services; | ||
(5) the Health and Human Services Council; | ||
(6) the Aging and Disability Services Council; | ||
(7) the Assistive and Rehabilitative Services | ||
Council; | ||
(8) the Family and Protective Services Council; | ||
(9) the State Health Services Council; | ||
(10) the Office for the Prevention of Developmental | ||
Disabilities; and | ||
(11) the Texas Council on Autism and Pervasive | ||
Developmental Disorders. | ||
(b) The abolition of a state agency or entity listed in | ||
Subsection (a) and the transfer of its powers, duties, functions, | ||
programs, activities, obligations, rights, contracts, records, | ||
property, funds, and employees to the commission 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 | ||
powers, duties, functions, programs, and activities from the state | ||
agencies and entities subject to abolition under Section 531.0202 | ||
to the commission as provided by this subchapter with a minimal | ||
negative effect on the delivery of services provided by those state | ||
agencies and entities. | ||
(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 powers, duties, | ||
functions, programs, and activities from the state agencies and | ||
entities subject to abolition under Section 531.0202 to the | ||
commission as provided by this subchapter with a minimal negative | ||
effect on the delivery of services provided by those agencies and | ||
entities; | ||
(2) with assistance from the commission and the state | ||
agencies and entities subject to abolition under Section 531.0202, | ||
advise the executive commissioner concerning: | ||
(A) the powers, duties, functions, programs, and | ||
activities to be transferred under this subchapter and the funds | ||
and obligations that are related to the powers, duties, functions, | ||
programs, or activities; | ||
(B) the transfer of the powers, duties, | ||
functions, programs, activities, records, property, funds, | ||
obligations, and employees 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, 531.00561, and 531.00562, 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 August 31, 2016, at least quarterly at the call | ||
of either chair, in addition to meeting at other times as determined | ||
appropriate by either chair; and | ||
(B) during the period between September 1, 2016, | ||
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, and speaker of the house of representatives | ||
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 powers, duties, functions, | ||
programs, and activities from the state agencies and entities | ||
subject to abolition under Section 531.0202 to the commission as | ||
provided by this subchapter; and | ||
(2) the reorganization of the commission's | ||
administrative structure in accordance with this subchapter, | ||
Sections 531.0055, 531.00561, and 531.00562, and other provisions | ||
enacted by the 84th Legislature that become law. | ||
(k) The committee is abolished September 1, 2023. | ||
Sec. 531.0204. TRANSITION AND WORK PLAN FOR IMPLEMENTATION | ||
OF CONSOLIDATION. (a) The transfer of powers, duties, functions, | ||
programs, and activities under Section 531.0201 to the commission | ||
must be accomplished in accordance with a transition plan developed | ||
by the executive commissioner. 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 and 531.00562, and other provisions | ||
enacted by the 84th Legislature that become law; | ||
(2) include a broad plan and schedule that specify the | ||
date on which each state agency or entity subject to abolition under | ||
Section 531.0202 is abolished and the respective transfers under | ||
Section 531.0201 are accomplished, and the date on which each | ||
division of the commission is created and its director is | ||
appointed; and | ||
(3) require all transfers under Section 531.0201 to be | ||
accomplished not later than September 1, 2016. | ||
(b) In developing the transition plan, the executive | ||
commissioner shall hold public hearings in various geographic areas | ||
in this state 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 (d). | ||
(c) Not later than the deadline specified by Subsection | ||
(a)(3), the commission shall begin administering the powers, | ||
duties, functions, programs, and activities assigned to the | ||
commission under this subchapter. The assumption of the | ||
administration of the powers, duties, functions, programs, and | ||
activities must be accomplished in accordance with a detailed work | ||
plan designed by the commission to ensure that the transfer and | ||
provision of health and human services in this state are | ||
accomplished in a careful and deliberative manner. The work plan | ||
must include details regarding the movement and specific timelines | ||
for the transfer of programs administered by the state agencies and | ||
entities subject to abolition under Section 531.0202 to the | ||
commission under this subchapter. | ||
(d) The executive commissioner shall submit the transition | ||
plan and the work plan to the Health and Human Services Transition | ||
Legislative Oversight Committee, the governor, and the Legislative | ||
Budget Board not later than December 1, 2015. The committee must | ||
approve the transition plan before the transition and work plans | ||
may be implemented. | ||
(e) The executive commissioner shall publish in the Texas | ||
Register: | ||
(1) the transition plan developed under this section; | ||
and | ||
(2) any changes to the transition plan required by 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 and work plans required under | ||
Section 531.0204; and | ||
(2) 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 for which federal law requires the | ||
designation of a responsible state agency and for which an agency | ||
subject to abolition under Section 531.0202, Government Code, as | ||
added by this article, is responsible. | ||
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 after | ||
its abolition under Section 531.0202 means the commission or the | ||
division of the commission performing a function previously | ||
performed by the state agency or entity before its abolition, 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, after the abolition under Section 531.0202 of 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 its abolition, 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, after the abolition under Section 531.0202 of | ||
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 its abolition. | ||
(d) This section applies notwithstanding Section | ||
531.001(4). This subsection and Section 531.001(4) expire on the | ||
deadline specified in Section 531.0204(a)(3). | ||
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 means the executive | ||
commissioner, the executive commissioner's designee, or the | ||
director appointed under Section 531.00561 of the division of the | ||
commission performing the relevant function previously performed | ||
by the state agency abolished by Section 531.0202 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, | ||
after the abolition under Section 531.0202 of the state agency that | ||
assumed or continued to perform a relevant function in accordance | ||
with Chapter 198 (H.B. 2292), Acts of the 78th Legislature, Regular | ||
Session, 2003, means the executive commissioner, or the director | ||
appointed under Section 531.00561 of the division of the commission | ||
performing the function previously performed by the state agency | ||
abolished or renamed by Chapter 198 (H.B. 2292) 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 (c); and | ||
(2) the governing body of a state agency listed in | ||
Section 531.0011(b) or (c). | ||
(c) A reference to any of the following councils means the | ||
executive commissioner or the executive commissioner's designee, | ||
as appropriate, and a power, duty, function, program, or other | ||
activity of any of the following councils is a power, duty, | ||
function, program, or other activity of that appropriate person: | ||
(1) the Health and Human Services Council; | ||
