By: Rose H.B. No. 3990

A BILL TO BE ENTITLED

AN ACT

relating to the study of the fiscal impact on local governments in Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties of restructuring the NorthSTAR behavioral health system and the effective implementation the Sunset Commission Health and Human Services Commission Issue 9 recommendation.

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

SECTION 1. The Texas Health and Human Services Commission shall contract with a private entity approved by the North Texas Behavioral Health Authority through a majority vote of the authority's board of directors to undertake a comprehensive study of the potential impact on local governments and continuity of services in Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties if the present behavioral health managed care structure, known as the NorthSTAR system, were to be dismantled in accordance with the recommendations in Issue 9 of the Health and Human Services Sunset Commission report.

SECTION 2. The scope of the study shall encompass but not be limited to

a) Defining the initial and expected impact on county and municipal budgets of any system that might replace the present configuration

b) Defining the likelihood of and anticipated impact of recidivism resulting from increased acuity in the indigent population presently served in the current system if care is dis rupted

c) Defining the potential impact on network access

d) Defining the impact on integrated care

e) Defining the overall impact on quality of care outcomes

f) Defining the overall impact on the cost of care

g) Defining the initial and expected impact on local medical and surgical hospitals

SECTION 3. The findings of this study will be reported back to the North Texas Behavioral Health Authority and the Texas Health and Human Services Commission no later than June 30, 2016.

SECTION 4. Collin County may exit NorthSTAR on or by October 1, 2016. The present deadline for any other changes to the NorthSTAR model shall be changed to September 1, 2017. This modification shall be made in order to align the current contract cycle with the State of Texas fiscal year and allow the next Legislature the ability to make an appropriately informed deliberation on the future of public behavioral health care in Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties.

SECTION 5. In the interim period the North Texas Behavioral Health Authority and the Texas Health and Human Services Commission shall solicit local stakeholder and community input, and incorporating the findings of the impact study, shall work with the representatives designated by the affected county governments in the development of a system that incorporates

a) Local control and governance of the system by member counties through their designated voting representatives on the North Texas Behavioral Health Authority

b) True integration and coordination of mental health services, substance use disorder services, crisis services and physical health care

c) Equal care for non-Medicaid and Medicaid behavioral health populations

d) Open access

e) Braided local, state, and federal funding

f) Connectivity and coordination of coverage which preserves the principles of 'no wrong door'

g) Choice of providers

h) Waiver of Institute of Mental Disease (IMD) Exclusion

i) Separation of authority and provider functions

j) Serving all those meeting state criteria for behavioral health services in one system:

i. Income at or below 200% of Federal Poverty Level,

ii. All individuals meeting state behavioral health clinical criteria;

iii. Individuals meeting state Medicaid requirements

k) Comprehensive evaluation and transparent publication of data

l) Status as a public local behavioral health authority entity eligible to put up non-federal dollars to match federal DSRIP funds

m) Provider payment plan and mechanisms to ensure a competitive provider market and an adequate network of providers capable of providing broad access to services;

n) Plan to ensure quality of services provided to clients and

o) Incentives of inclusion of local participation or match requirements

p) Option for Dallas, Ellis, Hunt, Kaufman, Navarro or Rockwall Counties to continue in the plan or choose an alternate model and for counties contiguous to present or future NorthSTAR counties to join the model if the county governments of those contiguous counties should so choose

SECTION 6. This Act takes effect immediately.