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4 Document(s) [ Subject: State Health Services, Texas Department of ]

Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Child abuse | Child Protective Services | Emergency management | Employees Retirement System of Texas | Family and Protective Services, Texas Department of | Foster care | Health and Human Services Commission, Texas | Health care costs | Healthy Texas Women | Hurricane Harvey | Insurance, Texas Department of | Juvenile justice system | Managed care | Medicaid | Natural disasters | Opioids | Prescription drugs | Public health | State Health Services, Texas Department of | Substance abuse | Teacher Retirement System of Texas |
Library Call Number: L1836.85 H349
Session: 85th R.S. (2017)
Online version: View report [98 pages]
Charges: This report should address the charges below.
1. Review the state's response to Hurricane Harvey with a focus on public health efforts at the local and state level. The review should include an analysis of the state and local response related to vector control, immunization needs, utilization of health-related volunteers, adequacy of an emergency medical network, evacuation of vulnerable populations from state operated or regulated facilities, and coordination between all levels of government. Recommend any legislative changes necessary to improve public health response and coordination during and after a disaster.
2. Evaluate the impact of Hurricane Harvey on the capacity of out-of-home placements and care for youth involved with the juvenile justice and child welfare systems. Determine how the state can ensure support is available to provide appropriate care as close to home as possible as facilities and offices are rebuilt.
3. Child Welfare: Review the efficacy and quality of services offered to ensure family preservation while in the Family Based Social Services (FESS) stage of service at the Department of Family and Protective Services. Make recommendations to better track quality of services and link payments to providers of these services to outcomes for families and children. Analyze the Department of Family and Protective Services' progress in meeting statutory requirements related to timely visits to children involved in a reported case of abuse or neglect. Make recommendations to further improve the timeliness of these visits. Review services and supports provided to children in Permanent Managing Conservatorship of the state, and the level of preparedness given to youth aging out of state care. Examine the impact of recent legislation related to these populations, and make recommendations to ensure youth in care are ready for adulthood and to reduce the likelihood of intergenerational perpetuation of child maltreatment. Assess the effectiveness of public and private agency efforts to recruit and retain foster parents. Identify barriers to entry and obstacles that prevent interested families from continuing to provide foster care. Recommend solutions to increase foster recruitment and address non-renewals, especially in first-time foster parents.
4. Substance Abuse/Opioids: Review substance use prevention, intervention, and recovery programs operated or funded by the state and make recommendations to enhance services, outreach, and agency coordination. Examine the adequacy of substance use, services for pregnant and postpartum women enrolled in Medicaid or the Healthy Texas Women Program and recommend ways to improve substance use related health outcomes for these women and their newborns. Examine the impact of recent legislative efforts to curb overprescribing and doctor shopping via the prescription monitoring program and recommend ways to expand on current efforts.
5. Medicaid Managed Care Quality and Compliance: Review the Health and Human Services Commission's efforts to improve quality and efficiency in the Medicaid program, including pay-for-quality initiatives in Medicaid managed care. Compare alternative payment models and value-based payment arrangements with providers in Medicaid managed care, the Employees Retirement System, and the Teachers Retirement System, and identify areas for cross-collaboration and coordination among these entities. Evaluate the commission's efforts to ensure Medicaid managed care organizations' compliance with contractual obligations and the use of incentives and sanctions to enforce compliance. Assess the commission's progress in implementing competitive bidding practices for Medicaid managed care contracts and other initiatives to ensure the best value for taxpayer dollars used in Medicaid managed care contracts.
6. Health Care Cost Transparency: Study efforts by the Department of State Health Services and the Texas Department of Insurance to increase health care cost transparency, including a review of the Texas Health Care Information Collection (THCIC) system, and the Consumer Guide to Healthcare. Recommend ways to make provider and facility fees more accessible to consumers to improve health care cost transparency, increase quality of care, and create a more informed health care consumer base.
7. Monitoring Charge: Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 85th Legislature and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to: • Initiatives to increase capacity and reduce waitlists in the mental health system, including the construction of state hospitals and new community grant programs; • Initiatives to better understand the causes of maternal mortality and morbidity, including the impact of legislation passed during the first special session of the 85th Legislature. Recommend ways to improve health outcomes for pregnant women and methods to better collect data related to maternal mortality and morbidity; • Initiatives intended to improve child safety, Child Protective Services workforce retention, and development of additional capacity in the foster care system. Make additional recommendations to ensure children with high levels of medical or mental health needs receive timely access to services in the least restrictive setting; • Efforts to transfer case management of foster children and families to Single Source Continuum Contractors (SSCCs). Monitor the progress of this transition and make recommendations to ensure the process provides continuity of services for children and families and ongoing community engagement; • Initiatives to strengthen oversight oflong-term care facilities to ensure safety and improve quality for residents and clients of these entities; and • Abortion complications and other reporting legislation that was passed by the 85th Legislatu re.
