HBA-JRA, MPM H.B. 3504 76(R)BILL ANALYSIS Office of House Bill AnalysisH.B. 3504 By: Solis, Jim Public Health 7/26/1999 Enrolled BACKGROUND AND PURPOSE The Texas Center for Infectious Diseases in San Antonio and South Texas Hospital in Harlingen, opening in 1954 and 1956, respectively, were built to treat tuberculosis in Texas. Additionally, these facilities were authorized to treat other persons with infectious or chronic respiratory ailments; to quarantine individuals under specified conditions; and to provide patient care, research, education, and support services for the Texas Department of Health (TDH) bureaus, public health regions, local health departments, and other TDH contractors. Due to the growing need for indigent health care, South Texas Hospital was authorized by the Texas Legislature in 1983 to broaden its scope to include medical and sub-acute surgical services, in addition to the authority to provide cancer screenings, and diagnostic, educational, obstetrical, gynecological, and other inpatient services. South Texas Hospital serves as the major provider of sub-acute indigent care in its region. Both hospitals' programs were found in 1996 to comply with regulations specified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), however, serious design and structural deficiencies were indicated at both facilities, resulting in JCAHO notification that they would not be re-accredited in 1999 unless a plan was developed to renovate the old facilities or construct new ones. During the 75th Texas Legislature, TDH requested appropriations to bring the facilities up to JCAHO standards, which resulted in appropriation Rider 44 which directed TDH to develop a long-range plan to determine the future of these two facilities. H.B. 3504 establishes a long-range plan for South Texas Hospital. Specifically, it requires TDH to contract for the construction of an initial facility in Harlingen, Texas, for outpatient health care services out of appropriated funds either at the hospital's original site, or colocated with the Regional Academic Health Center at a common site in Harlingen. This bill also addresses the transfer of services from the old facility to the new, contracts with public or private health care providers for services provided to the new facility, interim health care services, and issues affecting displaced state employees of South Texas Hospital. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. CONSTRUCTION OF NEW PHYSICAL FACILITY FOR OUTPATIENT HEALTH CARE SERVICES. (a) Requires the Texas Department of Health (TDH) to contract for the construction of an initial physical facility for outpatient health care services out of appropriated funds. (b) Provides that this facility must be located at the site of the South Texas Hospital or colocated with the initial site of the Regional Academic Health Center at a common site in Harlingen, Texas, and adjacent to the center. (c) Provides that the contract for this facility must specify that it be designed and constructed to provide for all outpatient health care services, including outpatient tuberculosis services, provided at the South Texas Hospital on the effective date of this Act. Authorizes the facility to be designed and constructed to allow for the provision of additional outpatient health care services. (d) Provides that if the facility is colocated with the Regional Academic Health Center, the contract must specify that, to the maximum extent possible, that facility and the Regional Academic Health Center must be designed and constructed together to save construction costs and long-term maintenance and operations costs by using common central utility plants, cafeterias, and laundry, maintenance, and other support facilities. Requires the board of regents of The University of Texas System (board) to cooperate with TDH to coordinate the structure and design of the physical facilities of the facility and the Regional Academic Health Center to achieve a maximally efficient use of resources. (e) Authorizes TDH to contract for the construction of additional physical facilities for outpatient health care services, including outpatient tuberculosis services, out of available funds. Authorizes one facility to be located in McAllen, Texas, and another in Brownsville, Texas. SECTION 2. OUTPATIENT HEALTH CARE SERVICES. (a) Requires the provision of all outpatient health care services provided by the South Texas Hospital on the effective date of this Act to be transferred to the initial facility in Harlingen, Texas upon its completion. (b) Authorizes TDH to contract with one or more public or private health care providers or entities for the management and operation of the facility and for provision of outpatient health care services at the facility. SECTION 3. INPATIENT HEALTH CARE AND RELATED LABORATORY SERVICES. (a) Requires TDH to contract with one or more public or private health care providers or entities, including a political subdivision that is located in the Rio Grande Valley region and is responsible for providing health care for its residents, for the provision of inpatient health care services, including inpatient tuberculosis services and related laboratory services provided by the South Texas Hospital on the effective date of this Act out of funds appropriated to TDH for that purpose. SECTION 4. INTERIM RENOVATION OF PHYSICAL FACILITIES OF THE SOUTH TEXAS HOSPITAL. Requires TDH, out of funds appropriated for that purpose, to contract for minimally necessary structural and design renovations to the physical facilities of the South Texas Hospital required for compliance with certain state and federal standards regarding accessibility for