H.B. No. 2377
1-1 AN ACT
1-2 relating to the provision and administration of mental health and
1-3 mental retardation services.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 531.001, Health and Safety Code, is
1-6 amended by amending Subsections (a), (b), and (e) and adding
1-7 Subsection (h) to read as follows:
1-8 (a) It is the purpose of this subtitle to provide for the
1-9 effective administration and coordination of mental health and
1-10 mental retardation services at the state and local levels.
1-11 (b) Recognizing that a variety of alternatives for serving
1-12 the mentally disabled exists, it is the purpose of this subtitle to
1-13 ensure that <provide for> a continuum of services is provided. The
1-14 continuum of services includes facilities operated by the Texas
1-15 Department of Mental Health and Mental Retardation and community
1-16 services provided by the department and other entities through
1-17 contracts with the department.
1-18 (e) It is the public policy of this state that mental health
1-19 and mental retardation services be the responsibility of local
1-20 agencies and organizations to the greatest extent possible. The
1-21 department shall assist the local agencies and organizations by
1-22 coordinating the implementation of a statewide system of services.
1-23 The department shall ensure that <provide state-administered>
1-24 mental health and mental retardation services are provided. The
2-1 department shall <and> provide technical assistance for and
2-2 regulation of the programs that receive funding through contracts
2-3 with the department.
2-4 (h) It is the policy of this state that the board serves as
2-5 the state's mental health and mental retardation authority and is
2-6 responsible for the planning, policy development, and resource
2-7 development and allocation for and oversight of mental health and
2-8 mental retardation services in this state. It is the policy of
2-9 this state that, when appropriate and feasible, the board may
2-10 delegate the board's authority to a single entity in each region of
2-11 the state that may function as the local mental health or mental
2-12 retardation authority for one or more service areas in the region.
2-13 SECTION 2. Sections 531.002(8) and (9), Health and Safety
2-14 Code, are amended to read as follows:
2-15 (8) "Local mental health authority" means an entity to
2-16 which the board delegates its authority and responsibility within a
2-17 specified region for planning, policy development, coordination,
2-18 and resource development and allocation and for supervising and
2-19 ensuring the provision of mental health <a local service provider
2-20 selected by the department to plan, facilitate, coordinate, or
2-21 provide> services to persons with mental illness in one or more <a>
2-22 local service areas <area>.
2-23 (9) "Local mental retardation authority" means an
2-24 entity to which the board delegates its authority and
2-25 responsibility within a specified region for planning, policy
2-26 development, coordination, and resource development and allocation
2-27 and for supervising and ensuring the provision of mental
3-1 retardation <a local service provider selected by the department to
3-2 plan, facilitate, coordinate, or provide> services to persons with
3-3 mental retardation in one or more <a> local service areas <area>.
3-4 SECTION 3. Section 532.001(a), Health and Safety Code, is
3-5 amended to read as follows:
3-6 (a) The Texas Department of Mental Health and Mental
3-7 Retardation is composed of:
3-8 (1) the Texas Board of Mental Health and Mental
3-9 Retardation;
3-10 (2) the commissioner of mental health and mental
3-11 retardation; and
3-12 (3) <the medical director;>
3-13 <(4) the deputy commissioner for mental health
3-14 services;>
3-15 <(5) the deputy commissioner for mental retardation
3-16 services; and>
3-17 <(6)> a staff under the direction of the
3-18 commissioner<, medical director, and deputy commissioners>.
3-19 SECTION 4. Section 532.003(b), Health and Safety Code, is
3-20 amended to read as follows:
3-21 (b) The members must be representatives of the public who
3-22 have demonstrated interest in mental health, mental retardation,
3-23 developmental disabilities, or the health and human services
3-24 system.
3-25 SECTION 5. Sections 532.011(e) and (g), Health and Safety
3-26 Code, are amended to read as follows:
3-27 (e) The commissioner shall:
4-1 (1) establish qualifications for <assistant deputy
4-2 commissioners and important> department personnel that balance
4-3 clinical and programmatic knowledge and management experience; and
4-4 (2) standardize qualifications for personnel positions
4-5 throughout the department.
4-6 (g) The commissioner is responsible for implementation of
4-7 the board's planning, policy, resource development and allocation,
4-8 and oversight related to <the state> mental health <authority> and
4-9 <the state> mental retardation services <authority>.
4-10 SECTION 6. Sections 532.012(a) and (c), Health and Safety
4-11 Code, are amended to read as follows:
4-12 (a) The commissioner shall appoint a medical director<,
4-13 subject to board approval>.
