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20 Document(s) [ Subject: Rural health care ]

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.
Supporting documents
Committee:	House Public Health
Title:	Committee meeting handouts and testimony, October 5, 2021
Library Call Number:
Session:	87th R.S. (2021)
Online version:	View document [129 pages  File size: 20,653 kb]
Committee:	House Public Health
Title:	Interim Report
Subjects:	Affordable housing | Alzheimer's disease | Child Protective Services | Children's mental health | Dementia | Family preservation | Homelessness | Housing | Maternal mortality | Medicaid | Mental health services | Mentally ill persons | Organ and tissue donations | Rural areas | Rural health care | Substance abuse | Telemedicine | Transitional housing | Women's health |
Library Call Number:	L1836.85 H349h
Session:	85th R.S. (2017)
Online version:	View report [125 pages]
Charges:	This report should address the charges below.
1.	Review state programs that provide women’s health services and recommend solutions to increase access to effective and timely care. During the review, identify services provided in each program, the number of providers and clients participating in the programs, and the enrollment and transition process between programs. Monitor the work of the Maternal Mortality and Morbidity Task Force and recommend solutions to reduce maternal deaths and morbidity. In addition, review the correlation between pre-term and low birth weight births and the use of alcohol and tobacco. Consider options to increase treatment options and deter usage of these substances.
2.	Study treatment of traumatic brain injury, Alzheimer's, and dementia, and recommend opportunities for advancing treatment and cures.
3.	Study and make recommendations to improve services available for identifying and treating children with mental illness, including the application of trauma- and grief-informed practices. Identify strategies to assist in understanding the impact and recognizing the signs of trauma in children and providing school-based or community-based mental health services to children who need them. Analyze the role of the Texas Education Agency and of the regional Education Service Centers regarding mental health. In addition, review programs that treat early psychosis among youth and young adults.
4.	Study the overlays among housing instability, homelessness, and mental illness. Review the availability of supportive housing opportunities for individuals with mental illness. Consider options to address housing stability and homelessness among people with mental illness. (Joint charge with the House Committee on Urban Affairs)
5.	Review opportunities to improve population health and health care delivery in rural and urban medically underserved areas. Identify potential opportunities to improve access to care, including the role of telemedicine. In the review, identify the challenges facing rural hospitals and the impact of rural hospital closures.
6.	Analyze the prevalence of children involved with Child Protective Services (CPS) who have a mental illness and/or a substance use disorder. In addition, analyze the prevalence of children involved with CPS due to their guardian's substance abuse or because of an untreated mental illness. Identify methods to strengthen CPS processes and services, including efforts for family preservation; increasing the number of appropriate placements designed for children with high needs; and ensuring Texas Medicaid is providing access to appropriate and effective behavioral health services. (Joint charge with the House Committee on Human Services)
7.	Evaluate the process of organ and bone marrow donations. Consider opportunities to improve organ and bone marrow donation awareness in order to increase the number of willing donors.
8.	Monitor the agencies and programs under the Committee’s jurisdiction and oversee the implementation of relevant legislation passed by the 85th Legislature. In conducting this oversight, the Committee will also specifically closely monitor the implementation of H.B. 10 (85R), H.B. 13 (85R), and S.B. 292 (85R).
9.	Consider testimony provided at the May 17 House Public Health Committee hearing regarding improving mental health services for children. Identify specific strategies that would enhance overall school safety. Study ways to help parents, youth and primary care providers support school personnel in their efforts to identify and intervene early when mental health problems arise. In addition to school-based trauma-informed programs and those that treat early psychosis, consider the benefits of universal screening tools and expanding the Child Psychiatry Access Program (CPAP). Make recommendations to enhance collaboration among the Health and Human Services Commission, the Texas Education Agency, local mental health authorities, and education service centers.
Committee:	House Mental Health, Select
Title:	Interim Report
Subjects:	Children's mental health | Homelessness | Mental health services | Rural health care | Veterans |
Library Call Number:	L1836.84 M528
Session:	84th R.S. (2015)
Online version:	View report [117 pages]
Charges:	This report should address the charges below.
