1-1                                   AN ACT
 1-2     relating to the continuation and functions of the Health and Human
 1-3     Services Commission.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5          ARTICLE 1. GENERAL POWERS AND DUTIES OF HEALTH AND HUMAN
 1-6                             SERVICES COMMISSION
 1-7           SECTION 1.01.  Section 531.004, Government Code, is amended
 1-8     to read as follows:
 1-9           Sec. 531.004.  SUNSET PROVISION.  The Health and Human
1-10     Services Commission is subject to Chapter 325 (Texas Sunset Act).
1-11     Unless continued in existence as provided by that chapter, the
1-12     commission is abolished and this chapter expires September 1, 2007
1-13     [1999].
1-14           SECTION 1.02.  Section 531.009, Government Code, is amended
1-15     to read as follows:
1-16           Sec. 531.009.  PERSONNEL.  (a)  The commissioner shall employ
1-17     a medical director to provide medical expertise to the commissioner
1-18     and the commission and may employ other personnel necessary to
1-19     administer the commission's duties.
1-20           (b)  The commissioner or the commissioner's designated
1-21     representative shall develop an intra-agency career ladder program,
1-22     one part of which must require the intra-agency posting of all
1-23     non-entry-level positions concurrently with any public posting.
1-24           (c)  The commissioner or the commissioner's designated
 2-1     representative shall develop a system of annual performance
 2-2     evaluations based on measurable job tasks.  All merit pay for
 2-3     commission employees must be based on the system established under
 2-4     this subsection.
 2-5           (d)  The commissioner shall provide to commission employees
 2-6     as often as is necessary information regarding their qualifications
 2-7     under this chapter and their responsibilities under applicable laws
 2-8     relating to standards of conduct for state employees.
 2-9           (e)  The commissioner or the commissioner's designated
2-10     representative shall prepare and maintain a written policy
2-11     statement that implements [to ensure implementation of] a program
2-12     of equal employment opportunity to ensure that [under which] all
2-13     personnel transactions are made without regard to race, color,
2-14     disability, sex, religion, age, or national origin.
2-15           (f)  The policy statement described by Subsection (e) must
2-16     include:
2-17                 (1)  personnel policies, including policies relating to
2-18     recruitment, evaluation, selection, [appointment,] training, and
2-19     promotion of personnel, that show the intent of the commission to
2-20     avoid the unlawful employment practices described by Chapter 21,
2-21     Labor Code; and
2-22                 (2)  an analysis of the extent to which the composition
2-23     of the commission's personnel is in accordance with state and
2-24     federal law and a description of reasonable methods to achieve
2-25     compliance with state and federal law [a comprehensive analysis of
2-26     the commission workforce that meets federal and state guidelines;]
2-27                 [(3)  procedures by which a determination can be made
 3-1     of significant underuse in the commission workforce of all persons
 3-2     for whom federal or state guidelines encourage a more equitable
 3-3     balance; and]
 3-4                 [(4)  reasonable methods to appropriately address areas
 3-5     of significant underuse in the commission workforce of all persons
 3-6     for whom federal or state guidelines encourage a more equitable
 3-7     balance].
 3-8           (g)  The policy statement described by Subsection (e) must:
 3-9                 (1)  be updated annually;
3-10                 (2)  be reviewed by the state Commission on Human
3-11     Rights for compliance with Subsection (f)(1); and
3-12                 (3)  be filed with the governor's office.
3-13           SECTION 1.03.  Section 531.011, Government Code, is amended
3-14     by adding Subsection (g) to read as follows:
3-15           (g)  In addition to the information file maintained under
3-16     Subsection (e), the commission shall maintain an information file
3-17     on a complaint received by the commission relating to any matter or
3-18     agency under the jurisdiction of the commission.
3-19           SECTION 1.04.  Subchapter A, Chapter 531, Government Code, is
3-20     amended by adding Section 531.014 to read as follows:
3-21           Sec. 531.014.  CONSOLIDATION OF REPORTS.  The commission may
3-22     consolidate any annual or biennial reports required to be made
3-23     under this chapter or another law if:
3-24                 (1)  the consolidated report is submitted not later
3-25     than the earliest deadline for the submission of any component of
3-26     the consolidated report; and
3-27                 (2)  each person required to receive a component of the
 4-1     consolidated report receives the consolidated report and the
 4-2     consolidated report identifies the component of the report the
 4-3     person was required to receive.
 4-4           SECTION 1.05.  Subchapter A, Chapter 531, Government Code,
 4-5     is amended by adding Section 531.015 to read as follows:
 4-6           Sec. 531.015.  NEW FACILITIES IN CERTAIN COUNTIES.  A health
 4-7     and human services agency is prohibited from establishing a new
 4-8     facility in a county with a population of less than 200,000 until
 4-9     the agency provides notification about the facility, its location,
4-10     and its purpose to each state representative and state senator that
4-11     represents all or part of the county, the county judge that
4-12     represents the county, and the mayor of any municipality in which
4-13     the facility would be located.
4-14      ARTICLE 2.  RELATIONSHIP WITH HEALTH AND HUMAN SERVICES AGENCIES
4-15           SECTION 2.01.  Subchapter A, Chapter 531, Government Code, is
4-16     amended by adding Sections 531.0055, 531.0056, and 531.0057 to read
4-17     as follows:
4-18           Sec. 531.0055.  COMMISSIONER: RESPONSIBILITY RELATING TO
4-19     CERTAIN FUNCTIONS OF HEALTH AND HUMAN SERVICES AGENCIES.  (a)  In
4-20     this section and in Section 531.0056:
4-21                 (1)  "Agency director" means the director, executive
4-22     director, or commissioner of a health and human services agency.
4-23                 (2)  "Policymaking body" means the board or commission
4-24     with policymaking authority over a health and human services
4-25     agency.
4-26           (b)  The commission shall:
4-27                 (1)  supervise the administration and operation of the
 5-1     Medicaid program, including the administration and operation of the
 5-2     Medicaid managed care system in accordance with Section 531.021;
 5-3                 (2)  supervise information systems planning and
 5-4     management for health and human services agencies under Section
 5-5     531.0273;
 5-6                 (3)  monitor and ensure the effective use of all
 5-7     federal funds received by a health and human services agency in
 5-8     accordance with Section 531.028 and the General Appropriations Act;
 5-9     and
5-10                 (4)  implement Texas Integrated Enrollment Services as
5-11     required by Subchapter F.
5-12           (c)  After implementation of the commission's duties under
5-13     Subsection (b), the commission shall implement the powers and
5-14     duties given to the commission under Sections 531.0246, 531.0247,
5-15     2155.144, as added by Chapter 1045, Acts of the 75th Legislature,
5-16     Regular Session, 1997, and 2167.004.
5-17           (d)  After implementation of the commission's duties under
5-18     Subsections (b) and (c), the commission shall implement the powers
5-19     and duties given to the commission under Section 531.0248. Nothing
5-20     in the priorities established by this section is intended to limit
5-21     the authority of the commission to work simultaneously to achieve
5-22     the multiple tasks assigned to the commission in this section, when
5-23     such an approach is beneficial in the judgment of the commission.
5-24     The commission shall plan and implement an efficient and effective
5-25     system of administrative support services for health and human
5-26     services agencies.  The term "administrative support services"
5-27     includes, but is not limited to, strategic planning, audit, legal,
 6-1     human resources, and accounting services.
 6-2           (e)  Notwithstanding any other law, the commissioner, as
 6-3     necessary to perform the functions described by Subsections (b),
 6-4     (c), and (d) in implementation of the policies established by each
 6-5     agency's policymaking body, shall:
 6-6                 (1)  manage and direct the operations of each health
 6-7     and human services agency; and
 6-8                 (2)  supervise and direct the activities of each agency
 6-9     director.
6-10           (f)  The operational authority of the commissioner for
6-11     purposes of Subsection (e) at each health and human services agency
6-12     includes authority over the:
6-13                 (1)  management of the daily operations of the agency,
6-14     including the organization and management of the agency and agency
6-15     operating procedures;
6-16                 (2)  allocation of resources within the agency,
6-17     including use of federal funds received by the agency;
6-18                 (3)  personnel and employment policies;
6-19                 (4)  contracting, purchasing, and related policies,
6-20     subject to this chapter and other laws relating to contracting and
6-21     purchasing by a state agency;
6-22                 (5)  information resources systems used by the agency;
6-23                 (6)  location of agency facilities; and
6-24                 (7)  coordination of agency activities with activities
6-25     of other state agencies, including other health and human services
6-26     agencies.
6-27           (g)  Notwithstanding any other law, the operational authority
 7-1     of the commissioner for purposes of Subsection (e) at each health
 7-2     and human services agency includes the authority to adopt or
 7-3     approve, subject to applicable limitations, any rate of payment or
 7-4     similar provision required by law to be adopted or approved by the
 7-5     agency.
 7-6           (h)  For each health and human services agency, the
 7-7     commissioner shall implement a program to evaluate and supervise
 7-8     the daily operations of the agency.  The program must include
 7-9     measurable performance objectives for each agency director and
7-10     adequate reporting requirements to permit the commissioner to
7-11     perform the duties assigned to the commissioner under this section.
7-12           (i)  To facilitate the operations of a health and human
7-13     services agency in accordance with this section, the commissioner
7-14     may delegate a specific power or duty given under Subsection (f) or
7-15     (g) to an agency director.
7-16           (j)  The commissioner may adopt rules to implement the
7-17     commissioner's authority under this section.
7-18           (k)  The commissioner and each agency director shall enter
7-19     into a memorandum of understanding that:
7-20                 (1)  clearly defines the responsibilities of the agency
7-21     director and the commissioner;
7-22                 (2)  establishes the program of evaluation and
7-23     supervision of daily operations required by Subsection (h); and
7-24                 (3)  describes each delegation of a power or duty made
7-25     under Subsection (i).
7-26           (l)  Notwithstanding any other provision of this section, a
7-27     policymaking body has the authority provided by law to adopt
 8-1     policies and rules governing the delivery of services to persons
 8-2     who are served by the agency and the rights and duties of persons
 8-3     who are served or regulated by the agency.  The commissioner and
 8-4     each policymaking body shall enter into a memorandum of
 8-5     understanding that clearly defines:
 8-6                 (1)  the policymaking authority of the policymaking
 8-7     body; and
 8-8                 (2)  the operational authority of the commissioner.
 8-9           Sec. 531.0056.  EMPLOYMENT OF AGENCY DIRECTOR.  (a)  This
8-10     section applies only to an agency director employed by the
8-11     commissioner.
8-12           (b)  An agency director employed by the commissioner may be
8-13     employed only with the concurrence of the agency's policymaking
8-14     body and the approval of the governor.
8-15           (c)  As established in Section 531.0055(k)(1), the
8-16     commissioner and agency director shall enter into a memorandum of
8-17     understanding that clearly defines the responsibilities of the
8-18     agency director and may establish terms and conditions of
8-19     employment in the memorandum of understanding.
8-20           (d)  The terms of the memorandum of understanding shall
8-21     outline specific performance objectives, as defined jointly by the
8-22     commissioner and the policymaking body, to be fulfilled by the
8-23     agency director, including the performance objectives outlined in
8-24     Section 531.0055(h).
8-25           (e)  Based upon the performance objectives outlined in the
8-26     memorandum of understanding, the commissioner shall perform an
8-27     employment evaluation of the agency director.
 9-1           (f)  The commissioner shall submit the evaluation, along with
 9-2     any recommendation regarding the employment of the agency director,
 9-3     to the agency's policymaking body and the governor not later than
 9-4     January 1 of each even-numbered year.
 9-5           (g)  The policymaking body shall consider the evaluation in a
 9-6     meeting of the policymaking body and take necessary action, if any,
 9-7     not later than 90 days after the date of the receipt of the
 9-8     evaluation.
 9-9           (h)  An agency director employed by the commissioner serves
9-10     at the pleasure of the commissioner but may be discharged only with
9-11     the concurrence of the agency's policymaking body.
9-12           Sec. 531.0057.  AUTHORITY OVER RULEMAKING AT HEALTH AND HUMAN
9-13     SERVICES AGENCY.  (a)  Notwithstanding any other law, a health and
9-14     human services agency must notify the commissioner before proposing
9-15     a rule.  A rule adopted in violation of this section is void.
9-16           (b)  The commissioner may waive the requirement of this
9-17     section as necessary to permit emergency rulemaking in accordance
9-18     with Section 2001.034.
9-19           SECTION 2.02.  Section 21.004, Human Resources Code, is
9-20     amended to read as follows:
9-21           Sec. 21.004.  COMMISSIONER.  (a)  The Commissioner of Human
9-22     Services is the executive and administrative officer of the
9-23     department.  The commissioner exercises all rights, powers, and
9-24     duties imposed or conferred by law on the department unless the
9-25     right, power, or duty is specifically delegated by the commissioner
9-26     of health and human services [board] to the department's agents or
9-27     employees.
 10-1          (b)  The commissioner is employed [appointed] by the
 10-2    commissioner of health and human services in accordance with
 10-3    Section 531.0056, Government Code [board with the approval of the
 10-4    governor and serves at the pleasure of the board].
 10-5          (c)  To be eligible for employment [appointment] as
 10-6    commissioner, a person must be at least 35 years old, have had
 10-7    experience as an executive or administrator, and not have served as
 10-8    an elected state officer as defined by Chapter 572, Government
 10-9    Code, during the six-month period preceding the date of the
10-10    employment [appointment].
10-11          SECTION 2.03.  Chapter 22, Human Resources Code, is amended
10-12    by adding Section 22.0001 to read as follows:
10-13          Sec. 22.0001.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
10-14    AND HUMAN SERVICES.  The commissioner of health and human services
10-15    has the powers and duties relating to the board and commissioner as
10-16    provided by Section 531.0055, Government Code.  To the extent a
10-17    power or duty given to the board or commissioner by this title or
10-18    another law conflicts with Section 531.0055, Government Code,
10-19    Section 531.0055 controls.
10-20          SECTION 2.04.  Section 40.027, Human Resources Code, is
10-21    amended to read as follows:
10-22          Sec. 40.027.  EXECUTIVE DIRECTOR.  (a)  The commissioner of
10-23    health and human services [board] shall employ the executive
10-24    director in accordance with Section 531.0056, Government Code [with
10-25    the approval of the governor.  The executive director serves at the
10-26    pleasure of the board].
10-27          (b)  The executive director is the executive head of the
 11-1    department. The executive director shall perform the duties
 11-2    assigned by the commissioner of health and human services [board]
 11-3    and state law.
 11-4          SECTION 2.05.  Subchapter C, Chapter 40, Human Resources
 11-5    Code, is amended by adding Section 40.0505 to read as follows:
 11-6          Sec. 40.0505.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
 11-7    AND HUMAN SERVICES.  The commissioner of health and human services
 11-8    has the powers and duties relating to the board and executive
 11-9    director as provided by Section 531.0055, Government Code.  To the
11-10    extent a power or duty given to the board or executive director by
11-11    this chapter or another law conflicts with Section 531.0055,
11-12    Government Code, Section 531.0055 controls.
