1-1 By: Delisi, Berlanga (Senate Sponsor - Zaffirini) H.B. No. 2377
1-2 (In the Senate - Received from the House May 15, 1995;
1-3 May 17, 1995, read first time and referred to Committee on Health
1-4 and Human Services; May 22, 1995, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 8, Nays
1-6 0; May 22, 1995, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 2377 By: Zaffirini
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the provision and administration of mental health and
1-11 mental retardation services.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Section 531.001, Health and Safety Code, is
1-14 amended by amending Subsections (a), (b), and (e) and adding
1-15 Subsection (h) to read as follows:
1-16 (a) It is the purpose of this subtitle to provide for the
1-17 effective administration and coordination of mental health and
1-18 mental retardation services at the state and local levels.
1-19 (b) Recognizing that a variety of alternatives for serving
1-20 the mentally disabled exists, it is the purpose of this subtitle to
1-21 ensure that <provide for> a continuum of services is provided. The
1-22 continuum of services includes facilities operated by the Texas
1-23 Department of Mental Health and Mental Retardation and community
1-24 services provided by the department and other entities through
1-25 contracts with the department.
1-26 (e) It is the public policy of this state that mental health
1-27 and mental retardation services be the responsibility of local
1-28 agencies and organizations to the greatest extent possible. The
1-29 department shall assist the local agencies and organizations by
1-30 coordinating the implementation of a statewide system of services.
1-31 The department shall ensure that <provide state-administered>
1-32 mental health and mental retardation services are provided. The
1-33 department shall <and> provide technical assistance for and
1-34 regulation of the programs that receive funding through contracts
1-35 with the department.
1-36 (h) It is the policy of this state that the board serves as
1-37 the state's mental health and mental retardation authority and is
1-38 responsible for the planning, policy development, and resource
1-39 development and allocation for and oversight of mental health and
1-40 mental retardation services in this state. It is the policy of
1-41 this state that, when appropriate and feasible, the board may
1-42 delegate the board's authority to a single entity in each region of
1-43 the state that may function as the local mental health or mental
1-44 retardation authority for one or more service areas in the region.
1-45 SECTION 2. Sections 531.002(8) and (9), Health and Safety
1-46 Code, are amended to read as follows:
1-47 (8) "Local mental health authority" means an entity to
1-48 which the board delegates its authority and responsibility within a
1-49 specified region for planning, policy development, coordination,
1-50 and resource development and allocation and for supervising and
1-51 ensuring the provision of mental health <a local service provider
1-52 selected by the department to plan, facilitate, coordinate, or
1-53 provide> services to persons with mental illness in one or more <a>
1-54 local service areas <area>.
1-55 (9) "Local mental retardation authority" means an
1-56 entity to which the board delegates its authority and
1-57 responsibility within a specified region for planning, policy
1-58 development, coordination, and resource development and allocation
1-59 and for supervising and ensuring the provision of mental
1-60 retardation <a local service provider selected by the department to
1-61 plan, facilitate, coordinate, or provide> services to persons with
1-62 mental retardation in one or more <a> local service areas <area>.
1-63 SECTION 3. Section 532.001(a), Health and Safety Code, is
1-64 amended to read as follows:
1-65 (a) The Texas Department of Mental Health and Mental
1-66 Retardation is composed of:
1-67 (1) the Texas Board of Mental Health and Mental
1-68 Retardation;
2-1 (2) the commissioner of mental health and mental
2-2 retardation; and
2-3 (3) <the medical director;>
2-4 <(4) the deputy commissioner for mental health
2-5 services;>
2-6 <(5) the deputy commissioner for mental retardation
2-7 services; and>
2-8 <(6)> a staff under the direction of the
2-9 commissioner<, medical director, and deputy commissioners>.
2-10 SECTION 4. Section 532.003(b), Health and Safety Code, is
2-11 amended to read as follows:
2-12 (b) The members must be representatives of the public who
2-13 have demonstrated interest in mental health, mental retardation,
2-14 developmental disabilities, or the health and human services
2-15 system.
2-16 SECTION 5. Sections 532.011(e) and (g), Health and Safety
2-17 Code, are amended to read as follows:
2-18 (e) The commissioner shall:
2-19 (1) establish qualifications for <assistant deputy
2-20 commissioners and important> department personnel that balance
2-21 clinical and programmatic knowledge and management experience; and
2-22 (2) standardize qualifications for personnel positions
2-23 throughout the department.
