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5 Document(s) [ Subject: Medical Board, Texas ]

Committee: Senate Health and Human Services
Title: Interim Report
Library Catalog Title: Interim report to the 82nd Legislature
Subjects: Adult Protective Services | Aging and Disability Services, Texas Department of | At-risk youth | Child abuse | Children's Health Insurance Program | Cloning | Community support services | Crime prevention | Diet and nutrition | Emergency management | Families | Family and Protective Services, Texas Department of | Family violence | Federal government | Foster care | H1N1 virus | Health care | Health care providers | Health insurance | Human services | Long-term care | Medicaid | Medicaid eligibility | Medical Board, Texas | Medical errors | Medical research | Mental health services | Mentally ill persons | Nurses | Obesity | Physicians | Quality of care | Senior citizens | State budgets | Stem cell research | Texas Integrated Eligibility Redesign System |
Library Call Number: L1836.81 H349
Session: 81st R.S. (2009)
Online version: View report [272 pages  File size: 6,511 kb]
Charges: This report should address the charges below.
1. Upon passage of federal legislation relating to reform of the health care industry and health insurance industry that the Texas Health and Human Services Commission estimates will costs the State of Texas $2 to 2.5 billion per year in General Revenue beginning as early as 2013, study the implications of such legislation on Texas, the health care industry, and public and private insurance. Study and monitor the implementation of the insurance regulatory changes, changes to high risk pool, and any other insurance mandates. Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget. Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs. (Joint charge with Senate State Affairs Committee)
2. Study the benefits, efficiencies and costs, and effectiveness of the social service related prevention and early intervention programs at the health and human services agencies, the juvenile and adult criminal justice agencies and other government agencies that have programs that address mental illness, substance abuse, child abuse and neglect, domestic violence, single-parent families, absentee fathers, early pregnancy, and unemployment. Study other states' prevention programs and efforts to administer these programs through a merged prevention department. Make recommendations to improve the efficiency and effectiveness of these programs.
3. Review the timeliness and efficiency of the Health and Human Service Commission's eligibility system. Include a review of staffing levels and staffing distribution; implementation of Rider 61; and the increased demand on the system. Make recommendations to improve the efficiency and effectiveness of the system, focusing on policy changes that will not create a large financial burden for the state.
4. Study and make recommendations on the state's role for facilitating the exchange of health care information in the future, including using the Medicaid exchange as a framework for the statewide exchange of health information between health care providers to improve quality of care; what information the state should provide; how to use this information to improve care management, prevent medical errors, and reduce unnecessary services; and policies and statutory changes needed to ensure that privacy is protected. Study the feasibility of developing multiple regional health information technology exchanges in Texas.
5. Study the state's current and long-range need for physicians, nurses, dentists and other allied health and long-term care professionals. Provide recommendations for ensuring sufficient numbers of health care professionals, focusing on medically underserved and rural areas of the state as well as the Border region. Consider health care delivered by Advanced Practice Nurses in terms of access, cost and patient safety and include an assessment of independent prescriptive authority with those states in which prescriptive authority is delegated by a physician. Make recommendations to enhance the efficient use of Advanced Practice Nurses in Texas.
6. Explore strategies to support the needs of aging Texans, including best practices in nursing home diversion, expediting access to community services, and programs to assist seniors and their families in navigating the long-term care system with the goal of helping seniors remain in the community. Study the guardianship program implemented by the Department of Aging and Disabilities and the Department of Adult Protective Services, including the efficiency and effectiveness of the program, the relationship between the two agencies, the appropriate rights for parents, and whether clients and their assets are adequately protected to ensure the state is appropriately identifying seniors in need of protection.
7. Examine how the state could enact policies to improve the overall health of Texans, focusing on programs that compliment individually-based prevention with community­based prevention to reduce obesity rates by increasing physical activity, improving nutrition, and improving self-management of chronic diseases such as diabetes. Examine obesity-related health disparities between different ethnic groups and ways to narrow these gaps. Consider the fiscal and health impact of second-hand smoke on businesses and service sector employees. Study state-level initiatives to incorporate these individual and community-based prevention strategies, including initiatives pursued in other states.
