1-1  By:  Zaffirini                                        S.B. No. 1675
    1-2        (In the Senate - Filed April 24, 1995; April 24, 1995, read
    1-3  first time and referred to Committee on Health and Human Services;
    1-4  April 27, 1995, reported favorably by the following vote:  Yeas 9,
    1-5  Nays 0; April 27, 1995, sent to printer.)
    1-6                         A BILL TO BE ENTITLED
    1-7                                AN ACT
    1-8  relating to powers and duties of the Health and Human Services
    1-9  Commission.
   1-10        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-11        SECTION 1.  Section 10, Article 4413(502), Revised Statutes,
   1-12  is amended by amending Subsection (d) and by adding Subsection (e)
   1-13  to read as follows:
   1-14        (d)  All health and human services agencies shall submit
   1-15  strategic plans and biennial updates to the commission on a date to
   1-16  be determined by commission rule.  The strategic plans and biennial
   1-17  updates are subject to commission approval.
   1-18        (e)  Not later than January 1 of each even-numbered year, the
   1-19  commission shall begin formal discussions with each health and
   1-20  human services agency regarding that agency's strategic plan or
   1-21  biennial update.
   1-22        SECTION 2.  Section 13, Article 4413(502), Revised Statutes,
   1-23  is amended to read as follows:
   1-24        Sec. 13.  Consolidated Health and Human Services Budget.
   1-25  (a)  The commission has comprehensive budget and planning authority
   1-26  for health and human services agencies in order to establish an
   1-27  integrated eligibility determination and service delivery system.
   1-28        (b)  The commission shall prepare and submit to the
   1-29  Legislative Budget Board and the governor by October 15 of
   1-30  even-numbered years a consolidated health and human services budget
   1-31  recommendation.
   1-32        (c) <(b)>  The commission shall base the consolidated budget
   1-33  recommendation prepared under this article on priorities set in the
   1-34  commission's coordinated strategic plan for health and human
   1-35  services.
   1-36        (d) <(c)>  All health and human services agencies shall
   1-37  submit to the commission a biennial agency legislative
   1-38  appropriations request on a date to be determined by commission
   1-39  rule.
   1-40        (e)  A health and human services agency may not submit to the
   1-41  legislature or the governor its legislative appropriations request
   1-42  until the legislative appropriations request is approved by the
   1-43  commission.
   1-44        SECTION 3.  Article 4413(502), Revised Statutes, is amended
   1-45  by adding Sections 13A, 13B, 13C, 13D, and 13E to read as follows:
   1-46        Sec. 13A.  HEALTH AND HUMAN SERVICES AGENCIES OPERATING
   1-47  BUDGETS.  (a)  In addition to the provisions of the General
   1-48  Appropriations Act, each agency subject to the provisions of this
   1-49  article shall:
   1-50              (1)  obtain commission approval of its annual operating
   1-51  budget prior to adoption of its annual operating budget;
   1-52              (2)  obtain commission approval of the transfer of
   1-53  funds between budget strategies prior to the transfer of the funds;
   1-54              (3)  report to the commission, on a quarterly basis,
   1-55  information regarding the agency's projected expenditures by budget
   1-56  strategy, compared to the agency's operating budget approved by the
   1-57  commission; and
   1-58              (4)  obtain commission approval for any adjustment to
   1-59  the agency's operating budget.
   1-60        (b)  The commission shall adopt rules to implement this
   1-61  section.
   1-62        Sec. 13B.  FEDERAL FUNDS.  (a)  Notwithstanding any other
   1-63  state law and to the extent permitted by federal law, an
   1-64  operational or funding plan or a modification to that plan prepared
   1-65  by a health and human services agency designated as the single
   1-66  state agency to administer federal funds is subject to commission
   1-67  approval.
   1-68        (b)  The commission shall evaluate the feasibility of
    2-1  designating the commission as the single state agency for federal
    2-2  funds received for a health and human services purpose.
    2-3        (c)  For the purpose of promoting integrated, community-based
    2-4  service delivery systems and to the extent permitted by federal
    2-5  law, the commission may consolidate federal funds to be given to
    2-6  local communities for the provision of health and human services.
    2-7        Sec. 13C.  AUTOMATED SYSTEMS.  A health and human services
    2-8  agency may not submit its plans to the Department of Information
    2-9  Resources under Subchapter E, Chapter 2054, Government Code, until
   2-10  those plans are approved by the commission.
   2-11        Sec. 13D.  INTERAGENCY TRANSFERS.  (a)  The commissioner may
   2-12  transfer funds between the health and human services agencies
   2-13  according to the provisions of the General Appropriations Act.
   2-14        (b)  The commission shall report to the governor's budget
   2-15  office, the Legislative Budget Board, and the comptroller regarding
   2-16  any transfer of funds the commissioner makes under this section.
