1-1     By:  Brown                                             S.B. No. 371
 1-2           (In the Senate - Filed March 8, 1999; March 9, 1999, read
 1-3     first time and referred to Committee on Economic Development;
 1-4     March 10, 1999, rereferred to Committee on Criminal Justice;
 1-5     April 8, 1999, reported adversely, with favorable Committee
 1-6     Substitute by the following vote:  Yeas 6, Nays 0; April 8, 1999,
 1-7     sent to printer.)
 1-8     COMMITTEE SUBSTITUTE FOR S.B. No. 371                   By:  Duncan
 1-9                            A BILL TO BE ENTITLED
1-10                                   AN ACT
1-11     relating to the continuation and functions of the Correctional
1-12     Managed Health Care Advisory Committee.
1-13           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-14           SECTION 1.  Chapter 501, Government Code, is amended by
1-15     adding Subchapter E to read as follows:
1-16                     SUBCHAPTER E.  MANAGED HEALTH CARE
1-17           Sec. 501.131.  DEFINITION.  In this subchapter, "committee"
1-18     means the Correctional Managed Health Care Committee.
1-19           Sec. 501.132.  APPLICATION OF SUNSET ACT.  The Correctional
1-20     Managed Health Care Committee is subject to Chapter 325 (Texas
1-21     Sunset Act).  Unless continued in existence as provided by that
1-22     chapter, the committee is abolished and this subchapter expires
1-23     September 1, 2005.
1-24           Sec. 501.133.  COMMITTEE MEMBERSHIP.  (a)  The committee
1-25     consists of nine members appointed as follows:
1-26                 (1)  two members employed full-time by the department,
1-27     at least one of whom is a physician, appointed by the executive
1-28     director;
1-29                 (2)  two members employed full-time by The University
1-30     of Texas Medical Branch at Galveston, at least one of whom is a
1-31     physician, appointed by the president of the medical branch;
1-32                 (3)  two members employed full-time by the Texas Tech
1-33     University Health Sciences Center, at least one of whom is a
1-34     physician, appointed by the president of the university; and
1-35                 (4)  three public members appointed by the governor who
1-36     are not affiliated with the department or with any entity with
1-37     which the committee has contracted to provide health care services
1-38     under this chapter, at least two of whom are licensed to practice
1-39     medicine in this state.
1-40           (b)  An appointment to the committee shall be made without
1-41     regard to the race, color, disability, sex, religion, age, or
1-42     national origin of the appointee.
1-43           Sec. 501.134.  PUBLIC MEMBER ELIGIBILITY.  A person may not
1-44     be a public member of the committee if the person or the person's
1-45     spouse:
1-46                 (1)  is employed by or participates in the management
1-47     of a business entity or other organization regulated by or
1-48     receiving money from the department or the committee;
1-49                 (2)  owns or controls, directly or indirectly, more
1-50     than a 10 percent interest in a business entity or other
1-51     organization regulated by or receiving money from the department or
1-52     the committee; or
1-53                 (3)  uses or receives a substantial amount of tangible
1-54     goods, services, or money from the department or the committee
1-55     other than compensation or reimbursement authorized by law for
1-56     committee membership, attendance, or expenses.
1-57           Sec. 501.135.  MEMBERSHIP AND EMPLOYEE RESTRICTIONS.  (a)  In
1-58     this section, "Texas trade association" means a cooperative and
1-59     voluntarily joined association of business or professional
1-60     competitors in this state designed to assist its members and its
1-61     industry or profession in dealing with mutual business or
1-62     professional problems and in promoting their common interest.
1-63           (b)  A person may not be a member of the committee and may
1-64     not be a committee employee employed in a "bona fide executive,
 2-1     administrative, or professional capacity," as that phrase is used
 2-2     for purposes of establishing an exemption to the overtime
 2-3     provisions of the federal Fair Labor Standards Act of 1938 (29
 2-4     U.S.C. Section 201 et seq.) and its subsequent amendments if:
 2-5                 (1)  the person is an officer, employee, or paid
 2-6     consultant of a Texas trade association in the field of health care
 2-7     or health care services; or
 2-8                 (2)  the person's spouse is an officer, manager, or
 2-9     paid consultant of a Texas trade association in the field of health
2-10     care or health care services.
2-11           (c)  A person may not be a member of the committee or act as
2-12     the general counsel to the committee if the person is required to
2-13     register as a lobbyist under Chapter 305 because of the person's
2-14     activities for compensation on behalf of a profession related to
2-15     the operation of the committee.
