By Brown S.B. No. 371
76R839 PEP-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the continuation and functions of the Correctional
1-3 Managed Health Care Advisory Committee.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 501, Government Code, is amended by
1-6 adding Subchapter E to read as follows:
1-7 SUBCHAPTER E. MANAGED HEALTH CARE
1-8 Sec. 501.131. DEFINITION. In this subchapter, "committee"
1-9 means the Correctional Managed Health Care Committee.
1-10 Sec. 501.132. APPLICATION OF SUNSET ACT. The Correctional
1-11 Managed Health Care Committee is subject to Chapter 325 (Texas
1-12 Sunset Act). Unless continued in existence as provided by that
1-13 chapter, the committee is abolished and this subchapter expires
1-14 September 1, 2005.
1-15 Sec. 501.133. COMMITTEE MEMBERSHIP. (a) The committee
1-16 consists of nine members appointed as follows:
1-17 (1) two members employed full-time by the department,
1-18 at least one of whom is a physician, appointed by the executive
1-19 director;
1-20 (2) two members employed full-time by The University
1-21 of Texas Medical Branch at Galveston, at least one of whom is a
1-22 physician, appointed by the president of the medical branch;
1-23 (3) two members employed full-time by the Texas Tech
1-24 University Health Sciences Center, at least one of whom is a
2-1 physician, appointed by the president of the university; and
2-2 (4) three public members appointed by the governor who
2-3 are not affiliated with the department or with any entity with
2-4 which the committee has contracted to provide health care services
2-5 under this chapter, at least two of whom are licensed to practice
2-6 medicine in this state.
2-7 (b) An appointment to the committee shall be made without
2-8 regard to the race, color, disability, sex, religion, age, or
2-9 national origin of the appointee.
2-10 Sec. 501.134. PUBLIC MEMBER ELIGIBILITY. A person may not
2-11 be a public member of the committee if the person or the person's
2-12 spouse:
2-13 (1) is employed by or participates in the management
2-14 of a business entity or other organization regulated by or
2-15 receiving money from the department or the committee;
2-16 (2) owns or controls, directly or indirectly, more
2-17 than a 10 percent interest in a business entity or other
2-18 organization regulated by or receiving money from the department or
2-19 the committee; or
2-20 (3) uses or receives a substantial amount of tangible
2-21 goods, services, or money from the department or the committee
2-22 other than compensation or reimbursement authorized by law for
2-23 committee membership, attendance, or expenses.
2-24 Sec. 501.135. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
2-25 this section, "Texas trade association" means a cooperative and
2-26 voluntarily joined association of business or professional
2-27 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
3-27 designate a physician member of the committee as presiding officer.
4-1 The presiding officer serves in that capacity at the will of the
4-2 governor.
4-3 Sec. 501.138. GROUNDS FOR REMOVAL. (a) It is a ground for
4-4 removal from the committee that a member:
4-5 (1) does not have at the time of taking office the
4-6 qualifications required by Section 501.133;
4-7 (2) does not maintain during service on the committee
4-8 the qualifications required by Section 501.133;
4-9 (3) is ineligible for membership under Section 501.134
4-10 or 501.135;
4-11 (4) cannot, because of illness or disability,
4-12 discharge the member's duties for a substantial part of the
4-13 member's term; or
4-14 (5) is absent from more than half of the regularly
4-15 scheduled committee meetings that the member is eligible to attend
4-16 during a calendar year without an excuse approved by a majority
4-17 vote of the committee.
4-18 (b) The validity of an action of the committee is not
4-19 affected by the fact that it is taken when a ground for removal of
4-20 a committee member exists.
4-21 (c) If the managed health care administrator has knowledge
4-22 that a potential ground for removal exists, the administrator shall
4-23 notify the presiding officer of the committee of the potential
4-24 ground. The presiding officer shall then notify the governor and
4-25 the attorney general that a potential ground for removal exists.
4-26 If the potential ground for removal involves the presiding officer,
4-27 the managed health care administrator shall notify the next highest
5-1 ranking officer of the committee, who shall then notify the
5-2 governor and the attorney general that a potential ground for
5-3 removal exists.
5-4 Sec. 501.139. MEETINGS. (a) The committee shall meet at
5-5 least once in each quarter of the calendar year and at any other
5-6 time at the call of the presiding officer.
5-7 (b) The committee may hold a meeting by telephone conference
5-8 call or other video or broadcast technology.
5-9 Sec. 501.140. TRAINING. (a) A person who is appointed to
5-10 and qualifies for office as a member of the committee may not vote,
5-11 deliberate, or be counted as a member in attendance at a meeting of
5-12 the committee until the person completes a training program that
5-13 complies with this section.
