By: Nelson, et al. S.B. No. 200
(In the Senate - Filed March 4, 2015; March 4, 2015, read
first time and referred to Committee on Health and Human Services;
April 7, 2015, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 8, Nays 0; April 7, 2015,
sent to printer.)
Click here to see the committee vote
COMMITTEE SUBSTITUTE FOR S.B. No. 200 By: Schwertner
A BILL TO BE ENTITLED
AN ACT
relating to the continuation and functions of the Health and Human
Services Commission and the provision of health and human services
in this state.
ARTICLE 1. CONSOLIDATION OF HEALTH AND HUMAN SERVICES SYSTEM
SECTION 1.01. (a) Chapter 531, Government Code, is amended
by adding Subchapter A-1 to read as follows:
SUBCHAPTER A-1. CONSOLIDATION OF HEALTH AND HUMAN SERVICES SYSTEM
Sec. 531.02001. CONSOLIDATION OF HEALTH AND HUMAN SERVICES
SYSTEM GENERALLY. In accordance with this subchapter, the
functions of each state agency and entity subject to abolition
under Section 531.0202 are consolidated in the commission through a
two-phase transfer of those functions under which:
(1) the initial transfers required under Section
531.0201 occur:
(A) on or after September 1, 2015; and
(B) not later than September 1, 2016; and
(2) the final transfers required under Section
531.02011 occur:
(A) on or after September 1, 2018; and
(B) not later than September 1, 2019.
Sec. 531.02002. MEANING OF FUNCTION IN RELATION TO
TRANSFERS. For purposes of the transfers mandated by this
subchapter, "function" includes a power, duty, program, or activity
of a state agency or entity.
Sec. 531.0201. PHASE ONE: INITIAL TRANSFERS TO COMMISSION.
On the dates specified in the transition plan required under
Section 531.0204, the functions of each state agency or entity
subject to abolition under Section 531.0202, other than the
functions that will be transferred under Section 531.02011, are
transferred to the commission as provided by this subchapter.
Sec. 531.02011. PHASE TWO: FINAL TRANSFERS TO COMMISSION.
On the dates specified in the transition plan required under
Section 531.0204, the following functions are transferred to the
commission as provided by this subchapter:
(1) the functions of the Department of Family and
Protective Services related to the following:
(A) child protective services, including
services that are required by federal law to be provided by this
state's child welfare agency; and
(B) adult protective services, other than
investigations of the alleged abuse, neglect, or exploitation of an
elderly person or person with a disability:
(i) in a facility operated or in a facility
or by a person licensed, certified, or registered by a state agency;
or
(ii) by a provider that has contracted to
provide home and community-based services; and
(2) the public health functions of the Department of
State Health Services, including health care data collection and
maintenance of the Texas Health Care Information Collection
program.
Sec. 531.02012. RELATED TRANSFERS; EFFECT OF
CONSOLIDATION. (a) All of the following that relate to a function
that is transferred under Section 531.0201 or 531.02011 are
transferred to the commission on the date the related function is
transferred as specified in the transition plan required under
Section 531.0204:
(1) all obligations and contracts;
(2) all property and records in the custody of the
state agency or entity from which the function is transferred;
(3) all funds appropriated by the legislature; and
(4) all complaints, investigations, or contested
cases that are pending before the state agency or entity from which
the function is transferred or a governing person or entity of the
state agency or entity, without change in status.
(b) A rule, policy, or form adopted by or on behalf of a
state agency or entity subject to abolition under Section 531.0202
that relates to a function that is transferred under Section
531.0201 or 531.02011 becomes a rule, policy, or form of the
commission upon transfer of the related function and remains in
effect:
(1) until altered by the commission; or
(2) unless it conflicts with a rule, policy, or form of
the commission.
(c) A license, permit, or certification in effect that was
issued by a state agency or entity subject to abolition under
Section 531.0202 is continued in effect as a license, permit, or
certification of the commission upon transfer of the function to
which the license, permit, or certification relates until the
license, permit, or certification expires, is suspended or revoked,
or otherwise becomes invalid.
Sec. 531.0202. ABOLITION OF STATE AGENCIES AND ENTITIES.
(a) Each of the following state agencies and entities is abolished
on a date that is within the period prescribed by Section
531.02001(1), that is specified in the transition plan required
under Section 531.0204 for the abolition of the state agency or
entity, and that occurs after all of the state agency's or entity's
functions have been transferred to the commission in accordance
with Section 531.0201:
(1) the Department of Aging and Disability Services;
(2) the Department of Assistive and Rehabilitative
Services;
(3) the Health and Human Services Council;
(4) the Aging and Disability Services Council;
(5) the Assistive and Rehabilitative Services
Council;
(6) the Family and Protective Services Council;
(7) the State Health Services Council;
(8) the Office for the Prevention of Developmental
Disabilities; and
(9) the Texas Council on Autism and Pervasive
Developmental Disorders.
(b) Each of the following state agencies is abolished on a
date that is within the period prescribed by Section 531.02001(2),
that is specified in the transition plan required under Section
531.0204 for the abolition of the state agency or entity, and that
occurs after all of the state agency's or entity's functions have
been transferred to the commission in accordance with Sections
531.0201 and 531.02011:
(1) the Department of Family and Protective Services;
and
(2) the Department of State Health Services.
(c) The abolition of a state agency or entity listed in
Subsection (a) or (b) and the transfer of its functions and related
obligations, rights, contracts, records, property, and funds 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
functions 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 functions 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 functions to be transferred under this
subchapter and the funds and obligations that are related to the
functions;
(B) the transfer of the functions and related
records, property, funds, and obligations by the state agencies and
entities as provided by this subchapter; and
(C) the reorganization of the commission's
administrative structure in accordance with this subchapter,
Sections 531.0055, 531.00561, 531.00562, and 531.008, and other
provisions enacted by the 84th Legislature that become law; and
(3) meet:
(A) during the period between the establishment
of the committee and December 31, 2016, at least quarterly at the
call of either chair, in addition to meeting at other times as
determined appropriate by either chair;
(B) during the period between January 1, 2017,
and December 31, 2019, at least semiannually at the call of either
chair, in addition to meeting at other times as determined
appropriate by either chair; and
(C) during the period between January 1, 2020,
and August 31, 2023, at least annually at the call of either chair,
in addition to meeting at other times as determined appropriate by
either chair.
(i) Chapter 551 applies to the committee.
(j) The committee shall submit a report to the governor,
lieutenant governor, 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 functions 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, 531.00562, and 531.008, and other
provisions enacted by the 84th Legislature that become law.
(k) The committee is abolished September 1, 2023.
Sec. 531.0204. TRANSITION AND WORK PLAN FOR IMPLEMENTATION
OF CONSOLIDATION. (a) The transfers of functions under Sections
531.0201 and 531.02011 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, 531.00562, and 531.008, and other
provisions enacted by the 84th Legislature that become law; and
(2) include a broad plan and schedule that, subject to
the periods prescribed by Section 531.02001, specify the dates on
which:
(A) the transfers under Sections 531.0201 and
531.02011 are to be made;
(B) each state agency or entity subject to
abolition under Section 531.0202 is abolished; and
(C) each division of the commission is created
and the division's director is appointed.
(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) Within the periods prescribed by Section 531.02001, the
commission shall begin administering the respective functions
assigned to the commission under Sections 531.0201 and 531.02011,
as applicable. The assumption of the administration of the
functions 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 functions performed 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 shall
comment on and make recommendations to the executive commissioner
regarding any concerns or adjustments to the transition plan the
committee determines appropriate. The executive commissioner may
not finalize any transition or work plan until the executive
commissioner has reviewed and considered the comments and
recommendations of the committee regarding the transition plan.
(e) The executive commissioner shall publish in the Texas
Register:
(1) the transition plan developed under this section;
(2) any adjustments to the transition plan recommended
by the Health and Human Services Transition Legislative Oversight
Committee;
(3) whether the executive commissioner adopted or
otherwise incorporated the recommended adjustments; and
(4) if the executive commissioner did not adopt a
recommended adjustment, the justification for not adopting the
adjustment.
Sec. 531.0205. 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.
(d) Notwithstanding Section 531.0201, Government Code, as
added by this article, a power, duty, program, function, or
activity of the Department of Assistive and Rehabilitative Services
may not be transferred to the Health and Human Services Commission
under that section if:
(1) H.B. No. 3294 or S.B. No. 208, 84th Legislature,
Regular Session, 2015, or similar legislation of the 84th
Legislature, Regular Session, 2015, is enacted, becomes law, and
provides for the transfer of the power, duty, program, function, or
activity to the Texas Workforce Commission subject to receipt of
any necessary federal approval or other authorization for the
transfer to occur; and
(2) the Department of Assistive and Rehabilitative
Services or the Texas Workforce Commission receives the necessary
federal approval or other authorization to enable the transfer to
occur not later than September 1, 2016.
(e) If neither the Department of Assistive and
Rehabilitative Services nor the Texas Workforce Commission
receives the federal approval or other authorization described by
Subsection (d) of this section to enable the transfer of the power,
duty, program, function, or activity to the Texas Workforce
Commission to occur not later than September 1, 2016, as provided by
the legislation described by Subsection (d) of this section, the
power, duty, program, function, or activity of the Department of
Assistive and Rehabilitative Services transfers to the Health and
Human Services Commission in accordance with Section 531.0201,
Government Code, as added by this article, and the transition plan
required under Section 531.0204, Government Code, as added by this
article.
SECTION 1.02. Subchapter A, Chapter 531, Government Code,
is amended by adding Sections 531.0011 and 531.0012 to read as
follows:
Sec. 531.0011. REFERENCES IN LAW MEANING COMMISSION OR
APPROPRIATE DIVISION. (a) In this code or in any other law, a
reference to any of the following state agencies or entities in
relation to a function transferred under Section 531.0201 or
531.02011, as applicable, means the commission or the division of
the commission performing the function previously performed by the
state agency or entity before the transfer, as appropriate:
(1) health and human services agency;
(2) the Department of State Health Services;
(3) the Department of Aging and Disability Services;
(4) the Department of Family and Protective Services;
or
(5) the Department of Assistive and Rehabilitative
Services.
(b) In this code or in any other law and notwithstanding any
other law, a reference to any of the following state agencies or
entities in relation to a function transferred under Section
531.0201 or 531.02011, as applicable, from the state agency that
assumed the relevant function in accordance with Chapter 198 (H.B.
2292), Acts of the 78th Legislature, Regular Session, 2003, means
the commission or the division of the commission performing the
function previously performed by the agency that assumed the
function before the transfer, as appropriate:
(1) the Texas Department on Aging;
(2) the Texas Commission on Alcohol and Drug Abuse;
(3) the Texas Commission for the Blind;
(4) the Texas Commission for the Deaf and Hard of
Hearing;
(5) the Texas Department of Health;
(6) the Texas Department of Human Services;
(7) the Texas Department of Mental Health and Mental
Retardation;
(8) the Texas Rehabilitation Commission;
(9) the Texas Health Care Information Council; or
(10) the Interagency Council on Early Childhood
Intervention.
(c) In this code or in any other law and notwithstanding any
other law, a reference to the Department of Protective and
Regulatory Services in relation to a function transferred under
Section 531.0201 or 531.02011, as applicable, from the Department
of Family and Protective Services means the commission or the
division of the commission performing the function previously
performed by the Department of Family and Protective Services
before the transfer.
(d) This section applies notwithstanding Section
531.001(4). This subsection and Section 531.001(4) expire on the
last day of the period prescribed by Section 531.02001(2).
Sec. 531.0012. REFERENCES IN LAW MEANING EXECUTIVE
COMMISSIONER OR DESIGNEE. (a) In this code or in any other law, a
reference to any of the following persons in relation to a function
transferred under Section 531.0201 or 531.02011, as applicable,
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 function previously
performed by the state agency from which it was transferred and that
the person represented, as appropriate:
(1) the commissioner of aging and disability services;
(2) the commissioner of assistive and rehabilitative
services;
(3) the commissioner of state health services; or
(4) the commissioner of the Department of Family and
Protective Services.
(b) In this code or in any other law and notwithstanding any
other law, a reference to any of the following persons or entities
in relation to a function transferred under Section 531.0201 or
531.02011, as applicable, from the state agency that assumed or
continued to perform the function in accordance with Chapter 198
(H.B. 2292), Acts of the 78th Legislature, Regular Session, 2003,
means the executive commissioner or the director appointed under
Section 531.00561 of the division of the commission performing the
function performed before the enactment of Chapter 198 (H.B. 2292)
by the state agency that was abolished or renamed by Chapter 198
(H.B. 2292) and that the person or entity represented:
(1) an executive director or other chief
administrative officer of a state agency listed in Section
531.0011(b) or of the Department of Protective and Regulatory
Services; or
(2) the governing body of a state agency listed in
Section 531.0011(b) or of the Department of Protective and
Regulatory Services.