(2) the State Health Services Council; | ||
(3) the Aging and Disability Services Council; | ||
(4) the Family and Protective Services Council; or | ||
(5) the Assistive and Rehabilitative 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. | ||
(a-1) The council shall also receive public input and advise | ||
the executive commissioner regarding the operation of the health | ||
and human services agencies. This subsection expires on the | ||
deadline specified in Section 531.0204(a)(3). | ||
(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(d); and | ||
(3) other individuals appointed by the executive | ||
commissioner as the executive commissioner determines necessary. | ||
(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)(3) 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)(3) 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 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 [ |
||
SECTION 1.05. Section 531.0055, Government Code, is amended | ||
by amending Subsections (b), (d), (e), (f), (g), (h), and (l) and | ||
adding Subsection (n) to read as follows: | ||
(b) The commission shall: | ||
(1) supervise the administration and operation of the | ||
Medicaid program, 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 [ |
||
under Section 531.0273, with: | ||
(A) the provision of information technology | ||
services for the [ |
||
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 [ |
||
human services; | ||
(3) monitor and ensure the effective use of all | ||
federal funds received for the [ |
||
system [ |
||
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) the medical assistance program under Chapter | ||
32, Human Resources Code; | ||
(D) the nutritional assistance programs 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 [ |
||
administrative support services for the health and human services | ||
system [ |
||
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 [ |
||
commissioner, as necessary to perform the functions described by | ||
Subsections (b), (c), and (d) in implementation of applicable | ||
policies established for a health and human services system [ |
||
agency or division, as applicable, by the executive commissioner, | ||
shall: | ||
(1) manage and direct the operations of each [ |
||
|
||
(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 [ |
||
services system agencies, if applicable, 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 [ |
||
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 [ |
||
(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 [ |
||
(7) coordination of agency or division activities with | ||
activities of other components of the health and human services | ||
system and state agencies[ |
||
|
||
(g) Notwithstanding any other law, the operational | ||
authority and responsibility of the executive commissioner for | ||
purposes of Subsection (e) for [ |
||
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 | ||
[ |
||
(h) For each health and human services system agency and | ||
division, as applicable, the executive commissioner shall | ||
implement a program to evaluate and supervise [ |
||
operations [ |
||
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. | ||
(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 | ||
[ |
||
duties of persons who are served or regulated by the system [ |
||
|
||
(n) This subsection and Subsections (a), (i), and (k) expire | ||
on the deadline specified by Section 531.0204(a)(3). | ||
SECTION 1.06. Section 531.0056, Government Code, is amended | ||
by adding Subsections (g) and (h) 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. | ||
(h) This section expires on the deadline specified by | ||
Section 531.0204(a)(3). | ||
SECTION 1.07. (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 | ||
Sections 531.008(a) and (d). | ||
(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 appointed under Section | ||
531.00561, 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 1.08. Section 531.007, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.007. TERM. The executive commissioner serves a | ||
two-year term expiring February 1 of each odd-numbered year. | ||
SECTION 1.09. (a) Section 531.008, Government Code, is | ||
amended by amending Subsections (a) and (b) and adding Subsections | ||
(d) and (e) to read as follows: | ||
(a) Subject to the requirements of this section [ |
||
|
||
within the commission as necessary for effective administration and | ||
for the discharge of the commission's functions. | ||
(b) Subject to the requirements of this section [ |
||
|
||
functions among the commission's divisions. | ||
(d) In establishing divisions under this section, the | ||
executive commissioner shall: | ||
(1) ensure that the commission is organized along | ||
functional lines; and | ||
(2) consider creating a division within the commission | ||
for each of the following: | ||
(A) medical and social services; | ||
(B) state institutions and facilities functions; | ||
(C) family and protective services; | ||
(D) public health services; | ||
(E) regulatory functions; | ||
(F) centralized administrative services; and | ||
(G) inspector general responsibilities. | ||
(e) Subsection (c) applies only until the executive | ||
commissioner establishes divisions in accordance with Subsections | ||
(a) and (d). This subsection and Subsection (c) expire on the | ||
deadline specified by Section 531.0204(a)(3). | ||
(b) The executive commissioner of the Health and Human | ||
Services Commission shall establish divisions within the | ||
commission as required under Section 531.008(a), Government Code, | ||
as amended by this article, and Section 531.008(d), 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 1.10. (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 divisions within | ||
the commission. 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 commission or a | ||
division within the commission; | ||
(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 commission 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 | ||
commission under Subsection (b)(2), the office shall: | ||
(1) ensure individuals receiving services from or | ||
participating in programs administered by the commission 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 commission staff 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 commission | ||
staff; 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 commission and divisions within the | ||
commission, 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 divisions or offices within the commission and | ||
the establishment of cross-functional teams when necessary to | ||
improve the coordination of services provided by the commission. | ||
(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 [ |
||
commission shall establish a purchasing unit [ |
||
management of administrative activities related to the purchasing | ||
functions within [ |
||
services system [ |
||
(b) The purchasing unit [ |
||
(1) seek to achieve targeted cost reductions, increase | ||
process efficiencies, improve technological support and customer | ||
services, and enhance purchasing support within the [ |
||
health and human services system [ |
||
(2) if cost-effective, contract with private entities | ||
to perform purchasing functions for the [ |
||
and human services system [ |
||
SECTION 1.12. (a) 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 | ||
531.009(c), Government Code [ |
||
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 531.009(c), Government Code, [ |
||
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 531.009(c), Government Code, [ |
||
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. | ||
(b) The changes in law made by this section apply to a | ||
performance review performed on or after the date that the powers | ||
and duties of the Department of Family and Protective Services are | ||
transferred to the Health and Human Services Commission in | ||
accordance with Subchapter A-1, Chapter 531, Government Code, as | ||