11-13          SECTION 2.06.  Chapter 73, Human Resources Code, is amended
11-14    by adding Section 73.0045 to read as follows:
11-15          Sec. 73.0045.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
11-16    AND HUMAN SERVICES.  The commissioner of health and human services
11-17    has the powers and duties relating to the board and the executive
11-18    director of the board as provided by Section 531.0055, Government
11-19    Code.  To the extent a power or duty given to the board or
11-20    executive director by this chapter or another law conflicts with
11-21    Section 531.0055, Government Code, Section 531.0055 controls.
11-22          SECTION 2.07.  Sections 73.0052(b) and (c), Human Resources
11-23    Code, are amended to read as follows:
11-24          (b)  The commissioner of health and human services [board]
11-25    shall employ an executive director in accordance with Section
11-26    531.0056, Government Code.  The[, and the] executive director shall
11-27    establish necessary administrative units[,] and hire other
 12-1    necessary employees.
 12-2          (c)  Utilizing established standards, the commissioner of
 12-3    health and human services [board] shall evaluate the performance of
 12-4    the executive director annually.
 12-5          SECTION 2.08.  Chapter 81, Human Resources Code, is amended
 12-6    by adding Section 81.0055 to read as follows:
 12-7          Sec. 81.0055.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
 12-8    AND HUMAN SERVICES.  The commissioner of health and human services
 12-9    has the powers and duties relating to the commission and the
12-10    executive director of the commission as provided by Section
12-11    531.0055, Government Code.  To the extent a power or duty given to
12-12    the commission or executive director by this chapter or another law
12-13    conflicts with Section 531.0055, Government Code, Section 531.0055
12-14    controls.
12-15          SECTION 2.09.  Sections 81.008(a) and (b), Human Resources
12-16    Code, are amended to read as follows:
12-17          (a)  The commissioner of health and human services
12-18    [commission] shall employ [appoint] an executive director in
12-19    accordance with Section 531.0056, Government Code [with the
12-20    approval of the governor].
12-21          (b)  In selecting an executive director, the commissioner of
12-22    health and human services [commission] shall give preference to a
12-23    deaf or hard of hearing person.
12-24          SECTION 2.10.  Sections 91.012(a), (b), and (d), Human
12-25    Resources Code, are amended to read as follows:
12-26          (a)  The commissioner of health and human services
12-27    [commission] shall employ [annually appoint] an executive director
 13-1    in accordance with Section 531.0056, Government Code [with the
 13-2    approval of the governor].
 13-3          (b)  The commissioner of health and human services
 13-4    [commission] shall select the executive director, according to
 13-5    established personnel standards, on the basis of education,
 13-6    training, experience, and demonstrated ability.
 13-7          (d)  The [On commission approval, the] executive director:
 13-8                (1)  shall appoint personnel necessary to efficiently
 13-9    accomplish commission purposes;
13-10                (2)  may delegate to an employee a power of the
13-11    executive director except the power to adopt rules or appoint
13-12    personnel;
13-13                (3)  shall establish appropriate administrative units
13-14    within commission programs;
13-15                (4)  may accept and use gifts and grants to the
13-16    commission to carry out the purposes of this title, if the
13-17    commission determines that the conditions of the gift or grant are
13-18    consistent with this title; and
13-19                (5)  may take other actions that the executive director
13-20    considers necessary or appropriate to carry out commission
13-21    purposes.
13-22          SECTION 2.11.  Subchapter C, Chapter 91, Human Resources
13-23    Code, is amended by adding Section 91.0205 to read as follows:
13-24          Sec. 91.0205.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
13-25    AND HUMAN SERVICES.  The commissioner of health and human services
13-26    has the powers and duties relating to the commission and executive
13-27    director as provided by Section 531.0055, Government Code.  To the
 14-1    extent a power or duty given to the commission or executive
 14-2    director by this chapter or another law conflicts with Section
 14-3    531.0055, Government Code, Section 531.0055 controls.
 14-4          SECTION 2.12.  Section 101.004(a), Human Resources Code, is
 14-5    amended to read as follows:
 14-6          (a)  The commissioner of health and human services [board]
 14-7    shall employ [appoint] an executive director of aging in accordance
 14-8    with Section 531.0056, Government Code [with the approval of the
 14-9    governor].  The executive director shall discharge all executive
14-10    and administrative functions of the department.  The executive
14-11    director must be a person with executive ability and experience in
14-12    the area of aging.  [The executive director serves at the pleasure
14-13    of the board.]
14-14          SECTION 2.13.  Subchapter B, Chapter 101, Human Resources
14-15    Code, is amended by adding Section 101.0205 to read as follows:
14-16          Sec. 101.0205.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
14-17    AND HUMAN SERVICES.  The commissioner of health and human services
14-18    has the powers and duties relating to the board and executive
14-19    director as provided by Section 531.0055, Government Code.  To the
14-20    extent a power or duty given to the board or executive director by
14-21    this chapter or another law conflicts with Section 531.0055,
14-22    Government Code, Section 531.0055 controls.
14-23          SECTION 2.14.  Section 111.017, Human Resources Code, is
14-24    amended to read as follows:
14-25          Sec. 111.017.  COMMISSIONER.  (a)  This chapter is
14-26    administered by the commissioner under operational policies
14-27    established by the commissioner of health and human services
 15-1    [board].  The commissioner is employed [appointed] by the
 15-2    commissioner of health and human services in accordance with
 15-3    Section 531.0056, Government Code [board, with the approval of the
 15-4    governor], on the basis of education, training, experience, and
 15-5    demonstrated ability.
 15-6          (b)  The commissioner serves as [at the pleasure of the board
 15-7    and is] secretary to the board, as well as chief administrative
 15-8    officer of the agency.
 15-9          SECTION 2.15.  Subchapter C, Chapter 111, Human Resources
15-10    Code, is amended by adding Section 111.0505 to read as follows:
15-11          Sec. 111.0505.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
15-12    AND HUMAN SERVICES.  The commissioner of health and human services
15-13    has the powers and duties relating to the commission and
15-14    commissioner as provided by Section 531.0055, Government Code.  To
15-15    the extent a power or duty given to the commission or commissioner
15-16    by this chapter or another law conflicts with Section 531.0055,
15-17    Government Code, Section 531.0055 controls.
15-18          SECTION 2.16.  Subchapter C, Chapter 141, Human Resources
15-19    Code, is amended by adding Section 141.0405 to read as follows:
15-20          Sec. 141.0405.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
15-21    AND HUMAN SERVICES.  The commissioner of health and human services
15-22    has the powers and duties relating to the commission and director
15-23    as provided by Section 531.0055, Government Code.  To the extent a
15-24    power or duty given to the commission or director by this chapter
15-25    or another law conflicts with Section 531.0055, Government Code,
15-26    Section 531.0055 controls.
15-27          SECTION 2.17.  Sections 11.012(a), (b), (c), and (d), Health
 16-1    and Safety Code, are amended to read as follows:
 16-2          (a)  The commissioner of health and human services [board]
 16-3    shall employ the commissioner in accordance with Section 531.0056,
 16-4    Government Code [with the approval of the governor.  The
 16-5    commissioner serves at the will of the board].
 16-6          (b)  Except as provided in Subsection (c), the commissioner
 16-7    must:
 16-8                (1)  have at least five years of experience in the
 16-9    administration of public health systems; and
16-10                (2)  be a person licensed to practice medicine in this
16-11    state.
16-12          (c)  The commissioner of health and human services [board]
16-13    may, based on the qualifications and experience in administering
16-14    public health systems [and on two thirds vote of the board], employ
16-15    a person other than a physician as the commissioner.
16-16          (d)  If the commissioner of health and human services [board]
16-17    employs a person as commissioner who is not a physician, then the
16-18    board shall designate a person licensed to practice medicine in
16-19    this state as chief medical executive.
16-20          SECTION 2.18.  Subchapter A, Chapter 12, Health and Safety
16-21    Code, is amended by adding Section 12.0001 to read as follows:
16-22          Sec. 12.0001.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
16-23    AND HUMAN SERVICES.  The commissioner of health and human services
16-24    has the powers and duties relating to the board and commissioner as
16-25    provided by Section 531.0055, Government Code.  To the extent a
16-26    power or duty given to the board or commissioner by this title or
16-27    another law conflicts with Section 531.0055, Government Code,
 17-1    Section 531.0055 controls.
 17-2          SECTION 2.19.  Section 461.011(a), Health and Safety Code, is
 17-3    amended to read as follows:
 17-4          (a)  The commissioner of health and human services
 17-5    [commission] shall employ an executive director in accordance with
 17-6    Section 531.0056, Government Code [with the approval of the
 17-7    governor].  The executive director shall hire other necessary
 17-8    employees.
 17-9          SECTION 2.20.  Chapter 461, Health and Safety Code, is
17-10    amended by adding Section 461.0115 to read as follows:
17-11          Sec. 461.0115.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
17-12    AND HUMAN SERVICES.  The commissioner of health and human services
17-13    has the powers and duties relating to the commission and executive
17-14    director as provided by Section 531.0055, Government Code.  To the
17-15    extent a power or duty given to the commission or executive
17-16    director by this chapter or another law conflicts with Section
17-17    531.0055, Government Code, Section 531.0055 controls.
17-18          SECTION 2.21.  Sections 532.011(a), (b), (d), and (f), Health
17-19    and Safety Code, are amended to read as follows:
17-20          (a)  The commissioner of health and human services [board]
17-21    shall employ [appoint] a commissioner in accordance with Section
17-22    531.0056, Government Code [with the approval of the governor].
17-23          (b)  To be qualified for employment [appointment] as
17-24    commissioner, a person must have:
17-25                (1)  professional training and experience in the
17-26    administration or management of comprehensive health care or human
17-27    service operations; and
 18-1                (2)  proven administrative and management ability,
 18-2    preferably in the health care area.
 18-3          (d)  The [Subject to board rules and basic and general
 18-4    policies, the] commissioner:
 18-5                (1)  has the administrative and decisional powers
 18-6    granted under this subtitle; and
 18-7                (2)  shall administer the department and this subtitle
 18-8    and ensure [assure] the effective administration of the department
 18-9    and its programs and services.
18-10          (f)  The [With the board's approval, the] commissioner shall:
18-11                (1)  establish an organizational structure within the
18-12    department that will promote the effective administration of this
18-13    subtitle; and
18-14                (2)  establish the duties and functions of the
18-15    department's staff.
18-16          SECTION 2.22.  Subchapter A, Chapter 533, Health and Safety
18-17    Code, is amended by adding Section 533.0001 to read as follows:
18-18          Sec. 533.0001.  POWERS AND DUTIES OF COMMISSIONER OF HEALTH
18-19    AND HUMAN SERVICES.  The commissioner of health and human services
18-20    has the powers and duties relating to the board and commissioner as
18-21    provided by Section 531.0055, Government Code.  To the extent a
18-22    power or duty given to the board or commissioner by this title or
18-23    another law conflicts with Section 531.0055, Government Code,
18-24    Section 531.0055 controls.
18-25          SECTION 2.23.  (a)  In this section, "agency director" and
18-26    "policymaking body" have the meanings assigned by Section 531.0055,
18-27    Government Code, as added by this Act.
 19-1          (b)  An agency director serving on the effective date of this
 19-2    Act continues to serve in that position until the earlier of the
 19-3    date that:
 19-4                (1)  the term provided by statute or contract for that
 19-5    person's appointment or employment expires; or
 19-6                (2)  the director is removed from the position as
 19-7    provided by law.
 19-8          (c)  The commissioner shall fill a position that becomes
 19-9    vacant as described by Subsections (b)(1)-(2) of this section, with
19-10    the concurrence of the appropriate policymaking body and the
19-11    approval of the governor, as required by  Section 531.0056,
19-12    Government Code, as added by this Act.
19-13          (d)  With the concurrence of the appropriate policymaking
19-14    body and the approval of the governor, the commissioner of health
19-15    and human services is authorized to employ the agency director of
19-16    an agency added to those agencies defined as health and human
19-17    services agencies by Section 531.001, Government Code, by any other
19-18    Act of the 76th Legislature. The agency director is employed and
19-19    serves in accordance with Section 531.0056, Government Code, as
19-20    added by this Act.
19-21                 ARTICLE 3.  SPECIFIC FUNCTIONS OF HEALTH
19-22                       AND HUMAN SERVICES COMMISSION
19-23          SECTION 3.01.  Section 531.021(b), Government Code, is
19-24    amended to read as follows:
19-25          (b)  The commission shall:
19-26                (1)  plan and direct the Medicaid program in each
19-27    agency that operates a portion of the Medicaid program, including
 20-1    the management of the Medicaid managed care system and the
 20-2    development, procurement, management, and monitoring of contracts
 20-3    necessary to implement the Medicaid managed care system;
 20-4                (2)  adopt [is responsible for adopting] reasonable
 20-5    rules and standards governing the determination of fees, charges,
 20-6    and rates for medical assistance payments under Chapter 32, Human
 20-7    Resources Code, in consultation[.  In adopting these rules and
 20-8    standards, the commission shall consult] with the agencies that
 20-9    operate the Medicaid program; and
20-10                (3)  establish requirements for and define the scope of
20-11    the ongoing evaluation of the Medicaid managed care system
20-12    conducted in conjunction with the Texas Health Care Information
20-13    Council under Section 108.0065, Health and Safety Code.
20-14          SECTION 3.02.  Subchapter B, Chapter 531, Government Code, is
20-15    amended by adding Sections 531.0246, 531.0247, 531.0248, and
20-16    531.0249 to read as follows:
20-17          Sec. 531.0246.  REGIONAL MANAGEMENT OF HEALTH AND HUMAN
20-18    SERVICES AGENCIES.  Subject to Section 531.0055(c), the commission
20-19    may require a health and human services agency, under the direction
20-20    of the commission, to:
20-21                (1)  locate all or a portion of the agency's employees
20-22    and programs in the same building as another health and human
20-23    services agency or at a location near or adjacent to the location
20-24    of another health and human services agency;
20-25                (2)  ensure that the agency's location is accessible to
20-26    disabled employees and agency clients; and
20-27                (3)  consolidate agency support services, including
 21-1    clerical and administrative support services and information
 21-2    resources support services, with support services provided to or by
 21-3    another health and human services agency.
 21-4          Sec. 531.0247.  ANNUAL BUSINESS PLAN.  Subject to Section
 21-5    531.0055(c), the commission shall develop and implement an annual
 21-6    business services plan for each health and human services region
 21-7    that establishes performance objectives for all health and human
 21-8    services agencies providing services in the region and measures
 21-9    agency effectiveness and efficiency in achieving those objectives.