(c) A reference to any of the following councils means the
executive commissioner or the executive commissioner's designee,
as appropriate, and a function of any of the following councils is a
function of that appropriate person:
(1) the Health and Human Services Council;
(2) the 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 last
day of the period prescribed by Section 531.02001(2).
(b) The council does not have authority to make
administrative or policy decisions.
(c) The council is composed of:
(1) the executive commissioner;
(2) the director of each division established by the
executive commissioner under Section 531.008(c); 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 [AGENCIES].
SECTION 1.05. Section 531.0055, Government Code, is amended
by amending Subsection (b), as amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, amending Subsections (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
Medicaid, including the administration and operation of the
Medicaid managed care system in accordance with Section 531.021;
(2) perform information systems planning and
management for the health and human services system [agencies]
under Section 531.0273, with:
(A) the provision of information technology
services for the [at] health and human services system [agencies]
considered to be a centralized administrative support service
either performed by commission personnel or performed under a
contract with the commission; and
(B) an emphasis on research and implementation on
a demonstration or pilot basis of appropriate and efficient uses of
new and existing technology to improve the operation of the health
and human services system [agencies] and delivery of health and
human services;
(3) monitor and ensure the effective use of all
federal funds received for the [by a] health and human services
system [agency] in accordance with Section 531.028 and the General
Appropriations Act;
(4) implement Texas Integrated Enrollment Services as
required by Subchapter F, except that notwithstanding Subchapter F,
determining eligibility for benefits under the following programs
is the responsibility of and must be centralized by the commission:
(A) the child health plan program;
(B) the financial assistance program under
Chapter 31, Human Resources Code;
(C) Medicaid;
(D) the supplemental nutrition assistance
program under Chapter 33, Human Resources Code;
(E) long-term care services, as defined by
Section 22.0011, Human Resources Code;
(F) community-based support services identified
or provided in accordance with Section 531.02481; and
(G) other health and human services programs, as
appropriate; and
(5) implement programs intended to prevent family
violence and provide services to victims of family violence.
(d) After implementation of the commission's duties under
Subsections (b) and (c), the commission shall implement the powers
and duties given to the commission under Section 531.0248. Nothing
in the priorities established by this section is intended to limit
the authority of the commission to work simultaneously to achieve
the multiple tasks assigned to the commission in this section, when
such an approach is beneficial in the judgment of the commission.
The commission shall plan and implement an efficient and effective
centralized system of administrative support services for the
health and human services system [agencies]. The performance of
administrative support services for the health and human services
system [agencies] is the responsibility of the commission. The
term "administrative support services" includes, but is not limited
to, strategic planning and evaluation, audit, legal, human
resources, information resources, purchasing, contract management,
financial management, and accounting services.
(e) Notwithstanding any other law, the executive
commissioner shall adopt rules and policies for the operation of
and provision of health and human services by the health and human
services system [agencies]. In addition, the executive
commissioner, as necessary to perform the functions described by
Subsections (b), (c), and (d) in implementation of applicable
policies established for a health and human services system [an]
agency or division, as applicable, by the executive commissioner,
shall:
(1) manage and direct the operations of each [health
and human services] agency or division, as applicable;
(2) supervise and direct the activities of each agency
or division director, as applicable; and
(3) be responsible for the administrative supervision
of the internal audit program for the [all] health and human
services system agencies, 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 [at] each
health and human services system agency or division, as applicable,
includes authority over and responsibility for the:
(1) management of the daily operations of the agency
or division, including the organization and management of the
agency or division and its [agency] operating procedures;
(2) allocation of resources within the agency or
division, including use of federal funds received by the agency or
division;
(3) personnel and employment policies;
(4) contracting, purchasing, and related policies,
subject to this chapter and other laws relating to contracting and
purchasing by a state agency;
(5) information resources systems used by the agency
or division;
(6) location of [agency] facilities; and
(7) coordination of agency or division activities with
activities of other components of the health and human services
system and state agencies[, including other health and human
services agencies].
(g) Notwithstanding any other law, the operational
authority and responsibility of the executive commissioner for
purposes of Subsection (e) for [at] each health and human services
system agency or division, as applicable, includes the authority
and responsibility to adopt or approve, subject to applicable
limitations, any rate of payment or similar provision required by
law to be adopted or approved by a health and human services system
[the] agency.
(h) For each health and human services system agency and
division, as applicable, the executive commissioner shall
implement a program to evaluate and supervise [the] daily
operations [of the agency]. The program must include measurable
performance objectives for each agency or division director and
adequate reporting requirements to permit the executive
commissioner to perform the duties assigned to the executive
commissioner under this section.
(l) Notwithstanding any other law, the executive
commissioner has the authority to adopt policies and rules
governing the delivery of services to persons who are served by the
[each] health and human services system [agency] and the rights and
duties of persons who are served or regulated by the system [each
agency].
(n) This subsection and Subsections (a), (i), and (k) expire
on the last day of the period prescribed by Section 531.02001(2).
SECTION 1.06. Section 531.00551, Government Code, as added
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended by adding Subsection (c) to read as follows:
(c) This section expires on the last day of the period
prescribed by Section 531.02001(2).
SECTION 1.07. 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 last day of the period
prescribed by Section 531.02001(2).
SECTION 1.08. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Sections 531.00561 and 531.00562 to read
as follows:
Sec. 531.00561. APPOINTMENT AND QUALIFICATIONS OF DIVISION
DIRECTORS. (a) The executive commissioner shall appoint a
director for each division established within the commission under
Section 531.008.
(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 1.09. (a) Section 531.008, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 531.008. DIVISIONS OF COMMISSION. (a) The [Subject
to Subsection (c), the] executive commissioner shall [may]
establish divisions within the commission along functional lines as
necessary for effective administration and for the discharge of the
commission's functions.
(b) The [Subject to Subsection (c), the] executive
commissioner may allocate and reallocate functions among the
commission's divisions.
(c) Notwithstanding Subsections (a) and (b), the [The]
executive commissioner shall establish the following divisions and
offices within the commission:
(1) a medical and social services division [the
eligibility services division to make eligibility determinations
for services provided through the commission or a health and human
services agency related to:
[(A) the child health plan program;
[(B) the financial assistance program under
Chapter 31, Human Resources Code;
[(C) Medicaid;
[(D) the supplemental nutrition assistance
program under Chapter 33, Human Resources Code;
[(E) long-term care services, as defined by
Section 22.0011, Human Resources Code;
[(F) community-based support services identified
or provided in accordance with Section 531.02481; and
[(G) other health and human services programs, as
appropriate];
(2) the office of inspector general to perform fraud
and abuse investigation and enforcement functions as provided by
Subchapter C and other law;
(3) a regulatory division [the office of the ombudsman
to:
[(A) provide dispute resolution services for the
commission and the health and human services agencies; and
[(B) perform consumer protection functions
related to health and human services];
(4) an administrative division [a purchasing division
as provided by Section 531.017]; and
(5) a facilities division for the purpose of
administering state facilities, including state hospitals and
state-supported living centers [an internal audit division to
conduct a program of internal auditing in accordance with Chapter
2102].
(d) Subsection (c) does not prohibit the executive
commissioner from establishing additional divisions under
Subsection (a) as the executive commissioner determines
appropriate. This subsection and Subsection (c) expire September
1, 2023.
(b) The executive commissioner of the Health and Human
Services Commission shall establish divisions within the
commission as required under Section 531.008, Government Code, as
amended by this article, on the date specified in the transition
plan required under Section 531.0204, Government Code, as added by
this article.
SECTION 1.10. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0083 to read as follows:
Sec. 531.0083. OFFICE OF POLICY AND PERFORMANCE. (a) In
this section, "office" means the office of policy and performance
established by this section.
(b) The executive commissioner shall establish the office
of policy and performance as an executive-level office designed to
coordinate policy and performance efforts across the health and
human services system. To coordinate those efforts, the office
shall:
(1) develop a performance management system;
(2) take the lead in supporting and providing
oversight for the implementation of major policy changes and in
managing organizational changes; and
(3) act as a centralized body of experts within the
commission that offers program evaluation and process improvement
expertise.
(c) In developing a performance management system under
Subsection (b)(1), the office shall:
(1) gather, measure, and evaluate performance
measures and accountability systems used by the health and human
services system;
(2) develop new and refined performance measures as
appropriate; and
(3) establish targeted, high-level system metrics
that are capable of measuring and communicating overall performance
and achievement of goals by the health and human services system to
both internal and public audiences through various mechanisms,
including the Internet.
(d) In providing support and oversight for the
implementation of policy or organizational changes within the
health and human services system under Subsection (b)(2), the
office shall:
(1) ensure individuals receiving services from or
participating in programs administered through the health and human
services system do not lose visibility or attention during the
implementation of any new policy or organizational change by:
(A) establishing timelines and milestones for
any transition;
(B) supporting staff of the health and human
services system in any change between service delivery methods; and
(C) providing feedback to executive management
on technical assistance and other support needed to achieve a
successful transition;
(2) address cultural differences among staff of the
health and human services system; and
(3) track and oversee changes in policy or
organization mandated by legislation or administrative rule.
(e) In acting as a centralized body of experts under
Subsection (b)(3), the office shall:
(1) for the health and human services system, provide
program evaluation and process improvement guidance both generally
and for specific projects identified with executive or stakeholder
input or through risk analysis; and
(2) identify and monitor cross-functional efforts
involving different administrative components within the health
and human services system and the establishment of cross-functional
teams when necessary to improve the coordination of services
provided through the system.
(f) The executive commissioner may otherwise develop the
office's structure and duties as the executive commissioner
determines appropriate.
(b) As soon as practicable after the effective date of this
article but not later than October 1, 2015, the executive
commissioner of the Health and Human Services Commission shall
establish the office of policy and performance as an executive
office within the commission as required under Section 531.0083,
Government Code, as added by this article.
(c) The office of policy and performance required under
Section 531.0083, Government Code, as added by this article, shall
assist the Health and Human Services Transition Legislative
Oversight Committee created under Section 531.0203, Government
Code, as added by this article, by performing the functions
required of the office under Section 531.0083(b)(2), Government
Code, as added by this article, with respect to the consolidation
mandated by Subchapter A-1, Chapter 531, Government Code, as added
by this article.
SECTION 1.11. Section 531.017, Government Code, is amended
to read as follows:
Sec. 531.017. PURCHASING UNIT [DIVISION]. (a) The
commission shall establish a purchasing unit [division] for the
management of administrative activities related to the purchasing
functions within [of the commission and] the health and human
services system [agencies].
(b) The purchasing unit [division] shall:
(1) seek to achieve targeted cost reductions, increase
process efficiencies, improve technological support and customer
services, and enhance purchasing support within the [for each]
health and human services system [agency]; and
(2) if cost-effective, contract with private entities
to perform purchasing functions for the [commission and the] health
and human services system [agencies].
SECTION 1.12. (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
40.032(c) of this code or Section 531.009(c), Government Code, as
applicable. The department shall ensure that disciplinary or other
corrective action is taken against a supervisor or other managerial
employee who is required to conduct a performance evaluation for
adult protective services personnel under Section 40.032(c) of this
code or Section 531.009(c), Government Code, as applicable, or a
performance review under Subsection (b)(3) and who fails to
complete that evaluation or review in a timely manner.
(e) The annual performance evaluation required under
Section 40.032(c) of this code or Section 531.009(c), Government
Code, as applicable, of the performance of a supervisor in the adult
protective services division must:
(1) be performed by an appropriate program
administrator; and
(2) include:
(A) an evaluation of the supervisor with respect
to the job performance standards applicable to the supervisor's
assigned duties; and
(B) an evaluation of the supervisor with respect
to the compliance of employees supervised by the supervisor with
the job performance standards applicable to those employees'
assigned duties.
(b) Effective September 1, 2019, 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 [40.032(c)]. The department shall
ensure that disciplinary or other corrective action is taken
against a supervisor or other managerial employee who is required
to conduct a performance evaluation for adult protective services
personnel under Section 531.009(c), Government Code, [40.032(c)]
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, [40.032(c)] of the
performance of a supervisor in the adult protective services
division must:
(1) be performed by an appropriate program
administrator; and
(2) include:
(A) an evaluation of the supervisor with respect
to the job performance standards applicable to the supervisor's
assigned duties; and
(B) an evaluation of the supervisor with respect
to the compliance of employees supervised by the supervisor with
the job performance standards applicable to those employees'
assigned duties.