   2-17        Sec. 13E.  COORDINATION AND APPROVAL OF CASELOAD ESTIMATES.
   2-18  (a)  The commission shall coordinate and approve caseload estimates
   2-19  made for programs administered by health and human services
   2-20  agencies.
   2-21        (b)  To implement this section, the commission shall:
   2-22              (1)  adopt uniform guidelines to be used by health and
   2-23  human services agencies in estimating their caseloads, with
   2-24  allowances given for those agencies for which exceptions from the
   2-25  guidelines may be necessary;
   2-26              (2)  assemble a single set of economic and demographic
   2-27  data and provide that data to each health and human services agency
   2-28  to be used in estimating its caseloads; and
   2-29              (3)  seek advice from health and human services
   2-30  agencies, the Legislative Budget Board, the governor's budget
   2-31  office, the comptroller, and other relevant agencies as needed to
   2-32  coordinate the caseload estimating process.
   2-33        (c)  The commission shall assemble caseload estimates made by
   2-34  health and human services agencies into a coherent, uniform report
   2-35  and shall  update the report quarterly, with assistance from those
   2-36  agencies.  The commission shall publish the report and make it
   2-37  readily available to state and local agencies and interested
   2-38  private organizations.
   2-39        (d)  In the report prepared under Subsection (c) of this
   2-40  section, the commission shall explain the caseload estimates using
   2-41  monthly averages, annual unduplicated recipients, annual service
   2-42  usage, and other commonly used measures.
   2-43        (e)  The commission shall attach a copy of the report
   2-44  prepared under Subsection (c) of this section to the consolidated
   2-45  health and human services budget recommendation submitted to the
   2-46  Legislative Budget Board under Section 13 of this article and shall
   2-47  also submit the report to the legislature when it convenes in
   2-48  regular session.
   2-49        SECTION 4.  Section 14, Article 4413(502), Revised Statutes,
   2-50  is amended  by amending Subsection (a) and by adding Subsection (d)
   2-51  to read as follows:
   2-52        (a)  The commissioner shall:
   2-53              (1)  arbitrate and render the <a> final decision on
   2-54  interagency disputes;
   2-55              (2)  facilitate and enforce coordinated planning and
   2-56  delivery of health and human services, including compliance with
   2-57  the coordinated strategic plan, co-location of services, integrated
   2-58  intake, and coordinated referral and case management;
   2-59              (3)  request budget execution for the transfer of funds
   2-60  from one agency to another;
   2-61              (4)  establish a federal health and human services
   2-62  funds management system and maximize the availability of those
   2-63  funds;
   2-64              (5)  develop with the Department of Information
   2-65  Resources automation standards for computer systems to enable
   2-66  health and human services agencies to share pertinent data;
   2-67              (6)  establish and enforce uniform regional boundaries
   2-68  for all health and human services agencies;
   2-69              (7)  carry out statewide health and human services
   2-70  needs surveys and forecasting;
    3-1              (8)  perform independent special outcome evaluations of
    3-2  health and human services programs and activities;
    3-3              (9)  adopt rules necessary to carry out the
    3-4  commission's duties under this Act; and
    3-5              (10)  review health and human services agency formulas
    3-6  <develop a formula> for the distribution of funds to ensure that
    3-7  the formulas, to the extent permitted by federal law, consider such
    3-8  need factors as client base, population, and economic and
    3-9  geographic factors within the regions of the state.
   3-10        (d)  Not later than the end of the first month of each fiscal
   3-11  year, the commissioner shall submit to the governor, the lieutenant
   3-12  governor, the speaker of the house of representatives, the
   3-13  comptroller, and the Legislative Budget Board a work plan outlining
   3-14  the activities of the commission for that fiscal year.  The work
   3-15  plan must establish priorities for the commission's activities
   3-16  based on available resources.
   3-17        SECTION 5.  Article 4413(502), Revised Statutes, is amended
   3-18  by adding Section 14A to read as follows:
   3-19        Sec. 14A.  DELIVERY OF SERVICES.  (a)  To accomplish the goal
   3-20  prescribed by Section 10(b)(3) of this article of integrating
   3-21  health and human services to provide for the efficient and timely
   3-22  delivery of services, each health and human services agency shall
   3-23  streamline the manner in which services are delivered by that
   3-24  agency in accordance with this section.