4-14 (c) The medical director reports to the commissioner and is
4-15 responsible for:
4-16 (1) oversight of the quality and appropriateness of
4-17 clinical services <by developing policies relating to clinical
4-18 services regulated by the department and those services> delivered
4-19 in department facilities or under contract to the department; and
4-20 (2) leadership in <directing the standards and quality
4-21 assurance program, a utilization review program, a> physician
4-22 recruitment and retention <program,> and <a> peer review <program
4-23 for physicians and other clinical staff employed by or under
4-24 contract to the department>.
4-25 SECTION 7. Section 532.014(a), Health and Safety Code, is
4-26 amended to read as follows:
4-27 (a) The <With the board's approval, the> commissioner shall
5-1 appoint the head of each facility the department administers.
5-2 SECTION 8. Sections 533.035(a)-(c), Health and Safety Code,
5-3 are amended to read as follows:
5-4 (a) The commissioner shall designate a local mental health
5-5 authority and a local mental retardation authority in one or more
5-6 <each> local service areas. The board may delegate to the local
5-7 authorities the board's authority and responsibility for the
5-8 planning, policy development, coordination, resource allocation,
5-9 and resource development for and oversight of <area to plan,
5-10 facilitate, coordinate, and provide> mental health and mental
5-11 retardation services in that service area. The commissioner may
5-12 designate a single entity as the mental health authority and the
5-13 mental retardation authority for a service area.
5-14 (b) The department by contract or other method of allocation
5-15 may disburse to a local mental health and mental retardation
5-16 authority department federal <mental health funds> and department
5-17 state funds to be spent in the local service area for:
5-18 (1) community mental health and mental retardation
5-19 services; and
5-20 (2) chemical dependency services for persons who are
5-21 dually diagnosed as having both chemical dependency and mental
5-22 illness or mental retardation.
5-23 (c) A local mental health and mental retardation authority,
5-24 with the department's approval, shall use the funds received under
5-25 Subsection (b) to ensure <provide> mental health, mental
5-26 retardation, and chemical dependency services are provided in the
5-27 local service area. The local authority shall consider public
6-1 input, ultimate cost-benefit, and client care issues to ensure
6-2 consumer choice and the best use of public money in:
6-3 (1) assembling a network of service providers; and
6-4 (2) determining whether to become a provider of a
6-5 service or to contract that service to another organization <or to
6-6 subcontract for those services>.
6-7 SECTION 9. Subchapter B, Chapter 533, Health and Safety
6-8 Code, is amended by adding Section 533.0355 to read as follows:
6-9 Sec. 533.0355. AUTHORITY STRUCTURE PILOT PROJECT. (a)
6-10 Notwithstanding other law, the board may implement a pilot project
6-11 to study an authority structure for service delivery at the local
6-12 or regional level through a pilot local mental health or mental
6-13 retardation authority. The project shall provide an
6-14 organizational separation between the pilot local mental health or
6-15 mental retardation authority and service providers. The board may
6-16 delegate to a pilot local mental health or mental retardation
6-17 authority the responsibility for the distribution, allocation, and
6-18 coordination of mental health or mental retardation service
6-19 resources in one or more service areas, including the
6-20 responsibility to make policy determinations, develop resources,
6-21 enter service contracts, and plan to meet future needs for services
6-22 in each service area.
6-23 (b) The board may establish one or more pilot local mental
6-24 health and mental retardation authorities under this section.
6-25 (c) If the board establishes a pilot program, the department
6-26 shall:
6-27 (1) evaluate the pilot project at least annually to
7-1 determine the feasibility of employing the authority structure in
7-2 other areas of the state or statewide;
7-3 (2) prepare a report on the success of the pilot
7-4 project that includes a list of statutory restrictions that would
7-5 impair the permanent implementation of the authority structure in
7-6 other areas of the state and suggested legislative changes; and
7-7 (3) submit the report to the 75th and 76th
7-8 legislatures on January 15, 1997, and January 15, 1999,
7-9 respectively.
7-10 (d) This section expires September 1, 1999.
7-11 SECTION 10. Subchapter D, Chapter 533, Health and Safety
7-12 Code, is amended by adding Section 533.087 to read as follows:
7-13 Sec. 533.087. LEASE OF REAL PROPERTY. (a) The department
7-14 may lease real property, including any improvements under the
7-15 department's management and control, regardless of whether the
7-16 property is surplus property. Except as provided by Subsection
7-17 (c), the department may award a lease of real property only:
7-18 (1) at the prevailing market rate; and
7-19 (2) by competitive bid.
