SRC-JJJ, DBM S.B. 358 76(R)BILL ANALYSIS Senate Research CenterS.B. 358 By: Madla Health Services 8/5/1999 Enrolled DIGEST Currently, the Texas Sunset Commission reports that the Texas Department of Mental Health and Mental Retardation (department) oversees and provides services to some of the state's most vulnerable citizens--persons with mental illness and mental retardation. The department's mission is "to improve the quality and efficiency of public and private services and supports for Texans with mental illness and mental retardation so that they can increase their opportunities and abilities to lead lives of dignity and independence." During 1997, an estimated 2.8 million Texans were diagnosed with some form of mental illness and 530,000 with mental retardation; approximately 19,000 persons received services through campus-based facilities and 168,000 persons through communitybased services. The department provides services through 22 campus-based facilities and 10 stateoperated community services, and funds and oversees locally-operated community services through performance contracts with 38 community centers across the state. As a result of its review of the department, the Sunset Advisory Commission recommended continuation of the department and several statutory modifications. PURPOSE As enrolled, S.B. 358 sets forth provisions concerning the continuation and functions of the Texas Department of Mental Health and Mental Retardation. RULEMAKING AUTHORITY Rulemaking authority is granted to the Texas Department of Mental Health and Mental Retardation in SECTIONS 6, 7, 8, and 17 (Section 533.0325, Chapter 533B, Health and Safety Code; Section 533.0345(a), Chapter 533B, Health and Safety Code; Section 533.0351(g), Chapter 533B, Health and Safety Code; and Section 461.0128(a), Chapter 461, Health and Safety Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 532.002, Health and Safety Code, to provide that the Texas Department of Mental Health and Mental Retardation (department) is abolished and this chapter expires on September 1, 2011, rather than September 1, 1999, unless continued as provided by Chapter 325, Government Code. SECTION 2. Amends Chapter 532, Health and Safety Code, by adding Section 532.0035, to add standard language developed by the Sunset Advisory Commission regarding board member training. SECTION 3. Amends Sections 532.016(d) and (e), Health and Safety Code, to add standard language developed by the Sunset Advisory Commission regarding equal employment opportunity policies. Makes a conforming change. SECTION 4. Amends Chapter 533A, Health and Safety Code, by adding Section 533.013, as follows: Sec. 533.013. DUPLICATION OF REHABILITATION SERVICES. Requires the department to enter into an agreement with the Texas Rehabilitation Commission (commission) that defines the roles and responsibilities of the department and the commission regarding the agencies' shared populations. Requires the agreement to establish methods to prevent the duplication and fragmentation of employment services provided by the agencies. SECTION 5. Amends Section 533.032, Health and Safety Code, by adding Section 533.032, as follows: Sec. 533.032. New heading: LONG-RANGE PLANNING. (a) Requires the department to have a long-range plan covering at least six years that includes at least the provisions required by Sections 531.022 and 531.023, Government Code, and Chapter 2056, Government Code. Requires the plan to cover the provision of services in and policies for state-operated institutions and ensure that the medical needs of the most medically fragile persons the department serves are met. (b) Sets forth the parties from which the department must solicit input. (c) Requires the department to develop a report containing information and recommendations regarding the most efficient long-term use and management of the department's campus-based facilities. Sets forth the information the report is required to include. (d) Requires the department to consider the medical needs of the most medically fragile clients and the provision of services to clients with severe and profound mental retardation. (e) Sets forth certain activities the department must undertake regarding the report, legislative appropriations, and the department's long-range biennial plan. SECTION 6. Amends Chapter 533B, Health and Safety Code, by adding Section 533.0325, as follows: Sec. 533.0325. CONTINUUM OF SERVICES IN CAMPUS FACILITIES. Requires the Texas Board of Mental Health and Mental Retardation (board) to establish, by rule, criteria regarding the uses of the department's campus-based facilities to ensure that a full continuum of services is available. SECTION 7. Amends Chapter 533B, Health and Safety Code, by adding Sections 533.0345 and 533.0346, as follows: Sec. 533.0345. STATE AGENCY SERVICES STANDARDS. (a) Requires the department to develop, by rule, model program standards for mental health and mental retardation services for use by each state agency that provides or pays for