By Delisi, Berlanga                                   H.B. No. 2377
       74R2341 JJT-D
                                 A BILL TO BE ENTITLED
    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 or under
   1-15  contract with the Texas Department of Mental Health and Mental
   1-16  Retardation and community services provided by the department and
   1-17  other entities through 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 the planning, policy development,
   2-18  coordination, resource allocation, and resource development for and
   2-19  oversight of mental health <a local service provider selected by
   2-20  the department to plan, facilitate, coordinate, or provide>
   2-21  services to persons with mental illness in one or more <a> local
   2-22  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 the planning, policy
   2-26  development, coordination, resource allocation, and resource
   2-27  development for and oversight of mental health <a local service
    3-1  provider selected by the department to plan, facilitate,
    3-2  coordinate, or provide> services to persons with mental retardation
    3-3  in one or more <a> local service areas <area>.
    3-4        SECTION 3.  Sections 532.003(b) and (c), Health and Safety
    3-5  Code, are amended to read as follows:
    3-6        (b)  The members must be representatives of the public who
    3-7  have demonstrated interest in mental health, mental retardation,
    3-8  developmental disabilities, or the health and human services
    3-9  system.
   3-10        (c)  Appointments to the board shall be made without regard
   3-11  to the race, color, handicap, sex, religion, age, or national
   3-12  origin of the appointees, except at least one board member must be
   3-13  or have been a primary consumer of mental health or mental
   3-14  retardation services.
   3-15        SECTION 4.  Section 532.011(g), Health and Safety Code, is
   3-16  amended to read as follows:
   3-17        (g)  The commissioner is responsible for implementation of
   3-18  the board's planning, policy, resource development and allocation,
   3-19  and oversight related to <the state> mental health <authority> and
   3-20  <the state> mental retardation services <authority>.
   3-21        SECTION 5.  Section 532.012(a), Health and Safety Code, is
   3-22  amended to read as follows:
   3-23        (a)  The commissioner shall appoint a medical director<,
   3-24  subject to board approval>.
   3-25        SECTION 6.  Section 532.013(a), Health and Safety Code, is
   3-26  amended to read as follows:
   3-27        (a)  The commissioner shall appoint a deputy commissioner for
    4-1  mental health services and a deputy commissioner for mental
    4-2  retardation services<, subject to board approval>.
    4-3        SECTION 7.  Section 532.014(a), Health and Safety Code, is
    4-4  amended to read as follows:
    4-5        (a)  The <With the board's approval, the> commissioner shall
    4-6  appoint the head of each facility the department administers.
    4-7        SECTION 8.  Sections 533.014(a) and (d), Health and Safety
    4-8  Code, are amended to read as follows:
    4-9        (a)  The board shall adopt rules that:
   4-10              (1)  relate to the designation of <local mental health
   4-11  authorities as> single portal authorities;
   4-12              (2)  govern commitments to a single portal authority;
   4-13              (3)  govern transfers of patients that involve a single
   4-14  portal authority; and
   4-15              (4)  provide for emergency admission to a department
   4-16  mental health facility if obtaining approval from the authority
   4-17  could result in a delay that might endanger the patient or others.
   4-18        (d)  If the board designates a <local mental health authority
   4-19  as a> single portal authority, the department shall notify each
   4-20  judge who has probate jurisdiction in the service area and any
   4-21  other person the single portal authority considers necessary of the
   4-22  designation and the new procedures required in the area.
   4-23        SECTION 9.  Section 533.035(a), Health and Safety Code, is
   4-24  amended to read as follows:
   4-25        (a)  The commissioner shall designate a local mental health
   4-26  authority and a local mental retardation authority in each local
   4-27  service area.  The board may delegate to the local authorities the
    5-1  board's authority and responsibility for the planning, policy
    5-2  development, coordination, resource allocation, and resource
    5-3  development for and oversight of <to plan, facilitate, coordinate,
    5-4  and provide> mental health and mental retardation services in that
    5-5  service area.  The commissioner may designate a single entity as
    5-6  the mental health authority and the mental retardation authority
    5-7  for a service area.