added by this article. A performance review to which Sections | ||
40.0515(d) and (e), Human Resources Code, as amended by this | ||
article, apply that is performed before that date is governed by the | ||
law in effect before the effective date of this article, and the | ||
former law is continued in effect for that purpose. | ||
SECTION 1.13. (a) The heading to Subchapter C, Chapter 112, | ||
Human Resources Code, is amended to read as follows: | ||
SUBCHAPTER C. [ |
||
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 deadline specified by Section | ||
531.0204(a)(3), 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 [ |
||
prevention of specific targeted developmental disabilities; | ||
(8) monitor and assess the effectiveness of divisions | ||
within the commission and of state agencies in preventing [ |
||
|
||
(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 [ |
||
committee shall establish guidelines for: | ||
(1) selecting targeted disabilities; | ||
(2) assessing prevention services needs; and | ||
(3) reviewing [ |
||
operations for programs under this section. | ||
(b) The executive committee shall [ |
||
|
||
prevention programs for specifically targeted developmental | ||
disabilities. [ |
||
|
||
|
||
(c) A program under this section [ |
||
(1) must include [ |
||
the incidence of a specifically targeted disability; | ||
(2) must include [ |
||
plan; | ||
(3) must be funded [ |
||
(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 [ |
||
|
||
|
||
[ |
||
|
||
|
||
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 [ |
||
frequency or severity of a targeted developmental disability. | ||
(b) The executive committee shall regularly monitor and | ||
evaluate the results of [ |
||
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 | ||
[ |
||
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 1.14. (a) The heading to Chapter 114, Human | ||
Resources Code, is amended to read as follows: | ||
CHAPTER 114. [ |
||
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 deadline | ||
specified by Section 531.0204(a)(3), 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 [ |
||
|
||
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 [ |
||
|
||
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 [ |
||
|
||
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) [ |
||
|
||
|
||
|
||
|
||
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 | ||
[ |
||
lieutenant governor, and the speaker of the house of | ||
representatives [ |
||
(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 [ |
||
|
||
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 [ |
||
commission [ |
||
|
||
coordinate resources for individuals with autism and other | ||
pervasive developmental disorders and their families. In | ||
coordinating those resources [ |
||
|
||
shall consult with [ |
||
state agencies[ |
||
(b) As part of coordinating resources under Subsection (a), | ||
the commission [ |
||
[ |
||
(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 1.15. (a) Effective September 1, 2016, the | ||
following provisions of the Government Code are repealed: | ||
(1) Section 531.0163; and | ||
(2) Subchapter K, Chapter 531. | ||
(b) Effective September 1, 2016, the following provisions | ||
of the Health and Safety Code are repealed: | ||
(1) Section 1001.002; | ||
(2) Section 1001.021; | ||
(3) Section 1001.022; | ||
(4) Section 1001.023; | ||
(5) Section 1001.024; | ||
(6) Section 1001.025; | ||
(7) Section 1001.026; | ||
(8) Section 1001.027; | ||
(9) Section 1001.028; | ||
(10) Section 1001.029; | ||
(11) Section 1001.030; | ||
(12) Section 1001.032; | ||
(13) Subchapter C, Chapter 1001; and | ||
(14) Section 1001.074. | ||
(c) Effective September 1, 2016, the following provisions | ||
of the Human Resources Code are repealed: | ||
(1) Section 40.002(a); | ||
(2) Section 40.004; | ||
(3) Section 40.0041; | ||
(4) Section 40.021; | ||
(5) Section 40.022; | ||
(6) Section 40.0226; | ||
(7) Section 40.024; | ||
(8) Section 40.025; | ||
(9) Section 40.026; | ||
(10) Section 40.027; | ||
(11) Section 40.032; | ||
(12) Section 40.033; | ||
(13) Section 117.002; | ||
(14) Section 117.021; | ||
(15) Section 117.022; | ||
(16) Section 117.023; | ||
(17) Section 117.024; | ||
(18) Section 117.025; | ||
(19) Section 117.026; | ||
(20) Section 117.027; | ||
(21) Section 117.028; | ||
(22) Section 117.029; | ||
(23) Section 117.030; | ||
(24) Section 117.032; | ||
(25) Section 117.051; | ||
(26) Section 117.052; | ||
(27) Section 117.053; | ||
(28) Section 117.054; | ||
(29) Section 117.055; | ||
(30) Section 117.056; | ||
(31) Section 117.072; | ||
(32) Section 161.002; | ||
(33) Subchapter B, Chapter 161; | ||
(34) Section 161.051; | ||
(35) Section 161.052; | ||
(36) Section 161.053; | ||
(37) Section 161.054; | ||
(38) Section 161.055; | ||
(39) Section 161.056; and | ||
(40) Section 161.072. | ||
(d) Notwithstanding Subsections (a), (b), and (c) of this | ||
section, the implementation of a provision repealed by this section | ||
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 531.00551 to read as follows: | ||
Sec. 531.00551. 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. | ||
(c) This section expires on the deadline specified by | ||
Section 531.0204(a)(3). | ||
SECTION 2.03. Section 531.006, Government Code, 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 [ |
||
|
||
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 [ |
||
manager, or paid consultant of a Texas trade association in the [ |
||
field of health and human services [ |
||
|
||
(b) A person may not be appointed as executive commissioner | ||
or act as general counsel of the commission if the person [ |
||
required to register as a lobbyist under Chapter 305 because of the | ||
person's activities for compensation [ |
||
profession related to the operation of the commission [ |
||
|
||
(c) A person may not be appointed [ |
||
|
||
financial interest in a corporation, organization, or association | ||
under contract with the commission or a health and human services | ||
agency [ |
||
|
||
developmental disability [ |
||
community center. | ||
SECTION 2.04. Section 531.008(c), Government Code, is | ||
amended to read as follows: | ||
(c) The executive commissioner shall establish the | ||
following divisions and offices within the commission: | ||
(1) 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) the medical assistance program under Chapter | ||
32, Human Resources Code; | ||
(D) the nutritional assistance programs 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) the office of the ombudsman as provided by Section | ||
531.0171 [ |
||
[ |
||
|
||
[ |
||
|
||
(4) a purchasing division as provided by Section | ||
531.017; and | ||
(5) an internal audit division to conduct a program of | ||
internal auditing in accordance with [ |
||
2102. | ||
SECTION 2.05. 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 2.06. (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 state agency or entity is | ||
abolished as provided by Section 531.0202, 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 operated by or | ||
related to the abolished state agency or entity is updated, | ||
transferred, or consolidated to reflect the consolidation mandated | ||
by Subchapter A-1, Chapter 531, Government Code, as added by this | ||
Act. | ||
SECTION 2.07. (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, 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, except that the | ||
following are not abolished 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. | ||
(d) 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 | ||
(c) of this section and shall publish that certification in the | ||
Texas Register not later than September 1, 2016. | ||
(e) Section 533.039, Health and Safety Code, is repealed. | ||
SECTION 2.08. (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; and | ||
(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. | ||
(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 state agency or entity is | ||
