HBA-JRA C.S.H.B. 1748 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 1748 By: Van de Putte Public Health 4/12/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE Currently, the Texas Department of Health (TDH) operates two hospitals that provide tuberculosis services, the Texas Center for Infectious Diseases (TCID) in San Antonio and the South Texas Hospital in Harlingen. Both hospitals are at a risk of losing accreditation due to aging and deteriorating buildings and lack of adequate operating funds. C.S.H.B. 1748 requires the Texas Board of Health (board) to either renovate the existing physical facilities of TCID or construct new facilities for TCID, construct physical facilities for a tuberculosis research laboratory at The University of Texas Health Science Center at San Antonio, and transfers the functions of the mycobacterial-mycology research laboratory from TCID to The University of Texas Health Science Center at San Antonio, and authorizes the board to coordinate statewide medical management of tuberculosis through The University of Texas Health Center at Tyler. Additionally, this bill requires TDH to collaborate with the United States Immigration and Naturalization Service (INS) regarding transportation of communicable disease patients through INS checkpoints. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the board of regents of The University of Texas System in SECTION 3 of this bill. SECTION BY SECTION ANALYSIS SECTION 1. RENOVATION OR CONSTRUCTION OF PHYSICAL FACILITIES OF TEXAS CENTER FOR INFECTIOUS DISEASE. (a) Requires the Texas Board of Health (board) to contract for the renovation of the existing physical facilities of the Texas Center for Infectious Disease (TCID) or construction of new physical facilities for TCID. (b) Provides that, if the board contracts for renovation of the existing facilities, the contract must specify that the renovations include structural and design changes required for reaccreditation during 1999 by the Joint Commission on Accreditation of Health Care Organizations, compliance with Texas accessibility standards and the federal American with Disabilities Act of 1990, and the continued operation of TCID to provide all tuberculosis, communicable infectious disease health care services, as designated by the commissioner of public health (commissioner), and women's health laboratory services that are provided at the center on the effective date of this Act. (c) Requires the board, if the board contracts for construction of new facilities, to ensure that the facilities are constructed to allow for the provision of all tuberculosis, communicable infectious disease health care services, as designated by the commissioner, and women's health laboratory services that are provided at the center on the effective date of this Act, except those services that the board contracts to be provided at another health care facility. Provides that the contract must specify minimally necessary structural and design renovations to the existing physical facilities required for reaccreditation during 1999 by the Joint Commission on Accreditation of Health Care Organizations, compliance with Texas accessibility standards and the federal American with Disabilities Act of 1990, and the continued operation of the existing facilities until construction of new facilities is completed. SECTION 2. TUBERCULOSIS AND COMMUNICABLE INFECTIOUS DISEASE HEALTH CARE SERVICES. Authorizes the board to contract with the board of regents of The University of Texas System (board of regents) or any other public or private health care entity or provider to provide physicians or other health care professionals who will provide tuberculosis and communicable infectious disease health care services, as designated by the commissioner, at TCID or at another health care facility in proximity to the center. SECTION 3. MYCOBACTERIAL-MYCOLOGY RESEARCH LABORATORY. (a) Requires the board of regents to contract for the construction of physical facilities for a mycobacterialmycology research laboratory located at The University of Texas Health Science Center at San Antonio to replace the laboratory located at TCID using funds appropriated to The University of Texas System (UT System) for that purpose. (b) Provides that the physical facilities constructed under Subsection (a) must be adequate for the provision of all mycobacterial-mycology services provided on the effective date of this Act by the mycobacterial-mycology research laboratory located at TCID. (c) Requires the board of regents to manage and operate the mycobacterial-mycology research laboratory at The University of Texas Health Science Center at San Antonio. (d) Requires the board and the board of regents to adopt a joint memorandum of understanding to facilitate and coordinate the transfer of mycobacterial-mycology research laboratory services from TCID to UT System. (e) Requires the board and the board of regents to adopt the memorandum of understanding. (f) Requires the mycobacterial-mycology research laboratory at TCID to close on a date provided by the memorandum of understanding. Transfers all