7-20 (b) The department shall advertise a proposal for lease at
7-21 least once a week for four consecutive weeks in:
7-22 (1) a newspaper published in the municipality in which
7-23 the property is located or the daily newspaper published nearest to
7-24 the property's location; and
7-25 (2) a newspaper of statewide circulation.
7-26 (c) The department may lease real property or an improvement
7-27 for less than the prevailing market rate, without advertisement or
8-1 without competitive bidding, if:
8-2 (1) the board determines that sufficient public
8-3 benefit will be derived from the lease; and
8-4 (2) the property is leased to:
8-5 (A) a federal or state agency;
8-6 (B) a unit of local government;
8-7 (C) a not-for-profit organization; or
8-8 (D) an entity related to the department by a
8-9 service contract.
8-10 (d) The board shall adopt leasing rules, forms, and
8-11 contracts that will protect the state's interests.
8-12 (e) The board may reject any bid.
8-13 (f) This section does not authorize the department to close
8-14 or consolidate a facility used to provide mental health or mental
8-15 retardation services without legislative approval.
8-16 SECTION 11. Section 534.022, Health and Safety Code, is
8-17 amended by adding Subsection (e) to read as follows:
8-18 (e) A county or municipality acting alone or two or more
8-19 counties or municipalities acting jointly pursuant to interlocal
8-20 contract may create a public facility corporation to act on behalf
8-21 of one or more community centers pursuant to the Public Facility
8-22 Corporation Act (Article 717s, Revised Statutes). Such counties or
8-23 municipalities may exercise the powers of a sponsor under that Act,
8-24 and any such corporation may exercise the powers of a corporation
8-25 under that Act (including but not limited to the power to issue
8-26 bonds). The corporation may exercise its powers on behalf of
8-27 community centers in such manner as may be prescribed by the
9-1 articles and bylaws of the corporation, provided that in no event
9-2 shall one community center ever be liable to pay the debts or
9-3 obligation or be liable for the acts, actions, or undertakings of
9-4 another community center.
9-5 SECTION 12. Sections 534.054(a) and (d), Health and Safety
9-6 Code, are amended to read as follows:
9-7 (a) The department shall identify and contract with a local
9-8 mental health or mental retardation authority for each service area
9-9 to ensure that <provide> services are provided to patient and
9-10 client populations determined by the department. A local mental
9-11 health or mental retardation authority shall ensure that <provide,
9-12 directly or by subcontract,> services to address the needs of
9-13 priority populations are provided as required by the department and
9-14 shall comply with the rules and standards adopted under Section
9-15 534.052.
9-16 (d) The department shall ensure that <provide> the required
9-17 services are provided in a service area directly through the
9-18 community services division of a department facility <outreach
9-19 program> or contract with another agency, entity <provider>, or
9-20 organization as the local mental health or mental retardation
9-21 authority if the department cannot identify and contract with a
9-22 community center in that service area.
9-23 SECTION 13. Sections 534.055(d) and (e), Health and Safety
9-24 Code, are amended to read as follows:
9-25 (d) The department shall design a competitive procurement or
9-26 similar system that a mental health or mental retardation authority
9-27 shall use in awarding an initial contract under this section. <To
10-1 facilitate continuity of services and to prevent disruption of
10-2 services, a mental health or mental retardation authority may not
10-3 require competitive bidding on the renewal of a contract.>
10-4 (e) The system must require that each mental health or
10-5 mental retardation authority:
10-6 (1) ensure public participation in the authority's
10-7 decisions regarding whether to provide or to contract for a
10-8 service;
10-9 (2) make a reasonable effort to give notice of the
10-10 intent to contract for services to each potential private provider
10-11 in the local service area of the authority; and
10-12 (3) <(2)> review each submitted proposal and award the
10-13 contract to the applicant that the authority determines has made
10-14 the lowest and best bid to provide the needed services.
10-15 SECTION 14. Section 534.064, Health and Safety Code, is
10-16 amended to read as follows:
10-17 Sec. 534.064. Contract Renewal. The commissioner may refuse
10-18 to renew a contract with a local mental health or mental
10-19 retardation authority and may select other agencies, entities
10-20 <providers>, or organizations to be the local mental health or
10-21 mental retardation authority if the department's evaluation of the
10-22 authority's performance indicates that the authority cannot ensure
10-23 the availability of the specific services to priority populations
10-24 required by the department and this subtitle.
