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3 Document(s) [ Subject: Healthy Texas Women ]

Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Child abuse | Child Protective Services | Emergency management | Employees Retirement System of Texas | Family and Protective Services, Texas Department of | Foster care | Health and Human Services Commission, Texas | Health care costs | Healthy Texas Women | Hurricane Harvey | Insurance, Texas Department of | Juvenile justice system | Managed care | Medicaid | Natural disasters | Opioids | Prescription drugs | Public health | State Health Services, Texas Department of | Substance abuse | Teacher Retirement System of Texas |
Library Call Number: L1836.85 H349
Session: 85th R.S. (2017)
Online version: View report [98 pages]
Charges: This report should address the charges below.
1. Review the state's response to Hurricane Harvey with a focus on public health efforts at the local and state level. The review should include an analysis of the state and local response related to vector control, immunization needs, utilization of health-related volunteers, adequacy of an emergency medical network, evacuation of vulnerable populations from state operated or regulated facilities, and coordination between all levels of government. Recommend any legislative changes necessary to improve public health response and coordination during and after a disaster.
2. Evaluate the impact of Hurricane Harvey on the capacity of out-of-home placements and care for youth involved with the juvenile justice and child welfare systems. Determine how the state can ensure support is available to provide appropriate care as close to home as possible as facilities and offices are rebuilt.
3. Child Welfare: Review the efficacy and quality of services offered to ensure family preservation while in the Family Based Social Services (FESS) stage of service at the Department of Family and Protective Services. Make recommendations to better track quality of services and link payments to providers of these services to outcomes for families and children. Analyze the Department of Family and Protective Services' progress in meeting statutory requirements related to timely visits to children involved in a reported case of abuse or neglect. Make recommendations to further improve the timeliness of these visits. Review services and supports provided to children in Permanent Managing Conservatorship of the state, and the level of preparedness given to youth aging out of state care. Examine the impact of recent legislation related to these populations, and make recommendations to ensure youth in care are ready for adulthood and to reduce the likelihood of intergenerational perpetuation of child maltreatment. Assess the effectiveness of public and private agency efforts to recruit and retain foster parents. Identify barriers to entry and obstacles that prevent interested families from continuing to provide foster care. Recommend solutions to increase foster recruitment and address non-renewals, especially in first-time foster parents.
4. Substance Abuse/Opioids: Review substance use prevention, intervention, and recovery programs operated or funded by the state and make recommendations to enhance services, outreach, and agency coordination. Examine the adequacy of substance use, services for pregnant and postpartum women enrolled in Medicaid or the Healthy Texas Women Program and recommend ways to improve substance use related health outcomes for these women and their newborns. Examine the impact of recent legislative efforts to curb overprescribing and doctor shopping via the prescription monitoring program and recommend ways to expand on current efforts.
5. Medicaid Managed Care Quality and Compliance: Review the Health and Human Services Commission's efforts to improve quality and efficiency in the Medicaid program, including pay-for-quality initiatives in Medicaid managed care. Compare alternative payment models and value-based payment arrangements with providers in Medicaid managed care, the Employees Retirement System, and the Teachers Retirement System, and identify areas for cross-collaboration and coordination among these entities. Evaluate the commission's efforts to ensure Medicaid managed care organizations' compliance with contractual obligations and the use of incentives and sanctions to enforce compliance. Assess the commission's progress in implementing competitive bidding practices for Medicaid managed care contracts and other initiatives to ensure the best value for taxpayer dollars used in Medicaid managed care contracts.
6. Health Care Cost Transparency: Study efforts by the Department of State Health Services and the Texas Department of Insurance to increase health care cost transparency, including a review of the Texas Health Care Information Collection (THCIC) system, and the Consumer Guide to Healthcare. Recommend ways to make provider and facility fees more accessible to consumers to improve health care cost transparency, increase quality of care, and create a more informed health care consumer base.
