BG C.S.S.B. 434 75(R)BILL ANALYSIS PUBLIC HEALTH C.S.S.B. 434 By: Harris (Berlanga) 3-19-97 Committee Report (Substituted) BACKGROUND Confusion exists regarding enforcement of regulations as they apply to free-standing psychiatric hospitals and to wings or units of acute care hospitals providing psychiatric services. Presently, the Texas Department of Health (TDH) enforces regulations developed by the Texas Department of Mental Health and Mental Retardation (TXMHMR). PURPOSE C.S.S.B. 434 directs the Health and Human Services Commission (HHSC) to coordinate the development and enforcement of regulations developed by TXMHMR. In addition, this legislation creates an advisory committee on inpatient mental health services to advise the Texas Board of Mental Health and Mental Retardation and the TXMHMR in the consideration and adoption of policies and regulations. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter B, Chapter 531, Government Code, by adding Section 531.0345 as follows: Sec. 531.0345. COORDINATION ON INPATIENT MENTAL HEALTH ISSUES; COMMISSION REVIEW. Requires HHSC to require TDH and TXMHMR to coordinate the development of proposed rules and policies, and the interpretation and enforcement of adopted rules and policies, relating to inpatient mental health facility services, included within the scope of Sections 571.003(9)(B) and (E), Health and Safety Code. Requires HHSC to review these activities to ensure compliance by TDH and TXMHMR. SECTION 2. Amends Chapter 571, Health and Safety Code, by adding Section 571.027, as follows: Sec. 571.027. ADVISORY COMMITTEE ON INPATIENT MENTAL HEALTH SERVICES. Subsection (a) requires the Texas Board of Mental Health and Mental Retardation (board) to appoint a committee on inpatient mental health to advise the board as specified on issues and policies, interdepartmental communication, and training for facility surveyors or investigators. Subsection (b) requires the board to appoint the following to the advisory committee: (1) three representatives of hospitals, as specified; (2) three consumers of mental health services, as specified; (3) two licensed physicians as specified; (4) one family member of a person who has received mental health services as specified. Subsection (c) requires the Texas Board of Health to provide the advisory committee with two persons representing TDH. Stipulates that the TDH representatives may address any issue before the advisory committee, but may not vote on any matter. Requires the Texas Board of Health to consider designating an inpatient facility surveyor or investigator to be a representative. Subsection (d) establishes that, except for the TDH representatives, advisory committee members serve staggered four-year terms. Establishes that a member's term expires on August 31 of the fourth year following appointment. Subsection (e) requires the board to fill vacancies in the same manner as the original appointment. Subsection (f) requires the advisory committee to meet at least four times a calendar year. SECTION 3. Requires the board to appoint nine initial members to the advisory committee as soon as practicable after the effective date of this Act. Requires the members of the committee to draw lots determining the length of their terms as specified. Establishes that four of the initial members serve for terms expiring August 31, 1999, and five of the initial members serve terms expiring on August 31, 2001. SECTION 4. Abolishes the advisory committee on inpatient mental health services created under Section 571.027. Health and Safety Code, as added by this Act on September 1, 2001 unless the board adopts an order continuing the committee in existence. Allows the board to rescind the order at any time and stipulates that if the order is rescinded, the committee would be abolished. SECTION 5. Establishes the effective date as September 1, 1997. SECTION 6. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE The caption to the bill has been changed in CSSB 434 to omit reference to the the review of agency rulemaking by HHSC and the creation of an inpatient mental health services advisory committee. In SECTION 1, CSSB 434 clarifies the manner by which it amends Subchapter B, Chapter 531, Government Code, by creating Section 531.045 with subsections (a) and (b) instead of placing bi-purposeful text in Sec. 531.04(d) as was in the original bill. Language was also changed to clarify that HHSC should review the described activities to ensure compliance, not just to determine compliance. The substitute bill revises the wording in SECTION 2 (Sec. 571.027(a), Health and Safety Code) to omit reference to the advisory committee being composed of nine-members and to specify its advising duties. CSSB 434 also revises the language used in the composition breakdown of the committee as provided in subsection (b) so as to clarify that they are all required to be appointed by the board. Also replaced in subsection (b) is the reference to two hospital representatives and subsequent consumer criteria involving association with a private or general hospital with the requirement that they represent a facility described by Section 571.003(9)(B) or (E). The composition of the committee has been revised in the substitute bill so as to include a family member, two physicians, instead of one, and remove the TDH member. Subsection (c) is inserted into in the substitute bill to add the provision for the two non-voting representatives from the board. Subsection (d) clarifies that the two non-voting representatives are excepted from the term limitations as applied to the other appointed members, and language describing the specifics of term expirations is omitted. Also, CSSB 434 adds the stipulation in subsection (e) that vacancies on the advisory committee be filled in the same manner as the original appointments. SECTION 3 of the substitute bill is reformatted to include two subsections and conform with the changes made in SECTION 2. CSSB 434 inserts a new SECTION 4 to provide for the abolishment of the advisory committee as specified, then renumbers the original bill's previous SECTION 4 and its subsequent section to SECTION 5 and 6 accordingly.