By:  Brown                                             S.B. No. 371
                                A BILL TO BE ENTITLED
                                       AN ACT
 1-1     relating to the continuation and functions of the Correctional
 1-2     Managed Health Care Advisory Committee.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Chapter 501, Government Code, is amended by
 1-5     adding Subchapter E to read as follows:
 1-6                     SUBCHAPTER E.  MANAGED HEALTH CARE
 1-7           Sec. 501.131.  DEFINITION.  In this subchapter, "committee"
 1-8     means the Correctional Managed Health Care Committee.
 1-9           Sec. 501.132.  APPLICATION OF SUNSET ACT.  The Correctional
1-10     Managed Health Care Committee is subject to Chapter 325 (Texas
1-11     Sunset Act).  Unless continued in existence as provided by that
1-12     chapter, the committee is abolished and this subchapter expires
1-13     September 1, 2005.
1-14           Sec. 501.133.  COMMITTEE MEMBERSHIP.  (a)  The committee
1-15     consists of nine members appointed as follows:
1-16                 (1)  two members employed full-time by the department,
1-17     at least one of whom is a physician, appointed by the executive
1-18     director;
1-19                 (2)  two members employed full-time by The University
1-20     of Texas Medical Branch at Galveston, at least one of whom is a
1-21     physician, appointed by the president of the medical branch;
1-22                 (3)  two members employed full-time by the Texas Tech
1-23     University Health Sciences Center, at least one of whom is a
1-24     physician, appointed by the president of the university; and
 2-1                 (4)  three public members appointed by the governor who
 2-2     are not affiliated with the department or with any entity with
 2-3     which the committee has contracted to provide health care services
 2-4     under this chapter, at least two of whom are licensed to practice
 2-5     medicine in this state.
 2-6           (b)  An appointment to the committee shall be made without
 2-7     regard to the race, color, disability, sex, religion, age, or
 2-8     national origin of the appointee.
 2-9           Sec. 501.134.  PUBLIC MEMBER ELIGIBILITY.  A person may not
2-10     be a public member of the committee if the person or the person's
2-11     spouse:
2-12                 (1)  is employed by or participates in the management
2-13     of a business entity or other organization regulated by or
2-14     receiving money from the department or the committee;
2-15                 (2)  owns or controls, directly or indirectly, more
2-16     than a 10 percent interest in a business entity or other
2-17     organization regulated by or receiving money from the department or
2-18     the committee; or
2-19                 (3)  uses or receives a substantial amount of tangible
2-20     goods, services, or money from the department or the committee
2-21     other than compensation or reimbursement authorized by law for
2-22     committee membership, attendance, or expenses.
2-23           Sec. 501.135.  MEMBERSHIP AND EMPLOYEE RESTRICTIONS.  (a)  In
2-24     this section, "Texas trade association" means a cooperative and
2-25     voluntarily joined association of business or professional
2-26     competitors in this state designed to assist its members and its
 3-1     industry or profession in dealing with mutual business or
 3-2     professional problems and in promoting their common interest.
 3-3           (b)  A person may not be a member of the committee and may
 3-4     not be a committee employee employed in a "bona fide executive,
 3-5     administrative, or professional capacity," as that phrase is used
 3-6     for purposes of establishing an exemption to the overtime
 3-7     provisions of the federal Fair Labor Standards Act of 1938 (29
 3-8     U.S.C. Section 201 et seq.) and its subsequent amendments if:
 3-9                 (1)  the person is an officer, employee, or paid
3-10     consultant of a Texas trade association in the field of health care
3-11     or health care services; or
3-12                 (2)  the person's spouse is an officer, manager, or
3-13     paid consultant of a Texas trade association in the field of health
3-14     care or health care services.
3-15           (c)  A person may not be a member of the committee or act as
3-16     the general counsel to the committee if the person is required to
3-17     register as a lobbyist under Chapter 305 because of the person's
3-18     activities for compensation on behalf of a profession related to
3-19     the operation of the committee.
3-20           Sec. 501.136.  TERMS OF OFFICE.  Committee members appointed
3-21     by the governor serve staggered six-year terms, with the term of
3-22     one of those members expiring on February 1 of each odd-numbered
3-23     year.  Other committee members serve at the will of the appointing
3-24     official or until termination of the member's employment with the
3-25     entity the member represents.
3-26           Sec. 501.137.  PRESIDING OFFICER.  The governor shall
 4-1     designate a physician member of the committee as presiding officer.
