SRC-JRN S.B. 940 75(R)   BILL ANALYSIS


Senate Research Center   S.B. 940
By: Nelson
Health & Human Services
4-15-97
As Filed


DIGEST 

Currently, Texas law has established certain contract regulatory
responsibilities through the Texas Department of Mental Health and Mental
Retardation (department).  However, statutory change is necessary to
ensure that the department has the authority and appropriate mechanisms to
ensure contract compliance and the continued provision of services.  This
bill creates mechanisms that enable the department to manage and operate a
community department center. 

PURPOSE

As proposed, S.B. 940 creates mechanisms that enable the Texas Department
of Mental Health and Mental Retardation to manage and operate a community
Mental Health and Mental Retardation Center. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Texas Board of Mental Health and
Mental Retardation in SECTIONS 5, 6, 13, and 14 (Sections 533.034,
533.035, 534.071 and, 534.092, Health and Safety Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 531, Health and Safety Code, by adding Section
531.003, as follows: 

Sec. 531.003. DEPARTMENT AS LEAD AGENCY.  Provides that the Texas
Department of Mental Health and Mental Retardation (department) is the
state's lead agency in policy and services related to mental health,
mental retardation, and behavioral health.  Requires certain agencies
having responsibilities related to mental health, mental retardation, or
behavioral health policy or services to conform to the department's
policies and standards.   

SECTION 2. Amends Section 532.003, Health and Safety Code, to require at
least two other members of the Texas Board of Mental Health and Mental
Retardation (board) to be consumers of services for persons with mental
illness or mental retardation or family members of consumers of those
services.  Makes conforming and nonsubstantive changes. 

SECTION 3. Amends Chapter 533A, Health and Safety Code, as follows:

Sec. 533.016. ALLOCATION OF SPACE.  Requires the department to conform the
department's use of space for departmental activities to the standards
adopted under Chapter 2165C, Government Code. 

SECTION 4. Amends Chapter 533B, Health and Safety Code, by adding Section
533.0321, as follows: 

Sec. 533.0321.  LONG-RANGE PLANNING FOR LOCAL AUTHORITIES.  Requires each
local mental health or mental retardation authority to develop a
long-range plan for services. Requires the local mental health or mental
retardation authority to amend the plan at least biennially to cover at
least six years immediately following the completion date of the most
recent plan update.  Requires the local mental health or mental
retardation authority to ensure  involvement of the public and families of
persons served by the local mental health or mental retardation authority
in all planning aspects and amendment processes.  Requires plans developed
under this section to cover all services that are relevant and
state-operated or funded by the local mental health or mental retardation
authority.  Sets forth purposes for the development of plans by the
department.  Sets forth requirements of plans developed under this
section. 

SECTION 5. Amends Section 533.034, Health and Safety Code, as follows:

Sec. 533.034. New heading:  COMMUNITY-BASED SERVICES CONTRACTS AND
PENALTIES RELATED TO SERVICES.  Requires the board, by rule, to establish
guidelines that provide penalties for violations of a service provider
contract provision or a department rule.  Requires rules to provide for a
range of appropriate penalties for certain categories of violations.
Provides that the rules may allow for the department to vary from a
guideline for particular contracts.  Requires rules adopted under
Subsection (b) to include the process by which a provider may appeal
adverse decisions or actions by the department. Sets forth penalties for a
violation of adopted rules.  Provides that an administrative penalty
imposed by a rule adopted under this section may be assessed and collected
as provided by Section 571.025. 

SECTION 6. Amends Section 533.035, Health and Safety Code, by adding
Subsection (e), to require the board to establish, by rule, a
reimbursement system for disbursements under Subsection (b).  Requires the
system to provide for funding services according to the median
expenditures for services in each region if the services are funded with
money from the general revenue fund. Requires the rule to provide for a
cost report modeled after the report used by providers of Medicaidfunded
services. 

SECTION 7. Amends Section 534.002, Health and Safety Code, as follows:

Sec. 534.002. BOARD OF TRUSTEES FOR CENTER ESTABLISHED BY ONE LOCAL
AGENCY.  Deletes a provision requiring the board of trustees of a
community center established by one local agency to be composed of the
members of the local agency's governing body. 