2-16           Sec. 501.136.  TERMS OF OFFICE.  Committee members appointed
2-17     by the governor serve staggered six-year terms, with the term of
2-18     one of those members expiring on February 1 of each odd-numbered
2-19     year.  Other committee members serve at the will of the appointing
2-20     official or until termination of the member's employment with the
2-21     entity the member represents.
2-22           Sec. 501.137.  PRESIDING OFFICER.  The governor shall
2-23     designate a physician member of the committee as presiding officer.
2-24     The presiding officer serves in that capacity at the will of the
2-25     governor.
2-26           Sec. 501.138.  GROUNDS FOR REMOVAL.  (a)  It is a ground for
2-27     removal from the committee that a member:
2-28                 (1)  does not have at the time of taking office the
2-29     qualifications required by Section 501.133;
2-30                 (2)  does not maintain during service on the committee
2-31     the qualifications required by Section 501.133;
2-32                 (3)  is ineligible for membership under Section 501.134
2-33     or 501.135;
2-34                 (4)  cannot, because of illness or disability,
2-35     discharge the member's duties for a substantial part of the
2-36     member's term; or
2-37                 (5)  is absent from more than half of the regularly
2-38     scheduled committee meetings that the member is eligible to attend
2-39     during a calendar year without an excuse approved by  a majority
2-40     vote of the committee.
2-41           (b)  The validity of an action of the committee is not
2-42     affected by the fact that it is taken when a ground for removal of
2-43     a committee member exists.
2-44           (c)  If the managed health care administrator has knowledge
2-45     that a potential ground for removal exists, the administrator shall
2-46     notify the presiding officer of the committee of the potential
2-47     ground.  The presiding officer shall then notify the governor and
2-48     the attorney general that a potential ground for removal exists.
2-49     If the potential ground for removal involves the presiding officer,
2-50     the managed health care administrator shall notify the next highest
2-51     ranking officer of the committee, who shall then notify the
2-52     governor and the attorney general that a potential ground for
2-53     removal exists.
2-54           Sec. 501.139.  MEETINGS.  (a)  The committee shall meet at
2-55     least once in each quarter of the calendar year and at any other
2-56     time at the call of the presiding officer.
2-57           (b)  The committee may hold a meeting by telephone conference
2-58     call or other video or broadcast technology.
2-59           Sec. 501.140.  TRAINING.  (a)  A person who is appointed to
2-60     and qualifies for office as a member of the committee may not vote,
2-61     deliberate, or be counted as a member in attendance at a meeting of
2-62     the committee until the person completes a training program that
2-63     complies with this section.
2-64           (b)  The training program must provide the person with
2-65     information regarding:
2-66                 (1)  the legislation that created the committee;
2-67                 (2)  the programs operated by the committee;
2-68                 (3)  the role and functions of the committee;
2-69                 (4)  the rules of the committee with an emphasis on the
 3-1     rules that relate to disciplinary and investigatory authority;
 3-2                 (5)  the current budget for the committee;
 3-3                 (6)  the results of the most recent formal audit of the
 3-4     committee;
 3-5                 (7)  the requirements of:
 3-6                       (A)  the open meetings law, Chapter 551;
 3-7                       (B)  the public information law, Chapter 552;
 3-8                       (C)  the administrative procedure law, Chapter
 3-9     2001; and
3-10                       (D)  other laws relating to public officials,
3-11     including conflict-of-interest laws; and
3-12                 (8)  any applicable ethics policies adopted by the
3-13     committee or the Texas Ethics Commission.
3-14           (c)  A person appointed to the committee is entitled to
3-15     reimbursement, as provided by the General Appropriations Act, for
3-16     the travel expenses incurred in attending the training program
3-17     regardless of whether the attendance at the program occurs before
3-18     or after the person qualifies for office.
3-19           Sec. 501.141.  COMPENSATION; REIMBURSEMENT.  A committee
3-20     member serves without compensation but is entitled to reimbursement
3-21     for actual and necessary expenses incurred in the performance of
3-22     the duties of the committee.
3-23           Sec. 501.142.  ADMINISTRATION; PERSONNEL.  The committee may
3-24     hire a managed health care administrator, who may employ personnel
3-25     necessary for the administration of the committee's duties.  The
3-26     committee shall pay necessary costs for its operation, including
3-27     costs of hiring the managed health care administrator and other
3-28     personnel, from funds appropriated by the legislature to the
3-29     department for correctional health care.
3-30           Sec. 501.143.  DIVISION OF RESPONSIBILITIES.  The committee
3-31     shall develop and implement policies that clearly separate the
3-32     policy-making responsibilities of the committee and the management
3-33     responsibilities of the managed health care administrator and staff
3-34     of the committee.
