HBA-NLM H.B. 2073 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2073
By: Bosse
Human Services
3/18/1999
Introduced

BACKGROUND AND PURPOSE 

The Texas Department of Human Services (department) is primarily
responsible for determining eligibility for and accessability to long-term
care and public assistance benefits.  The agency administers more than 30
state and federally-funded programs designed to help support
selfsufficiency, provide long-term care services, and provide domestic
violence education to low income families and children, persons who are
elderly or disabled, and victims of family violence. 

The department is subject to the Texas Sunset Act and will be abolished on
September 1, 1999, unless continued by the legislature. After its review of
the department, the Sunset Advisory Commission recommended continuation and
several statutory modifications. 

H.B. 2073 changes the department's expiration date from September 1, 1999,
to September 1, 2007. This bill creates a family assessment and referral
function to address the needs of families on public assistance.  H.B. 2073
requires contracts for nursing facilities to include performance agreements
related to program outcomes, and amount and quality of services delivered
to clients. H.B. 2073 also transfers the administrative duties of certain
nutrition assistance programs and rulemaking authority from the department
to the Texas Education Agency and transfers the department's administrative
hearings to the State Office of Administrative Hearings. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Department of Human Services
in  SECTION 5 (Section 22.0071, Human Resources Code) and in SECTION 11
(Section 32.0212, Human Resources Code), and to the secretary of state in
SECTION 29 and  rulemaking authority previously delegated to the department
is transferred to the Texas Education Agency in SECTION 29. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 21.002, Human Resources Code, to provide that the
Texas Department of Human Services (department) expires September 1, 2007,
rather than on September 1, 1999.  Deletes the provision providing for the
expiration of Chapter 40 (Department of Protective and Regulatory
Services), Human Resources Code. 

SECTION 2.  Amends Sections 21.003(b) and (d), Human Resources Code, to
provide that the composition of the department must include one licensed
physician with expertise in geriatrics and one other health care
professional.  Requires the governor to designate the presiding officer of
the board to serve in that capacity at the will of the governor.  Deletes
the requirement for the board to elect a presiding officer. 

SECTION 3.  Amends Chapter 21, Human Resources Code, by adding Section
21.0033, to require that members of the board must complete training
described in this section before assuming their duties. Provides that the
training program must provide information regarding the creation of the
department and board, programs operated by the department, the role and
functions of the department, the rule of the department, the current budget
for the department, the results of the most recent formal audit, and
certain statutory requirements. Entitles a person appointed to the board to
reimbursement of travel expenses incurred in attending the training
program. 

SECTION 4.  Amends Chapter 21, Human Resource Code, by adding Section
21.0061, as follows: 
 
Sec. 21.0061. REGIONAL PERFORMANCE AGREEMENTS WITH LOCAL ADMINISTRATIVE
UNITS. (a) Requires the Commissioner of Human Services (commissioner) to
enter into a region-specific performance agreement with each department
regional administrator.   

(b) Requires the commissioner to establish and periodically update goals,
objectives, and performance criteria for each local administrative unit of
the department.  Requires the agreements to include performance criteria
related to program outcomes, and amount and quality of services delivered
to clients.   

(c)  Requires the commissioner to develop the regional performance
agreement with input from community health and human services providers,
including nursing facilities and personal care homes, clients, and advocacy
groups. 

(d)  Requires the commissioner to distribute the performance agreements to
the public and other health and human services agencies. 

(e) Requires the commissioner to consider regional objectives and
performance in establishing regional budgets. 

(f)  Requires the department to inform health and human services agencies
and the general public of the contents of the performance agreement. 

SECTION 5.  Amends Chapter 22, Human Resources Code, by adding Section
22.0071, as follows: 

Sec. 22.0071. CONTRACTS FOR COMMUNITY CARE SERVICES. Requires the
department, by rule, to develop and implement a system of selective
contracting with providers.  Requires the department to ensure that more
than one provider is available in each region of the state. Prohibits use
of open enrollment contracting and specifies contracting procedures for
community care services.  Provides that the department must include
provisions in a contract for community care services that include clearly
defined and measurable program performance standards based on client
service objectives, clearly defined penalties for not meeting contracted
obligations, and clear accounting and reporting requirements. Requires the
department to use a risk-assessment methodology for statewide monitoring of
contract compliance, and to evaluate costs to ensure they are reasonable
and necessary. 

SECTION 6.  Amends Section 22.018, Human Resources Code, as follows:

Sec. 22.018.  New title: COOPERATION WITH STATE OFFICE OF ADMINISTRATIVE
HEARINGS.  Requires the department and the chief administrative law judge
of the State Office of Administrative Hearings to adopt a memorandum of
understanding to conduct all contested case hearings authorized or required
by law, except as otherwise provided in this section.  Sets forth
requirements regarding a contested case hearing under the memorandum of
understanding. Removes the department's authority to conduct administrative
hearings. 