21-10          Sec. 531.0248.  COMMUNITY-BASED SUPPORT SYSTEMS.  (a)
21-11    Subject to Section 531.0055(d), the commission shall assist
21-12    communities in this state in developing comprehensive,
21-13    community-based support systems for health and human services. At
21-14    the request of a community, the commission shall provide resources
21-15    and assistance to the community to enable the community to:
21-16                (1)  identify and overcome institutional barriers to
21-17    developing more comprehensive community support systems, including
21-18    barriers that result from the policies and procedures of state
21-19    health and human services agencies; and
21-20                (2)  develop a system of blended funds to allow the
21-21    community to customize services to fit individual community needs.
21-22          (b)  At the request of the commission, a health and human
21-23    services agency shall provide resources and assistance to a
21-24    community as necessary to perform the commission's duties under
21-25    Subsection (a).
21-26          (c)  A health and human services agency that receives or
21-27    develops a proposal for a community initiative shall submit the
 22-1    initiative to the commission for review and approval. The
 22-2    commission shall review the initiative to ensure that the
 22-3    initiative is consistent with other similar programs offered in
 22-4    communities and does not duplicate other services provided in the
 22-5    community.
 22-6          (d)  In implementing this section, the commission shall
 22-7    consider models used in other service delivery systems, including
 22-8    the mental health and mental retardation service delivery system.
 22-9          Sec. 531.0249.  ADVISORY COMMITTEE FOR LOCAL GOVERNMENTAL
22-10    ENTITIES.  (a)  The commission shall appoint an advisory committee
22-11    composed of representatives of governmental entities identified
22-12    under Section 531.022(e).
22-13          (b)  The advisory committee:
22-14                (1)  shall advise the commission with respect to
22-15    establishing flexible and responsive strategies for blending
22-16    federal, state, and other available funding sources to meet local
22-17    program needs and service priorities, in implementation of Sections
22-18    531.022, 531.024, and 531.0248; and
22-19                (2)  may assist the commission in performing its other
22-20    functions under Sections 531.022, 531.024, 531.0248, and
22-21    531.028(b)(6).
22-22          (c)  A member of the advisory committee may not receive
22-23    compensation, but is entitled to reimbursement of the travel
22-24    expenses incurred by the member while conducting the business of
22-25    the committee, as provided by the General Appropriations Act.
22-26          (d)  The advisory committee is not subject to Chapter 2110.
22-27          SECTION 3.03.  Sections 531.0271 and 531.0273, Government
 23-1    Code, are amended to read as follows:
 23-2          Sec. 531.0271.  HEALTH AND HUMAN SERVICES AGENCIES OPERATING
 23-3    BUDGETS.  The commission may, within the limits established by and
 23-4    subject to [(a)  In addition to the provisions of] the General
 23-5    Appropriations Act, transfer amounts appropriated to health and
 23-6    human services agencies among the agencies to [the commission shall
 23-7    review and comment on]:
 23-8                (1)  enhance the receipt of federal money under the
 23-9    federal funds management system established under Section 531.028;
23-10                (2)  achieve efficiencies in the administrative support
23-11    functions of the agencies; and
23-12                (3)  perform the functions assigned to the commissioner
23-13    under Section 531.0055 [the annual operating budget of each health
23-14    and human services agency; and]
23-15                [(2)  the transfer of funds between budget strategies
23-16    made by each health and human services agency before that transfer.]
23-17          [(b)  The commission shall issue a quarterly report regarding
23-18    the projected expenditures by budget strategy of each health and
23-19    human services agency compared to each agency's operating budget].
23-20          Sec. 531.0273.  INFORMATION RESOURCES PLANNING AND
23-21    MANAGEMENT; ADVISORY COMMITTEE [AUTOMATED SYSTEMS].  (a)  The
23-22    commission is responsible for strategic planning for information
23-23    resources at each health and human services agency and shall direct
23-24    the management of information resources at each health and human
23-25    services agency.  The commission shall:
23-26                (1)  develop a coordinated strategic plan for
23-27    information resources management that:
 24-1                      (A)  covers a five-year period;
 24-2                      (B)  defines objectives for information resources
 24-3    management at each health and human services agency;
 24-4                      (C)  prioritizes information resources projects
 24-5    and implementation of new technology for all health and human
 24-6    services agencies;
 24-7                      (D)  integrates planning and development of each
 24-8    information resources system used by a health and human services
 24-9    agency into a coordinated information resources management planning
24-10    and development system established by the commission;
24-11                      (E)  establishes standards for information
24-12    resources system security and that promotes the ability of
24-13    information resources systems to operate with each other; and
24-14                      (F)  achieves economies of scale and related
24-15    benefits in purchasing for health and human services information
24-16    resources systems;
24-17                (2)  establish information resources management
24-18    policies, procedures, and technical standards and ensure compliance
24-19    with those policies, procedures, and standards; and
24-20                (3)  review and approve the information resources
24-21    management and biennial operating plan of each health and human
24-22    services agency.
24-23          (b)  Not later than December 15 of each even-numbered year,
24-24    the commission shall file the coordinated information resources
24-25    strategic plan with the governor, the lieutenant governor, and the
24-26    speaker of the house of representatives.
24-27          (c)  A health and human services agency may not submit its
 25-1    plans to the Department of Information Resources under Subchapter
 25-2    E, Chapter 2054, until those plans are approved by the commission.
 25-3          (d)  The commission shall appoint an advisory committee
 25-4    composed of:
 25-5                (1)  information resources managers for state agencies
 25-6    and for private employers; and
 25-7                (2)  the directors, executive directors, and
 25-8    commissioners of health and human services agencies.
 25-9          (e)  The advisory committee appointed under Subsection (d)
25-10    shall advise the commission with respect to the implementation of
25-11    the commission's duties under Subsection (a)(1) and:
25-12                (1)  shall advise the commission about:
25-13                      (A)  overall goals and objectives for information
25-14    resources management for all health and human services agencies;
25-15                      (B)  coordination of agency information resources
25-16    management plans;
25-17                      (C)  development of short-term and long-term
25-18    strategies for:
25-19                            (i)  implementing information resources
25-20    management policies, procedures, and technical standards; and
25-21                            (ii)  ensuring compatibility of information
25-22    resources systems across health and human services agencies as
25-23    technology changes;
25-24                      (D)  information resources training and skill
25-25    development for health and human services agency employees and
25-26    policies to facilitate recruitment and retention of trained
25-27    employees;
 26-1                      (E)  standards for determining:
 26-2                            (i)  the circumstances in which obtaining
 26-3    information resources services under contract is appropriate;
 26-4                            (ii)  the information resources services
 26-5    functions that must be performed by health and human services
 26-6    agency information resources services employees; and
 26-7                            (iii)  the information resources services
 26-8    skills that must be maintained by health and human services agency
 26-9    information resources services employees;
26-10                      (F)  optimization of the use of information
26-11    resources technology that is in place at health and human services
26-12    agencies; and
26-13                      (G)  existing and potential future information
26-14    resources technologies and practices and the usefulness of those
26-15    technologies and practices to health and human services agencies;
26-16    and
26-17                (2)  shall review and make recommendations to the
26-18    commission relating to the consolidation and improved efficiency of
26-19    information resources management functions, including:
26-20                      (A)  cooperative leasing of information resources
26-21    systems equipment;
26-22                      (B)  consolidation of data centers;
26-23                      (C)  improved network operations;
26-24                      (D)  technical support functions, including help
26-25    desk services, call centers, and data warehouses;
26-26                      (E)  administrative applications;
26-27                      (F)  purchases of standard software;
 27-1                      (G)  joint training efforts;
 27-2                      (H)  recruitment and retention of trained agency
 27-3    employees;
 27-4                      (I)  video conferencing; and
 27-5                      (J)  other related opportunities for improved
 27-6    efficiency.
 27-7          (f)  A member of the advisory committee may not receive
 27-8    compensation, but is entitled to reimbursement of the travel
 27-9    expenses incurred by the member while conducting the business of
27-10    the committee, as provided by the General Appropriations Act.
27-11          (g)  The advisory committee is not subject to Chapter 2110.
27-12          SECTION 3.04.  Section 531.028, Government Code, is amended
27-13    to read as follows:
27-14          Sec. 531.028.  MONITORING AND EFFECTIVE MANAGEMENT [AND
27-15    DISTRIBUTION] OF FUNDS.  (a)  The commission, within the limits
27-16    established by and subject to the General Appropriations Act, shall
27-17    be responsible for planning for, and managing the use of, all
27-18    federal funds in a manner that maximizes the federal funding
27-19    available to the state while promoting the delivery of services.
27-20          (b)  The commissioner shall establish a federal money
27-21    management system to coordinate and monitor the use of federal
27-22    money that is received by health and human services agencies to
27-23    ensure that the money is spent in the most efficient manner and
27-24    shall:
27-25                (1)  establish priorities for use of federal money by
27-26    all health and human services agencies, in coordination with the
27-27    coordinated strategic plan established under Section 531.022 and
 28-1    the budget prepared under Section 531.026;
 28-2                (2)  coordinate and monitor the use of federal money
 28-3    for health and human services to ensure that the money is spent in
 28-4    the most cost-effective manner throughout the health and human
 28-5    services system;
 28-6                (3)  review and approve all federal funding plans for
 28-7    health and human services in this state;
 28-8                (4)  estimate available federal money, including earned
 28-9    federal money, and monitor unspent money;
28-10                (5)  ensure that the state meets federal requirements
28-11    relating to receipt of federal money for health and human services,
28-12    including requirements relating to state matching money and
28-13    maintenance of effort;
28-14                (6)  transfer appropriated amounts as described by
28-15    Section 531.0271; and
28-16                (7)  ensure that each governmental entity identified
28-17    under Section 531.022(e) has access to complete and timely
28-18    information about all sources of federal money for health and human
28-19    services programs and that technical assistance is available to
28-20    governmental entities seeking grants of federal money to provide
28-21    health and  human services.
28-22          (c)  The commission shall prepare an annual report with
28-23    respect to the results of the implementation of this section. The
28-24    report must identify strategies to maximize the receipt and use of
28-25    federal funds and to improve federal funds management. The
28-26    commission shall file the report with the governor, the lieutenant
28-27    governor, and the speaker of the house of representatives not later
 29-1    than December 15 of each year [request budget execution for the
 29-2    transfer of funds from one agency to another;]
 29-3                [(2)  establish a federal health and human services
 29-4    funds management system and maximize the availability of those
 29-5    funds; and]
 29-6                [(3)  review and comment on health and human services
 29-7    agency formulas for the distribution of funds to ensure that the
 29-8    formulas, to the extent permitted by federal law, consider such
 29-9    need factors as client base, population, and economic and
29-10    geographic factors within the regions of the state].
29-11          SECTION 3.05.  Section 531.0312, Government Code, is amended
29-12    to read as follows:
29-13          Sec. 531.0312.  TEXAS INFORMATION AND REFERRAL NETWORK.
29-14    (a)  The Texas Information and Referral Network at the commission
29-15    is the program responsible for the development, coordination, and
29-16    implementation of a statewide information and referral network that
29-17    integrates existing community-based structures with state and local
29-18    agencies.  The network must include information relating to
29-19    transportation  services provided to clients of state and local
29-20    agencies.
29-21          (b)  The commission shall cooperate with the Records
29-22    Management Interagency Coordinating Council and the General
29-23    Services Commission to establish a single method of categorizing
29-24    information about health and human services to be used by the
29-25    Records Management Interagency Coordinating Council and the Texas
29-26    Information and Referral Network. The network, in cooperation with
29-27    the council and the General Services Commission, shall ensure that:
 30-1                (1)  information relating to health and human services
 30-2    is included in each residential telephone directory published by a
 30-3    for-profit publisher and distributed to the public at minimal or no
 30-4    cost; and
 30-5                (2)  the single method of categorizing information
 30-6    about health and human services is used in a residential telephone
 30-7    directory described by Subdivision (1).
 30-8          (c)  A health and human services agency shall provide the
 30-9    Texas Information and Referral Network and the Records Management
30-10    Interagency  Coordinating Council with information about the health
30-11    and human services provided by the agency for inclusion in the
30-12    statewide information and referral network, residential telephone
30-13    directories described by Subsection (b), and any other materials
30-14    produced under the direction of the network or the council.  The
30-15    agency shall provide the information in the format required by the
30-16    Texas  Information and Referral Network or the Records Management
30-17    Interagency Coordinating Council and shall update the information
30-18    at least quarterly or as required by the network or the council.
30-19          SECTION 3.06.  Section 531.034, Government Code, is amended
30-20    by amending Subsection (b) and adding Subsection (d) to read as
30-21    follows:
30-22          (b)  The commission shall review agency rules:
30-23                (1)  for compliance with:
30-24                      (A) [(1)]  the coordinated strategic plan;
30-25                      (B) [(2)]  existing statutory authority;
30-26                      (C) [(3)]  rules of other health and human
30-27    services agencies; and
 31-1                      (D) [(4)]  budgetary implications; and
 31-2                (2)  to ensure that the rules do not:
 31-3                      (A)  discourage marriage; or
 31-4                      (B)  encourage divorce.
 31-5          (d)  The commission shall adopt rules to establish criteria
 31-6    for determining, as required by Subsection (b), whether an agency
 31-7    rule discourages marriage or encourages divorce.
 31-8          SECTION 3.07.  Section 441.053(j), Government Code,  is
 31-9    redesignated as Subsection (j) of Section 441.203, Government Code,
31-10    as added by Chapter 873, Acts of the 75th Legislature, Regular
31-11    Session, 1997, and is amended to read as follows:
31-12          (j)  The council shall categorize state agency programs and
31-13    telephone numbers by subject matter as well as by agency.  The
31-14    council shall cooperate with the Texas Information and Referral
31-15    Network under Section 531.0312 to ensure that the council and the
31-16    network use a single method of defining and organizing information
31-17    about health and human services.  State agencies shall cooperate
31-18    with the council by providing the council with the information it
31-19    needs to perform this function.
31-20          SECTION 3.08.  Section 9.12, Chapter 655, Acts of the 74th
31-21    Legislature, Regular Session, 1995, as amended by Section 1,
31-22    Chapter 1116, Acts of the 75th Legislature, Regular Session, 1997,
31-23    is redesignated as Subchapter F, Chapter 531, Government Code, and
31-24    amended to read as follows:
31-25            SUBCHAPTER F.  TEXAS INTEGRATED ENROLLMENT SERVICES
31-26          Sec. 531.191 [9.12].  INTEGRATED ELIGIBILITY DETERMINATION.