8. Study the state's ability to appropriately respond to the H1N1 influenza pandemic by examining issues related to vaccine distribution and capacity. Consider the benefit of providing the state's independent school districts and various health authorities with standardized protocols for issues including, but not limited to, vaccine administration, absenteeism and the cancellation of school and other school-related events. Assess the state's ability to track and record H1N1 vaccinations through the ImmTrac registry, and review statutes governing ImmTrac to increase the effectiveness and efficiency of immunization information systems.
9. Study current state health care quality improvement initiatives in Texas, including statewide health care-associated infection and adverse event reporting, reimbursement reductions in the Texas Medicaid program for preventable adverse events, potentially preventable readmissions identification, health information technology implementation, pay-far-performance programs, and other initiatives aimed at improving the efficiency, safety, and quality of health care in Texas. Identify statutory changes that may build upon efforts to improve quality of care and contain health care costs in Texas. Study policies that encourage and facilitate the use of best practices by health care providers including the best way to report and distribute information on quality of care and the use of best practices to the public and to promote health care provider and payment incentives that will encourage the use of best practices. The study/recommendations could also include assessing the best way to bring provider groups together to increase quality of care, the use of best practices, and reduce unnecessary services.
10. Study current practices of the Texas Medical Board relating to disclosure of complaints.
11. Review the types of human stem cell and human cloning research being conducted, funded, or supported by state agencies, including institutions of higher education. Make recommendations for appropriate data collection and funding protocols.
12. Review the Medicaid HCBS waivers (CBA, STAR Plus, CLASS, MDCP, DBMT, TxHmL) and develop recommendations to assure that people with significant disabilities, regardless of disability label or age, receive needed services to remain in or transition to the community. Review should look at the delivery system, eligibility, service packages, rate structures, workforce issues and funding caps. Examine options for the provision of services for children aging out of the Medicaid system. Make recommendations for streamlining/combining these waivers, ensuring that these waivers are cost effective or create cost savings, and developing policies that contain costs in an effort to increase access to these services. The review should examine other states' community care waivers and provide recommendations relating to efforts that have been successful in other states.
13. Study the type, duration, frequency and effectiveness of mental health services available to and accessed by abused and neglected Texas children. Recommend strategies to address the impact of the trauma, and enhance therapeutic services available to this population in an effort to eliminate the cycle of abuse and neglect.
14. Monitor the implementation of legislation addressed by the Senate Committee on Health & Human Services, 81st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
  • Monitor Department of Family and Protective Services' implementation of the U.S. Fostering Connections Act, including the new Kinship Care program. Include recommendations on how to optimize the use of monetary assistance to qualified relative caregivers.
  • Monitor the Department of Aging and Disability Services (DADS) implementation of SB 643, relating to Texas' state-supported living centers (SSLCs), implementation of Special Provisions relating to All Health and Human Services Agencies, Section 48. Contingency Appropriation for the Reshaping of the System for Providing Services to Individuals with Developmental Disabilities, and implementation of the United States Department of Justice (DOJ) Settlement Agreement terms.
Committee: House Public Health
Title: Interim Report
Library Catalog Title: Interim report to the 81st Legislature
Subjects: Anatomical Board, Texas | Anatomical gifts | Asthma | Disease prevention | Driver Responsibility Program | Emergency management | Emergency medical services | Health care providers | Indigent health care | Medical Board, Texas | Organ and tissue donations | Prescription drugs | State employees | Trauma Facilty/EMS account |
Library Call Number: L1836.80 H349h
Session: 80th R.S. (2007)
Online version: View report [74 pages  File size: 8,191 kb]
Charges: This report should address the charges below.
1. Monitor and evaluate the full array of wellness initiatives undertaken by the State of Texas to include the newly adopted state employee wellness and prevention legislation (HB 1297, 80th Legislature, Regular Session) and a pilot program to encourage health lifestyles, such as smoking cessation within the Medicaid program (SB 10, 80th Legislature, Regular Session) and for state employees. Develop strategies for maximizing potential health benefits and optimizing the return on the State of Texas' investments in wellness. Include a review of other state and private sector programs for employee wellness that result in prevention cost savings.
