By Moncrief S.B. No. 566
76R4738 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to local public health services.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 121.002, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 121.002. DEFINITIONS [DEFINITION]. In this chapter:
1-7 (1) "Essential public health services" means services
1-8 to:
1-9 (A) monitor the health status of individuals in
1-10 the community to identify community health problems;
1-11 (B) diagnose health problems and investigate
1-12 health problems and hazards in the community;
1-13 (C) inform, educate, and empower the community
1-14 with respect to health issues;
1-15 (D) mobilize community participation in
1-16 identifying and solving community health problems;
1-17 (E) develop policies and plans that support
1-18 individual and community efforts to improve health;
1-19 (F) link individuals to personal health
1-20 services;
1-21 (G) ensure that the health care providers in the
1-22 community, including public and personal health care providers, are
1-23 competent;
1-24 (H) research new insights and innovative
2-1 solutions to health problems; and
2-2 (I) evaluate the effectiveness, accessibility,
2-3 and quality of public and personal health services in a community.
2-4 (2) "Physician" [, "physician"] means a person
2-5 licensed to practice medicine by the Texas State Board of Medical
2-6 Examiners.
2-7 SECTION 2. Subchapter A, Chapter 121, Health and Safety
2-8 Code, is amended by amending Section 121.006 and adding Sections
2-9 121.0065, 121.0066, and 121.0067 to read as follows:
2-10 Sec. 121.006. PUBLIC HEALTH SERVICES FEES[; STATE SUPPORT].
2-11 (a) The governing body of a municipality, the commissioners court
2-12 of a county, or the administrative board of a public health
2-13 district may adopt ordinances or rules to charge fees for public
2-14 health services.
2-15 (b) A municipality, county, or public health district may
2-16 not deny essential public health services to an individual because
2-17 of inability to pay for the services. A municipality, county, or
2-18 public health district shall provide for the reduction or waiver of
2-19 a fee for an individual who cannot pay for essential services in
2-20 whole or in part.
2-21 Sec. 121.0065. POPULATION-BASED GRANTS FOR ESSENTIAL PUBLIC
2-22 HEALTH SERVICES. (a) The department shall administer a program
2-23 under which appropriated funds may be granted to counties and
2-24 municipalities for use by the counties and municipalities to
2-25 provide or pay for essential public health services.
2-26 (b) The department shall determine the amount of a grant
2-27 made under the program based on the ratio that the population to be
3-1 served under the grant bears to the total number of individuals to
3-2 be served under all grants and by the department under Section
3-3 121.0066.
3-4 (c) The board may adopt rules governing:
3-5 (1) the manner in which a municipality or county
3-6 applies for a grant;
3-7 (2) the procedures for awarding grants; and
3-8 (3) the minimum essential public health services to be
3-9 provided under the grant and other standards applicable to the
3-10 services to be provided under the grant.
3-11 (d) A municipality or county that receives a grant under
3-12 this section, in consultation with the department, shall develop a
3-13 plan to permit the evaluation of effectiveness, accessibility, and
3-14 quality of the essential public health services that are provided
3-15 under the grant. The plan must:
3-16 (1) identify the outcomes that are intended to result
3-17 from the use of the grant money and establish a mechanism to
3-18 measure those outcomes; and
3-19 (2) establish performance standards for the delivery
3-20 of essential public health services and a mechanism to measure
3-21 compliance with those standards.
3-22 (e) To be eligible to receive a grant under this section,
3-23 the governing body of the municipality or the commissioners court
3-24 of the county must appoint or serve as a local health board to
3-25 monitor the use of the money received. A public health board
3-26 established under Section 121.034 or 121.046 may serve as the local
3-27 health board required under this subsection. If the governing body
4-1 of the municipality or the commissioners court of the county elects
4-2 to serve as the local health board, the governing body or
4-3 commissioners court may appoint an advisory body committee to
4-4 advise the governing body or commissioners court with respect to
4-5 the use of the money granted under this section.
4-6 (f) Chapter 783, Government Code, [(c) The Uniform Grant and
4-7 Contract Management Act of 1981 (Article 4413(32g), Vernon's Texas
4-8 Civil Statutes)] and standards adopted under that chapter [Act]
4-9 control, if applicable, to a grant made under this section [if the
4-10 local health unit, local health department, or public health
4-11 district receives state support for the provision of public health
4-12 services].