SECTION 1.13. (a) The heading to Subchapter C, Chapter
112, Human Resources Code, is amended to read as follows:
SUBCHAPTER C. [OFFICE FOR THE] PREVENTION OF DEVELOPMENTAL
DISABILITIES
(b) Section 112.042, Human Resources Code, is amended by
amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
read as follows:
(1) "Commission" means the Health and Human Services
Commission.
(1-a) "Developmental disability" means a severe,
chronic disability that:
(A) is attributable to a mental or physical
impairment or to a combination of a mental and physical impairment;
(B) is manifested before a person reaches the age
of 22;
(C) is likely to continue indefinitely;
(D) results in substantial functional
limitations in three or more major life activities, including:
(i) self-care;
(ii) receptive and expressive language;
(iii) learning;
(iv) mobility;
(v) self-direction;
(vi) capacity for independent living; and
(vii) economic sufficiency; and
(E) reflects the person's needs for a combination
and sequence of special interdisciplinary or generic care,
treatment, or other lifelong or extended services that are
individually planned and coordinated.
(1-b) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(c) Subchapter C, Chapter 112, Human Resources Code, is
amended by adding Sections 112.0421 and 112.0431 to read as
follows:
Sec. 112.0421. APPLICABILITY AND EXPIRATION OF CERTAIN
PROVISIONS. (a) Sections 112.041(a), 112.043, 112.045, 112.0451,
112.0452, 112.0453, 112.0454, 112.046, 112.047, 112.0471, and
112.0472 apply only until the date the executive commissioner
begins to administer this subchapter and the commission assumes the
duties and functions of the Office for the Prevention of
Developmental Disabilities in accordance with Section 112.0431.
(b) On the date the provisions listed in Subsection (a)
cease to apply, the executive committee under Section 112.045 and
the board of advisors under Section 112.046 are abolished.
(c) This section and Sections 112.041(a), 112.043, 112.045,
112.0451, 112.0452, 112.0453, 112.0454, 112.046, 112.047,
112.0471, and 112.0472 expire on the last day of the period
prescribed by Section 531.02001(1), Government Code.
Sec. 112.0431. ADMINISTRATION OF SUBCHAPTER; CERTAIN
REFERENCES. (a) Notwithstanding any other provision in this
subchapter, the executive commissioner shall administer this
subchapter beginning on the date specified in the transition plan
under Section 531.0204, Government Code, and the commission shall
perform the duties and functions of the Office for the Prevention of
Developmental Disabilities in the organizational form the
executive commissioner determines appropriate.
(b) Following the assumption of the administration of this
subchapter by the executive commissioner and the duties and
functions by the commission in accordance with Subsection (a):
(1) a reference in this subchapter to the office, the
Office for the Prevention of Developmental Disabilities, or the
executive committee of that office means the commission, the
division or other organizational unit within the commission
designated by the executive commissioner, or the executive
commissioner, as appropriate; and
(2) a reference in any other law to the Office for the
Prevention of Developmental Disabilities has the meaning assigned
by Subdivision (1).
(d) Section 112.044, Human Resources Code, is amended to
read as follows:
Sec. 112.044. DUTIES. The office shall:
(1) educate the public and attempt to promote sound
public policy regarding the prevention of developmental
disabilities;
(2) identify, collect, and disseminate information
and data concerning the causes, frequency of occurrence, and
preventability of developmental disabilities;
(3) work with appropriate divisions within the
commission, state agencies, and other entities to develop a
coordinated long-range plan to effectively monitor and reduce the
incidence or severity of developmental disabilities;
(4) promote and facilitate the identification,
development, coordination, and delivery of needed prevention
services;
(5) solicit, receive, and spend grants and donations
from public, private, state, and federal sources;
(6) identify and encourage establishment of needed
reporting systems to track the causes and frequencies of occurrence
of developmental disabilities;
(7) develop, operate, and monitor programs created
under Section 112.048 addressing [task forces to address] the
prevention of specific targeted developmental disabilities;
(8) monitor and assess the effectiveness of divisions
within the commission and of state agencies in preventing [to
prevent] developmental disabilities;
(9) recommend the role each division within the
commission and each state agency should have with regard to
prevention of developmental disabilities;
(10) facilitate coordination of state agency
prevention services and activities within the commission and among
appropriate state agencies; and
(11) encourage cooperative, comprehensive, and
complementary planning among public, private, and volunteer
individuals and organizations engaged in prevention activities,
providing prevention services, or conducting related research.
(e) Sections 112.048 and 112.049, Human Resources Code, are
amended to read as follows:
Sec. 112.048. PREVENTION PROGRAMS FOR TARGETED
DEVELOPMENTAL DISABILITIES [TASK FORCES]. (a) The executive
committee shall establish guidelines for:
(1) selecting targeted disabilities;
(2) assessing prevention services needs; and
(3) reviewing [task force] plans, budgets, and
operations for programs under this section.
(b) The executive committee shall [create task forces made
up of members of the board of advisors to] plan and implement
prevention programs for specifically targeted developmental
disabilities. [A task force operates as an administrative division
of the office and can be abolished when it is ineffective or is no
longer needed.]
(c) A program under this section [task force shall]:
(1) must include [develop] a plan designed to reduce
the incidence of a specifically targeted disability;
(2) must include [prepare] a budget for implementing a
plan;
(3) must be funded [arrange for funds] through:
(A) contracts for services from participating
agencies;
(B) grants and gifts from private persons and
consumer and advocacy organizations; and
(C) foundation support; and
(4) must be approved by [submit the plan, budget, and
evidence of funding commitments to] the executive committee [for
approval].
[(d) A task force shall regularly report to the executive
committee, as required by the committee, the operation, progress,
and results of the task force's prevention plan.]
Sec. 112.049. EVALUATION. (a) The office shall identify
or encourage the establishment of needed statistical bases for each
targeted group against which the office can measure how effectively
a [task force] program under Section 112.048 is reducing the
frequency or severity of a targeted developmental disability.
(b) The executive committee shall regularly monitor and
evaluate the results of [task force prevention] programs under
Section 112.048.
(f) The heading to Section 112.050, Human Resources Code, is
amended to read as follows:
Sec. 112.050. GRANTS AND OTHER FUNDING.
(g) Section 112.050, Human Resources Code, is amended by
amending Subsection (c) and adding Subsection (d) to read as
follows:
(c) The executive committee may not submit a legislative
appropriation request for general revenue funds for purposes of
this subchapter.
(d) In addition to funding under Subsection (a), the office
may accept and solicit gifts, donations, and grants of money from
public and private sources, including the federal government, local
governments, and private entities, to assist in financing the
duties and functions of the office. The commission shall support
office fund-raising efforts authorized by this subsection. Funds
raised under this subsection may only be spent in furtherance of a
duty or function of the office or in accordance with rules
applicable to the office.
(h) Section 112.051, Human Resources Code, is amended to
read as follows:
Sec. 112.051. REPORTS TO LEGISLATURE. The office shall
submit by February 1 of each odd-numbered year biennial reports to
the legislature detailing findings of the office and the results of
[task force prevention] programs under Section 112.048 and
recommending improvements in the delivery of developmental
disability prevention services.
(i) Notwithstanding the changes in law made by this section,
the Office for the Prevention of Developmental Disabilities and any
administrative entity of the Office for the Prevention of
Developmental Disabilities shall continue to operate under the law
as it existed before the effective date of this article, and that
law is continued in effect for that purpose, until the executive
commissioner of the Health and Human Services Commission begins
administering Subchapter C, Chapter 112, Human Resources Code, as
amended by this article, and the commission begins performing the
duties and functions of the Office for the Prevention of
Developmental Disabilities as required by Section 112.0431, Human
Resources Code, as added by this article, on the date specified in
the transition plan required under Section 531.0204, Government
Code, as added by this article.
(j) The executive commissioner of the Health and Human
Services Commission shall begin administering Subchapter C,
Chapter 112, Human Resources Code, as amended by this article, and
the commission shall begin performing the duties and functions of
the Office for the Prevention of Developmental Disabilities as
required by Section 112.0431, Human Resources Code, as added by
this article, on the date specified in the transition plan required
under Section 531.0204, Government Code, as added by this article.
SECTION 1.14. (a) The heading to Chapter 114, Human
Resources Code, is amended to read as follows:
CHAPTER 114. [TEXAS COUNCIL ON] AUTISM AND PERVASIVE
DEVELOPMENTAL DISORDERS
(b) Section 114.002, Human Resources Code, is amended by
adding Subdivisions (1-a) and (3) to read as follows:
(1-a) "Commission" means the Health and Human Services
Commission.
(3) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(c) Chapter 114, Human Resources Code, is amended by adding
Sections 114.0021 and 114.0031 to read as follows:
Sec. 114.0021. APPLICABILITY AND EXPIRATION OF CERTAIN
PROVISIONS. (a) Sections 114.001, 114.003, 114.004, 114.005,
114.007(a), and 114.010(d) apply only until the date the executive
commissioner begins to administer this chapter and the commission
assumes the duties and functions of the Texas Council on Autism and
Pervasive Developmental Disorders in accordance with Section
114.0031.
(b) On the date the provisions listed in Subsection (a)
cease to apply, the Texas Council on Autism and Pervasive
Developmental Disorders is abolished.
(c) This section and Sections 114.001, 114.003, 114.004,
114.005, 114.007(a), and 114.010(d) expire on the last day of the
period prescribed by Section 531.02001(1), Government Code.
Sec. 114.0031. ADMINISTRATION OF CHAPTER; CERTAIN
REFERENCES. (a) Notwithstanding any other provision in this
chapter, the executive commissioner shall administer this chapter
beginning on the date specified in the transition plan under
Section 531.0204, Government Code, and the commission shall perform
the duties and functions of the Texas Council on Autism and
Pervasive Developmental Disorders in the organizational form the
executive commissioner determines appropriate.
(b) Following the assumption of the administration of this
chapter by the executive commissioner and the duties and functions
by the commission in accordance with Subsection (a):
(1) a reference in this chapter to the council, the
Texas Council on Autism and Pervasive Developmental Disorders, or
an agency represented on the council means the commission, the
division or other organizational unit within the commission
designated by the executive commissioner, or the executive
commissioner, as appropriate; and
(2) a reference in any other law to the Texas Council
on Autism and Pervasive Developmental Disorders has the meaning
assigned by Subdivision (1).
(d) Section 114.006(b), Human Resources Code, is amended to
read as follows:
(b) The council shall make written recommendations on the
implementation of this chapter. If the council considers a
recommendation that will affect another state [an] agency [not
represented on the council], the council shall seek the advice and
assistance of the agency before taking action on the
recommendation. On approval of the governing body of the agency,
each agency affected by a council recommendation shall implement
the recommendation. If an agency does not have sufficient funds to
implement a recommendation, the agency shall request funds for that
purpose in its next budget proposal.
(e) Sections 114.007(b) and (c), Human Resources Code, are
amended to read as follows:
(b) The council with [the advice of the advisory task force
and] input from people with autism and other pervasive
developmental disorders, their families, and related advocacy
organizations shall address contemporary issues affecting services
available to persons with autism or other pervasive developmental
disorders in this state, including:
(1) successful intervention and treatment strategies,
including transitioning;
(2) personnel preparation and continuing education;
(3) referral, screening, and evaluation services;
(4) day care, respite care, or residential care
services;
(5) vocational and adult training programs;
(6) public awareness strategies;
(7) contemporary research;
(8) early identification strategies;
(9) family counseling and case management; and
(10) recommendations for monitoring autism service
programs.
(c) The council with [the advice of the advisory task force
and] input from people with autism and other pervasive
developmental disorders, their families, and related advocacy
organizations shall advise the legislature on legislation that is
needed to develop further and to maintain a statewide system of
quality intervention and treatment services for all persons with
autism or other pervasive developmental disorders. The council may
develop and recommend legislation to the legislature or comment on
pending legislation that affects those persons.
(f) Section 114.008, Human Resources Code, is amended to
read as follows:
Sec. 114.008. REPORT. (a) [The agencies represented on
the council and the public members shall report to the council any
requirements identified by the agency or person to provide
additional or improved services to persons with autism or other
pervasive developmental disorders.] Not later than November 1 of
each even-numbered year, the council shall:
(1) prepare a report summarizing requirements the
council identifies and recommendations for providing additional or
improved services to persons with autism or other pervasive
developmental disorders; and
(2) deliver the report to the executive commissioner
[of the Health and Human Services Commission], the governor, the
lieutenant governor, and the speaker of the house of
representatives [a report summarizing the recommendations].
(b) The council shall develop a strategy for establishing
new programs to meet the requirements identified through the
council's review and assessment and from input from [the task
force,] people with autism and related pervasive developmental
disorders, their families, and related advocacy organizations.