   3-25        (b)  To integrate and streamline service delivery and
   3-26  facilitate access to services, the commissioner may require a
   3-27  health and human services agency to take a specific action and may
   3-28  direct the manner in which the streamlining is to be accomplished,
   3-29  including requiring each health and human services agency to:
   3-30              (1)  simplify agency procedures;
   3-31              (2)  automate agency procedures;
   3-32              (3)  coordinate service planning and management tasks
   3-33  between and among health and human services agencies;
   3-34              (4)  reallocate staff resources;
   3-35              (5)  adopt rules;
   3-36              (6)  amend, waive, or repeal existing rules; and
   3-37              (7)  take other necessary actions.
   3-38        SECTION 6.  Article 4413(502), Revised Statutes, is amended
   3-39  by adding Section 23 to read as follows:
   3-40        Sec. 23.  USE OF AGENCY STAFF.  To the extent requested by
   3-41  the commission, a health and human services agency shall assign
   3-42  existing staff to perform a function under this article.
   3-43        SECTION 7.  Article 4413(502), Revised Statutes, is amended
   3-44  by adding Section 24 to read as follows:
   3-45        Sec. 24.  REPORTS ON DELIVERY OF SERVICES.  (a)  Each
   3-46  executive head of a health and human services agency shall report
   3-47  quarterly to the governing body of that agency on that agency's
   3-48  efforts to streamline and simplify the delivery of services as
   3-49  required by Section 14A of this article.  The agency shall submit a
   3-50  copy of the report to the commission.
   3-51        (b)  The commission shall prepare and deliver a semiannual
   3-52  report to the governor, the lieutenant governor, the speaker of the
   3-53  house of representatives, the comptroller, the Legislative Budget
   3-54  Board, and appropriate legislative committees on the efforts of the
   3-55  health and human services agencies to streamline the delivery of
   3-56  services provided by those agencies.
   3-57        (c)  The commissioner shall adopt rules relating to the
   3-58  reports required by Subsection (a) of this section, including rules
   3-59  specifying when and in what manner an agency must report and what
   3-60  information must be included in the report.  Each agency shall
   3-61  follow the rules adopted by the commissioner under this section.
   3-62        SECTION 8.  Section 3.08, Chapter 15, Acts of the 72nd
   3-63  Legislature, 1st Called Session, 1991 (Article 4413(505), Vernon's
   3-64  Texas Civil Statutes), is amended to read as follows:
   3-65        Sec. 3.08.  LOCATION <CO-LOCATION> OF OFFICES AND FACILITIES.
   3-66  (a)  As leases on office space expire, the commission shall
   3-67  determine the needs for space and the location of health and human
   3-68  services agency offices to enable the commission to achieve a
   3-69  cost-effective one-stop or service center method of health and
   3-70  human service delivery.  <The administrative heads of the health
    4-1  and human service agencies shall review the agencies' current
    4-2  office and facility arrangements and study the feasibility of
    4-3  co-locating offices or facilities located in the same geographic
    4-4  area and shall report back to the commission not later than
    4-5  September 1, 1992.>
    4-6        (b)  <On receiving approval from the commission, the
    4-7  administrative heads of two or more health and human service
    4-8  agencies with offices or facilities located in the same geographic
    4-9  region shall co-locate the offices or facilities if the results of
   4-10  the study conducted under this section show that client access
   4-11  would be enhanced, the cost of co-location is not greater than the
   4-12  combined operating costs of the separate offices or facilities of
   4-13  those agencies, and the co-location would improve the efficiency of
   4-14  the delivery of services.>
   4-15        <(c)>  In this section, "health and human service agencies"
   4-16  includes the:
   4-17              (1)  Interagency Council on Early Childhood
   4-18  Intervention Services;
   4-19              (2)  Texas Department on Aging;
   4-20              (3)  Texas Commission on Alcohol and Drug Abuse;
   4-21              (4)  Texas Commission for the Blind;
   4-22              (5)  Texas Commission for the Deaf and Hearing
   4-23  Impaired;
   4-24              (6)  Texas Department of Health;
   4-25              (7)  Texas Department of Human Services;
   4-26              (8)  Texas Juvenile Probation Commission;
   4-27              (9)  Texas Department of Mental Health and Mental
   4-28  Retardation;
   4-29              (10)  Texas Rehabilitation Commission; and
   4-30              (11)  Department of Protective and Regulatory Services.
   4-31        SECTION 9.  Subsection (a), Section 6.031, Article 6, State
   4-32  Purchasing and General Services Act (Article 601b, Vernon's Texas
   4-33  Civil Statutes), is amended to read as follows:
   4-34        (a)  Notwithstanding any other provision of this article, the
   4-35  <The> commission may not lease office space to service the needs of
   4-36  any <a single> health and human service agency unless the Health
   4-37  and Human Services Commission has approved the office space for the
   4-38  agency <agency can provide the commission with a reason for not
   4-39  sharing the office space with one or more other health and human
   4-40  service agencies>.