Committee: 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 Criminal Justice
Title: Interim Report
Library Catalog Title: Interim report to the 82nd Legislature / Senate Committee on Criminal Justice
Subjects: Alcohol-related deaths | Alternatives to incarceration | Blood alcohol concentration | Child abuse | Child sexual abuse | Community notification of sex offenders | Concealed weapons | Crime laboratories | Criminal Justice, Texas Department of | DNA testing | Driving while intoxicated | Forensics | Indigent criminal defense | Jail Standards, Texas Commission on | Juvenile detention facilities | Juvenile justice system | Juvenile Probation Commission, Texas | Mental health services | Mentally ill inmates | Municipal jails | Prison security | Public Safety, Texas Department of | Recidivism | School discipline | Sex offender registration | State Health Services, Texas Department of | Texas Fair Defense Act | Witnesses | Youth Commission, Texas |
Library Call Number: L1836.81 C868
Session: 81st R.S. (2009)
Online version: View report [115 pages  File size: 3,355 kb]
Charges: This report should address the charges below.
1. Study the efficiency and fairness of the current sexual offender registry system and make recommendations to improve the system, if necessary. Study the issue of compliance with the Adam Walsh Act, focusing on the associated costs to the state and the punishment of juveniles. Examine the risk assessment tools used to measure the likelihood of recidivism of sexual predators.
2. Review statistics regarding the crime of driving while intoxicated, including accident statistics, alcohol-related deaths and injury, and other impacts on the community. Examine enforcement options used nationwide to deter driving under the influence and make recommendations to reduce the number of alcohol-related traffic fatalities and accidents in Texas.
3. Review the performance of the Fair Defense Act and the Task Force on Indigent Defense. Study key outcomes of the law, including: appointment rates in felony and misdemeanor cases; state and county indigent defense expenditures; attorney caseloads; attorney compensation; access to investigators and experts; and overall quality of counsel for the indigent. Examine the Task Force on Indigent Defense's effectiveness in monitoring and enforcing standards and design strategies to improve the delivery of services for indigent defense, including timing of the appointment of counsel, the use of the appointment wheel and the monitoring of workloads and performance of attorneys.
4. Study and make recommendations related to municipal jails and other detention facilities that operate without state agency oversight. Identify the number of such facilities and the population detained, as well as best practices for municipal jails. Make recommendations to improve services and consider options for oversight of facilities by the Texas Commission on Jail Standards.
5. Review the detention of juvenile offenders in local jails, state jails, and Texas Department of Criminal Justice prison units by examining conditions of confinement, including quality of education, mental health treatment and medical services, rehabilitative treatment, and equality of access to services for young female inmates. Review access to administrative and inspector general grievances in TDCJ facilities. Make recommendations for improving the system and reduce recidivism of juvenile offenders.
6. Study and make recommendations to ensure the accuracy and timeliness of testing done in Texas forensic laboratories, including DNA and blood/alcohol testing. Assess and make recommendations for improving the capacity of Texas criminal laboratories to process evidence, identify ways to reduce the backlog of DNA evidence processing, identify ways to encourage qualified applicants for crime lab jobs, ensure adequate training for new crime lab technicians, ensure the availability of efficient crime lab processing to all regions of the state, and determine the impact of additional collection requirements on the capacity of Texas crime labs to process evidence. Consider the costs and benefits of creating a statewide crime lab.
7. Assess how the Commission on Jail Standards, the Department of Public Safety, the Department of Criminal Justice, and Department of State Health Services are working together to identify defendants with mental health issues, notify magistrates when defendants have been identified and, where appropriate, provide crisis stabilization services to defendants. Monitor legislation passed by the 81st Legislature for mental illness and make recommendations for any needed improvements to improve mental health services and reduce recidivism.
8. Study and evaluate the success of juvenile probation pilot programs aimed at community-based diversion of youth from Texas Youth Commission facilities. Make recommendations for needed legislative action and additional programs to increase the number of delinquent youth successfully rehabilitated in their home communities.