abolished as provided by Section 531.0202, 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 operated or | ||
administered by the abolished state agency or entity is transferred | ||
or consolidated to reflect the consolidation mandated by Subchapter | ||
A-1, Chapter 531, Government Code, as added by this Act. | ||
SECTION 2.09. (a) Section 531.02111(b), Government Code, | ||
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 Medicaid | ||
programs administered or operated by the agency; and | ||
(B) an accounting of all funds related to the | ||
state Medicaid program received and disbursed by the agency during | ||
the period covered by the report, including: | ||
(i) the amount of any federal medical | ||
assistance funds allocated to the agency for the support of each of | ||
the Medicaid programs operated or administered by the agency; | ||
(ii) the amount of any funds appropriated | ||
by the legislature to the agency for each of those programs; and | ||
(iii) the amount of medical assistance | ||
payments and related expenditures made by or in connection with | ||
each of those programs; and | ||
(2) for each Medicaid program identified in the | ||
report: | ||
(A) the amount and source of funds or other | ||
revenue received by or made available to the agency for the program; | ||
[ |
||
(B) the amount spent on each type of service or | ||
benefit provided by or under the program; | ||
(C) the amount spent on program operations, | ||
including eligibility determination, claims processing, and case | ||
management; and | ||
(D) the amount spent on any other administrative | ||
costs [ |
||
(b) The following provisions 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 2.10. (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 the Medicaid | ||
program. | ||
(b) In streamlining the Medicaid provider enrollment | ||
process, the commission shall establish a centralized Internet | ||
portal through which providers may enroll in the Medicaid program. | ||
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 the Medicaid program. | ||
(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 | ||
the Medicaid program and comparing the performance of managed care | ||
organizations participating in the program. 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 531.02731 to read as follows: | ||
Sec. 531.02731. REPORT OF INFORMATION RESOURCES MANAGER TO | ||
COMMISSION. (a) 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. | ||
(b) This section expires on the deadline specified by | ||
Section 531.0204(a)(3). | ||
SECTION 2.13. 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 | ||
the Medicaid program 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 the Medicaid program; 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 the Medicaid program. | ||
SECTION 2.14. (a) Section 531.1031(a), Government Code, 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[ |
||
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 [ |
||
with authority to issue a license to [ |
||
|
||
that may participate in the [ |
||
(C) the [ |
||
|
||
(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 the Medicaid program. 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 the Medicaid | ||
program; 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 the Medicaid | ||
program 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 the Medicaid program, the office, after seeking public input, | ||
shall establish and the executive commissioner by rule shall adopt | ||
guidelines for the evaluation of criminal history record | ||
information of providers and potential providers not subject to a | ||
criminal history record information check by a licensing authority | ||
described by Subsection (a). 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 the | ||
Medicaid program, taking into consideration: | ||
(1) the extent to which the underlying conduct relates | ||
to the services provided under the program; | ||
(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 the Medicaid program. | ||
(d) The office and the commission shall use the guidelines | ||
adopted under Subsection (c) to determine whether a provider about | ||
whom the office is notified as provided by Subsection (a)(2) may | ||
continue participating in the Medicaid program as a provider. | ||
(e) The provider enrollment contractor, if applicable, and | ||
a managed care organization participating in the Medicaid program | ||
shall defer to the office regarding whether a person's criminal | ||
history record information precludes the person from participating | ||
in the Medicaid program 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 the | ||
Medicaid or Medicare program by the federal government is not | ||
participating as a provider in the program. | ||
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 the Medicaid program, 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 excluded from participating in | ||
the Medicaid program 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 2.15. (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 | ||
the Medicaid program. | ||
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 2.16. 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[ |
||
|
||
SECTION 2.17. 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 2.18. 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 2.19. 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 the Medicaid program. | ||
(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 2.20. (a) Section 533.015, Government Code, 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 the state | ||
Medicaid program 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 | ||
the Medicaid program 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 the Medicaid program. | ||
(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 2.21. Section 533.041(a), Government Code, 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 intellectual and developmental disabilities or | ||
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 program | ||
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[ |
||
[ |
||
|
||
SECTION 2.22. (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. With the assistance of the work group | ||
established under Section 533.083, 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 | ||
pilot program must: | ||
(1) be operated in one managed care service delivery | ||
area selected in accordance with Section 533.083(a)(1)(A); | ||
(2) require all managed care organizations in the | ||
selected service delivery area to participate in the program; and | ||
(3) pilot incentive-based provider payment structures | ||
determined in accordance with Section 533.083(a)(2). | ||
Sec. 533.083. PILOT PROGRAM DEVELOPMENT WORK GROUP. (a) | ||
The executive commissioner shall establish a work group to assist | ||
the commission with developing the pilot program required under | ||
this subchapter. The work group shall assist the commission with: | ||
(1) selecting: | ||
(A) the managed care service delivery area in | ||
which the pilot program will be implemented; and | ||
(B) managed care programs to be included in the | ||
pilot program; | ||
(2) determining the types of incentive-based provider | ||
payment structures to pilot and the services that most | ||
appropriately fit into those payment structures; and | ||
(3) determining a timeline for implementation of the | ||
pilot program that requires implementation to begin not later than | ||
January 1, 2017. | ||
(b) The executive commissioner shall determine the number | ||
of members of the work group and ensure that the work group consists | ||
of representatives from: | ||
(1) the commission; | ||
(2) managed care organizations providing services | ||
under the Medicaid managed care program; and | ||
(3) professional associations composed of health care | ||
providers. | ||
(c) A member of the work group serves at the pleasure of the | ||
executive commissioner and without compensation. | ||
Sec. 533.084. 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 | ||
