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Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Cancer Prevention and Research Institute of Texas | Caseworkers | Child Protective Services | Children's Health Insurance Program | Dental care | Foster care | Health care | Health care costs | Health insurance | Immunizations | Long-term care | Managed care | Medicaid | Medicaid eligibility | Medical research | Mental health services | Nursing homes | Patient Protection and Affordable Care Act | Public health | State Health Services, Texas Department of | State supported living centers |
Library Call Number: L1836.82 H349
Session: 82nd R.S. (2011)
Online version: View report [186 pages]
Charges: This report should address the charges below.
1. Monitor the potential impact of the Patient Protection and Affordable Care Act (PPACA) on insurance regulations, Medicaid and CHIP, health care outcomes and overall health of all Texans, and the state budget in Texas. Additionally, monitor the current constitutional challenges to PPACA and other court cases associated with PPACA, and ensure that the state does not expend any resources until judicial direction is clear. (Joint charge with Senate State Affairs Committee)
2. Monitor the potential impact of the Patient Protection and Affordable Care Act (PPACA) on insurance regulations, Medicaid and Children's Health Insurance Program (CHIP), health care outcomes, health care workforce, overall health of all Texans, and the state budget in Texas. Additionally, monitor the current constitutional challenges to PPACA, and other court cases associated with PPACA, and ensure that the state does not expend any resources until judicial direction is clear. (Joint charge with Senate State Affairs Committee)
3. Evaluate the implementation of cost-containment strategies across the Health and Human Services Enterprise to determine if and how each strategy can be expanded upon to achieve additional savings next biennium. The evaluation should include but is not limited to: the expansion of managed care, co-­pays in Medicaid, electronic visit verification, and independent assessments for long-­? term care services. The evaluation should also consider new cost-containment strategies that will increase efficiencies and reduce costs. This evaluation should include but not be limited to: Medicaid, Early Childhood Intervention Services, and immunizations.
4. Review the state's current investment in health care innovation, including translational research and the Cancer Prevention Research Institute, which focuses on rapid transfer of new technology experimentation directly into the clinical environment. Make recommendations to improve the health of Texans and encourage continued medical research in the most cost-effective manner possible.
5. Review existing policies for prior authorization and medical necessity review across the Medicaid Program, including nursing homes and orthodontic services. Make recommendations on how these policies could be improved to save money by reducing unnecessary utilization and fraud.
6. Review the Medicaid Home and Community Based Services Waivers to identify strategies to lower costs, improve quality, and increase access to services. Areas of the review should include, but are not limited to:
  • Functional eligibility determinations to ensure services are only being delivered to individuals that qualify;
  • Financial eligibility determinations to ensure parental income and resources are considered when the client is a minor;
  • Coordination of acute and long-term care services;
  • Development and use of lower-cost community care waiver options;
  • Coordination with the Department of Family and Protective Services (DFPS) for waiver services for children in conservatorships;
  • Reinvesting savings into accessibility of community care for individuals waiting for services.
7. Evaluate the management structure and supervision of CPS caseworkers with an emphasis on rural areas. Identify any legislative changes that could assist DFPS in maximizing efficiency, improving quality casework and supervision, and increasing caseworker retention. Identify any legislative changes that could improve the quality of care children receive while in Child Protective Services custody, including improving permanency outcomes.
8. Examine the delivery and financing of public health services in our state, including how federal funds are distributed by the state to local health departments and whether the work done by Regional Health Departments operated by the Department of State Health Services overlap unnecessarily with local health departments.
9. Review the state's public mental health system and make recommendations to improve access, service utilization, patient outcomes and system efficiencies. Study current service delivery models for outpatient and inpatient care, funding levels, financing methodologies, services provided, and available community-based alternatives to hospitalization. The review should look to other states for best practices or models that may be successful in Texas. The study shall also review and recommend "best value" practices that the state's public mental health system may implement to maximize the use of federal, state, and local funds.
10. Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to:
  • Health Care Quality and Efficiency - Monitor implementation of initiatives aimed at improving health care quality and efficiency in Texas, including: the transition of Medicaid and the CHIP to quality-based payments, establishment of the Texas Institute of Health Care Quality and Efficiency, implementation of the Health Care Collaborative certificate, patient-centered medical home for high-cost populations, development and use of potentially preventable event outcome measures, and reduction of health care-associated infections. Include recommendations on how to improve and build upon these initiatives, including improving birth outcomes and reducing infant and maternal mortality;
  • Federal Flexibility - Monitor implementation of initiatives to increase state flexibility, including the Health Care Compact and the Medicaid Demonstration Waiver;
  • Foster Care Redesign - Monitor implementation of the initiative to redesign the foster care system;
  • Implementation of DOJ Settlement agreement to address State Supported Living Center concerns.
