By: Kolkhorst  S.B. No. 1101
         (In the Senate - Filed February 25, 2019; March 7, 2019,
  read first time and referred to Committee on Health & Human
  Services; April 11, 2019, reported adversely, with favorable
  Committee Substitute by the following vote:  Yeas 9, Nays 0;
  April 11, 2019, sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 1101 By:  Kolkhorst
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the consolidation of ombudsman programs administered by
  the Health and Human Services Commission.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading to Subchapter Y, Chapter 531,
  Government Code, is amended to read as follows:
  SUBCHAPTER Y. HEALTH AND HUMAN SERVICES OMBUDSMAN PROGRAMS [FOR
  THE DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES]
         SECTION 2.  Section 531.991, Government Code, is amended to
  read as follows:
         Sec. 531.991.  DEFINITIONS. In this subchapter:
               (1)  "Complaint" means any expression of
  dissatisfaction by a consumer about a program or service of the
  health and human services system or of the department.
               (2)  "Consumer" means:
                     (A)  an applicant or client of a program of the
  health and human services system;
                     (B)  the applicant's or client's legally
  authorized representative;
                     (C)  a member of the public seeking information
  about a program of the health and human services system; or
                     (D)  a child or youth in the conservatorship of
  the department. 
               (3)  "Department" means the Department of Family and
  Protective Services.
               (4) [(2)]  "Ombudsman" means the individual appointed
  as the ombudsman for an ombudsman program [the Department of Family
  and Protective Services].
               (5)  "Ombudsman program" means an ombudsman program
  administered by the commission under this subchapter. 
               (6)  "Retaliation" means a harmful action taken because
  of, or substantially motivated by, reprisal or revenge in response
  to a legally protected activity, including making a good faith
  complaint.
               (7)  "Substantiated complaint" means a complaint for
  which research clearly indicates:
                     (A)  the policy of a program of the health and
  human services system or the department was violated; or
                     (B)  the health and human services system's
  expectations were not met.
         SECTION 3.  Subchapter Y, Chapter 531, Government Code, is
  amended by adding Section 531.9912 to read as follows:
         Sec. 531.9912.  ESTABLISHMENT OF OMBUDSMAN PROGRAMS. The
  executive commissioner shall establish the following ombudsman
  programs:
               (1)  the health and human services office of the
  ombudsman in accordance with Section 531.9915;
               (2)  the ombudsman for children and youth in foster
  care in accordance with Section 531.9931; 
               (3)  the ombudsman for managed care in accordance with
  Section 531.9932;
               (4)  the ombudsman for behavioral health access to care
  in accordance with Section 531.9933; and
               (5)  the ombudsman for individuals with intellectual or
  developmental disabilities in accordance with Section 531.9934.
         SECTION 4.  Section 531.0171, Government Code, is
  transferred to Subchapter Y, Chapter 531, Government Code,
  redesignated as Section 531.9915, Government Code, and amended to
  read as follows:
         Sec. 531.9915 [531.0171].  OFFICE OF OMBUDSMAN. (a)  The
  executive commissioner shall establish the commission's office of
  the ombudsman with authority and responsibility over the health and
  human services system in performing the following functions:
               (1)  providing consumer dispute resolution services
  for the health and human services system;
               (2)  performing consumer protection and advocacy
  functions related to health and human services, including assisting
  a consumer [or other interested person] with:
                     (A)  raising a matter within the health and human
  services system that the consumer [person] feels is being ignored;
  and
                     (B)  obtaining information regarding a filed
  complaint; and
               (3)  collecting consumer inquiry and complaint data
  related to the health and human services system.
         (b)  The office of the ombudsman does not have the authority
  to process case actions or overturn a decision by the department or
  a program of the health and human services system [provide a
  separate process for resolving complaints or appeals].
         (c)  The executive commissioner shall develop a standard
  process for tracking and reporting received inquiries and
  complaints within the health and human services system.  The
  process must provide for the centralized tracking of inquiries and
  complaints submitted to field, regional, or other local health and
  human services system offices, including vendors contracted to
  provide services on behalf of a program of the health and human
  services system.
         (d)  Using the process developed under Subsection (c), the
  office of the ombudsman shall collect inquiry and complaint data
  from all offices, agencies, divisions, and other entities within
  the health and human services system, including vendors contracted
  to provide services on behalf of a program of the health and human
  services system.  To assist with the collection of data under this
  subsection, the office may access any system or process for
  recording inquiries and complaints used or maintained within the
  health and human services system.