5-14 (b) The training program must provide the person with
5-15 information regarding:
5-16 (1) the legislation that created the committee;
5-17 (2) the programs operated by the committee;
5-18 (3) the role and functions of the committee;
5-19 (4) the rules of the committee with an emphasis on the
5-20 rules that relate to disciplinary and investigatory authority;
5-21 (5) the current budget for the committee;
5-22 (6) the results of the most recent formal audit of the
5-23 committee;
5-24 (7) the requirements of:
5-25 (A) the open meetings law, Chapter 551;
5-26 (B) the public information law, Chapter 552;
5-27 (C) the administrative procedure law, Chapter
6-1 2001; and
6-2 (D) other laws relating to public officials,
6-3 including conflict-of-interest laws; and
6-4 (8) any applicable ethics policies adopted by the
6-5 committee or the Texas Ethics Commission.
6-6 (c) A person appointed to the committee is entitled to
6-7 reimbursement, as provided by the General Appropriations Act, for
6-8 the travel expenses incurred in attending the training program
6-9 regardless of whether the attendance at the program occurs before
6-10 or after the person qualifies for office.
6-11 Sec. 501.141. COMPENSATION; REIMBURSEMENT. A committee
6-12 member serves without compensation but is entitled to reimbursement
6-13 for actual and necessary expenses incurred in the performance of
6-14 the duties of the committee.
6-15 Sec. 501.142. ADMINISTRATION; PERSONNEL. The department
6-16 shall pay necessary costs for the operation of the committee,
6-17 including costs of hiring a managed health care administrator and
6-18 other personnel, from funds appropriated by the legislature to the
6-19 department.
6-20 Sec. 501.143. DIVISION OF RESPONSIBILITIES. The committee
6-21 shall develop and implement policies that clearly separate the
6-22 policy making responsibilities of the committee and the management
6-23 responsibilities of the managed health care administrator and staff
6-24 of the committee.
6-25 Sec. 501.144. QUALIFICATIONS AND STANDARDS OF CONDUCT
6-26 INFORMATION. The managed health care administrator or the
6-27 administrator's designee shall provide to members of the committee
7-1 and to committee employees, as often as necessary, information
7-2 regarding the requirements for office or employment under this
7-3 subchapter, including information regarding a person's
7-4 responsibilities under applicable laws relating to standards of
7-5 conduct for state officers or employees.
7-6 Sec. 501.145. EQUAL EMPLOYMENT OPPORTUNITY POLICY. (a) The
7-7 managed health care administrator or the administrator's designee
7-8 shall prepare and maintain a written policy statement that
7-9 implements a program of equal employment opportunity to ensure that
7-10 all personnel decisions are made without regard to race, color,
7-11 disability, sex, religion, age, or national origin.
7-12 (b) The policy statement must include:
7-13 (1) personnel policies, including policies relating to
7-14 recruitment, evaluation, selection, training, and promotion of
7-15 personnel, that show the intent of the committee to avoid the
7-16 unlawful employment practices described by Chapter 21, Labor Code;
7-17 and
7-18 (2) an analysis of the extent to which the composition
7-19 of the committee's personnel is in accordance with state and
7-20 federal law and a description of reasonable methods to achieve
7-21 compliance with state and federal law.
7-22 (c) The policy statement must:
7-23 (1) be updated annually;
7-24 (2) be reviewed by the state Commission on Human
7-25 Rights for compliance with Subsection (b)(1); and
7-26 (3) be filed with the governor's office.
7-27 Sec. 501.146. MANAGED HEALTH CARE PLAN. (a) The committee
8-1 shall develop a managed health care plan for all persons confined
8-2 by the department that includes:
8-3 (1) the establishment of a managed health care
8-4 provider network of physicians and hospitals that will serve the
8-5 department as the exclusive health care provider for persons
8-6 confined in institutions operated by the department;
8-7 (2) cost containment studies;
8-8 (3) care case management and utilization management
8-9 studies performed for the department; and
8-10 (4) concerning the establishment of criteria for
8-11 hospitals, home health, or hospice providers, a provision requiring
8-12 the managed health care plan to accept certification by the
8-13 Medicare program under Title XVIII, Social Security Act (42 U.S.C.
8-14 Section 1395 et seq.), and its subsequent amendments as an
8-15 alternative to accreditation by the Joint Commission on
8-16 Accreditation of Healthcare Organizations.
8-17 (b) To implement the managed health care plan, The
8-18 University of Texas Medical Branch at Galveston and the Texas Tech
8-19 University Health Sciences Center, for employees who are entitled
8-20 to retain salary and benefits applicable to employees of the Texas
8-21 Department of Criminal Justice under Section 9.01, Chapter 238,
8-22 Acts of the 73rd Legislature, Regular Session, 1993, may
8-23 administer, offer, and report through their payroll systems
8-24 participation by those employees in the Texas employees uniform
8-25 group insurance benefits program and the Employees Retirement
8-26 System of Texas.
8-27 Sec. 501.147. COMMITTEE AUTHORITY TO CONTRACT. (a) The
9-1 committee may enter into a contract on behalf of the department to
9-2 fully implement the managed health care plan under this subchapter.
9-3 (b) The committee may, in addition to providing services to
9-4 the department, contract with other governmental entities for
9-5 similar health care services and integrate those services into the
9-6 managed health care provider network.