structures are most appropriate for statewide implementation and | ||
the services that can be provided under those structures; and | ||
(2) require that a managed care organization that has | ||
contracted with the commission to provide health care services to | ||
recipients implement the payment structures identified under | ||
Subdivision (1). | ||
Sec. 533.085. EXPIRATION. Sections 533.081, 533.082, and | ||
533.083 and this section expire September 1, 2018. | ||
(b) As soon as possible after the effective date of this | ||
article, the executive commissioner of the Health and Human | ||
Services Commission shall establish the work group and the | ||
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 | ||
structures identified by the commission under Section 533.084, | ||
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 structures identified by the | ||
commission under Section 533.084, 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 2.23. 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) [ |
||
|
||
[ |
||
mental health hospitals under Chapter 552; | ||
(13) [ |
||
mental health hospitals under Chapter 552; and | ||
(14) [ |
||
or service designated by the department. | ||
SECTION 2.24. 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 [ |
||
|
||
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 [ |
||
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, is | ||
amended to read as follows: | ||
Sec. 531.012. ADVISORY COMMITTEES. (a) The executive | ||
commissioner shall establish and maintain [ |
||
committees to consider issues and solicit public input across all | ||
major areas of the health and human services system, 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; | ||
(12) prevention efforts; and | ||
(13) faith- and community-based initiatives. | ||
(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 report any recommendations to the executive commissioner at a | ||
meeting of the Health and Human Services Commission Executive | ||
Council established under Section 531.0051 [ |
||
(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. | ||
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 [ |
||
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 531.02443(e), Government Code, is | ||
amended to read as follows: | ||
(e) The department, with the advice and assistance of [ |
||
|
||
|
||
legally authorized representatives of adult residents, persons | ||
with an intellectual disability [ |
||
supported living centers [ |
||
developmental disability [ |
||
(1) develop an effective community living options | ||
information process; | ||
(2) create uniform procedures for the implementation | ||
of the community living options information process; and | ||
(3) minimize any potential conflict of interest | ||
regarding the community living options information process between | ||
a state supported living center [ |
||
adult resident's legally authorized representative, or a local | ||
intellectual and developmental disability [ |
||
authority. | ||
SECTION 3.06. The heading to Section 531.0273, Government | ||
Code, is amended to read as follows: | ||
Sec. 531.0273. INFORMATION RESOURCES PLANNING AND | ||
MANAGEMENT [ |
||
SECTION 3.07. Section 531.051(c), Government Code, is | ||
amended to read as follows: | ||
(c) In adopting rules for the consumer direction models, the | ||
executive commissioner [ |
||
(1) [ |
||
|
||
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) [ |
||
|
||
the implementation of the consumer direction models. | ||
SECTION 3.08. Sections 531.057(b) and (c), Government Code, | ||
are amended to read as follows: | ||
(b) The executive commissioner shall [ |
||
|
||
volunteer advocate program for the elderly receiving services from | ||
or under the direction of the commission or a health and human | ||
services agency. | ||
(c) In developing the program, the executive commissioner | ||
[ |
||
principles: | ||
(1) the intent of the program is to evaluate, through | ||
operation of pilot projects, whether providing the services of a | ||
trained volunteer advocate selected by an elderly individual or the | ||
individual's designated caregiver is effective in achieving the | ||
following goals: | ||
(A) extend the time the elderly individual can | ||
remain in an appropriate home setting; | ||
(B) maximize the efficiency of services | ||
delivered to the elderly individual by focusing on services needed | ||
to sustain family caregiving; | ||
(C) protect the elderly individual by providing a | ||
knowledgeable third party to review the quality of care and | ||
services delivered to the individual and the care options available | ||
to the individual and the individual's family; and | ||
(D) facilitate communication between the elderly | ||
individual or the individual's designated caregiver and providers | ||
of health care and other services; | ||
(2) a volunteer advocate curriculum must be | ||
established that incorporates best practices as determined and | ||
recognized by a professional organization recognized in the elder | ||
health care field; | ||
(3) the use of pro bono assistance from qualified | ||
professionals must be maximized in developing the volunteer | ||
advocate curriculum and designing the program; | ||
(4) trainers must be certified on the ability to | ||
deliver training; | ||
(5) training shall be offered through multiple | ||
community-based organizations; and | ||
(6) participation in the program is voluntary and must | ||
be initiated by the elderly individual or the individual's | ||
designated caregiver. | ||
SECTION 3.09. Section 531.067, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.067. PROGRAM TO IMPROVE AND MONITOR CERTAIN | ||
OUTCOMES OF RECIPIENTS UNDER CHILD HEALTH PLAN AND MEDICAID | ||
PROGRAMS [ |
||
|
||
|
||
|
||
|
||
|
||
|
||
[ |
||
|
||
[ |
||
|
||
[ |
||
|
||
|
||
|
||
|
||
|
||
[ |
||
|
||
[ |
||
|
||
[ |
||
|
||
|
||
[ |
||
[ |
||
commission may design and implement a program to improve and | ||
monitor clinical and functional outcomes of a recipient of services | ||
under the state child health plan or medical assistance program. | ||
The program may use financial, clinical, and other criteria based | ||
on pharmacy, medical services, and other claims data related to the | ||
child health plan or the state medical assistance program. [ |
||
|
||
|
||
|
||
SECTION 3.10. (a) Section 531.0691, Government Code, is | ||
redesignated as Section 531.0735, Government Code, and amended to | ||
read as follows: | ||
Sec. 531.0735 [ |
||
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 the Medicaid program. | ||
(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 the Medicaid | ||
program; 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; and | ||
(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. | ||
(d) Members appointed under Subsection (c)(2) may attend | ||
quarterly and other regularly scheduled meetings, but may not: | ||
(1) attend executive sessions; or | ||
(2) otherwise 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. | ||
(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 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 cost-effective medically appropriate drug therapies for | ||
Medicaid recipients, 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 [ |
||
REVIEW BOARD: CONFLICTS OF INTEREST. (a) A member of the [ |
||
|
||
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 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 [ |
||
under Section 531.0736 [ |
||
(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 [ |
||
|
||
the board [ |
||
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 [ |
||
(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 [ |
||
|
||
(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 | ||
[ |
||
Section 531.0736 [ |
||
(g) Section 531.074, Government Code, is repealed. | ||
(h) The term of a member serving on the Medicaid Drug | ||
Utilization Review Board on September 1, 2015, expires on that | ||