1.	Review the behavioral health system, including substance abuse treatment, for adults and children. Make recommendations to improve the delivery and coordination of services to create an integrated system to improve early identification of mental illness, improve access and continuity of services, reduce barriers to treatment, and increase collaboration between entities responsible for the delivery of care in a manner that will ultimately reduce cost and improve care.
2.	Identify educational, healthcare, law enforcement, criminal justice, judiciary, state, county, and city entities that are statutorily or contractually responsible for the identification or delivery of behavioral health services. Review how the services are directly or indirectly connected and how the entities work together.
3.	Review entry points into the mental health system for both adults and children; how individuals gain access to services; what services are available; the effectiveness of services; and how to define, prioritize, measure, and improve outcomes achieved for adults and children.
4.	Identify local and state cost of mental health in Texas and identify measures to reduce cost to the overall system by improving care.
5.	Study and recommend solutions for the challenges within the current system, including, but not limited to, how to provide effective services in the short term and close gaps over the longer term in mental-health workforce shortage areas; access to appropriate mental health care for school-age children, including those identified through Mental Health First Aid training, to break the school to juvenile detention to prison pipeline; factors contributing to differences in communities’ access to law enforcement and Judges with specific mental health training; communities’ access to crises intervention and jail diversion services; communities’ ability to plan and coordinate between healthcare providers and systems, law enforcement, the judiciary, and the criminal justice systems to deliver and coordinate care; and the location and availability of inpatient treatment beds, including how the need for inpatient beds varies by the effectiveness of the entire system. Also, identify obstacles to adequate insurance coverage for mental health services.
6.	Identify the challenges of providing care and increasing access to veterans, homeless Texans, and individuals with serious mental illness.
7.	Examine challenges of providing services in underserved and rural areas of the state and in communities serving high numbers of Texans below 200% poverty level.
Supporting documents
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, February 18, 2016 (Mental health and behavioral health)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [181 pages  File size: 9,046 kb]
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, March 22, 2016 (Children and mental health)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [184 pages  File size: 11,847 kb]
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, April 27, 2016 (Mental health and behavioral health care)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [87 pages  File size: 4,917 kb]
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, April 28, 2016 (Mental health and behavioral health care)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [79 pages  File size: 4,218 kb]
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, June 2, 2016 (Insurance - coverage for collaborate care, representatives of commercial health plans and state employee health plans, Medicaid and CHIP; law enforcement/criminal justice)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [149 pages  File size: 6,864 kb]
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, August 18, 2016 (Homeless, substance abuse, and veteran services)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [156 pages  File size: 9,496 kb]
Committee:	House Mental Health, Select
Title:	Committee meeting handouts and testimony, September 22, 2016 (Mental health hospitals, mental health services - public institutions of higher ed)
Library Call Number:
Session:	84th R.S. (2015)
Online version:	View document [130 pages  File size: 6,254 kb]
Committee:	Senate Finance
Title:	Interim Report
Library Catalog Title:	Interim charge recommendations to the 82nd Legislature
Subjects:	Affordable housing | Aging and Disability Services, Texas Department of | Border security | Business taxes | Cancer Prevention and Research Institute of Texas | Disaster relief | Economic stabilization | Federal aid | Highway finance | Hospitals | Mineral rights | Nursing education | Prepaid tuition plans | Property tax exemptions | Property taxes | Rural health care | State budgets | Tax and expenditure limits | Tax appraisals | Tax incentives | Tax revenue | Tobacco taxes | Traffic | Transportation, Texas Department of | Tropical storms | University finance | University of Texas Medical Branch at Galveston |
Library Call Number:	L1836.81 F49
Session:	81st R.S. (2009)
Online version:	View report [158 pages  File size: 7,366 kb]
Charges:	This report should address the charges below.
1.	Review and make recommendations regarding existing and future public debt at all levels of government in Texas, including independent school districts, cities, other local governments and the Texas Guaranteed Tuition Plan.
2.	Study the impact of recent hurricanes for which a federal disaster declaration was issued on local economies. Examine the basis for the distribution of federal dollars for hurricane cleanup across the state. Review past methods of distribution, including those involving the Texas Department of Housing and Community Affairs and the Office of Rural Community Affairs. Develop policy and statutory recommendations to ensure that the system of distribution is effective to address needs of the various regions of the state in the event of future disasters. Provide effective budget oversight of state agencies that received appropriations as a result of hurricane damage. Examine the rebuilding of University of Texas Medical Branch at Galveston and the collection and proper deposit of federal reimbursements.
