HBA-EVB S.B. 371 76(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 371 By: Brown Corrections 4/23/1999 Engrossed BACKGROUND AND PURPOSE The legislature created the Correctional Managed Health Care Advisory Committee (committee) in 1993 to oversee contracts on behalf of the Texas Department of Criminal Justice (department) for prison health care services. The committee contracts with the University of Texas Medical Branch at Galveston and Texas Tech University Health Sciences Center to provide health care to the department's inmates. The committee is subject to the Texas Sunset Act and will be abolished on September 1, 1999, unless continued by the legislature. S.B. 371 continues the Correctional Managed Health Care Advisory Committee for a six-year period and makes statutory modifications recommended by the Sunset Advisory Commission. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 501, Government Code, by adding Subchapter E, as follows: SUBCHAPTER E. MANAGED HEALTH CARE Sec. 501.131. DEFINITION. Defines "committee." Sec. 501.132. APPLICATION OF SUNSET ACT. Provides that the Correctional Managed Health Care Committee (committee) is subject to Chapter 325 (Texas Sunset Act), Government Code. Provides that unless continued in existence as provided by that chapter, the committee is abolished and this subchapter expires September 1, 2005. Sec. 501.133. COMMITTEE MEMBERSHIP. Sets forth the composition of the ninemember committee. Requires an appointment to the committee to be made without regard to the race, color, disability, sex, religion, age, or national origin of the appointee. Sec. 501.134. PUBLIC MEMBER ELIGIBILITY. Prohibits a person from being a public member of the committee if the person or the person's spouse is employed by or participates in the management of a business entity or other organization regulated by or receiving money from the Texas Department of Criminal Justice (department) or the committee; owns or controls, directly or indirectly, more than a 10 percent interest in a business entity or other organization regulated by or receiving money from the department or the committee; or uses or receives a substantial amount of tangible goods, services, or money from the department or the committee other than compensation or reimbursement authorized by law for committee membership, attendance, or expenses. Sec. 501.135. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. Defines "Texas trade association." Prohibits a person from being a member of the committee and from being a committee employee employed in a "bona fide executive, administrative, or professional capacity," as that phrase is used for specified purposes if the person is an officer, employee, or paid consultant of a Texas trade association in the field of health care or health care services or the person's spouse is an officer, manager, or paid consultant of a Texas trade association in the field of health care or health care services. Prohibits a person from being a member of the committee or acting as the general counsel to the committee if the person is required to register as a lobbyist under Chapter 305 (Registration of Lobbyists) because of the person's activities for compensation on behalf of a profession related to the operation of the committee. Sec. 501.136. TERMS OF OFFICE. Provides that committee members appointed by the governor serve staggered six-year terms, with the term of one of those members expiring on February 1 of each odd-numbered year. Provides that other committee members serve at the will of the appointing official or until termination of the member's employment with the entity the member represents. Sec. 501.137. PRESIDING OFFICER. Requires the governor to designate a physician member of the committee as presiding officer. Provides that the presiding officer serves in that capacity at the will of the governor. Sec. 501.138. GROUNDS FOR REMOVAL. Provides that any of the enumerated provisions is grounds for removal from the committee. Provides that the validity of an action of the committee is not affected by the fact that it is taken when a ground for removal of a committee member exists. Requires the administrator to notify the presiding officer of the committee of the potential ground if the managed health care administrator has knowledge that a potential ground for removal exists. Requires the presiding officer to then notify the governor and the attorney general that a potential ground for removal exists. Requires that if the potential ground for removal involves the presiding officer, the managed health care administrator shall notify the next highest ranking officer of the committee, who is then required to notify the governor and the attorney general that a potential ground for removal exists. Sec. 501.139. MEETINGS. Requires the committee to meet at least once in each quarter of the calendar year and at any other time at the call of the presiding officer. Authorizes the committee to hold a meeting by telephone conference call or other video or broadcast technology. Sec. 501.140. TRAINING. Prohibits a person who is appointed to and qualifies for office as a member of the committee from voting, deliberating, or being counted as a member in attendance at a meeting of the committee until the person completes a training program that complies with this section. Provides that the training program must provide the person with certain information regarding the stipulations and functions relating to the committee. Provides that a person appointed to the committee is entitled to reimbursement, as provided by the General Appropriations Act, for the travel expenses incurred in attending the training program regardless of whether the attendance at the program occurs before or after the person qualifies for office. Sec. 501.141. COMPENSATION; REIMBURSEMENT. Provides that a committee member serves without compensation but is entitled to reimbursement for actual and necessary expenses incurred in the performance of the duties of the committee. Sec. 501.142. ADMINISTRATION; PERSONNEL. Authorizes the committee to hire a managed health care administrator, who is authorized to employ personnel necessary for the administration of the committee's duties. Requires the committee to pay necessary costs for its operation, including costs of hiring the managed health care administrator and other personnel, from funds appropriated by the legislature to the department for correctional health care. Sec. 501.143. DIVISION OF RESPONSIBILITIES. Requires the committee to develop and implement policies that clearly