the disabled and for the continued operation of the hospital to provide services until construction of the initial facility in Harlingen, Texas, and the provision of those services is complete. SECTION 5. FUTURE OF THE SOUTH TEXAS HOSPITAL. Requires the board to give the Texas Department of Mental Health and Mental Retardation (MHMR) the first option to lease the current physical facilities of the South Texas Hospital on completion of the initial physical facility in Harlingen, Texas, for outpatient health care services and after contracting providers or entities under SECTION 3 of this Act have begun providing inpatient health care and related laboratory services. Requires the board to study and prepare leasing and other options for potential future uses of the facilities if MHMR does not lease the facilities. SECTION 6. CONTINUATION OF SUPPORT SERVICES. (a) Requires TDH and the Texas Department of Mental Health and Mental Retardation (MHMR) to enter into an interagency contract to provide for continuation of support services for the facility operated by MHMR that is colocated with the South Texas Hospital, if the initial facility required by Section 1 of this Act in Harlingen, Texas, is colocated with the Regional Academic Health Center. (b) Authorizes the contract to include a provision requiring TDH to continue providing employees for support facilities at the site. SECTION 7. DISPLACED EMPLOYEES OF SOUTH TEXAS HOSPITAL. (a) Requires TDH to reassign a member of the employee class of TDH who is employed at the South Texas Hospital and whose position is displaced as a result of the contract entered into by TDH under this Act or the transfer of services from the South Texas Hospital to an open position within TDH in reasonable proximity to the hospital and for which the member is qualified. Requires TDH to provide job placement assistance to a member of the employee class if reassignment within TDH is not possible. (b) Provides that a contract awarded by TDH under this Act must include a provision that the contracting entity is required to offer an employee of the South Texas Hospital whose position is displaced as a result of the contract a similar employment position with the entity before offering the position to any other person if the contracting entity determines that the displaced employee is qualified for the position. SECTION 8. TIME FRAME. Requires TDH to enter into the contracts required by this Act no later than September 1, 2000. SECTION 9. AMENDMENTS. (a) Amends Subchapter B, Chapter 814, Government Code, by adding Section 814.1043, as follows: Sec. 814.1043. TEMPORARY SERVICE RETIREMENT OPTION FOR MEMBERS EMPLOYED AT SOUTH TEXAS HOSPITAL. (a) Makes this section applicable to members of the employee class who are employed by TDH at the South Texas Hospital on or after the effective date of this section and on or before September 1, 2000, and who separate from state service at that time. (b) Makes an eliminated employee eligible to retire and receive a service retirement annuity if the member's age and service credit, each increased by three years, would meet age and service requirements for service retirement under Section 814.104(a) (Eligibility of Member for Service Retirement), Government Code, which states that a member who has service credit in the retirement system is eligible to retire and receive a service retirement annuity if the member is at least 60 years old and has 5 years of service credit in the employee class, or if the sum of the member's age and amount of service credit in the employee class, including months of age and credit, equals the number 80. Provides that the annuity of a person retiring under this section is computed based on the person's accrued service credit increased by three years. (c) Provides that an eliminated employee becomes eligible to retire and receive a service retirement annuity on the date on which the member would have met age and service requirements for service retirement under Section 814.104(a), Government Code, had the member remained employed by the state if, on the date of separation from state service, the member's age and service credit, each increased by five years, would meet age and service requirements for service retirement under that section. Provides that the annuity of a person retiring under this subsection is computed based on the person's accrued service credit. (d) Provides that if a member described by Subsection (c) is reemployed by the state before retirement, the time between the member's separation from state service and reemployment is authorized to be used only to compute eligibility for service retirement and is prohibited from being used to compute the amount of any service retirement annuity. (e) Requires a member applying to retire under this section and TDH to provide documentation required by the retirement system to establish eligibility to retire under this section. (b) Amends Section 13.003, Health and Safety Code, to provide that the purpose of the South Texas Hospital is to provide outpatient, in addition to inpatient, services, either directly or by contract with one or more private health care providers or entities, to the residents of the Lower Rio Grande Valley. Adds outpatient health care services, including diagnostic, treatment, disease management, and supportive care services to those services the board may establish at the hospital. SECTION 10. Provides that this Act takes effect only if a specific appropriation for the implementation of this Act is provided in H.B. 1 (General Appropriations Act), Acts of the 76th Legislature, Regular Session, 1999. SECTION 11.Emergency clause. Effective date: upon passage.