         (e)  The office of the ombudsman must be sufficiently
  independent from programs of the health and human services system
  to perform the ombudsman's duties outlined in this subchapter.
         SECTION 5.  Sections 531.992 and 531.993, Government Code,
  are amended to read as follows:
         Sec. 531.992.  APPOINTMENT OF OMBUDSMAN [FOR THE DEPARTMENT
  OF FAMILY AND PROTECTIVE SERVICES].  (a)  The executive
  commissioner [governor] shall appoint an ombudsman for each
  ombudsman program [the Department of Family and Protective
  Services] to serve at the will of the executive commissioner
  [governor].
         (b)  The ombudsman programs are managed as part of [is
  administratively attached to] the office of the ombudsman for the
  commission.
         (c)  Subject to the appropriation of money for those purposes
  [that purpose], each [the] ombudsman may employ staff to assist the
  ombudsman in performing the ombudsman's duties under this
  subchapter.
         [(d)     The ombudsman may not use the name or any logo of the
  department on any forms or other materials produced and distributed
  by the ombudsman.]
         Sec. 531.993.  DUTIES OF OMBUDSMAN. (a)  An [The] ombudsman
  serves as a neutral party in assisting:
               (1)  children and youth in the conservatorship of the
  department with complaints regarding issues within the authority of
  the commission, the department, or a [another] health and human
  services agency; and
               (2)  consumers [persons] with a complaint against the
  commission or a health and human services agency [department]
  regarding case-specific activities of the programs of the
  commission or agency [department, including adult protective
  services, child protective services, child-care licensing, and
  statewide intake].
         (b)  An [The] ombudsman shall, as applicable:
               (1)  develop and implement statewide procedures to:
                     (A)  receive complaints from:
                           (i)  children and youth in the
  conservatorship of the department; and
                           (ii)  consumers [other persons] with a
  complaint against the commission or a health and human services
  agency [department];
                     (B)  review complaints filed with the ombudsman
  and take appropriate action, including:
                           (i)  conducting an investigation into
  individual complaints that allege violations of commission,
  department, or agency procedure or policy or other violations; and
                           (ii)  referring to commission, department,
  or agency management for resolution any trends or systemic issues
  identified in complaints;
                     (C)  provide any necessary assistance to:
                           (i)  children and youth in the
  conservatorship of the department in making complaints and
  reporting allegations of abuse or neglect to the department; and
                           (ii)  any consumer in making complaints to
  the commission or a health and human services agency;
                     (D)  maintain the confidentiality of:
                           (i)  the ombudsman's communications and
  records;
                           (ii)  records of another person that have
  been provided to the ombudsman; and
                           (iii)  communications of another person with
  the ombudsman; and
                     (E)  ensure that the commission, the department, a
  health and human services agency, and any consumer who files a
  complaint with the commission, including [person or] a child or
  youth in the conservatorship of the department who files a
  complaint with the ombudsman, are informed of the results of the
  ombudsman's investigation of the complaint, including whether the
  ombudsman was able to substantiate the [person's, child's, or
  youth's] complaint;
               (2)  collaborate with the commission, the department,
  or a health and human services agency, as applicable, to develop and
  implement an annual outreach plan to promote awareness of the
  ombudsman among the public, children and youth in the
  conservatorship of the department, [family members and caretakers
  of those children,] and facilities licensed by the commission
  [department] and that includes:
                     (A)  how the office may be contacted;
                     (B)  the purpose of the office; and
                     (C)  the services the office provides;
               (3)  notify in writing [issue and file with] the
  commission, the department, and a [any applicable] health and human
  services agency, as applicable, of [a report that contains] the
  ombudsman's final determination regarding a complaint and any
  recommended corrective actions to be taken as a result of the
  complaint;
               (4)  establish a secure form of communication with any
  individual who files a complaint with the ombudsman;
               (5)  collaborate with the commission, the department,
  and a health and human services agency, as applicable, to identify
  consequences for any retaliatory action related to a complaint
  filed with the ombudsman, in accordance with Section 531.997
  [40.0041(g), Human Resources Code]; and
               (6)  monitor and evaluate the commission's, the 
  department's, or a health and human services agency's corrective
  actions taken in response to a recommendation by the ombudsman.
