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4 Document(s) [ Subject: Disease management ]

Committee: House Corrections
Title: Interim Report
Subjects: Alternatives to incarceration | Communicable diseases | Criminal justice | Criminal Justice, Texas Department of | Disease management | Disease preparedness | Disease prevention | Emergency management | Ex-offenders | Hot weather | Hurricane Harvey | Inmate lawsuits | Inmate sexual assaults | Natural disasters | Pardons and Paroles, Texas Board of | Parole | Prison Rape Elimination Act | Probation | Recidivism | Social workers | State jail system | Women | Women inmates | Youthful offenders |
Library Call Number: L1836.85 C817
Session: 85th R.S. (2017)
Online version: View report [75 pages]
Charges: This report should address the charges below.
1. Evaluate the Texas Department of Criminal Justice response to Hurricane Harvey. Recommend any changes that could improve the operational stability of state criminal justice institutions following a natural disaster and changes that would allow for a more effective response.
2. Examine the use of social workers and peer support specialists in the Texas criminal justice system to assist individuals on probation, on parole, or who have been discharged, in order to reduce recidivism and improve outcomes. Identify best practices and make recommendations for legislative action.
3. Examine the current Texas criminal justice system policies and practices regarding 17- to 25- year-olds, specific to probation, parole, state jail confinement, and discharge from the Texas Department of Criminal Justice or county jail. Review any gaps in services that may be causing this population to recidivate. Make recommendations to improve the state's response to the needs of this population in order to lower revocation, re-arrest, and re-incarceration rates.
4. Examine treatment options, services, and programs available to women in institutional settings, on community supervision, on parole, and in community-based programs. Make recommendations for best strategies to address the needs of women in the Texas criminal justice system.
5. Review the Texas state jail system. Examine its original intent, sentencing guidelines, effectiveness, and recidivism rates. Make recommendations for changes in the state jail system. (Joint charge with the House Committee on Criminal Jurisprudence)
6. Study policies and protocols within the Texas Department of Criminal Justice to prevent the spread of infectious diseases. Examine when protocols are implemented and their efficacy in protecting the health and safety of inmates and state employees.
7. Review assessments used by the Board of Pardons and Paroles and parole panels to determine an inmate's risk of recidivism for purposes of granting parole and the use of GPS technology to monitor offenders.
8. Monitor Texas prison system heat-related litigation currently making its way through the courts. Monitor Prison Rape Elimination Act (PREA) compliance within Texas state and county criminal justice facilities.
9. Monitor the agencies and programs under the Committee’s jurisdiction and oversee the implementation of relevant legislation passed by the 85th Legislature.
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 | 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.
Supporting documents
Committee: House Public Health
Title: Committee meeting handouts and testimony, April 5, 2016 (Interim charge, Chronic Disease)
Library Call Number:
Session: 84th R.S. (2015)
Online version: View document [145 pages  File size: 6,864 kb]
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.

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