 4-2     The presiding officer serves in that capacity at the will of the
 4-3     governor.
 4-4           Sec. 501.138.  GROUNDS FOR REMOVAL.  (a)  It is a ground for
 4-5     removal from the committee that a member:
 4-6                 (1)  does not have at the time of taking office the
 4-7     qualifications required by Section 501.133;
 4-8                 (2)  does not maintain during service on the committee
 4-9     the qualifications required by Section 501.133;
4-10                 (3)  is ineligible for membership under Section 501.134
4-11     or 501.135;
4-12                 (4)  cannot, because of illness or disability,
4-13     discharge the member's duties for a substantial part of the
4-14     member's term; or
4-15                 (5)  is absent from more than half of the regularly
4-16     scheduled committee meetings that the member is eligible to attend
4-17     during a calendar year without an excuse approved by  a majority
4-18     vote of the committee.
4-19           (b)  The validity of an action of the committee is not
4-20     affected by the fact that it is taken when a ground for removal of
4-21     a committee member exists.
4-22           (c)  If the managed health care administrator has knowledge
4-23     that a potential ground for removal exists, the administrator shall
4-24     notify the presiding officer of the committee of the potential
4-25     ground.  The presiding officer shall then notify the governor and
4-26     the attorney general that a potential ground for removal exists.
 5-1     If the potential ground for removal involves the presiding officer,
 5-2     the managed health care administrator shall notify the next highest
 5-3     ranking officer of the committee, who shall then notify the
 5-4     governor and the attorney general that a potential ground for
 5-5     removal exists.
 5-6           Sec. 501.139.  MEETINGS.  (a)  The committee shall meet at
 5-7     least once in each quarter of the calendar year and at any other
 5-8     time at the call of the presiding officer.
 5-9           (b)  The committee may hold a meeting by telephone conference
5-10     call or other video or broadcast technology.
5-11           Sec. 501.140.  TRAINING.  (a)  A person who is appointed to
5-12     and qualifies for office as a member of the committee may not vote,
5-13     deliberate, or be counted as a member in attendance at a meeting of
5-14     the committee until the person completes a training program that
5-15     complies with this section.
5-16           (b)  The training program must provide the person with
5-17     information regarding:
5-18                 (1)  the legislation that created the committee;
5-19                 (2)  the programs operated by the committee;
5-20                 (3)  the role and functions of the committee;
5-21                 (4)  the rules of the committee with an emphasis on the
5-22     rules that relate to disciplinary and investigatory authority;
5-23                 (5)  the current budget for the committee;
5-24                 (6)  the results of the most recent formal audit of the
5-25     committee;
5-26                 (7)  the requirements of:
 6-1                       (A)  the open meetings law, Chapter 551;
 6-2                       (B)  the public information law, Chapter 552;
 6-3                       (C)  the administrative procedure law, Chapter
 6-4     2001; and
 6-5                       (D)  other laws relating to public officials,
 6-6     including conflict-of-interest laws; and
 6-7                 (8)  any applicable ethics policies adopted by the
 6-8     committee or the Texas Ethics Commission.
 6-9           (c)  A person appointed to the committee is entitled to
6-10     reimbursement, as provided by the General Appropriations Act, for
6-11     the travel expenses incurred in attending the training program
6-12     regardless of whether the attendance at the program occurs before
6-13     or after the person qualifies for office.
6-14           Sec. 501.141.  COMPENSATION; REIMBURSEMENT.  A committee
6-15     member serves without compensation but is entitled to reimbursement
6-16     for actual and necessary expenses incurred in the performance of
6-17     the duties of the committee.
6-18           Sec. 501.142.  ADMINISTRATION; PERSONNEL.  The committee may
6-19     hire a managed health care administrator, who may employ personnel
6-20     necessary for the administration of the committee's duties.  The
6-21     committee shall pay necessary costs for its operation, including
6-22     costs of hiring the managed health care administrator and other
6-23     personnel, from funds appropriated by the legislature to the
6-24     department for correctional health care.
6-25           Sec. 501.143.  DIVISION OF RESPONSIBILITIES.  The committee
6-26     shall develop and implement policies that clearly separate the
 7-1     policy-making responsibilities of the committee and the management
 7-2     responsibilities of the managed health care administrator and staff
 7-3     of the committee.
