By: Nelson S.B. No. 571

A BILL TO BE ENTITLED

AN ACT

relating to efficiencies and cost-savings in the health and human services agencies and other related regulatory agencies.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Notwithstanding any statute to the contrary, the legislature, in its discretion, may determine the amount of each appropriation of state funds. The amounts required by statute for entities that receive state funds under the General Appropriations Act, 82nd Legislature, Regular Session, 2011, may be reduced or eliminated in order to achieve a balanced budget.

SECTION 2. All health and human services agencies shall identify efficiencies and reduce expenditures by:

(1) Eliminating or modifying programs not funded or funded at a reduced level through Article II of the General Appropriations Act;

(2) Reviewing, updating, and modifying rules to streamline functions while preserving care for consumers;

(3) Consolidating administrative and service functions where applicable;

(4) Evaluating the sufficiency of existing fees to cover costs associated with administering all applicable programs;

(5) Maximizing co-sharing, including co-payments, in all programs;

(6) Expanding billing coordination to all programs;

(7) Renegotiating more efficient contracts;

(8) Evaluating regulatory requirements as they relate to available resources;

(9) Requesting any waiver or authorization from a federal agency determined to be necessary for implementation of any initiative aimed at improving efficiency and reducing expenditures;

(10) Increasing access to preventive primary care;

(11) Evaluating the state medical assistance and children and child health plan programs; and

(12) Implementing additional initiatives identified by the health and human services agencies.

SECTION 3. The Health and Human Services Commission shall identify efficiencies and reduce expenditures by:

(1) Streamlining eligibility determination processes;

(2) Evaluating the elimination of Temporary Assistance for Needy Families exemptions not required by federal law; and

(3) Implementing additional initiatives identified by the Health and Human Services Commission.

SECTION 4. The Department of Aging and Disability Services shall identify efficiencies and reduce expenditures by:

(1) Evaluating the current forensic commitment process to ensure that alleged offenders with an intellectual disability are being served in the most appropriate and cost-effective setting;

(2) Ensuring that clients are being served in the most cost-effective Section 1915(c) waiver program appropriate for their needs;

(3) Streamlining the administration and delivery of services through Section 1915(c) waiver programs;

(4) Performing utilization management and review activities for all community entitlement and Section 1915(c) waiver programs;

(5) Increasing community based long term care service delivery options while containing costs;

(6) Requiring clients of Section 1915(c) waiver programs to access attendant services through community based entitlement programs wherever possible; and

(7) Implementing additional initiatives identified by the Department of Aging and Disability Services.

SECTION 5. The Department of Family and Protective Services shall identify efficiencies and reduce expenditures by:

(1) Maximizing use of programs at the Department of State Health Services to provide mental health and substance abuse services that are purchased through the child protective services program and adult protective services program;

(2) Creating efficiencies in child care regulation;

(3) Redesigning the foster care system with the goal of improving outcomes for children and families; and

(4) Implementing additional initiatives identified by the Department of Family and Protective Services.

SECTION 6. The Department of State Health Services shall identify efficiencies and reduce expenditures by:

(1) Evaluating the current forensic commitment process to ensure that alleged offenders with a mental illness are being served in the most appropriate and cost-effective setting;

(2) Partnering with local health departments to streamline public health efforts;

(3) Privatizing a state hospital;

(4) Utilizing residential units in state hospitals to provide cost-effective care and to maintain bed capacity;

(5) Requiring hospitals, which accept the state medical assistance program, to charge state mental health hospitals no more than the state medical assistance program fee for service rate;

(6) Expanding cost-effective models of care for mental illness;

(7) Optimizing federal matching funds for all state and local funding streams, including Trauma Funds;

(8) Managing expenditures for drugs provided through the state mental health hospitals and community care settings; and

(9) Implementing additional initiatives identified by the Department of State Health Services.

SECTION 7. The Department of Assistive and Rehabilitative Services shall identify efficiencies and reduce expenditures by:

(1) Evaluating the feasibility and cost-effectiveness of providing services to clients in the early childhood intervention program through the state medical assistance and child health plan programs; and

(2) Implementing additional initiatives identified by the Department of Assistive and Rehabilitative Services.

SECTION 8. 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, 2011.