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3 Document(s) [ Subject: Family preservation ]

Committee: House Human Services
Title: Interim Report
Subjects: Adoption | Assisted living facilities | Child abuse | Child abuse prevention | Child Protective Services | Early childhood intervention | Emergency management | Family preservation | Foster care | Hurricane Harvey | Long-term care | Managed care | Medicaid | Medicaid program management | Mentally ill persons | Natural disasters | Nursing homes | Pharmaceutical industry | Prescription drugs | State supported living centers | Substance abuse | Tropical storms |
Library Call Number: L1836.85 H88
Session: 85th R.S. (2017)
Online version: View report [50 pages]
Charges: This report should address the charges below.
1. Study the impact of Hurricane Harvey and the response to the storm on individuals living in long-term care facilities, assisted living facilities, state supported living centers, licensed community group homes, and children in the foster care system. Identify and recommend necessary solutions to ensure appropriate disaster-related protocols are in place to keep vulnerable Texans protected. Also, identify any challenges state agencies experienced in responding to the storm or during recovery efforts.
2. Review the history and any future roll-out of Medicaid Managed Care in Texas. Determine the impact managed care has had on the quality and cost of care. In the review, determine: initiatives that managed care organizations (MCOs) have implemented to improve quality of care; whether access to care and network adequacy contractual requirements are sufficient; and whether MCOs have improved the coordination of care. Also determine provider and Medicaid participants’ satisfaction within STAR, STAR Health, Star Kids, and STAR+Plus managed care programs. In addition, review the Health and Human Services Commission's (HHSC) oversight of managed care organizations, and make recommendations for any needed improvement.
3. Examine the survey process for nursing facilities to determine any duplication of government regulations. Consider recommendations to reduce duplication while ensuring patient safety is preserved.
4. Review the availability of prevention and early intervention programs and determine their effectiveness in reducing maltreatment of children. In addition, review services available to children emancipating out of foster care, as well as services available to families post-adoption. Determine if current services are adequately providing for children's needs and meeting the objectives of the programs. While reviewing possible system improvements for children, follow the work of the Supreme Court of Texas Children's Commissions' Statewide Collaborative of Trauma-Informed Care to determine how trauma-informed care impacts outcomes for children.
5. 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 Public Health)
6. Monitor the HHSC's implementation of Rider 219 in Article II of the General Appropriations Act related to prescription drug benefit administration in Medicaid. Analyze the role of pharmacy benefit managers in Texas Medicaid.
7. 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 closely monitor the implementation of H.B. 4 (85R), H.B. 5 (85R), H.B. 7 (85R), and S.B. 11 (85R).
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).
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 | Anti-smoking campaigns | Asthma | Caseworkers | Child abuse prevention | Child Protective Services | Community support services | Disabled persons | 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 | Preparation for Adult Living | Rural health care | 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 Legislature, Regular Session, 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 Legislature, Regular Session, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. Specifically, report on the implementation of SB 10, 80th Legislature, Regular Session, 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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