(g) Section 114.013, Human Resources Code, is amended to
read as follows:
Sec. 114.013. COORDINATION OF RESOURCES FOR INDIVIDUALS
WITH AUTISM SPECTRUM DISORDERS [RESOURCE CENTER]. (a) The
commission [Health and Human Services Commission] shall [establish
and administer an autism spectrum disorders resource center to]
coordinate resources for individuals with autism and other
pervasive developmental disorders and their families. In
coordinating those resources [establishing and administering the
center], the commission [Health and Human Services Commission]
shall consult with [the council and coordinate with] appropriate
state agencies[, including each agency represented on the council].
(b) As part of coordinating resources under Subsection (a),
the commission [The Health and Human Services Commission] shall
[design the center to]:
(1) collect and distribute information and research
regarding autism and other pervasive developmental disorders;
(2) conduct training and development activities for
persons who may interact with an individual with autism or another
pervasive developmental disorder in the course of their employment,
including school, medical, or law enforcement personnel;
(3) coordinate with local entities that provide
services to an individual with autism or another pervasive
developmental disorder; and
(4) provide support for families affected by autism
and other pervasive developmental disorders.
(h) Notwithstanding the changes in law made by this section,
the Texas Council on Autism and Pervasive Developmental Disorders
and any administrative entity of the Texas Council on Autism and
Pervasive Developmental Disorders shall continue to operate under
the law as it existed before the effective date of this article, and
that law is continued in effect for that purpose, until the
executive commissioner of the Health and Human Services Commission
begins administering Chapter 114, Human Resources Code, as amended
by this article, and the commission begins performing the duties
and functions of the Texas Council on Autism and Pervasive
Developmental Disorders as required by Section 114.0031, Human
Resources Code, as added by this article, on the date specified in
the transition plan required under Section 531.0204, Government
Code, as added by this article.
(i) The executive commissioner of the Health and Human
Services Commission shall begin administering Chapter 114, Human
Resources Code, as amended by this article, and the commission
shall begin performing the duties and functions of the Texas
Council on Autism and Pervasive Developmental Disorders as required
by Section 114.0031, Human Resources Code, as added by this
article, on the date specified in the transition plan required
under Section 531.0204, Government Code, as added by this article.
SECTION 1.15. (a) Effective September 1, 2016, Subchapter
K, Chapter 531, Government Code, including provisions amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
(b) Effective September 1, 2016, the following provisions
of the Health and Safety Code are repealed:
(1) Section 1001.021;
(2) Section 1001.022;
(3) Section 1001.023;
(4) Section 1001.024;
(5) Section 1001.025;
(6) Section 1001.026; and
(7) Section 1001.027.
(c) Effective September 1, 2016, the following provisions
of the Human Resources Code, including provisions amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, are
repealed:
(1) Section 40.021;
(2) Section 40.022;
(3) Section 40.0226;
(4) Section 40.024;
(5) Section 40.025;
(6) Section 40.026;
(7) Section 117.002;
(8) Section 117.021;
(9) Section 117.022;
(10) Section 117.023;
(11) Section 117.024;
(12) Section 117.025;
(13) Section 117.026;
(14) Section 117.027;
(15) Section 117.028;
(16) Section 117.029;
(17) Section 117.030;
(18) Section 117.032;
(19) Section 117.051;
(20) Section 117.052;
(21) Section 117.053;
(22) Section 117.054;
(23) Section 117.055;
(24) Section 117.056;
(25) Section 117.072;
(26) Section 161.002;
(27) Subchapter B, Chapter 161;
(28) Section 161.051;
(29) Section 161.052;
(30) Section 161.053;
(31) Section 161.054;
(32) Section 161.055;
(33) Section 161.056; and
(34) Section 161.072.
SECTION 1.16. (a) Effective September 1, 2019, Section
531.0163, Government Code, is repealed.
(b) Effective September 1, 2019, the following provisions
of the Health and Safety Code, including provisions amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, are
repealed:
(1) Section 1001.002;
(2) Section 1001.028;
(3) Section 1001.029;
(4) Section 1001.030;
(5) Section 1001.032;
(6) Subchapter C, Chapter 1001; and
(7) Section 1001.074.
(c) Effective September 1, 2019, the following provisions
of the Human Resources Code, including provisions amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, are
repealed:
(1) Section 40.002(a);
(2) Section 40.004;
(3) Section 40.0041;
(4) Section 40.027;
(5) Section 40.032; and
(6) Section 40.033.
SECTION 1.17. Notwithstanding Sections 1.15 and 1.16 of
this article, the implementation of a provision repealed by those
sections ceases on the date the responsible state agency or entity
listed in Section 531.0202, Government Code, as added by this
article, is abolished as provided by Subchapter A-1, Chapter 531,
Government Code, as added by this article.
ARTICLE 2. HEALTH AND HUMAN SERVICES SYSTEM OPERATIONS
SECTION 2.01. Section 531.001, Government Code, is amended
by adding Subdivision (3-a) to read as follows:
(3-a) "Health and human services system" means the
system for providing or otherwise administering health and human
services in this state by the commission, including through an
office or division of the commission or through another entity
under the administrative and operational control of the executive
commissioner.
SECTION 2.02. Subchapter A, Chapter 531, Government Code,
is amended by adding Section 531.00552 to read as follows:
Sec. 531.00552. CONSOLIDATED INTERNAL AUDIT PROGRAM.
(a) Notwithstanding Section 2102.005, the commission shall
operate the internal audit program required under Chapter 2102 for
the commission and each health and human services agency as a
consolidated internal audit program.
(b) For purposes of this section, a reference in Chapter
2102 to the administrator of a state agency with respect to a health
and human services agency means the executive commissioner.
(c) This section expires on the last day of the period
prescribed by Section 531.02001(2).
SECTION 2.03. Section 531.006, Government Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
Sec. 531.006. ELIGIBILITY FOR APPOINTMENT AS EXECUTIVE
COMMISSIONER; EMPLOYEE RESTRICTIONS. (a) In this section, "Texas
trade association" means a cooperative and voluntarily joined
statewide association of business or professional competitors in
this state designed to assist its members and its industry or
profession in dealing with mutual business or professional problems
and in promoting their common interest.
(a-1) A person may not be appointed [is not eligible for
appointment] as executive commissioner, may not serve on the
commission's executive council, and may not be a commission
employee employed in a "bona fide executive, administrative, or
professional capacity," as that phrase is used for purposes of
establishing an exemption to the overtime provisions of the federal
Fair Labor Standards Act of 1938 (29 U.S.C. Section 201 et seq.) if:
(1) the person is an officer, employee, or paid
consultant of a Texas trade association in the field of health and
human services; or
(2) the person's spouse is an [employee,] officer,
manager, or paid consultant of a Texas trade association in the [a]
field of health and human services [under the commission's
jurisdiction].
(b) A person may not be appointed as executive commissioner
or act as general counsel of the commission if the person [who] is
required to register as a lobbyist under Chapter 305 because of the
person's activities for compensation [in or] on behalf of a
profession related to the operation of the commission [a field
under the commission's jurisdiction may not serve as executive
commissioner].
(c) A person may not be appointed [is not eligible for
appointment] as executive commissioner if the person has a
financial interest in a corporation, organization, or association
under contract with:
(1) the commission or a health and human services
agency [Department of State Health Services, if the contract
involves mental health services];
(2) [the Department of Aging and Disability Services,
if the contract involves intellectual and developmental disability
services;
[(3)] a local mental health or intellectual and
developmental disability authority; or
(3) [(4)] a community center.
SECTION 2.04. Section 531.0161, Government Code, is amended
by adding Subsection (c) to read as follows:
(c) The commission shall:
(1) coordinate the implementation of the policy
developed under Subsection (a);
(2) provide training as needed to implement the
procedures for negotiated rulemaking or alternative dispute
resolution; and
(3) collect data concerning the effectiveness of those
procedures.
SECTION 2.05. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0164 to read as follows:
Sec. 531.0164. HEALTH AND HUMAN SERVICES SYSTEM INTERNET
WEBSITE COORDINATION. The commission shall establish a process to
ensure Internet websites across the health and human services
system are developed and maintained according to standard criteria
for uniformity, efficiency, and technical capabilities. Under the
process, the commission shall:
(1) develop and maintain an inventory of all health
and human services system Internet websites;
(2) on an ongoing basis, evaluate the inventory
maintained under Subdivision (1) to:
(A) determine whether any of the Internet
websites should be consolidated to improve public access to those
websites' content; and
(B) ensure the Internet websites comply with the
standard criteria; and
(3) if appropriate, consolidate the websites
identified under Subdivision (2)(A).
(b) As soon as possible after the effective date of this
article, the Health and Human Services Commission shall implement
Section 531.0164, Government Code, as added by this article.
(c) As soon as possible after a 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 2.06. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0171 to read as follows:
Sec. 531.0171. OFFICE OF OMBUDSMAN. (a) The executive
commissioner shall establish the commission's office of the
ombudsman with authority and responsibility over the health and
human services system in performing the following functions:
(1) providing dispute resolution services for the
health and human services system;
(2) performing consumer protection and advocacy
functions related to health and human services, including assisting
a consumer or other interested person with:
(A) raising a matter within the health and human
services system that the person feels is being ignored; and
(B) obtaining information regarding a filed
complaint; and
(3) collecting inquiry and complaint data related to
the health and human services system.
(b) The office of the ombudsman does not have the authority
to provide a separate process for resolving complaints or appeals.
(c) The executive commissioner shall develop a standard
process for tracking and reporting received inquiries and
complaints within the health and human services system. The
process must provide for the centralized tracking of inquiries and
complaints submitted to field, regional, or other local health and
human services system offices.
(d) Using the process developed under Subsection (c), the
office of the ombudsman shall collect inquiry and complaint data
from all offices, agencies, divisions, and other entities within
the health and human services system. To assist with the collection
of data under this subsection, the office may access any system or
process for recording inquiries and complaints used or maintained
within the health and human services system.
(b) As soon as possible after the effective date of this
article, the executive commissioner of the Health and Human
Services Commission shall implement Section 531.0171, Government
Code, as added by this article.
(c) Notwithstanding any other provision of state law, 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.
SECTION 2.07. (a) Subchapter A, Chapter 531, Government
Code, is amended by adding Section 531.0192 to read as follows:
Sec. 531.0192. HEALTH AND HUMAN SERVICES SYSTEM HOTLINE AND
CALL CENTER COORDINATION. (a) The commission shall establish a
process to ensure all health and human services system hotlines and
call centers are necessary and appropriate. Under the process, the
commission shall:
(1) develop criteria for use in assessing whether a
hotline or call center serves an ongoing purpose;
(2) develop and maintain an inventory of all system
hotlines and call centers;
(3) use the inventory and assessment criteria
developed under this subsection to periodically consolidate
hotlines and call centers along appropriate functional lines; 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 2.08. (a) Section 531.02111(b), Government Code,
as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(b) The report must include:
(1) for each state agency described by Subsection (a):
(A) a description of each of the components of
Medicaid operated by the agency; and
(B) an accounting of all funds related to
Medicaid received and disbursed by the agency during the period
covered by the report, including:
(i) the amount of any federal Medicaid
funds allocated to the agency for the support of each of the
Medicaid components operated by the agency;
(ii) the amount of any funds appropriated
by the legislature to the agency for each of those components; and
(iii) the amount of Medicaid payments and
related expenditures made by or in connection with each of those
components; and
(2) for each Medicaid component identified in the
report:
(A) the amount and source of funds or other
revenue received by or made available to the agency for the
component; [and]
(B) the amount spent on each type of service or
benefit provided by or under the component;
(C) the amount spent on component operations,
including eligibility determination, claims processing, and case
management; and
(D) the amount spent on any other administrative
costs [information required by Section 531.02112(b)].
(b) The following provisions, including provisions amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015,
are repealed:
(1) Section 531.02112, Government Code;
(2) Sections 531.03131(f) and (g), Government Code;
(3) Section 2155.144(o), Government Code; and
(4) Section 22.0251(b), Human Resources Code.
SECTION 2.09. (a) Subchapter B, Chapter 531, Government
Code, is amended by adding Section 531.02118 to read as follows:
Sec. 531.02118. STREAMLINING MEDICAID PROVIDER ENROLLMENT
AND CREDENTIALING PROCESSES. (a) The commission shall streamline
provider enrollment and credentialing processes under Medicaid.
(b) In streamlining the Medicaid provider enrollment
process, the commission shall establish a centralized Internet
portal through which providers may enroll in Medicaid. The
commission may use the Internet portal created under this
subsection to create a single, consolidated Medicaid provider
enrollment and credentialing process.
