The House Committee on Appropriations
79th Legislature
March 15, 2005
7:00 a.m.
Capitol Extension, E1.030
Pursuant to a notice posted on March 9, 2005, and revised on
March 14, 2005, the House Committee on Appropriations met in a
public hearing and was called to order by the chair,
Representative Pitts, at 7:08 a.m.
The roll was answered as follows:
Present: Representatives Pitts; Luna; Berman; Brown, Betty;
Brown, Fred; Chisum; Crownover; Davis, John; Edwards;
Guillen; Haggerty; Hamric; Hegar; Hopson; Isett;
Martinez; Pickett; Smith, Todd; Truitt (19).
Absent: Representatives Branch; Dukes; Gattis; Hope; King,
Tracy; Kolkhorst; McClendon; Menendez; Pena; Turner
(10).
A quorum was present.
(Representative Turner now present.)
The chair recognized Representative John Davis to give an
overview of the Health and Human Services Subcommittee
recommendations.
(Representative McClendon now present.)
The chair recognized Representative Isett to lay out the
recommendations for the Department of Assistive and
Rehabilitative Services.
The chair recognized Representative John Davis to lay out the
recommendations for the Department of Aging and Disability
Services.
The chair recognized Legislative Budget Board staff to explain
the recommendations of the Health and Human Services
Subcommittee.
Testimony was taken. (See attached witness list.)
(Representative Hope now present.) (Representative Branch now
present.) (Representative Dukes now present.) (Representative
Kolkhorst now present.) (Representative King, Tracy now
present.)
The chair recognized Representative John Davis to lay out the
proposed riders for the Department of Aging and Disability
Services.
The chair recognized Representative Hopson to lay out the
proposed riders for the Department of State Health Services.
(Representative Luna in chair.)
The chair recognized Representative Dukes to lay out the
recommendations for the Department of Family and Protective
Services.
(Representative Pitts in chair.)
At 9:58 a.m., on the motion of the chair and without objection,
the meeting was recessed until adjournment of the house.
The committee reconvened at 12:04 p.m. and was called to order
by the chair, Representative Pitts. The roll was answered as
follows:
Present: Representatives Pitts; Luna; Berman; Brown, Fred;
Davis, John; Dukes; Edwards; Guillen; Haggerty;
Hamric; Hegar; Hope; Hopson; Isett; King, Tracy;
Martinez; Pena; Pickett; Truitt (19).
Absent: Representatives Branch; Brown, Betty; Chisum;
Crownover; Gattis; Kolkhorst; McClendon; Menendez;
Smith, Todd; Turner (10).
A quorum was present.
(Representative Smith, Todd now present.)
The chair recognized Representative Truitt to lay out the
recommendations for the Health and Human Services Commission.
(Representative Crownover now present.) (Representative Branch
now present.) (Representative Brown, Betty now present.)
(Representative Chisum now present.)
The chair recognized Representative John Davis to lay out the
recommendations for the Special Provisions Relating to All
Health and Human Services Agencies.
(Representative Turner now present.) (Representative Kolkhorst
now present.) (Representative McClendon now present.)