7. Monitoring Charge: Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 85th Legislature and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to: • Initiatives to increase capacity and reduce waitlists in the mental health system, including the construction of state hospitals and new community grant programs; • Initiatives to better understand the causes of maternal mortality and morbidity, including the impact of legislation passed during the first special session of the 85th Legislature. Recommend ways to improve health outcomes for pregnant women and methods to better collect data related to maternal mortality and morbidity; • Initiatives intended to improve child safety, Child Protective Services workforce retention, and development of additional capacity in the foster care system. Make additional recommendations to ensure children with high levels of medical or mental health needs receive timely access to services in the least restrictive setting; • Efforts to transfer case management of foster children and families to Single Source Continuum Contractors (SSCCs). Monitor the progress of this transition and make recommendations to ensure the process provides continuity of services for children and families and ongoing community engagement; • Initiatives to strengthen oversight oflong-term care facilities to ensure safety and improve quality for residents and clients of these entities; and • Abortion complications and other reporting legislation that was passed by the 85th Legislatu re.
Committee: House Public Health
Title: Interim Report
Subjects: Cancer | Communicable diseases | Contraceptives | Diabetes | Disease management | Disease prevention | Emergency communications | Emergency management | Employees Retirement System of Texas | Family planning | Healthy Texas Women | Heart disease | Infant mortality | Kidney disease | Lung diseases | Obesity | Pregnancy | Premature infants | Prenatal care | Public health | Respiratory diseases | Teacher Retirement System of Texas | Telemedicine |
Library Call Number: L1836.84 H349h
Session: 84th R.S. (2015)
Online version: View report [45 pages]
Charges: This report should address the charges below.
1. Study and assess the state’s preparedness for public health threats and emergencies including responding to natural disasters and highly infectious diseases. Review current protocols and examine public health resources to determine if they are sufficient. Identify weaknesses within the public health response framework and make recommendations for improvements.
2. Study the impact of chronic disease in Texas and identify the major regional chronic health challenges. Review the types of health data collected by the state related to chronic disease and how the data is utilized to improve health care. Study state programs targeting chronic disease, including the Texas Health Improvement Network, and identify the direct and indirect costs associated with obesity, tobacco, and other related chronic health conditions including impacts to Medicaid, Employees Retirement System, Teacher Retirement System, University of Texas System, and Texas A&M University System. Identify public health interventions for chronic disease and preventative healthcare services that improve health outcomes and reduce cost.
3. Examine the history of telemedicine in Texas and the adequacy of the technological infrastructure for use between Texas healthcare providers. Review the benefits of using telemedicine in rural and underserved areas and current reimbursement practices. Explore opportunities to expand and improve the delivery of healthcare and identify methods to increase awareness by provider groups, including institutions of higher education, and payers of telemedicine activities being reimbursed in Texas.
4. Review programs focused on improving birth outcomes including evaluating the effectiveness and identifying any cost avoidance associated with them. Study barriers pregnant women face enrolling in services and receiving regular prenatal care. Identify factors, including substance abuse, associated with preterm birth and review services available for mothers postpartum.
5. Study the trauma system in the State of Texas including financing, service delivery, planning, and coordination between Emergency Medical Services providers, Trauma Services Area Regional Advisory Councils, The Emergency Medical Task Force, and hospitals. Determine strengths and weaknesses including challenges for rural areas of the state. Make recommendations to reduce any duplicated services, improve the coordination of services, and advance the delivery of trauma services in Texas. (Joint charge with the House Committee on Appropriations)
6. Conduct legislative oversight and monitoring of the agencies and programs under the committee's jurisdiction and the implementing of relevant legislation passed by the 84th Legislature. In conducting this oversight, the committee should: a. consider any reforms to state agencies to make them more responsive to Texas taxpayers and citizens; b. identify issues regarding the agency or its governance that may be appropriate to investigate, improve, remedy, or eliminate; c. determine whether an agency is operating in a transparent and efficient manner; and d. identify opportunities to streamline programs and services while maintaining the mission of the agency and its programs.
Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Cancer Prevention and Research Institute of Texas | Child abuse | Child Protective Services | Computers and government | Contraceptives | Dental Examiners, Texas State Board of | Family planning | Foster care | Healthy Texas Women | Homelessness | Medicaid | Medicaid fraud | Medically uninsured | Mental health services | Mentally ill persons | Office of Inspector General, Health and Human Services Commission, Texas | Patient Protection and Affordable Care Act | Substance abuse | Temporary Assistance for Needy Families | Welfare eligibility | Welfare reform | Welfare-to-work | Women's health |
Library Call Number: L1836.83 H349
Session: 83rd R.S. (2013)
Online version: View report [58 pages]
Charges: This report should address the charges below.
1. Review the Department of Family and Protective Services’ efforts to reduce child fatalities. Review the process by which the Department of Family and Protective Services collects and uses data to evaluate agency performance and improve outcomes for children in the Child Protective Services system. Make recommendations to ensure the process effectively uses data to strategically improve caseworker performance, and identify and improve upon deficiencies within the system and improve overall outcomes for children and reduce child fatalities.
2. Monitor the implementation of programs that were created or expanded by the 83rd Legislature to improve mental health and substance abuse services and assess these efforts' contribution to improved outcomes such as reduced recidivism in state hospitals, diversion from emergency rooms and county jails, and access to permanent supportive housing. Identify and address gaps in the current mental health and substance abuse system and make recommendations to better coordinate services across agencies and programs.
3. Build on previous legislative achievements in women's healthcare by examining women’s access to preventative health care, pregnancy services, and post-partum care, and exploring ways to expand access and improve quality, particularly in rural and underserved areas of the state. Monitor the implementation of women's health programs in Texas. Assess these programs' impact on outcomes such as improving access to preventative services, reducing unplanned pregnancies, and achieving cost savings. Recommend ways to better coordinate the various programs in a manner that increases the number of women served, ensures adequate provider capacity statewide, and maximizes efficiencies to the state.
4. Identify cost-effective alternatives to Medicaid and the Affordable Care Act to better connect low income individuals to health care services through private market-based solutions, including Medicaid block grants and waivers. Recommendations should strive to encourage cost sharing, promote personal responsibility, reduce uncompensated care costs, contain increasing health care costs, improve access to care, address access to emergency department care issues in rural areas, promote the use of existing private coverage or employee sponsored coverage, reduce non-­?emergency use of emergency departments, and reduce the need for federal approval to the state Medicaid plan.
5. Evaluate the Temporary Assistance for Needy Families (TANF) program structure. Make recommendations to improve the program's operations and ensure the program achieves outcomes that allow TANF recipients to find employment and achieve self-sufficiency. Recommendations should seek to ensure Texas is using the most effective work-related requirements and drug testing protocols.
6. Evaluate the current state of prescription drug abuse and strategies for reducing prescription drug abuse in Texas. Make recommendations on how these policies can be improved or modified to enhance the State of Texas’ handling of services, treatments and education related to prescription drug abuse and to reduce the overall prevalence of prescription drug abuse.
7. Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 83rd Legislature, Regular Session, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to:
  • Monitor implementation of initiatives aimed at improving the quality and efficiency of Medicaid long-term care services and supports, including the redesign of services for individuals with intellectual and developmental disabilities.
  • Monitor implementation of initiatives aimed at reducing fraud, waste, and abuse in Texas Medicaid and other health and human services programs.
  • Dental Board Reforms: Monitor implementation of initiatives aimed at improving the State Board of Dental Examiners' ability to protect public safety, including strengthening the Board's authority and enforcement powers, improving the complaint review and resolution processes, and increasing staffing to improve the Board's ability to respond to complaints and potential fraudulent activity. Determine whether there are additional changes necessary to ensure that the Board is able to regulate the practice of dentistry and ensure public safety.
  • Cancer Prevention and Research Institute: Monitor implementation of initiatives aimed at restructuring the governance structure, eliminating conflicts of interest, and increasing transparency at the Cancer Prevention and Research Institute of Texas (CPRIT).

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