BILL ANALYSIS


                                                         H.B. 869
                                              By: Maxey (Sponsor)
                                        Health and Human Services
                                                          5-11-95
                                Senate Committee Report (Amended)
BACKGROUND

In 1991, Texas lawmakers adopted a "systems approach" to integrated
health and human services delivery.  Three pilot projects were
authorized in different sized locales of the state to demonstrate
and evaluate the effects of integrated service delivery through
streamlined client processing and improved client access to "one-stop shopping" centers.

For the "one-stop shopping" concept to succeed, health and human
services staff at all levels must be involved in the development of
priorities and plans designed to meet the health and human services
delivery needs of each community.

PURPOSE

As proposed, H.B. 869 requires the commissioner of health and human
services to consider priorities and plans submitted by governmental
entities that coordinate the delivery of health and human services
in different regions, counties, and cities as part of the strategic
planning process.  H.B. 869 also requires the commissioner to
assist local governmental entities in implementing coordinated
plans tailored to the needs of the entities.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is granted
to the Texas Department of Mental Health and Mental Retardation and
the Texas Department of Human Services under SECTION 4 (Section
533.044(a), Health and Safety Code) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 10, Article 4413(502), V.T.C.S., by
amending Subsection (c), and adding Subsection (e), as follows:

     (c) Requires the commissioner of health and human services
     (commissioner), in developing a strategic health and human
     services plan and plan updates under this section, to
     consider, among other factors, the health and human services
     priorities and plans submitted to the commissioner by
     governmental entities under Subsection (e) of this section.
     
     (e) Requires the commissioner to identify governmental
     entities that coordinate the delivery of health and human
     services in different regions, counties, and municipalities in
     the state, and to request that each of these entities identify
     the health and human services priorities in the entity's
     jurisdiction and the most effective ways to deliver and
     coordinate services in that jurisdiction; develop a
     coordinated plan for the delivery of services; and make the
     information described by Subdivisions (1) and (2) available to
     the Health and Human Services Commission (commission).
     
     SECTION 2.     Amends Section 14(a), Article 4413(502), V.T.C.S., to
require the commissioner to arbitrate and render the final decision
in interagency disputes; at the request of a governmental entity
identified under Section 10(e) of this article, among other
requirements, to assist the entity in implementing a coordinated
plan tailored to the needs and priorities of that entity; and to
develop with the Department of Information Resources automation
standards for computer systems to enable health and human services
agencies, including agencies operating on a local level, to share
pertinent data.

SECTION 3. Amends Article 4413(502), V.T.C.S., by adding Section
10A, as follows:

     Sec. 10A.  USE OF AGENCY STAFF.  Requires a health and human
     services agency, to the extent requested by the commission, to
     assign existing staff to perform a function under this
     article.
     
     SECTION 4.     Amends Section 533.044(a), Health and Safety Code, to
require the Texas Department of Mental Health and Mental
Retardation (MHMR) and the Texas Department of Human Services
(DHS), by rule, to adopt a joint memorandum of understanding that
requires the use of a uniform assessment tool to assess whether an
elderly person, a person with mental retardation, a person with a
developmental disability, or a person who is suspected of being a
person with mental retardation or a developmental disability and
who is receiving services in a facility regulated or operated by
MHMR or DHS needs a guardian of the person or estate, or both.

SECTION 5. COORDINATION OF EARLY CHILDHOOD PROGRAMS.  (a) Requires
the commissioner, in collaboration with certain agencies, to
coordinate the program services, eligibility requirements, funding,
enrollment periods, fees, and administrative functions of the child
care programs of DHS and the prekindergarten programs of the
Central Education Agency no later than December 1, 1996.

     (b) Requires the commissioner to report the results of the
     initiative prescribed by this provision to the legislature on
     or before December 1, 1996.
     
     (c) Declares that nothing in this section shall be construed
     to transfer funding for or the administration of childcare or
     prekindergarten programs to the commission.
SECTION 6. Emergency clause.
           Effective date: upon passage.