BILL ANALYSIS
S.B. 1675
By: Zaffirini
Health and Human Services
4-27-95
Committee Report (Unamended)
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
As proposed, S.B. 1675 expands the powers and duties of the Health
and Human Services Commission regarding operating budgets of health
and human services agencies, federal funds, automated systems,
interagency fund transfers, coordination and approval 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 rulemaking authority is granted
to the Health and Human Services Commission under SECTION 3
(Section 13A(b), Article 4413(502), V.T.C.S.) and the commissioner
of health and human services under SECTION 7 (Section 24(c),
Article 4413(502), V.T.C.S.) of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 10, Article 4413(502), V.T.C.S., by
amending Subsection (d), and adding Subsection (e), as follows:
(d) Subjects to Health and Human Services Commission
(commission) approval 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. Amends Section 13, Article 4413(502), V.T.C.S., as
follows:
(a) Grants the commission comprehensive budget and planning
authority for health and human services agencies in order to
establish an integrated eligibility determination and service
delivery system.
(b) Created from existing text.
(c)-(d) Redesignate existing Subsections (b)-(c).
(e) Prohibits a health and human services agency from
submitting to the legislature or the governor its legislative
appropriations request until the legislative appropriations
request is approved by the commission.
SECTION 3. Amends Article 4413(502), V.T.C.S., by adding Sections
13A-13E, as follows:
Sec. 13A. HEALTH AND HUMAN SERVICES AGENCIES OPERATING
BUDGETS. (a) Requires each health and human service agency
subject to this Act to obtain commission approval of its
annual operating budget prior to adoption of such budget and
of the transfer of funds between budget strategies prior to
the transfer of such funds; report quarterly to the commission
information regarding the agency's projected expenditures by
budget strategy, compared to the agency's operating budget
approved by the commission; and obtain commission approval for
any adjustment to the agency's operating budget.
(b) Requires the commission to adopt rules to implement this
section.
Sec. 13B. FEDERAL FUNDS. (a) Subjects to commission approval
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.
(b) Requires the commission to evaluate the feasibility of
designating the commission as the single state agency for
federal funds received for a health and human services
purpose.
(c) Authorizes the commission to consolidate federal funds
to be given to local communities for the provision of health
and human services.
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. INTERAGENCY TRANSFERS. (a) Authorizes the
commissioner of health and human services (commissioner) to
transfer funds between the health and human services agencies
according to the provisions of the General Appropriations Act.
(b) Requires the commission to report to the governor's
budget office, the Legislative Budget Board (LBB), and the
comptroller regarding any transfer of funds the commissioner
makes under this section.
Sec. 13E. 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.
(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
LBB under Section 13 of this article, and to submit the
report to the legislature when it convenes in regular
session.
SECTION 4. Amends Section 14, Article 4413(502), V.T.C.S., by
amending Subsection (a), and adding Subsection (d), as follows:
(a) Requires the commissioner to render the final decision on
interagency disputes and review health and human services
agency formulas for the distribution of funds to ensure that
the formulas, to the extent permitted by federal law, consider
certain 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 5. Amends Article 4413(502), V.T.C.S., by adding Section
14A, as follows:
Sec. 14A. DELIVERY OF SERVICES. (a) Requires each health and
human services agency to streamline the manner in which
services are delivered by that agency in accordance with this
section.
(b) Authorizes the commissioner to require a health and
human services agency to take a specific action and direct
the manner in which the streamlining is to be accomplished.
SECTION 6. Amends Article 4413(502), V.T.C.S., by adding Section
23, as follows:
Sec. 23. USE OF AGENCY STAFF. Requires a health and human
services agency, to the extent required by the commission, to
assign existing staff to perform a function under this
article.
SECTION 7. Amends Article 4413(502), V.T.C.S., by adding Section
24, 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 as
required by Section 14A of this article. 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 8. Amends Section 3.08, Article 4413(505), V.T.C.S., 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 9. Amends Section 6.031(a), Article 601b, V.T.C.S. (State
Purchasing and General Services Act), 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.
SECTION 10. (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 11. (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 12. (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 13. Provides that the changes in law made by this Act
apply with appropriations made for the fiscal year beginning
September 1, 1995.
SECTION 14. Effective date: September 1, 1995.
SECTION 15. Emergency clause.