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Estimated Two-year Net Impact to General Revenue Related Funds for HB 2510, Committee Report 1st House, Substituted: a negative impact of ($8,304,616) through the biennium ending August 31, 2017.
There would be a net revenue loss to the state for two reasons: (1) the programs at DSHS currently raise more revenue than what is required at TDLR and TMB, and (2) there would be a reduction in fee revenue from programs whose oversight is discontinued.
No fiscal implication to units of local government is anticipated.
The legislation would partially implement the Sunset Advisory Commission's recommendations regarding the Department of State Health Services (DSHS). If enacted, HB 2510 would accomplish three tasks: 1) Increase state mental health hospital capacity; 2) Improve delivery of behavioral health services; and 3) Eliminate burdensome regulatory functions. The bill is divided into 12 articles.
Article I - State Mental Health Hospital System
Section (Sec.) 1001.086 would require DSHS to collaborate with the court of criminal appeals in the development and implementation of a training curriculum for judges and attorneys on treatment alternatives to inpatient forensic commitment. The training curriculum would be due no later than March 1, 2016.
Article II - Community Health Programs
Sec. 533.0347 would require the Health and Human Services Commission (HHSC) to review, evaluate, and improve the performance measures and payment mechanisms that are included in DSHS contracts with providers of behavioral health services. The bill would define behavioral health services in this section as mental health services, substance abuse services, or both. The review process would be conducted in three phases. By December 1, 2016, this section would require HHSC to develop and publish a web-based dashboard online that enables the public to make comparisons between behavioral health services providers. Section 533.0347 would expire on September 1, 2017.
Sec. 533.0515 would require HHSC, with input from the local mental health authorities (LMHAs) and local behavioral health authorities (LBHAs), to divide the state into regions for purposes of allocating mental health beds in state hospitals. This section would require LMHAs and LBHAs to submit a methodology for allocating state hospital beds to each region approved allocation. HHSC would be required to collect a quarterly fee, which will be distributed to LMHAs and LBHAs in regions that underuse state hospital beds in that quarter.
Sec. 533.088 would authorize the executive commissioner of HHSC to adopt rules establishing new types of community-based crisis and treatment facilities for persons with mental health disorders, substance abuse disorders, or simultaneous mental health and substance abuse disorders. A new type of facility established by rule under this section would have to provide mental health or substance abuse services to patients in a residential setting.
Sec. 533.089 would require DSHS to review its rules and
contracts governing crisis and treatment facilities and remove any unnecessary
barriers to improve delivery of care. The section would expire September 1, 2017.
Sec. 1001.0731 would permit DSHS to contract only with LMHAs and LBHAs to administer outreach, screening, assessment, and referral functions relating to the provision of substance abuse services.
Sec. 1001.0732 would require DSHS to verify each LMHA and LBHA operates a single hotline for persons seeking to acquire information regarding mental health services and substance abuse services.
Article III - Emergency Medical Services Regulation
The bill would amend chapter 773 of the Health and Safety Code to authorize DSHS to develop and administer a jurisprudence examination at least twice a year in order to determine the knowledge than an emergency medical services (EMS) provider license applicant has of chapter 773, DSHS rule, and any other applicable laws affecting the applicant's activities. The bill would require an EMS provider to have a permanent physical location serving as the provider's primary place of business. Only one EMS provider would be allowed to operate out of a single physical location. An EMS provider would be required to own or hold a long-term lease for all equipment DSHS deems as necessary to provide EMS services. DSHS would be required to track and maintain records of complaints and investigations regarding EMS providers and EMS personnel. DSHS
would be required to publish an annual report on the DSHS website that contains
statistical information regarding each complaint received, and each investigation
or disciplinary action initiated.
Article IV - Public Health System
Sec. 117.101 (a) would require the Public Health Funding and
Policy Committee to submit recommendations to DSHS on a biennial basis rather
than an annual basis, as currently required by law.
Sec. 1001.0785 would require DSHS to develop and
periodically update a comprehensive inventory of the roles and
responsibilities, relating to public health services of the DSHS central
office, each designated health region, and each local health department,
district, and authority in Texas. The section would require DSHS to create and
update a clear matrix of duties specific to each health region. DSHS would be
required to biennially present the inventory and matrix at a Public Health
Funding and Policy Committee meeting and State Health Services Council meeting.