9. Consider the impact that secondary education school disciplinary laws and policies have on the juvenile justice system and the adult prison system. Recommend changes, if needed, to current law.
10. Evaluate the usage of current Texas practices for facilitating the fair and accurate courtroom testimony of children and reducing the trauma associated with testifying, particularly for children who are victims of sexual abuse. Specifically consider recent efforts and trends across the nation to develop best practices, including "court orientation" programs, and ensure that courtrooms are more child friendly and accommodating for young victims to reduce the trauma associated with testifying in court while ensuring that fair and accurate information is solicited from the child as a witness.
11. Monitor the implementation of legislation addressed by the Senate Committee on Criminal Justice, 81st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
  • Study the impact of certain provisions in the 2009 DPS Sunset bill on the timely processing of concealed handgun license applications and the issuance of licenses.
  • Monitor and make recommendations, if needed, on actions by TDCJ to improve security and reduce contraband.
Committee: Senate Finance
Title: Interim Report
Library Catalog Title: Interim report
Subjects: Aging and Disability Services, Texas Department of | Criminal Justice, Texas Department of | Employees Retirement System of Texas | Employers | Financial investments | Frew lawsuits | Health and Human Services Commission, Texas | Health insurance | Health insurance premium subsidies | Higher Education Coordinating Board, Texas | Highway finance | Investment of public funds | Iran | Medicaid | Medical reimbursements | Parks and Wildlife, Texas Department of | Permanent School Fund, Texas | Permanent University Fund | State agency budgets | State government debt | State Health Services, Texas Department of | State supported living centers | Sudan | Tax incentives | Teacher Retirement System of Texas | Texas Southern University | Transportation, Texas Department of | Youth Commission, Texas |
Library Call Number: L1836.80 F49
Session: 80th R.S. (2007)
Online version: View report [46 pages  File size: 698 kb]
Charges: This report should address the charges below.
1. Provide effective budget oversight of state agencies to ensure that monies appropriated are spent wisely. Particular areas of focus will include the Texas Department of Transportation, Department of State Health Services coordination of Mental Health Services, Texas Parks and Wildlife Department revitalization of State Parks, Health and Human Services Commission management of Frew settlement agreement and waiting list slots, Department of Aging and Disability Services improvement of State Schools, Texas Department of Criminal Justice roll out of treatment programs and review of the salary career ladder for employees for retention purposes, Texas Youth Commission achievement of reform, Texas Southern University rehabilitation, Higher Education Coordinating Board implementation of incentive programs and the creation of the Texas Cancer Research and Prevention Institute.
2. Evaluate the effectiveness of existing state tax incentives that encourage employers to provide health coverage to their employees, including tax incentives under the revised state business tax, and make recommendations for additional deductions or credits that increase the number of employees covered by health care insurance.
3. 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 State Affairs Committee)
4. 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 Health and Human Services Committee)
5. Study and review state and local options for expanding transportation funding and explore options to reduce diversions of Fund 6 revenue. (Joint charge with Senate Committee on Transportation and Homeland Security)
6. Study and make recommendations relating to whether the Texas Department of Transportation is in compliance with Transportation Code §201.109, Revenue Enhancement, and whether the Texas Department of Transportation is using the funding sources provided by the Legislature, including, but not limited to, General Obligation, Fund 6 and Mobility Fund bonds, to build new roads. (Joint charge with Senate Committee on Transportation and Homeland Security)
7. Monitor and provide a brief update on the implementation of legislation addressed by the Finance Committee, 80th Legislature, Regular Session, and make recommendations for any legislation needed to improve or enhance and complete implementation.
  • SB 247, 80th Legislature, Regular Session, relating to Sudan divestment, and make recommendations about whether to include Iran in the divestment strategy;
  • SB1332, 80th Legislature, Regular Session, to help improve the state's debt management and oversight, including a more comprehensive review of state debt and improved communication between entities and oversight of state bond issuance;
  • SB 10, 80th Legislature, Regular Session, and the Frew settlement to ensure that the initiatives carried out by the Health and Human Services Commission affect meaningful improvement in access to quality care in the Texas Medicaid program; and
  • HB 3732, 80th Legislature, Regular Session, relating to ultra-clean coal technologies, and determine the amount of property tax removed from the tax rolls, as well as the corresponding impact on school finance. Identify any changes needed to strengthen the program and ensure its success.

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