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8 Document(s) [ Subject: Opioids ]

Committee: House Public Health
Title: Interim Report
Subjects: Border health | Drug overdoses | Drug-related deaths | Hospitals | Interstate compacts | Medical education | Medical licensing | Medical marijuana | Nursing shortages | Opioids | Physician shortages | Public health | Rural health care | Substance abuse | Telemedicine |
Library Call Number: L1836.87 H39h
Session: 87th R.S. (2021)
Online version: View report [108 pages  File size: 2,369 kb]
Charges: This report should address the charges below.
1. Consider issues involving access to health care along the Texas-Mexico border, including, but not limited to, the ability to access providers, hospital capacity, pharmaceutical adequacy and whether any particularized training or education is necessary or appropriate.
2. Monitor the agencies and programs under the Committee’s jurisdiction and oversee the implementation of relevant legislation passed by the 87th Legislature. Conduct active oversight of all associated rulemaking and other governmental actions taken to ensure the intended legislative outcome of all legislation, including the following:
  • HB 4, 87th R.S., relating to the provision and delivery of telemedicine and telehealth services; and
  • HB 1616, 87th R.S., relating to the Interstate Medical Licensure Compact.
3. Study the impact of fentanyl-related overdoses and deaths in Texas. Evaluate existing data collection, dissemination, and mitigation strategies regarding opioid abuse in Texas. Make recommendations to improve coordinated prevention, education, treatment, and data-sharing.
4. Study current telemedicine trends by assessing and making recommendations related to standardizing required documentation healthcare providers must obtain for consent for treatment, data collection, sharing and retention schedules, and providing telemedicine medical services to certain cancer patients receiving pain management services and supportive palliative care.
5. Examine existing resources and available opportunities to strengthen the state’s nursing and other health professional workforce, including rural physicians and nurses.
6. Assess ongoing challenges in the rural health care system and the impact of legislation and funding from the 87th regular and special sessions on strengthening rural health care and the sustainability of rural hospitals and health care providers. Evaluate federal regulations authorizing the creation of a Rural Emergency Hospital provider type and determine if promoting this type of facility could increase local access to care in rural areas of the state.
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 of long-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 Legislature.
Committee: House Opioids and Substance Abuse, Select
Title: Interim Report
Subjects: Child Protective Services | Criminal justice | Drug courts | Drug rehabilitation programs | Emergency medical services | Homelessness | Juvenile justice system | Law enforcement | Mentally ill persons | Opioids | Penalties and sentences (Criminal justice) | Pregnancy | Prescription drugs | Specialty courts | State agencies | Substance abuse | Synthetic drugs | Veterans |
Library Call Number: L1836.85 Op3
Session: 85th R.S. (2017)
Online version: View report [117 pages]
Charges: This report should address the charges below.
1. Study the prevalence and impact of substance use and substance use disorders in Texas, including co-occurring mental illness. Study the prevalence and impact of opioids and synthetic drugs in Texas. Review the history of overdoses and deaths due to overdoses. Also review other health-related impacts due to substance abuse. Identify substances that are contributing to overdoses, related deaths and health impacts, and compare the data to other states. During the review, identify effective and efficient prevention and treatment responses by health care systems, including hospital districts and coordination across state and local governments. Recommend solutions to prevent overdoses and related health impacts and deaths in Texas.
2. Review the prevalence of substance abuse and substance use disorders in pregnant women, veterans, homeless individuals, and people with co-occurring mental illness. In the review, study the impact of opioids and identify available programs specifically targeted to these populations and the number of people served. Consider whether the programs have the capacity to meet the needs of Texans. In addition, research innovative programs from other states that have reduced substance abuse and substance use disorders, and determine if these programs would meet the needs of Texans. Recommend strategies to increase the capacity to provide effective services.
3. Review policies and guidelines used by state agencies to monitor for and prevent abuse of prescription drugs in state-funded or state-administered programs. Include in this review policies implemented by the Texas Medicaid Program, the Division of Workers’ Compensation of the Texas Department of Insurance, the Teacher Retirement System, and the Employee Retirement System. Make recommendations regarding best practices.
4. Monitor and evaluate the implementation of legislation passed by the 85th Legislature regarding the Prescription Monitoring Program. In addition, review the prescribing of addictive drugs by physicians and other health care providers within various geographic regions of this state. Determine the role of health care professionals in preventing overutilization and diversion of addictive prescriptions. Provide recommendations that will improve efforts to prevent overutilization and diversion of addictive prescriptions.
5. Identify how opioids have impacted the normal scope of work for law enforcement, first responders, and hospital emergency department personnel.
6. Examine the impact of substance abuse and substance use disorders on Texans who are involved in the adult or juvenile criminal justice system and/or the Child Protective Services system. Identify barriers to treatment and the availability of treatment in various areas of the state. Recommend solutions to improve state and local policy, including alternatives to justice system involvement, and ways to increase access to effective treatment and recovery options.
7. Examine the impact of overdose reporting defense laws known as "Good Samaritan" laws.
8. Identify the specialty courts in Texas that specialize in substance use disorders. Determine the effectiveness of these courts and consider solutions to increase the number of courts in Texas.
Supporting documents
Committee: House Opioids and Substance Abuse, Select
Title: Committee meeting handouts and testimony, March 27, 2018
Library Call Number:
Session: 85th R.S. (2017)
Online version: View document [233 pages  File size: 9,665 kb]
Committee: House Opioids and Substance Abuse, Select
Title: Committee meeting handouts and testimony, April 17, 2018 (Overview of opioids and substance abuse, prevalence of substance use disorders in special populations, review of policies and guidelines of state agencies, opioids and substance abuse impact on children and foster care).
Library Call Number:
Session: 85th R.S. (2017)
Online version: View document [140 pages  File size: 7,655 kb]
Committee: House Opioids and Substance Abuse, Select
Title: Committee meeting handouts and testimony, June 26, 2018 (Good Samaritan laws, law enforcement and first responders).
Library Call Number:
Session: 85th R.S. (2017)
Online version: View document [30 pages  File size: 1,629 kb]
Committee: House Opioids and Substance Abuse, Select
Title: Committee meeting handouts and testimony, August 7, 2018 (law enforcement and first responders, specialty courts)
Library Call Number:
Session: 85th R.S. (2017)
Online version: View document [142 pages  File size: 9,539 kb]
Committee: Joint Prescribing and Dispensing Controlled Substances
Title: Interim Report
Subjects: Opioids | Pharmacists | Prescription drugs | Substance abuse |
Library Call Number: L1836.85 P925
Session: 85th R.S. (2017)
Online version: View report [10 pages]
Charge: This report should address the charge below.
1. Conduct an interim study on the monitoring of the prescribing and dispensing of controlled substances.

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