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 providers, or hospice providers, a provision
8-19 requiring the managed health care plan to accept certification by
8-20 the Medicare program under Title XVIII, Social Security Act (42
8-21 U.S.C. 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. REVIEW OF RURAL HOSPITAL CONTRACTS; REPORT.
11-2 (a) The committee, in conjunction with The University of Texas
11-3 Medical Branch at Galveston, the Texas Tech Health Sciences Center,
11-4 and the department, shall review the use of rural hospital
11-5 contracts for medical care to persons confined by the department.
11-6 The review shall include an analysis of inmate transportation
11-7 costs, including transportation-related security costs, and health
11-8 care costs. The review may include recommendations for improving
11-9 the use of contracts with rural hospitals to implement the managed
11-10 health care plan.
11-11 (b) The committee shall report to the 77th Legislature
11-12 regarding its findings and any recommendations.
11-13 (c) This section expires September 1, 2001.
11-14 Sec. 501.150. QUALITY OF CARE MONITORING BY THE DEPARTMENT
11-15 AND HEALTH CARE PROVIDERS. (a) The committee shall establish a
11-16 procedure for monitoring the quality of care delivered by the
11-17 health care providers. Under the procedure, the department's
11-18 monitoring activities must be limited to investigating medical
11-19 grievances, ensuring access to medical care, and conducting
11-20 periodic operational reviews of medical care provided at its units.
11-21 (b) The department and the medical care providers shall
11-22 cooperate in monitoring quality of care. The clinical and
11-23 professional resources of the health care providers shall be used
11-24 to the greatest extent feasible for clinical oversight of quality
11-25 of care issues.
11-26 (c) The department and the medical care providers shall
12-1 communicate the results of their monitoring activities to the
12-2 committee.
12-3 Sec. 501.151. COMPLAINTS. (a) The committee shall maintain
12-4 a file on each written complaint filed with the committee. The
12-5 file must include:
12-6 (1) the name of the person who filed the complaint;
12-7 (2) the date the complaint is received by the
12-8 committee;
12-9 (3) the subject matter of the complaint;
12-10 (4) the name of each person contacted in relation to
12-11 the complaint;
12-12 (5) a summary of the results of the review or
12-13 investigation of the complaint; and
12-14 (6) an explanation of the reason the file was closed,
12-15 if the committee closed the file without taking action other than
12-16 to investigate the complaint.
12-17 (b) The committee shall provide to the person filing the
12-18 complaint and to each person who is a subject of the complaint a
12-19 copy of the committee's policies and procedures relating to
12-20 complaint investigation and resolution.
12-21 (c) The committee, at least quarterly until final
12-22 disposition of the complaint, shall notify the person filing the
12-23 complaint and each person who is a subject of the complaint of the
12-24 status of the investigation unless the notice would jeopardize an
12-25 undercover investigation.
12-26 Sec. 501.152. PUBLIC PARTICIPATION. The committee shall
13-1 develop and implement policies that provide the public with a
13-2 reasonable opportunity to appear before the committee and to speak
13-3 on any issue under the jurisdiction of the committee.
13-4 SECTION 2. Section 501.059, Government Code, is repealed.
13-5 SECTION 3. The name of the Correctional Managed Health Care
13-6 Advisory Committee is changed to the Correctional Managed Health
13-7 Care Committee. The change in the name of the Correctional Managed
13-8 Health Care Advisory Committee does not affect the validity of any
13-9 action taken by the committee before, on, or after the effective
13-10 date of this Act. A reference in law to the Correctional Managed
13-11 Health Care Advisory Committee means the Correctional Managed
13-12 Health Care Committee.
13-13 SECTION 4. The governor shall make initial gubernatorial
13-14 appointments to the Correctional Managed Health Care Committee to
13-15 accomplish the membership required by Section 501.133, Government
13-16 Code, as added by this Act, not later than January 1, 2000, and
13-17 shall designate one member for a term expiring January 31, 2001,
13-18 one member for a term expiring January 31, 2003, and one member for
13-19 a term expiring January 31, 2005.
13-20 SECTION 5. The Correctional Managed Health Care Committee,
13-21 in conjunction with The University of Texas Medical Branch at
13-22 Galveston, the Texas Tech Health Sciences Center, and the Texas
13-23 Department of Criminal Justice, shall begin the review required by
13-24 Section 501.149, Government Code, as added by this Act, not later
13-25 than January 1, 2000.
13-26 SECTION 6. This Act takes effect September 1, 1999.
S.B. No. 371
14-1 SECTION 7. The importance of this legislation and the
14-2 crowded condition of the calendars in both houses create an
14-3 emergency and an imperative public necessity that the
14-4 constitutional rule requiring bills to be read on three several
14-5 days in each house be suspended, and this rule is hereby suspended.
________________________________ ________________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 371 passed the Senate on
April 16, 1999, by a viva-voce vote; May 18, 1999, Senate refused
to concur in House amendments and requested appointment of
Conference Committee; May 20, 1999, House granted request of the
Senate; May 30, 1999, Senate adopted Conference Committee Report by
a viva-voce vote.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 371 passed the House, with
amendments, on May 14, 1999, by a non-record vote; May 20, 1999,
House granted request of the Senate for appointment of Conference
Committee; May 29, 1999, House adopted Conference Committee Report
by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
________________________________
Date
________________________________
Governor