SECTION 7.  Amends Section 31.0032, Human Resources Code, by amending
Subsection (a) and by adding Subsection (d), to require the department to
prioritize the processing of recipient sanctions and immediately apply
sanctions. 

SECTION 8.  Amends Section 31.0095, Human Resources Code, as follows:

Sec. 31.0095.  New title:  EMPLOYABILITY NEEDS ASSESSMENT.

SECTION 9.  Amends Section 31.010, Human Resources Code, as follows:

Sec. 31.010.  New title:  SUPPORT SERVICES RELATED TO EMPLOYABILITY OF A
RECIPIENT. 
  
 SECTION 10.  Amends Subchapter A, Chapter 31, Human Resources Code, by
adding Section 31.011, as follows: 

Sec. 31.011.  PERSONAL AND FAMILIAL NEEDS ASSESSMENT AND SUPPORT SERVICES.
Requires the department to assess the needs of recipients of public
assistance, and their family members, and refer these persons to preventive
and support services, including: 

_substance abuse services,
_domestic violence services,
_child abuse prevention services,
_health care and nutrition services, and 
_other services that will assist families in becoming independent from
public assistance. 

SECTION 11.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.0212, as follows: 

Sec. 32.0212.  CONTRACTS FOR NURSING FACILITY CARE.  Requires the
department, by rule, to develop minimum contract performance standards for
all nursing facility care contracts.  Requires the department to use all
performance data collected by the department including regulatory
information, cost reports, utilization review data, and data relating to
the assessments made by a nursing facility.  Requires the department to
promptly address a nursing facility's failure to meet contract performance
standards. 

SECTION 12.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.0251, as follows: 

Sec. 32.0251.  COMMUNITY CARE SERVICES FOR THE ELDERLY AND DISABLED.
Requires the department to inform applicants seeking nursing facility care
of specific alternatives to nursing facility care. Requires the department,
by rule, to develop and implement a process of presumptive eligibility
determination for appropriate elderly or disabled applicants for community
care services. Requires the department to adjust a client's plan of care in
response to a change in the client's condition, as determined by an initial
assessment. Requires the department to maintain need-based waiting lists
for community care programs and to assign to the applicant a priority level
based on the assessment of the applicant's need and the applicant's degree
of risk for placement in a nursing facility. 

SECTION 13.  Amends Chapter 51, Human Resources Code, as follows:

CHAPTER 51.  New title:  FAMILY VIOLENCE CENTERS

SECTION 14.  Amends Section 51.002, Human Resources Code, as follows:

Sec. 51.002. DEFINITIONS. Defines "family violence center" and "family
violence nonresidential center."  Redesignates existing Subdivision (2) to
Subdivision (4). 

SECTION 15.  Amends Section 51.003, Human Resources Code, to provide that
activities contracted under this section must include, rather than require,
the provision of technical assistance and training for family violence
centers.  Authorizes the department, rather than requires, to contract for
the provisions described by this section.  Requires the department to award
a contract made to a family violence center through a competitive bidding
process.  Makes conforming and nonsubstantive changes. 

SECTION 16.  Amends Section 51.004, Human Resources Code, to specify the
conditions under which a family violence center may be eligible for
contract with the department. Specifies the conditions under which the
department may use a noncompetitive procurement process in areas of the
state where services would not be otherwise available. Redesignates
existing Subsection (c) to Subsection (d).  Makes conforming and
nonsubstantive changes. 
 
SECTION 17.  Amends Section 51.005, Human Resources Code, to make
conforming changes.  

SECTION 18.  Amends Section 51.006, Human Resources Code, to make a
conforming change. 

SECTION 19.  Amends Section 51.007, Human Resources Code, to make a
conforming change. 

SECTION 20.  Amends Section 51.008, Human Resources Code, to require the
department to coordinate the services provided under this chapter with
other services for victims of family violence provided by the Department of
Protective and Regulatory Services. 

SECTION 21.  Amends Section 242.309, Health and Safety Code, as added by
Section 1.01, Chapter 1280, Acts of the 75th Legislature, Regular Session,
1997 (effective until federal determination of failure to comply with
federal regulations), as follows: 

Sec. 242.309.  PROVISIONAL LICENSE.  Authorizes the Texas Board of Human
Services (board) to issue provisional licenses to nursing facility
administrators that are licensed in good standing in another jurisdiction
for at least two years.  Provides that the board will issue a license if
the provisional license holder passes the part of the examination relating
to the practice of nursing facility administration in this state.
Authorizes the board to establish a fee for provisional licenses in a
reasonable and necessary amount to cover the cost of issuing the license. 