Committee: Senate Health and Human Services
Title: Interim Report
Library Catalog Title: Interim report to the 82nd Legislature
Subjects: Adult Protective Services | Aging and Disability Services, Texas Department of | At-risk youth | Child abuse | Children's Health Insurance Program | Cloning | Community support services | Crime prevention | Diet and nutrition | Emergency management | Families | Family and Protective Services, Texas Department of | Family violence | Federal government | Foster care | H1N1 virus | Health care | Health care providers | Health insurance | Human services | Long-term care | Medicaid | Medicaid eligibility | Medical Board, Texas | Medical errors | Medical research | Mental health services | Mentally ill persons | Nurses | Obesity | Physicians | Quality of care | Senior citizens | State budgets | Stem cell research | Texas Integrated Eligibility Redesign System |
Library Call Number: L1836.81 H349
Session: 81st R.S. (2009)
Online version: View report [272 pages  File size: 6,511 kb]
Charges: This report should address the charges below.
1. Upon passage of federal legislation relating to reform of the health care industry and health insurance industry that the Texas Health and Human Services Commission estimates will costs the State of Texas $2 to 2.5 billion per year in General Revenue beginning as early as 2013, study the implications of such legislation on Texas, the health care industry, and public and private insurance. Study and monitor the implementation of the insurance regulatory changes, changes to high risk pool, and any other insurance mandates. Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget. Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs. (Joint charge with Senate State Affairs Committee)
2. Study the benefits, efficiencies and costs, and effectiveness of the social service related prevention and early intervention programs at the health and human services agencies, the juvenile and adult criminal justice agencies and other government agencies that have programs that address mental illness, substance abuse, child abuse and neglect, domestic violence, single-parent families, absentee fathers, early pregnancy, and unemployment. Study other states' prevention programs and efforts to administer these programs through a merged prevention department. Make recommendations to improve the efficiency and effectiveness of these programs.
3. Review the timeliness and efficiency of the Health and Human Service Commission's eligibility system. Include a review of staffing levels and staffing distribution; implementation of Rider 61; and the increased demand on the system. Make recommendations to improve the efficiency and effectiveness of the system, focusing on policy changes that will not create a large financial burden for the state.
4. Study and make recommendations on the state's role for facilitating the exchange of health care information in the future, including using the Medicaid exchange as a framework for the statewide exchange of health information between health care providers to improve quality of care; what information the state should provide; how to use this information to improve care management, prevent medical errors, and reduce unnecessary services; and policies and statutory changes needed to ensure that privacy is protected. Study the feasibility of developing multiple regional health information technology exchanges in Texas.
5. Study the state's current and long-range need for physicians, nurses, dentists and other allied health and long-term care professionals. Provide recommendations for ensuring sufficient numbers of health care professionals, focusing on medically underserved and rural areas of the state as well as the Border region. Consider health care delivered by Advanced Practice Nurses in terms of access, cost and patient safety and include an assessment of independent prescriptive authority with those states in which prescriptive authority is delegated by a physician. Make recommendations to enhance the efficient use of Advanced Practice Nurses in Texas.
6. Explore strategies to support the needs of aging Texans, including best practices in nursing home diversion, expediting access to community services, and programs to assist seniors and their families in navigating the long-term care system with the goal of helping seniors remain in the community. Study the guardianship program implemented by the Department of Aging and Disabilities and the Department of Adult Protective Services, including the efficiency and effectiveness of the program, the relationship between the two agencies, the appropriate rights for parents, and whether clients and their assets are adequately protected to ensure the state is appropriately identifying seniors in need of protection.
7. Examine how the state could enact policies to improve the overall health of Texans, focusing on programs that compliment individually-based prevention with community­based prevention to reduce obesity rates by increasing physical activity, improving nutrition, and improving self-management of chronic diseases such as diabetes. Examine obesity-related health disparities between different ethnic groups and ways to narrow these gaps. Consider the fiscal and health impact of second-hand smoke on businesses and service sector employees. Study state-level initiatives to incorporate these individual and community-based prevention strategies, including initiatives pursued in other states.
