BILL ANALYSIS
S.B. 1675
By: Zaffirini, et al. (Berlanga, et al.)
05-18-95
Committee Report (Substituted)
BACKGROUND
In June 1994, in his interim charge to the Senate Committee on
Health and Human Services, Lt. Governor Bob Bullock directed the
committee to "review compliance with the requirements of House Bill
7, 72nd Legislature, First Called Session, 1991, and subsequent
amendments thereto." This legislation is, in part, a result of the
recommendations contained in the report, The Texas Health and Human
Services Commission: Compliance with HB 7. Additionally, this
legislation is based in part on the recommendations of Comptroller
John Sharp in Gaining Ground, the November 1994 report from the
Texas Performance Review. This legislation is also based on
recommendations by the newly appointed Health and Human Services
Commissioner at the request of the Senate Committee on Health and
Human Services in its report referenced above.
PURPOSE
S.B. 1675 would expand the oversight duties of the Health and Human
Services Commission regarding operating budgets of health and human
services agencies, federal funds, automated systems, coordination
of caseload estimates, and the integration of health and human
services to provide for the efficient and timely delivery of those
services.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill expressly grants
additional rulemaking authority to the Health and Human Services
Commissioner under SECTION 6 (Sec. 14A, Article 4413(502), Revised
Statutes) and SECTION 8 (Sec. 24, Article 4413(502), Revised
Statutes).
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 10, Article 4413(502), Revised Statutes,
by amending Subsection (d), and adding Subsection (e), as follows:
(d) Amends subsection to require the Health and Human Services
Commission (commission) to review and comment on the strategic
plans and biennial updates that are required of health and
human services agencies under this subsection.
(e) Requires the commission, not later than January 1 of each
even-numbered year, to begin formal discussions with each
health and human services agency regarding that agency's
strategic plan or biennial update.
SECTION 2. Adds Section 12(b), Article 4413(502), Revised Statutes,
to require the commission to develop and implement routine and
ongoing mechanisms in accessible formats for specified purposes.
Remaining subsections are relettered to reflect the addition.
SECTION 3. Adds Section 13(d), Article 4413(502), Revised Statutes,
stating that a health and human services agency may not submit to
the legislature or the governor its legislative appropriations
request until the commission reviews and comments on the
legislative appropriations request.
SECTION 4. Adds Sections 13A-13D to Article 4413(502), Revised
Statutes, as follows:
Sec. 13A. HEALTH AND HUMAN SERVICES AGENCIES OPERATING
BUDGETS. (a) States that in addition to the provisions of the
General Appropriations Act, the commission shall review and
comment on the annual operating budget of each health and
human services agency and the transfer of funds between budget
strategies made by each health and human services agency prior
to the transfer of the funds.
(b) Requires the commission to issue quarterly reports
regarding the projected expenditures by budget strategy of
each health and human services agency compared to each
agency's operating budget.
Sec. 13B. FEDERAL FUNDS. States that notwithstanding any
other state law and to the extent permitted by federal law,
the commission may review and comment on an operational or
funding plan or a modification to that plan prepared by a
health and human services agency designated as the single
state agency to administer federal funds.
Sec. 13C. AUTOMATED SYSTEMS. Prohibits a health and human
services agency from submitting its plans to the Department of
Information Resources under Chapter 2054E, Government Code,
until those plans are approved by the commission.
Sec. 13D. COORDINATION AND APPROVAL OF CASELOAD ESTIMATES.
(a) Requires the commission to coordinate and approve caseload
estimates made for programs administered by health and human
services agencies.
(b) Requires the commission to take specific measures to
implement this section, including adopting specified uniform
guidelines, assembling a single set of specified data, and
seeking the advise of specified entities.
(c) Requires the commission to assemble caseload estimates
made by health and human services agencies into a coherent,
uniform report, and to update the report quarterly, with
assistance from those agencies. Requires the commission to
publish the report and make it readily available to state and
local agencies and interested private organizations.
(d) Requires the commission to explain in the report the
caseload estimates using monthly averages, annual unduplicated
recipients, annual service usage, and other commonly used
measures.