 7-4           Sec. 501.144.  QUALIFICATIONS AND STANDARDS OF CONDUCT
 7-5     INFORMATION.  The managed health care administrator or the
 7-6     administrator's designee shall provide to members of the committee
 7-7     and to committee employees, as often as necessary, information
 7-8     regarding the requirements for office or employment under this
 7-9     subchapter, including information regarding a person's
7-10     responsibilities under applicable laws relating to standards of
7-11     conduct for state officers or employees.
7-12           Sec. 501.145.  EQUAL EMPLOYMENT OPPORTUNITY POLICY.  (a)  The
7-13     managed health care administrator or the administrator's designee
7-14     shall prepare and maintain a written policy statement that
7-15     implements a program of equal employment opportunity to ensure that
7-16     all personnel decisions are made without regard to race, color,
7-17     disability, sex, religion, age, or national origin.
7-18           (b)  The policy statement must include:
7-19                 (1)  personnel policies, including policies relating to
7-20     recruitment, evaluation, selection, training, and promotion of
7-21     personnel, that show the intent of the committee to avoid the
7-22     unlawful employment practices described by Chapter 21, Labor Code;
7-23     and
7-24                 (2)  an analysis of the extent to which the composition
7-25     of the committee's personnel is in accordance with state and
7-26     federal law and a description of reasonable methods to achieve
 8-1     compliance with state and federal law.
 8-2           (c)  The policy statement must:
 8-3                 (1)  be updated annually;
 8-4                 (2)  be reviewed by the state Commission on Human
 8-5     Rights for compliance with Subsection (b)(1); and
 8-6                 (3)  be filed with the governor's office.
 8-7           Sec. 501.146.  MANAGED HEALTH CARE PLAN.  (a)  The committee
 8-8     shall develop a managed health care plan for all persons confined
 8-9     by the department that includes:
8-10                 (1)  the establishment of a managed health care
8-11     provider network of physicians and hospitals that will serve the
8-12     department as the exclusive health care provider for persons
8-13     confined in institutions operated by the department;
8-14                 (2)  cost containment studies;
8-15                 (3)  care case management and utilization management
8-16     studies performed for the department; and
8-17                 (4)  concerning the establishment of criteria for
8-18     hospitals, home health, or hospice providers, a provision requiring
8-19     the managed health care plan to accept certification by the
8-20     Medicare program under Title XVIII, Social Security Act (42 U.S.C.
8-21     Section 1395 et seq.), and its subsequent amendments as an
8-22     alternative to accreditation by the Joint Commission on
8-23     Accreditation of Healthcare Organizations.
8-24           (b)  To implement the managed health care plan, The
8-25     University of Texas Medical Branch at Galveston and the Texas Tech
8-26     University Health Sciences Center, for employees who are entitled
 9-1     to retain salary and benefits applicable to employees of the Texas
 9-2     Department of Criminal Justice under Section 9.01, Chapter 238,
 9-3     Acts of the 73rd Legislature, Regular Session, 1993, may
 9-4     administer, offer, and report through their payroll systems
 9-5     participation by those employees in the Texas employees uniform
 9-6     group insurance benefits program and the Employees Retirement
 9-7     System of Texas.
 9-8           Sec. 501.147.  COMMITTEE AUTHORITY TO CONTRACT.  (a)  The
 9-9     committee may enter into a contract on behalf of the department to
9-10     fully implement the managed health care plan under this subchapter.
9-11           (b)  The committee may, in addition to providing services to
9-12     the department, contract with other governmental entities for
9-13     similar health care services and integrate those services into the
9-14     managed health care provider network.
9-15           (c)  In contracting for implementation of the managed health
9-16     care plan, the committee, to the extent possible, shall integrate
9-17     the managed health care provider network with the public medical
9-18     schools of this state and the component and affiliated hospitals of
9-19     those medical schools.
9-20           (d)  For services that the public medical schools and their
9-21     components and affiliates cannot provide, the committee shall
9-22     initiate a competitive bidding process for contracts with other
9-23     providers for medical care to persons confined by the department.
9-24           Sec. 501.148.  GENERAL POWERS AND DUTIES OF COMMITTEE.
9-25     (a)  The committee shall:
9-26                 (1)  develop the contracts for health care services in
 10-1    consultation with the department and the health care providers;
 10-2                (2)  determine a capitation rate reflecting the true
 10-3    cost of correctional health care, including necessary catastrophic
 10-4    reserves;
 10-5                (3)  monitor and develop reports on general quality of
 10-6    care issues;
 10-7                (4)  act as an independent third party in the
 10-8    allocation of money to inmate health care providers;
 10-9                (5)  act as an independent third party for the purpose
10-10    of dispute resolution in the event of a disagreement between the
10-11    department and the health care providers; and
10-12                (6)  enforce compliance with contract provisions,
10-13    including requiring corrective action if care does not meet
10-14    expectations as determined by quality of care monitoring
10-15    activities.