4-13 Sec. 121.0066. ESSENTIAL PUBLIC HEALTH SERVICES PROVIDED BY
4-14 DEPARTMENT. (a) The department shall provide essential public
4-15 health services for a population for which a municipality or
4-16 county is not receiving a grant to provide those services under
4-17 Section 121.0065.
4-18 (b) The department shall develop a plan that complies with
4-19 Section 121.0065(d) to permit evaluation of the effectiveness,
4-20 accessibility, and quality of essential public health services
4-21 provided under this section.
4-22 Sec. 121.0067. EVALUATION AND REPORT OF DELIVERY OF
4-23 ESSENTIAL PUBLIC HEALTH SERVICES. (a) The department, in
4-24 cooperation with municipalities and counties that receive grants
4-25 under Section 121.0065, shall evaluate:
4-26 (1) the effectiveness, accessibility, and quality of
4-27 essential public health services provided under the grant program
5-1 established by Section 121.0065 and under Section 121.0066; and
5-2 (2) the adequacy of funding for those services.
5-3 (b) Not later than January 1 of each odd-numbered year, the
5-4 department shall file with the governor and the presiding officer
5-5 of each house of the legislature a report detailing the results of
5-6 the evaluation conducted under Subsection (a). The report may
5-7 include recommendations relating to:
5-8 (1) legislation to improve the effectiveness,
5-9 accessibility, and quality of essential public health services; and
5-10 (2) appropriate funding for those services.
5-11 [(d) In this section, "public health services" means:]
5-12 [(1) personal health promotion and maintenance
5-13 services;]
5-14 [(2) infectious disease control and prevention
5-15 services;]
5-16 [(3) environmental and consumer health programs;]
5-17 [(4) public health education and information services;]
5-18 [(5) laboratory services; and]
5-19 [(6) administrative services.]
5-20 SECTION 3. Section 121.007(c), Health and Safety Code, is
5-21 amended to read as follows:
5-22 (c) The board or its designee may require a regional
5-23 director to perform the duties of a health authority. The regional
5-24 director may perform those duties, as authorized by the board or
5-25 commissioner, in a jurisdiction in the region in which[:]
5-26 [(1) there is no health authority; or]
5-27 [(2)] the health authority fails to perform duties
6-1 prescribed by the board under Section 121.024. The regional
6-2 director shall perform the duties of a health authority in a
6-3 jurisdiction in the region in which there is not a health
6-4 authority.
6-5 SECTION 4. Section 121.028, Health and Safety Code, is
6-6 amended to read as follows:
6-7 Sec. 121.028. APPOINTMENT OF HEALTH AUTHORITY. (a) The
6-8 governing body of a municipality or the commissioners court of a
6-9 county that has not established a local health department or a
6-10 public health district and that is receiving a grant under Section
6-11 121.0065 shall [may] appoint a physician as health authority to
6-12 administer state and local laws relating to public health in the
6-13 municipality's or county's jurisdiction.
6-14 (b) The governing body of a municipality or the
6-15 commissioners court of a county described by Subsection (a) that is
6-16 not receiving a grant under Section 121.0065 may appoint a
6-17 physician as health authority.
6-18 (c) An individual appointed to serve as health authority for
6-19 a county or municipality may serve as the health authority for one
6-20 or more other jurisdictions under an interlocal contract made in
6-21 accordance with Chapter 791, Government Code.
6-22 SECTION 5. Section 121.032, Health and Safety Code, is
6-23 amended to read as follows:
6-24 Sec. 121.032. POWERS AND DUTIES. [(a)] A local health
6-25 department may perform all public health functions that the
6-26 municipality or county that establishes the local health department
6-27 may perform.
7-1 [(b) For purposes of Section 121.005, a local health
7-2 department shall be identified by its program of public health
7-3 services and shall, at a minimum, provide:]
7-4 [(1) personal health promotion and maintenance
7-5 services;]
7-6 [(2) infectious disease control and prevention
7-7 services;]
7-8 [(3) environmental and consumer health programs for
7-9 the enforcement of health and safety laws relating to food, water,
7-10 waste control, general sanitation, and vector control;]
7-11 [(4) public health education and information services;]
7-12 [(5) laboratory services; and]
7-13 [(6) administrative services.]