3.	Review the effect that Texas Business Tax credits, such as a research and development credit, have on economic development in Texas. Determine whether the costs of various tax credits would be adequately offset by the net increase in state sales tax and other revenues and jobs produced by each credit. Focus on businesses relocating to or from the State of Texas, the impact on the tax base, employment, and the overall economic condition of the state.
4.	Identify and evaluate potential improvements to the property tax system. Consider and make recommendations relating to the following: Methods to increase public participation in the tax rate-setting process and ensure fairness in appraisal protests and appeals; Requirement that property appraisal values may not increase by more than inflation and/or population growth, or another amount to be determined by local taxing authorities, with a maximum cap of 10 percent; Exemptions provided to community housing development organizations to determine if changes are needed to ensure that the public benefits outweigh the revenue loss; Methods and procedures for determining a real property interest in oil or gas in place, as contained in Texas Tax Code Sec. 23.175, including how market-based data and market-based methodology could possibly be used to ensure fair, reliable, and equitable price forecasts of oil and gas interests. Analyze the need for the creation of an Oil and Gas Valuation Advisory Committee to assist in forecasting current calendar year statewide average prices for oil and gas; and the constitutional constraints and fiscal implications of exempting real property, leased to a school, as defined by Section 11.21 of the Tax Code, from ad valorem taxation.
5.	Examine the Texas Tomorrow Fund and its impact on institutions of higher education. Assess current and future costs, the ability of institutions to absorb the costs, and make recommendations for ensuring a sound fiscal approach to managing the fund for the future.
6.	Study the impact of changing the constitutional and statutory spending limit based on the sum of the rate of population growth and the rate of inflation. Examine what past biennial spending limits would have been, and what the next biennium's limit might be, under a new definition. Consider the impact of exempting growth from federally mandated programs.
7.	Study and make recommendations regarding formula funding and its impact on the cost of attendance and methods of financing higher education institutions, including funding differences for pharmacy and nursing programs; research funding; performance funding; and funding for institutions that face capacity student enrollment. Specifically address the following: Methods of financing capital projects at higher education institutions, including the levels of deferred maintenance, the impact of deferred maintenance on the ability to offer basic instructional services, and the methods used to finance deferred maintenance projects. Recommend alternatives for providing a structured and recurring funding mechanism more suited to the state's fiscal capacity and institutional needs Supplemental funding for structured programs that are essential for student success and for meeting the goals of Closing the Gaps, including those that provide concentrated student academic and personal support services for universities that enroll a high proportion of non-traditional or at-risk students. Study and make recommendations regarding the quality and effectiveness of academic advising, focusing on resources, staff development, and impact on time­ to-degree.
8.	Review the capacity of rural hospitals, rural hospital infrastructure, and the statewide impact of services provided by rural hospitals. Make recommendations for funding options to help communities that do not have adequate resources to replace aging infrastructure and consider the creation ofa rural hospital infrastructure support program similar to the courthouse preservations fund.
9.	Examine transportation funding concepts contained in legislation considered during the 81 st Legislature, Regular and Special Sessions. Analyze options and make recommendations relating to historical funding strategies, including prioritization of existing revenues, as well as alternative state and local transportation funding concepts. (Joint charge with Senate Transportation and Homeland Security Committee) Ensure that the pass-through program reimbursements to contractors and local public entities are based on actual project costs and not cost estimates. Prioritize necessary road construction projects and target financing to those segments that affect the largest number of Texans through congestion mitigation. Ensure that Texas receives the best value for its investment. (Subcharges added pursuant to Dewhurst letter dated 4/8/2010.)