mental health and mental retardation services. Requires the department to provide the model standards to each agency that provides mental health and mental retardation services as identified by the Health and Human Services Commission. (b) Requires model standards developed under Subsection (a) to be designed to improve the consistency of mental health services provided by or through a state agency. (c) Requires the department to biennially review the model standards developed under Subsection (a) and determine whether each standard contributes effectively to the consistency of service delivery by state agencies. Sec. 533.0346. AUTHORITY TO TRANSFER SERVICES TO COMMUNITY CENTERS. (a) Authorizes the department to transfer certain operations to a community center. (b) Authorizes the transfer to occur only on the department's approval of a plan or of an amendment to a previously approved plan. Sets forth requirements for developing the plan. (c) Requires the center or proposed center to publish notice of the initial plan or plan amendment before it is submitted. Requires the notice to include time and location of the meeting. Sets forth requirements for content and publishing of the notice within the proposed service area. (d) Requires money supporting the cost of providing operations and services at a state center to be transferred to the community center to ensure continuity of service, at the time of transfer. (e) Provides that the Amarillo State Center is exempt from the requirements of Subsections (b) and (c). SECTION 8. Amends Chapter 533B, Health and Safety Code, by adding Section 533.0351, as follows: Sec. 533.0351. LOCAL AUTHORITY TECHNICAL ADVISORY COMMITTEE. (a) Defines "local authority." (b) Requires the commissioner of mental health and mental retardation (commissioner) to establish a nine-member local authority advisory committee to advise the commissioner on certain issues that directly affect local authority responsibilities. (c) Provides that the committee is composed of representatives of local authorities and one member representing the public appointed by the commissioner. Requires the commissioner, to ensure a balanced representation of single-county and multi-county local authorities. (d) Requires members, except for members representing the public, appointed to the advisory committee to have expertise in the day-to-day operations of a local authority. (e) Sets forth the required duties of the advisory committee. (f) Requires the department to provide the advisory committee with a written response to any recommendation the advisory committee makes to the department. (g) Subjects the committee to Chapter 2110, Government Code. Requires the department, by rule, to provide, in accordance with Section 2110.008, Government Code, that the committee is abolished on September 1, 2007, unless the board votes to continue the committee in existence. SECTION 9. Amends Chapter 533B, Health and Safety Code, by adding Section 533.0356, as follows: Sec. 533.0356. LOCAL BEHAVIORAL HEALTH AUTHORITIES. (a) Defines "commission." (b) Authorizes the department and the Texas Commission on Alcohol and Drug Abuse (TCADA) to jointly designate a local behavioral health authority on a local service area to provide mental health and chemical dependancy services in that area. Authorizes the department and TCADA to delegate to a designated authority certain authority and responsibility regarding resource development for and oversight of mental health and chemical dependancy services. Sets forth responsibilities and duties of the designated authority. (c) Requires the authority to give proportionate priority to mental health services and chemical dependancy services and ensure that funds are used in accordance with specific regulatory and statutory requirements that govern the respective funds. (d) Authorizes a local mental health authority to apply to the department and TCADA for designation as a local behavior health authority. (e) Authorizes the department and TCADA to disburse money to a local behavioral health authority for services. (f) Requires a local behavior authority to use money to ensure that mental health and chemical dependancy services are provided in the local service area at the same level as the level of services previously provided through other entities. (g) Requires the department and TCADA, in determining whether to designate a location, to solicit and consider written comments from certain persons. (h) Requires a designated authority to demonstrate to the department and TCADA that services involving state funds that the authority oversees comply with relevant state standards. (i) Authorizes the board and TCADA to jointly adopt rules to govern the operations of local behavioral health authorities. Authorizes the department and TCADA jointly to assign the local behavioral health authority the duty of providing a single point of entry for mental and chemical dependancy services. SECTION 10. Amends Section 533.038, Health and Safety Code, by