         (c)  An [The] ombudsman's notification [final determination
  in a report] described by Subsection (b)(3) must include a
  determination of whether the complaint is a substantiated complaint
  [there was wrongdoing or negligence by the department or an agent of
  the department or whether the complaint was frivolous and without
  merit].  If the ombudsman determines a complaint is a substantiated
  complaint [there was wrongdoing or negligence], the ombudsman shall
  recommend corrective actions to be taken by the commission, the
  department, or a health and human services agency.
         (d)  The commission, the department, or a health and human
  services agency, as applicable, shall provide written notice to an
  ombudsman on whether the commission, department, or agency adopted
  or rejected the ombudsman's recommended corrective action.  On
  rejection of the recommended corrective action, the commission,
  department, or health and human services agency shall include in
  the notice the reason for the rejection  [The ombudsman may attend
  any judicial proceeding related to a complaint filed with the
  office].
         SECTION 6.  Section 531.9931, Government Code, is amended to
  read as follows:
         Sec. 531.9931.  [DIVISION OF] OMBUDSMAN FOR CHILDREN AND
  YOUTH IN FOSTER CARE.  (a)  The [division of the] ombudsman for
  children and youth in foster care is created within the office of
  the ombudsman for the purpose of:
               (1)  receiving complaints from children and youth in
  the conservatorship of the department as provided under Section
  531.993(a)(1);
               (2)  informing children and youth in the
  conservatorship of the department who file a complaint under this
  subchapter about the result of the ombudsman's investigation of the
  complaint, including whether the ombudsman was able to substantiate
  the child's or youth's complaint; and
               (3)  collaborating with the department to develop an
  outreach plan for children and youth in the conservatorship of the
  department to promote awareness of the ombudsman.
         (b)  If a child or youth in the conservatorship of the
  department contacts an [the] ombudsman by telephone call to report
  a complaint under this subchapter, the call shall be transferred
  directly to a person employed by the [division of the] ombudsman
  created under this section.
         (c)  The ombudsman for children and youth in foster care
  shall promptly refer to the department for the department to
  address in accordance with Section 40.0041, Human Resources Code,
  each complaint received by the ombudsman regarding the department,
  other than those made by a child or youth in the conservatorship of
  the department.
         (d)  Not later than the fifth day of each month, the
  ombudsman for children and youth in foster care shall compile and
  provide to the commission and the department, as applicable, a
  written report regarding the investigations the ombudsman compiled
  during the preceding month.  The report must include:
               (1)  a summary of each complaint investigated;
               (2)  the ombudsman's final determination on the
  complaint; and
               (3)  any corrective action recommended by the
  ombudsman.
         SECTION 7.  Subchapter Y, Chapter 531, Government Code, is
  amended by adding Section 531.99315 to read as follows:
         Sec. 531.99315.  COMPLAINT PROCESS FOR FOSTER CHILDREN AND
  YOUTH SERVED BY SINGLE SOURCE CONTINUUM CONTRACTOR. (a)  In this
  section, "contractor" means a single source continuum contractor in
  this state providing services identified under Subchapter B-1,
  Chapter 264, Family Code.
         (b)  A child or youth in the conservatorship of the
  department and served by a contractor may file a complaint directly
  with the ombudsman for children and youth in foster care and is not
  required to file an initial complaint with the contractor.
         (c)  The ombudsman for children and youth in foster care may
  access the internal records of a contractor that are relevant to a
  complaint filed under this section and not included in the
  department's automated case tracking and information management
  system.
         (d)  The ombudsman for children and youth in foster care
  shall provide written notice of the results of the investigation of
  a complaint filed under this section to:
               (1)  the child or youth who filed the complaint;
               (2)  the child's or youth's contractor; and
               (3)  the department.
         (e)  Each contractor in this state shall provide to the
  ombudsman for children and youth in foster care:
               (1)  the contractor's contact information for the
  ombudsman to receive records and provide notice under this section;
  and
               (2)  updates to the contact information as necessary.
         (f)  A contractor may not directly or indirectly use or cause
  to be used the term "ombudsman" to describe the contractor or the
  contractor's internal complaint process.