10.	Monitor the implementation of legislation addressed by the Senate Committee on Finance, 81 st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. Specifically, monitor the following: The Legislative Budget Board effectiveness and efficiency review of Chapter 313, Tax Code. Consider whether tax provisions provide a net benefit to the state. Monitor ongoing faculty recruitment and retention for Texas nursing schools, and assess the impact ofincreased state funds to nursing schools to increase faculty salaries and add new teaching schools. Monitor the use of Byrne Grant Border security funds, including whether additional funds need to be spent on communications interoperability. Monitor the Department of Aging and Disability Services (DADS) implementation of SB 643, emergency legislation 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. Provide effective budget oversight of Texas Department of Transportation's implementation of Riders 55 and 56, appropriations from State Highway Fund No. 006 and Proposition 12 General Obligation Bonds for reducing congested road segments. Monitor the revenue receipts associated with the weight-based tobacco tax. Monitor the Cancer Prevention and Research Institute of Texas grant making process to ensure that funds are spent efficiently and effectively. Monitor the expenditure of federal American Resource and Recovery Act funds. Review the extent to which federal stimulus funds affected each agency's ability to meet or surpass its Performance Measure Targets. Consider the effect that delays in federal approvals have had on funding for public education and weatherization programs.
Committee:	Senate Health and Human Services
Title:	Interim Report
Library Catalog Title:	Interim report to the 81st Legislature
Subjects:	Adoption | Aging and Disability Services, Texas Department of | Asthma | Caseworkers | Child abuse prevention | Child Protective Services | Disease management | Disease preparedness | Disease prevention | Family and Protective Services, Texas Department of | Family Based Safety Services | Family preservation | Foster care | Health care providers | Health Enterprise Zones | Health insurance premium subsidies | Home health care services | Immunizations | Influenza | Medicaid | Medical errors | Medical reimbursements | Medically uninsured | Mental health services | Mentally disabled persons | Nursing homes | Obesity | Persons with disabilities | Preparation for Adult Living | Rural health care | Services for persons with disabilities | Smoking bans | State supported living centers | Stem cell research | Umbilical cord blood |
Library Call Number:	L1836.80 H349
Session:	80th R.S. (2007)
Online version:	View report [379 pages  File size: 16,580 kb]
Charges:	This report should address the charges below.
1.	Monitor the Department of Aging and Disability Services' improvement plan for the system of care for individuals with developmental disabilities, focusing on efforts to improve state schools and provide more community care options. Evaluate the process for preventing, reporting, and investigating abuse and neglect in state schools, ICF/MRs and the Home and Community-Based Services (HCS) program. Determine the short-term and long-term financial impact of increasing the number of individuals served in home or community locations and the financial impact this shift has on state schools. Monitor the department's efforts to convert institutions to community care providers through the money-follows-the-person program designed to improve access to community care services. Specifically make recommendations on: how to further improve the system of care for individuals with developmental disabilities; preventing, reporting, and investigating abuse and neglect; developing a transition plan for reducing waiting list for community care service; incentives for converting institutions into community care providers; and a long term plan to address issues that result from the current federal Department of Justice investigation.
2.	Study and make recommendations related to creating an outcome-based reimbursement model in Texas' Medicaid program as a way to improve quality of care, reduce medical errors, and create cost savings. Develop a pilot health care program that pays for best practices, rather than only paying for actual procedures performed. Examine the Centers for Medicare and Medicaid's (CMS) efforts to create an outcome-based system in the Medicare payment system that sanctions serious, preventable medical errors. Examine Pennsylvania's efforts to implement a similar outcome-based reimbursement model to make providers more vigilant about patient care, encourage best practices, and reduce costs in their Medicaid program. If necessary, examine other health care coverage models that have successfully incorporated an outcome-based reimbursement system. Consider pay-for-performance, options that reward good outcomes and the use of best practices, and changes to the reimbursement system that will reduce serious preventable medical errors and hospital acquired infections.
3.	Study the effectiveness of the Resiliency and Disease Management (RDM) program in the mental health service delivery system, implementation of changes to the crisis care program, and recommendations for appropriate use of the mental health transformation grant. Identify strategies to increase access to services and meet future demand for services. Examine resource allocation and opportunities to maximize funding. Policy recommendations should maximize the number of inpatient psychiatric acute care beds, enhance access to outpatient services, promote the use of recovery-based services, and enhance access to community-based services.