SECTION 8. Amends Sections 534.003(b) and (c), Health and Safety Code, to
require the governing bodies of the local agencies to appoint the board
members from among certain qualified voters, rather than either from among
the membership of the governing bodies or certain qualified voters.
Requires the governing bodies to enter into a contract that stipulates the
number of board members, and not the group from which the members are
chosen, when the center is established. Provides that a contract may be
renegotiated or amended to change the membership of the board of trustees
to more accurately reflect the ethnic and geographic diversity of the
local service, rather than to change the method of choosing the members. 

SECTION 9. Amends Section 534.004(b), Health and Safety Code, to require
the local agency or organizational combination to include at least two
persons otherwise qualified under this chapter who are consumers of the
types of services the center provides. 

SECTION 10. Amends Sections 534.005(a) and (b), Health and Safety Code, to
require appointed members of the board of trustees to serve staggered
two-year terms, rather than members who are not members of a local
agency's governing body.  Requires a vacancy, rather than a vacancy
composed of qualified voters, on a board of trustees to be filled by
appointment for the remainder of the unexpired term. 

SECTION 11. Amends Chapter 534A, Health and Safety Code, by adding Section
534.0055, as follows: 

Sec. 534.0055.  DEPARTMENTAL TRAINING AND ASSISTANCE.  Requires the
department to train each board of trustees of a community center in the
board of trustees' roles and responsibilities.  Requires the department to
provide technical assistance to each  board of trustees of a community
center related to certain issues. 

SECTION 12. Amends Section 534.060(b), Health and Safety Code, to require
the department to conduct a comprehensive review of the program quality
and program performance results of each local mental health or mental
retardation authority at least once every three, rather than each fiscal
year.  Authorizes the department to conduct other reviews of a local
authority as necessary to ensure quality of services and compliance with
contract provisions and department rules, rather than providing the
department the authority to determine the scope of each review. 

SECTION 13. Amends Chapter 534B, Health and Safety Code, by adding Section
534.071, as follows: 

Sec. 534.071. VOUCHER PROGRAMS.  Requires the department to revise its
methods of reimbursing providers of services to incorporate a voucher
system to promote consumer choice in obtaining appropriate services that
the department finances, including certain other services.  Requires the
board to establish rules and sets forth required rules. 

SECTION 14. Amends Chapter 534, Health and Safety Code, by adding
Subchapter C, as follows: 

SUBCHAPTER C.  DEPARTMENT INTERVENTION OR CONSERVATORSHIP
FOR INADEQUATELY PERFORMING PROVIDERS

Sec. 534.091. FINDINGS AND PURPOSE.  Provides that the legislature finds
that the closing of a facility that provides mental health or mental
retardation services or the cancellation of a mental health or mental
retardation service provider's contract in some circumstances may have
adverse effects on certain persons or result in a lack of certain
resources.  Sets forth purposes of this subchapter. 

 Sec. 534.092. CAUSES FOR INTERVENTION OR APPOINTMENT OF CONSERVATOR.
Requires the board, by rule, to describe the causes for intervention with
or appointment of a conservator for a provider, including a community
center or local mental health or mental retardation authority.  Sets forth
requirements for which the causes must be related to a pattern of
deficient practices of a provider. 

Sec. 534.093. INTERVENTION.  Authorizes the department to intervene in
order to protect persons receiving services from the provider or to
correct the deficiencies, by assigning an intervention team or a monitor
to the provider, if the department has reason to believe that a provider
exhibits a cause for intervention described by rules adopted under Section
534.092.   

Sec. 534.094. INTERVENTION TEAM.  Requires an intervention team the
department assigns to consist of persons who have the expertise to assist
the provider in correcting the deficiencies under Section 534.093.  Sets
forth the requirements of an intervention team. 

Sec. 534.095. MONITOR.  Requires a monitor assigned to a provider to
oversee the provider's activities in correcting deficiencies under Section
534.093.  Requires the monitor to give the provider assistance and advice
to complete the intervention team's plan for the provider to correct the
deficiencies, if an intervention team has been assigned to the provider.
Authorizes the monitor to amend the plan in order to facilitate correcting
the deficiencies. Requires the monitor to consult with the intervention
team before amending the plan if the team is still assigned to work with
the provider.  Requires the monitor to carry out the duties of an
intervention team provided by Section 534.094 and work closely with the
provider to assist and advise the provider in completing the plan, if an
intervention team has not been assigned to the provider.  Authorizes the
monitor to recommend to the department actions the department should take. 