   4-41        SECTION 10.  (a)  The Health and Human Services Commission
   4-42  shall expand its existing integrated eligibility pilot programs to
   4-43  include the Harris County Hospital District and The University of
   4-44  Texas Medical Branch at Galveston.
   4-45        (b)  A contract with the Harris County Hospital District or
   4-46  The University of Texas Medical Branch at Galveston shall:
   4-47              (1)  specify performance-based measures to ensure error
   4-48  rates are kept within acceptable federal limits;
   4-49              (2)  assure that the contractor assumes all liability
   4-50  for any penalty incurred as a result of failure to meet federal
   4-51  standards; and
   4-52              (3)  authorize the district and the medical branch to
   4-53  simplify processes as much as possible and to use proprietary
   4-54  software.
   4-55        (c)  Subject to approval by the Health and Human Services
   4-56  Commission,  the Texas Department of Human Services shall establish
   4-57  standards for other automated systems to allow other entities to
   4-58  file information directly.
   4-59        (d)  The Health and Human Services Commission shall study the
   4-60  feasibility of enabling contractors or agencies other than the
   4-61  Texas Department of Human Services to provide or assist in the
   4-62  provision of client eligibility studies, determinations, and
   4-63  certifications.  In determining feasibility, the commission shall
   4-64  consider:
   4-65              (1)  error rates;
   4-66              (2)  the state's potential liability;
   4-67              (3)  expansion of the client population; and
   4-68              (4)  the federal single state agency restrictions.
   4-69        SECTION 11.  (a)  Not later than September 1, 1996, the
   4-70  Health and Human Services Commission, subject to the availability
    5-1  of funds to the commission and to health and human services
    5-2  agencies, shall have completed the development and substantial
    5-3  implementation of a plan for an integrated eligibility
    5-4  determination and service delivery system for health and human
    5-5  services at the local and regional levels.  The plan shall specify
    5-6  the dates by which all elements of the plan must be implemented.
    5-7        (b)  The integrated eligibility determination and service
    5-8  delivery system shall be developed and implemented to achieve at
    5-9  least a one percent savings in the cost of providing administrative
   5-10  and other services and staff resulting from streamlining and
   5-11  eliminating duplication of services.  The commission shall use the
   5-12  resulting savings to further develop the integrated system and to
   5-13  provide other health and human services.
   5-14        (c)  The commission shall examine cost-effective methods to
   5-15  address:
   5-16              (1)  fraud in the assistance programs; and
   5-17              (2)  the error rate in eligibility determination.
   5-18        (d)  In consultation and coordination with the State Council
   5-19  on Competitive Government, the commission shall make and implement
   5-20  recommendations on services or functions of the integrated
   5-21  eligibility determination and service delivery system that could be
   5-22  provided more effectively through the use of competitive bidding or
   5-23  by contracting with local governments and other appropriate
   5-24  entities.  If the commission determines that private contracting
   5-25  may be effective, the commission may automate the determination of
   5-26  client eligibility by contracting with a private firm to conduct
   5-27  application processing.
   5-28        (e)  Not later than October 1, 1996, the commission shall
   5-29  develop a plan to consolidate administrative and service delivery
   5-30  functions in addition to the integrated eligibility determination
   5-31  and service delivery system in order to minimize duplication.  The
   5-32  commission shall prepare a report of the plan for submission to the
   5-33  governor, the lieutenant governor, the speaker of the house of
   5-34  representatives, the comptroller, and the 75th Legislature when it
   5-35  convenes.
   5-36        SECTION 12.  (a)  Not later than September 1, 1997, the
   5-37  Health and Human Services Commission shall develop, using existing
   5-38  state, local, and private resources, an integrated approach to the
   5-39  health and human service delivery system that includes a
   5-40  cost-effective one-stop or service center method of delivery to a
   5-41  client.  The commission shall determine the feasibility of using
   5-42  hospitals, schools, mental health and mental retardation centers,
   5-43  health clinics, commercial locations in malls, and other
   5-44  appropriate locations to achieve this integrated approach.
   5-45        (b)  The health and human services agencies shall cooperate
   5-46  with the commission in developing the integrated eligibility
   5-47  determination and service delivery system.
   5-48        (c)  This section expires September 1, 1997.
   5-49        SECTION 13.  The changes in law made by this Act apply
   5-50  beginning with appropriations made for the fiscal year beginning
   5-51  September 1, 1995.
   5-52        SECTION 14.  This Act takes effect September 1, 1995.
   5-53        SECTION 15.  The importance of this legislation and the
   5-54  crowded condition of the calendars in both houses create an
   5-55  emergency and an imperative public necessity that the
   5-56  constitutional rule requiring bills to be read on three several
   5-57  days in each house be suspended, and this rule is hereby suspended.
   5-58                               * * * * *