8. Study the state's ability to appropriately respond to the H1N1 influenza pandemic by examining issues related to vaccine distribution and capacity. Consider the benefit of providing the state's independent school districts and various health authorities with standardized protocols for issues including, but not limited to, vaccine administration, absenteeism and the cancellation of school and other school-related events. Assess the state's ability to track and record H1N1 vaccinations through the ImmTrac registry, and review statutes governing ImmTrac to increase the effectiveness and efficiency of immunization information systems.
9. Study current state health care quality improvement initiatives in Texas, including statewide health care-associated infection and adverse event reporting, reimbursement reductions in the Texas Medicaid program for preventable adverse events, potentially preventable readmissions identification, health information technology implementation, pay-far-performance programs, and other initiatives aimed at improving the efficiency, safety, and quality of health care in Texas. Identify statutory changes that may build upon efforts to improve quality of care and contain health care costs in Texas. Study policies that encourage and facilitate the use of best practices by health care providers including the best way to report and distribute information on quality of care and the use of best practices to the public and to promote health care provider and payment incentives that will encourage the use of best practices. The study/recommendations could also include assessing the best way to bring provider groups together to increase quality of care, the use of best practices, and reduce unnecessary services.
10. Study current practices of the Texas Medical Board relating to disclosure of complaints.
11. Review the types of human stem cell and human cloning research being conducted, funded, or supported by state agencies, including institutions of higher education. Make recommendations for appropriate data collection and funding protocols.
12. Review the Medicaid HCBS waivers (CBA, STAR Plus, CLASS, MDCP, DBMT, TxHmL) and develop recommendations to assure that people with significant disabilities, regardless of disability label or age, receive needed services to remain in or transition to the community. Review should look at the delivery system, eligibility, service packages, rate structures, workforce issues and funding caps. Examine options for the provision of services for children aging out of the Medicaid system. Make recommendations for streamlining/combining these waivers, ensuring that these waivers are cost effective or create cost savings, and developing policies that contain costs in an effort to increase access to these services. The review should examine other states' community care waivers and provide recommendations relating to efforts that have been successful in other states.
13. Study the type, duration, frequency and effectiveness of mental health services available to and accessed by abused and neglected Texas children. Recommend strategies to address the impact of the trauma, and enhance therapeutic services available to this population in an effort to eliminate the cycle of abuse and neglect.
14. Monitor the implementation of legislation addressed by the Senate Committee on Health & Human Services, 81st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
  • Monitor Department of Family and Protective Services' implementation of the U.S. Fostering Connections Act, including the new Kinship Care program. Include recommendations on how to optimize the use of monetary assistance to qualified relative caregivers.
  • Monitor the Department of Aging and Disability Services (DADS) implementation of SB 643, relating to Texas' state-supported living centers (SSLCs), implementation of Special Provisions relating to All Health and Human Services Agencies, Section 48. Contingency Appropriation for the Reshaping of the System for Providing Services to Individuals with Developmental Disabilities, and implementation of the United States Department of Justice (DOJ) Settlement Agreement terms.
Committee: Senate State Affairs
Title: Interim Report
Subjects: Eight-liners | Election fraud | Employees Retirement System of Texas | Entergy Corporation | Gambling | Health care costs | Health insurance | Health maintenance organizations | Insurance industry | Investment of public funds | Legislative intent | Medical research | Medically uninsured | Mental health services | Mentally ill inmates | Mentally ill persons | Privatization | Public retirement systems | Statutory revision | Strategic Lawsuits Against Public Participation | Texas Health Insurance Risk Pool | Texas Lottery | Tort reform | Voter identification | Voting systems | Workers' compensation |
Library Call Number: L1836.80 St29a
Session: 80th R.S. (2007)
Online version: View report [308 pages  File size: 43,740 kb]
Charges: This report should address the charges below.