7-14 SECTION 6. Subtitle F, Chapter 121, Health and Safety Code,
7-15 is amended by adding Subchapter F to read as follows:
7-16 SUBCHAPTER F. LOCAL PUBLIC HEALTH CONSORTIUM
7-17 Sec. 121.101. DEFINITIONS. In this chapter:
7-18 (1) "Consortium" means the local public health
7-19 consortium established under this subchapter.
7-20 (2) "Health science facility" means:
7-21 (A) The University of Texas Health Science
7-22 Center at San Antonio;
7-23 (B) The University of Texas M. D. Anderson
7-24 Cancer Center;
7-25 (C) The University of Texas Southwestern Medical
7-26 Center at Dallas;
7-27 (D) The University of Texas Medical Branch at
8-1 Galveston;
8-2 (E) The University of Texas Health Science
8-3 Center at Houston;
8-4 (F) The University of Texas Health Science
8-5 Center at Tyler;
8-6 (G) the Texas Tech University Health Sciences
8-7 Center;
8-8 (H) The Texas A&M University Health Science
8-9 Center;
8-10 (I) the University of North Texas Health Science
8-11 Center at Fort Worth; and
8-12 (J) the regional academic health center.
8-13 Sec. 121.102. CONSORTIUM ESTABLISHED. The department shall
8-14 establish a local public health consortium composed of health
8-15 science facilities.
8-16 Sec. 121.103. DUTIES OF CONSORTIUM. (a) The consortium, in
8-17 consultation with the department and local health units, local
8-18 health departments, and public health districts, shall:
8-19 (1) develop and distribute curricula for use to
8-20 provide training to public health workers;
8-21 (2) conduct research on health status outcomes for
8-22 clients of local health units, local health departments, and public
8-23 health districts;
8-24 (3) develop performance standards for local health
8-25 units, local health departments, and public health districts that
8-26 are linked to competency certification achieved by:
8-27 (A) local health units, local health
9-1 departments, and public health districts; and
9-2 (B) the public health workers of the local
9-3 health units, local health departments, and public health
9-4 districts; and
9-5 (4) study the technology infrastructure available to
9-6 local health units, local health departments, and public health
9-7 districts and make recommendations for use of this infrastructure
9-8 to permit:
9-9 (A) statewide communication relating to disease
9-10 surveillance and reporting public health information; and
9-11 (B) collaboration among local health units,
9-12 local health departments, and public health districts.
9-13 (b) The training curricula described by Subsection (a)(1)
9-14 must provide training related to providing prevention services in
9-15 conjunction with the delivery of other public health services.
9-16 SECTION 7. (a) In this section:
9-17 (1) "Board" means the Texas Board of Health.
9-18 (2) "Department" means the Texas Department of Health.
9-19 (3) "Task force" means the public health task force
9-20 established under this section.
9-21 (b) The department shall establish a public health task
9-22 force to make recommendations to the board with respect to
9-23 improving the competency and capacity of the health care providers
9-24 providing public health services in this state.
9-25 (c) The task force is composed of:
9-26 (1) five individuals appointed by the board who
9-27 represent municipalities and counties that provide public health
10-1 services; and
10-2 (2) four individuals appointed by the Texas Higher
10-3 Education Coordinating Board who represent institutions of higher
10-4 education.
10-5 (d) The task force shall make recommendations to the board
10-6 not later than June 1, 2001.
10-7 (e) Not later than December 1, 2000, the board shall submit
10-8 a written report to the governor, lieutenant governor, and speaker
10-9 of the house of representatives concerning the recommendations of
10-10 the task force. The report shall include:
10-11 (1) a plan for implementation of the recommendations
10-12 of the task force, if appropriate; and
10-13 (2) recommendations for legislation that the board
10-14 considers necessary to implement the recommendations of the task
10-15 force.
10-16 (f) The department shall provide administrative support and
10-17 services to the task force.
10-18 (g) This section expires and the task force is abolished
10-19 June 1, 2001.
10-20 SECTION 8. Sections 121.007(d) and (e), Health and Safety
10-21 Code, are repealed.
10-22 SECTION 9. The importance of this legislation and the
10-23 crowded condition of the calendars in both houses create an
10-24 emergency and an imperative public necessity that the
10-25 constitutional rule requiring bills to be read on three several
10-26 days in each house be suspended, and this rule is hereby suspended,
10-27 and that this Act take effect and be in force from and after its
11-1 passage, and it is so enacted.