SECTION 22.  Amends Section 242.310, Health and Safety Code, as added by
Section 1.01, Chapter 1280, Acts of the 75th Legislature, Regular Session,
1997 (effective until federal determination of failure to comply with
federal regulations), as follows: 

Sec. 242.310.  LICENSE RENEWAL.  Authorizes a person to renew a license by
including a provision that the renewal fee must be paid prior to expiration
of the license.  Prohibits a person with an expired license from practicing
until the license is renewed. Updates the renewal fee amount to 1-1/2 times
the normally required renewal fee if the license has been expired for less
than 90 days, and to two times the normal fee if the license has been
expired for over 90 days but less than one year.  Updates the requirements
for renewal of a license that has been expired for more than one year by
including compliance with the examination requirements.  Authorizes a
person who was licensed in this state and moves from another state to
obtain a new license without reexamination and provides that the person
must pay two times the normally required renewal fee.  Updates the
requirement for the department to send written notice of impending license
expiration no later than the 31st day, rather than at least 30 days, before
the date of expiration. 

SECTION 23.  Amends Section 242.314, Health and Safety Code, as added by
Section 2.01, Chapter 1280, Acts of the 75th Legislature, Regular Session,
1997 (effective upon federal determination of failure to comply with
federal regulations), to make a conforming change. 

SECTION 24. Amends Section 242.315, Health and Safety Code, as added by
Section 2.01, Chapter 1280, Acts of the 75th Legislature, Regular Session,
1997 (effective upon federal determination of failure to comply with
federal regulations), to make a conforming change. 

SECTION 25.  Amends Chapter 242, Health and Safety Code, by adding
Subchapter Q, as follows: 

SUBCHAPTER Q.  PUBLIC ACCESS TO QUALITY OF SERVICE INFORMATION

Sec. 242.901.  COMPILATION OF QUALITY OF SERVICE INFORMATION.  Requires the
department to assemble existing regulatory and service quality information
on nursing facilities in a format that is readily accessible to and
comprehensible to the general public. Provides that the compilation must
include complaint information, staff turnover rates, staff to resident
ratios, and percentages of budgets spent on direct patient care.   

Sec. 242.902.  ACCESS TO QUALITY OF SERVICE INFORMATION.  Requires the
department to provides access to the information compiled under Section
242.901, through  a toll-free line and the Internet, or other electronic
means. 

SECTION 26.  Amends Section 7.021, Education Code, by adding Subsection
(d), to require the Texas Education Agency (agency) to administer federal
nutrition programs as otherwise required by law. 

SECTION 27.  Amends Subchapter B, Chapter 7, Education Code, by adding
Section 7.025, to transfer the administration responsibilities of the child
and adult nutrition programs from the department to the agency. 

SECTION 28.  Amends Section 30.05(b)(3), Penal Code, to provide that
"shelter center" has the meaning assigned by Section 51.002, rather than
51.002(1), Human Resources Code. 

SECTION 29.  Establishes an instructional procedure to transfer the
nutrition programs from the department to the agency. 

SECTION 30.  Repealer:  Section 32.025(c) (Application for Medical
Assistance), Human Resources Code, relating to informing clients of
community care services of other available services. 

SECTION 31.  Repealer:  Section 32.024 (Summer Food Service Program), Human
Resources Code, relating to the administration of summer school food
programs by the department. 

SECTION 32.  Provides that the transfer of powers, duties, functions,
programs, and activities from the department to the agency does not affect
an act done, any obligation, right, order, license, permit, rule,
criterion, standard, or requirement existing, any investigation begun, or
any penalty accrued under former law, and that law remains in effect for
any action concerning those matters.   Provides that any action brought
before the effective date of this Act is governed by the law and rules
applicable to the action before the effective date of this Act. 

SECTION 33.  Makes application of this Act prospective and provides that an
application made for a license by the department before the effective date
of this Act is governed by the law in effect on the date the application
was made, and the former law is continued in effect for that purpose. 

SECTION 34.  Provides that the changes in law made by this Act relating to
the qualifications of and the prohibitions applying to members of the board
do not affect the entitlement of a board member immediately before
September 1, 1999.  Makes application of this Act prospective.  Requires
the governor to ensure that the composition of the board complies with the
requirements of Section 21.003(b), Human Resources Code, as amended by this
Act. 

SECTION 35.  Requires the department to begin selective contracting by
January 1, 2000. Authorizes the department to continue to use an open
enrollment contracting system until implementation of the selective
contracting system begins, notwithstanding Section 22.0071, Human Resources
Code.  Makes application of this Act prospective. 

SECTION 36.  Makes application of the change in law made to Section 22.018,
Human Resources Code, of this Act prospective. 

SECTION 37.  Makes application of Section 32.0212, Human Resources Code, as
added by this Act, prospective. 

SECTION 38.  Provides that if any state agency determines a waiver from
federal requirements is needed to implement any provision of this Act, the
affected agency is authorized to request a waiver and delay implementation
of the provision until the waiver is granted. 

SECTION 39. (a) Provides that this Act takes effect September 1, 1999,
except as provided by                            Subsection (b) of this
section. 

                        (b)  Provides that Sections 27 and 31 of this Act
take effect January 1, 2000. 

 SECTION 40.  Emergency clause.