3-35           Sec. 501.144.  QUALIFICATIONS AND STANDARDS OF CONDUCT
3-36     INFORMATION.  The managed health care administrator or the
3-37     administrator's designee shall provide to members of the committee
3-38     and to committee employees, as often as necessary, information
3-39     regarding the requirements for office or employment under this
3-40     subchapter, including information regarding a person's
3-41     responsibilities under applicable laws relating to standards of
3-42     conduct for state officers or employees.
3-43           Sec. 501.145.  EQUAL EMPLOYMENT OPPORTUNITY POLICY.  (a)  The
3-44     managed health care administrator or the administrator's designee
3-45     shall prepare and maintain a written policy statement that
3-46     implements a program of equal employment opportunity to ensure that
3-47     all personnel decisions are made without regard to race, color,
3-48     disability, sex, religion, age, or national origin.
3-49           (b)  The policy statement must include:
3-50                 (1)  personnel policies, including policies relating to
3-51     recruitment, evaluation, selection, training, and promotion of
3-52     personnel, that show the intent of the committee to avoid the
3-53     unlawful employment practices described by Chapter 21, Labor Code;
3-54     and
3-55                 (2)  an analysis of the extent to which the composition
3-56     of the committee's personnel is in accordance with state and
3-57     federal law and a description of reasonable methods to achieve
3-58     compliance with state and federal law.
3-59           (c)  The policy statement must:
3-60                 (1)  be updated annually;
3-61                 (2)  be reviewed by the state Commission on Human
3-62     Rights for compliance with Subsection (b)(1); and
3-63                 (3)  be filed with the governor's office.
3-64           Sec. 501.146.  MANAGED HEALTH CARE PLAN.  (a)  The committee
3-65     shall develop a managed health care plan for all persons confined
3-66     by the department that includes:
3-67                 (1)  the establishment of a managed health care
3-68     provider network of physicians and hospitals that will serve the
3-69     department as the exclusive health care provider for persons
 4-1     confined in institutions operated by the department;
 4-2                 (2)  cost containment studies;
 4-3                 (3)  care case management and utilization management
 4-4     studies performed for the department; and
 4-5                 (4)  concerning the establishment of criteria for
 4-6     hospitals, home health, or hospice providers, a provision requiring
 4-7     the managed health care plan to accept certification by the
 4-8     Medicare program under Title XVIII, Social Security Act (42 U.S.C.
 4-9     Section 1395 et seq.), and its subsequent amendments as an
4-10     alternative to accreditation by the Joint Commission on
4-11     Accreditation of Healthcare Organizations.
4-12           (b)  To implement the managed health care plan, The
4-13     University of Texas Medical Branch at Galveston and the Texas Tech
4-14     University Health Sciences Center, for employees who are entitled
4-15     to retain salary and benefits applicable to employees of the Texas
4-16     Department of Criminal Justice under Section 9.01, Chapter 238,
4-17     Acts of the 73rd Legislature, Regular Session, 1993, may
4-18     administer, offer, and report through their payroll systems
4-19     participation by those employees in the Texas employees uniform
4-20     group insurance benefits program and the Employees Retirement
4-21     System of Texas.
4-22           Sec. 501.147.  COMMITTEE AUTHORITY TO CONTRACT.  (a)  The
4-23     committee may enter into a contract on behalf of the department to
4-24     fully implement the managed health care plan under this subchapter.
4-25           (b)  The committee may, in addition to providing services to
4-26     the department, contract with other governmental entities for
4-27     similar health care services and integrate those services into the
4-28     managed health care provider network.
4-29           (c)  In contracting for implementation of the managed health
4-30     care plan, the committee, to the extent possible, shall integrate
4-31     the managed health care provider network with the public medical
4-32     schools of this state and the component and affiliated hospitals of
4-33     those medical schools.
4-34           (d)  For services that the public medical schools and their
4-35     components and affiliates cannot provide, the committee shall
4-36     initiate a competitive bidding process for contracts with other
4-37     providers for medical care to persons confined by the department.
4-38           Sec. 501.148.  GENERAL POWERS AND DUTIES OF COMMITTEE.