2. Research issues relating to the Indigent Health Care and Treatment Act (Chapter 61, Health and Safety Code) and related local health care initiatives (Chapter 534, Government Code), and make recommendations to address any imbalance between counties for the provision of health care.
3. Review issues related to federal changes for tamper-resistant prescription pad requirements, and monitor the activity of the Texas Department of Public Safety Controlled Substances Advisory Committee in response to SB 1879, 80th Legislature, Regular Session.
4. Examine issues related to the Texas Anatomical Gift Act (Chapter 692, Health and Safety Code.)
5. Examine the status of asthma in Texas, and make recommendations to prevent asthma and to assist children and adults with asthma to more effectively manage their disease. Develop strategies for decreasing the direct medical and indirect related costs associated with asthma.
6. Examine activities at the Texas Medical Board as they relate to the protection of public health and the practice of medicine, and the status of implementation requirements established by HB 1973, 80th Legislature, Regular Session. The committees should consider any findings by the Texas Sunset Commission. (Joint Interim Charge with the House Committee on Appropriations.)
7. Examine the State of Texas' preparedness level to handle a public health emergency. (Joint Interim Charge with the House Committees on Defense Affairs and State-Federal Relations.)
8. Review the effectiveness of the Driver Responsibility Programs, and provide recommendations for increasing the collection rate of assessed penalties. Provide recommendations for amnesty and incentive programs established by the passage of SB 1723, 80th Legislature, Regular Session. Examine the status of Texas' current statewide trauma system infrastructure and how the system may be optimized to meet future trauma care needs in a rapidly growing state with overburdened emergency rooms. (Joint Interim Charge with the House Committee on Transportation.)
9. Study the state's current and long-range need for physicians, dentists, nurses and other allied health and long-term care professionals. Make recommendations regarding strategies related to geographic distribution and barriers to recruitment of high-need professions, especially for primary care providers and long-term care professionals. (Joint Interim Charge with the House Committees on Border and International Affairs and Appropriations.)
10. Monitor the agencies and programs under the committee's jurisdiction.
Committee: Joint Medical Peer Review Process, Interim
Title: Interim Report
Library Catalog Title: Joint Select Committee to Study the Medical Peer Review Process interim report 2007 : a report to the Texas Legislature, 80th Legislature
Subjects: Liability | Medical Board, Texas | Medical licensing | Medical malpractice | Physicians |
Library Call Number: L1836.79 M468
Session: 79th R.S. (2005)
Online version: View report [23 pages  File size: 230 kb]
Charges: This report should address the charges below.
1.

Study the medical peer review process in hospitals and other health care entities in this state. The study shall include an examination of:
(1) the use of medical peer review in identifying and reporting to the Texas Medical Board the conduct of or the quality of care provided by physicians who are members of the medical staffs of hospitals and other health care entities;
(2) the use of medical peer review in disciplining a physician based on the conduct or quality of care provided by the physician as a member of the medical staff of a hospital or other health care entity;
(3) the appropriate level of immunity protections for hospitals and other health care entities, medical peer review committees, and individuals who participate on those committees in health care liability claims brought by patients alleging bad faith physician credentialing; and
(4) whether there are adequate mechanisms in state law to ensure appropriate regulatory supervision of the appropriateness and effectiveness of medical peer review in hospitals and other health care entities.

2.

As part of the joint interim committee's study, the committee shall investigate:
(1) the adequacy of the Texas Medical Board's oversight and investigation of physician claims that the medical peer review process is misused, including whether the board's oversight and investigation powers should be strengthened and how other states investigate claims of misuse of the medical peer review process;
(2) the state regulatory reporting mechanisms relating to the appropriateness and effectiveness of medical peer review in hospitals and other health care entities and the oversight and authority of the state to ensure good faith medical peer review in hospitals and other health care entities in this state;
(3) the potentially negative impact on medical peer review in this state that could result from potential changes to:
(A) immunity protections; or
(B) the oversight and investigation of physician claims of misuse of the medical peer review process;
(4) how the laws of other states address immunity protections for medical peer review; and
(5) any other matter relevant to the medical peer review process, including how state and federal law identifies physician conduct that is considered to be unprofessional or unsafe by a medical peer review committee.

