By Delisi, Gray, Hilderbran, Coleman,                 H.B. No. 1444
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to local public health services.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Section 121.002, Health and Safety Code, is
 1-5     amended to read as follows:
 1-6           Sec. 121.002.  DEFINITIONS [DEFINITION].  In this chapter:
 1-7                 (1)  "Essential public health services" means services
 1-8     to:
 1-9                       (A)  monitor the health status of individuals in
1-10     the community to identify community health problems;
1-11                       (B)  diagnose and investigate community health
1-12     problems and community health hazards;
1-13                       (C)  inform, educate, and empower the community
1-14     with respect to health issues;
1-15                       (D)  mobilize community partnerships in
1-16     identifying and solving community health problems;
1-17                       (E)  develop policies and plans that support
1-18     individual and community efforts to improve health;
1-19                       (F)  enforce laws and rules that protect the
1-20     public health and ensure safety in accordance with those laws and
1-21     rules;
1-22                       (G)  link individuals who have a need for
1-23     community and personal health services to appropriate community and
1-24     private providers;
1-25                       (H)  ensure a competent workforce for the
 2-1     provision of essential public health services;
 2-2                       (I)  research new insights and innovative
 2-3     solutions to community health problems; and
 2-4                       (J)  evaluate the effectiveness, accessibility,
 2-5     and quality of personal and population-based health services in a
 2-6     community.
 2-7                 (2)  "Physician" [, "physician"] means a person
 2-8     licensed to practice medicine by the Texas State Board of Medical
 2-9     Examiners.
2-10           SECTION 2.  Subchapter A, Chapter 121, Health and Safety
2-11     Code, is amended by adding Sections 121.0065, 121.0066, and
2-12     121.0067 to read as follows:
2-13           Sec. 121.0065.  GRANTS FOR ESSENTIAL PUBLIC HEALTH SERVICES.
2-14     (a)  Subject to the availability of funds, the department shall
2-15     administer a program under which appropriated money may be granted
2-16     to counties, municipalities, public health districts, and other
2-17     political subdivisions for use by the counties, municipalities,
2-18     public health districts, and other political subdivisions to
2-19     provide or pay for essential public health services.
2-20           (b)  The board shall adopt rules governing:
2-21                 (1)  the allocation formula for grants awarded under
2-22     this section;
2-23                 (2)  the manner in which a municipality, county, public
2-24     health district, or other political subdivision applies for a
2-25     grant;
2-26                 (3)  the procedures for awarding grants; and
2-27                 (4)  the minimum essential public health services to be
 3-1     provided under the grant and other standards applicable to the
 3-2     services to be provided under the grant.
 3-3           (c)  A municipality, county, public health district, or other
 3-4     political subdivision that receives a grant under this section, in
 3-5     consultation with the department, shall develop a plan to evaluate
 3-6     the effectiveness, accessibility, and quality of the essential
 3-7     public health services that are provided under the grant. The plan
 3-8     must:
 3-9                 (1)  identify the outcomes that are intended to result
3-10     from the use of the grant money and establish a mechanism to
3-11     measure those outcomes; and
3-12                 (2)  establish performance standards for the delivery
3-13     of essential public health services and a mechanism to measure
3-14     compliance with those standards.
3-15           (d)  The governing body of the municipality, the
3-16     commissioners court of the county, or the members of a public
3-17     health district may appoint a local health board to monitor the use
3-18     of the money received under this section.
3-19           (e)  A public health board established under Section 121.034
3-20     or 121.046 may serve as the local health board authorized under
3-21     Subsection (d).
3-22           (f)  The governing body of the municipality or the
3-23     commissioners court of a county may serve as the local health board
3-24     authorized under Subsection (d).  If the governing body of the
3-25     municipality or the commissioners court of the county elects to
3-26     serve as the local health board, the governing body or
3-27     commissioners court may appoint an advisory committee to advise the
 4-1     governing body or commissioners court with respect to the use of
 4-2     the money granted under this section.
 4-3           (g)  Chapter 783, Government Code, and standards adopted
 4-4     under that chapter control if applicable to a grant made under this
 4-5     section.
 4-6           Sec. 121.0066.  ESSENTIAL PUBLIC HEALTH SERVICES PROVIDED BY
 4-7     DEPARTMENT.  (a)  Subject to the availability of funds, the
 4-8     department may provide  essential public health services for  a
 4-9     population for which a municipality, county, public health
4-10     district, or other political subdivision is not receiving a grant
4-11     to provide those services under Section 121.0065.
4-12           (b)  Subject to the availability of funds, the department
4-13     shall develop a plan that complies with Section 121.0065(c) to
4-14     evaluate the effectiveness, accessibility, and quality of essential
4-15     public health services provided under this section.
4-16           Sec. 121.0067.  EVALUATION AND REPORT OF DELIVERY OF
4-17     ESSENTIAL PUBLIC HEALTH SERVICES.  (a)  The department, in
4-18     cooperation with municipalities, counties, public health districts,
4-19     and other political subdivisions that receive grants under Section
4-20     121.0065, and the consortium established under Subchapter F, shall
4-21     evaluate:
4-22                 (1)  the effectiveness, accessibility, and quality of
4-23     essential public health services provided under the grant program
4-24     established by Section 121.0065 and under Section 121.0066; and
4-25                 (2)  the adequacy of funding for those services.
4-26           (b)  Not later than January 1 of each odd-numbered year, the
4-27     department shall file with the governor and the presiding officer
 5-1     of each house of the legislature a report detailing the results of
 5-2     the evaluation conducted under Subsection (a). The report must
 5-3     include recommendations relating to:
 5-4                 (1)  legislation to improve the effectiveness,
 5-5     accessibility, and quality of essential public health services; and
 5-6                 (2)  appropriate funding for those services.
