Amend CSHB 2233 by adding the following new SECTION to the
bill, appropriately numbered, and renumbering subsequent SECTIONS
of the bill accordingly:
SECTION __. Section 533.050, Health and Safety Code, is
amended to read as follows:
Sec. 533.050. PRIVATIZATION OF STATE MENTAL HOSPITAL;
CONSTRUCTION AND OPERATION OF REPLACEMENT HOSPITAL. (a) The
Department of State Health Services shall [After August 31, 2004,
and before September 1, 2005, the department may] contract with a
private service provider to finance, design, construct, and operate
one or more new [a] state mental hospitals to replace an existing
state mental hospital or hospitals [hospital owned by the
department only] if:
(1) the executive commissioner of the Health and Human
Services Commission determines that the private service provider
will operate the new state mental hospital at a cost that is at
least five [25] percent less than the cost to the department to
operate the hospital to be replaced;
(2) the executive commissioner of the Health and Human
Services Commission approves the contract;
(3) the new state mental hospital, when operated under
the contract, treats a population with materially the same
characteristics and acuity levels as the population treated at the
replaced state mental hospital when operated by the department;
[and]
(4) the private service provider is required under the
contract to operate the new state mental hospital at a quality level
at least equal to the quality level achieved by the department when
the department operated the replaced state mental hospital, as
measured by the hospital's most recent applicable accreditation
determination from the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO); and
(5) the state mental hospital to be replaced under the
contract is located in a county with a population of more than
150,000.
(b) The Department of State Health Services [On or before
April 1, 2004, the department] shall report to the executive
commissioner of the Health and Human Services Commission regarding
[health and human services] whether the department has received a
proposal by a private service provider to finance, design,
construct, and operate a new state mental hospital. The report must
include an evaluation of the private service provider's
qualifications, experience, and financial strength, a
determination of whether the provider can operate the new hospital
under the same standard of care as the department, and an analysis
of the projected savings under a proposed contract with the
provider. The savings analysis must include all department costs
to operate the hospital, including costs, such as employee
benefits, that are not appropriated to the department.
(c) A contract entered into under Subsection (a) must:
(1) provide that the Department of State Health
Services retains the right to assume management of the new state
mental hospital if contract terms are not met or if the five percent
cost savings requirement is not met;
(2) provide that the private service provider must
give priority consideration to each state employee employed at the
state mental hospital to be replaced who wants to continue working
at the new hospital and who the department determines is an employee
in good standing; and
(3) establish specific goals for the provider to meet:
(A) in significantly reducing the use of
restraints on patients and the seclusion of patients;
(B) in significantly reducing patient waiting
lists;
(C) in significantly reducing total length of
stay for patients, measured annually;
(D) in increasing access to mental health
inpatient services; and
(E) in reducing recidivism.
(d) As a condition of a contract under this section, the
private service provider shall:
(1) provide office space at the new state mental
hospital for an organization that advocates for persons with mental
illness;
(2) include that advocacy organization as a part of
the service delivery process; and
(3) provide for that advocacy organization to have
input regarding client care.
(e) The Department of State Health Services shall monitor
care of patients at the new state hospital operated by contract.
The department shall develop and maintain information on activities
carried out under the contract without violating privacy or
confidentiality rules. The information developed under this
subsection must include:
(1) the number of incidents in which patients were
restrained or secluded;
(2) the number of incidents of serious assaults in the
hospital setting;
(3) the number of occurrences in the hospital setting
involving contacts with law enforcement personnel;
(4) individual and average lengths of stay, including
computation of lengths of stay according to the number of days a
patient is in the facility during each calendar year, regardless of
discharge and readmission; and
(5) client outcomes.
(f) The Department of State Health Services may not enter
into a contract under this section with a private service provider
unless the provider has a documented and verified successful record
of:
(1) providing mental health services over a five-year
period; and
(2) managing an inpatient mental health facility with
a population of at least 250 patients.
(g) If the Department of State Health Services [department]
contracts with a private service provider to finance, design,
construct, and operate a new state mental hospital under Subsection
(a), the department, the Governor's Office of Budget and Planning,
and the Legislative Budget Board shall identify sources of funding
that must be transferred to the department to fund the contract.
(h) [(d)] The Department of State Health Services
[department] may renew a contract under this section. The
conditions provided by this section [listed in Subsections
(a)(1)-(3)] apply to the renewal of the contract.
(i) A contract under this section may be for a term not to
exceed 25 years. The contract must provide for the department to
acquire the hospital under a lease-purchase agreement with a term
not to exceed 25 years and authorize the private entity to issue
certificates of participation or other appropriate securities to
finance the construction of the hospital. In negotiating a
contract under this section, the department shall ensure that total
payments to be made under the contract for operating the hospital
and under the lease-purchase agreement do not exceed the projected
costs of operating the hospital proposed to be replaced.
Operational savings used to pay debt service payments for financing
a new hospital shall be counted in calculating whether the proposal
meets the five percent savings required by Subsection (a)(1).
(j) The Department of State Health Services and each private
entity that contracts with the department under this section shall
provide to the legislature a report on the progress of activities
under the contract and performance of services under the contract.
The report must be provided to the legislature not later than
November 1 of each even-numbered year.
(k) Not later than October 14, 2005, the Department of State
Health Services shall issue a request for proposals for a private
service provider to contract with the department to finance,
design, construct, and operate a new state mental hospital as
authorized by this section.