Sec. 1001.0786 would require DSHS, in consultation with the Public Health Funding and Policy Committee, to create a public health action plan with regional strategies and milestones to achieve the goals of developing and improving the public health services delivery system. The action plan would need to be presented on a biennial basis.
Sec. 191.0031 would prohibit a state registrar or a local
registrar from issuing a certified copy of a vital statistic record unless a
person requesting the information provides notarized proof of identity.
Sec. 191.022 (g) would require each local registrar to
submit an annual self-assessment report to the state registrar. DSHS would
prescribe the information that must be included in the report to allow a
thorough desk audit of a local registrar.
Sec. 191.071 – In order to access vital records maintained by DSHS, a person would be required to undergo a fingerprint-based criminal background check, utilizing state and federal databases. DSHS would be allowed to adopt a policy waiving the background check requirement if a person submitted a background check as a condition of licensure by a state agency.
Sec. 108.009 would require the executive commissioner of
HHSC to adopt rules to establish a process by which DSHS may grant a waiver to
exempt a facility from the data submission requirements if the facility
conducts no more than 600 procedures a year and does not have information
systems capable of automated reporting of claims.
Sec. 108.0145 would exempt providers from being civilly or criminally liable for the use of data as required by Sec. 108.009.
The bill would abolish the following advisory committees, panels, and boards: Worksite Wellness Advisory Board; Sickle Cell Advisory Committee; Arthritis Advisory Committee; Advisory Panel on Health Care-Associated Infections and Preventable Adverse Events; Youth Camp Training Advisory Committee; and the Texas Medical Child Abuse Resources and Education System (MEDCARES) Advisory Committee. The bill would transfer rulemaking authority to the executive commissioner and transfer responsibilities of the abolished advisory committees, panels, and boards to DSHS.
Article VIII - Regulatory Programs Transferred to the Texas Department of Licensing and Regulation - Part I. Transfers during the biennium ending August 31, 2017
The bill would transfer the following occupational licensing programs to the Texas Department of Licensing and Regulation (TDLR): athletic trainers, dieticians, fitters and dispensers of hearing instruments, midwives, orthotists and prosthetists, and speech-language pathologists and audiologists.
Part II. Transfers during the biennium ending August 31, 2019.
The bill would transfer the following occupational licensing programs to the TDLR: code enforcement officers, laser hair removal, massage therapists, mold assessors and remediators, offender education providers, and sanitatians.
Article IX - Regulatory Programs Transferred to the Texas Medical Board
The bill would transfer the following occupational licensing programs to the Texas Medical Board: respiratory care practitioners, medical radiologic technologists, medical physicists, and perfusionists.
Article X - Deregulation of Certain Activities and Occupations
The bill would discontinue the following regulatory programs: bottled and vended water, certified food handler certification providers, contact lens dispensers, dyslexia therapists and practitioners, opticians, personal emergency response systems, bedding, indoor air quality in state buildings, rendering, and tanning bed facilities. The bill would remove DSHS' licensing and permit regulations that are currently required to execute the aforementioned activities and occupations.
Article XI - Continuation of DSHS
The bill would continue DSHS until September 1, 2027, unless other legislation enacted by the 84th Legislature providing for the transfer of DSHS functions to HHSC becomes law.
Article XII - General Provisions and Effective Date
This Act would take effect on September 1, 2015. Part II of Article VIII of this Act would take effect September 1, 2017.
The purpose of the legislation is to implement Sunset provisions to reform
the Department of State Health Services (DSHS). The bill would help improve the
state’s ability to assess whether DSHS contracts with behavioral health
providers are an efficient way to increase capacity in state mental health
hospitals. Encouraging DSHS and the Health and Human Services Commission (HHSC)
to establish new types of community-based behavioral health services will help
reduce the inevitable and inappropriate treatment in mental health hospitals,
jails, and emergency rooms. Discontinuing 10 programs from DSHS regulatory
oversight will alleviate the unnecessarily burdensome regulatory functions that
inhibit the state’s ability to protect the public health.
We support HB 2510 because it promotes government efficiency and limited