1. Study the factors that impact the transparency and efficiency of the health insurance market. Make recommendation to result in the use of best practices, lower health care costs, and better health outcomes, including the following:
  • Study factors contributing to the increasing cost of health care;
  • Study insurer and health maintenance organization (HMO) use of tiers, ratings, or classifications to differentiate among credentialed physicians already admitted to the insurer or HMO panel of preferred providers or network;
  • Examine methods to remediate incorrect tiering, ratings, or classifications;
  • Examine how physicians are notified of the standards against which they will be compared and whether they are notified of the standards prior to the evaluation period;
  • Improve transparency with respect to the marketing of prescription drugs; and
  • Study the use of certain nonprofit health corporations - approved under Chapter 162, Occupations Code, in Texas. Examine whether such entities operate on a statewide scale or on a limited scale, whether such entities adhere to the formalities required of corporations, whether the operation of such entities are influenced by owners or members who are not licensed to practice medicine, and whether such entities have ever been decertified or investigated for failure to maintain compliance with Texas law or regulations.
2. Study and make recommendations for reducing the number of uninsured Texans, focusing on the following:
  • Options to increase access to private health insurance, including 3 Share programs, employer sponsored plans and portable, individual insurance;
  • Incentives for encouraging counties and local governments to participate in private health insurance cost sharing for their respective residents;
  • Options to reduce health care premiums, including creation of special plans with increased deductibles and catastrophic coverage;
  • Implementation and possible expansion of health services districts;
  • Other state programs for increasing market-based coverage of the uninsured, including costs and effectiveness;
  • Options that will increase consumer choice and personal responsibility; and
  • Analysis of state and federal regulations that contribute to higher premium costs.
3. Study and make recommendations relating to the Texas Health Insurance Risk Pool, including the current eligibility for coverage requirements, the economic profiles of participants and former participants, the affordability of the insurance products’ premiums and deductibles, and the public's awareness of the Pool.
4. Study the issue of security and accuracy in Texas elections. The study should include the benefits and risks of electronic voting technology, including the necessity of maintaining a paper record of each electronic vote. The study should also include an analysis of fraud in Texas elections, including prosecution rates for voter fraud, the processes for purging ineligible voters from voter lists, and the integrity of the mail-in and provisional ballot systems. Study the effectiveness of electronic voting technology and voter ID laws in other states. Monitor the implementation of the federal Help America Vote Act of 2002, including the implementation of the Texas Election Administration Management system. Recommend statutory and regulatory changes designed to ensure that only eligible voters are allowed to vote in Texas elections and that each vote is accurately counted.
5. Review and make recommendations for requiring insurance coverage of routine medical care for patients with a life-threatening disease or condition who have elected to participate in a clinical trial.
6. Study the economic impact of recent civil justice reform legislation in Texas.
7. Study whether Texas should adopt the Restatement 2nd of Torts Sec. 674 (Wrongful use of Civil Proceedings) and whether a person should be allowed to recover court and attorneys fees when he has been forced to defend a lawsuit filed without probable cause or for intimidation purposes.
8. Monitor the Texas workers' compensation system, and the continued implementation of the reforms of HB 7, 79th Legislature, Regular Session, by the Texas Department of Insurance and other state agencies. Specifically evaluate the recent decision by the Texas Supreme Court in Entergy v. Summers in terms of its impact and the impact of previous legislation on the workers' compensation system.
9. Study and make recommendations to reduce illegal gambling in Texas, including, but not limited to, the illegal use of Eight-Liners.
10. Analyze the advantages and disadvantages of phasing in a defined-contribution pension for future employees versus the existing defined-benefit pension plan. Study options for transition or implementation issues and how the phase-in could be structured. Evaluate the possibility of requiring the state employee contribution rate to meet the annually required contribution for the statewide retirement funds each biennium in order to prevent unfunded liabilities.
11. Study the relationship between the public mental health system and the criminal justice and civil courts systems, including the identification and sharing of information regarding mentally ill offenders, including minors, among criminal justice and mental health agencies, the courts, state hospitals, and the Veterans Administration. Study how current confidentiality laws impact the exchange of information among groups described above. Study the sentencing of mentally ill offenders compared to non-mentally ill offenders, including minors, and the affect that has on statewide prison capacity and on the quality of health care provided to mentally ill offenders. (Joint charge with Senate Criminal Justice Committee)
12. Review and evaluate appropriate state regulation of a private operator of the state lottery should the state receive bids for a lease of the lottery that merit strong consideration. Provide recommendations for ensuring the security and integrity of the lottery and for adequate consumer protections. (Joint charge with Senate Finance Committee)
13. Study the feasibility and the advisability of establishing an investment policy that is consistent across all state trust funds, including the trust funds of the Employees Retirement System, the Teachers Retirement System, the Permanent University Fund, and the Permanent School Fund. Identify best investment policies for state trust funds. Examine recent portfolio diversification strategies and the effect they have on long-term fund performance. The recommendations should consider what is an acceptable rate of return, an acceptable degree of risk, the appropriateness of certain investments. (Joint charge with Senate Finance Committee)
14. Monitor the implementation of legislation addressed by the State Affairs Committee, 80th Legislature, Regular Session, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. In particular, monitor and report on the effect of HB 2365, 80th Legislature, Regular Session, which allows public entities to report "other post employment benefits" (OPEBs) on a statutory modified accrual basis, including any effect on auditor opinions, bond ratings, or other fiscal issues. Monitor the implementation of SB 1731, 80th Legislature, Regular Session, relating to transparency of health information, and SB 1846, 80th Legislature, Regular Session, relating to TRS.
