C.S.H.B. 3181 78(R) BILL ANALYSIS C.S.H.B. 3181 By: Delisi State Health Care Expenditures, Select Committee Report (Substituted) BACKGROUND AND PURPOSE Currently there is no single state entity that researches and analyzes state-wide health expenditures in areas of long term needs, identifies critical problems, and assesses cost-effective use of state, federal, and local dollars. The state would benefit from an agency that is specifically charged with providing cost-savings recommendations to the Governor, Lieutenant Governor, and Texas Legislature. Such an agency would provide the research and policy analysis resources required to draft and such recommendations and evaluate their effectiveness after adoption. C.S.H.B. 3181 establishes the Commission for State Health Expenditures. The substitute requires the commission to identify methods to improve the state's health care systems and identify potential cost savings in all areas of the state's health expenditures. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 3181 creates a new commission for the sole purpose of evaluating state health care expenditures and providing recommendations for programs, plans and recommendations to improve the efficiency of care, identify the long-term health needs of the citizens of Texas, assess costeffectiveness of the use of state, federal and local dollars, calculate daily costs and compare interagency costs on services provided, identify critical problems in the state's health care systems and recommend strategies to solve those problems. C.S.H.B. 3181 provides sunset provision, and allows for the governor to appoint the commissioner, and sets forth eligibility for the position of commissioner. Additionally, this Act sets forth the parameters for the commission's duties, personnel, and the constitution of conflicts of interest. C.S.H.B. 3181 requires consultation with the governor, and legislative officials in setting priorities for research projects. EFFECTIVE DATE This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2003. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute differs from the original by conforming to Texas Legislative Council style and format. The substitute changes the bill caption by removing "health." The substitute renames the commission to "Commission for State Health Expenditures." The substitute adds commissioner to the definitions section. The substitute makes changes to Section 534.007, General Duty of the Commission by expanding the duties of the commission to include in-depth analysis of health expenditures funded by the state to determine the long-term needs of the state's health care system and recommend policy priorities for the state and elected state officials; identify critical problems in the state's health care systems and recommend strategies to solve those problems; assess the cost effectiveness of the use of federal, state, and local money in the state's health care expenditures; advise and assist the legislature in developing plans, programs and proposed legislation to improve effectiveness of the state's health care systems, and identify potential costs savings, innovative practices and best practices, efficiency in delivery of care, and evidence-based models of care; calculate daily costs and compare interagency costs on services provided by agencies that are a part of the state's health care systems; calculate relevant populations for use in planning for the long-term needs of the state's health care systems; determine the long-term information needs of the state's health care systems and acquire information to meet those needs; and engage in other activities consistent with the responsibilities of the commission. The substitute removes the following sections and renumbers the bill accordingly: Section 534.007, "Appointment of Other Advisory Bodies"; Section 534.010, " Contractual Authority"; Section 534.011, "Funds, grants and donations"; Section 534.012, "Health and human services plan"; Section 534.013, "Consumer information and complaints". In Section 534.006, "Conflicts of interest" the substitute makes conforming changes by adding the words "business, insurance, or." The substitute differs in that it removes the sentence in the section "Access to programs and facilities" (534.009 in the substituted version): "The commission shall also prepare and maintain a written plan that describes how a person who does not speak English can be provided reasonable access to the commission's programs and services."