Representatives John Davis, Isett, Hopson, Dukes and Truitt
moved the adoption of the Legislative Budget Board
recommendations for the Department of Assistive and
Rehabilitative Services [hereinafter: "DARS"], Department of
State Health Services [hereinafter: "DSHS"], Department of
Family and Protective Services [hereinafter: "DFPS"], Department
of Aging and Disability Services [hereinafter: "DADS"], Health
and Human Services Commission [hereinafter: "HHSC"], and Special
Provisions Relating to All Health and Human Services Agencies
[hereinafter: "Special Provisions"] with the following changes:
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House Committee on Appropriations
3/15/2005
Proposed Fiscal Changes:
HHSC - Medicaid Caseload and Cost
DFPS - Foster Care Caseload Growth
DFPS - Foster Care--Replace Crime Victims Fund Funding
DFPS - Adoption Subsidies Caseload Growth
DFPS - APS--Replace Crime Victims Fund Funding
DADS - LTC Caseload Growth
DADS - LTC Functional Eligibility
HHSC - CHIP Caseload Growth and Cost
HHSC - Apply New CHIP Cost Sharing
HHSC -Add CHIP Hospice Benefit
DSHS - Civil Commitment Program
DADS - LTC Waiver Cost
DSHS - HIV Program
DSHS - State Mental Health Hospital Capacity Growth
DFPS - CPS Reform
DFPS - Maintain APS MH/MR Current Caseload per Worker
DADS - Promoting Independence
DSHS - MH Hospitals
DSHS - Maintain Service Levels
Strategies Restored:
1.1.1 Coordinated Public Health Services
1.1.3. Maintain Vital Records
1.1.4 Special Health Initiatives
1.1.5 Registries, Information and Analysis
1.2.5 Infectious Disease Epidemiology/Surveillance
1.3.1 Cardiovascular Disease, Diabetes, and Injury
Prevention
1.3.2 Abstinence Education
1.3.5 Epilepsy, Hemophilia, and Alzheimer's
1.4.1 Laboratory Services
2.1.3 Family Planning Services
2.1.5 Community Primary Care Services
2.2.4 Substance Abuse Prevention
2.2.5 Substance Abuse Intervention
2.2.6 Substance Abuse Prevention
2.3.2 FQHC Infrastructure Grants
3.1.1 Texas Center for Infectious Disease
4.1.1. Food (Meat) and Drug Safety
4.1.2. Environmental Health
4.1.3. Radiation Control
4.1.4. Health Care Professionals
4.1.5. Health Care Facilities
5.1.1 Central Administration
5.1.2 Information Technology Program Support
5.1.3 Other Support Services
5.1.4 Regional Administration
HHSC - Reduce HHS Waiting List Demographic Growth
DFPS - Restore Foster Care Rates to FY02-03
DFPS - Increase Foster Care Rates over FY02-03
DSHS - Childhood Vaccinations (Hepatitis A)
DFPS - Increase Monitoring of Licensed Facilities
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House Committee on Appropriations
3/15/2005
HHSC - Medicaid Buy-In
DSHS - Newborn Screening
DSHS - Childhood Vaccines (PCV-7)
HHSC - Expand Family Violence Services
HHSC - 2-1-1 Information and Referral
DADS - State School Cost Allocation Issue
HHSC - Maintain Program Admin and Support
HHSC - Maintain Technology Critical for Agency Functions
HHSC - Maintain Support of Integrated Eligibility
DFPS - Fund Technology (MLPP)
DFPS - Fund IMPACT
DFPS - Fund Statewide Intake Technology Needs (MLPP)
DFPS - Fund Stemmons Office Relocation
HHSC- Improve HHS Contract Management and Oversight
DADS - Critical State School Renovations
DADS - Technology and Equipment (includes MLPP)
DADS - Critical Accountability and Oversight
DSHS - MH Hospital Critical Renovations
DSHS - Laboratory Information System
DSHS - Technology and Equipment (includes MLPP)
DFPS - Restore Prevention Services FY04-05 (TANF)
DFPS - Restore Prevention Services FY02-03 (TANF)
DADS - Title XX Community Care Services (Title XX)
DSHS - Cancer Registry
Technical Adjustments and Movements of Appropriations to Conform
to Subcommittee Recommendations:
DSHS--align dedicated tobacco to BRE
DSHS--bond refunding
DSHS--add FTEs to MH State Hospitals
DSHS--shift funding from Health Care Facility Strategy
DSHS--shift funding from Parkland Senior Care
DSHS--increase for FQHC
FPS--APS Reform Plan
FPS--back out unavailable CCDF from CPS Reform
FPS--back-out Crime Victim Fund
HHSC - Deferral of Medicaid August 2007 Payment to HMOs
HHSC - Deferral of CHIP August 2007 Payment to HMOs
DADS--Title XX for Guardianship
DARS--increase in GR-D for BET
DARS--Increase in IAC and FF for transition services
DFPS--One Month Deferral for Foster Care
DADS--Deferral for Com. MR and Reduction for Cash Accounting
FTE Changes:
Increase the FTE cap for DADS, DFPS, DSHS, and HHSC.
