By: Rose H.B. No. 3990
A BILL TO BE ENTITLED
AN ACT
relating to the study of the fiscal impact on local governments in
Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties of
restructuring the NorthSTAR behavioral health system and the
effective implementation the Sunset Commission Health and Human
Services Commission Issue 9 recommendation.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The Texas Health and Human Services Commission
shall contract with a private entity approved by the North Texas
Behavioral Health Authority through a majority vote of the
authority's board of directors to undertake a comprehensive study
of the potential impact on local governments and continuity of
services in Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall
Counties if the present behavioral health managed care structure,
known as the NorthSTAR system, were to be dismantled in accordance
with the recommendations in Issue 9 of the Health and Human Services
Sunset Commission report.
SECTION 2. The scope of the study shall encompass but not be
limited to
a) Defining the initial and expected impact on county
and municipal budgets of any system that might replace the present
configuration
b) Defining the likelihood of and anticipated impact
of recidivism resulting from increased acuity in the indigent
population presently served in the current system if care is
dis
rupted
c) Defining the potential impact on network access
d) Defining the impact on integrated care
e) Defining the overall impact on quality of care
outcomes
f) Defining the overall impact on the cost of care
g) Defining the initial and expected impact on local
medical and surgical hospitals
SECTION 3. The findings of this study will be reported back
to the North Texas Behavioral Health Authority and the Texas Health
and Human Services Commission no later than June 30, 2016.
SECTION 4. Collin County may exit NorthSTAR on or by October
1, 2016. The present deadline for any other changes to the
NorthSTAR model shall be changed to September 1, 2017. This
modification shall be made in order to align the current contract
cycle with the State of Texas fiscal year and allow the next
Legislature the ability to make an appropriately informed
deliberation on the future of public behavioral health care in
Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties.
SECTION 5. In the interim period the North Texas Behavioral
Health Authority and the Texas Health and Human Services Commission
shall solicit local stakeholder and community input, and
incorporating the findings of the impact study, shall work with the
representatives designated by the affected county governments in
the development of a system that incorporates
a) Local control and governance of the system by
member counties through their designated voting representatives on
the North Texas Behavioral Health Authority
b) True integration and coordination of mental health
services, substance use disorder services, crisis services and
physical health care
c) Equal care for non-Medicaid and Medicaid behavioral
health populations
d) Open access
e) Braided local, state, and federal funding
f) Connectivity and coordination of coverage which
preserves the principles of 'no wrong door'
g) Choice of providers
h) Waiver of Institute of Mental Disease (IMD)
Exclusion
i) Separation of authority and provider functions
j) Serving all those meeting state criteria for
behavioral health services in one system:
i. Income at or below 200% of Federal Poverty
Level,
ii. All individuals meeting state behavioral
health clinical criteria;
iii. Individuals meeting state Medicaid
requirements
k) Comprehensive evaluation and transparent
publication of data
l) Status as a public local behavioral health
authority entity eligible to put up non-federal dollars to match
federal DSRIP funds
m) Provider payment plan and mechanisms to ensure a
competitive provider market and an adequate network of providers
capable of providing broad access to services;
n) Plan to ensure quality of services provided to
clients and
o) Incentives of inclusion of local participation or
match requirements
p) Option for Dallas, Ellis, Hunt, Kaufman, Navarro or
Rockwall Counties to continue in the plan or choose an alternate
model and for counties contiguous to present or future NorthSTAR
counties to join the model if the county governments of those
contiguous counties should so choose
SECTION 6. This Act takes effect immediately.