BILL ANALYSIS
C.S.S.B. 192
By: Henderson (Uher)
02-14-95
Committee Report (Substituted)
BACKGROUND
The M.D. Anderson Cancer Center (MDA) was statutorily created in
1941 to specialize in the research, treatment, and prevention of
cancer and related diseases. Since that time, it has become
internationally recognized for its work in these areas. However,
a recent shift in the health care marketplace has had an adverse
economic impact on state-operated, specialty hospitals. Total
revenues at MDA dropped 10 percent during the last fiscal year and
are dropping at the same rate this year.
Consultants hired by M.D. Anderson have made a number of
recommendations for its future, including both internal measures,
such as employment entrenchment, and external measures, such as
reducing state regulations that apply to MDA and not to private-sector counterparts.
PURPOSE
As proposed, C.S.S.B. 192 sets forth more flexible regulations and
responsibilities and increases internal programs of the University
of Texas M.D. Anderson Cancer Center concerning indigent patient
treatment, financial responsibilities, incentive retirement plans,
and freer methods for acquiring goods and services.
RULEMAKING AUTHORITY
It is the committee's opinion that rulemaking authority is granted
to the president of the University of Texas M.D. Anderson Cancer
Center in Section 4 (Section 73.115(d), Education Code) of this
bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 73.106, Education Code, as follows:
Sec. 73.106. PATIENTS. Requires this subchapter to govern the
admission of patients to the institution and its substations,
the support of patients, and other matters relating to patients, without exception.
SECTION 2. Amends Section 73.108(c), Education Code, to authorize,
rather than require, the application to be accompanied by a written
request for the patient's admission by the patient's attending
physician.
SECTION 3. Amends Chapter 73C, Education Code, By adding Sections
73.112-73.115, as follows:
Sec. 73.112. TREATMENT OF INDIGENT PATIENTS.
(a) Authorizes the institution to enter into a contract with
a county, public hospital, or a hospital district to provide
treatment to residents who are eligible for health care
assistance.
(b) Prohibits the liability of a county, public hospital, or
a hospital district from exceeding the responsibility of a
county as provided for in Chapter 61, Health and Safety Code,
unless contractually agreed to by the county, public hospital,
or hospital district.
(c) When entering into a contract pursuant to this section,
this provision requires the liability of a county, public
hospital or hospital district to
take into consideration the actual
costs of the institution.
(d) In the absence of a contract, this provision requires the
institution to receive approval of a county, public hospital
or hospital district before providing nonemergency health care
services to an eligible resident of the county or service
area. Without such approval, the county, public hospital or
hospital district is not liable to the institution.
(e) Clarifies the definitions of terms used in this section.
Sec. 73.113. SUFFICIENCY OF INSTITUTIONAL FUNDS, FEES, AND
PATIENT BASE.
Requires the institution to ensure that its institutional
funds, hospital and clinic fees, and patient base are
sufficient to fund and achieve the mission of the institution
and protect the state's investment in the institution.
Sec. 73.114. INCENTIVE RETIREMENT PLANS.
(a) Authorizes the institution to offer incentive retirement
plans to employees.
(b) Requires incentives to be paid from institutional funds or
hospital or clinic fees.
(c) Requires any institutional plan for incentive retirement
to be filed with the Legislative Budget Board not later than the
61st day before the plan is
implemented.
(d) Prohibits employees receiving retirement incentives from
being rehired unless specifically approved by the president of
the institution.
Sec. 73.115. ACQUISITION OF GOODS AND SERVICES.
(a) Authorizes the institution to acquire goods or services by
any method that provides the best value to them.
(b) Sets forth factors the institution is required to consider
in selecting a vendor.
(c) Authorizes the state auditor to audit purchases of goods
or services of the institution.
(d) Authorizes the institution to adopt necessary or desirable
rules and procedures for the acquisition of goods and services.
(e) Provides that under conflict, this section prevails over
any other law.
SECTION 4. Amends Chapter 552B, Health and Safety Code, by adding
Section 552.020, as follows:
Sec. 552.020. APPLICATION. Provides that this subchapter
does not apply to the institution, with an exception.
SECTION 5. Provides that this Act takes effect immediately, with
the exception of Section 1 and 4 and Section 73.112, Education
Code, which take effect September 1, 1995.
SECTION 6. Emergency clause.
COMPARISON OF ORIGINAL TO SUBSTITUTE
The primary differences between the original and substitute bills
relate to the treatment of indigent patients as outlined in Section
3 of the bills. The original version allows M.D. Anderson to enter
into a contract with a county or a hospital district to provide
treatment to eligible residents in those areas. The committee
substitute expands the possibility for such contracts to include
public hospitals. The substitute also adds three other provisions
addressing indigent treatment. Two of the provisions clarify the
liability of a county, public hospital, or hospital district to
M.D. Anderson if the latter provides health care services to
eligible residents. The third provision clarifies definitions used
in the section.
The substitute also stipulates that M.D. Anderson must adhere to
laws governing the purchasing of goods and services as related to
contracting with historically underutilized businesses. The
original bill gives prevalence to the purchasing and contracting
provisions outlined in S.B. 192 if a conflict arises with any other
law. The substitute adds the exception for historically
underutilized businesses.
SUMMARY OF COMMITTEE ACTION
S.B. 192 was considered in a public hearing on February 14, 1995.
Testifying for the bill were Leonard Spearman Jr., representing
Harris County Judge Robert A. Eckels. No one testified against the
bill. Other witnesses testifying on the bill were William H.
Cunningham, representing the U.T. System, Charles A. LeMaistre,
representing the University of Texas M.D. Anderson Cancer Center,
and Jim Allison, representing the County Judges and Commissioners
Association of Texas. A motion that the committee substitute S.B.
192 be reported to the House with the recommendation that it do
pass was approved with 7 Ayes, 0 Nays, 0 PNV, and 2 Absent.