(e) Requires the commission to attach a copy of the report to
the consolidated budget recommendation submitted to the
Legislative Budget Board (LBB) under Section 13 of this
article, and to submit the report to the legislature when it
convenes in regular session.
SECTION 5. Amends Section 14, Article 4413(502), Revised Statutes,
by amending Subsection (a) and adding Subsection (d), as follows:
(a) Amends Subdivision (1) to require the commissioner to
render "the" final decision on interagency disputes, instead
of "a" final decision. Amends Subdivision (10) to require the
commissioner to review and comment on health and human
services agency formulas for the distribution of funds to
ensure that the formulas, to the extent permitted by federal
law, consider such need factors as client base, population,
and economic and geographic factors within the regions of the
state. Deletes language requiring the commissioner to "develop
a formula for distribution of funds that considers" the same
specified need factors.
(d) Requires the commissioner, not later than the end of the
first month of each fiscal year, to submit to the governor,
lieutenant governor, speaker of the house of representatives,
comptroller, and the LBB a work plan outlining the activities
of the commission for that fiscal year. Requires the work plan
to establish priorities for the commission's activities based
on available resources.
SECTION 6. Adds Sec. 14A to Article 4413(502), Revised Statutes, as
follows:
Sec. 14A. DELIVERY OF SERVICES. To integrate and streamline
service delivery and facilitate access to services, allows the
commissioner to request a health and human services agency to
take a specific action and to recommend the manner in which
the streamlining is to be accomplished, including requesting
that each health and human services agency undertake specified
tasks and other necessary actions.
SECTION 7. Adds Sec. 23 to Article 4413(502), Revised Statutes, as
follows:
Sec. 23. 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 8. Adds Sec. 24 to Article 4413(502), Revised Statutes, as
follows:
Sec. 24. REPORTS ON DELIVERY OF SERVICES. (a) Requires each
head of a health and human service agency to report quarterly
to the governing board of that agency on that agency's efforts
to streamline and simplify the delivery of services. Requires
the agency to submit a copy of the report to the commission.
(b) Requires the commission to prepare and deliver a
semiannual report to the governor, lieutenant governor,
speaker of the house of representatives, comptroller, the
LBB, and appropriate legislative committees on the efforts
of the health and human services agencies to streamline the
delivery of services provided by those agencies.
(c) Requires the commissioner to adopt rules relating to the
reports required by Subsection (a) of this section.
Requires each agency to follow the rules adopted by the
commissioner under this section.
SECTION 9. Amends Section 3.08, Chapter 15, Acts of the 72nd
Legislature, 1st Called Session, 1991 (Article 4413(505), Vernon's
Texas Civil Statutes), as follows:
Sec. 3.08. New heading: LOCATION OF OFFICES AND FACILITIES.
(a) Requires the commission, as leases on office space expire,
to determine the needs for space and the location of health
and human services agency offices to enable the commission to
achieve a cost-effective one-stop or service center method of
health and human service delivery. Deletes existing
Subsection (a) regarding review of office arrangements.
(b) Redesignates existing Subsection (c). Deletes existing
Subsection (b) regarding co-location of certain offices.
SECTION 10. Amends Section 6.031(a), State Purchasing and General
Services Act (Article 601b, V.T.C.S.), to prohibit the commission,
notwithstanding any other provision of this article, from leasing
office space to service the needs of any health and human services
agency, unless the commission has approved the office space for the
agency. The language allowing the agency to provide the commission
with a reason for not sharing the office space with one or more
other health and human services agencies is deleted.
SECTION 11. (a) Requires the commission to expand its existing
integrated eligibility pilot programs to include the Harris County
Hospital District and the University of Texas Medical Branch at
Galveston.
(b) Sets forth requirements for a contract with the Harris
County Hospital District or the University of Texas Medical
Branch at Galveston.
(c) Requires the Texas Department of Human Services
(department), subject to commission approval, to establish
standards for other automated systems to allow other entities
to file information directly.
(d) Requires the commission to study the feasibility of
enabling contractors or agencies other than the department to
provide or assist in the provision of client eligibility
studies, determinations, and certifications. Requires the
commission to make certain considerations in determining
feasibility.