separate the policy-making responsibilities of the committee and the management responsibilities of the managed health care administrator and staff of the committee. Sec. 501.144. QUALIFICATIONS AND STANDARDS OF CONDUCT INFORMATION. Requires the managed health care administrator or the administrator's designee to provide to members of the committee and to committee employees, as often as necessary, information regarding the requirements for office or employment under this subchapter, including information regarding a person's responsibilities under applicable laws relating to standards of conduct for state officers or employees. Sec. 501.145. EQUAL EMPLOYMENT OPPORTUNITY POLICY. Requires the managed health care administrator or the administrator's designee to prepare and maintain a written policy statement that implements a program of equal employment opportunity to ensure that all personnel decisions are made without regard to race, color, disability, sex, religion, age, or national origin. Provides that the policy statement must include specified provisions relating to personnel policies and an analysis of the extent of compliance with state and federal laws. Provides that the policy statement must follow certain conditions. Sec. 501.146. MANAGED HEALTH CARE PLAN. (a) Requires the committee to develop a managed health care plan for all persons confined by the department that includes certain conditions concerning criteria and studies for specified health care providers. (b) Authorizes the University of Texas Medical Branch at Galveston and the Texas Tech University Health Sciences Center, to implement the managed health care plan for employees who are entitled to retain salary and benefits applicable to specified employees, to administer, offer, and report through their payroll systems participation by those employees in the Texas employees uniform group insurance benefits program and the Employees Retirement System of Texas. Sec. 501.147. COMMITTEE AUTHORITY TO CONTRACT. Authorizes the committee to enter into a contract on behalf of the department to fully implement the managed health care plan under this subchapter. Authorizes the committee to, in addition to providing services to the department, contract with other governmental entities for similar health care services and integrate those services into the managed health care provider network. Requires the committee, in contracting for implementation of the managed health care plan and to the extent possible, to integrate the managed health care provider network with the public medical schools of this state and the component and affiliated hospitals of those medical schools. Requires the committee to initiate a competitive bidding process for contracts with other providers for medical care to persons confined by the department for services that the public medical schools and their components and affiliates cannot provide. Sec. 501.148. GENERAL POWERS AND DUTIES OF COMMITTEE. Requires the committee to follow procedures relating to the development, performance, and monitoring of services and to enforce contractual compliance with health care providers. _Requires the committee to evaluate and recommend to the board sites for new medical facilities that appropriately support the managed health care provider network. _Requires the committee to contract with an individual for financial consulting services and to make use of financial monitoring of the managed health care plan to assist the committee in determining an accurate capitation rate. _Authorizes the committee to contract with an individual for actuarial consulting services to assist the committee in determining trends in the health of the inmate population and the impact of those trends on future financial needs. Sec. 501.149. QUALITY OF CARE MONITORING BY THE DEPARTMENT AND HEALTH CARE PROVIDERS. Requires the committee to establish a procedure for monitoring the quality of care delivered by the health care providers, including investigating medical grievances, ensuring access to medical care, and conducting periodic operational reviews of medical care provided at its units. Requires the department and the medical care providers to cooperate in monitoring quality of care. Requires the clinical and professional resources of the health care providers to be used to the greatest extent feasible for clinical oversight of quality of care issues. Requires the department and the medical care providers to communicate the results of their monitoring activities to the committee. Sec. 501.150. COMPLAINTS. Requires the committee to maintain a file on each written complaint filed with the committee including specified information. Requires the committee to provide to the person filing the complaint and to each person who is a subject of the complaint a copy of the committee's policies and procedures relating to complaint investigation and resolution. Requires the committee, at least quarterly until final disposition of the complaint, to notify the person filing the complaint and each person who is a subject of the complaint of the status of the investigation unless the notice would jeopardize an undercover investigation. Sec. 501.151. PUBLIC PARTICIPATION. Requires the committee to develop and implement policies that provide the public with a reasonable opportunity to appear before the committee and to speak on any issue under the jurisdiction of the committee. SECTION 2. Repealer: Section 501.059 (Correctional Managed Health Care Advisory Committee), Government Code, which established the Correctional Managed Health Care Advisory Committee to the Texas Department of Criminal Justice. SECTION 3. Provides that the name of the Correctional Managed Health Care Advisory Committee is changed to the Correctional Managed Health Care Committee. Provides that the change in the name of the committee does not affect the validity of any action taken by the committee before, on, or after the effective date of this Act. Provides that a reference in law to the Correctional Managed Health Care Advisory Committee means the Correctional Managed Health Care Committee. SECTION 4. Requires the governor to make initial gubernatorial appointments to the committee to accomplish the membership required by Section 501.133, Government Code, as added by this Act, not later than January 1, 2000, and to designate one member for a term expiring January 31, 2001, one member for a term expiring January 31, 2003, and one member for a term expiring January 31, 2005. SECTION 5. Effective date: September 1, 1999. SECTION 6. Emergency clause.