BILL ANALYSIS

C.S.S.B. 1449

By: Zaffirini

Human Services

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Observers note that many licensed health care facilities that receive outside accreditation may forgo state inspections as part of the license renewal process if the facilities provide evidence of accreditation, but that this option is not available to chemical dependency facilities.  The observers further note that facilities accredited by organizations such as the Joint Commission or the Commission on Accreditation of Rehabilitation Facilities, whose standards for accreditation are higher than the state's standards, must currently undergo multiple inspections for license renewal.

Interested parties assert that this duplication of effort can result in unnecessary administrative costs and burdens for facilities, as well as unnecessary expenses for the state, and that such costs and burdens could be avoided if outside accreditation were accepted for license renewal. The parties further assert that such a policy would also provide an incentive for licensed facilities to obtain the heightened accreditation, resulting in increased quality and safety for patients.

C.S.S.B. 1449 seeks to address this issue by addressing matters relating to an alternative method of satisfying certain licensing and program participation requirements for chemical dependency treatment facilities.

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.S.B. 1449 amends the Health and Safety Code to require the Department of State Health Services (DSHS) to accept an accreditation review from an accreditation commission for a chemical dependency treatment facility instead of an inspection by DSHS for renewal of a license.  The bill makes such an authorization contingent on the following conditions: the treatment facility is accredited by the Commission on Accreditation of Rehabilitation Facilities, the Joint Commission, or another national accreditation organization recognized by DSHS; the accreditation commission maintains and updates an inspection or review program that, for each treatment facility, meets the department's applicable minimum standards; the accreditation commission conducts a regular on-site inspection or review of the treatment facility according to the accreditation commission's guidelines; and the treatment facility submits to DSHS a copy of its most recent accreditation review from the accreditation commission in addition to the application, fee, and any report or other document required for renewal of a license.

C.S.S.B. 1449 establishes that its provisions do not limit DSHS in performing any duties, investigations, or inspections authorized under provisions of law relating to facilities treating alcoholics and drug-dependent persons, including authority to take appropriate action relating to a treatment facility, such as closing the treatment facility. The bill clarifies that its provisions do not require a treatment facility to obtain accreditation from an accreditation commission. The bill defines "accreditation commission" and "department" and makes conforming and nonsubstantive changes.

EFFECTIVE DATE

September 1, 2011.

COMPARISON OF ORIGINAL AND SUBSTITUTE

C.S.S.B. 1449 differs from the original, in the bill provision defining "accreditation commission," by specifying that the term includes another national accreditation organization recognized by the Department of State Health Services (DSHS), whereas the original contains no such specification. 

C.S.S.B. 1449 differs from the original, in the bill provision requiring DSHS to accept an accreditation review from an accreditation commission for a chemical dependency treatment facility instead of an inspection for renewal of a license, by omitting a specification included in the original specifying that the accreditation review is an annual review. The substitute differs from the original by omitting a requirement included in the original for DSHS to accept an accreditation review from an accreditation commission for a chemical dependency treatment facility in satisfaction of the requirements for DSHS certification for participation in the Medicaid program and the federal Medicare program. 

C.S.S.B. 1449 differs from the original, in the bill provision including a requirement that a treatment facility be accredited by certain accreditation commissions among the conditions under which DSHS is authorized to accept an accreditation review for a chemical dependency treatment facility instead of an inspection for renewal of a license, by omitting the specification that the treatment facility be accredited under behavioral health standards of those accreditation commissions.

C.S.S.B. 1449 differs from the original, in the bill provision establishing the conditions under which DSHS is authorized to accept an accreditation review for a chemical dependency treatment facility instead of an inspection for renewal of a license, by making that authorization contingent on the accreditation commission maintaining and updating an inspection or review program that meets the department's applicable minimum standards and conducting a regular on-site inspection or review of the treatment facility, whereas the original makes the authorization contingent on the accreditation commission maintaining an annual inspection or review and conducting an annual on-site inspection or review. The substitute differs from the original by specifying that the regular on-site inspection or review conducted by the accreditation commission is an inspection or review conducted according to the accreditation commission's guidelines, whereas the original contains no such specification. The substitute differs from the original, in the bill provision establishing the conditions under which DSHS is authorized to accept an accreditation review for a chemical dependency treatment facility instead of an inspection for renewal of a license, by making that authorization contingent on the treatment facility submitting to DSHS a copy of its most recent accreditation review, whereas the original makes the authorization contingent on the treatment facility submitting its annual accreditation review.

C.S.S.B. 1449 omits a provision included in the original including among the conditions under which DSHS is authorized to accept an accreditation review for a chemical dependency treatment facility instead of an inspection for renewal of a license the condition that DSHS has determined whether a federal waiver or authorization is necessary before accepting an accreditation review from an accreditation commission for a treatment facility instead of an inspection for license renewal purposes, as satisfaction of requirements relating to participation in Medicaid and Medicare, and for obtaining any necessary federal waiver or authorization.

C.S.S.B. 1449 differs from the original by establishing that the bill's provisions do not limit DSHS in performing any authorized duties, investigations, or inspections under statutory provisions relating to facilities treating alcoholics and drug-dependent persons, whereas the original establishes that the bill's provisions, except as specifically provided, do not limit DSHS in performing any duties and inspections authorized under those same statutory provisions or under any contract relating to Medicaid or Medicare. The substitute differs from the original in conforming and nonsubstantive ways.