Align funding decisions among agency strategies and adjust FTE
levels and make technical adjustments to measure targets,
capital budgets, and riders to reflect funding decisions. Also
align funding among agencies for decisions that impact more than
one agency.
Items for Future Consideration:
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House Committee on Appropriations
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HHSC - Restore Optional Medicaid Services
HHSC - Maintain Technology Critical for Agency Functions
HHSC - Maintain Program Admin and Support
HHSC - Reduce Waiting/Interest Lists
HHSC - Office of Inspector General Staff Increases
DADS - LTC Acuity Cost Increase
DADS - LTC - Rate Restoration to FY03
DADS - LTC - Rebase and Rate Increase
DADS - LTC- TILES to RUGS
HHSC - Medically Needy
HHSC - Medicaid & CHIP Provider Rate Restorations
HHSC - Fund Urban-Non Public Upper Payment Limit (UPL) Program
HHSC - Graduate Medical Education (GME)
HHSC - Provide Funding Hospital Financing
HHSC - Provide Medicaid & CHIP Rate Increases
HHSC - Revise TEFRA Rider
HHSC - State Facilities HR Staff
DSHS - Parkland Senior Care Project
DARS- Expand Independent Living Centers
FPS - Critical Accountability & Oversight
Motions, Riders and Rider Revisions for DARS:
Technical
28. GR-Dedicated Account No. 492 Business Enterprises of Texas
4. Reimbursement of Advisory Council Members.
New or Modified Riders
2. Capital Budget
9. Amend Reporting on Early Childhood Intervention Rider
30. GR-Dedicated Account No. 107 Comprehensive Rehabilitation
Fund
31. Contingency for House Bill 2
Motions, Riders and Rider Revisions for DADS:
Technical
Adjust Informational Item
8. Accounting of Support Costs
36. Revolving Fund Services: Canteen Services and Sheltered
Workshops
46. Contingency Appropriation out of the Quality Assurance
Account
44. Reimbursement of Advisory Council Members
New or Modified Riders
5. Nursing Home Program Provisions
7. Appropriations Limited to Revenue Collections
17. Survey of Nursing Facility Residents
Delete 22. Community Care Waiver Slots
32. Disposition of Construction Appropriation Related to Mental
Retardation
Delete 43. Area Agencies on Aging
Retain Struck Rider 72. Pilot Project for Persons with
developmental Disabilities
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House Committee on Appropriations
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New Rider - Dual Diagnosis Pilot
New Rider - Additional Program of All-Inclusive Care for the
Elderly (PACE) Sites
New Rider - Contingency Appropriation for Senate Bill 6 -
Transfer of Guardianship Contracts
New Rider - Cost Comparison Report
New Rider - HCSSA Monitoring and Oversight Study
New Rider - Use of State Schools
New Rider - Study of the Utilization Review and Level of Need
Determination Processes for Home and
Community-based Services, Texas Home Living Waiver Programs, and
Intermediate Care
Facilities/Mental Retardation Program.
New Rider - Study of Community Care Services Eligibility
Determination and Hours Allocation.
Motions, Riders and Rider Revisions for DSHS:
Technical
Fully appropriate interest earnings in permanent tobacco
endowments to conform to Biennial
Revenue Estimate.
Adjust FTES to conform to State Hospital restoration.
Adjust Bond Debt Service due to refunding of revenue bonds.