date. Not later than September 1, 2015, the executive commissioner | ||
of the Health and Human Services Commission shall appoint members | ||
to the Drug Utilization Review Board in accordance with Section | ||
531.0736, Government Code, as added by this article, for terms | ||
beginning September 2, 2015. 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 September 1, 2017, and the remaining members to serve for | ||
terms expiring September 1, 2019. | ||
(i) Not later than January 1, 2016, 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 3.11. The heading to Subchapter D, Chapter 531, | ||
Government Code, is amended to read as follows: | ||
SUBCHAPTER D. PLAN TO SUPPORT GUARDIANSHIPS [ |
||
|
||
SECTION 3.12. Section 531.124, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.124. COMMISSION DUTIES. The [ |
||
|
||
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. | ||
[ |
||
|
||
|
||
|
||
SECTION 3.13. Section 531.159(f), Government Code, is | ||
amended to read as follows: | ||
(f) The executive commissioner [ |
||
develop procedures by which to conduct the reviews required by | ||
Subsections (c), (d), and (e). [ |
||
|
||
|
||
|
||
SECTION 3.14. Section 531.551(a), Government Code, is | ||
amended to read as follows: | ||
(a) The executive commissioner shall adopt rules providing | ||
for: | ||
(1) a standard definition of "uncompensated hospital | ||
care"; | ||
(2) a methodology to be used by hospitals in this state | ||
to compute the cost of that care that incorporates a [ |
||
set of adjustments to a hospital's initial computation of the cost | ||
of uncompensated hospital care that account for all funding streams | ||
that: | ||
(A) are not patient-specific; and | ||
(B) are used to offset the hospital's initially | ||
computed amount of uncompensated care [ |
||
|
||
(3) procedures to be used by those hospitals to report | ||
the cost of that care to the commission and to analyze that cost. | ||
SECTION 3.15. Section 531.907(a), Government Code, is | ||
amended to read as follows: | ||
(a) Based on [ |
||
|
||
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 under Section 531.905 as technology becomes available and | ||
interoperability capabilities improve. | ||
SECTION 3.16. Section 531.909, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.909. INCENTIVES. The commission [ |
||
|
||
strategies to encourage health care providers to use the health | ||
information exchange system, including incentives, education, and | ||
outreach tools to increase usage. | ||
SECTION 3.17. Section 533.0025(a), Government Code, is | ||
amended to read as follows: | ||
(a) In this section and Sections 533.00251, 533.002515, and | ||
[ |
||
the meaning assigned by Section 32.003, Human Resources Code. | ||
SECTION 3.18. Section 533.00251(c), Government Code, is | ||
amended to read as follows: | ||
(c) Subject to Section 533.0025 and notwithstanding any | ||
other law, the commission [ |
||
|
||
program 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 adopted 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 | ||
the medical assistance program 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 3.19. Section 533.00253(b), Government Code, is | ||
amended to read as follows: | ||
(b) Subject to Section 533.0025, the commission shall[ |
||
|
||
|
||
establish a mandatory STAR Kids capitated managed care program | ||
tailored to provide medical assistance benefits to children with | ||
disabilities. The managed care program developed under this | ||
section must: | ||
(1) provide medical assistance 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 medical assistance 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. | ||
SECTION 3.20. Section 533.00256(a), Government Code, is | ||
amended to read as follows: | ||
(a) In consultation with [ |
||
|
||
|
||
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 3.21. Section 534.052, Government Code, is amended | ||
to read as follows: | ||
Sec. 534.052. IMPLEMENTATION OF SYSTEM REDESIGN. The | ||
commission and department shall [ |
||
|
||
long-term services and supports system for individuals with | ||
intellectual and developmental disabilities in the manner and in | ||
the stages described in this chapter. | ||
SECTION 3.22. Section 534.104(d), Government Code, is | ||
amended to read as follows: | ||
(d) The department [ |
||
|
||
proposal and determine whether: | ||
(1) the proposed strategy satisfies the requirements | ||
of this section; and | ||
(2) the private services provider that submitted the | ||
proposal has a demonstrated ability to provide the long-term | ||
services and supports appropriate to the individuals who will | ||
receive services through the pilot program based on the proposed | ||
strategy, if implemented. | ||
SECTION 3.23. Section 534.105, Government Code, is amended | ||
to read as follows: | ||
Sec. 534.105. PILOT PROGRAM: MEASURABLE GOALS. (a) The | ||
department [ |
||
identify measurable goals to be achieved by each pilot program | ||
implemented under this subchapter. The identified goals must: | ||
(1) align with information that will be collected | ||
under Section 534.108(a); and | ||
(2) be designed to improve the quality of outcomes for | ||
individuals receiving services through the pilot program. | ||
(b) The department [ |
||
|
||
identified goals. A proposed strategy may be evidence-based if | ||
there is an evidence-based strategy available for meeting the pilot | ||
program's goals. | ||
SECTION 3.24. Section 534.108(d), Government Code, is | ||
amended to read as follows: | ||
(d) On or before December 1, 2016, and December 1, 2017, the | ||
commission and the department [ |
||
|
||
each pilot program implemented under this subchapter and submit a | ||
report to the legislature during the operation of the pilot | ||
programs. Each report must include recommendations for program | ||
improvement and continued implementation. | ||
SECTION 3.25. Section 534.201(d), Government Code, is | ||
amended to read as follows: | ||
(d) In implementing the transition described by Subsection | ||
(b), the commission shall develop a process to receive and evaluate | ||
input from interested statewide stakeholders [ |
||
|
||
SECTION 3.26. Section 534.202(d), Government Code, is | ||
amended to read as follows: | ||
(d) In implementing the transition described by Subsection | ||
(b), the commission shall develop a process to receive and evaluate | ||
input from interested statewide stakeholders [ |
||
|
||
SECTION 3.27. Section 535.051(c), Government Code, is | ||
amended to read as follows: | ||
(c) The commissioner of higher education[ |
||
|
||
shall designate one employee from an institution of higher | ||
education, as that term is defined under Section 61.003, Education | ||
Code, to serve as a liaison for faith- and community-based | ||
organizations. | ||
SECTION 3.28. 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 [ |
||
|
||
not used to advance a sectarian purpose or to engage in any form of | ||
proselytization. | ||
SECTION 3.29. Section 535.106(b), Government Code, is | ||
amended to read as follows: | ||
(b) If awarded a contract or grant under Section 535.104, | ||
the State Commission on National and Community Service must provide | ||
to the commission periodic reports on a schedule determined by the | ||
executive commissioner. The schedule of periodic reports must | ||
include an annual report that includes: | ||
(1) a specific accounting with respect to the use by | ||
that entity of money appropriated from the account, including the | ||
names of persons to whom grants have been awarded and the purposes | ||
of those grants; and | ||
(2) a summary of the efforts of the faith- and | ||
community-based liaisons designated under Section 535.051 to | ||
comply with the duties imposed by and the purposes of Section | ||
[ |
||
SECTION 3.30. 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 [ |
||
|
||
SECTION 3.31. Section 536.003(a), Government Code, is | ||
amended to read as follows: | ||
(a) The commission [ |
||
|
