HBA-DMD, EVB S.B. 371 76(R)BILL ANALYSIS


Office of House Bill AnalysisS.B. 371
By: Brown
Corrections
4/30/1999
Committee Report (Amended)




BACKGROUND AND PURPOSE 

The legislature created the Correctional Managed Health Care Advisory
Committee (committee) in 1993 to oversee contracts on behalf of the Texas
Department of Criminal Justice (department) for prison health care
services.  The committee contracts with the University of Texas Medical
Branch at Galveston and Texas Tech University Health Sciences Center to
provide health care to the department's inmates. The committee is subject
to the Texas Sunset Act and will be abolished on September 1, 1999, unless
continued by the legislature. S.B. 371 continues the Correctional Managed
Health Care Advisory Committee for a six-year period and makes statutory
modifications recommended by the Sunset Advisory Commission.  

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 501, Government Code, by adding Subchapter E, as
follows: 

SUBCHAPTER E.  MANAGED HEALTH CARE

Sec. 501.131.  DEFINITION.  Defines "committee."

Sec. 501.132.  APPLICATION OF SUNSET ACT.  Provides that the Correctional
Managed Health Care Committee (committee) is subject to Chapter 325 (Texas
Sunset Act), Government Code.  Provides that unless continued in existence
as provided by that chapter, the committee is abolished and this subchapter
expires September 1, 2005.  

Sec. 501.133.  COMMITTEE MEMBERSHIP.  Sets forth the composition of the
ninemember committee. Requires an appointment to the committee to be made
without regard to the race, color, disability, sex, religion, age, or
national origin of the appointee.  

Sec. 501.134.  PUBLIC MEMBER ELIGIBILITY.  Prohibits a person from being a
public member of the committee if the person or the person's spouse  is
employed by or participates in the management of a business entity or other
organization regulated by or receiving money from the Texas Department of
Criminal Justice (department) or the committee; owns or controls, directly
or indirectly, more than a 10 percent interest in a business entity or
other organization regulated by or receiving money from the department or
the committee; or uses or receives a substantial amount of tangible goods,
services, or money from the department or the committee other than
compensation or reimbursement authorized by law for committee membership,
attendance, or expenses. 
 
Sec. 501.135.  MEMBERSHIP AND EMPLOYEE RESTRICTIONS.  Defines  "Texas trade
association."  Prohibits a person from being a member of the committee and
from being a committee employee employed in a "bona fide executive,
administrative, or professional capacity," as that phrase is used for
specified purposes if the person is an officer, employee,  or paid
consultant of a Texas trade association in the field of health care or
health care services or the person's spouse is an officer, manager, or paid
consultant of a Texas trade association in the field of health care or
health care services.  Prohibits a person from being a member of the
committee or acting as the general counsel to the committee if the person
is required to register as a lobbyist under Chapter 305 (Registration of
Lobbyists) because of the person's activities for compensation on behalf of
a profession related to the operation of the committee.  

Sec. 501.136.  TERMS OF OFFICE.  Provides that committee members appointed
by the governor serve staggered six-year terms, with the term of one of
those members expiring on February 1 of each odd-numbered year.  Provides
that other committee members serve at the will of the appointing official
or until termination of the member's employment with the entity the member
represents.  

Sec. 501.137.  PRESIDING OFFICER.  Requires the governor to designate a
physician member of the committee as presiding officer.  Provides that the
presiding officer serves in that capacity at the will of the governor.  

Sec. 501.138.  GROUNDS FOR REMOVAL.  Provides that any of the enumerated
provisions is grounds for removal from the committee.  Provides that the
validity of an action of the committee is not affected by the fact that it
is taken when a ground for removal of a committee member exists.  Requires
the administrator to notify the presiding officer of the committee of the
potential ground if the managed health care administrator has knowledge
that a potential ground for removal exists.  Requires the presiding officer
to then notify the governor and the attorney general that a potential
ground for removal exists. Requires that if the potential ground for
removal involves the presiding officer, the managed health care
administrator shall notify the next highest ranking officer of the
committee, who is then required to notify the governor and the attorney
general that a potential ground for removal exists. 
 
Sec. 501.139.  MEETINGS.  Requires the committee to meet at least once in
each quarter of the calendar year and at any other time at the call of the
presiding officer.  Authorizes the committee to hold a meeting by telephone
conference call or other video or broadcast technology.  