4-39     (a)  The committee shall:
4-40                 (1)  develop the contracts for health care services in
4-41     consultation with the department and the health care providers;
4-42                 (2)  determine a capitation rate reflecting the true
4-43     cost of correctional health care, including necessary catastrophic
4-44     reserves;
4-45                 (3)  monitor and develop reports on general quality of
4-46     care issues;
4-47                 (4)  act as an independent third party in the
4-48     allocation of money to inmate health care providers;
4-49                 (5)  act as an independent third party for the purpose
4-50     of dispute resolution in the event of a disagreement between the
4-51     department and the health care providers; and
4-52                 (6)  enforce compliance with contract provisions,
4-53     including requiring corrective action if care does not meet
4-54     expectations as determined by quality of care monitoring
4-55     activities.
4-56           (b)  The committee shall evaluate and recommend to the board
4-57     sites for new medical facilities that appropriately support the
4-58     managed health care provider network.
4-59           (c)  The committee may contract with an individual for
4-60     financial consulting services and may make use of financial
4-61     monitoring of the managed health care plan to assist the committee
4-62     in determining an accurate capitation rate.
4-63           (d)  The committee may contract with an individual for
4-64     actuarial consulting services to assist the committee in
4-65     determining trends in the health of the inmate population and the
4-66     impact of those trends on future financial needs.
4-67           Sec. 501.149.  QUALITY OF CARE MONITORING BY THE DEPARTMENT
4-68     AND HEALTH CARE PROVIDERS.  (a)  The committee shall establish a
4-69     procedure for monitoring the quality of care delivered by the
 5-1     health care providers.  Under the procedure, the department's
 5-2     monitoring activities must be limited to investigating medical
 5-3     grievances, ensuring access to medical care, and conducting
 5-4     periodic operational reviews of medical care provided at its units.
 5-5           (b)  The department and the medical care providers shall
 5-6     cooperate in monitoring quality of care.  The clinical and
 5-7     professional resources of the health care providers shall be used
 5-8     to the greatest extent feasible for clinical oversight of quality
 5-9     of care issues.
5-10           (c)  The department and the medical care providers shall
5-11     communicate the results of their monitoring activities to the
5-12     committee.
5-13           Sec. 501.150.  COMPLAINTS.  (a)  The committee shall maintain
5-14     a file on each written complaint filed with the committee.  The
5-15     file must include:
5-16                 (1)  the name of the person who filed the complaint;
5-17                 (2)  the date the complaint is received by the
5-18     committee;
5-19                 (3)  the subject matter of the complaint;
5-20                 (4)  the name of each person contacted in relation to
5-21     the complaint;
5-22                 (5)  a summary of the results of the review or
5-23     investigation of the complaint; and
5-24                 (6)  an explanation of the reason the file was closed,
5-25     if the committee closed the file without taking action other than
5-26     to investigate the complaint.
5-27           (b)  The committee shall provide to the person filing the
5-28     complaint and to each person who is a subject of the complaint a
5-29     copy of the committee's policies and procedures relating to
5-30     complaint investigation and resolution.
5-31           (c)  The committee, at least quarterly until final
5-32     disposition of the complaint, shall notify the person filing the
5-33     complaint and each person who is a subject of the complaint of the
5-34     status of the investigation unless the notice would jeopardize an
5-35     undercover investigation.
5-36           Sec. 501.151.  PUBLIC PARTICIPATION.  The committee shall
5-37     develop and implement policies that provide the public with a
5-38     reasonable opportunity to appear before the committee and to speak
5-39     on any issue under the jurisdiction of the committee.
5-40           SECTION 2.  Section 501.059, Government Code, is repealed.
5-41           SECTION 3.  The name of the Correctional Managed Health Care
5-42     Advisory Committee is changed to the Correctional Managed Health
5-43     Care Committee.  The change in the name of the Correctional Managed
5-44     Health Care Advisory Committee does not affect the validity of any
5-45     action taken by the committee before, on, or after the effective
5-46     date of this Act.  A reference in law to the Correctional Managed
5-47     Health Care Advisory Committee means the Correctional Managed
5-48     Health Care Committee.
5-49           SECTION 4.  The governor shall make initial gubernatorial
5-50     appointments to the Correctional Managed Health Care Committee to
5-51     accomplish the membership required by Section 501.133, Government
5-52     Code, as added by this Act, not later than January 1, 2000, and
5-53     shall designate one member for a term expiring January 31, 2001,
5-54     one member for a term expiring January 31, 2003, and one member for
5-55     a term expiring January 31, 2005.
5-56           SECTION 5.  This Act takes effect September 1, 1999.
5-57           SECTION 6.  The importance of this legislation and the
5-58     crowded condition of the calendars in both houses create an
5-59     emergency and an imperative public necessity that the
5-60     constitutional rule requiring bills to be read on three several
5-61     days in each house be suspended, and this rule is hereby suspended.
5-62                                  * * * * *