By: Hall S.B. No. 1979
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 disrupted
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.