 5-7           SECTION 3.  Section 121.007(c), Health and Safety Code, is
 5-8     amended to read as follows:
 5-9           (c)  The board or its designee may require a regional
5-10     director to perform the duties of a health authority.  The regional
5-11     director may perform those duties, as authorized by the board or
5-12     commissioner, in a jurisdiction in the region in which[:]
5-13                 [(1)  there is no health authority; or]
5-14                 [(2)]  the health authority fails to perform duties
5-15     prescribed by the board under Section 121.024. The regional
5-16     director shall perform the duties of a health authority in a
5-17     jurisdiction in the region in which there is not a health
5-18     authority.
5-19           SECTION 4.  Section 121.028, Health and Safety Code, is
5-20     amended to read as follows:
5-21           Sec. 121.028.  APPOINTMENT OF HEALTH AUTHORITY.  (a)  The
5-22     governing body of a municipality or the commissioners court of a
5-23     county that has not established a local health department or a
5-24     public health district may appoint a physician as health authority
5-25     to administer state and local laws relating to public health in the
5-26     municipality's or county's jurisdiction.
5-27           (b)  The governing body of a municipality or the
 6-1     commissioners court of a county described by Subsection (a) that is
 6-2     receiving a grant under Section 121.0065 shall appoint a physician
 6-3     as health authority.
 6-4           (c)  An individual appointed to serve as health authority for
 6-5     a county or municipality may serve as the health authority for one
 6-6     or more other jurisdictions under an interlocal contract made in
 6-7     accordance with Chapter 791, Government Code.
 6-8           SECTION 5.  Section 121.032, Health and Safety Code, is
 6-9     amended to read as follows:
6-10           Sec. 121.032.  POWERS AND DUTIES.  [(a)] A local health
6-11     department may perform all public health functions that the
6-12     municipality or county that establishes the local health department
6-13     may perform.
6-14           [(b)  For purposes of Section 121.005, a local health
6-15     department shall be identified by its program of public health
6-16     services and shall, at a minimum, provide:]
6-17                 [(1)  personal health promotion and maintenance
6-18     services;]
6-19                 [(2)  infectious disease control and prevention
6-20     services;]
6-21                 [(3)  environmental and consumer health programs for
6-22     the enforcement of health and safety laws relating to food, water,
6-23     waste control, general sanitation, and vector control;]
6-24                 [(4)  public health education and information services;]
6-25                 [(5)  laboratory services; and]
6-26                 [(6)  administrative services.]
6-27           SECTION 6.  Chapter 121, Health and Safety Code, is amended
 7-1     by adding Subchapter F to read as follows:
 7-2                   SUBCHAPTER F.  PUBLIC HEALTH CONSORTIUM
 7-3           Sec. 121.101.  DEFINITION.  In this chapter, "consortium"
 7-4     means the public health consortium established under this
 7-5     subchapter.
 7-6           Sec. 121.102.  CONSORTIUM ESTABLISHED.  Subject to
 7-7     availability of funds, the department shall establish a public
 7-8     health consortium composed of:
 7-9                 (1)  The University of Texas Health Science Center at
7-10     San Antonio;
7-11                 (2)  The University of Texas M. D. Anderson Cancer
7-12     Center;
7-13                 (3)  The University of Texas Southwestern Medical
7-14     Center at Dallas;
7-15                 (4)  The University of Texas Medical Branch at
7-16     Galveston;
7-17                 (5)  The University of Texas Health Science Center at
7-18     Houston;
7-19                 (6)  The University of Texas Health Science Center at
7-20     Tyler;
7-21                 (7)  the Texas Tech University Health Sciences Center;
7-22                 (8)  The Texas A&M University Health Science Center;
7-23                 (9)  the University of North Texas Health Science
7-24     Center at Fort Worth; and
7-25                 (10)  any other public institution of higher education
7-26     that elects to participate in the consortium.
7-27           Sec. 121.103.  GENERAL DUTIES.  (a)  Subject to the
 8-1     availability of funds, the department, in consultation with the
 8-2     consortium and local health units, local health departments, and
 8-3     public health districts, shall:
 8-4                 (1)  develop curricula to provide training to public
 8-5     health workers;
 8-6                 (2)  conduct research on improving health status
 8-7     outcomes and methods of monitoring those outcomes;
 8-8                 (3)  develop performance standards for local health
 8-9     units, local health departments, and public health districts;
8-10                 (4)  develop competency certification standards for
8-11     public health workers; and
8-12                 (5)  study the technology infrastructure available to
8-13     local health units, local health departments, and public health
8-14     districts and improve the use of this infrastructure to permit:
8-15                       (A)  statewide communication relating to disease
8-16     surveillance and reporting of public health information; and
8-17                       (B)  immediate access to public health
8-18     information and collaboration among public health professionals.
8-19           (b)  The training curricula described by Subsection (a)(1)
8-20     may include training for local health authorities.
8-21           SECTION 7.  Sections 121.007(d) and (e), Health and Safety
8-22     Code, are repealed.
8-23           SECTION 8.  The importance of this legislation and the
8-24     crowded condition of the calendars in both houses create an
8-25     emergency and an imperative public necessity that the
8-26     constitutional rule requiring bills to be read on three several
8-27     days in each house be suspended, and this rule is hereby suspended,
 9-1     and that this Act take effect and be in force from and after its
 9-2     passage, and it is so enacted.