Sec. 501.140.  TRAINING. Prohibits a person who is appointed to and
qualifies for office as a member of the committee from voting,
deliberating, or being counted as a member in attendance at a meeting of
the committee until the person completes a training program that complies
with this section. Provides that the training program must provide the
person with certain information regarding the stipulations and functions
relating to the committee. Provides that a person appointed to the
committee is entitled to reimbursement, as provided by the General
Appropriations Act, for the travel expenses incurred in attending the
training program regardless of whether the attendance at the program occurs
before or after the person qualifies for office.  

Sec. 501.141.  COMPENSATION; REIMBURSEMENT.  Provides that a committee
member serves without compensation but is entitled to reimbursement for
actual and necessary expenses incurred in the performance of the duties of
the committee.  

Sec. 501.142.  ADMINISTRATION; PERSONNEL.  Authorizes the committee to hire
a managed health care administrator, who is authorized to employ personnel
necessary for the administration of the committee's duties. Requires the
committee to pay necessary costs for its operation, including costs of
hiring the managed health care administrator and other personnel, from
funds appropriated by the legislature to the department for correctional
health care. 
 
Sec. 501.143.  DIVISION OF RESPONSIBILITIES.  Requires the committee to
develop and implement policies that clearly separate the policy-making
responsibilities of the committee and the management responsibilities of
the managed health care administrator and staff of  the committee.  

Sec. 501.144.  QUALIFICATIONS AND STANDARDS OF CONDUCT INFORMATION.
Requires the managed health care administrator or the administrator's
designee to provide to members of the committee and to committee employees,
as often as necessary, information regarding the requirements for office or
employment under this subchapter, including information regarding a
person's responsibilities under applicable laws relating to standards of
conduct for state officers or employees.  

Sec. 501.145.  EQUAL EMPLOYMENT OPPORTUNITY POLICY.  Requires the managed
health care administrator or the administrator's designee to prepare and
maintain a written policy statement that implements a program of equal
employment opportunity to ensure that all personnel decisions are made
without regard to race, color, disability, sex, religion, age, or national
origin. Provides that the policy statement must include specified
provisions relating to personnel policies and an analysis of the extent of
compliance with state and federal laws.  Provides that the policy statement
must follow certain conditions. 

Sec. 501.146.  MANAGED HEALTH CARE PLAN.  (a) Requires the committee to
develop a managed health care plan for all persons confined by the
department that includes certain conditions concerning criteria and studies
for specified health care providers. 

(b)  Authorizes the University of Texas Medical Branch at Galveston and the
Texas Tech University Health Sciences Center, to implement the managed
health care plan for employees who are entitled to retain salary and
benefits applicable to specified employees, to administer, offer, and
report through their payroll systems participation by those employees in
the Texas employees uniform group insurance benefits program and the
Employees Retirement System of Texas.  

Sec. 501.147.  COMMITTEE AUTHORITY TO CONTRACT.  Authorizes the committee
to enter into a contract on behalf of the department to fully implement the
managed health care plan under this subchapter. Authorizes the committee
to, in addition to providing services to the department, contract with
other governmental entities for similar health care services and integrate
those services into the managed health care provider network. Requires the
committee, in contracting for implementation of the managed health care
plan and to the extent possible, to integrate the managed health care
provider network with the public medical schools of this state and the
component and affiliated hospitals of those medical schools. Requires the
committee to initiate a competitive bidding process for contracts with
other providers for medical care to persons confined by the department for
services that the public medical schools and their components and
affiliates cannot provide.  

Sec. 501.148.  GENERAL POWERS AND DUTIES OF COMMITTEE.  Requires the
committee to follow procedures relating to the development, performance,
and monitoring of services and to enforce contractual compliance with
health care providers. 

_Requires the committee to evaluate and recommend to the board sites for
new medical facilities that appropriately support the managed health care
provider network.  

_Requires the committee to contract with an individual for financial
consulting services and to make use of financial monitoring of the managed
health care plan to assist the committee in determining an accurate
capitation rate. 

_Authorizes the committee to contract with an individual for actuarial
consulting services to assist the committee in determining trends in the
health of the inmate population and the impact of those trends on future
financial needs.  