9-7 (c) In contracting for implementation of the managed health
9-8 care plan, the committee, to the extent possible, shall integrate
9-9 the managed health care provider network with the public medical
9-10 schools of this state and the component and affiliated hospitals of
9-11 those medical schools.
9-12 (d) For services that the public medical schools and their
9-13 components and affiliates cannot provide, the committee shall
9-14 initiate a competitive bidding process for contracts with other
9-15 providers for medical care to persons confined by the department.
9-16 Sec. 501.148. GENERAL POWERS AND DUTIES OF COMMITTEE. (a)
9-17 The committee shall:
9-18 (1) develop the contracts for health care services in
9-19 consultation with the department and the health care providers;
9-20 (2) determine a capitation rate reflecting the true
9-21 cost of correctional health care, including necessary catastrophic
9-22 reserves;
9-23 (3) monitor and develop reports on general quality of
9-24 care issues;
9-25 (4) act as an independent third party in the
9-26 allocation of money to inmate health care providers;
9-27 (5) act as an independent third party for the purpose
10-1 of dispute resolution in the event of a disagreement between the
10-2 department and the health care providers; and
10-3 (6) enforce compliance with contract provisions,
10-4 including requiring corrective action if care does not meet
10-5 expectations as determined by quality of care monitoring
10-6 activities.
10-7 (b) The committee shall evaluate and recommend to the board
10-8 sites for new medical facilities that appropriately support the
10-9 managed health care provider network.
10-10 (c) The committee shall contract with an individual for
10-11 financial consulting services and shall make use of financial
10-12 monitoring of the managed health care plan to assist the committee
10-13 in determining an accurate capitation rate.
10-14 (d) The committee shall contract with an individual for
10-15 actuarial consulting services to assist the committee in
10-16 determining trends in the health of the inmate population and the
10-17 impact of those trends on future financial needs.
10-18 Sec. 501.149. QUALITY OF CARE MONITORING BY THE DEPARTMENT
10-19 AND HEALTH CARE PROVIDERS. (a) The department shall monitor the
10-20 quality of care delivered by the health care providers, including
10-21 investigating medical grievances, ensuring access to medical care,
10-22 and conducting periodic operational reviews of medical care
10-23 provided at its units.
10-24 (b) The department and the medical care providers shall
10-25 cooperate in monitoring quality of care. The clinical and
10-26 professional resources of the health care providers shall be used
10-27 to the greatest extent feasible for clinical oversight of quality
11-1 of care issues.
11-2 (c) The department shall communicate the results of its
11-3 monitoring activities to the committee.
11-4 Sec. 501.150. COMPLAINTS. (a) The committee shall maintain
11-5 a file on each written complaint filed with the committee. The
11-6 file must include:
11-7 (1) the name of the person who filed the complaint;
11-8 (2) the date the complaint is received by the
11-9 committee;
11-10 (3) the subject matter of the complaint;
11-11 (4) the name of each person contacted in relation to
11-12 the complaint;
11-13 (5) a summary of the results of the review or
11-14 investigation of the complaint; and
11-15 (6) an explanation of the reason the file was closed,
11-16 if the committee closed the file without taking action other than
11-17 to investigate the complaint.
11-18 (b) The committee shall provide to the person filing the
11-19 complaint and to each person who is a subject of the complaint a
11-20 copy of the committee's policies and procedures relating to
11-21 complaint investigation and resolution.
11-22 (c) The committee, at least quarterly until final
11-23 disposition of the complaint, shall notify the person filing the
11-24 complaint and each person who is a subject of the complaint of the
11-25 status of the investigation unless the notice would jeopardize an
11-26 undercover investigation.
11-27 Sec. 501.151. PUBLIC PARTICIPATION. The committee shall
12-1 develop and implement policies that provide the public with a
12-2 reasonable opportunity to appear before the committee and to speak
12-3 on any issue under the jurisdiction of the committee.
12-4 SECTION 2. Section 501.059, Government Code, is repealed.
12-5 SECTION 3. The name of the Correctional Managed Health Care
12-6 Advisory Committee is changed to the Correctional Managed Health
12-7 Care Committee. The change in the name of the Correctional Managed
12-8 Health Care Advisory Committee does not affect the validity of any
12-9 action taken by the committee before, on, or after the effective
12-10 date of this Act. A reference in law to the Correctional Managed
12-11 Health Care Advisory Committee means the Correctional Managed
12-12 Health Care Committee.
12-13 SECTION 4. The governor shall make initial gubernatorial
12-14 appointments to the Correctional Managed Health Care Committee to
12-15 accomplish the membership required by Section 501.133, Government
12-16 Code, as added by this Act, not later than January 1, 2000, and
12-17 shall designate one member for a term expiring January 31, 2001,
12-18 one member for a term expiring January 31, 2003, and one member for
12-19 a term expiring January 31, 2005.
12-20 SECTION 5. This Act takes effect September 1, 1999.
12-21 SECTION 6. The importance of this legislation and the
12-22 crowded condition of the calendars in both houses create an
12-23 emergency and an imperative public necessity that the
12-24 constitutional rule requiring bills to be read on three several
12-25 days in each house be suspended, and this rule is hereby suspended.