adding Subsections (d), (e) and (f), to require a person with mental retardation, or the person's legal representation, seeking residential services to receive a clear explanation of programs and services for which the person is eligible. Requires the preferred programs chosen by the person or the person's representative to be documented in the person's record. Requires the person or the person's representative to be given assistance in gaining access to alternative services and the selected waiting list should the preferred services be unavailable. Requires the department to ensure that the information regarding the program and service preferences is documented and maintained in a manner that permits the department to access and use the information for planning activities. Authorizes the department to spend money appropriated for the state school system only in accordance with certain limitations. SECTION 11. Amends Chapter 533B, Health and Safety Code, by adding Section 533.039, as follows: Sec. 533.039. CLIENT SERVICES OMBUDSMAN. Requires the commissioner to employ an ombudsman who is responsible for assisting a person who has been denied service by the department, a program or facility, or a local mental health or mental retardation authority. Requires the ombudsman to explain information on department and local mental health or mental retardation authority services, facilities, programs, and the rules, procedures, and guidelines to the person denied services and to refer the person to the appropriate program, facility, or service of the department or any other entity, if any. SECTION 12. Amends Section 534.004(a), Health and Safety Code, to require the local agency or organizational combination of local agencies that establishes a community center to prescribe certain procedures. Deletes text requiring a term limit procedure. SECTION 13. Amends Section 534.005, Health and Safety Code, to delete existing Subsection(c), regarding limiting a person appointed to the board to four terms, under certain conditions. SECTION 14. Amends Section 534.007, Health and Safety Code, to add standard language developed by the Sunset Advisory Commission regarding prohibited activities by former officers or employees and offenses. Provides that this section does not apply to a former employee who is compensated on the last date of service or employment below the amount prescribed by the General Appropriations Act for salary group 17, Schedule A, or salary group 9, Schedule B, of the position classification schedule. SECTION 15. Amends Section 534.065(b), Health and Safety Code, to authorize the mental health or mental retardation authority to renew the contract only if the contract meets the criteria provided by Section 533.016, Health and Safety Code. Deletes text concerning the renewal of the contract. SECTION 16. Amends Chapter 534C, Health and Safety Code, by adding Section 534.106, as follows: Sec. 534.106. CONDITIONS FOR CERTAIN CONTRACTS. Requires a contract between the department and a health maintenance organization (HMO) formed by one or more community centers to provide that the HMO may not form a for-profit entity unless the HMO transfers all of its assets to the control of the boards of trustees of the community centers that formed the HMO. SECTION 17. Amends Chapter 461, Human Resources Code, by adding Section 461.0128, as follows: Sec. 461.0128. STATE AGENCY SERVICES STANDARDS. (a) Requires the commission, by rule, to develop model program standards for substance abuse services for use by each state agency that provides or pays for substance abuse services. Requires the commission to provide the model standards to each agency that provides substance abuse as services identified by the Health and Human Services Commission. (b) Requires model standards developed under Subsection (a) to be designed to improve the consistency of substance abuse services provided by or through a state agency. (c) Requires the commission to biennially review the model standards developed under Subsection (a) and determine whether each standard contributes effectively to the consistency of service delivery by state agencies. SECTION 18. Amends Chapter 461, Health and Safety Code, by adding Section 461.0129, as follows: Sec. 461.029. LOCAL BEHAVIORAL HEALTH AUTHORITIES. Authorizes TCADA to designate and provide services through local behavioral health authorities. SECTION 19. Amends Section 574.083, Health and Safety Code, as follows: Sec. 574.083. New heading: RETURN TO FACILITY UNDER COURT ORDER. Provides that an order issued under this subsection extends to any part of this state and authorizes any peace officer to whom the order is directed or transferred to execute the order. Requires an affidavit to set out facts establishing that the patient is receiving court-ordered inpatient mental health services at a facility and show certain reasonable beliefs of the facility administrator. Authorizes a peace or health officer who cannot immediately return a patient to the facility