2-24 (g) The commissioner is responsible for implementation of
2-25 the board's planning, policy, resource development and allocation,
2-26 and oversight related to <the state> mental health <authority> and
2-27 <the state> mental retardation services <authority>.
2-28 SECTION 6. Sections 532.012(a) and (c), Health and Safety
2-29 Code, are amended to read as follows:
2-30 (a) The commissioner shall appoint a medical director<,
2-31 subject to board approval>.
2-32 (c) The medical director reports to the commissioner and is
2-33 responsible for:
2-34 (1) oversight of the quality and appropriateness of
2-35 clinical services <by developing policies relating to clinical
2-36 services regulated by the department and those services> delivered
2-37 in department facilities or under contract to the department; and
2-38 (2) leadership in <directing the standards and quality
2-39 assurance program, a utilization review program, a> physician
2-40 recruitment and retention <program,> and <a> peer review <program
2-41 for physicians and other clinical staff employed by or under
2-42 contract to the department>.
2-43 SECTION 7. Section 532.014(a), Health and Safety Code, is
2-44 amended to read as follows:
2-45 (a) The <With the board's approval, the> commissioner shall
2-46 appoint the head of each facility the department administers.
2-47 SECTION 8. Sections 533.035(a)-(c), Health and Safety Code,
2-48 are amended to read as follows:
2-49 (a) The commissioner shall designate a local mental health
2-50 authority and a local mental retardation authority in one or more
2-51 <each> local service areas. The board may delegate to the local
2-52 authorities the board's authority and responsibility for the
2-53 planning, policy development, coordination, resource allocation,
2-54 and resource development for and oversight of <area to plan,
2-55 facilitate, coordinate, and provide> mental health and mental
2-56 retardation services in that service area. The commissioner may
2-57 designate a single entity as the mental health authority and the
2-58 mental retardation authority for a service area.
2-59 (b) The department by contract or other method of allocation
2-60 may disburse to a local mental health and mental retardation
2-61 authority department federal <mental health funds> and department
2-62 state funds to be spent in the local service area for:
2-63 (1) community mental health and mental retardation
2-64 services; and
2-65 (2) chemical dependency services for persons who are
2-66 dually diagnosed as having both chemical dependency and mental
2-67 illness or mental retardation.
2-68 (c) A local mental health and mental retardation authority,
2-69 with the department's approval, shall use the funds received under
2-70 Subsection (b) to ensure <provide> mental health, mental
3-1 retardation, and chemical dependency services are provided in the
3-2 local service area. The local authority shall consider public
3-3 input, ultimate cost-benefit, and client care issues to ensure
3-4 consumer choice and the best use of public money in:
3-5 (1) assembling a network of service providers; and
3-6 (2) determining whether to become a provider of a
3-7 service or to contract that service to another organization <or to
3-8 subcontract for those services>.
3-9 SECTION 9. Subchapter B, Chapter 533, Health and Safety
3-10 Code, is amended by adding Section 533.0355 to read as follows:
3-11 Sec. 533.0355. AUTHORITY STRUCTURE PILOT PROJECT. (a)
3-12 Notwithstanding other law, the board may implement a pilot project
3-13 to study an authority structure for service delivery at the local
3-14 or regional level through a pilot local mental health or mental
3-15 retardation authority. The project shall provide an
3-16 organizational separation between the pilot local mental health or
3-17 mental retardation authority and service providers. The board may
3-18 delegate to a pilot local mental health or mental retardation
3-19 authority the responsibility for the distribution, allocation, and
3-20 coordination of mental health or mental retardation service
3-21 resources in one or more service areas, including the
3-22 responsibility to make policy determinations, develop resources,
3-23 enter service contracts, and plan to meet future needs for services
3-24 in each service area.
3-25 (b) The board may establish one or more pilot local mental
3-26 health and mental retardation authorities under this section.
3-27 (c) If the board establishes a pilot program, the department
3-28 shall:
3-29 (1) evaluate the pilot project at least annually to
3-30 determine the feasibility of employing the authority structure in
3-31 other areas of the state or statewide;
3-32 (2) prepare a report on the success of the pilot
3-33 project that includes a list of statutory restrictions that would
3-34 impair the permanent implementation of the authority structure in
3-35 other areas of the state and suggested legislative changes; and
3-36 (3) submit the report to the 75th and 76th
3-37 legislatures on January 15, 1997, and January 15, 1999,
3-38 respectively.
3-39 (d) This section expires September 1, 1999.