10-25 SECTION 15. Section 534.065(b), Health and Safety Code, is
10-26 amended to read as follows:
10-27 (b) The mental health or mental retardation authority shall
11-1 renew the contract if the authority finds that:
11-2 (1) funding is available;
11-3 (2) the authority plans to continue the services;
11-4 (3) the provider is in substantial compliance with
11-5 each material provision of the contract, unless the authority
11-6 determines that the provision is not legal and enforceable under
11-7 applicable state and federal law;
11-8 (4) the provider is providing a reasonably adequate
11-9 level of service in accordance with the contract and at a
11-10 reasonable cost;
11-11 (5) the provider agrees to a renewal contract that is
11-12 substantially in compliance with a model contract developed by the
11-13 department under Section 534.055;
11-14 (6) the provider was during the term of any contract
11-15 with the authority and is at the time of renewal in compliance with
11-16 applicable laws governing the subject matter of the contract; and
11-17 (7) neither the provider nor any of its officers,
11-18 directors, or principal employees has been convicted or found by a
11-19 final administrative decision to have been guilty of fraud or abuse
11-20 in the provision of health care services under a contract with a
11-21 state or federal agency.
11-22 SECTION 16. Section 534.066(b), Health and Safety Code, is
11-23 amended to read as follows:
11-24 (b) The department shall establish, for community services
11-25 divisions of department facilities <facility outreach programs>
11-26 that provide community-based services required under this
11-27 subchapter, a local match requirement that is consistent with the
12-1 requirements applied to other local mental health or mental
12-2 retardation authorities.
12-3 SECTION 17. Sections 551.022(c) and (d), Health and Safety
12-4 Code, are amended to read as follows:
12-5 (c) The superintendent shall:
12-6 (1) oversee the admission and discharge of <admit and
12-7 discharge> patients and clients;
12-8 (2) keep a register of all patients and clients
12-9 admitted to or discharged from the facility;
12-10 (3) supervise repairs and improvements to the
12-11 facility;
12-12 (4) ensure that facility money <entrusted to the
12-13 superintendent> is spent judiciously and economically;
12-14 (5) keep an accurate and detailed account of all money
12-15 received and spent, stating the source of the money and to whom and
12-16 the purpose for which the money is spent; and
12-17 (6) keep a full record of the facility's operations.
12-18 (d) In accordance with board rules and departmental
12-19 operating procedures, the <The> superintendent may:
12-20 (1) establish policy <rules> to govern the facility
12-21 that the superintendent considers will best promote the patients'
12-22 and clients' interest and welfare;
12-23 (2) appoint subordinate officers, teachers,
12-24 <attendants,> and other employees and set their salaries, in the
12-25 absence of other law; and
12-26 (3) remove an officer, teacher, or employee for good
12-27 cause <and with the board's consent>.
13-1 SECTION 18. Sections 532.013, 533.064, 534.062, 551.021, and
13-2 551.023, Health and Safety Code, are repealed.
13-3 SECTION 19. (a) The changes in law made by this Act apply
13-4 only to an action taken by the Texas Board of Mental Health and
13-5 Mental Retardation, the Texas Department of Mental Health and
13-6 Mental Retardation, or the commissioner of mental health and mental
13-7 retardation or to an appointment made by the governor on or after
13-8 September 1, 1995.
13-9 (b) An action taken or appointment made before September 1,
13-10 1995, is governed by the law in effect when the action was taken
13-11 or appointment was made, and that law is continued in effect for
13-12 that purpose.
13-13 (c) The change in law made by this Act in the qualifications
13-14 of members of the Texas Board of Mental Health and Mental
13-15 Retardation does not affect the entitlement of a member of that
13-16 board who was appointed before September 1, 1995, to continue to
13-17 hold office for the term to which the member was appointed. The
13-18 change in qualifications applies only to a member appointed on or
13-19 after September 1, 1995.
13-20 SECTION 20. Nothing in this Act authorizes the department to
13-21 privatize the administration of state facilities.
13-22 SECTION 21. This Act takes effect September 1, 1995.
13-23 SECTION 22. The importance of this legislation and the
13-24 crowded condition of the calendars in both houses create an
13-25 emergency and an imperative public necessity that the
13-26 constitutional rule requiring bills to be read on three several
13-27 days in each house be suspended, and this rule is hereby suspended.