||
measures that promote the provision of efficient, quality health | ||
care and that can be used in the child health plan and Medicaid | ||
programs 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 3.32. Section 536.004(a), Government Code, 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 [ |
||
|
||
of acute care and long-term services and supports under the child | ||
health plan and Medicaid programs, 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 | ||
or Medicaid program 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 3.33. Section 536.006(a), Government Code, is | ||
amended to read as follows: | ||
(a) The commission [ |
||
(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 3.34. Section 536.052(b), Government Code, is | ||
amended to read as follows: | ||
(b) The commission [ |
||
|
||
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 3.35. Section 536.102(a), Government Code, is | ||
amended to read as follows: | ||
(a) Subject to this subchapter, the commission [ |
||
|
||
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 3.36. 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 [ |
||
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 3.37. Section 536.202(a), Government Code, is | ||
amended to read as follows: | ||
(a) The commission shall [ |
||
|
||
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 3.38. Section 536.204(a), Government Code, is | ||
amended to read as follows: | ||
(a) The executive commissioner shall [ |
||
[ |
||
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 [ |
||
[ |
||
|
||
SECTION 3.39. Section 536.251(a), Government Code, is | ||
amended to read as follows: | ||
(a) Subject to this subchapter, the commission, after | ||
consulting with [ |
||
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 3.40. Section 538.052(a), Government Code, 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 [ |
||
|
||
(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[ |
||
[ |
||
|
||
SECTION 3.41. Sections 533.0335(c) and (d), Health and | ||
Safety Code, are amended to read as follows: | ||
(c) The department [ |
||
|
||
requests for supervised living or residential support services | ||
available in the home and community-based services (HCS) Medicaid | ||
waiver program. The process must ensure that supervised living or | ||
residential support services available in the home and | ||
community-based services (HCS) Medicaid waiver program are | ||
available only to individuals for whom a more independent setting | ||
is not appropriate or available. | ||
(d) The department shall [ |
||
|
||
Subsection (c). This subsection expires January 1, 2024. | ||
SECTION 3.42. Section 533.03551(b), Health and Safety Code, | ||
is amended to read as follows: | ||
(b) The Department of Aging and Disability Services, in | ||
cooperation with the Texas Department of Housing and Community | ||
Affairs, the Department of Agriculture, and the Texas State | ||
Affordable Housing Corporation [ |
||
|
||
|
||
coordinate with federal, state, and local public housing entities | ||
as necessary to expand opportunities for accessible, affordable, | ||
and integrated housing to meet the complex needs of individuals | ||
with disabilities, including individuals with intellectual and | ||
developmental disabilities. | ||
SECTION 3.43. Sections 1002.060(c) and (e), Health and | ||
Safety Code, are amended to read as follows: | ||
(c) The commission, department, or institute or an officer | ||
or employee of the commission, department, or institute[ |
||
|
||
confidential under this section. | ||
(e) An officer or employee of the commission, department, or | ||
institute[ |
||
civil, criminal, special, administrative, or other proceeding as to | ||
information that is confidential under this section. | ||
SECTION 3.44. Section 1002.061, Health and Safety Code, is | ||
amended by amending Subsection (c) and adding Subsection (c-1) to | ||
read as follows: | ||
(c) Except as otherwise provided by law, each of the | ||
following state agencies or systems [ |
||
|
||
institute and implement this chapter: | ||
(1) the department; | ||
(2) the commission; | ||
(3) the Texas Department of Insurance; | ||
(4) the Employees Retirement System of Texas; | ||
(5) the Teacher Retirement System of Texas; | ||
(6) the Texas Medical Board; | ||
(7) the Department of Aging and Disability Services; | ||
(8) the Texas Workforce Commission; | ||
(9) the Texas Higher Education Coordinating Board; and | ||
(10) each state agency or system of higher education | ||
that purchases or provides health care services, as determined by | ||
the governor. | ||
(c-1) The commission shall establish a funding formula to | ||
determine the level of support each state agency listed in | ||
Subsection (c) is required to provide. | ||
SECTION 3.45. Section 22.038(b), Human Resources Code, is | ||
amended to read as follows: | ||
(b) The memorandum of understanding must: | ||
(1) define the responsibilities of each agency in | ||
implementing the components of the pilot program; and | ||
(2) provide for interagency coordination and | ||
integration with respect to appropriate components of the pilot | ||
program, including any components: | ||
(A) that serve persons for whom each of the | ||
agencies otherwise provides services; or | ||
(B) for which coordination and integration among | ||
the agencies will result in the more efficient accomplishment of | ||
the goals of the comprehensive, effectively working plan | ||
implemented under Section 531.0244, Government Code [ |
||
[ |
||
|
||
|
||
SECTION 3.46. (a) Section 32.022(b), Human Resources Code, | ||
is amended to read as follows: | ||
(b) The executive commissioner [ |
||
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 September 1, 2015, 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 3.47. Section 32.0641(a), Human Resources Code, 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 | ||
of the Health and Human Services Commission shall adopt [ |
||
|
||
|
||
|
||
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 3.48. 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 [ |
||
|
||
|
||
training described by this subsection. | ||
SECTION 3.49. Section 1352.005(b), Insurance Code, is | ||
amended to read as follows: | ||
(b) The commissioner [ |
||
|
||
the specific contents and wording of the notice required under this | ||
section. | ||
SECTION 3.50. (a) The following provisions of the | ||
Government Code are repealed: | ||
(1) Section 531.0217(j); | ||
(2) Section 531.02172; | ||
(3) Section 531.02173(c); | ||
(4) Section 531.02441; | ||
(5) Sections 531.0273(d), (e), (f), and (g); | ||
(6) Section 531.052; | ||
(7) Section 531.0571; | ||
(8) Section 531.068; | ||
(9) Sections 531.121(1), (5), and (6); | ||
(10) Section 531.122; | ||
(11) Section 531.123; | ||
(12) Section 531.1235; | ||
(13) Section 531.251; | ||
(14) Section 531.552; | ||
(15) Subchapters R and T, Chapter 531; | ||
(16) Section 531.904; | ||
(17) Section 533.00251(a)(1); | ||
(18) Section 533.00252; | ||
(19) Sections 533.00253(a)(1) and (f); | ||
(20) Section 533.00254; | ||
(21) Sections 533.00255(e) and (f); | ||
(22) Section 533.00285; | ||
(23) Subchapters B and C, Chapter 533; | ||
(24) Section 534.001(1); | ||
(25) Section 534.053; | ||
(26) Section 535.053; | ||
(27) Section 535.054; | ||
(28) Section 535.055; | ||
(29) Section 535.108; | ||
(30) Section 536.001(1); | ||
(31) Section 536.002; and | ||
(32) Section 536.007(b). | ||
(b) The following provisions of the Health and Safety Code | ||
are repealed: | ||
(1) Subchapter C, Chapter 32; | ||
(2) Section 62.151(e); | ||
(3) Section 62.157(c), as added by Chapter 1255 (S.B. | ||
789), Acts of the 77th Legislature, Regular Session, 2001; | ||
(4) Section 81.010; | ||
(5) Section 92.011; | ||
(6) Subchapter B, Chapter 92; | ||
(7) Chapter 115; | ||
(8) Section 241.187; | ||
(9) Section 533.0335(a)(1); | ||
(10) Section 1002.001(1); | ||
(11) Section 1002.052; | ||
(12) Section 1002.053; | ||
(13) Section 1002.055; | ||
(14) Section 1002.056; | ||