3-40 SECTION 10. Subchapter D, Chapter 533, Health and Safety
3-41 Code, is amended by adding Section 533.087 to read as follows:
3-42 Sec. 533.087. LEASE OF REAL PROPERTY. (a) The department
3-43 may lease real property, including any improvements under the
3-44 department's management and control, regardless of whether the
3-45 property is surplus property. Except as provided by Subsection
3-46 (c), the department may award a lease of real property only:
3-47 (1) at the prevailing market rate; and
3-48 (2) by competitive bid.
3-49 (b) The department shall advertise a proposal for lease at
3-50 least once a week for four consecutive weeks in:
3-51 (1) a newspaper published in the municipality in which
3-52 the property is located or the daily newspaper published nearest to
3-53 the property's location; and
3-54 (2) a newspaper of statewide circulation.
3-55 (c) The department may lease real property or an improvement
3-56 for less than the prevailing market rate, without advertisement or
3-57 without competitive bidding, if:
3-58 (1) the board determines that sufficient public
3-59 benefit will be derived from the lease; and
3-60 (2) the property is leased to:
3-61 (A) a federal or state agency;
3-62 (B) a unit of local government;
3-63 (C) a not-for-profit organization; or
3-64 (D) an entity related to the department by a
3-65 service contract.
3-66 (d) The board shall adopt leasing rules, forms, and
3-67 contracts that will protect the state's interests.
3-68 (e) The board may reject any bid.
3-69 (f) This section does not authorize the department to close
3-70 or consolidate a facility used to provide mental health or mental
4-1 retardation services without legislative approval.
4-2 SECTION 11. Section 534.022, Health and Safety Code, is
4-3 amended by adding Subsection (e) to read as follows:
4-4 (e) A county or municipality acting alone or two or more
4-5 counties or municipalities acting jointly pursuant to interlocal
4-6 contract may create a public facility corporation to act on behalf
4-7 of one or more community centers pursuant to the Public Facility
4-8 Corporation Act (Article 717s, Revised Statutes). Such counties or
4-9 municipalities may exercise the powers of a sponsor under that Act,
4-10 and any such corporation may exercise the powers of a corporation
4-11 under that Act (including but not limited to the power to issue
4-12 bonds). The corporation may exercise its powers on behalf of
4-13 community centers in such manner as may be prescribed by the
4-14 articles and bylaws of the corporation, provided that in no event
4-15 shall one community center ever be liable to pay the debts or
4-16 obligation or be liable for the acts, actions, or undertakings of
4-17 another community center.
4-18 SECTION 12. Sections 534.054(a) and (d), Health and Safety
4-19 Code, are amended to read as follows:
4-20 (a) The department shall identify and contract with a local
4-21 mental health or mental retardation authority for each service area
4-22 to ensure that <provide> services are provided to patient and
4-23 client populations determined by the department. A local mental
4-24 health or mental retardation authority shall ensure that <provide,
4-25 directly or by subcontract,> services to address the needs of
4-26 priority populations are provided as required by the department and
4-27 shall comply with the rules and standards adopted under Section
4-28 534.052.
4-29 (d) The department shall ensure that <provide> the required
4-30 services are provided in a service area directly through the
4-31 community services division of a department facility <outreach
4-32 program> or contract with another agency, entity <provider>, or
4-33 organization as the local mental health or mental retardation
4-34 authority if the department cannot identify and contract with a
4-35 community center in that service area.
4-36 SECTION 13. Sections 534.055(d) and (e), Health and Safety
4-37 Code, are amended to read as follows:
4-38 (d) The department shall design a competitive procurement or
4-39 similar system that a mental health or mental retardation authority
4-40 shall use in awarding an initial contract under this section. <To
4-41 facilitate continuity of services and to prevent disruption of
4-42 services, a mental health or mental retardation authority may not
4-43 require competitive bidding on the renewal of a contract.>
4-44 (e) The system must require that each mental health or
4-45 mental retardation authority:
4-46 (1) ensure public participation in the authority's
4-47 decisions regarding whether to provide or to contract for a
4-48 service;
4-49 (2) make a reasonable effort to give notice of the
4-50 intent to contract for services to each potential private provider
4-51 in the local service area of the authority; and
4-52 (3) <(2)> review each submitted proposal and award the
4-53 contract to the applicant that the authority determines has made
4-54 the lowest and best bid to provide the needed services.
4-55 SECTION 14. Section 534.064, Health and Safety Code, is
4-56 amended to read as follows:
4-57 Sec. 534.064. Contract Renewal. The commissioner may refuse
4-58 to renew a contract with a local mental health or mental
4-59 retardation authority and may select other agencies, entities
4-60 <providers>, or organizations to be the local mental health or
4-61 mental retardation authority if the department's evaluation of the
4-62 authority's performance indicates that the authority cannot ensure
4-63 the availability of the specific services to priority populations
4-64 required by the department and this subtitle.