powers, duties, functions, programs, activities, rights, contracts, records, property, and all funds appropriated by the legislature to TDH relating to the management or operation of the mycobacterial-mycology research laboratory at TCID to The University of Texas Health Science Center at San Antonio. Provides that a reference in law to TDH or the board that relates to the management and operation of the mycobacterial-mycology research laboratory means the UT System or The University of Texas Health Science Center at San Antonio, as appropriate. (g) Requires the board of regents, before a transfer occurs, to adopt rules and regulations necessary for the operation, control, and management of the mycobacterial-mycology research laboratory at The University of Texas Health Science Center at San Antonio that will take effect when the transfer occurs. SECTION 4. STATEWIDE COORDINATION OF MEDICAL MANAGEMENT OF TUBERCULOSIS. Authorizes the board to contract with the board of regents for the coordination of medical management of tuberculosis throughout this state by The University of Texas Health Center at Tyler. Authorizes the contract to require that the statewide coordination of medical management of tuberculosis include the provision of a full-time medical director; management of a state tuberculosis education center; and, for all health care facilities operated by TDH that provide tuberculosis health care services, credentialling of medical directors, provision of tuberculosis education, medical consultations, and oversight of and protocols for inpatient tuberculosis management, and determination of appropriate placement of tuberculosis patients. SECTION 5. AGREEMENT FOR TRANSPORTATION OF COMMUNICABLE DISEASE PATIENTS. Requires TDH, in cooperation with the governor, to collaborate with the United States Immigration and Naturalization Service to develop a formal agreement regarding transportation of communicable disease patients through Immigration and Naturalization Service checkpoints to TCID. Requires TDH to report the status of negotiations and a summary of TDH activities relating to the agreement to the 77th Legislature. SECTION 6. DISPLACED EMPLOYEES OF TEXAS CENTER FOR INFECTIOUS DISEASE. (a) Requires TDH, to the extent possible, to reassign an employee of TDH at TCID to an open position within TDH for which the employee is qualified if the employee's displacement is due to a contract entered into by TDH under this Act of the transfer or the mycobacterial-mycology research laboratory from TCID to The University of Texas Health Science Center at San Antonio. (b) Provides that a contract entered into by TDH with the board of regents or any other health care entity or provider under this Act must include a requirement that, to the maximum extent possible as determined by UT System, UT System offer an employee of TCID who is displaced due to the contract a similar position with UT System. SECTION 7. FUTURE USE OF EXISTING FACILITIES. Requires the board and the General Services Commission to collaborate to prepare leasing and other options for potential future uses of the existing physical facilities on completion of construction of the new physical facilities if the board contracts for construction of new physical facilities for TCID. SECTION 8. SCHEDULE. Requires the board to enter into the contracts required by this Act by September 1, 2000. Requires UT System to enter into a contract for the construction of physical facilities for a research laboratory required by Section 3 of this Act by September 1, 2000. Requires the board and the board of regents to adopt the joint memorandum of understanding by Section 3 of this Act by September 1, 2000. SECTION 9. AMENDMENT. Amends Subchapter B, Chapter 814, Government Code, by adding Section 814.1042, as follows: Sec. 814.1042. TEMPORARY SERVICE RETIREMENT OPTION FOR MEMBERS AFFECTED BY CONTRACTS ENTERED INTO BY TEXAS DEPARTMENT OF HEALTH. (a) Makes this section applicable only to employees whose positions with TDH at TCID are eliminated and who separate from state service as a result of a contract with the board of regents entered into on or after the effective date of this section and on or before September 1, 2000, or the transfer of the mycobacterial-mycology research laboratory to The University of Texas Health Science Center at San Antonio. (b) Provides that an employee described by Subsection (a) is eligible to retire and receive a service retirement annuity if the member's age and service credit, each increased by three years, would meet age and service requirements for service retirement at the time the employee separates from state service. (c) Provides that an employee described by Subsection (a) is eligible to retire and receive a service retirement annuity on the date on which the employee would have met the age and service requirements for service retirement had the member remained employed by the state if, on the date of separation from state service, the member's age and service credit, each increased by five years, would meet age and service requirements for service retirement. Provides that the annuity of a person is computed on the person's accrued service credit. (d) Authorizes an employee described by Subsection (c), if reemployed by the state before retirement, to use the time between the employee's separation from state service and reemployment only to compute eligibility for service retirement and prohibits it from being used to compute the amount of any service retirement annuity. (e) Requires an employee who applies to retire to provide TDH with documentation required by the retirement system to establish eligibility. (f) Makes this section applicable only to positions eliminated on or after the effective date of this section. SECTION 10. EMERGENCY. Emergency clause. Effective date: upon passage. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute modifies the original in the caption to make a conforming change. The substitute modifies the original in SECTION 1 to provide the Texas Board of Health (board) with the option of contracting for the construction of new physical facilities for the Texas Center for Infectious Disease (TCID). The substitute also sets forth the services which the new facility must provide and the standards for the renovation of the existing facilities to ensure the continued operation of the existing facilities until construction of new facilities is completed. In addition, the substitute adds communicable infectious disease health care services to the services which TCID must continue to provide, at either the existing or the new facilities. The substitute modifies the original in SECTION 2 to change the section title from "Tuberculosis Research Laboratory" to "Tuberculosis and Communicable Infectious Disease Health Care Services." The substitute also authorizes the board to contract with the board of regents of The University of Texas System (board of regents) or any other public or private health care entity or provider to provide physicians or other health care professionals who will provide tuberculosis and communicable infectious disease health care services, as designated by the commissioner, at TCID or at another health care facility in proximity to the center. The original required the board to contract with the board of regents to provide tuberculosis and other health care services. The substitute modifies the original in SECTION 3 to rename the research laboratory from the tuberculosis research laboratory to the mycobacterial-mycology research laboratory." In Subsection (a), the substitute requires the board of regents to construct the physical facilities for the mycobacterial-mycology, rather than requiring the board of regents to contract for the construction of such facilities. In Subsection (c), the substitute requires the board and the board of regents to transfer of laboratory services from TCID to UT System, rather than to The University of Texas Health Science Center at San Antonio. In Subsection (d), the substitute deletes the requirement that the board and the board of regents transfer employees from the Texas Department of Health (TDH) to UT System if UT System determines that employees are to be transferred. In Subsection (e), the substitute deletes rulemaking authority that the original delegated to the board and the board of regents by requiring the board and the board of regents to adopt the memorandum of understanding, rather than requiring them to do so by rule. In Subsection (f), the substitute also deletes the provision transferring all obligations of TDH relating to the management or operation of TCID to The University of Texas Health Science Center at San Antonio. The substitute deletes proposed Subsection (g), which provided that a rule, policy, procedure, decision, or form adopted by TDH relating to the research laboratory at TCID is a rule, policy, procedure, decision, or form of The University of Texas Health Science Center at San Antonio, and authorized the secretary of state to adopt rules as necessary to expedite the implementation of this subsection. The substituted Subsection (g) requires the board of regents, before a transfer occurs, to adopt rules and regulations necessary for the operation, control, and management of the mycobacterial-mycology research laboratory at The University of Texas Health Science Center at San Antonio that will take effect when the transfer occurs. The substitute modifies the original in SECTION 4 to make a nonsubstantive change. The substitute modifies the original in SECTION 6 to make conforming changes. The substitute modifies the original by adding a new SECTION 7 to require the board and the General Services Commission to collaborate to prepare leasing and other options for potential future uses of the existing physical facilities on completion of construction of the new physical facilities if the board contracts for construction of new physical facilities for TCID. The substitute modifies the original in SECTION 8 to require the board and UT System to enter into the contracts and the board and the board of regents to adopt the joint memorandum of understanding required by this Act by September 1, 2000, rather than January 1, 2000. The substitute modifies the original in SECTION 9 to make conforming changes. The substitute redesignates proposed SECTIONS 7-9 to SECTIONS 8-10.