Committee: Senate Health and Human Services
Title: Interim Report
Library Catalog Title: Interim report to the 79th Legislature
Subjects: Adult Protective Services | Call centers | Child Protective Services | Children's Health Insurance Program | Databases | Family and Protective Services, Texas Department of | Health care | Hospitals | Immunizations | Indigent health care | Long-term care | Medicaid | Medicaid fraud | Medical Board, Texas | Medicare | Prompt payment of insurance claims | Social service agencies | State government reorganization | Welfare |
Library Call Number: L1936.78 H349
Session: 78th R.S. (2003)
Online version: View report [247 pages  File size: 1,485 kb]
Charges: This report should address the charges below.
1. Study and make recommendations on structural reform, efficiency improvements, and cost savings in the state Medicaid and CHIP programs, with a goal of changing the method and delivery of service to reduce costs while providing the intended services. The Committee should examine and make recommendations to: lower institutional costs; subsidize private insurance in lieu of Medicaid and CHIP where possible; use consumer-directed care models; reimburse health care providers based upon outcomes where feasible; match currently unmatched local funds with federal funds; alter Texas' current method of finance and distribution of DSH; develop possible HIFA waiver options that incorporate premium subsidization; develop accountability and incentive measures for outcomes within Medicaid managed care and CHIP; seek flexibility from federal government to allow options and waivers and enhance federal funds; examine local models for delivery of Medicaid while maintaining best practices; and expand access to mental health services through expansion of behavioral health organization model. The Committee will coordinate these studies with the Health and Human Services Transition Legislative Oversight Committee review of mental health and mental retardation services.
2. Monitor implementation and make recommendations to improve HB 2292, 78th Legislature, Regular Session. Include reviews of implementation of the preferred drug list and prior authorization and the new call center for determination of program and service eligibility. The Committee will coordinate activities with the Health and Human Services Transition Legislative Oversight Committee.
3. Study and make recommendations on improving Texas's county and local indigent health care system. Consider whether the system should be regionalized to reflect usage and gain efficiencies, so that one or more counties are not paying for regional health care.
4. Monitor the implementation and make recommendations to enhance the effectiveness of legislation relating to the Board of Medical Examiners, legislation relating to childhood immunizations, legislation relating to the pilot front end Medicaid fraud reduction systems, federal developments related to TANF reauthorization and related programs, expansion and new construction of Federally Qualified Health Centers, federal developments related to prescription drugs in Medicare and the effect on Medicaid. Also, monitor and report on the use of new federal Medicare funds allocated for Texas
5. Study and make recommendations on increasing electronic transactions in health care. Review the use and make recommendations on improving technology in health care administration, including expediting pre-authorizations and increasing the efficiency of claims processing so that medical providers are paid once procedures are pre-authorized and performed, and administrative costs lowered, benefitting both the consumer and the managed health care organizations.
6. Study health facility regulation in Texas and make recommendations that facilitate innovation and patient safety. Concentrate studies on hospitals, including niche hospitals, Federally Qualified Health Centers and long term care facilities, and make recommendations for improving patient choice, facility competition, indigent health care, and for maintaining a competitive, patient-oriented health care industry.
7. Study and make recommendations on improving the Protective and Regulatory Services service levels payment system and tiered adoption subsidy program. Study and make recommendations on improving the recruitment and retention of foster care families.
Committee: House Licensing and Examining Boards
Title: Interim report
Library Catalog Title: A factual report to the House of Representatives of the 58th Legislature of Texas.
Subjects: Architectural Examiners, Texas Board of | Barber Examiners, Texas State Board of | Dental Examiners, Texas State Board of | Law Examiners, Texas Board of | Medical Board, Texas | Nursing, Texas Board of | Occupational licenses | Real Estate Commission, Texas | Veterinary Medical Examiners, Texas State Board of | Vocational Nurse Examiners, Texas Board of |
Library Call Number: L1836.57 M588
Session: 57th R.S. (1961)
Online version: View report [85 pages  File size: 4,669 kb]
Charge: This report should address the charge below.
1. Study the operations of the Texas examining and licensing boards with a view to possible improvements and economies.

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