31-27    (a)  The commission [In consultation and coordination with the
 32-1    Texas Integrated Enrollment Services Legislative Oversight
 32-2    Committee established under Section 531.202, Government Code, the
 32-3    Health and Human Services Commission], subject to the approval of
 32-4    the governor and the Legislative Budget Board, shall develop and
 32-5    implement a plan for the integration of services and functions
 32-6    relating to eligibility determination and service delivery by
 32-7    health and human services agencies, the Texas Workforce Commission,
 32-8    and other agencies.  The plan must include a reengineering of
 32-9    eligibility determination business processes, streamlined service
32-10    delivery, a unified and integrated process for the transition from
32-11    welfare to work, and improved access to benefits and services for
32-12    clients. In developing and implementing the plan, the  commission
32-13    [Health and Human Services Commission]:
32-14                (1)  shall give priority to the design and development
32-15    of computer hardware and software for and provide technical support
32-16    relating to the integrated eligibility determination system;
32-17                (2)  shall consult with agencies whose programs are
32-18    included in the plan, including the Texas Department of Human
32-19    Services, the Texas Department of Health, and the Texas Workforce
32-20    Commission;
32-21                (3)  may contract for appropriate professional and
32-22    technical assistance; and
32-23                (4)  may use the staff and resources of agencies whose
32-24    programs are included in the plan.
32-25          (b)  The integrated eligibility determination and service
32-26    delivery system shall be developed and implemented to achieve
32-27    increased quality of and client access to services and savings in
 33-1    the cost of providing administrative and other services and staff
 33-2    resulting from streamlining and eliminating duplication of
 33-3    services. The commission, subject to any spending limitation
 33-4    prescribed in the General Appropriations Act, may use the resulting
 33-5    savings to further develop the integrated system and to provide
 33-6    other health and human services.
 33-7          (c)  The commission shall examine cost-effective methods to
 33-8    address:
 33-9                (1)  fraud in the assistance programs; and
33-10                (2)  the error rate in eligibility determination.
33-11          (d)  On receipt by the state of any necessary federal
33-12    approval and subject to the approval of the governor and the
33-13    Legislative Budget Board, the commission may contract for
33-14    implementation of all or part of the plan required by Subsection
33-15    (a) [of this section] if the commission determines that contracting
33-16    may advance the objectives of Subsections (a) and (b) [of this
33-17    section] and meets the criteria set out in the cost-benefit
33-18    analysis described in this subsection.  Before the awarding of a
33-19    contract, the commission shall provide a detailed cost-benefit
33-20    analysis to the governor and[,] the Legislative Budget Board[, and
33-21    the Texas Integrated Enrollment Services Legislative Oversight
33-22    Committee established under Section 531.202, Government Code]. The
33-23    analysis must demonstrate the cost-effectiveness of the plan,
33-24    mechanisms for monitoring performance under the plan, and specific
33-25    improvements to the service delivery system and client access made
33-26    by the plan.  The commission shall make the analysis available to
33-27    the public. Within 10 days after the release of a request for bids,
 34-1    proposals, offers, or other applicable expressions of interest
 34-2    relating to the development or implementation of the plan required
 34-3    by Subsection (a) [of this section], the commission shall hold a
 34-4    public hearing and receive public comment on the request. [The
 34-5    commission may coordinate with a legislative committee to hold the
 34-6    hearings.]
 34-7          (e)  [Not later than October 1, 1996, the commission shall
 34-8    develop a plan to consolidate administrative and service delivery
 34-9    functions in addition to the integrated eligibility determination
34-10    and service delivery system in order to minimize duplication. The
34-11    commission shall prepare a report of the plan for submission to the
34-12    governor, the lieutenant governor, the speaker of the house of
34-13    representatives, the comptroller, and the 75th Legislature when it
34-14    convenes.]
34-15          [(f)]  If requested by the commission [Health and Human
34-16    Services Commission], the agencies whose programs are included in
34-17    the plan required by Subsection (a) [of this section] shall
34-18    cooperate with the commission to provide available staff and
34-19    resources that will be subject to the direction of the commission.
34-20          (f) [(g)]  The design, development, and operation of an
34-21    automated data processing system to support the plan required by
34-22    Subsection (a) [of this section] may be financed through the
34-23    issuance of bonds or other obligations under the Texas Public
34-24    Finance Authority Act (Article 601d, Vernon's Texas Civil
34-25    Statutes).
34-26          Sec. 531.192.  COORDINATION WITH LEGISLATIVE OVERSIGHT
34-27    COMMITTEE.  (a)  The commission shall develop and implement the
 35-1    plan required by Section 531.191 in consultation and coordination
 35-2    with the Texas Integrated Enrollment Services Legislative Oversight
 35-3    Committee established by Section 531.202.
 35-4          (b)  Before awarding a contract under Section 531.191(d), the
 35-5    commission shall provide the detailed cost-benefit analysis
 35-6    described by that subsection to the legislative oversight
 35-7    committee.  The commission may coordinate with the legislative
 35-8    oversight committee to hold any hearing required under Section
 35-9    531.191(d).
35-10          (c)  This section expires September 1, 2002.
35-11          SECTION 3.09.  Subchapter D, Chapter 531, Government Code, as
35-12    added by Chapter 1116, Acts of the 75th Legislature, Regular
35-13    Session, 1997, is redesignated as Subchapter G, Chapter 531,
35-14    Government Code, and the subchapter heading is amended to read as
35-15    follows:
35-16       SUBCHAPTER G [D].  LEGISLATIVE OVERSIGHT FOR TEXAS INTEGRATED
35-17                            ENROLLMENT SERVICES
35-18          SECTION 3.10.  Section 531.203(a), Government Code, is
35-19    amended to read as follows:
35-20          (a)  The committee shall:
35-21                (1)  meet at the call of the presiding officer;
35-22                (2)  receive information about rules proposed or
35-23    adopted by the commission;
35-24                (3)  review specific recommendations for legislation
35-25    proposed by the commission; and
35-26                (4)  hold public hearings concerning the development
35-27    and implementation of the plan required by Subchapter F [Section
 36-1    9.12(a), Chapter 655, Acts of the 74th Legislature, Regular
 36-2    Session, 1995,] in at least four geographically diverse locations
 36-3    in the state.
 36-4          SECTION 3.11.  Section 2155.144, Government Code, as added by
 36-5    Chapter 1045, Acts of the 75th Legislature, Regular Session, 1997,
 36-6    is amended to read as follows:
 36-7          Sec. 2155.144.  PROCUREMENTS BY HEALTH AND HUMAN SERVICES
 36-8    AGENCIES.  (a)  This section applies only to the Health and Human
 36-9    Services Commission and to each health and human services agency.
36-10          (b)  An agency to which this section applies is delegated the
36-11    authority to procure its goods and services, except as provided by
36-12    this section.
36-13          (c)  An agency to which this section applies shall acquire
36-14    goods or services by any procurement method approved by the Health
36-15    and Human Services Commission that provides the best value to the
36-16    agency.  The agency shall document that it considered all relevant
36-17    factors under Subsection (d) in making the acquisition.
36-18          (d)  Subject to Subsection (e), the agency may consider all
36-19    relevant factors in determining the best value, including:
36-20                (1)  any installation costs;
36-21                (2)  the delivery terms;
36-22                (3)  the quality and reliability of the vendor's goods
36-23    or services;
36-24                (4)  the extent to which the goods or services meet the
36-25    agency's needs;
36-26                (5)  indicators of probable vendor performance under
36-27    the contract such as past vendor performance, the vendor's
 37-1    financial resources and ability to perform, the vendor's experience
 37-2    and responsibility, and the vendor's ability to provide reliable
 37-3    maintenance agreements;
 37-4                (6)  the impact on the ability of the agency to comply
 37-5    with laws and rules relating to historically underutilized
 37-6    businesses or relating to the procurement of goods and services
 37-7    from persons with disabilities;
 37-8                (7)  the total long-term cost to the agency of
 37-9    acquiring the vendor's goods or services;
37-10                (8)  the cost of any employee training associated with
37-11    the acquisition;
37-12                (9)  the effect of an acquisition on agency
37-13    productivity;
37-14                (10)  the acquisition price; and
37-15                (11)  any other factor relevant to determining the best
37-16    value for the agency in the context of a particular acquisition.
37-17          (e)  If an agency to which this section applies acquires
37-18    goods or services with a value that exceeds $100,000, the agency
37-19    shall notify the state auditor and shall consult with and receive
37-20    approval from the Health and Human Services Commission before
37-21    considering factors other than price and meeting specifications.
37-22          (f)  The state auditor may audit the agency's acquisitions of
37-23    goods and services before or after a warrant is issued to pay for
37-24    an acquisition.
37-25          (g)  The agency may adopt rules and procedures for the
37-26    acquisition of goods and services under this section.
37-27          (h)  The Health and Human Services Commission shall adopt
 38-1    rules and procedures for the acquisition of goods and services
 38-2    under this section that apply to all health and human services
 38-3    agencies, including rules adopted with the commission's assistance
 38-4    that allow an agency to make purchases through a group purchasing
 38-5    program except when a better value is available through another
 38-6    procurement method.  The rules of the health and human services
 38-7    agencies must be consistent with the rules of the Health and Human
 38-8    Services Commission.
 38-9          (i)  Subject to Section 531.0055(c), the Health and Human
38-10    Services Commission shall develop a single statewide risk analysis
38-11    procedure.  Each health and human services agency shall comply with
38-12    the procedure.  The procedure must provide for:
38-13                (1)  assessing the risk of fraud, abuse, or waste in
38-14    health and human services agencies contractor selection processes,
38-15    contract provisions, and payment and reimbursement rates and
38-16    methods for the different types of goods and services for which
38-17    health and human services agencies contract;
38-18                (2)  identifying contracts that require enhanced
38-19    contract monitoring; and
38-20                (3)  coordinating contract monitoring efforts among
38-21    health and human services agencies.
38-22          (j)  Subject to Section 531.0055(c), the Health and Human
38-23    Services Commission shall publish a contract management handbook
38-24    that establishes consistent contracting policies and practices to
38-25    be followed by health and human services agencies.   The handbook
38-26    may include standard contract provisions and formats for health and
38-27    human services agencies to incorporate as applicable in their
 39-1    contracts.
 39-2          (k)  Subject to Section 531.0055(c), the Health and Human
 39-3    Services Commission, in cooperation with the comptroller, shall
 39-4    establish a central contract management database that identifies
 39-5    each contract made with a health and human services agency.  The
 39-6    commission may use the database to monitor health and human
 39-7    services agency contracts, and health and human services agencies
 39-8    may use the database in contracting.  A state agency shall send to
 39-9    the commission in the manner prescribed by the commission the
39-10    information the agency possesses that the commission requires for
39-11    inclusion in the database.
39-12          (l)  The Health and Human Services Commission shall
39-13    coordinate the procurement practices of all health and human
39-14    services agencies and encourage those agencies to use efficient
39-15    procurement practices such as the use of a group purchasing
39-16    program, combining maintenance contracts into one contract, and
39-17    obtaining prompt payment discounts.  In implementing this duty, the
39-18    Health and Human Services Commission may review the procurement and
39-19    rate-setting procedures of each health and human services agency to
39-20    ensure that amounts paid to contractors are consistent and
39-21    represent the best value for the state.  The Health and Human
39-22    Services Commission may disapprove a procurement and rate-setting
39-23    procedure of a health and human services agency.  A health and
39-24    human services agency may not use a procurement or rate-setting
39-25    procedure that has been disapproved by the commission.  The Health
39-26    and Human Services Commission may transfer the procurement
39-27    functions of a health and human services agency to another
 40-1    appropriate state agency if it determines that transferring those
 40-2    functions would be advantageous to the state.  Other state agencies
 40-3    and institutions with experience in acquiring goods and services
 40-4    using the procedures allowed under Subsections (c) and (d) shall on
 40-5    request assist the Health and Human Services Commission to perform
 40-6    its functions under this section.
 40-7          (m)  Subject to Section 531.0055(c), the Health and Human
 40-8    Services Commission shall develop and implement a statewide plan to
 40-9    ensure that each entity that contracts with a health and human
40-10    services agency and any subcontractor of the entity complies with
40-11    the accessibility requirements of the Americans with Disabilities
40-12    Act of 1990 (42 U.S.C. Section 12101 et seq.).
40-13          (n) [(j)]  To the extent of any conflict, this section
40-14    prevails over any other state law relating to the procurement of
40-15    goods and services except a law relating to contracting with
40-16    historically underutilized businesses or relating to the
40-17    procurement of goods and services from persons with disabilities.
40-18          (o)  The Health and Human Services Commission shall prepare
40-19    an annual report that assesses the compliance of each health and
40-20    human services agency with the requirements imposed under this
40-21    section and that identifies any material risk to the state or to
40-22    the clients of the health and human services agency that results
40-23    from the agency's procurement and contracting practices.  The
40-24    commission may request the assistance of the state auditor in
40-25    preparing the report. The state auditor shall conduct reviews as
40-26    necessary to assess compliance under this subsection as determined
40-27    by the Legislative Audit Committee.  The commission shall file the
 41-1    report with the governor, the lieutenant governor, and the speaker
 41-2    of the house of representatives not later than December 15 of each
 41-3    year.
 41-4          (p) [(k)]  In this section, "health and human services
 41-5    agency" has the meaning assigned by Section 531.001.
 41-6          SECTION 3.12.  Section 2167.004, Government Code, is amended
 41-7    to read as follows:
 41-8          Sec. 2167.004.  LEASING SPACE FOR HEALTH AND HUMAN SERVICES
 41-9    AGENCIES.  (a)  Notwithstanding any other provision of this chapter
41-10    or of Subchapter C, Chapter 2165, the commission may not lease
41-11    office space to serve the needs of any health and human services
41-12    agency unless the Health and Human Services Commission has approved
41-13    the office space for the agency.
41-14          (b)  The commission may not enter into an emergency lease to
41-15    serve the needs of a health and human services agency  unless the
41-16    emergency lease is entered into under criteria adopted by the
41-17    Health and Human Services Commission in consultation with the
41-18    commission.  The criteria must:
41-19                (1)  encourage advance planning by the health and human
41-20    services agency to facilitate regional management of health and
41-21    human services agencies by the Health and Human Services Commission
41-22    under Section 531.0246; and
41-23                (2)  ensure that the circumstances that require an
41-24    emergency lease are outside of the control of the agency and that
41-25    the agency could not reasonably have been expected to foresee the
41-26    circumstances.
41-27          (c)  In this section, "health and human services agency" has
 42-1    the meaning assigned by Section 531.001 [means the:]
 42-2                [(1)  Interagency Council on Early Childhood
 42-3    Intervention Services;]
 42-4                [(2)  Texas Department on Aging;]
 42-5                [(3)  Texas Commission on Alcohol and Drug Abuse;]
 42-6                [(4)  Texas Commission for the Blind;]
 42-7                [(5)  Texas Commission for the Deaf and Hearing
 42-8    Impaired;]
 42-9                [(6)  Texas Department of Health;]
42-10                [(7)  Texas Department of Human Services;]
42-11                [(8)  Texas Juvenile Probation Commission;]
42-12                [(9)  Texas Department of Mental Health and Mental
42-13    Retardation;]
42-14                [(10)  Texas Rehabilitation Commission; or]
42-15                [(11)  Department of Protective and Regulatory
42-16    Services].