4.	Monitor the implementation of the Department of Family and Protective Services’ improvement plan to reduce caseloads for Child Protective Service caseworkers, and to provide family-based safety services and ongoing substitute care services. Evaluate the efficiency of Child Protective Services "functional units," and determine if other organizational models would allow for a reduction in caseworkers' caseloads, without increasing other administrative costs. Develop recommendations aimed at lowering individual caseloads, making casework more efficient, and improving the retention of caseworkers. Assess the viability of caseworker reimbursement as a manner to lower caseworker turnover.
5.	Monitor the implementation of the Department of Family and Protective Services' plan to stabilize the foster care system and increase permanency options for children. Study placement capacity to determine how Child Protective Services can better develop the necessary adoptions or foster homes to meet the needs of children and families by increasing foster care capacity, recruiting and retaining more foster and adoptive parents, increasing the use of relative care, and developing best practices for reducing foster care placement breakdowns. This includes studying innovative ways to promote adoption and kinship care in Texas and best practices for foster/adoptive parents to improve their ability to care for abused and neglected children. Explore potential improvements and enhancements in the Preparation for Adult Living (PAL) program to increase successful transitioning from foster care to adult living. Study current death review processes for children who die while in state care.
6.	Examine Texas' current strategies for preventing child abuse. Specifically study the effectiveness of current programs and how these programs compare to other state efforts. Identify national research-based solutions, including best practices and programs addressing sexual abuse. Explore promising existing and emerging approaches to child abuse and neglect prevention, especially those with a strong evidence base. Identify additional funding sources for increased child abuse prevention activities by the state.
7.	Study the changes in statute contained in SB 10, 80th R.S., as well as the state's current prevention and wellness efforts and chronic care management efforts, and identify opportunities for improvement in state policies and programs. Examine options for expanding and optimizing the state's current investment in wellness programs and management tools for individuals with chronic care conditions, including options that address childhood asthma. Review partnerships with the private sector that specifically address the following: tobacco cessation, including the evaluation of a statewide smoking ban in public places; reducing obesity; availability and effectiveness of childhood and adult vaccines, including public education programs to promote the use of vaccines; and more effective management of chronic care conditions.
8.	Study the effectiveness and efficiency of nursing homes and home-based solutions/home care in Texas, and make recommendations to improve nursing homes and their funding. Identify and study successful nursing home funding models established by other states. Consider ways to fund infrastructure for nursing and therapists and home care. Examine the possibility of an incentive-based “pay for performance” rate plan for nursing facilities and consider factors that it could be based on, taking into account similar plans implemented in other states. Make recommendations on how best to use Medicaid to fund skilled nursing and home health care in Texas. Explore options for improving graduation rates for nurses in Texas.
9.	Study and address ethical issues surrounding the impact of a pandemic influenza in this state, particularly focusing on the following: the availability of human and material resources; the benefits and burdens of mass vaccination plans; the involvement of private sector professional organizations and businesses in the state's pandemic influenza preparedness and response plans; and development and implementation of communication plans that will inform and prepare the public on risk reduction behaviors and local/state preparedness and response.
10.	Study the potential for development of Health Enterprise Zones, which could offer tax incentives to medical providers who locate within the boundaries of designated medically underserved areas. Analyze similar legislation enacted in other states, specifically New Jersey, and estimate costs and benefits. Consider expanding incentives to medically related industries such as medical research facilities, laboratories and equipment manufacturers in order to spur economic development.
11.	Monitor the collection and availability of cord blood stem cells for treatments and research in Texas. Review the current state of basic and clinical research using these and other types of adult stem cells. Assess the potential for clinical and economic benefits from current and increased adult stem cell research.
12.	Review Medicaid provider reimbursement rate methodologies, including the impact of factors such as infrastructure concerns, federal minimum wage changes, and cost reports. Study the impact on access to care, quality of care, and value, and make recommendations for legislative changes, taking into account rate increases contained in the current budget. (Joint charge with Senate Finance Committee)
13.	Study the state's current and long-range need for physicians, dentists, nurses, and other allied health and long-term care professionals. Make recommendations on how the state can help recruit high-need professions, especially for primary care providers and long-term care professionals in the underserved regions of Texas. (Joint charge with the Senate Committee on International Relations and Trade)
14.	Monitor the implementation of legislation addressed by the Health and Human Services Committee, 80th R.S., and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. Specifically, report on the implementation of SB 10, 80th R.S., to ensure meaningful improvement in access to quality care in the Texas Medicaid program, focusing on how to cover more uninsured in Texas with market-based plans or premium assistance for employer health plans, and monitor the creation of the Texas Cancer Research and Prevention Institute.