    5-8        SECTION 10.  Subchapter B, Chapter 533, Health and Safety
    5-9  Code, is amended by adding Section 533.0355 to read as follows:
   5-10        Sec. 533.0355.  AUTHORITY STRUCTURE PILOT PROJECT.  (a)
   5-11  Notwithstanding other law, the board may implement a pilot project
   5-12  to study an authority structure for service delivery at the local
   5-13  or regional level through a pilot local mental health or mental
   5-14  retardation authority.  The project shall provide an
   5-15  organizational separation between the pilot local mental health or
   5-16  mental retardation authority and service providers.  The board may
   5-17  delegate to a pilot local mental health or mental retardation
   5-18  authority the responsibility for the distribution, allocation, and
   5-19  coordination of mental health or mental retardation service
   5-20  resources in one or more service areas, including the
   5-21  responsibility to make policy determinations, develop resources,
   5-22  enter service contracts, and plan to meet future needs for services
   5-23  in each service area.
   5-24        (b)  The board may establish one or more pilot local mental
   5-25  health and mental retardation authorities under this section.
   5-26        (c)  If the board establishes a pilot program, the department
   5-27  shall:
    6-1              (1)  evaluate the pilot project at least annually to
    6-2  determine the feasibility of employing the authority structure in
    6-3  other areas of the state or statewide;
    6-4              (2)  prepare a report on the success of the pilot
    6-5  project that includes a list of statutory restrictions that would
    6-6  impair the permanent implementation of the authority structure in
    6-7  other areas of the state and suggested legislative changes; and
    6-8              (3)  submit the report to the 75th and 76th
    6-9  legislatures on January 15, 1997, and January 15, 1999,
   6-10  respectively.
   6-11        (d)  This section expires September 1, 1999.
   6-12        SECTION 11.  Section 533.063, Health and Safety Code, is
   6-13  amended to read as follows:
   6-14        Sec. 533.063.  Review of ICF-MR Rules.  (a)  The department,
   6-15  the Health and Human Services Commission, the Texas Department of
   6-16  Health, and the Texas Department of Human Services shall meet as
   6-17  necessary to discuss proposed changes in the rules or the
   6-18  interpretation of the rules that govern the ICF-MR program.
   6-19        (b)  The agencies <departments> shall jointly adopt a written
   6-20  policy interpretation letter that describes the proposed change and
   6-21  shall make a copy of the letter available to providers.
   6-22        SECTION 12.  Section 533.065(d), Health and Safety Code, is
   6-23  amended to read as follows:
   6-24        (d)  The department shall notify the Texas Department of
   6-25  Human Services <Health> of each application for a license or for
   6-26  compliance with licensing standards the department approves.
   6-27        SECTION 13.  Section 533.066(a), Health and Safety Code, is
    7-1  amended to read as follows:
    7-2        (a)  At least annually, the department<, Texas Department of
    7-3  Health,> and the Texas Department of Human Services shall jointly
    7-4  sponsor a conference on the ICF-MR program to:
    7-5              (1)  assist providers in understanding survey rules;
    7-6              (2)  review and discuss deficiencies commonly found in
    7-7  ICF-MR facilities; and
    7-8              (3)  inform providers of any recent changes in the
    7-9  rules or in the interpretation of the rules relating to the ICF-MR
   7-10  program.
   7-11        SECTION 14.  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 15.  Sections 534.054(a) and (d), Health and Safety
   8-17  Code, are amended to read as follows:
   8-18        (a)  The department shall identify and contract with a local
   8-19  mental health or mental retardation authority for each service area
   8-20  to ensure that <provide> services are provided to patient and
   8-21  client populations determined by the department.  A local mental
   8-22  health or mental retardation authority shall ensure that <provide,
   8-23  directly or by subcontract,> services to address the needs of
   8-24  priority populations are provided as required by the department and
   8-25  shall comply with the rules and standards adopted under Section
   8-26  534.052.
   8-27        (d)  The department shall ensure that <provide> the required
    9-1  services are provided in a service area directly through a
    9-2  department facility outreach program or contract with another
    9-3  agency, provider, or organization as the local mental health or
    9-4  mental retardation authority if the department cannot identify and
    9-5  contract with a community center in that service area.