42-17          SECTION 3.13.  Not later than January 1, 2000, the Health and
42-18    Human Services Commission shall adopt the rules required by Section
42-19    531.034(d), Government Code, as added by this article.
42-20          SECTION 3.14.  (a)  Not later than December 15, 2000, the
42-21    Health and Human Services Commission shall submit a report relating
42-22    to the delivery of mental health and substance abuse services in
42-23    this state to the governor, the lieutenant governor, the speaker of
42-24    the house of representatives, and the committees of the house of
42-25    representatives and senate identified under Section 531.171,
42-26    Government Code, as added by this Act. The report must include:
42-27                (1)  a comprehensive inventory of all mental health and
 43-1    substance abuse services provided by state agencies;
 43-2                (2)  the populations to which the services are
 43-3    provided;
 43-4                (3)  the amount of state resources expended on the
 43-5    services;
 43-6                (4)  a comprehensive description of interagency
 43-7    coordination and collaborative initiatives related to those
 43-8    services; and
 43-9                (5)  an assessment of whether any of those services are
43-10    redundant of other services provided by state agencies.
43-11          (b)  A health and human services agency or any other state
43-12    agency that provides mental health or substance abuse services
43-13    shall provide the Health and Human Services Commission any
43-14    information, other than confidential information, requested by the
43-15    commission relating to mental health and substance abuse services
43-16    provided by the agency.
43-17          (c)  This section expires December 31, 2000.
43-18          SECTION 3.15.  (a)  Not later than December 15, 2000, the
43-19    Health and Human Services Commission shall submit a report relating
43-20    to regulatory programs conducted by the Texas Department of Health
43-21    to the governor, the lieutenant governor, the speaker of the house
43-22    of representatives, and the committees of the house of
43-23    representatives and senate identified under Section 531.171,
43-24    Government Code, as added by this Act. In preparing the report, the
43-25    commission must consider whether:
43-26                (1)  health-related regulatory programs conducted by
43-27    the Texas Department of Health should be consolidated or
 44-1    restructured;
 44-2                (2)  a new agency, similar to the Texas Department of
 44-3    Licensing and Regulation, should be established to administer all
 44-4    or some of the health-related regulatory programs;
 44-5                (3)  a new agency should be established to administer
 44-6    regulatory programs related to health-related professions;
 44-7                (4)  a new agency should be established to regulate
 44-8    health-related facilities;
 44-9                (5)  the duties of the Health Professions Council
44-10    should be expanded to encompass all or some of the health-related
44-11    regulatory programs; or
44-12                (6)  health-related regulatory programs administered by
44-13    the Texas Department of Health should continue to be administered
44-14    by the department without consolidation or restructuring.
44-15          (b)  This section expires December 31, 2000.
44-16          SECTION 3.16.  (a)  The Health and Human Services Commission
44-17    shall:
44-18                (1)  assess the benefits of consolidating support
44-19    services provided to health and human services agencies in agency
44-20    headquarters and in regional offices; and
44-21                (2)  develop a proposed plan and schedule for
44-22    colocating offices and consolidating support services in accordance
44-23    with Section 531.0246, Government Code, as added by this article.
44-24          (b)  Not later than September 1, 2000, the Health and Human
44-25    Services Commission shall report the results of the assessment,
44-26    together with the proposed plan and schedule, to the governor, the
44-27    lieutenant governor, the speaker of the house of representatives,
 45-1    and the committees of the house of representatives and senate
 45-2    identified under Section 531.171, Government Code, as added by this
 45-3    Act.
 45-4          SECTION 3.17.  The Health and Human Services Commission, the
 45-5    General Services Commission, and the Records Management Interagency
 45-6    Coordinating Council shall  ensure that information about health
 45-7    and human services presented in the format required by Section
 45-8    531.0312, Government Code, as amended by this article, is available
 45-9    for publication in residential telephone directories to be
45-10    distributed to the public after December 1, 2000. Not later than
45-11    December 31, 2000, the Health and Human Services Commission, the
45-12    General Services Commission, and the Records Management Interagency
45-13    Coordinating Council shall each report to the governor, the
45-14    lieutenant governor, the speaker of the house of representatives,
45-15    and the committees of the house of representatives and senate
45-16    identified under Section 531.171, Government Code, as added by this
45-17    Act, with respect to the implementation of this section.
45-18          SECTION 3.18.  Notwithstanding Section 2155.144(o),
45-19    Government Code, as added by this article, the state auditor shall
45-20    conduct initial reviews as necessary to assess compliance under
45-21    that subsection and complete those reviews not later than September
45-22    1, 2001.
45-23          SECTION 3.19.  (a)  The Health and Human Services Commission
45-24    shall study the feasibility of a subacute care pilot project.  The
45-25    Texas Department of Human Services and the Texas Department of
45-26    Health shall cooperate with and assist the commission in this
45-27    study.  In conducting the study, the Health and Human Services
 46-1    Commission shall consider:
 46-2                (1)  estimates of the potential fiscal impact,
 46-3    including the potential to save money;
 46-4                (2)  the impact of subacute care on quality of care;
 46-5                (3)  reimbursement under the state's reimbursement and
 46-6    regulatory policies;
 46-7                (4)  the capacity of facilities in this state to
 46-8    provide subacute care; and
 46-9                (5)  the impact of subacute care reimbursement on
46-10    Medicaid, including managed care initiatives.
46-11          (b)  Not later than September 1, 2000, the commission shall
46-12    submit a report on the feasibility of a subacute care pilot project
46-13    to the governor, the lieutenant governor, the speaker of the house
46-14    of representatives, and the chair of each legislative committee
46-15    with jurisdiction over long-term care.
46-16          (c)  This section expires September 1, 2001.
46-17       ARTICLE 4.  INVESTIGATIONS OF FRAUD, ABUSE, AND EXPLOITATION
46-18          SECTION 4.01.  In this article:
46-19                (1)  "Commission" means the Health and Human Services
46-20    Commission.
46-21                (2)  "Working group" means the working group convened
46-22    under Section 4.02 of this article.
46-23          SECTION 4.02.  Except as provided by Section 4.05 of this
46-24    article, the commission shall identify each health and human
46-25    services agency that may be required to conduct an investigation of
46-26    abuse, neglect, or exploitation of a client of the agency at a
46-27    facility operated by or under contract with the agency and any
 47-1    agency covered under Section 261.401, Family Code, or Section
 47-2    48.082, Human Resources Code, and shall convene a working group of
 47-3    representatives of those agencies and advocates for the affected
 47-4    clients.
 47-5          SECTION 4.03.  Not later than August 1, 2000, the working
 47-6    group shall develop:
 47-7                (1)  proposed definitions of "abuse," "neglect," and
 47-8    "exploitation";
 47-9                (2)  proposed minimum standards for investigatory
47-10    techniques for investigations of abuse, neglect, or exploitation of
47-11    a client; and
47-12                (3)  proposed uniform data collection procedures,
47-13    including procedures for collection of information on deaths that
47-14    occur in the affected facilities.
47-15          SECTION 4.04.  (a)  The commission shall present a report on
47-16    the results of the working group to the governor, the lieutenant
47-17    governor, and the speaker of the house of representatives not later
47-18    than November 1, 2000.
47-19          (b)  The report must include any recommendations, based on
47-20    the results of the working group, for changes in law the commission
47-21    considers necessary.
47-22          SECTION 4.05.  The working group may not include a
47-23    representative of the Texas Juvenile Probation Commission and may
47-24    not include recommendations relating to facilities operated by or
47-25    under contract with the Texas Juvenile Probation Commission.
47-26                  ARTICLE 5. GUARDIANSHIP ADVISORY BOARD
47-27          SECTION 5.01.  Sections 531.122(b) and (d), Government Code,
 48-1    are amended to read as follows:
 48-2          (b)  The advisory board is composed of one representative
 48-3    from each of the health and human services regions, as defined by
 48-4    the commission, three public representatives, and one
 48-5    representative of the Department of Protective and Regulatory
 48-6    Services. The representatives of the health and human services
 48-7    regions are appointed by a majority vote of the judges of the
 48-8    statutory probate courts in each region.  If a health and human
 48-9    services region does not contain a statutory probate court, the
48-10    representative shall be appointed by a majority vote of the judges
48-11    of the statutory probate courts in the state. The public
48-12    representatives are appointed by the commissioner and the
48-13    representative of the Department of Protective and Regulatory
48-14    Services is appointed by the Board of Protective and Regulatory
48-15    Services.
48-16          (d)  A member of the advisory board serves at the pleasure of
48-17    a majority of the judges of the statutory probate courts that
48-18    appointed the member, of the commissioner, or of the Board of
48-19    Protective and Regulatory Services, as appropriate.
48-20          SECTION 5.02.  Subchapter D, Chapter 531, Government Code, as
48-21    added by Chapter 1033, Acts of the 75th Legislature, Regular
48-22    Session, 1997, is amended by adding Section 531.1235 to read as
48-23    follows:
48-24          Sec. 531.1235.  ADVISORY BOARD; ADDITIONAL DUTIES; STATEWIDE
48-25    GUARDIANSHIP SYSTEM.  (a)  In addition to performing the duties
48-26    described by Section 531.122, the advisory board shall:
48-27                (1)  advise the commission and the Department of
 49-1    Protective and Regulatory Services with respect to a statewide
 49-2    guardianship program and develop a proposal for a statewide
 49-3    guardianship program; and
 49-4                (2)  review and comment on the guardianship policies of
 49-5    all health and human services agencies and recommend changes to the
 49-6    policies the advisory board considers necessary or advisable.
 49-7          (b)  The advisory board shall prepare an annual report with
 49-8    respect to the recommendations of the advisory board under
 49-9    Subsection (a).  The advisory board shall file the report with the
49-10    commission, the Department of Protective and Regulatory Services,
49-11    the governor, the lieutenant governor, and the speaker of the house
49-12    of representatives not later than December 15 of each year.
49-13          SECTION 5.03.  Section 531.124, Government Code, is amended
49-14    by adding Subsection (c) to read as follows:
49-15          (c)  The advisory board shall annually review and comment on
49-16    the minimum standards adopted under Subsection (a)(1) and the plan
49-17    implemented under Subsection (a)(2) and shall include its
49-18    conclusions in the report submitted under Section 531.1235.
49-19          SECTION 5.04.  Not later than October 1, 1999, the Board of
49-20    Protective and Regulatory Services shall appoint the additional
49-21    members of the Guardianship Advisory Board, as required by Section
49-22    531.122, Government Code, as amended by this article.
49-23               ARTICLE 6.  HEALTH AND HUMAN SERVICES OFFICE
49-24                   OF COMMUNITY TRANSPORTATION SERVICES
49-25          SECTION 6.01.  Chapter 131, Human Resources Code, is amended
49-26    to read as follows:
49-27        CHAPTER 131.  HEALTH AND HUMAN SERVICES OFFICE OF COMMUNITY
 50-1               TRANSPORTATION SERVICES [AND PLANNING OFFICE]
 50-2          Sec. 131.001.  OFFICE.  The Health and Human Services
 50-3    [Transportation and Planning] Office of Community Transportation
 50-4    Services is in the Health and Human Services Commission.
 50-5          Sec. 131.002.  DEFINITIONS.  In this chapter:
 50-6                (1)  "Commissioner" means the commissioner of health
 50-7    and human services.
 50-8                (2)  "Health and human services agency" has the meaning
 50-9    assigned by Section 531.001, Government Code.
50-10                (3)  "Office" means the Health and Human Services
50-11    Office of Community Transportation Services.
50-12          Sec. 131.003.  POWERS AND DUTIES.  (a)  The office, with
50-13    assistance from the commissioner, shall:
50-14                (1)  collect data on health and human services client
50-15    transportation needs, services, and expenditures;
50-16                (2)  create a statewide coordination plan regarding a
50-17    system of transportation for clients of health and human services
50-18    agencies that provides for coordinated, community-based services,
50-19    including the designation of local transportation coordinators;
50-20                (3)  establish a standardized system [standards] of
50-21    reporting and accounting to be used by [methods for] all health and
50-22    human services agencies providing [health and human services]
50-23    client transportation, and ensure that information reported under
50-24    that system is available through the Texas Information and Referral
50-25    Network;
50-26                (4)  maximize federal funds for client transportation
50-27    through the use of available state funds for matching purposes and
 51-1    the possible use of oil overcharge money and planning funds
 51-2    available through the federal department of transportation;
 51-3                (5)  evaluate the effectiveness of pooling client
 51-4    transportation resources for capital acquisition and the joint
 51-5    purchase of liability insurance;
 51-6                (6)  assist state agencies in coordinating
 51-7    transportation resources;
 51-8                (7)  ensure coordination between the office and the
 51-9    Texas Department of Transportation with regard to the use of funds
51-10    received by the department under 49 U.S.C.  Section 1612(b)(1);
51-11                (8)  examine the feasibility of consolidating all
51-12    funding for health and human services client transportation and
51-13    creating a transportation system through which clients of a state
51-14    or local agency or program could be matched with the most
51-15    cost-effective and appropriate transportation services for their
51-16    needs, including, to the extent practicable, use of private,
51-17    nonprofit entities that provide services at little or no cost
51-18    beyond reimbursement for insurance, fuel, mileage, or other
51-19    expenses that might deter the entities from otherwise providing
51-20    services;
51-21                (9)  evaluate the use of existing computer software for
51-22    use at the local level in client transportation services; and
51-23                (10)  review the feasibility of taking medical care to
51-24    those in need, including the use of mobile clinics, and review the
51-25    possibility of using federal highway funds for those transportation
51-26    needs.
51-27          (b)  The office [Health and Human Services Transportation and
 52-1    Planning Office] shall coordinate with the Health and Human
 52-2    Services Commission and health and human services agencies in
 52-3    implementing the goals listed in Section 531.022(c), Government
 52-4    Code [10(b), Article 4413(502), Revised Statutes].  The office
 52-5    shall report its findings and proposals to the governor, the
 52-6    Legislative Budget Board, the secretary of state, and the
 52-7    commissioner [of health and human services] not later than
 52-8    September 1 of each even-numbered year.
 52-9          Sec. 131.004 [131.003].  OFFICE STAFF.  The commissioner [of
52-10    health and human services] shall employ staff needed to carry out
52-11    the duties of the office.
52-12          Sec. 131.005.  REPORTING AND ACCOUNTING SYSTEM.  Each health
52-13    and human services agency that provides, purchases, or otherwise
52-14    funds transportation services for clients shall:
52-15                (1)  comply with the standardized system of reporting
52-16    and accounting established by the office under Section
52-17    131.003(a)(3);
52-18                (2)  make any changes to agency data collection systems
52-19    that are necessary to enable  the agency to comply with the
52-20    standardized system; and
52-21                (3)  not later than August 31 of each year, submit to
52-22    the office a report relating to transportation services that
52-23    complies with the standardized system.