         SECTION 8.  Section 531.0213, Government Code, is
  transferred to Subchapter Y, Chapter 531, Government Code,
  redesignated as Section 531.9932, Government Code, and amended to
  read as follows:
         Sec. 531.9932 [531.0213].  OMBUDSMAN FOR MANAGED CARE
  [SUPPORT SERVICES FOR MEDICAID RECIPIENTS]. (a)  The commission
  shall establish an ombudsman for managed care to provide support
  and information services to a consumer [person] enrolled in or
  applying for Medicaid coverage who experiences barriers to
  receiving health care services.
         (b)  The ombudsman for managed care [commission] shall give
  emphasis to assisting a consumer [person] with an urgent or
  immediate medical or support need.
         (b-1)  The commission shall provide support and information
  services required by this section through a network of entities
  coordinated by the [commission's office of the] ombudsman for
  managed care [or other division of the commission designated by the
  executive commissioner] and composed of:
               (1)  the [commission's office of the] ombudsman [or
  other division of the commission designated by the executive
  commissioner to coordinate the network];
               (2)  the office of the state long-term care ombudsman
  required under Subchapter F, Chapter 101A, Human Resources Code;
               (3)  the division within the commission responsible for
  oversight of Medicaid managed care contracts;
               (4)  area agencies on aging;
               (5)  aging and disability resource centers established
  under the Aging and Disability Resource Center initiative funded in
  part by the federal Administration on Aging and the Centers for
  Medicare and Medicaid Services; and
               (6)  any other entity the executive commissioner
  determines appropriate, including nonprofit organizations with
  which the commission contracts under Subsection (c).
         (c)  The ombudsman for managed care [commission] may provide
  support and information services by requesting the commission to
  contract [contracting] with nonprofit organizations that are not
  involved in providing health care, health insurance, or health
  benefits.
         (d)  As a part of the support and information services
  required by this section, the ombudsman for managed care
  [commission] shall:
               (1)  operate a statewide toll-free assistance
  telephone number that includes relay services for consumers
  [persons] with speech or hearing disabilities and assistance for
  consumers [persons] who speak Spanish;
               (2)  intervene promptly with the state Medicaid office,
  managed care organizations and providers, and any other appropriate
  entity on behalf of a consumer [person] who has an urgent need for
  medical services;
               (3)  assist a consumer [person] who is experiencing
  barriers in the Medicaid application and enrollment process and
  refer the consumer [person] for further assistance if appropriate;
               (4)  educate consumers [persons] so that they:
                     (A)  understand the concept of managed care;
                     (B)  understand their rights under Medicaid,
  including grievance and appeal procedures; and
                     (C)  are able to advocate for themselves;
               (5)  collect and maintain statistical information on a
  regional basis regarding cases [calls] received by the ombudsman
  [assistance lines] and publish quarterly reports on the
  commission's Internet website that:
                     (A)  list the number of cases [calls] received by
  region;
                     (B)  identify trends in delivery and access
  problems;
                     (C)  identify recurring barriers in the Medicaid
  system; and
                     (D)  indicate other problems identified with
  Medicaid managed care;
               (6)  assist the state Medicaid office and managed care
  organizations and providers in identifying and correcting
  problems, including site visits to affected regions if necessary;
               (7)  meet the needs of all current and future Medicaid
  managed care recipients, including children receiving dental
  benefits and other recipients receiving benefits, under the:
                     (A)  STAR Medicaid managed care program;
                     (B)  STAR + PLUS Medicaid managed care program,
  including the Texas Dual Eligibles Integrated Care Demonstration
  Project provided under that program;
                     (C)  STAR Kids managed care program established
  under Section 533.00253; and
                     (D)  STAR Health program; and
               (8)  [incorporate support services for children
  enrolled in the child health plan established under Chapter 62,
  Health and Safety Code; and
               [(9)]  ensure that staff providing support and
  information services receives sufficient training, including
  training in the Medicare program for the purpose of assisting
  recipients who are dually eligible for Medicare and Medicaid, and
  has sufficient authority to resolve barriers experienced by
  recipients to health care and long-term services and supports.
         [(e)     The commission's office of the ombudsman, or other
  division of the commission designated by the executive commissioner
  to coordinate the network of entities responsible for providing
  support and information services under this section, must be
  sufficiently independent from other aspects of Medicaid managed
  care to represent the best interests of recipients in problem
  resolution.]