    9-6        SECTION 16.  Sections 534.055(d) and (e), Health and Safety
    9-7  Code, are amended to read as follows:
    9-8        (d)  The department shall design a competitive procurement or
    9-9  similar system that a mental health or mental retardation authority
   9-10  shall use in awarding an initial contract under this section.  A
   9-11  <To facilitate continuity of services and to prevent disruption of
   9-12  services, a> mental health or mental retardation authority may
   9-13  <not> require competitive bidding on the renewal of a contract.  A
   9-14  mental health or  mental retardation authority to the extent
   9-15  practicable shall facilitate continuity of services and prevent
   9-16  disruption of services when renewing a contract or when requiring
   9-17  competitive bids on a contract.
   9-18        (e)  The system must require that each mental health or
   9-19  mental retardation authority:
   9-20              (1)  ensure public participation in the authority's
   9-21  decisions regarding whether to provide or to contract for a
   9-22  service;
   9-23              (2)  make a reasonable effort to give notice of the
   9-24  intent to contract for services to each potential private provider
   9-25  in the local service area of the authority; and
   9-26              (3) <(2)>  review each submitted proposal and award the
   9-27  contract to the applicant that the authority determines has made
   10-1  the lowest and best bid to provide the needed services.
   10-2        SECTION 17.  Sections 551.022(c) and (d), Health and Safety
   10-3  Code, are amended to read as follows:
   10-4        (c)  The superintendent shall:
   10-5              (1)  oversee the admission and discharge of <admit and
   10-6  discharge> patients and clients;
   10-7              (2)  keep a register of all patients and clients
   10-8  admitted to or discharged from the facility;
   10-9              (3)  supervise repairs and improvements to the
  10-10  facility;
  10-11              (4)  ensure that facility money <entrusted to the
  10-12  superintendent> is spent judiciously and economically;
  10-13              (5)  keep an accurate and detailed account of all money
  10-14  received and spent, stating the source of the money and to whom and
  10-15  the purpose for which the money is spent; and
  10-16              (6)  keep a full record of the facility's operations.
  10-17        (d)  In accordance with board rules and departmental
  10-18  operating procedures, the <The> superintendent may:
  10-19              (1)  establish policy <rules> to govern the facility
  10-20  that the superintendent considers will best promote the patients'
  10-21  and clients' interest and welfare;
  10-22              (2)  appoint subordinate officers, teachers,
  10-23  <attendants,> and other employees and set their salaries, in the
  10-24  absence of other law; and
  10-25              (3)  remove an officer, teacher, or employee for good
  10-26  cause <and with the board's consent>.
  10-27        SECTION 18.  Sections 533.064 and 551.023, Health and Safety
   11-1  Code, are repealed.
   11-2        SECTION 19.  (a)  The changes in law made by this Act apply
   11-3  only to an action taken by the Texas Board of Mental Health and
   11-4  Mental Retardation, the Texas Department of Mental Health and
   11-5  Mental Retardation, or the commissioner of mental health and mental
   11-6  retardation or to an appointment made by the governor on or after
   11-7  September 1, 1995.
   11-8        (b)  An action taken or appointment made before September 1,
   11-9  1995, is governed by the law in effect when the action was  taken
  11-10  or appointment was made, and that law is continued in effect for
  11-11  that purpose.
  11-12        (c)  The change in law made by this Act in the qualifications
  11-13  of  members of the Texas Board of Mental Health and Mental
  11-14  Retardation does not affect the entitlement of a member of that
  11-15  board who was appointed before September 1, 1995, to continue to
  11-16  hold office for the term to which the member was appointed.  The
  11-17  change in qualifications applies only to a member appointed on or
  11-18  after September 1, 1995.
  11-19        SECTION 20.  This Act takes effect September 1, 1995.
  11-20        SECTION 21.  The importance of this legislation and the
  11-21  crowded condition of the calendars in both houses create an
  11-22  emergency and an imperative public necessity that the
  11-23  constitutional rule requiring bills to be read on three several
  11-24  days in each house be suspended, and this rule is hereby suspended.