1-1 By: Delisi, et al. (Senate Sponsor - Moncrief) H.B. No. 1444
1-2 (In the Senate - Received from the House May 7, 1999;
1-3 May 10, 1999, read first time and referred to Committee on Health
1-4 Services; May 14, 1999, reported favorably, as amended, by the
1-5 following vote: Yeas 5, Nays 0; May 14, 1999, sent to printer.)
1-6 COMMITTEE AMENDMENT NO. 1 By: Moncrief
1-7 Amend H.B. 1444, as engrossed, by adding a new subsection (b) in
1-8 Section 121.0065, to read as follows:
1-9 "(b) The grants authorized by subsection (a) of this
1-10 subchapter shall be distributed equally between urban and rural
1-11 areas of the state."
1-12 Renumber subsequent subsections.
1-13 COMMITTEE AMENDMENT NO. 2 By: Moncrief
1-14 Amend H.B. 1444, by adding an appropriately numbered SECTION to
1-15 read as follows:
1-16 "SECTION . This Act takes effect only if a specific
1-17 appropriation for the implementation of this Act is provided in
1-18 H.B.1 (General Appropriations Act), Acts of the 76th Legislature,
1-19 Regular Session, 1999. If no specific appropriation is provided in
1-20 H.B. 1, the General Appropriations Act, this Act has no effect."
1-21 A BILL TO BE ENTITLED
1-22 AN ACT
1-23 relating to local public health services.
1-24 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-25 SECTION 1. Section 121.002, Health and Safety Code, is
1-26 amended to read as follows:
1-27 Sec. 121.002. DEFINITIONS [DEFINITION]. In this chapter:
1-28 (1) "Essential public health services" means services
1-29 to:
1-30 (A) monitor the health status of individuals in
1-31 the community to identify community health problems;
1-32 (B) diagnose and investigate community health
1-33 problems and community health hazards;
1-34 (C) inform, educate, and empower the community
1-35 with respect to health issues;
1-36 (D) mobilize community partnerships in
1-37 identifying and solving community health problems;
1-38 (E) develop policies and plans that support
1-39 individual and community efforts to improve health;
1-40 (F) enforce laws and rules that protect the
1-41 public health and ensure safety in accordance with those laws and
1-42 rules;
1-43 (G) link individuals who have a need for
1-44 community and personal health services to appropriate community and
1-45 private providers;
1-46 (H) ensure a competent workforce for the
1-47 provision of essential public health services;
1-48 (I) research new insights and innovative
1-49 solutions to community health problems; and
1-50 (J) evaluate the effectiveness, accessibility,
1-51 and quality of personal and population-based health services in a
1-52 community.
1-53 (2) "Physician" [, "physician"] means a person
1-54 licensed to practice medicine by the Texas State Board of Medical
1-55 Examiners.
1-56 SECTION 2. Subchapter A, Chapter 121, Health and Safety
1-57 Code, is amended by adding Sections 121.0065, 121.0066, and
1-58 121.0067 to read as follows:
1-59 Sec. 121.0065. GRANTS FOR ESSENTIAL PUBLIC HEALTH SERVICES.
1-60 (a) Subject to the availability of funds, the department shall
1-61 administer a program under which appropriated money may be granted
2-1 to counties, municipalities, public health districts, and other
2-2 political subdivisions for use by the counties, municipalities,
2-3 public health districts, and other political subdivisions to
2-4 provide or pay for essential public health services.
2-5 (b) The board shall adopt rules governing:
2-6 (1) the allocation formula for grants awarded under
2-7 this section;
2-8 (2) the manner in which a municipality, county, public
2-9 health district, or other political subdivision applies for a
2-10 grant;
2-11 (3) the procedures for awarding grants; and
2-12 (4) the minimum essential public health services to be
2-13 provided under the grant and other standards applicable to the
2-14 services to be provided under the grant.