Sec. 501.149.  QUALITY OF CARE MONITORING BY THE DEPARTMENT AND HEALTH CARE
PROVIDERS. Requires the committee to establish a procedure for monitoring
the quality of care delivered by the health care providers,  including
investigating  medical grievances, ensuring access to medical care, and
conducting periodic operational reviews of medical care provided at its
units. Requires the department and the medical care providers to cooperate
in monitoring quality of care.  Requires the clinical and professional
resources of the health care providers to be used to the greatest extent
feasible for clinical oversight of quality of care issues. Requires the
department and the medical care providers to communicate the results of
their monitoring activities to the committee.  

Sec. 501.150.  COMPLAINTS.  Requires the committee to maintain a file on
each written complaint filed with the committee including specified
information.  Requires the committee to provide to the person filing the
complaint and to each person who is a subject of the complaint a copy of
the committee's policies and procedures relating to complaint investigation
and resolution.  Requires the committee, at least quarterly until final
disposition of the complaint, to notify the person filing the complaint and
each person who is a subject of the complaint of the status of the
investigation unless the notice would jeopardize an undercover
investigation.  

Sec. 501.151.  PUBLIC PARTICIPATION.  Requires the committee to develop and
implement policies that provide the public with a reasonable opportunity to
appear before the committee and to speak on any issue under the
jurisdiction of the committee.  

SECTION 2.  Repealer: Section 501.059 (Correctional Managed Health Care
Advisory Committee), Government Code, which established the Correctional
Managed Health Care Advisory Committee to the Texas Department of Criminal
Justice. 

SECTION 3.  Provides that the name of the Correctional Managed Health Care
Advisory Committee is changed to the Correctional Managed Health Care
Committee.  Provides that the change in the name of the committee does not
affect the validity of any action taken by the committee before, on, or
after the effective date of this Act.  Provides that a reference in law to
the Correctional Managed Health Care Advisory Committee means the
Correctional Managed Health Care Committee.  

SECTION 4.  Requires the governor to make initial gubernatorial
appointments to the committee to accomplish the membership required by
Section 501.133, Government Code, as added by this Act, not later than
January 1, 2000, and to designate one member for a term expiring January
31, 2001, one member for a term expiring January 31, 2003, and one member
for a term expiring January 31, 2005.  

SECTION 5.  Effective date: September 1, 1999. 

SECTION 6.  Emergency clause.

EXPLANATION OF AMENDMENTS

Amendment #1

Replaces proposed Section 501.133(a)(4), Government Code, in SECTION 1, and
in so doing, removes the specification that the three public members
(appointee) appointed by the governor to the nine-member Correctional
Managed Health Care Committee (committee), not be affiliated with any
entity with which the committee has contracted to provide health care
services. Specifies that at least one of the appointees be a practicing
physician in a rural area and one be a rural hospital administrator,
whereas, the existing bill specifies that two of the appointees be licensed
to practice medicine in this state. 

Amendment #2

Amends SECTION 1, to add new Sections 501.149 and 501.1491, Government
Code, as follows: 

 Sec. 501.149. USE OF RURAL HOSPITAL CONTRACTS. Requires the University of
Texas Medical Branch at Galveston (UTMBG) and the Texas Tech Health
Sciences Center (TTHSC), in conjunction with the Correctional Managed
Health Care Committee  (committee), to develop and implement a
comprehensive plan for expanding the use of rural hospital contracts for
inmate care. Provides that the plan must include measures designed to
reduce inmate transportation costs, including transportation-related
security costs, and health care costs. 

Sec. 501.1491. REPORT TO LEGISLATURE. Requires the committee to report to
the 77th Legislature regarding the progress made in expanding the use of
rural hospital contracts in providing inmate health care services and
reducing inmate transportation and health care costs. Provides that the
report must include implementation plans, a timetable, and an analysis of
costs incurred and savings realized through expanding the use of rural
hospital contracts. Sets forth that this section expires September 1, 2001. 

Amends SECTION 1, to renumber proposed Sections 501.149, 501.150, and
501.151, Government Code, as Sections 501.150, 501.151, and 501.152,
Government Code, respectively. 

Adds a new SECTION 5, and renumbers current SECTIONS 5 and 6 as SECTIONS 6
and 7, respectively. New SECTION 5, requires UTMBG and TTHSC, in
conjunction with the committee, to develop and begin implementation of the
comprehensive plan required by Section 501.149, Government Code, as added
by this Act, no later than January 1, 2000.