(c) In streamlining the Medicaid provider credentialing
process under this section, the commission may designate a
centralized credentialing entity and may:
(1) share information in the database established
under Subchapter C, Chapter 32, Human Resources Code, with the
centralized credentialing entity; and
(2) require all managed care organizations
contracting with the commission to provide health care services to
Medicaid recipients under a managed care plan issued by the
organization to use the centralized credentialing entity as a hub
for the collection and sharing of information.
(d) If cost-effective, the commission may contract with a
third party to develop the single, consolidated Medicaid provider
enrollment and credentialing process authorized under Subsection
(b).
(b) The Health and Human Services Commission shall
streamline provider enrollment and credentialing processes as
required under Section 531.02118, Government Code, as added by this
article, not later than September 1, 2016.
SECTION 2.10. (a) Section 531.02141, Government Code, is
amended by adding Subsections (c), (d), and (e) to read as follows:
(c) The commission shall regularly evaluate data submitted
by managed care organizations that contract with the commission
under Chapter 533 to determine whether:
(1) the data continues to serve a useful purpose; and
(2) additional data is needed to oversee contracts or
evaluate the effectiveness of Medicaid.
(d) The commission shall collect Medicaid managed care data
that effectively captures the quality of services received by
Medicaid recipients.
(e) The commission shall develop a dashboard for agency
leadership that is designed to assist leadership with overseeing
Medicaid and comparing the performance of managed care
organizations participating in Medicaid. The dashboard must
identify a concise number of important Medicaid indicators,
including key data, performance measures, trends, and problems.
(b) Not later than March 1, 2016, the Health and Human
Services Commission shall develop the dashboard required by Section
531.02141(e), Government Code, as added by this article.
SECTION 2.11. 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 last day of the period
prescribed by Section 531.02001(2).
SECTION 2.12. Section 531.102, Government Code, is amended
by adding Subsections (p) and (q) to read as follows:
(p) In accordance with Section 533.015(b), the office shall
consult with the executive commissioner regarding the adoption of
rules defining the office's role in and jurisdiction over, and the
frequency of, audits of managed care organizations participating in
Medicaid that are conducted by the office and the commission.
(q) The office shall coordinate all audit and oversight
activities, including the development of audit plans, risk
assessments, and findings, with the commission to minimize the
duplication of activities. In coordinating activities under this
subsection, the office shall:
(1) on an annual basis, seek input from the commission
and consider previous audits and onsite visits made by the
commission for purposes of determining whether to audit a managed
care organization participating in Medicaid; and
(2) request the results of any informal audit or
onsite visit performed by the commission that could inform the
office's risk assessment when determining whether to conduct, or
the scope of, an audit of a managed care organization participating
in Medicaid.
SECTION 2.13. (a) Section 531.1031(a), Government Code,
as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(a) In this section and Sections 531.1032, 531.1033, and
531.1034:
(1) "Health care professional" means a person issued a
license[, registration, or certification] to engage in a health
care profession.
(1-a) "License" means a license, certificate,
registration, permit, or other authorization that:
(A) is issued by a licensing authority; and
(B) must be obtained before a person may practice
or engage in a particular business, occupation, or profession.
(1-b) "Licensing authority" means a department,
commission, board, office, or other agency of the state that issues
a license.
(1-c) "Office" means the commission's office of
inspector general unless a different meaning is plainly required by
the context in which the term appears.
(2) "Participating agency" means:
(A) the Medicaid fraud enforcement divisions of
the office of the attorney general;
(B) each licensing authority [board or agency]
with authority to issue a license to[, register, regulate, or
certify] a health care professional or managed care organization
that may participate in Medicaid; and
(C) the [commission's] office [of inspector
general].
(3) "Provider" has the meaning assigned by Section
531.1011(10)(A).
(b) Subchapter C, Chapter 531, Government Code, is amended
by adding Sections 531.1032, 531.1033, and 531.1034 to read as
follows:
Sec. 531.1032. OFFICE OF INSPECTOR GENERAL: CRIMINAL
HISTORY RECORD INFORMATION CHECK. (a) The office and each
licensing authority that requires the submission of fingerprints
for the purpose of conducting a criminal history record information
check of a health care professional shall enter into a memorandum of
understanding to ensure that only persons who are licensed and in
good standing as health care professionals participate as providers
in Medicaid. The memorandum under this section may be combined with
a memorandum authorized under Section 531.1031(c-1) and must
include a process by which:
(1) the office may confirm with a licensing authority
that a health care professional is licensed and in good standing for
purposes of determining eligibility to participate in Medicaid; and
(2) the licensing authority immediately notifies the
office if:
(A) a provider's license has been revoked or
suspended; or
(B) the licensing authority has taken
disciplinary action against a provider.
(b) The office may not, for purposes of determining a health
care professional's eligibility to participate in Medicaid as a
provider, conduct a criminal history record information check of a
health care professional who the office has confirmed under
Subsection (a) is licensed and in good standing. This subsection
does not prohibit the office from performing a criminal history
record information check of a provider that is required or
appropriate for other reasons, including for conducting an
investigation of fraud, waste, or abuse.
(c) For purposes of determining eligibility to participate
in Medicaid and subject to Subsection (d), the office, after
seeking public input, shall establish and the executive
commissioner by rule shall adopt guidelines for the evaluation of
criminal history record information of providers and potential
providers. The guidelines must outline conduct, by provider type,
that may be contained in criminal history record information that
will result in exclusion of a person from Medicaid as a provider,
taking into consideration:
(1) the extent to which the underlying conduct relates
to the services provided under Medicaid;
(2) the degree to which the person would interact with
Medicaid recipients as a provider; and
(3) any previous evidence that the person engaged in
fraud, waste, or abuse under Medicaid.
(d) The guidelines adopted under Subsection (c) may not
impose stricter standards for the eligibility of a person to
participate in Medicaid than a licensing authority described by
Subsection (a) requires for the person to engage in a health care
profession without restriction in this state.
(e) The office and the commission shall use the guidelines
adopted under Subsection (c) to determine whether a provider
participating in Medicaid continues to be eligible to participate
in Medicaid as a provider.
(f) The provider enrollment contractor, if applicable, and
a managed care organization participating in Medicaid shall defer
to the office regarding whether a person's criminal history record
information precludes the person from participating in Medicaid as
a provider.
Sec. 531.1033. MONITORING OF CERTAIN FEDERAL DATABASES.
The office shall routinely check appropriate federal databases,
including databases referenced in 42 C.F.R. Section 455.436, to
ensure that a person who is excluded from participating in Medicaid
or in the Medicare program by the federal government is not
participating as a provider in Medicaid.
Sec. 531.1034. TIME TO DETERMINE PROVIDER ELIGIBILITY;
PERFORMANCE METRICS. (a) Not later than the 10th day after the
date the office receives the complete application of a health care
professional seeking to participate in Medicaid, the office shall
inform the commission or the health care professional, as
appropriate, of the office's determination regarding whether the
health care professional should be excluded from participating in
Medicaid based on:
(1) information concerning the licensing status of the
health care professional obtained as described by Section
531.1032(a);
(2) information contained in the criminal history
record information check that is evaluated in accordance with
guidelines adopted under Section 531.1032(c);
(3) a review of federal databases under Section
531.1033;
(4) the pendency of an open investigation by the
office; or
(5) any other reason the office determines
appropriate.
(b) Completion of an on-site visit of a health care
professional during the period prescribed by Subsection (a) is not
required.
(c) The office shall develop performance metrics to measure
the length of time for conducting a determination described by
Subsection (a) with respect to applications that are complete when
submitted and all other applications.
(c) Not later than September 1, 2016, the executive
commissioner of the Health and Human Services Commission shall
adopt the guidelines required under Section 531.1032(c),
Government Code, as added by this section.
SECTION 2.14. (a) Chapter 531, Government Code, is amended
by adding Subchapter M to read as follows:
SUBCHAPTER M. COORDINATION OF QUALITY INITIATIVES
Sec. 531.451. OPERATIONAL PLAN TO COORDINATE INITIATIVES.
(a) The commission shall develop and implement a comprehensive,
coordinated operational plan to ensure a consistent approach across
the major quality initiatives of the health and human services
system for improving the quality of health care.
(b) The operational plan developed under this section must
include broad goals for the improvement of the quality of health
care in this state, including health care services provided through
Medicaid.
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 2.15. Section 533.00255(a), Government Code, is
amended to read as follows:
(a) In this section, "behavioral health services" means
mental health and substance abuse disorder services[, other than
those provided through the NorthSTAR demonstration project].
SECTION 2.16. 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 2.17. 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 2.18. Subchapter A, Chapter 533, Government Code,
is amended by adding Section 533.0077 to read as follows:
Sec. 533.0077. STATEWIDE EFFORT TO PROMOTE MAINTENANCE OF
ELIGIBILITY. (a) The commission shall develop and implement a
statewide effort to assist recipients who satisfy Medicaid
eligibility requirements and who receive Medicaid services through
a managed care organization with maintaining eligibility and
avoiding lapses in coverage under Medicaid.
(b) As part of its effort under Subsection (a), the
commission shall:
(1) require each managed care organization providing
health care services to recipients to assist those recipients with
maintaining eligibility;
(2) if the commission determines it is cost-effective,
develop specific strategies for assisting recipients who receive
Supplemental Security Income (SSI) benefits under 42 U.S.C. Section
1381 et seq. with maintaining eligibility; and
(3) ensure information that is relevant to a
recipient's eligibility status is provided to the managed care
organization through which the recipient receives Medicaid
services.
SECTION 2.19. (a) Section 533.015, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 533.015. COORDINATION OF EXTERNAL OVERSIGHT
ACTIVITIES. (a) To the extent possible, the commission shall
coordinate all external oversight activities to minimize
duplication of oversight of managed care plans under Medicaid and
disruption of operations under those plans.
(b) The executive commissioner, after consulting with the
commission's office of inspector general, shall, by rule, define
the commission's and office's roles in and jurisdiction over, and
frequency of, audits of managed care organizations participating in
Medicaid that are conducted by the commission and the commission's
office of inspector general.
(c) In accordance with Section 531.102(q), the commission
shall share with the commission's office of inspector general, at
the request of the office, the results of any informal audit or
onsite visit that could inform that office's risk assessment when
determining whether to conduct, or the scope of, an audit of a
managed care organization participating in Medicaid.
(b) Not later than September 1, 2016, the executive
commissioner of the Health and Human Services Commission shall
adopt rules required by Section 533.015(b), Government Code, as
added by this article.
SECTION 2.20. Section 533.041(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) The executive commissioner shall appoint a state
Medicaid managed care advisory committee. The advisory committee
consists of representatives of:
(1) hospitals;
(2) managed care organizations and participating
health care providers;
(3) primary care providers and specialty care
providers;
(4) state agencies;
(5) low-income recipients or consumer advocates
representing low-income recipients;
(6) recipients with disabilities, including
recipients with an intellectual or developmental disability or with
physical disabilities, or consumer advocates representing those
recipients;
(7) parents of children who are recipients;
(8) rural providers;
(9) advocates for children with special health care
needs;
(10) pediatric health care providers, including
specialty providers;
(11) long-term services and supports providers,
including nursing facility providers and direct service workers;
(12) obstetrical care providers;
(13) community-based organizations serving low-income
children and their families;
(14) community-based organizations engaged in
perinatal services and outreach;
(15) recipients who are 65 years of age or older;
(16) recipients with mental illness;
(17) nonphysician mental health providers
participating in the Medicaid managed care program; and
(18) entities with responsibilities for the delivery
of long-term services and supports or other Medicaid service
delivery, including:
(A) independent living centers;
(B) area agencies on aging;
(C) aging and disability resource centers
established under the Aging and Disability Resource Center
initiative funded in part by the federal Administration on Aging
and the Centers for Medicare and Medicaid Services; and
(D) community mental health and intellectual
disability centers[; and
[(E) the NorthSTAR Behavioral Health Program
provided under Chapter 534, Health and Safety Code].
SECTION 2.21. (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 2.22. Section 1001.080(b), Health and Safety Code,
is amended to read as follows:
(b) This section applies to health or mental health
benefits, services, or assistance provided by the department that
the department anticipates will be impacted by a health insurance
exchange as defined by Section 1001.081(a), including:
(1) community primary health care services provided
under Chapter 31;
(2) women's and children's health services provided
under Chapter 32;
(3) services for children with special health care
needs provided under Chapter 35;
(4) epilepsy program assistance provided under
Chapter 40;
(5) hemophilia program assistance provided under
Chapter 41;
(6) kidney health care services provided under Chapter
42;
(7) human immunodeficiency virus infection and
sexually transmitted disease prevention programs and services
provided under Chapter 85;
(8) immunization programs provided under Chapter 161;
(9) programs and services provided by the Rio Grande
State Center under Chapter 252;
(10) mental health services for adults provided under
Chapter 534;
(11) mental health services for children provided
under Chapter 534;
(12) [the NorthSTAR Behavioral Health Program
provided under Chapter 534;
[(13)] programs and services provided by community
mental health hospitals under Chapter 552;
(13) [(14)] programs and services provided by state
mental health hospitals under Chapter 552; and
(14) [(15)] any other health or mental health program
or service designated by the department.