2-15 (c) A municipality, county, public health district, or other
2-16 political subdivision that receives a grant under this section, in
2-17 consultation with the department, shall develop a plan to evaluate
2-18 the effectiveness, accessibility, and quality of the essential
2-19 public health services that are provided under the grant. The plan
2-20 must:
2-21 (1) identify the outcomes that are intended to result
2-22 from the use of the grant money and establish a mechanism to
2-23 measure those outcomes; and
2-24 (2) establish performance standards for the delivery
2-25 of essential public health services and a mechanism to measure
2-26 compliance with those standards.
2-27 (d) The governing body of the municipality, the
2-28 commissioners court of the county, or the members of a public
2-29 health district may appoint a local health board to monitor the use
2-30 of the money received under this section.
2-31 (e) A public health board established under Section 121.034
2-32 or 121.046 may serve as the local health board authorized under
2-33 Subsection (d).
2-34 (f) The governing body of the municipality or the
2-35 commissioners court of a county may serve as the local health board
2-36 authorized under Subsection (d). If the governing body of the
2-37 municipality or the commissioners court of the county elects to
2-38 serve as the local health board, the governing body or
2-39 commissioners court may appoint an advisory committee to advise the
2-40 governing body or commissioners court with respect to the use of
2-41 the money granted under this section.
2-42 (g) Chapter 783, Government Code, and standards adopted
2-43 under that chapter control if applicable to a grant made under this
2-44 section.
2-45 Sec. 121.0066. ESSENTIAL PUBLIC HEALTH SERVICES PROVIDED BY
2-46 DEPARTMENT. (a) Subject to the availability of funds, the
2-47 department may provide essential public health services for a
2-48 population for which a municipality, county, public health
2-49 district, or other political subdivision is not receiving a grant
2-50 to provide those services under Section 121.0065.
2-51 (b) Subject to the availability of funds, the department
2-52 shall develop a plan that complies with Section 121.0065(c) to
2-53 evaluate the effectiveness, accessibility, and quality of essential
2-54 public health services provided under this section.
2-55 Sec. 121.0067. EVALUATION AND REPORT OF DELIVERY OF
2-56 ESSENTIAL PUBLIC HEALTH SERVICES. (a) The department, in
2-57 cooperation with municipalities, counties, public health districts,
2-58 and other political subdivisions that receive grants under Section
2-59 121.0065, and the consortium established under Subchapter F, shall
2-60 evaluate:
2-61 (1) the effectiveness, accessibility, and quality of
2-62 essential public health services provided under the grant program
2-63 established by Section 121.0065 and under Section 121.0066; and
2-64 (2) the adequacy of funding for those services.
2-65 (b) Not later than January 1 of each odd-numbered year, the
2-66 department shall file with the governor and the presiding officer
2-67 of each house of the legislature a report detailing the results of
2-68 the evaluation conducted under Subsection (a). The report must
2-69 include recommendations relating to:
3-1 (1) legislation to improve the effectiveness,
3-2 accessibility, and quality of essential public health services; and
3-3 (2) appropriate funding for those services.
3-4 SECTION 3. Section 121.007(c), Health and Safety Code, is
3-5 amended to read as follows:
3-6 (c) The board or its designee may require a regional
3-7 director to perform the duties of a health authority. The regional
3-8 director may perform those duties, as authorized by the board or
3-9 commissioner, in a jurisdiction in the region in which[:]
3-10 [(1) there is no health authority; or]
3-11 [(2)] the health authority fails to perform duties
3-12 prescribed by the board under Section 121.024. The regional
3-13 director shall perform the duties of a health authority in a
3-14 jurisdiction in the region in which there is not a health
3-15 authority.
3-16 SECTION 4. Section 121.028, Health and Safety Code, is
3-17 amended to read as follows:
3-18 Sec. 121.028. APPOINTMENT OF HEALTH AUTHORITY. (a) The
3-19 governing body of a municipality or the commissioners court of a
3-20 county that has not established a local health department or a
3-21 public health district may appoint a physician as health authority
3-22 to administer state and local laws relating to public health in the
3-23 municipality's or county's jurisdiction.