Committee:	Senate State Affairs
Title:	Interim Report
Library Catalog Title:	Interim report to the 79th Legislature
Subjects:	Border health | Damage award caps | Election administration | Election laws | Employee Retirement Income Security Act of 1974 | Employees Retirement System of Texas | Health insurance | Liability insurance | Managed care | Medical liability insurance | Medically uninsured | Nursing homes | Patients' rights | Quality of care | Rural health care | State employee benefits | State mandated health insurance | Teacher health insurance | Teacher Retirement System of Texas | Tort reform | Voter registration | Voting systems |
Library Call Number:	L1836.78 St29a
Session:	78th R.S. (2003)
Online version:	View report [0 pages]
Charges:	This report should address the charges below.
1.	Study the implementation of changes made to the state group health insurance plans and identify additional cost-saving measures. Study the feasibility and practicality of offering health reimbursement accounts as an alternate health insurance plan for those insured in ERS, TRS, and university plans. Provide recommendations regarding whether the current method of administering these programs is in the best interest of the State of Texas and the various insured populations, or whether such programs might be more efficiently administered in another fashion.
2.	Monitor the implementation of HB 1549, 78th R.S., the Federal Help America Vote Act of 2002, to assure that Texas meets the criteria to secure the proposed federal funding. Make recommendations for statutory changes required to implement federal legislation and improve the efficiency of the process.
3.	Study the implementation of SB 10, 78th R.S., and SB 541, 78th R.S., and make recommendations, as needed, to make health insurance more accessible, and affordable for all Texans.
4.	Study the April 2003 United States Supreme Court decision in Kentucky Association of Health Plans v. Miller to determine its impact on Texas laws regulating health insurance plans under the Employee Retirement Income Security Act of 1974 (ERISA) and make recommendations to changes in state law to conform with recent federal court decisions.
5.	Study the reimbursement methodology of health care plans operating in Texas for out-of-network claims, specifically focusing upon the reimbursement of usual and customary charges, and make recommendations on how to improve their effectiveness. The study and recommendations should encompass all plans, including those participating in Texas Medicaid managed care program and should consider federal and state laws as well as Health & Human Services Commission rules relating to the reimbursement of out-of-network claims.
6.	Study the implementation of HB 4, 78th R.S., and Proposition 12 in achieving lower medical malpractice rates and providing more access to affordable health care. Monitor and report on trends in medical malpractice insurance rates and the effect of tort reform on access to health care and provider shortages in certain regions, particularly along the Border.
7.	Study and report on the affordability, reasonableness, and impact of mandatory liability insurance on the nursing home industry. Assess and report on the effects of the admissibility of quality reports.
Committee:	House Rural Development, Select
Title:	Interim Report
Library Catalog Title:	House Select Committee on Rural Development, Texas House of Representatives interim report, 2000 : a report to the House of Representatives, 77th Texas Legislature.
Subjects:	County roads | Economic development | Farm-to-market roads | Railroads | Rural areas | Rural health care | Rural issues | Rural population | Rural schools | Telecommunications infrastructure | Telecommunications Infrastructure Fund |
Library Call Number:	L1836.76 r88
Session:	76th R.S. (1999)
Online version:	View report [92 pages  File size: 5,357 kb]
Charges:	This report should address the charges below.
1.	Conduct a comprehensive study of all issues pertaining to the current and future viability of rural areas and small cities and towns in Texas. The committee shall develop plans to maintain and improve the economic, social and cultural life of rural Texans.
2.	Studies shall include rural industries, transportation, telecommunications, environmental and natural resource issues, health and human needs, housing, and any other matters substantially affecting the quality of life in rural Texas.
3.	Report should recommend both short-term and long-term strategic changes in state policy, rules and regulations.
Committee:	Joint Rural Health Care Delivery, Special Task Force
Title:	Interim report
Library Catalog Title:	Report and recommendations / the Special Task Force on Rural Health Care Delivery in Texas.