52-24          Sec. 131.006.  IMPLEMENTATION OF STATEWIDE COORDINATION PLAN.
52-25    In order to implement the statewide coordination plan created by
52-26    the office under Section 131.003(a)(2), the office shall:
52-27                (1)  review rules, policies, contracts, grants, and
 53-1    funding mechanisms relating to transportation services of each
 53-2    health and human services agency that provides, purchases, or
 53-3    otherwise funds transportation services for clients to determine
 53-4    whether the rules, policies, contracts, grants, and funding
 53-5    mechanisms are consistent with the plan;
 53-6                (2)  make recommendations for revisions to rules,
 53-7    policies, contracts, grants, and funding mechanisms determined
 53-8    under Subdivision (1) to be inconsistent  with the plan; and
 53-9                (3)  not later than September 30 of each even-numbered
53-10    year, submit a report by electronic mail and by hand delivery to
53-11    the governor, the secretary of state, the  Legislative Budget
53-12    Board, and the commissioner relating to the results of the review
53-13    conducted by the office under this section.
53-14          Sec. 131.007.  ADVISORY COMMITTEE ON COORDINATED
53-15    TRANSPORTATION.  The office may create an advisory committee
53-16    consisting of representatives of state agencies, transportation
53-17    agencies, and nonprofit consumer groups.
53-18          Sec. 131.008.  MEMORANDUM OF UNDERSTANDING.  (a)  The Health
53-19    and Human Services Commission and the Texas Department of
53-20    Transportation shall enter into a memorandum of understanding
53-21    relating to functions performed by each agency that relate to the
53-22    duties of the office.
53-23          (b)  The agencies shall include provisions in the memorandum
53-24    of understanding necessary to ensure that the agencies do not have
53-25    duplicative authority, responsibilities, or activities in the area
53-26    of transportation services for clients of health and human services
53-27    agencies.  Specifically, the memorandum of understanding must
 54-1    include the following provisions:
 54-2                (1)  an acknowledgement that the data collection and
 54-3    analysis activities of the office and the Health and Human Services
 54-4    Commission are comprehensive in scope, with the goal of developing
 54-5    a statewide coordination plan for the provision of transportation
 54-6    services for clients of health and human services agencies;
 54-7                (2)  an acknowledgement that the data collection and
 54-8    analysis activities of the Texas Department of Transportation are
 54-9    focused on providing more accurate social service contracting
54-10    information to transit providers;
54-11                (3)  a requirement that the Texas Department of
54-12    Transportation participate and assist in the collection of
54-13    information about transportation service funding from local social
54-14    service providers and make any database with that information
54-15    available to the Health and Human Services Commission; and
54-16                (4)  a requirement that the Health and Human Services
54-17    Commission:
54-18                      (A)  develop standardized reporting methods for
54-19    health and human services agencies and social service providers to
54-20    use when reporting information about transportation services,
54-21    funding, contracting, and all other information needed to develop a
54-22    statewide coordination plan for transportation services; and
54-23                      (B)  make the information collected under
54-24    Paragraph (A) available to the Texas Department of Transportation.
54-25          SECTION 6.02.  Section 459.003, Transportation Code, is
54-26    amended by amending Subsection (c) and adding Subsection (e) to
54-27    read as follows:
 55-1          (c)  A social services provider receiving information under
 55-2    Subsection (b) shall, not later than January 1 of each year,
 55-3    provide to the transportation provider and the department an
 55-4    inventory of current contracts and in-house capital resources for
 55-5    the provision of client transportation services within each
 55-6    transportation provider's service area or an area contiguous to the
 55-7    service area that is not served by a transportation provider.
 55-8          (e)  The department will compile a statewide database to
 55-9    document transportation expenses and track the number of instances
55-10    in which social service contract dollars are actually awarded to a
55-11    transit operator as a result of compliance with this section. The
55-12    department shall make the information in the database available to
55-13    the Health and Human Services Commission.
55-14          SECTION 6.03.  Not later than January 1, 2001, the Health and
55-15    Human Services Office of Community Transportation Services and the
55-16    commissioner of health and human services shall create the
55-17    statewide  coordination plan required by Section 131.003(a)(2),
55-18    Human Resources Code, as amended by this article.
55-19         ARTICLE 7.  EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES
55-20          SECTION 7.01.  Subchapter B, Chapter 481, Government Code, is
55-21    amended by adding Section 481.025 to read as follows:
55-22          Sec. 481.025.  EMPOWERMENT ZONE AND ENTERPRISE COMMUNITY
55-23    PROGRAM.  The department is the agency of this state responsible
55-24    for administering the Empowerment Zone and Enterprise Community
55-25    grant program in this state. The department shall cooperate with
55-26    appropriate federal and local agencies as necessary to administer
55-27    the grant program.
 56-1          SECTION 7.02.  Effective September 1, 1999, administration of
 56-2    the Empowerment Zone and Enterprise Community grant program in this
 56-3    state is transferred from the Health and Human Services Commission
 56-4    to the Texas Department of Economic Development. The commissioner
 56-5    of health and human services and the governing board of the Texas
 56-6    Department of Economic Development shall enter into a memorandum of
 56-7    understanding as necessary to implement the transfer required by
 56-8    this section.
 56-9                ARTICLE 8.  HEALTH CARE INFORMATION COUNCIL
56-10          SECTION 8.01.  Section 531.001(4), Government Code, is
56-11    amended to read as follows:
56-12                (4)  "Health and human services agencies" includes the:
56-13                      (A)  Interagency Council on Early Childhood
56-14    Intervention [Services];
56-15                      (B)  Texas Department on Aging;
56-16                      (C)  Texas Commission on Alcohol and Drug Abuse;
56-17                      (D)  Texas Commission for the Blind;
56-18                      (E)  Texas Commission for the Deaf and Hard of
56-19    Hearing;
56-20                      (F)  Texas Department of Health;
56-21                      (G)  Texas Department of Human Services;
56-22                      (H)  Texas Juvenile Probation Commission;
56-23                      (I)  Texas Department of Mental Health and Mental
56-24    Retardation;
56-25                      (J)  Texas Rehabilitation Commission; [and]
56-26                      (K)  Department of Protective and Regulatory
56-27    Services; and
 57-1                      (L)  Texas Health Care Information Council.
 57-2          SECTION 8.02.  Section 108.002(4), Health and Safety Code, is
 57-3    amended to read as follows:
 57-4                (4)  "Data" means information collected under Section
 57-5    108.0065 or 108.009 in the form initially received.
 57-6          SECTION 8.03.  Chapter 108, Health and Safety Code,  is
 57-7    amended by adding Section 108.0065 to read as follows:
 57-8          Sec. 108.0065.  POWERS AND DUTIES OF COUNCIL RELATING TO
 57-9    MEDICAID MANAGED CARE.  (a)  In this section:
57-10                (1)  "Commission" means the Health and Human Services
57-11    Commission.
57-12                (2)  "Medicaid managed care organization" means a
57-13    managed care organization, as defined by Section 533.001,
57-14    Government Code, that is contracting with the commission to
57-15    implement the Medicaid managed care program under Chapter 533,
57-16    Government Code.
57-17          (b)  The commission may direct the council to collect data
57-18    under this chapter with respect to Medicaid managed care
57-19    organizations. The council shall coordinate the collection of the
57-20    data with the collection of data for health benefit plan providers,
57-21    but with the approval of the commission may collect data in
57-22    addition to the data otherwise required of health benefit plan
57-23    providers.
57-24          (c)  Each Medicaid managed care organization shall provide
57-25    the data required by the council in the form required by the
57-26    council or, if the data is also being submitted to the commission
57-27    or Medicaid operating agency, in the form required by the
 58-1    commission or Medicaid operating agency.
 58-2          (d)  Dissemination of data collected under this section is
 58-3    subject to Sections 108.010, 108.011, 108.012, 108.013, 108.014,
 58-4    and 108.0141.
 58-5          (e)  The commission shall analyze the data collected in
 58-6    accordance with this section and shall use the data to:
 58-7                (1)  evaluate the effectiveness and efficiency of the
 58-8    Medicaid managed care system;
 58-9                (2)  determine the extent to which Medicaid managed
58-10    care does or does not serve the needs of Medicaid recipients in
58-11    this state; and
58-12                (3)  assess the cost-effectiveness of the Medicaid
58-13    managed care system in comparison to the fee-for-service system,
58-14    considering any improvement in the quality of care provided.
58-15          (f)  Not later than October 1 of each even-numbered year, the
58-16    commission shall report to the governor, the lieutenant governor,
58-17    and the speaker of the house of representatives with respect to:
58-18                (1)  the commission's conclusions under Subsection (e)
58-19    and any improvement made in the delivery of services under the
58-20    Medicaid managed care system since the date of the commission's
58-21    last report under this section;
58-22                (2)  recommendations for implementation by the state
58-23    agencies operating the Medicaid managed care system for improvement
58-24    to the Medicaid managed care system; and
58-25                (3)  any recommendations for legislation.
58-26          (g)  The report made under Subsection (f) may be consolidated
58-27    with any report made under Section 108.006(a)(9).
 59-1          (h)  The commission, using existing funds, may contract with
 59-2    an entity to comply with the requirements under Subsections (e) and
 59-3    (f).
 59-4                           ARTICLE 9.  MEDICAID
 59-5          SECTION 9.01.  Subchapter B, Chapter 12, Health and Safety
 59-6    Code, is amended by adding Section 12.0123 to read as follows:
 59-7          Sec. 12.0123.  EXTERNAL AUDITS OF CERTAIN MEDICAID
 59-8    CONTRACTORS.  (a)  In this section, "Medicaid contractor" means an
 59-9    entity that:
59-10                (1)  is not a health and human services agency as
59-11    defined by Section 531.001, Government Code; and
59-12                (2)  under contract with or otherwise on behalf of the
59-13    department, performs one or more administrative services in
59-14    relation to the department's operation of a part of the state
59-15    Medicaid program, such as claims processing, utilization review,
59-16    client enrollment, provider enrollment, quality monitoring, or
59-17    payment of claims.
59-18          (b)  The department shall contract with an independent
59-19    auditor to perform annual independent external financial and
59-20    performance audits of any Medicaid contractor used by the
59-21    department in the department's operation of a part of the state
59-22    Medicaid program.
59-23          (c)  The department shall ensure that audit procedures
59-24    related to financial audits and performance audits are used
59-25    consistently in audits under this section.
59-26          (d)  An audit required by this section must be completed
59-27    before the end of the fiscal year immediately following the fiscal
 60-1    year for which the audit is performed.
 60-2          SECTION 9.02.  Section 533.003, Government Code, is amended
 60-3    to read as follows:
 60-4          Sec. 533.003.  CONSIDERATIONS IN AWARDING CONTRACTS.  In
 60-5    awarding contracts to managed care organizations, the commission
 60-6    shall:
 60-7                (1)  give preference to organizations that have
 60-8    significant participation in the organization's provider network
 60-9    from each health care provider in the region who has traditionally
60-10    provided care to Medicaid and charity care patients;
60-11                (2)  give extra consideration to organizations that
60-12    agree to assure continuity of care for at least three months beyond
60-13    the period of Medicaid eligibility for recipients; [and]
60-14                (3)  consider the need to use different managed care
60-15    plans to meet the needs of different populations; and
60-16                (4)  consider the ability of organizations to process
60-17    Medicaid claims electronically.
60-18          SECTION 9.03.  Section 533.004, Government Code, is amended
60-19    by amending Subsection (a)  and adding Subsection (e) to read as
60-20    follows:
60-21          (a)  In providing health care services through Medicaid
60-22    managed care to recipients in a health care service region, the
60-23    commission shall contract with a [at least one] managed care
60-24    organization in that region that is licensed under the Texas Health
60-25    Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
60-26    Code) to provide health care in that region and that is:
60-27                (1)  wholly owned and operated by a hospital district
 61-1    in that region;
 61-2                (2)  created by a nonprofit corporation that:
 61-3                      (A)  has a contract, agreement, or other
 61-4    arrangement with a hospital district in that region or with a
 61-5    municipality in that region that owns a hospital licensed under
 61-6    Chapter 241, Health and Safety Code, and has an obligation to
 61-7    provide health care to indigent patients; and
 61-8                      (B)  under the contract, agreement, or other
 61-9    arrangement, assumes the obligation to provide health care to
61-10    indigent patients and leases, manages, or operates a hospital
61-11    facility owned by the hospital district or municipality; or
61-12                (3)  created by a nonprofit corporation that has a
61-13    contract, agreement, or other arrangement with a hospital district
61-14    in that region under which the nonprofit corporation acts as an
61-15    agent of the district and assumes the district's obligation to
61-16    arrange for services under the Medicaid expansion for children as
61-17    authorized by Chapter 444, Acts of the 74th Legislature, Regular
61-18    Session, 1995.
61-19          (e)  In providing health care services through Medicaid
61-20    managed care to recipients in a health care service region, with
61-21    the exception of the Harris service area for the STAR Medicaid
61-22    managed care program, as defined by the commission as of September
61-23    1, 1999, the commission shall also contract with a managed care
61-24    organization in that region that holds a certificate of authority
61-25    as a health maintenance organization under Section 5, Texas Health
61-26    Maintenance Organization Act (Article 20A.05, Vernon's Texas
61-27    Insurance Code), and that:
 62-1                (1)  is certified under Section 5.01(a), Medical
 62-2    Practice Act (Article 4495b, Vernon's Texas Civil Statutes);
 62-3                (2)  is created by The University of Texas Medical
 62-4    Branch at Galveston; and
 62-5                (3)  has obtained a certificate of authority as a
 62-6    health maintenance organization to serve one or more counties in
 62-7    that region from the Texas Department of Insurance before September
 62-8    2, 1999.
 62-9          SECTION 9.04.  Section 533.005, Government Code, is amended
62-10    to read as follows:
62-11          Sec. 533.005.  REQUIRED CONTRACT PROVISIONS.  A contract
62-12    between a managed care organization and the commission for the
62-13    organization to provide health care services to recipients must
62-14    contain:
62-15                (1)  procedures to ensure accountability to the state
62-16    for the provision of health care services, including procedures for
62-17    financial reporting, quality assurance, utilization review, and
62-18    assurance of contract and subcontract compliance;
62-19                (2)  capitation and provider payment rates that ensure
62-20    the cost-effective provision of quality health care;
62-21                (3)  a requirement that the managed care organization
62-22    provide ready access to a person who assists recipients in
62-23    resolving issues relating to enrollment, plan administration,
62-24    education and training, access to services, and grievance
62-25    procedures;
62-26                (4)  a requirement that the managed care organization
62-27    provide ready access to a person who assists providers in resolving
 63-1    issues relating to payment, plan administration, education and
 63-2    training, and grievance procedures;
 63-3                (5)  a requirement that the managed care organization
 63-4    provide information and referral about the availability of
 63-5    educational, social, and other community services that could
 63-6    benefit a recipient;
 63-7                (6)  procedures for recipient outreach and education;
 63-8                (7)  a requirement that the managed care organization
 63-9    make payment to a physician or provider for health care services
63-10    rendered to a recipient under a managed care plan not later than
63-11    the 45th day after the date a claim for payment is received with
63-12    documentation reasonably necessary for the managed care
63-13    organization to process the claim, or within a period, not to
63-14    exceed 60 days, specified by a written agreement between the
63-15    physician or provider and the managed care organization;
63-16                (8)  a requirement that the commission, on the date of
63-17    a recipient's enrollment in a managed care plan issued by the
63-18    managed care organization, inform the organization of the
63-19    recipient's Medicaid certification [recertification] date; and
63-20                (9)  a requirement that the managed care organization
63-21    comply with Section 533.006 as a condition of contract retention
63-22    and renewal.