3-24 (b) The governing body of a municipality or the
3-25 commissioners court of a county described by Subsection (a) that is
3-26 receiving a grant under Section 121.0065 shall appoint a physician
3-27 as health authority.
3-28 (c) An individual appointed to serve as health authority for
3-29 a county or municipality may serve as the health authority for one
3-30 or more other jurisdictions under an interlocal contract made in
3-31 accordance with Chapter 791, Government Code.
3-32 SECTION 5. Section 121.032, Health and Safety Code, is
3-33 amended to read as follows:
3-34 Sec. 121.032. POWERS AND DUTIES. [(a)] A local health
3-35 department may perform all public health functions that the
3-36 municipality or county that establishes the local health department
3-37 may perform.
3-38 [(b) For purposes of Section 121.005, a local health
3-39 department shall be identified by its program of public health
3-40 services and shall, at a minimum, provide:]
3-41 [(1) personal health promotion and maintenance
3-42 services;]
3-43 [(2) infectious disease control and prevention
3-44 services;]
3-45 [(3) environmental and consumer health programs for
3-46 the enforcement of health and safety laws relating to food, water,
3-47 waste control, general sanitation, and vector control;]
3-48 [(4) public health education and information services;]
3-49 [(5) laboratory services; and]
3-50 [(6) administrative services.]
3-51 SECTION 6. Chapter 121, Health and Safety Code, is amended
3-52 by adding Subchapter F to read as follows:
3-53 SUBCHAPTER F. PUBLIC HEALTH CONSORTIUM
3-54 Sec. 121.101. DEFINITION. In this chapter, "consortium"
3-55 means the public health consortium established under this
3-56 subchapter.
3-57 Sec. 121.102. CONSORTIUM ESTABLISHED. Subject to
3-58 availability of funds, the department shall establish a public
3-59 health consortium composed of:
3-60 (1) The University of Texas Health Science Center at
3-61 San Antonio;
3-62 (2) The University of Texas M. D. Anderson Cancer
3-63 Center;
3-64 (3) The University of Texas Southwestern Medical
3-65 Center at Dallas;
3-66 (4) The University of Texas Medical Branch at
3-67 Galveston;
3-68 (5) The University of Texas Health Science Center at
3-69 Houston;
4-1 (6) The University of Texas Health Science Center at
4-2 Tyler;
4-3 (7) the Texas Tech University Health Sciences Center;
4-4 (8) The Texas A&M University Health Science Center;
4-5 (9) the University of North Texas Health Science
4-6 Center at Fort Worth; and
4-7 (10) any other public institution of higher education
4-8 that elects to participate in the consortium.
4-9 Sec. 121.103. GENERAL DUTIES. (a) Subject to the
4-10 availability of funds, the department, in consultation with the
4-11 consortium and local health units, local health departments, and
4-12 public health districts, shall:
4-13 (1) develop curricula to provide training to public
4-14 health workers;
4-15 (2) conduct research on improving health status
4-16 outcomes and methods of monitoring those outcomes;
4-17 (3) develop performance standards for local health
4-18 units, local health departments, and public health districts;
4-19 (4) develop competency certification standards for
4-20 public health workers; and
4-21 (5) study the technology infrastructure available to
4-22 local health units, local health departments, and public health
4-23 districts and improve the use of this infrastructure to permit:
4-24 (A) statewide communication relating to disease
4-25 surveillance and reporting of public health information; and
4-26 (B) immediate access to public health
4-27 information and collaboration among public health professionals.
4-28 (b) The training curricula described by Subsection (a)(1)
4-29 may include training for local health authorities.
4-30 SECTION 7. Sections 121.007(d) and (e), Health and Safety
4-31 Code, are repealed.
4-32 SECTION 8. The importance of this legislation and the
4-33 crowded condition of the calendars in both houses create an
4-34 emergency and an imperative public necessity that the
4-35 constitutional rule requiring bills to be read on three several
4-36 days in each house be suspended, and this rule is hereby suspended,
4-37 and that this Act take effect and be in force from and after its
4-38 passage, and it is so enacted.
4-39 * * * * *