SECTION 2.23. Section 1001.201(2), Health and Safety Code,
as added by Chapter 1306 (H.B. 3793), Acts of the 83rd Legislature,
Regular Session, 2013, is amended to read as follows:
(2) "Local mental health authority" has the meaning
assigned by Section 531.002 [and includes the local behavioral
health authority for the NorthSTAR Behavioral Health Program].
ARTICLE 3. HEALTH AND HUMAN SERVICES SYSTEM ADVISORY ENTITIES
SECTION 3.01. Section 262.353(d), Family Code, is amended
to read as follows:
(d) Not later than September 30, 2014, the department and
the Department of State Health Services shall file a report with the
legislature [and the Council on Children and Families] on the
results of the study required by Subsection (a). The report must
include:
(1) each option to prevent relinquishment of parental
custody that was considered during the study;
(2) each option recommended for implementation, if
any;
(3) each option that is implemented using existing
resources;
(4) any policy or statutory change needed to implement
a recommended option;
(5) the fiscal impact of implementing each option, if
any;
(6) the estimated number of children and families that
may be affected by the implementation of each option; and
(7) any other significant information relating to the
study.
SECTION 3.02. (a) Section 531.012, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 531.012. ADVISORY COMMITTEES. (a) The executive
commissioner shall establish and maintain [may appoint] advisory
committees to consider issues and solicit public input across all
major areas of the health and human services system, 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 [as needed].
(b) Not later than March 1, 2016, the executive commissioner
of the Health and Human Services Commission shall adopt rules under
Section 531.012, Government Code, as amended by this article.
SECTION 3.03. Subchapter A, Chapter 531, Government Code,
is amended by adding Section 531.0121 to read as follows:
Sec. 531.0121. PUBLIC ACCESS TO ADVISORY COMMITTEE
MEETINGS. (a) This section applies to an advisory committee
established under Section 531.012.
(b) The commission shall create a master calendar that
includes all advisory committee meetings across the health and
human services system.
(c) The commission shall make available on the commission's
Internet website:
(1) the master calendar;
(2) all meeting materials for an advisory committee
meeting; and
(3) streaming live video of each advisory committee
meeting.
(d) The commission shall provide Internet access in each
room used for a meeting that appears on the master calendar.
SECTION 3.04. Section 531.0216(b), Government Code, is
amended to read as follows:
(b) In developing the system, the executive commissioner by
rule shall:
(1) review programs and pilot projects in other states
to determine the most effective method for reimbursement;
(2) establish billing codes and a fee schedule for
services;
(3) provide for an approval process before a provider
can receive reimbursement for services;
(4) consult with the Department of State Health
Services [and the telemedicine and telehealth advisory committee]
to establish procedures to:
(A) identify clinical evidence supporting
delivery of health care services using a telecommunications system;
and
(B) annually review health care services,
considering new clinical findings, to determine whether
reimbursement for particular services should be denied or
authorized;
(5) establish a separate provider identifier for
telemedicine medical services providers, telehealth services
providers, and home telemonitoring services providers; and
(6) establish a separate modifier for telemedicine
medical services, telehealth services, and home telemonitoring
services eligible for reimbursement.
SECTION 3.05. Section 531.02443(e), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(e) The department, with the advice and assistance of [the
interagency task force on ensuring appropriate care settings for
persons with disabilities and] representatives of family members or
legally authorized representatives of adult residents, persons
with an intellectual disability, state supported living centers,
and local intellectual and developmental disability authorities,
shall:
(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 and an adult resident, an adult
resident's legally authorized representative, or a local
intellectual and developmental disability authority.
SECTION 3.06. Section 531.051(c), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(c) In adopting rules for the consumer direction models, the
executive commissioner shall:
(1) [with assistance from the work group established
under Section 531.052,] determine which services are appropriate
and suitable for delivery through consumer direction;
(2) ensure that each consumer direction model is
designed to comply with applicable federal and state laws;
(3) maintain procedures to ensure that a potential
consumer or the consumer's legally authorized representative has
adequate and appropriate information, including the
responsibilities of a consumer or representative under each service
delivery option, to make an informed choice among the types of
consumer direction models;
(4) require each consumer or the consumer's legally
authorized representative to sign a statement acknowledging
receipt of the information required by Subdivision (3);
(5) maintain procedures to monitor delivery of
services through consumer direction to ensure:
(A) adherence to existing applicable program
standards;
(B) appropriate use of funds; and
(C) consumer satisfaction with the delivery of
services;
(6) ensure that authorized program services that are
not being delivered to a consumer through consumer direction are
provided by a provider agency chosen by the consumer or the
consumer's legally authorized representative; and
(7) [work in conjunction with the work group
established under Section 531.052 to] set a timetable to complete
the implementation of the consumer direction models.
SECTION 3.07. Section 531.067, Government Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
Sec. 531.067. PROGRAM TO IMPROVE AND MONITOR CERTAIN
OUTCOMES OF RECIPIENTS UNDER CHILD HEALTH PLAN PROGRAM AND MEDICAID
[PUBLIC ASSISTANCE HEALTH BENEFIT REVIEW AND DESIGN COMMITTEE].
The [(a) The commission shall appoint a Public Assistance Health
Benefit Review and Design Committee. The committee consists of
nine representatives of health care providers participating in
Medicaid or the child health plan program, or both. The committee
membership must include at least three representatives from each
program.
[(b) The executive commissioner shall designate one member
to serve as presiding officer for a term of two years.
[(c) The committee shall meet at the call of the presiding
officer.
[(d) The committee shall review and provide recommendations
to the commission regarding health benefits and coverages provided
under Medicaid, the child health plan program, and any other
income-based health care program administered by the commission or
a health and human services agency. In performing its duties under
this subsection, the committee must:
[(1) review benefits provided under each of the
programs; and
[(2) review procedures for addressing high
utilization of benefits by recipients.
[(e) The commission shall provide administrative support
and resources as necessary for the committee to perform its duties
under this section.
[(f) Section 2110.008 does not apply to the committee.
[(g) In performing the duties under this section, the]
commission may design and implement a program to improve and
monitor clinical and functional outcomes of a recipient of services
under Medicaid or the state child health plan program. The program
may use financial, clinical, and other criteria based on pharmacy,
medical services, and other claims data related to Medicaid or the
child health plan program. [The commission must report to the
committee on the fiscal impact, including any savings associated
with the strategies utilized under this section.]
SECTION 3.08. (a) Section 531.0691, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is redesignated as Section 531.0735, Government Code, to read
as follows:
Sec. 531.0735 [531.0691]. MEDICAID DRUG UTILIZATION REVIEW
PROGRAM: DRUG USE REVIEWS AND ANNUAL REPORT. (a) In this section:
(1) "Medicaid Drug Utilization Review Program" means
the program operated by the vendor drug program to improve the
quality of pharmaceutical care under Medicaid.
(2) "Prospective drug use review" means the review of
a patient's drug therapy and prescription drug order or medication
order before dispensing or distributing a drug to the patient.
(3) "Retrospective drug use review" means the review
of prescription drug claims data to identify patterns of
prescribing.
(b) The commission shall provide for an increase in the
number and types of retrospective drug use reviews performed each
year under the Medicaid Drug Utilization Review Program, in
comparison to the number and types of reviews performed in the state
fiscal year ending August 31, 2009.
(c) In determining the number and types of drug use reviews
to be performed, the commission shall:
(1) allow for the repeat of retrospective drug use
reviews that address ongoing drug therapy problems and that, in
previous years, improved client outcomes and reduced Medicaid
spending;
(2) consider implementing disease-specific
retrospective drug use reviews that address ongoing drug therapy
problems in this state and that reduced Medicaid prescription drug
use expenditures in other states; and
(3) regularly examine Medicaid prescription drug
claims data to identify occurrences of potential drug therapy
problems that may be addressed by repeating successful
retrospective drug use reviews performed in this state and other
states.
(d) In addition to any other information required by federal
law, the commission shall include the following information in the
annual report regarding the Medicaid Drug Utilization Review
Program:
(1) a detailed description of the program's
activities; and
(2) estimates of cost savings anticipated to result
from the program's performance of prospective and retrospective
drug use reviews.
(e) The cost-saving estimates for prospective drug use
reviews under Subsection (d) must include savings attributed to
drug use reviews performed through the vendor drug program's
electronic claims processing system and clinical edits screened
through the prior authorization system implemented under Section
531.073.
(f) The commission shall post the annual report regarding
the Medicaid Drug Utilization Review Program on the commission's
website.
(b) Subchapter B, Chapter 531, Government Code, is amended
by adding Section 531.0736 to read as follows:
Sec. 531.0736. DRUG UTILIZATION REVIEW BOARD. (a) In this
section, "board" means the Drug Utilization Review Board.
(b) In addition to performing any other duties required by
federal law, the board shall:
(1) develop and submit to the commission
recommendations for preferred drug lists adopted by the commission
under Section 531.072;
(2) suggest to the commission restrictions or clinical
edits on prescription drugs;
(3) recommend to the commission educational
interventions for Medicaid providers;
(4) review drug utilization across Medicaid; and
(5) perform other duties that may be specified by law
and otherwise make recommendations to the commission.
(c) The executive commissioner shall determine the
composition of the board, which must:
(1) comply with applicable federal law, including 42
C.F.R. Section 456.716; 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 [531.0692]. [MEDICAID] DRUG UTILIZATION
REVIEW BOARD: CONFLICTS OF INTEREST. (a) A member of the [board
of the Medicaid] Drug Utilization Review Board [Program] may not
have a contractual relationship, ownership interest, or other
conflict of interest with a pharmaceutical manufacturer or labeler
or with an entity engaged by the commission to assist in the
administration of the Medicaid Drug Utilization Review Program.
(b) The executive commissioner may implement this section
by adopting rules that identify prohibited relationships and
conflicts or requiring the board to develop a conflict-of-interest
policy that applies to the board.
(d) Sections 531.072(c) and (e), Government Code, are
amended to read as follows:
(c) In making a decision regarding the placement of a drug
on each of the preferred drug lists, the commission shall consider:
(1) the recommendations of the Drug Utilization Review
Board [Pharmaceutical and Therapeutics Committee established]
under Section 531.0736 [531.074];
(2) the clinical efficacy of the drug;
(3) the price of competing drugs after deducting any
federal and state rebate amounts; and
(4) program benefit offerings solely or in conjunction
with rebates and other pricing information.
(e) In this subsection, "labeler" and "manufacturer" have
the meanings assigned by Section 531.070. The commission shall
ensure that:
(1) a manufacturer or labeler may submit written
evidence supporting the inclusion of a drug on the preferred drug
lists before a supplemental agreement is reached with the
commission; and
(2) any drug that has been approved or has had any of
its particular uses approved by the United States Food and Drug
Administration under a priority review classification will be
reviewed by the Drug Utilization Review Board [Pharmaceutical and
Therapeutics Committee] at the next regularly scheduled meeting of
the board [committee]. On receiving notice from a manufacturer or
labeler of the availability of a new product, the commission, to the
extent possible, shall schedule a review for the product at the next
regularly scheduled meeting of the board [committee].
(e) Section 531.073(b), Government Code, is amended to read
as follows:
(b) The commission shall establish procedures for the prior
authorization requirement under the Medicaid vendor drug program to
ensure that the requirements of 42 U.S.C. Section 1396r-8(d)(5) and
its subsequent amendments are met. Specifically, the procedures
must ensure that:
(1) a prior authorization requirement is not imposed
for a drug before the drug has been considered at a meeting of the
Drug Utilization Review Board [Pharmaceutical and Therapeutics
Committee established] under Section 531.0736 [531.074];
(2) there will be a response to a request for prior
authorization by telephone or other telecommunications device
within 24 hours after receipt of a request for prior authorization;
and
(3) a 72-hour supply of the drug prescribed will be
provided in an emergency or if the commission does not provide a
response within the time required by Subdivision (2).
(f) Section 531.0741, Government Code, is amended to read as
follows:
Sec. 531.0741. PUBLICATION OF INFORMATION REGARDING
COMMISSION DECISIONS ON PREFERRED DRUG LIST PLACEMENT. The
commission shall publish on the commission's Internet website any
decisions on preferred drug list placement, including:
(1) a list of drugs reviewed and the commission's
decision for or against placement on a preferred drug list of each
drug reviewed;
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070; and
(3) the rationale for any departure from a
recommendation of the Drug Utilization Review Board
[pharmaceutical and therapeutics committee established] under
Section 531.0736 [531.074].