         SECTION 9.  Section 531.02251, Government Code, is
  transferred to Subchapter Y, Chapter 531, Government Code,
  redesignated as Section 531.9933, Government Code, and amended to
  read as follows:
         Sec. 531.9933 [531.02251].  OMBUDSMAN FOR BEHAVIORAL HEALTH
  ACCESS TO CARE. (a)  [In this section, "ombudsman" means the
  individual designated as the ombudsman for behavioral health access
  to care.
         [(b)     The executive commissioner shall designate an
  ombudsman for behavioral health access to care.
         [(c)     The ombudsman is administratively attached to the
  office of the ombudsman for the commission.
         [(d)     The commission may use an alternate title for the
  ombudsman in consumer-facing materials if the commission
  determines that an alternate title would be beneficial to consumer
  understanding or access.
         [(e)]  The ombudsman for behavioral health serves as a
  neutral party to help consumers, including consumers who are
  uninsured or have public or private health benefit coverage, and
  behavioral health care providers navigate and resolve issues
  related to consumer access to behavioral health care, including
  care for mental health conditions and substance use disorders.
         (b) [(f)]  The ombudsman for behavioral health shall:
               (1)  interact with consumers and behavioral health care
  providers with concerns or complaints to help the consumers and
  providers resolve behavioral health care access issues, including:
                     (A)  patients of state hospitals as defined by
  Section 552.0011, Health and Safety Code; and
                     (B)  consumers seeking and receiving services
  through:
                           (i)  a local behavioral health authority, as
  described by Section 533.0356, Health and Safety Code; or
                           (ii)  a local mental health authority, as
  described by Section 533.035, Health and Safety Code;
               (2)  identify, track, and help report potential
  violations of state or federal rules, regulations, or statutes
  concerning the availability of, and terms and conditions of,
  benefits for mental health conditions or substance use disorders,
  including potential violations related to quantitative and
  nonquantitative treatment limitations;
               (3)  report concerns, complaints, and potential
  violations described by Subdivision (2) to the appropriate
  regulatory or oversight agency;
               (4)  receive and report concerns and complaints
  relating to inappropriate care or mental health commitment;
               (5)  provide appropriate information to help consumers
  obtain behavioral health care and understand their rights;
               (6)  develop appropriate points of contact for
  referrals to other state and federal agencies; and
               (7)  provide appropriate information to help consumers
  or providers file appeals or complaints with the appropriate
  entities, including insurers and other state and federal agencies.
         (c) [(g)]  The ombudsman for behavioral health shall
  participate in the mental health condition and substance use
  disorder parity work group established under Section 531.02252 and
  provide summary reports of concerns, complaints, and potential
  violations described by Subsection (b)(2) [(f)(2)] to the work
  group.  This subsection expires September 1, 2021.
         (d) [(h)]  The Texas Department of Insurance shall appoint a
  liaison to the ombudsman for behavioral health to receive reports
  of concerns, complaints, and potential violations described by
  Subsection (b)(2) [(f)(2)] from the ombudsman, consumers, or
  behavioral health care providers.
         SECTION 10.  Subchapter Y, Chapter 531, Government Code, is
  amended by adding Section 531.9934 to read as follows:
         Sec. 531.9934.  OMBUDSMAN FOR INDIVIDUALS WITH INTELLECTUAL
  OR DEVELOPMENTAL DISABILITIES. (a)  In this section, "local
  intellectual and developmental disability authority" has the
  meaning assigned by Section 531.002, Health and Safety Code.
         (b)  The ombudsman for individuals with intellectual or
  developmental disabilities serves as a neutral party to assist
  individuals with intellectual or developmental disabilities and
  the individuals' representatives and providers in navigating and
  resolving issues related to services for those individuals provided
  through:
               (1)  the home and community-based services and Texas
  home living Medicaid waiver programs; and
               (2)  local intellectual and developmental disability
  authorities.