63-23          SECTION 9.05.  Section 533.006(a), Government Code, is
63-24    amended to read as follows:
63-25          (a)  The commission shall require that each managed care
63-26    organization that contracts with the commission to provide health
63-27    care services to recipients in a region:
 64-1                (1)  seek participation in the organization's provider
 64-2    network from:
 64-3                      (A)  each health care provider in the region who
 64-4    has traditionally provided care to Medicaid recipients; [and]
 64-5                      (B)  each hospital in the region that has been
 64-6    designated as a disproportionate share hospital under the state
 64-7    Medicaid program; and
 64-8                      (C)  each specialized pediatric laboratory in the
 64-9    region, including those laboratories located in children's
64-10    hospitals; and
64-11                (2)  include in its provider network for not less than
64-12    three years:
64-13                      (A)  each health care provider in the region who:
64-14                            (i)  previously provided care to Medicaid
64-15    and charity care recipients at a significant level as prescribed by
64-16    the commission;
64-17                            (ii)  agrees to accept the prevailing
64-18    provider contract rate of the managed care organization; and
64-19                            (iii)  has the credentials required by the
64-20    managed care organization, provided that lack of board
64-21    certification or accreditation by the Joint Commission on
64-22    Accreditation of Healthcare Organizations may not be the sole
64-23    ground for exclusion from the provider network;
64-24                      (B)  each accredited primary care residency
64-25    program in the region; and
64-26                      (C)  each disproportionate share hospital
64-27    designated by the commission as a statewide significant traditional
 65-1    provider.
 65-2          SECTION 9.06.  Section 533.007(e), Government Code, is
 65-3    amended to read as follows:
 65-4          (e)  The commission shall conduct a compliance and readiness
 65-5    review of each managed care organization that contracts with the
 65-6    commission not later than the 15th day before the date on which the
 65-7    commission plans to begin the enrollment process in a region and
 65-8    again not later than the 15th day before the date on which the
 65-9    commission plans to begin to provide health care services to
65-10    recipients in that region through managed care.  The review must
65-11    include an on-site inspection and tests of service authorization
65-12    and claims payment systems, including the ability of the managed
65-13    care organization to process claims electronically, complaint
65-14    processing systems, and any other process or system required by the
65-15    contract.
65-16          SECTION 9.07.  Section 533.0075, Government Code, is amended
65-17    to read as follows:
65-18          Sec. 533.0075.  RECIPIENT ENROLLMENT.  The commission shall:
65-19                (1)  encourage recipients to choose appropriate managed
65-20    care plans and primary health care providers by:
65-21                      (A)  providing initial information to recipients
65-22    and providers in a region about the need for recipients to choose
65-23    plans and providers not later than the 90th day before the date on
65-24    which the commission plans to begin to provide health care services
65-25    to recipients in that region through managed care;
65-26                      (B)  providing follow-up information before
65-27    assignment of plans and providers and after assignment, if
 66-1    necessary, to recipients who delay in choosing plans and providers;
 66-2    and
 66-3                      (C)  allowing plans and providers to provide
 66-4    information to recipients or engage in marketing activities under
 66-5    marketing guidelines established by the commission under Section
 66-6    533.008 after the commission approves the information or
 66-7    activities;
 66-8                (2)  consider the following factors in assigning
 66-9    managed care plans and primary health care providers to recipients
66-10    who fail to choose plans and providers:
66-11                      (A)  the importance of maintaining existing
66-12    provider-patient and physician-patient relationships, including
66-13    relationships with specialists, public health clinics, and
66-14    community health centers;
66-15                      (B)  to the extent possible, the need to assign
66-16    family members to the same providers and plans; and
66-17                      (C)  geographic convenience of plans and
66-18    providers for recipients; [and]
66-19                (3)  retain responsibility for enrollment and
66-20    disenrollment of recipients in managed care plans, except that the
66-21    commission may delegate the responsibility to an independent
66-22    contractor who receives no form of payment from, and has no
66-23    financial ties to, any managed care organization;
66-24                (4)  develop and implement an expedited process for
66-25    determining eligibility for and enrolling pregnant women and
66-26    newborn infants in managed care plans;
66-27                (5)  ensure immediate access to prenatal services and
 67-1    newborn care for pregnant women and newborn infants enrolled in
 67-2    managed care plans, including ensuring that a pregnant woman may
 67-3    obtain an appointment with an obstetrical care provider for an
 67-4    initial maternity evaluation not later than the 30th day after the
 67-5    date the woman applies for Medicaid; and
 67-6                (6)  temporarily assign Medicaid-eligible newborn
 67-7    infants to the traditional fee-for-service component of the state
 67-8    Medicaid program for a period not to exceed the earlier of:
 67-9                      (A)  60 days; or
67-10                      (B)  the date on which the Texas Department of
67-11    Human Services has completed the newborn's Medicaid eligibility
67-12    determination, including assignment of the newborn's Medicaid
67-13    eligibility number.
67-14          SECTION 9.08.  Subchapter A, Chapter 533, Government Code, is
67-15    amended by adding Sections 533.012-533.015 to read as follows:
67-16          Sec. 533.012.  MORATORIUM ON IMPLEMENTATION OF CERTAIN PILOT
67-17    PROGRAMS; REVIEW; REPORT.  (a)   Notwithstanding any other law, the
67-18    commission may not implement Medicaid managed care pilot programs,
67-19    Medicaid behavioral health pilot programs, or Medicaid Star + Plus
67-20    pilot programs in a region for which the commission has not:
67-21                (1)  received a bid from a managed care organization to
67-22    provide health care services to recipients in the region through a
67-23    managed care plan; or
67-24                (2)  entered into a contract with a managed care
67-25    organization to provide health care services to recipients in the
67-26    region through a managed care plan.
67-27          (b)  The commission shall:
 68-1                (1)  review any outstanding administrative and
 68-2    financial issues with respect to Medicaid managed care pilot
 68-3    programs, Medicaid behavioral health pilot programs, and Medicaid
 68-4    Star + Plus pilot programs implemented in health care service
 68-5    regions;
 68-6                (2)  review the impact of the Medicaid managed care
 68-7    delivery system, including managed care organizations, prepaid
 68-8    health plans, and primary care case management, on:
 68-9                      (A)  physical access and program-related access
68-10    to appropriate services by recipients, including recipients who
68-11    have special health care needs;
68-12                      (B)  quality of health care delivery and patient
68-13    outcomes;
68-14                      (C)  utilization patterns of recipients;
68-15                      (D)  statewide Medicaid costs;
68-16                      (E)  coordination of care and care coordination
68-17    in Medicaid Star + Plus pilot programs;
68-18                      (F)  the level of administrative complexity for
68-19    providers, recipients, and managed care organizations;
68-20                      (G)  public hospitals, medical schools, and other
68-21    traditional providers of indigent health care; and
68-22                      (H)  competition in the marketplace and network
68-23    retention; and
68-24                (3)  evaluate the feasibility of developing a separate
68-25    reimbursement methodology for public hospitals under a Medicaid
68-26    managed care delivery system.
68-27          (c)  In performing its duties and functions under Subsection
 69-1    (b), the commission shall seek input from the state Medicaid
 69-2    managed care advisory committee created under Subchapter C.  The
 69-3    commission may coordinate the review required under Subsection (b)
 69-4    with any other study or review the commission is required to
 69-5    complete.
 69-6          (d)  Notwithstanding Subsection (a), the commission may
 69-7    implement Medicaid managed care pilot programs, Medicaid behavioral
 69-8    health pilot programs, and Medicaid Star + Plus pilot programs in a
 69-9    region described by that subsection if the commission finds that:
69-10                (1)  outstanding administrative and financial issues
69-11    with respect to the implementation of those programs in health care
69-12    service regions have been resolved; and
69-13                (2)  implementation of those programs in a region
69-14    described by Subsection (a)  would benefit both recipients and
69-15    providers.
69-16          (e)  Not later than November 1, 2000, the commission shall
69-17    submit a report to the governor and the legislature that:
69-18                (1)  states whether the outstanding administrative and
69-19    financial issues with respect to the pilot programs described by
69-20    Subsection (b)(1) have been sufficiently resolved;
69-21                (2)  summarizes the findings of the review conducted
69-22    under Subsection (b);
69-23                (3)  recommends which elements of the Medicaid managed
69-24    care delivery system should be applied to the traditional
69-25    fee-for-service component of the state Medicaid program to achieve
69-26    the goals specified in Section 533.002(1); and
69-27                (4)  recommends whether Medicaid managed care pilot
 70-1    programs, Medicaid behavioral health pilot programs, or Medicaid
 70-2    Star + Plus pilot programs should be implemented in health care
 70-3    service regions described by Subsection (a).
 70-4          (f)  To the extent practicable, this section may not be
 70-5    construed to affect the duty of the commission to plan the
 70-6    continued expansion of Medicaid managed care pilot programs,
 70-7    Medicaid behavioral health pilot programs, and Medicaid Star + Plus
 70-8    pilot programs in health care service regions described by
 70-9    Subsection (a)  after July 1, 2001.
70-10          (g)  This section expires July 1, 2001.
70-11          Sec. 533.013.  PREMIUM PAYMENT RATE DETERMINATION; REVIEW AND
70-12    COMMENT.  (a)  In determining premium payment rates paid to a
70-13    managed care organization under a managed care plan, the commission
70-14    shall consider:
70-15                (1)  the regional variation in costs of health care
70-16    services;
70-17                (2)  the range and type of health care services to be
70-18    covered by premium payment rates;
70-19                (3)  the number of managed care plans in a region;
70-20                (4)  the current and projected number of recipients in
70-21    each region, including the current and projected number for each
70-22    category of recipient;
70-23                (5)  the ability of the managed care plan to meet costs
70-24    of operation under the proposed premium payment rates;
70-25                (6)  the applicable requirements of the federal
70-26    Balanced Budget Act of 1997 and implementing regulations that
70-27    require adequacy of premium payments to managed care organizations
 71-1    participating in the state Medicaid program;
 71-2                (7)  the adequacy of the management fee paid for
 71-3    assisting enrollees of Supplemental Security Income (SSI) (42
 71-4    U.S.C. Section 1381 et seq.) who are voluntarily enrolled in the
 71-5    managed care plan;
 71-6                (8)  the impact of reducing premium payment rates for
 71-7    the category of recipients who are pregnant; and
 71-8                (9)  the ability of the managed care plan to pay under
 71-9    the proposed premium payment rates inpatient and outpatient
71-10    hospital provider payment rates that are comparable to the
71-11    inpatient and outpatient hospital provider payment rates paid by
71-12    the commission under a primary care case management model or a
71-13    partially capitated model.
71-14          (b)  In determining the maximum premium payment rates paid to
71-15    a managed care organization that is licensed under the Texas Health
71-16    Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
71-17    Code), the commission shall consider and adjust for the regional
71-18    variation in costs of services under the traditional
71-19    fee-for-service component of the state Medicaid program,
71-20    utilization patterns, and other factors that influence the
71-21    potential for cost savings.  For a service area with a service area
71-22    factor of .93 or less, or another appropriate service area factor,
71-23    as determined by the commission, the commission may not discount
71-24    premium payment rates in an amount that is more than the amount
71-25    necessary to meet federal budget neutrality requirements for
71-26    projected fee-for-service costs unless:
71-27                (1)  a historical review of managed care financial
 72-1    results among managed care organizations in the service area served
 72-2    by the organization demonstrates that additional savings are
 72-3    warranted;
 72-4                (2)  a review of Medicaid fee-for-service delivery in
 72-5    the service area served by the organization has historically shown
 72-6    a significant overutilization by recipients of certain services
 72-7    covered by the premium payment rates in comparison to utilization
 72-8    patterns throughout the rest of the state; or
 72-9                (3)  a review of Medicaid fee-for-service delivery in
72-10    the service area served by the organization has historically shown
72-11    an above-market cost for services for which there is substantial
72-12    evidence that Medicaid managed care delivery will reduce the cost
72-13    of those services.
72-14          (c)  The premium payment rates paid to a managed care
72-15    organization that is licensed under the Texas Health Maintenance
72-16    Organization Act (Chapter 20A, Vernon's Texas Insurance Code) shall
72-17    be established by a competitive bid process but may not exceed the
72-18    maximum premium payment rates established by the commission under
72-19    Subsection (b).
72-20          (d)  Subsection (b) applies only to a managed care
72-21    organization with respect to Medicaid managed care pilot programs,
72-22    Medicaid behavioral health pilot programs, and Medicaid Star + Plus
72-23    pilot programs implemented in a health care service region after
72-24    June 1, 1999.
72-25          Sec. 533.014.  PROFIT SHARING.  (a)  The commission shall
72-26    adopt rules regarding the sharing of profits earned by a managed
72-27    care organization through a managed care plan providing health care
 73-1    services under a contract with the commission under this chapter.
 73-2          (b)  Any amount received by the state under this section
 73-3    shall be deposited in the general revenue fund for the purpose of
 73-4    funding the state Medicaid program.
 73-5          Sec. 533.015.  COORDINATION OF EXTERNAL OVERSIGHT ACTIVITIES.
 73-6    To the extent possible, the commission shall coordinate all
 73-7    external oversight activities to minimize duplication of oversight
 73-8    of managed care plans under the state Medicaid program and
 73-9    disruption of operations under those plans.
73-10          SECTION 9.09.  Chapter 533, Government Code, is amended by
73-11    adding Subchapter C to read as follows:
73-12                SUBCHAPTER C.  STATEWIDE ADVISORY COMMITTEE
73-13          Sec. 533.041.  APPOINTMENT AND COMPOSITION.  (a)  The
73-14    commission shall appoint a state Medicaid managed care advisory
73-15    committee.  The advisory committee consists of representatives of:
73-16                (1)  hospitals;
73-17                (2)  managed care organizations;
73-18                (3)  primary care providers;
73-19                (4)  state agencies;
73-20                (5)  consumer advocates representing low-income
73-21    recipients;
73-22                (6)  consumer advocates representing recipients with a
73-23    disability;
73-24                (7)  parents of children who are recipients;
73-25                (8)  rural providers;
73-26                (9)  advocates for children with special health care
73-27    needs;
 74-1                (10)  pediatric health care providers, including
 74-2    specialty providers;
 74-3                (11)  long-term care providers, including nursing home
 74-4    providers;
 74-5                (12)  obstetrical care providers;
 74-6                (13)  community-based organizations serving low-income
 74-7    children and their families; and
 74-8                (14)  community-based organizations engaged in
 74-9    perinatal services and outreach.