to transport the patient to a local facility for detention. Prohibits the patient from being detained in a nonmedical facility that is used to detain persons who are charged with or convicted of a crime, unless the detention facility is warranted by an extreme emergency. Sets forth conditions if a patient is detained in a nonmedical facility. Requires the county health authority to ensure that the patient detained in a nonmedical facility received proper care and medical attention. Authorizes the facility administrator to release to a law enforcement official information about the patient if the administrator determines the information is needed to facilitate the return of the patient of the facility. Makes conforming changes. SECTION 20. Amends Section 593.012, Health and Safety Code, as follows: Sec. 593.012. New heading: ABSENT WITHOUT AUTHORITY. Authorizes the superintendent of a residential care facility to which a client has been admitted for courtordered care and treatment to have a client who is absent without authority taken into custody, detained, and returned to that facility by filing an affidavit with a magistrate. Requires the client to be returned to the residential care facility in accordance with prescribed procedures. Deletes text regarding the authorization of a peace officer to detain a committed resident and immediately notify the superintendent. SECTION 21. Requires the department and the Texas Department of Housing and Community Affairs (TDHCA) to implement a program to demonstrate the effectiveness of interagency cooperation for providing supported housing services to individuals with mental illness who reside in personal care facilities. Requires the department and TDHCA to design the supported housing services to give individualized assistance to persons to acquire and retain certain living arrangements. Requires the supported housing services to be provided in accordance with certain rules of the department. Requires the department and TDHCA to work with the Department of Human Services (DHS) to allocate resources for the demonstration program so that priority is given to certain communities. Requires the department and TDHCA to establish an application process for communities that seek to participate in the demonstration program. Requires the department and TDHCA to establish a committee to supervise the design and implementation of the demonstration program. Sets forth individuals required to be represented in the committee. Prohibits a community from being selected to participate in the program unless the person that applies for the communities participation demonstrates collaboration between certain entities. Sets forth conditions by which a person is not eligible for assistance under the demonstration program. Requires the department and TDHCA to implement the demonstration program as soon as possible after the effective date of this Act and not later than January 1, 2000. Requires the department and TDHCA, on or before January 15, 2001, to make a joint report for certain entities. Sets forth information required in the report. Provides that this section expires August 31, 2001. SECTION 22. Requires the commissioner to appoint a committee to evaluate the delivery and regulation of services to residents of intermediate care facilities for the mentally retarded. Sets forth individuals that compose the nine-member committee. Requires the committee to evaluate the impact and feasibility of consolidating certain aspects of intermediate care facilities for the mentally retarded. Sets forth goals and objectives the committee shall consider in evaluating the impact and feasibility. Requires the committee to prepare a report that includes its findings and recommendations, and to present that report not later than October 1, 2000, to certain individuals. SECTION 23. Prohibits the transfer prescribed by this section from occurring if the committee determines that consolidating certain services is not in the best interests of the residents. Establishes that on September 1, 2001, subject to limitations, the licensing, surveying, and regulation of intermediate care facilities for the mentally retarded are transferred from the DHS, or its successor agency, to the Texas Department of Mental Health and Mental Retardation. Sets forth provisions that must occur upon the transfer of functions listed in Subsection (b). Authorizes the secretary of state to adopt rules as necessary to expedite the implementation of Subsection (c)(4). Sets forth functions that are not affected or impaired by the transfer that were existing, begun, or accrued penalties under former law, and that law remains in effect for any action concerning those matters. Sets forth provisions regarding the transfer prescribed by this section. Requires the commissioner of health and human services to facilitate and supervise the prescribed transfer. SECTION 24.Makes application of this Act prospective. SECTION 25. Effective date: September 1, 1999. SECTION 26. Emergency clause.