(g) Section 531.074, Government Code, as amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
(h) The term of a member serving on the Medicaid Drug
Utilization Review Board on 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 3.09. The heading to Subchapter D, Chapter 531,
Government Code, is amended to read as follows:
SUBCHAPTER D. PLAN TO SUPPORT GUARDIANSHIPS [GUARDIANSHIP
ADVISORY BOARD]
SECTION 3.10. Section 531.124, Government Code, is amended
to read as follows:
Sec. 531.124. COMMISSION DUTIES. The [(a) With the advice
of the advisory board, the] commission shall develop and, subject
to appropriations, implement a plan to:
(1) ensure that each incapacitated individual in this
state who needs a guardianship or another less restrictive type of
assistance to make decisions concerning the incapacitated
individual's own welfare and financial affairs receives that
assistance; and
(2) foster the establishment and growth of local
volunteer guardianship programs.
[(b) The advisory board shall biennially review and comment
on the minimum standards adopted under Section 111.041 and the plan
implemented under Subsection (a) and shall include its conclusions
in the report submitted under Section 531.1235.]
SECTION 3.11. Section 531.159(f), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(f) The executive commissioner by rule shall develop
procedures by which to conduct the reviews required by Subsections
(c), (d), and (e). [In developing the procedures, the commission
may seek input from the work group on children's long-term
services, health services, and mental health services established
under Section 22.035, Human Resources Code.]
SECTION 3.12. Section 531.907(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Based on [the recommendations of the advisory committee
established under Section 531.904 and] feedback provided by
interested parties, the commission in stage two of implementing the
health information exchange system may expand the system by:
(1) providing an electronic health record for each
child enrolled in the child health plan program;
(2) including state laboratory results information in
an electronic health record, including the results of newborn
screenings and tests conducted under the Texas Health Steps
program, based on the system developed for the health passport
under Section 266.006, Family Code;
(3) improving data-gathering capabilities for an
electronic health record so that the record may include basic
health and clinical information in addition to available claims
information, as determined by the executive commissioner;
(4) using evidence-based technology tools to create a
unique health profile to alert health care providers regarding the
need for additional care, education, counseling, or health
management activities for specific patients; and
(5) continuing to enhance the electronic health record
created for each Medicaid recipient as technology becomes available
and interoperability capabilities improve.
SECTION 3.13. Section 531.909, Government Code, is amended
to read as follows:
Sec. 531.909. INCENTIVES. The commission [and the advisory
committee established under Section 531.904] shall develop
strategies to encourage health care providers to use the health
information exchange system, including incentives, education, and
outreach tools to increase usage.
SECTION 3.14. Section 533.00251(c), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(c) Subject to Section 533.0025 and notwithstanding any
other law, the commission [, in consultation with the advisory
committee,] shall provide benefits under Medicaid to recipients who
reside in nursing facilities through the STAR + PLUS Medicaid
managed care program. In implementing this subsection, the
commission shall ensure:
(1) that the commission is responsible for setting the
minimum reimbursement rate paid to a nursing facility under the
managed care program, including the staff rate enhancement paid to
a nursing facility that qualifies for the enhancement;
(2) that a nursing facility is paid not later than the
10th day after the date the facility submits a clean claim;
(3) the appropriate utilization of services
consistent with criteria established by the commission;
(4) a reduction in the incidence of potentially
preventable events and unnecessary institutionalizations;
(5) that a managed care organization providing
services under the managed care program provides discharge
planning, transitional care, and other education programs to
physicians and hospitals regarding all available long-term care
settings;
(6) that a managed care organization providing
services under the managed care program:
(A) assists in collecting applied income from
recipients; and
(B) provides payment incentives to nursing
facility providers that reward reductions in preventable acute care
costs and encourage transformative efforts in the delivery of
nursing facility services, including efforts to promote a
resident-centered care culture through facility design and
services provided;
(7) the establishment of a portal that is in
compliance with state and federal regulations, including standard
coding requirements, through which nursing facility providers
participating in the STAR + PLUS Medicaid managed care program may
submit claims to any participating managed care organization;
(8) that rules and procedures relating to the
certification and decertification of nursing facility beds under
Medicaid are not affected; and
(9) that a managed care organization providing
services under the managed care program, to the greatest extent
possible, offers nursing facility providers access to:
(A) acute care professionals; and
(B) telemedicine, when feasible and in
accordance with state law, including rules adopted by the Texas
Medical Board.
SECTION 3.15. Section 533.00253(b), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(b) Subject to Section 533.0025, the commission shall[, in
consultation with the advisory committee and the Children's Policy
Council established under Section 22.035, Human Resources Code,]
establish a mandatory STAR Kids capitated managed care program
tailored to provide Medicaid benefits to children with
disabilities. The managed care program developed under this
section must:
(1) provide Medicaid benefits that are customized to
meet the health care needs of recipients under the program through a
defined system of care;
(2) better coordinate care of recipients under the
program;
(3) improve the health outcomes of recipients;
(4) improve recipients' access to health care
services;
(5) achieve cost containment and cost efficiency;
(6) reduce the administrative complexity of
delivering Medicaid benefits;
(7) reduce the incidence of unnecessary
institutionalizations and potentially preventable events by
ensuring the availability of appropriate services and care
management;
(8) require a health home; and
(9) coordinate and collaborate with long-term care
service providers and long-term care management providers, if
recipients are receiving long-term services and supports outside of
the managed care organization.
SECTION 3.16. Section 533.00256(a), Government Code, is
amended to read as follows:
(a) In consultation with [the Medicaid and CHIP
Quality-Based Payment Advisory Committee established under Section
536.002 and other] appropriate stakeholders with an interest in the
provision of acute care services and long-term services and
supports under the Medicaid managed care program, the commission
shall:
(1) establish a clinical improvement program to
identify goals designed to improve quality of care and care
management and to reduce potentially preventable events, as defined
by Section 536.001; and
(2) require managed care organizations to develop and
implement collaborative program improvement strategies to address
the goals.
SECTION 3.17. Section 534.052, Government Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
Sec. 534.052. IMPLEMENTATION OF SYSTEM REDESIGN. The
commission and department shall[, in consultation with the advisory
committee,] jointly implement the acute care services and long-term
services and supports system for individuals with an intellectual
or developmental disability in the manner and in the stages
described in this chapter.
SECTION 3.18. Section 534.104(d), Government Code, is
amended to read as follows:
(d) The department[, in consultation with the advisory
committee,] shall evaluate each submitted managed care strategy
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 3.19. Section 534.105, Government Code, is amended
to read as follows:
Sec. 534.105. PILOT PROGRAM: MEASURABLE GOALS. (a) The
department[, in consultation with the advisory committee,] shall
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[, in consultation with the advisory
committee,] shall propose specific strategies for achieving the
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 3.20. 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[, in consultation with the advisory
committee,] shall review and evaluate the progress and outcomes of
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 3.21. 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 [that is in addition
to the input provided by the advisory committee].
SECTION 3.22. 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 [that is in addition
to the input provided by the advisory committee].
SECTION 3.23. Section 535.051(c), Government Code, is
amended to read as follows:
(c) The commissioner of higher education[, in consultation
with the presiding officer of the interagency coordinating group,]
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 3.24. Section 535.104(a), Government Code, is
amended to read as follows:
(a) The commission shall:
(1) contract with the State Commission on National and
Community Service to administer funds appropriated from the account
in a manner that:
(A) consolidates the capacity of and strengthens
national service and community and faith- and community-based
initiatives; and
(B) leverages public and private funds to benefit
this state;
(2) develop a competitive process to be used in
awarding grants from account funds that is consistent with state
law and includes objective selection criteria;
(3) oversee the delivery of training and other
assistance activities under this subchapter;
(4) develop criteria limiting awards of grants under
Section 535.105(1)(A) to small and medium-sized faith- and
community-based organizations that provide charitable services to
persons in this state;
(5) establish general state priorities for the
account;
(6) establish and monitor performance and outcome
measures for persons to whom grants are awarded under this
subchapter; and
(7) establish policies and procedures to ensure that
any money appropriated from the account to the commission that is
allocated to build the capacity of a faith-based organization or
for a faith-based initiative [, including money allocated for the
establishment of the advisory committee under Section 535.108,] is
not used to advance a sectarian purpose or to engage in any form of
proselytization.
SECTION 3.25. 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
[Sections] 535.052 [and 535.053].
SECTION 3.26. Section 536.001(20), Government Code, is
amended to read as follows:
(20) "Potentially preventable readmission" means a
return hospitalization of a person within a period specified by the
commission that may have resulted from deficiencies in the care or
treatment provided to the person during a previous hospital stay or
from deficiencies in post-hospital discharge follow-up. The term
does not include a hospital readmission necessitated by the
occurrence of unrelated events after the discharge. The term
includes the readmission of a person to a hospital for:
(A) the same condition or procedure for which the
person was previously admitted;
(B) an infection or other complication resulting
from care previously provided;
(C) a condition or procedure that indicates that
a surgical intervention performed during a previous admission was
unsuccessful in achieving the anticipated outcome; or
(D) another condition or procedure of a similar
nature, as determined by the executive commissioner [after
consulting with the advisory committee].
SECTION 3.27. Section 536.003(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) The commission[, in consultation with the advisory
committee,] shall develop quality-based outcome and process
measures that promote the provision of efficient, quality health
care and that can be used in the child health plan program and
Medicaid to implement quality-based payments for acute care
services and long-term services and supports across all delivery
models and payment systems, including fee-for-service and managed
care payment systems. Subject to Subsection (a-1), the commission,
in developing outcome and process measures under this section, must
include measures that are based on potentially preventable events
and that advance quality improvement and innovation. The
commission may change measures developed:
(1) to promote continuous system reform, improved
quality, and reduced costs; and
(2) to account for managed care organizations added to
a service area.
SECTION 3.28. Section 536.004(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Using quality-based outcome and process measures
developed under Section 536.003 and subject to this section, the
commission, after consulting with [the advisory committee and
other] appropriate stakeholders with an interest in the provision
of acute care and long-term services and supports under the child
health plan program and Medicaid, shall develop quality-based
payment systems, and require managed care organizations to develop
quality-based payment systems, for compensating a physician or
other health care provider participating in the child health plan
program or Medicaid that:
(1) align payment incentives with high-quality,
cost-effective health care;
(2) reward the use of evidence-based best practices;
(3) promote the coordination of health care;
(4) encourage appropriate physician and other health
care provider collaboration;
(5) promote effective health care delivery models; and
(6) take into account the specific needs of the child
health plan program enrollee and Medicaid recipient populations.
SECTION 3.29. Section 536.006(a), Government Code, is
amended to read as follows:
(a) The commission [and the advisory committee] shall:
(1) ensure transparency in the development and
establishment of:
(A) quality-based payment and reimbursement
systems under Section 536.004 and Subchapters B, C, and D,
including the development of outcome and process measures under
Section 536.003; and
(B) quality-based payment initiatives under
Subchapter E, including the development of quality of care and
cost-efficiency benchmarks under Section 536.204(a) and efficiency
performance standards under Section 536.204(b);
(2) develop guidelines establishing procedures for
providing notice and information to, and receiving input from,
managed care organizations, health care providers, including
physicians and experts in the various medical specialty fields, and
other stakeholders, as appropriate, for purposes of developing and
establishing the quality-based payment and reimbursement systems
and initiatives described under Subdivision (1);
(3) in developing and establishing the quality-based
payment and reimbursement systems and initiatives described under
Subdivision (1), consider that as the performance of a managed care
organization or physician or other health care provider improves
with respect to an outcome or process measure, quality of care and
cost-efficiency benchmark, or efficiency performance standard, as
applicable, there will be a diminishing rate of improved
performance over time; and
(4) develop web-based capability to provide managed
care organizations and health care providers with data on their
clinical and utilization performance, including comparisons to
peer organizations and providers located in this state and in the
provider's respective region.
SECTION 3.30. Section 536.052(b), Government Code, is
amended to read as follows:
(b) The commission [, after consulting with the advisory
committee,] shall develop quality of care and cost-efficiency
benchmarks, including benchmarks based on a managed care
organization's performance with respect to reducing potentially
preventable events and containing the growth rate of health care
costs.