10-16          (b)  The committee shall evaluate and recommend to the board
10-17    sites for new medical facilities that appropriately support the
10-18    managed health care provider network.
10-19          (c)  The committee may contract with an individual for
10-20    financial consulting services and may make use of financial
10-21    monitoring of the managed health care plan to assist the committee
10-22    in determining an accurate capitation rate.
10-23          (d)  The committee may contract with an individual for
10-24    actuarial consulting services to assist the committee in
10-25    determining trends in the health of the inmate population and the
10-26    impact of those trends on future financial needs.
 11-1          Sec. 501.149.  QUALITY OF CARE MONITORING BY THE DEPARTMENT
 11-2    AND HEALTH CARE PROVIDERS.  (a)  The committee shall establish a
 11-3    procedure for monitoring the quality of care delivered by the
 11-4    health care providers.  Under the procedure, the department's
 11-5    monitoring activities must be limited to investigating medical
 11-6    grievances, ensuring access to medical care, and conducting
 11-7    periodic operational reviews of medical care provided at its units.
 11-8          (b)  The department and the medical care providers shall
 11-9    cooperate in monitoring quality of care.  The clinical and
11-10    professional resources of the health care providers shall be used
11-11    to the greatest extent feasible for clinical oversight of quality
11-12    of care issues.
11-13          (c)  The department and the medical care providers shall
11-14    communicate the results of their monitoring activities to the
11-15    committee.
11-16          Sec. 501.150.  COMPLAINTS.  (a)  The committee shall maintain
11-17    a file on each written complaint filed with the committee.  The
11-18    file must include:
11-19                (1)  the name of the person who filed the complaint;
11-20                (2)  the date the complaint is received by the
11-21    committee;
11-22                (3)  the subject matter of the complaint;
11-23                (4)  the name of each person contacted in relation to
11-24    the complaint;
11-25                (5)  a summary of the results of the review or
11-26    investigation of the complaint; and
 12-1                (6)  an explanation of the reason the file was closed,
 12-2    if the committee closed the file without taking action other than
 12-3    to investigate the complaint.
 12-4          (b)  The committee shall provide to the person filing the
 12-5    complaint and to each person who is a subject of the complaint a
 12-6    copy of the committee's policies and procedures relating to
 12-7    complaint investigation and resolution.
 12-8          (c)  The committee, at least quarterly until final
 12-9    disposition of the complaint, shall notify the person filing the
12-10    complaint and each person who is a subject of the complaint of the
12-11    status of the investigation unless the notice would jeopardize an
12-12    undercover investigation.
12-13          Sec. 501.151.  PUBLIC PARTICIPATION.  The committee shall
12-14    develop and implement policies that provide the public with a
12-15    reasonable opportunity to appear before the committee and to speak
12-16    on any issue under the jurisdiction of the committee.
12-17          SECTION 2.  Section 501.059, Government Code, is repealed.
12-18          SECTION 3.  The name of the Correctional Managed Health Care
12-19    Advisory Committee is changed to the Correctional Managed Health
12-20    Care Committee.  The change in the name of the Correctional Managed
12-21    Health Care Advisory Committee does not affect the validity of any
12-22    action taken by the committee before, on, or after the effective
12-23    date of this Act.  A reference in law to the Correctional Managed
12-24    Health Care Advisory Committee means the Correctional Managed
12-25    Health Care Committee.
12-26          SECTION 4.  The governor shall make initial gubernatorial
 13-1    appointments to the Correctional Managed Health Care Committee to
 13-2    accomplish the membership required by Section 501.133, Government
 13-3    Code, as added by this Act, not later than January 1, 2000, and
 13-4    shall designate one member for a term expiring January 31, 2001,
 13-5    one member for a term expiring January 31, 2003, and one member for
 13-6    a term expiring January 31, 2005.
 13-7          SECTION 5.  This Act takes effect September 1, 1999.
 13-8          SECTION 6.  The importance of this legislation and the
 13-9    crowded condition of the calendars in both houses create an
13-10    emergency and an imperative public necessity that the
13-11    constitutional rule requiring bills to be read on three several
13-12    days in each house be suspended, and this rule is hereby suspended.