(15) Section 1002.057; | ||
(16) Section 1002.058; and | ||
(17) Section 1002.059. | ||
(c) The following provisions of the Human Resources Code are | ||
repealed: | ||
(1) Section 22.035; and | ||
(2) Section 32.022(e). | ||
SECTION 3.51. 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 Children's Policy Council; | ||
(5) the Consumer Direction Work Group; | ||
(6) the Council on Children and Families; | ||
(7) the Electronic Health Information Exchange System | ||
Advisory Committee; | ||
(8) the Guardianship Advisory Board; | ||
(9) the hospital payment advisory committee; | ||
(10) the advisory committee for information resources | ||
planning and management; | ||
(11) the Intellectual and Developmental Disability | ||
System Redesign Advisory Committee; | ||
(12) the Interagency Coordinating Council for HIV and | ||
Hepatitis; | ||
(13) the interagency coordinating group for faith- and | ||
community-based initiatives; | ||
(14) the interagency task force on ensuring | ||
appropriate care settings for persons with disabilities; | ||
(15) the Medicaid and CHIP Quality-Based Payment | ||
Advisory Committee; | ||
(16) each Medicaid managed care advisory committee | ||
appointed for a health care service region under Subchapter B, | ||
Chapter 533, Government Code; | ||
(17) the Perinatal Advisory Council; | ||
(18) the Public Assistance Health Benefit Review and | ||
Design Committee; | ||
(19) the renewing our communities account advisory | ||
committee; | ||
(20) the STAR + PLUS Nursing Facility Advisory | ||
Committee; | ||
(21) the STAR + PLUS Quality Council; | ||
(22) the STAR Kids Managed Care Advisory Committee; | ||
(23) the state Medicaid managed care advisory | ||
committee; | ||
(24) the task force on domestic violence; | ||
(25) the Interagency Task Force for Children With | ||
Special Needs; | ||
(26) the telemedicine and telehealth advisory | ||
committee; | ||
(27) the board of directors of the Texas Institute of | ||
Health Care Quality and Efficiency; | ||
(28) the Texas Nonprofit Council; | ||
(29) the Texas System of Care Consortium; | ||
(30) the Texas Traumatic Brain Injury Advisory | ||
Council; | ||
(31) the volunteer advocate program advisory | ||
committee; and | ||
(32) the work group on uncompensated hospital care. | ||
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 [ |
||
SECTION 4.02. Section 11.003(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) The Texas Board of Health and the Texas Department of | ||
Health were abolished by Section 1.26, Chapter 198 (H.B. 2292), | ||
Acts of the 78th Legislature, Regular Session, 2003. The [ |
||
|
||
those entities' successor in function are [ |
||
Subchapter A-1, Chapter 531, Government Code, to the Health and | ||
Human Services Commission [ |
||
to Chapter 325, Government Code (Texas Sunset Act). Unless the | ||
commission is [ |
||
|
||
chapter, this chapter expires on the date the commission is | ||
abolished under Section 531.004, Government Code [ |
||
|
||
SECTION 4.03. Section 108.016, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 108.016. SUNSET REVIEW. Unless continued in | ||
existence in accordance with Chapter 325, Government Code (Texas | ||
Sunset Act), after the review required by Section 531.004, | ||
Government Code [ |
||
commission is abolished under that section [ |
||
SECTION 4.04. Section 532.002, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 532.002. SUNSET PROVISION. The Texas Department of | ||
Mental Health and Mental Retardation was abolished by Section 1.26, | ||
Chapter 198 (H.B. 2292), Acts of the 78th Legislature, Regular | ||
Session, 2003. The [ |
||
under this chapter of that agency's successors in function are | ||
[ |
||
Code, to the Health and Human Services Commission [ |
||
which is [ |
||
Sunset Act). Unless the commission is [ |
||
|
||
provided by that Act, this chapter expires on the date the | ||
commission is abolished under Section 531.004, Government Code | ||
[ |
||
SECTION 4.05. Section 1001.003, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 1001.003. SUNSET PROVISION. Unless the commission | ||
is [ |
||
|
||
existence as provided by Chapter 325, Government Code [ |
||
|
||
Code, [ |
||
date the commission is abolished under that section [ |
||
|
||
SECTION 4.06. Section 21.002, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 21.002. SUNSET PROVISION. The Texas Department of | ||
Human Services was abolished by Section 1.26, Chapter 198 (H.B. | ||
2292), Acts of the 78th Legislature, Regular Session, 2003. The [ |
||
|
||
that agency's successors in function are [ |
||
Subchapter A-1, Chapter 531, Government Code, to the Health and | ||
Human Services Commission [ |
||
to Chapter 325, Government Code (Texas Sunset Act). Unless the | ||
commission is [ |
||
|
||
chapter, this title expires on the date the commission is abolished | ||
under Section 531.004, Government Code [ |
||
|
||
SECTION 4.07. Section 40.003, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 40.003. SUNSET PROVISION. Unless the commission | ||
is [ |
||
|
||
continued in existence as provided by Chapter 325, Government Code | ||
[ |
||
Government Code, [ |
||
expires on the date the commission is abolished under that section | ||
[ |
||
SECTION 4.08. Section 81.004, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 81.004. SUNSET PROVISION. The Texas Commission for | ||
the Deaf and Hard of Hearing was abolished by Section 1.26, Chapter | ||
198 (H.B. 2292), Acts of the 78th Legislature, Regular Session, | ||
2003. The [ |
||
chapter of that agency's successor in function are [ |
||
transferred under Subchapter A-1, Chapter 531, Government Code, to | ||
the Health and Human Services Commission [ |
||
[ |
||
Unless the commission is [ |
||
|
||
chapter, this chapter expires on the date the commission is | ||
abolished under Section 531.004, Government Code [ |
||
|
||
SECTION 4.09. Section 91.001, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 91.001. SUNSET PROVISION. The Texas Commission for | ||
the Blind was abolished by Section 1.26, Chapter 198 (H.B. 2292), | ||
Acts of the 78th Legislature, Regular Session, 2003. The [ |
||
|
||
agency's successor in function are [ |
||
Subchapter A-1, Chapter 531, Government Code, to the Health and | ||
Human Services Commission [ |
||
to Chapter 325, Government Code (Texas Sunset Act). Unless the | ||
commission is [ |
||
|
||
chapter, this chapter expires on the date the commission is | ||
abolished under Section 531.004, Government Code [ |
||
|
||
SECTION 4.10. Section 111.012, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 111.012. SUNSET PROVISION. The Texas Rehabilitation | ||
Commission was abolished by Section 1.26, Chapter 198 (H.B. 2292), | ||
Acts of the 78th Legislature, Regular Session, 2003. The [ |
||
|
||
agency's successor in function are [ |
||
Subchapter A-1, Chapter 531, Government Code, to the Health and | ||
Human Services Commission [ |
||
to Chapter 325, Government Code (Texas Sunset Act). Unless the | ||
commission is [ |
||
|
||
chapter, this chapter expires on the date the commission is | ||
abolished under Section 531.004, Government Code [ |
||
|
||
SECTION 4.11. Section 117.003, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 117.003. SUNSET PROVISION. Unless the commission | ||
is [ |
||
|
||
continued in existence as provided by Chapter 325, Government Code | ||
[ |
||
Government Code, [ |
||
expires on the date the commission is abolished under that section | ||
[ |
||
SECTION 4.12. Section 161.003, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 161.003. SUNSET PROVISION. Unless the commission | ||
is [ |
||
|
||
continued in existence as provided by Chapter 325, Government Code | ||
[ |
||
Government Code, [ |
||
expires on the date the commission is abolished under that section | ||
[ |
||
ARTICLE 5. FEDERAL AUTHORIZATION AND EFFECTIVE DATE | ||
SECTION 5.01. 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 5.02. Except as otherwise provided by this Act, | ||
this Act takes effect September 1, 2015. |