Sec. 534.096. APPOINTMENT OF CONSERVATOR BY AGREEMENT.  Authorizes the
department to appoint a conservator to direct the provision of the
provider's services, at the request of a provider, if the department
determines the appointment of a conservator is  desirable and consistent
with the purposes of this subchapter.  Requires an agreement under this
section to preserve all rights granted by law to the persons receiving the
services. Provides that an agreement under this section terminates as
specified by the agreement or when the provider or the department notifies
the other party in writing that the party wishes to terminate the
agreement. 

Sec. 534.097. INVOLUNTARY APPOINTMENT.  Authorizes the department to
request that the attorney general bring suit on behalf of the state for
the appointment of a conservator to take charge of the provision of a
provider's services, if certain conditions are met. Requires a court to
appoint a conservator to take charge of the provision of services if the
court finds that the appointment is warranted, after a hearing.  Requires
the court to consider a person the department recommends for the
appointment.  Requires the court to appoint a conservator who has
experience in providing services of the type the conservator is appointed
to provide.  Requires an action under this section to be brought in Travis
County or the county where the provider provides services. 

Sec. 534.098. COSTS AND FEES OF CONSERVATOR.  Requires the department to
pay the conservator's fee and reasonable expenses promptly.  Provides that
a provider is liable to the department if the provider meets certain
requirements.  Prohibits a provider from using state money to reimburse
the department under this section.  Authorizes the department to withhold
contract payments to a provider for whom a conservator has been appointed,
to ensure that state money is not used for reimbursement under this
section. 

Sec. 534.099. POWERS AND DUTIES OF CONSERVATOR.  Sets forth actions a
conservator appointed under this subchapter is authorized to take.
Requires a conservator appointed under this subchapter to undertake to
rehabilitate the practices of the provider so that the provider may
continue to operate in accordance with law, department rules, and
contracts.  Requires the conservator to administrate the closure of the
provider's facility or business, to protect the health, safety, or welfare
of persons receiving the provider's services. Requires a conservator
appointed under this subchapter to report any practices to the department
that indicate other deficiencies described by rules adopted under Section
534.092.  Authorizes a conservator to recommend to the department at any
time that the conservatorship be ended.  Provides that a conservator is
under the direction and supervision of the department and is required to
comply with orders of the board in fulfilling the conservator's duties.
Requires the department to train conservators to ensure that a conservator
will carry out responsibilities under this chapter appropriately. 

Sec. 534.100. EXPIRATION OF CONSERVATORSHIP.  Requires a conservator to
serve unless the board makes certain determinations.  Authorizes a
provider to petition the board for an order modifying the conservator's
duties, or relief from certain actions of the conservator.  Authorizes the
provider to petition the court that appointed the conservator for relief
or for the conservatorship to end, if the board does not satisfy the
provider under Subsection (b). 

SECTION 15.  Requires each local mental health or mental retardation
authority to develop the first long-range plan for services as required by
Section 533.0321, Health and Safety Code, as added by this Act, during the
authority's first fiscal year that begins after this Act becomes law. 

SECTION 16. (a) Provides that changes in law made by this Act to the
requirements for membership on the board do not affect the entitlement of
a member serving on the board on August 31, 1997, to continue to hold
office for the remainder of the term for which the person was appointed.
Requires the governor to appoint persons to fill vacancies on the board. 

(b) Requires a local agency or organizational combination of local
agencies that appoints a board of trustees that is serving under Section
534.002 or 534.003, Health and Safety Code, to appoint a new board as
provided by the appropriate section of that code, as amended by this Act.
Sets forth provisions for the establishment of staggered terms to be
served by the board members. 

 
(c) Authorizes members of local governmental bodies who are serving as
members of a board of trustees under Section 534.002(1) or 534.003(b),
Health and Safety Code, to continue to serve, notwithstanding the changes
made by this Act, until the newly appointed board members have qualified
for and taken office. 

SECTION 17. Emergency clause.
  Effective date: upon passage.