Committee: Senate Border Affairs, Special
Title: Interim Report - Health
Library Catalog Title: Health interim report : Texas border health.
Subjects: Air pollution | Air quality | Birth defects | Border health | Border Health Institute | Children's Health Insurance Program | Dengue Fever | Dental hygienists | Dentists | Diabetes | Drinking water | Immunizations | Indigent health care | Medicaid | Medicaid application process | Medicaid Disproportionate Share Hospital Program, Texas | Medical reimbursements | Medical research | Mental health services | Mosquitoes | Sewer service | Surface water pollution | Texas Center for Infectious Diseases | Tire disposal | Tuberculosis | Wastewater management | Water quality management | Water supplies |
Library Call Number: L1836.76 b644h
Session: 76th R.S. (1999)
Online version: View report [108 pages  File size: 503 kb]
Charges: This report should address the charges below.
1. Assess the Border Region's water and wastewater system infrastructure needs and the impact of the lack of adequate water and wastewater systems on health conditions along the Border. The Committee shall develop both short-term and long-term recommendations to address these infrastructure needs.
2. Assess the health conditions in the Border Region, including childhood diseases and chronic health problems endemic to the Border such as diabetes and tuberculosis. Included in this assessment shall be an evaluation of the utilization of immunization and prevention programs and of collaborative efforts on common health issues between Texas and the Mexican Border States. The Committee shall develop health care strategies to improve Border health conditions and recommendations for their implementation.
Committee: House Business and Industry
Title: Interim Report
Library Catalog Title: House Committee on Business & Industry, Texas House of Representatives interim report, 2000 : a report to the House of Representatives, 77th Texas Legislature.
Subjects: Biotechnology industry | Construction industry | Consumer protection | Fraud | General contractors | Medical research | Senior citizens | Sweepstakes | Telemarketers | Texas Workers' Compensation Insurance Fund | Workers Compensation Commission, Texas | Workers' compensation |
Library Call Number: L1836.76 b964
Session: 76th R.S. (1999)
Online version: View report [107 pages  File size: 535 kb]
Charges: This report should address the charges below.
1. Examine ways to deter and punish consumer fraud directed at senior citizens, including telemarketing fraud.
2. Assess the public's view of telemarketing generally, the desire and need for simpler ways to prevent nuisance calls, and whether views depend on the business of the vendor or solicitor.
3. Consider the legal status and policies appropriate to any surplus funds held by the Texas Workers' Compensation Insurance Fund. The committee's consideration should be directed at assuring that sufficient funds are available to deal with all possible market conditions.
4. Consider the benefits and problems associated with contingency clauses in construction contracts.
5. Study the emergence of the healthcare technology industry in Texas. Identify factors promoting and inhibiting development of the industry and consider state or private actions potentially affecting its growth.
Committee: House Public Health
Title: Interim report
Library Catalog Title: Interim report to the 72nd Texas Legislature / Committee on Public Health.
Subjects: At-risk youth | Health maintenance organizations | Medical research | Pharmaceutical industry | Pharmacists | Prescription drug costs | Prescription drugs | Substance abuse | Texas Pharmacy Act | Underage drinking |
Library Call Number: L1836.71 h349
Session: 71st R.S. (1989)
Online version: View report [39 pages  File size: 1,612 kb]
Charges: This report should address the charges below.
1. To study substance abuse problems of Texas youth.
2. To study the benefits and public necessity of licensing and regulating medical laboratories in Texas, including the relative merits of state regulation versus federal regulation.
3. To study prescription drug programs provided under health insurance policies or contracts and employee benefit plans.

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