SECTION 12. (a) Requires the commission, not later than September
1, 1996, subject to the availability of certain funds, to have
completed the development and substantial implementation of a plan
for an integrated eligibility determination and service delivery
system (system) for health and human services at the local and
regional levels. Requires the plan to specify the dates by which
all elements of the plan must be implemented.
(b) Requires the system to be developed and implemented to
achieve at least a one percent savings in the cost of
providing administrative and other services and staff
resulting from streamlining and eliminating duplication of
services. Requires the commission to use the resulting savings
to further develop the system and provide other health and
human services.
(c) Requires the commission to examine cost-effective methods
to address fraud in the assistance programs and the error rate
in eligibility determination.
(d) Requires the commission to make and implement
recommendations on services or functions of the system that
could be provided more effectively through the use of
competitive bidding or contracting with local governments and
other appropriate entities. Authorizes the commission, if it
determines that private contracting may be effective, to
automate the determination of client eligibility by
contracting with a private firm to conduct application
processing.
(e) Requires the commission, not later than October 1, 1996,
to develop a plan to consolidate administrative and service
delivery functions in order to minimize duplication. Requires
the commission to prepare a report of the plan for submission
to the governor, lieutenant governor, speaker of the house of
representatives, comptroller, and 75th Legislature, when it
convenes.
SECTION 13. (a) Requires the commission, not later than September
1, 1997, to develop an integrated approach to the health and human
service delivery system that includes a cost-effective one-stop or
service center method of delivery to a client. Requires the
commission to determine the feasibility of using appropriate
locations to achieve this integrated approach.
(b) Requires the health and human services agencies to
cooperate with the commission in developing the system.
(c) Provides that this section expires September 1, 1997.
SECTION 14. Provides that the changes in law made by this Act apply
with appropriations made for the fiscal year beginning September 1,
1995.
SECTION 15. Effective date: September 1, 1995.
SECTION 16. Emergency clause.
COMPARISON OF ORIGINAL TO SUBSTITUTE
The substitute generally relaxes requirements proposed in the
engrossed version in regard to commission approval of specified
actions of health and human services agencies. In several
instances, the substitute offers permissive language and replaces
requirements for commission approval with a stipulation that the
commission review and comment on certain agency activities.
More specifically, significant differences between the engrossed
version of the bill and the substitute include the following:
Section 1 of the substitute requires the commission to review
and comment on agency strategic plans; the engrossed version
requires commission approval.
Section 2 of the substitute deletes the requirement that
commission report to the public on the input received and
actions taken in response.
In Section 3, the substitute deletes language establishing
the commission's comprehensive budget and planning authority
over the agencies. The substitute requires comment and review
by the commission before a health and human services agency
can submit its legislative appropriations request (LAR) to the
legislature or the governor; the engrossed version would
require commission approval prior to submission of agency
LARs.
The substitute, in Section 4, requires the commission to
comment and review on annual operating budgets of the affected
agencies and of agency transfers of funds between budget
strategies. The engrossed version would require commission
approval. The substitute also allows commission review and
comment of operational or funding plans or modifications to
those plans for specified agencies administering federal
funds, instead of stipulating that these plans and their
modifications are subject to commission approval.
Also in Section 4, the substitute deletes a provision in the
engrossed version allowing the commissioner to transfer funds
between the health and human services agencies, subject to
provisions of the General Appropriations Act, and requiring
the commission to report to the governor's budget office, the
LBB, and the comptroller regarding any transfer of funds under
the section.
In Section 7 of the bill, the substitute changes "required"
to "requested" in the following provision: "To the extent
requested by the commission, a health and human services
agency shall assign existing staff to perform a function under
this article."
SUMMARY OF COMMITTEE ACTION
S.B. 1675 was considered in a formal meeting by the Public Health
Committee on May 18, 1995. The committee considered a complete
substitute for the bill. The substitute was adopted without
objection. The bill was reported favorably as substituted, with the
recommendation that it do pass and be printed, by the record vote
of 7 AYES, 0 NAYS, 0 PNV, and 2 ABSENT.