Subjects:	Center for Rural Health Initiatives | Emergency medical services | Medicaid | Medical liability insurance | Medical reimbursements | Nursing shortages | Rural areas | Rural health care | Rural issues | Trauma centers |
Library Call Number:	L1836.70 r88
Session:	70th R.S. (1987)
Online version:	View report [142 pages  File size: 5,399 kb]
Charge:	This report should address the charge below.
1.	Define minimal desired medical care for rural counties and communities with due regard for population, geography, proximity to tertiary care centers, physician manpower, and medical transportation availability; define the resources available and/or needed to provide a voluntary plan to meet the needs of Texas counties, including methods of financing the implementation and operation of such a voluntary plan; and seek consensus among affected parties to support the plan when and where counties and communities seek to implement it.
Supporting documents
Committee:	Joint Rural Health Care Delivery, Special Task Force
Title:	SCR 25, 70th Leg.
Library Call Number:	SCR 25
Session:	70th R.S. (1987)
Online version:	View document [2 pages  File size: 170 kb]
Committee:	House Health Services
Title:	Interim Report
Library Catalog Title:	To the speaker and members of the Texas House of Representatives, 67th Legislature : interim report of the / Committee on Health Services, Texas House of Representatives, 66th Legislature.
Subjects:	Alcohol laws and regulations | Alcoholism | Child care | Freedom of religion | Health, Texas Department of | Medical assistants | Nursing shortages | Rabies | Rural health care | State agencies |
Library Call Number:	L1836.66 h349r
Session:	66th R.S. (1979)
Online version:	View report [236 pages  File size: 10,319 kb]
Charges:	This report should address the charges below.
1.	Determine what standards, operational changes, funding, and other matters are needed to improve outpatient health facilities and rural health clinics.
2.	Study the implementation of HB 1323, 66th R.S., and determine if additional authority is needed for the Board of Health to effectively deal with the statewide control and eradication of rabies.
3.	Recommend means of eliminating the shortage of nursing home care in Texas with emphasis on needed statutory changes, funding needs, and alternative care.
4.	Review the Child Care Licensing Act of 1975 exploring the constitutional aspects of State involvement in such licensure.
5.	Review the effects of the Uniform Alcoholism and Intoxication Treatment Act on those states which have implemented it; determine the cost of enforcing the state laws dealing with public intoxication, and make recommendations regarding the feasibility of decriminalizing public intoxication.
6.	Study the operations of health systems agencies (HSA) in Texas as to their responsiveness to local needs, adherence to the State Health Plan, and overall productivity and effectiveness.
7.	Study the Texas Department of Health (TDH) to monitor its growth and determine its role and scope and future needs.
8.	Study the implications of Texas Attorney General Opinion H-1295 and other legal restraints on the use of protocols and standing orders in the provision of health services.
Committee:	Senate Human Resources Special Subcommittee on Rural Health Care Services
Title:	Interim Report
Library Catalog Title:	Final report of the Special Subcommittee on Rural Health Care Services, Senate Human Resources Committee.
Subjects:	Medical assistants | Rural health care |
Library Call Number:	L1836.65 r88
Session:	65th R.S. (1977)
Online version:	View report [111 pages  File size: 4,491 kb]
Charge:	This report should address the charge below.
1.	Study the implementation in Texas of the federal Rural Health Clinic Services Act, Public Law 95-210, signed into law by President Carter in December of 1977. Particularly consider if state laws allow nurse practitioners and physicians' assistants to provide primary health care services at rural health clinics without direct supervision by a physician. *
Committee:	House Health Care
Title:	Interim Report
Library Catalog Title:	Report of the Texas Health Care Committee to Speaker Gus F. Mutscher and the House of Representatives of the 62nd Legislature.
Subjects:	Hospitals | Medicare | Nursing shortages | Rural health care |
Library Call Number:	L1836.61 m468
Session:	61st R.S. (1969)
Online version:	View report [9 pages  File size: 361 kb]
Charge:	This report should address the charge below.
1.	Study federal Medicare regulations as they are applied to Class 7-C hospitals in Texas. *

* This represents an abstract of the report contents. Charge text is incomplete or unavailable.

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