4-65 SECTION 15. Section 534.065(b), Health and Safety Code, is
4-66 amended to read as follows:
4-67 (b) The mental health or mental retardation authority shall
4-68 renew the contract if the authority finds that:
4-69 (1) funding is available;
4-70 (2) the authority plans to continue the services;
5-1 (3) the provider is in substantial compliance with
5-2 each material provision of the contract, unless the authority
5-3 determines that the provision is not legal and enforceable under
5-4 applicable state and federal law;
5-5 (4) the provider is providing a reasonably adequate
5-6 level of service in accordance with the contract and at a
5-7 reasonable cost;
5-8 (5) the provider agrees to a renewal contract that is
5-9 substantially in compliance with a model contract developed by the
5-10 department under Section 534.055;
5-11 (6) the provider was during the term of any contract
5-12 with the authority and is at the time of renewal in compliance with
5-13 applicable laws governing the subject matter of the contract; and
5-14 (7) neither the provider nor any of its officers,
5-15 directors, or principal employees has been convicted or found by a
5-16 final administrative decision to have been guilty of fraud or abuse
5-17 in the provision of health care services under a contract with a
5-18 state or federal agency.
5-19 SECTION 16. Section 534.066(b), Health and Safety Code, is
5-20 amended to read as follows:
5-21 (b) The department shall establish, for community services
5-22 divisions of department facilities <facility outreach programs>
5-23 that provide community-based services required under this
5-24 subchapter, a local match requirement that is consistent with the
5-25 requirements applied to other local mental health or mental
5-26 retardation authorities.
5-27 SECTION 17. Sections 551.022(c) and (d), Health and Safety
5-28 Code, are amended to read as follows:
5-29 (c) The superintendent shall:
5-30 (1) oversee the admission and discharge of <admit and
5-31 discharge> patients and clients;
5-32 (2) keep a register of all patients and clients
5-33 admitted to or discharged from the facility;
5-34 (3) supervise repairs and improvements to the
5-35 facility;
5-36 (4) ensure that facility money <entrusted to the
5-37 superintendent> is spent judiciously and economically;
5-38 (5) keep an accurate and detailed account of all money
5-39 received and spent, stating the source of the money and to whom and
5-40 the purpose for which the money is spent; and
5-41 (6) keep a full record of the facility's operations.
5-42 (d) In accordance with board rules and departmental
5-43 operating procedures, the <The> superintendent may:
5-44 (1) establish policy <rules> to govern the facility
5-45 that the superintendent considers will best promote the patients'
5-46 and clients' interest and welfare;
5-47 (2) appoint subordinate officers, teachers,
5-48 <attendants,> and other employees and set their salaries, in the
5-49 absence of other law; and
5-50 (3) remove an officer, teacher, or employee for good
5-51 cause <and with the board's consent>.
5-52 SECTION 18. Sections 532.013, 533.064, 534.062, 551.021, and
5-53 551.023, Health and Safety Code, are repealed.
5-54 SECTION 19. (a) The changes in law made by this Act apply
5-55 only to an action taken by the Texas Board of Mental Health and
5-56 Mental Retardation, the Texas Department of Mental Health and
5-57 Mental Retardation, or the commissioner of mental health and mental
5-58 retardation or to an appointment made by the governor on or after
5-59 September 1, 1995.
5-60 (b) An action taken or appointment made before September 1,
5-61 1995, is governed by the law in effect when the action was taken
5-62 or appointment was made, and that law is continued in effect for
5-63 that purpose.
5-64 (c) The change in law made by this Act in the qualifications
5-65 of members of the Texas Board of Mental Health and Mental
5-66 Retardation does not affect the entitlement of a member of that
5-67 board who was appointed before September 1, 1995, to continue to
5-68 hold office for the term to which the member was appointed. The
5-69 change in qualifications applies only to a member appointed on or
5-70 after September 1, 1995.
6-1 SECTION 20. Nothing in this Act authorizes the department to
6-2 privatize the administration of state facilities.
6-3 SECTION 21. This Act takes effect September 1, 1995.
6-4 SECTION 22. The importance of this legislation and the
6-5 crowded condition of the calendars in both houses create an
6-6 emergency and an imperative public necessity that the
6-7 constitutional rule requiring bills to be read on three several
6-8 days in each house be suspended, and this rule is hereby suspended.
6-9 * * * * *