         (c)  The ombudsman for individuals with intellectual or
  developmental disabilities shall:
               (1)  interact with individuals with intellectual or
  developmental disabilities and the individuals' representatives
  and providers with concerns or complaints to assist the
  individuals, representatives, providers, and local intellectual
  and developmental disability authorities in resolving those
  issues;
               (2)  identify, track, and assist with reporting
  potential violations of state or federal rules, regulations, or
  statutes concerning the rights of individuals with intellectual or
  developmental disabilities and services provided through:
                     (A)  the home and community-based services and
  Texas home living Medicaid waiver programs; and
                     (B)  local intellectual and developmental
  disability authorities;
               (3)  provide appropriate information to assist
  individuals with intellectual or developmental disabilities in
  obtaining services and understanding their rights;
               (4)  develop appropriate points of contact for
  referrals to other state and federal agencies; and
               (5)  provide appropriate information to assist
  individuals with intellectual or developmental disabilities and
  the individuals' representatives and providers in filing appeals or
  complaints with the appropriate entities.
         SECTION 11.  Sections 531.994, 531.995, 531.996, 531.997,
  and 531.998, Government Code, are amended to read as follows:
         Sec. 531.994.  INVESTIGATION OF UNREPORTED COMPLAINTS. If,
  during the investigation of a complaint, an [the] ombudsman
  discovers unreported violations of the commission's, the
  department's, or a health and human services agency's rules and
  policies, the ombudsman may [shall] open a new investigation for
  each unreported violation.
         Sec. 531.995.  ACCESS TO INFORMATION. The commission, the
  department, and each health and human services agency shall provide
  an [the] ombudsman access to the commission's, department's, or
  agency's records and personnel that relate to a complaint the
  ombudsman is reviewing or investigating.
         Sec. 531.996.  COMMUNICATION AND CONFIDENTIALITY. (a)  A
  person may communicate with an [the] ombudsman relating to a
  complaint by telephone, by mail, by electronic mail, or by any other
  means the ombudsman determines to be feasible, secure, and
  accessible [to children and youth].
         (b)  A communication with an [the] ombudsman is confidential
  during an investigation or review of a complaint and remains
  confidential after the complaint is resolved.
         (c)  The records of an [the] ombudsman are confidential and
  must be maintained in a manner that preserves the confidentiality
  of the records.
         (d)  The disclosure of confidential information to an [the]
  ombudsman under this section or Section 531.995 does not constitute
  a waiver of confidentiality.  Any information disclosed to the
  ombudsman under this section or Section 531.995 remains
  confidential and privileged following disclosure.
         (e)  An [The] ombudsman is not prohibited from communicating
  with the commission, the department, or a [another] health and
  human services agency regarding confidential information disclosed
  to the ombudsman by the commission, department, or agency.
         (f)  An [The] ombudsman may make reports relating to an
  investigation of a complaint public after the complaint is
  resolved.  A report may not include information that identifies an
  individual consumer [complainant], client, parent, or employee or
  any other person involved in the complaint.
         Sec. 531.997.  RETALIATION PROHIBITED. The commission, the
  department, or a [another] health and human services agency may not
  retaliate against a commission, department, or agency employee, a
  child or youth in the conservatorship of the department, or any
  other consumer [person] who in good faith makes a complaint to an
  [the] ombudsman or against any person who cooperates with the
  ombudsman in an investigation.
         Sec. 531.998.  REPORT. (a)  The health and human services
  office of the ombudsman shall prepare an annual report that
  contains:
               (1)  a description of the [ombudsman's] work of the
  commission's ombudsman programs;
               (2)  any change made by the commission, the department,
  or a [another] health and human services agency in response to a
  substantiated complaint;
               (3)  a description of any trends in the nature of
  complaints received by an [the] ombudsman, any recommendations
  related to addressing those trends, and an evaluation of the
  feasibility of the ombudsman's recommendations;
               (4)  a glossary of terms used in the report;
               (5)  a description of the methods used to promote
  awareness of the ombudsman under Section 531.993(b) and the
  ombudsman's promotion plan for the next year; and
               (6)  any public feedback received by the ombudsman
  relating to the ombudsman's previous annual reports.
         (b)  The report must be submitted to the governor, the
  lieutenant governor, each standing committee of the legislature
  with jurisdiction over matters involving the commission, the
  department, and each health and human services agency, each member
  of the legislature, the executive commissioner, and the
  commissioner of the department not later than December 1 of each
  year.  On receipt of the report, [the department and] the commission
  shall make the report publicly available on [the department's and]
  the commission's Internet website [websites].
         SECTION 12.  Sections 531.9921 and 531.9941, Government
  Code, are repealed.
         SECTION 13.  If before implementing any provision of this
  Act a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 14.  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, 2019.
 
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