74-10          (b)  The advisory committee must include a member of each
74-11    regional Medicaid managed care advisory committee appointed by the
74-12    commission under Subchapter B.
74-13          Sec. 533.042.  MEETINGS.  The advisory committee shall meet
74-14    at least quarterly and is subject to Chapter 551.
74-15          Sec. 533.043.  POWERS AND DUTIES.  The advisory committee
74-16    shall:
74-17                (1)  provide recommendations to the commission on the
74-18    statewide implementation and operation of Medicaid managed care;
74-19                (2)  assist the commission with issues relevant to
74-20    Medicaid managed care to improve the policies established for and
74-21    programs operating under  Medicaid managed care, including the
74-22    early and periodic screening, diagnosis, and treatment program,
74-23    provider and patient education issues, and patient eligibility
74-24    issues; and
74-25                (3)  disseminate or make available to each regional
74-26    advisory committee appointed under Subchapter B information on best
74-27    practices with respect to Medicaid managed care that is obtained
 75-1    from a regional advisory committee.
 75-2          Sec. 533.044.  OTHER LAW.  Except as provided by this
 75-3    subchapter, the advisory committee is subject to Chapter 2110.
 75-4          SECTION 9.10.  Section 2.07(c), Chapter 1153, Acts of the
 75-5    75th Legislature, Regular Session, 1997, is amended to read as
 75-6    follows:
 75-7          (c)  As soon as possible after development of the new
 75-8    provider contract, the commission and each agency operating part of
 75-9    the state Medicaid program by rule shall require each provider who
75-10    enrolled in the program before completion of the new contract to
75-11    reenroll in the program under the new contract or modify the
75-12    provider's existing contract in accordance with commission or
75-13    agency procedures as necessary to comply with the requirements of
75-14    the new contract.  The commission shall study the feasibility of
75-15    authorizing providers to reenroll in the program online or through
75-16    other electronic means.  On completion of the study, if the
75-17    commission determines that an online or other electronic method for
75-18    reenrollment of providers is feasible, the commission shall develop
75-19    and implement the electronic method of reenrollment for providers
75-20    not later than September 1, 2000.  A provider must reenroll in the
75-21    state Medicaid program or make the necessary contract modifications
75-22    not later than March 31, 2000 [September 1, 1999], to retain
75-23    eligibility to participate in the program, unless the commission
75-24    implements under this subsection an electronic method of
75-25    reenrollment for providers, in which event a provider must reenroll
75-26    or make the contractual modifications not later than September 1,
75-27    2000.  The commission by rule may extend a reenrollment deadline
 76-1    prescribed by this subsection if a significant number of providers,
 76-2    as determined by the commission, have not met the reenrollment
 76-3    requirements by the applicable deadline.
 76-4          SECTION 9.11.  (a)  Not later than January 1, 2000, the
 76-5    Health and Human Services Commission shall implement the expedited
 76-6    process for determining eligibility for and enrollment of certain
 76-7    recipients in Medicaid managed care plans required by Section
 76-8    533.0075(4), Government Code, as added by this Act.
 76-9          (b)  The Health and Human Services Commission shall report
76-10    quarterly to the standing committees of the senate and house of
76-11    representatives with primary jurisdiction over Medicaid managed
76-12    care regarding the status of the expedited process described by
76-13    Subsection (a) of this section.  The commission shall submit
76-14    quarterly reports under this subsection until the commission
76-15    determines the process is fully implemented and functioning
76-16    successfully.
76-17          SECTION 9.12.  This article takes effect only if a specific
76-18    appropriation for the implementation of this article is provided in
76-19    H.B. No. 1, Acts of the 76th Legislature, Regular Session, 1999
76-20    (General Appropriations Act).  If no specific appropriation is
76-21    provided in H.B. No. 1 (General Appropriations Act), this article
76-22    has no effect.
76-23          ARTICLE 10.  FINANCIAL ASSISTANCE AND SERVICE PROGRAMS
76-24          SECTION 10.01.  Subchapter A, Chapter 31, Human Resources
76-25    Code, is amended by adding Section 31.0127 to read as follows:
76-26          Sec. 31.0127.  COORDINATION OF SERVICES TO CERTAIN CLIENTS.
76-27    (a)  The Health and Human Services Commission is the state agency
 77-1    designated to coordinate between the department and another state
 77-2    agency providing child care services, Temporary Assistance for
 77-3    Needy Families work programs, and Food Stamp Employment and
 77-4    Training services to an individual or family who has been referred
 77-5    for programs and services by the department.  The purpose of this
 77-6    section is to accomplish the following:
 77-7                (1)  increase the self-sufficiency of recipients of
 77-8    Temporary Assistance for Needy Families and improve the delivery of
 77-9    services to those recipients; and
77-10                (2)  improve the effectiveness of job-training programs
77-11    funded under the Job Training Partnership Act (29 U.S.C. Section
77-12    1501 et seq.) or a successor program in obtaining employment for
77-13    individuals receiving Temporary Assistance for Needy Families cash
77-14    assistance.
77-15          (b)  The Health and Human Services Commission shall require a
77-16    state agency providing program services described by Subsection (a)
77-17    to comply with Chapter 531, Government Code, solely for:
77-18                (1)  the promulgation of rules relating to the programs
77-19    described by Subsection (a);
77-20                (2)  the expenditure of funds relating to the programs
77-21    described by Subsection (a), within the limitations established by
77-22    and subject to the General Appropriations Act and federal and other
77-23    law applicable to the use of the funds;
77-24                (3)  data collection and reporting relating to the
77-25    programs described by Subsection (a); and
77-26                (4)  evaluation of services relating to the programs
77-27    described by Subsection (a).
 78-1          (c)  The department and a state agency providing program
 78-2    services described by Subsection (a)  shall jointly develop and
 78-3    adopt a memorandum of understanding, subject to the approval of the
 78-4    Health and Human Services Commission. The memorandum of
 78-5    understanding must:
 78-6                (1)  outline measures to be taken to increase the
 78-7    number of individuals receiving Temporary Assistance for Needy
 78-8    Families cash assistance who are using job-training programs funded
 78-9    under the Job Training Partnership Act (29 U.S.C. Section 1501 et
78-10    seq.), or a successor program; and
78-11                (2)  identify specific measures to improve the delivery
78-12    of services to clients served by programs described by Subsection
78-13    (a).
78-14          (d)  Not later than January 15 of each odd-numbered year, the
78-15    Health and Human Services Commission shall provide a report to the
78-16    governor, the lieutenant governor, and the speaker of the house of
78-17    representatives that:
78-18                (1)  evaluates the efficiency and effectiveness of
78-19    client services in the Temporary Assistance for Needy Families
78-20    program;
78-21                (2)  evaluates the status of the coordination among
78-22    agencies and compliance with this section;
78-23                (3)  recommends measures to increase self-sufficiency
78-24    of recipients of Temporary Assistance for Needy Families cash
78-25    assistance and to improve the delivery of services to these
78-26    recipients; and
78-27                (4)  evaluates the effectiveness of job-training
 79-1    programs funded under the Job Training Partnership Act (29 U.S.C.
 79-2    Section 1501 et seq.) or a successor program in obtaining
 79-3    employment outcomes for recipients of Temporary Assistance for
 79-4    Needy Families cash assistance.
 79-5          (e)  Subsection (b) does not authorize the Health and Human
 79-6    Services Commission to require a state agency, other than a health
 79-7    and human services agency, to comply with Chapter 531, Government
 79-8    Code, except as specifically provided by Subsection (b). The
 79-9    authority granted under Subsection (b) does not affect Section
79-10    301.041, Labor Code.
79-11          (f)  If the change in law made by this section with regard to
79-12    any program or service conflicts with federal law or would have the
79-13    effect of invalidating a waiver granted under federal law, the
79-14    state agency is not required to comply with this section with
79-15    regard to that program or service.
79-16          (g)  This section does not authorize the Health and Human
79-17    Services Commission to change the allocation or disbursement of
79-18    funds allocated to the state under the Workforce Investment Act of
79-19    1998 (29 U.S.C. Section 2801 et seq.) in a manner that would result
79-20    in the loss of exemption status.
79-21          (h)  This section does not authorize the Health and Human
79-22    Services Commission to transfer programs to or from the department
79-23    and another agency serving clients of the Temporary Assistance for
79-24    Needy Families program or the federal food stamp program
79-25    administered under Chapter 33 without explicit legislative
79-26    authorization.
79-27          (i)  The Health and Human Services Commission and any state
 80-1    agency providing program services described by Subsection (a)  may
 80-2    not promulgate rules in accordance with Subsection (b)(1) without
 80-3    holding a public hearing.
 80-4          SECTION 10.02.  Not later than October 1, 1999, the Health
 80-5    and Human Services Commission and each state agency subject to
 80-6    Section 31.0127, Human Resources Code, as added by this article,
 80-7    shall develop and adopt the memorandum of understanding required by
 80-8    that section.
 80-9                    ARTICLE 11.  LEGISLATIVE OVERSIGHT
80-10          SECTION 11.01.  Chapter 531, Government Code, is amended by
80-11    adding Subchapter E to read as follows:
80-12      SUBCHAPTER E.  HEALTH AND HUMAN SERVICES LEGISLATIVE OVERSIGHT
80-13          Sec. 531.171.  COMMITTEE DUTIES.  (a)  The standing or other
80-14    committees of the house of representatives and the senate that have
80-15    jurisdiction over the Health and Human Services Commission and
80-16    other agencies relating to implementation of this chapter, as
80-17    identified by the speaker of the house of representatives and the
80-18    lieutenant governor, shall:
80-19                (1)  monitor the commission's implementation of Section
80-20    531.0055 and the commission's other duties in consolidating and
80-21    integrating health and human services to ensure implementation
80-22    consistent with law;
80-23                (2)  recommend, as needed, adjustments to the
80-24    implementation of Section 531.0055 and the commission's other
80-25    duties in consolidating and integrating health and human services;
80-26    and
80-27                (3)  review the rulemaking process used by the
 81-1    commission, including the commission's plan for obtaining public
 81-2    input.
 81-3          (b)  The commission shall provide copies of all required
 81-4    reports to the committees and shall provide the committees with
 81-5    copies of proposed rules before the rules are published in the
 81-6    Texas Register.  At the request of a committee or the commissioner,
 81-7    a health and human services agency shall provide other information
 81-8    to the committee, including information relating to the health and
 81-9    human services system, and shall report on agency progress in
81-10    implementing statutory directives identified by the committee and
81-11    the directives of the commission.
81-12          SECTION 11.02.  (a)  The committees of the house of
81-13    representatives and senate identified under Section 531.171,
81-14    Government Code, as added by this article, shall report to the
81-15    governor, the lieutenant governor, and the speaker of the house of
81-16    representatives not later than December 31, 2000.
81-17          (b)  The report must include:
81-18                (1)  an evaluation and analysis of the implementation
81-19    of Section 531.0055, Government Code, as added by this Act, and the
81-20    Health and Human Services Commission's other duties in
81-21    consolidating and integrating health and human services, with
81-22    recommendations for action by the commissioner;
81-23                (2)  the status of the implementation of Section
81-24    531.0055, Government Code, as added by this Act, and the
81-25    commission's other duties in consolidating and integrating health
81-26    and human services; and
81-27                (3)  recommendations for legislative action, including
 82-1    legislation to further consolidate health and human services agency
 82-2    functions as appropriate.
 82-3                      ARTICLE 12.  APPLICATION OF ACT
 82-4          SECTION 12.01.  Unless an appropriate federal waiver has been
 82-5    granted, if a change in law made by this Act with regard to any
 82-6    program or service conflicts with federal law, the Health and Human
 82-7    Services Commission may not require an agency to comply with the
 82-8    change with regard to that program or service.
 82-9          SECTION 12.02.  Notwithstanding any provision of this Act,
82-10    the Health and Human Services Commission, in consultation with the
82-11    appropriate policymaking body, shall ensure that:
82-12                (1)  all necessary federal waivers and approvals have
82-13    been obtained to implement the provisions of this Act;
82-14                (2)  direct client services are not decreased as a
82-15    direct result of the implementation of this Act;
82-16                (3)  any colocation of offices between health and human
82-17    services agencies complies with state and federal laws relating to
82-18    building accessibility for the disabled;
82-19                (4)  a public comment process on agency operations is
82-20    established for each agency and that at least one meeting of the
82-21    policy board provides an opportunity for public input on agency
82-22    operations;
82-23                (5)  allocations of federal funding conform to the
82-24    General Appropriations Act and other applicable law; and
82-25                (6)  each agency's priorities, in addition to the
82-26    overall priorities of the Health and Human Services Commission, are
82-27    communicated to the legislature and the governor before and during
 83-1    the biennial appropriations process.
 83-2             ARTICLE 13.  REPEALER; EFFECTIVE DATE; EMERGENCY
 83-3          SECTION 13.01.  The following laws are repealed:
 83-4                (1)  Section 441.053(k), Government Code;
 83-5                (2)  Section 531.0272, Government Code; and
 83-6                (3)  Section 532.011(c), Health and Safety Code.
 83-7          SECTION 13.02.  This Act takes effect September 1, 1999.
 83-8          SECTION 13.03.  The importance of this legislation and the
 83-9    crowded condition of the calendars in both houses create an
83-10    emergency and an imperative public necessity that the
83-11    constitutional rule requiring bills to be read on three several
83-12    days in each house be suspended, and this rule is hereby suspended.
         _______________________________     _______________________________
             President of the Senate              Speaker of the House
               I certify that H.B. No. 2641 was passed by the House on April
         20, 1999, by a non-record vote; that the House refused to concur in
         Senate amendments to H.B. No. 2641 on May 21, 1999, and requested
         the appointment of a conference committee to consider the
         differences between the two houses; and that the House adopted the
         conference committee report on H.B. No. 2641 on May 30, 1999, by a
         non-record vote.
                                             _______________________________
                                                 Chief Clerk of the House
               I certify that H.B. No. 2641 was passed by the Senate, with
         amendments, on May 19, 1999, by a viva-voce vote; at the request of
         the House, the Senate appointed a conference committee to consider
         the differences between the two houses; and that the Senate adopted
         the conference committee report on H.B. No. 2641 on May 30, 1999,
         by a viva-voce vote.
                                             _______________________________
                                                 Secretary of the Senate
         APPROVED:  _____________________
                            Date
                    _____________________
                          Governor