SECTION 3.31. Section 536.102(a), Government Code, is
amended to read as follows:
(a) Subject to this subchapter, the commission [, after
consulting with the advisory committee,] may develop and implement
quality-based payment systems for health homes designed to improve
quality of care and reduce the provision of unnecessary medical
services. A quality-based payment system developed under this
section must:
(1) base payments made to a participating enrollee's
health home on quality and efficiency measures that may include
measurable wellness and prevention criteria and use of
evidence-based best practices, sharing a portion of any realized
cost savings achieved by the health home, and ensuring quality of
care outcomes, including a reduction in potentially preventable
events; and
(2) allow for the examination of measurable wellness
and prevention criteria, use of evidence-based best practices, and
quality of care outcomes based on the type of primary or specialty
care provider practice.
SECTION 3.32. Section 536.152(a), Government Code, is
amended to read as follows:
(a) Subject to Subsection (b), using the data collected
under Section 536.151 and the diagnosis-related groups (DRG)
methodology implemented under Section 536.005, if applicable, the
commission [, after consulting with the advisory committee,] shall
to the extent feasible adjust child health plan and Medicaid
reimbursements to hospitals, including payments made under the
disproportionate share hospitals and upper payment limit
supplemental payment programs, based on the hospital's performance
with respect to exceeding, or failing to achieve, outcome and
process measures developed under Section 536.003 that address the
rates of potentially preventable readmissions and potentially
preventable complications.
SECTION 3.33. Section 536.202(a), Government Code, is
amended to read as follows:
(a) The commission shall [, after consulting with the
advisory committee,] establish payment initiatives to test the
effectiveness of quality-based payment systems, alternative
payment methodologies, and high-quality, cost-effective health
care delivery models that provide incentives to physicians and
other health care providers to develop health care interventions
for child health plan program enrollees or Medicaid recipients, or
both, that will:
(1) improve the quality of health care provided to the
enrollees or recipients;
(2) reduce potentially preventable events;
(3) promote prevention and wellness;
(4) increase the use of evidence-based best practices;
(5) increase appropriate physician and other health
care provider collaboration;
(6) contain costs; and
(7) improve integration of acute care services and
long-term services and supports, including discharge planning from
acute care services to community-based long-term services and
supports.
SECTION 3.34. Section 536.204(a), Government Code, is
amended to read as follows:
(a) The executive commissioner shall [:
[(1) consult with the advisory committee to] develop
quality of care and cost-efficiency benchmarks and measurable goals
that a payment initiative must meet to ensure high-quality and
cost-effective health care services and healthy outcomes [; and
[(2) approve benchmarks and goals developed as
provided by Subdivision (1)].
SECTION 3.35. Section 536.251(a), Government Code, is
amended to read as follows:
(a) Subject to this subchapter, the commission, after
consulting with [the advisory committee and other] appropriate
stakeholders representing nursing facility providers with an
interest in the provision of long-term services and supports, may
develop and implement quality-based payment systems for Medicaid
long-term services and supports providers designed to improve
quality of care and reduce the provision of unnecessary services. A
quality-based payment system developed under this section must base
payments to providers on quality and efficiency measures that may
include measurable wellness and prevention criteria and use of
evidence-based best practices, sharing a portion of any realized
cost savings achieved by the provider, and ensuring quality of care
outcomes, including a reduction in potentially preventable events.
SECTION 3.36. Section 538.052(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Subject to Subsection (b), the commission shall solicit
and accept suggestions for clinical initiatives, in either written
or electronic form, from:
(1) a member of the state legislature;
(2) the executive commissioner;
(3) the commissioner of aging and disability services;
(4) the commissioner of state health services;
(5) the commissioner of the Department of Family and
Protective Services;
(6) the commissioner of assistive and rehabilitative
services;
(7) the medical care advisory committee established
under Section 32.022, Human Resources Code; and
(8) the physician payment advisory committee created
under Section 32.022(d), Human Resources Code[; and
[(9) the Electronic Health Information Exchange
System Advisory Committee established under Section 531.904].
SECTION 3.37. Sections 533A.0335(c) and (d), Health and
Safety Code, as redesignated from Sections 533.0335(c) and (d),
Health and Safety Code, by S.B. 219, Acts of the 84th Legislature,
Regular Session, 2015, are amended to read as follows:
(c) The department[, in consultation with the advisory
committee,] shall establish a prior authorization process for
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 [cooperate with the advisory
committee to] establish the prior authorization process required by
Subsection (c). This subsection expires January 1, 2024.
SECTION 3.38. Section 533A.03551(b), Health and Safety
Code, as redesignated from Section 533.03551(b), Health and Safety
Code, and amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(b) The department, in cooperation with the Texas
Department of Housing and Community Affairs, the Department of
Agriculture, and the Texas State Affordable Housing Corporation[,
and the Intellectual and Developmental Disability System Redesign
Advisory Committee established under Section 534.053, Government
Code], shall 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 3.39. 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[, including
a board member,] may not disclose any information that is
confidential under this section.
(e) An officer or employee of the commission, department, or
institute[, including a board member,] may not be examined in a
civil, criminal, special, administrative, or other proceeding as to
information that is confidential under this section.
SECTION 3.40. 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 [agency represented on the
board as a nonvoting member] shall provide funds to support the
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 or system listed in
Subsection (c) is required to provide.
SECTION 3.41. (a) Section 32.022(b), Human Resources
Code, as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(b) The executive commissioner shall appoint the committee
in compliance with the requirements of the federal agency
administering medical assistance. The appointments shall:
(1) provide for a balanced representation of the
general public, providers, consumers, and other persons, state
agencies, or groups with knowledge of and interest in the
committee's field of work; and
(2) include one member who is the representative of a
managed care organization.
(b) Not later than 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 3.42. Section 32.0641(a), Human Resources Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) To the extent permitted under and in a manner that is
consistent with Title XIX, Social Security Act (42 U.S.C. Section
1396 et seq.) and any other applicable law or regulation or under a
federal waiver or other authorization, the executive commissioner
shall adopt [, after consulting with the Medicaid and CHIP
Quality-Based Payment Advisory Committee established under Section
536.002, Government Code,] cost-sharing provisions that encourage
personal accountability and appropriate utilization of health care
services, including a cost-sharing provision applicable to a
recipient who chooses to receive a nonemergency medical service
through a hospital emergency room.
SECTION 3.43. Section 1352.004(b), Insurance Code, is
amended to read as follows:
(b) The commissioner by rule shall require a health benefit
plan issuer to provide adequate training to personnel responsible
for preauthorization of coverage or utilization review under the
plan. The purpose of the training is to prevent denial of coverage
in violation of Section 1352.003 and to avoid confusion of medical
benefits with mental health benefits. The commissioner [, in
consultation with the Texas Traumatic Brain Injury Advisory
Council,] shall prescribe by rule the basic requirements for the
training described by this subsection.
SECTION 3.44. Section 1352.005(b), Insurance Code, is
amended to read as follows:
(b) The commissioner [, in consultation with the Texas
Traumatic Brain Injury Advisory Council,] shall prescribe by rule
the specific contents and wording of the notice required under this
section.
SECTION 3.45. (a) The following provisions of the
Government Code, including provisions amended by S.B. 219, Acts of
the 84th Legislature, Regular Session, 2015, are repealed:
(1) Section 531.0217(j);
(2) Section 531.02172;
(3) Section 531.02173(c);
(4) Section 531.02441;
(5) Section 531.052;
(6) Section 531.0571;
(7) Section 531.068;
(8) Sections 531.121(1), (5), and (6);
(9) Section 531.122;
(10) Section 531.123;
(11) Section 531.1235;
(12) Section 531.251;
(13) Subchapters R and T, Chapter 531;
(14) Section 531.904;
(15) Section 533.00251(a)(1);
(16) Section 533.00252;
(17) Sections 533.00253(a)(1) and (f);
(18) Section 533.00254;
(19) Sections 533.00255(e) and (f);
(20) Section 533.00285;
(21) Subchapters B and C, Chapter 533;
(22) Section 534.001(1);
(23) Section 534.053;
(24) Section 535.053;
(25) Section 535.054;
(26) Section 535.055;
(27) Section 535.108;
(28) Section 536.001(1);
(29) Section 536.002; and
(30) Section 536.007(b).
(b) The following provisions of the Health and Safety Code,
including provisions amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, are repealed:
(1) Subchapter C, Chapter 32;
(2) Section 62.151(e);
(3) Section 62.1571(c);
(4) Section 81.010;
(5) Section 92.011;
(6) Subchapter B, Chapter 92;
(7) Chapter 115;
(8) Section 241.187;
(9) Section 533A.0335(a)(1);
(10) Section 1002.001(1);
(11) Section 1002.051;
(12) Section 1002.052;
(13) Section 1002.053;
(14) Section 1002.055;
(15) Section 1002.056;
(16) Section 1002.057;
(17) Section 1002.058; and
(18) Section 1002.059.
(c) The following provisions of the Human Resources Code,
including provisions amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, are repealed:
(1) Section 22.035; and
(2) Section 32.022(e).
SECTION 3.46. 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 Intellectual and Developmental Disability
System Redesign Advisory Committee;
(11) the Interagency Coordinating Council for HIV and
Hepatitis;
(12) the interagency coordinating group for faith- and
community-based initiatives;
(13) the interagency task force on ensuring
appropriate care settings for persons with disabilities;
(14) the Medicaid and CHIP Quality-Based Payment
Advisory Committee;
(15) each Medicaid managed care advisory committee
appointed for a health care service region under Subchapter B,
Chapter 533, Government Code;
(16) the Perinatal Advisory Council;
(17) the Public Assistance Health Benefit Review and
Design Committee;
(18) the renewing our communities account advisory
committee;
(19) the STAR + PLUS Nursing Facility Advisory
Committee;
(20) the STAR + PLUS Quality Council;
(21) the STAR Kids Managed Care Advisory Committee;
(22) the state Medicaid managed care advisory
committee;
(23) the task force on domestic violence;
(24) the Interagency Task Force for Children With
Special Needs;
(25) the telemedicine and telehealth advisory
committee;
(26) the board of directors of the Texas Institute of
Health Care Quality and Efficiency;
(27) the Texas Nonprofit Council;
(28) the Texas System of Care Consortium;
(29) the Texas Traumatic Brain Injury Advisory
Council; and
(30) the volunteer advocate program advisory
committee.
ARTICLE 4. CONTINUATION OF HEALTH AND HUMAN SERVICES POWERS AND
DUTIES
SECTION 4.01. Section 531.004, Government Code, is amended
to read as follows:
Sec. 531.004. SUNSET PROVISION. The Health and Human
Services Commission is subject to Chapter 325 (Texas Sunset Act).
Unless continued in existence as provided by that chapter, the
commission is abolished and this chapter expires September 1, 2027
[2015].
SECTION 4.02. Section 108.016, Health and Safety Code, is
amended to read as follows:
Sec. 108.016. SUNSET REVIEW. Unless the commission is
continued in existence in accordance with Chapter 325, Government
Code (Texas Sunset Act), after the review required by Section
531.004, Government Code [11.003(b)], this chapter expires on the
date the commission is abolished under that section [September 1,
2015].
SECTION 4.03. Section 1001.003, Health and Safety Code, is
amended to read as follows:
Sec. 1001.003. SUNSET PROVISION. Unless the commission is
[The Department of State Health Services is subject to Chapter 325,
Government Code (Texas Sunset Act). Unless] continued in existence
as provided by Chapter 325, Government Code [that chapter], after
the review required by Section 531.004, Government Code, [the
department is abolished and] this chapter expires on the date the
commission is abolished under that section [September 1, 2015].
SECTION 4.04. Section 40.003, Human Resources Code, is
amended to read as follows:
Sec. 40.003. SUNSET PROVISION. Unless the commission is
[The Department of Family and Protective Services is subject to
Chapter 325, Government Code (Texas Sunset Act). Unless] continued
in existence as provided by Chapter 325, Government Code [that
chapter], after the review required by Section 531.004, Government
Code, [the department is abolished and] this chapter expires on the
date the commission is abolished under that section [September 1,
2015].
SECTION 4.05. Section 117.003, Human Resources Code, is
amended to read as follows:
Sec. 117.003. SUNSET PROVISION. Unless the commission
is [The Department of Assistive and Rehabilitative Services is
subject to Chapter 325, Government Code (Texas Sunset Act). Unless]
continued in existence as provided by Chapter 325, Government Code
[that chapter], after the review required by Section 531.004,
Government Code, [the department is abolished and] this chapter
expires on the date the commission is abolished under that section
[September 1, 2015].
SECTION 4.06. Section 161.003, Human Resources Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 161.003. SUNSET PROVISION. Unless the commission is
[The department is subject to Chapter 325, Government Code (Texas
Sunset Act). Unless] continued in existence as provided by Chapter
325, Government Code [that chapter], after the review required by
Section 531.004, Government Code, [the department is abolished and]
this chapter expires on the date the commission is abolished under
that section [September 1, 2015].
ARTICLE 5. 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.
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