16. Transfers of Appropriations - State Owned Hospitals
18. Community Hospital Funding for Galveston Community Hospital
25. New Generation Medications
Delete 27. Expenditures on Bond Homes
30. Use of Timber Receipts for Capital Projects
45. Reimbursement of Advisory Council Members
47. Unexpended Balances - Preparedness and Prevention and
Consumer Protection Services
69. Estimated Appropriation and Unexpended Balance
79. Nuisance Surveys for the Economically Disadvantaged
Communities Program
80. Medically Fragile Children
New or Modified Riders
2. Capital Budget
Delete 4. Priority Populations Defined
Delete 5. Youth at Risk of Selling Controlled Substances
Delete 6. Coordination of Support Services
10. Limitation of Specific Strategy Transfers
36. Medical Treatment
44. Reimbursement of Advisory Committee Members
59. Rabies Control
62. Use of Community Primary Care Services, FQHC, and Special
Health Initiatives Funds
65. Emergency Care Attendant (ECA) Training
Delete 76. Small Urban Hospitals
82. Renovations at the Texas Center for Infectious Disease
142. Estimated Appropriation: Perpetual Care Account
New Rider - Contingent Appropriation of Additional Fee Revenue
New Rider - Exemption from Article IX, Section 11.04, Efficient
Use of State Owned and Leased Space
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House Committee on Appropriations
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New Rider - Federal Funds and Capital Budget Expenditures
New Rider - Contingent Appropriation and Authority to Expend
Funds for Texas Cancer Registry
Motions, Riders and Rider Revisions for DFPS:
Technical
23. Reimbursement of Advisory Council Members
New or Modified Riders
Delete 8. Fund Transfers for Funds Consolidation
13. Appropriation Transfer Between Fiscal Years
16. Use of Personal Cellular Telephones
New Rider - Reporting Requirement on Minority Child Removals
New Rider - Prevention and Early Intervention Program Grants
New Rider - Funding for At-Risk Prevention Services
Motions, Riders and Rider Revisions for HHSC:
Technical
Make Method of Finance substitution of tobacco for General
Revenue Match for Medicaid in order to fully reflect available
Tobacco funds in accordance with the Biennial Revenue Estimate.
Replace General Revenue Match for Medicaid with GR Dedicated
Permanent Fund Tobacco
Education and Enforcement to align with Biennial Revenue
Estimate.
4. Reimbursement of Advisory Committee Members.
47. Reimbursement of Advisory Council Members.
New or Modified Riders
16. Risk Stabilization Reserve
Delete 24. Medicaid Reimbursement Rates for Texas State Veterans
Homes
Delete 30. Evaluation of Mental Retardation Services
57. Collection of Rebates on Physician Administered Drugs
58. Medicaid Quality Initiative Pilot Project
New Rider - Medicaid Provider Reimbursement
New Rider - Review Process for Injectable Drugs
New Rider - Medicaid Reimbursement for Immunizations
28. Medicaid Support and Information Services
New Rider - Unexpended Balance Authority for Eligibility
Determination Services
Motions, Riders and Rider Revisions for Special Provisions:
Technical
26. Texas Capital Trust Account No. 543
37. Collection of Fees from the Copyright of Training Materials
and Patent of Technologies
39. Maximum Security Salaries
49. Efficiencies at Local Mental Health and Mental Retardation
Authorities
New or Modified Riders
11. Medicaid Managed Care Contracts
13. Limitation on Transfer Authority
17. Limitation on Use of Tobacco Funds
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House Committee on Appropriations
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20. Rate Analysis and Reporting Requirements
29. Funding Equity Among Local Mental Health and Mental
Retardation Authorities
Delete 30. Report on Local Authorities
44. Professional Trainees and Interns
45. Limit on Spending New Generation Medication Funds
New Rider - Limitation on Appropriations for Long-term Care
Waiver Slots.
Substitute New Rider 50. Appropriation Reduction for Care
Management of the Medicaid
Aged/Blind/Disabled Population
Various: Motion and Riders
Motion and Riders to implement: deferral of one month for Foster
Care, shift to cash-basis accounting for nursing home and other
Medicaid strategies at DADS, deferral of one month for MR
Community, deferral of one month for Medicaid HMOs, and deferral
of one month for CHIP HMOs.
Riders for the Items for Future Consideration for HHSC:
New or Modified Riders
19. Payments to Rural Hospitals Under Managed Care.
New Rider - State Facilities Human Resources Staff
New Rider - Direct Care Staff and Assisted Living Facilities
Riders for the Items for Future Consideration for Special
Provisions:
50. Appropriation Reduction for STAR+PLUS Expansion.
Without objection, the motion was adopted.
Testimony was taken. (See attached witness list.)
(Representative Luna in chair.)
(Representative Pitts in chair.)
At 2:47 p.m., on the motion of the chair and without objection,
the meeting was adjourned until 7:00 a.m., March 16, 2005.
________________________
Rep. Pitts, Chair
________________________
Cristina Self, Clerk
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House Committee on Appropriations
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