HBA-MPM H.B. 3504 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 3504
By: Solis, Jim
Public Health
4/5/1999
Introduced



BACKGROUND AND PURPOSE 

The Texas Center for Infectious Diseases in San Antonio and South Texas
Hospital in Harlingen, opening in 1954 and 1956, respectively, were built
to treat tuberculosis in Texas.  Additionally, these facilities were
authorized to treat other persons with infectious or chronic respiratory
ailments; to quarantine individuals under specified conditions; and to
provide patient care, research, education, and support services for the
Texas Department of Health (TDH) bureaus, public health regions, local
health departments, and other TDH contractors. 

Due to the growing need for indigent health care, South Texas Hospital was
authorized by the Texas Legislature in 1983 to broaden its scope to include
medical and sub-acute surgical services, in addition to the authority to
provide cancer screenings, and diagnostic, educational, obstetrical,
gynecological, and other inpatient services.  South Texas Hospital serves
as the major provider of sub-acute indigent care in its region. 

Both hospitals' programs were found in 1996 to comply with regulations
specified by the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO), however, serious design and structural deficiencies
were indicated at both facilities, resulting in JCAHO notification that
they would not be re-accredited in 1999 unless a plan was developed to
renovate the old facilities or construct new ones.  During the 75th Texas
Legislature, TDH requested appropriations to bring the facilities up to
JCAHO standards, which resulted in appropriation Rider 44 which directed
TDH to develop a long-range plan to determine the future of these two
facilities. 

H.B. 3504 establishes a long-range plan for South Texas Hospital.
Specifically, it requires TDH to contract for the construction of a new
facility for outpatient health care services out of appropriated funds
either at the hospital's original site, or colocated with the Regional
Academic Health Center at a common site in Harlingen.  This bill also
addresses the transfer of services from the old facility to the new,
contracts with public or private health care providers for services
provided to the new facility, interim health care services, and issues
affecting displaced state employees of South Texas Hospital. 

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.  CONSTRUCTION OF NEW PHYSICAL FACILITY FOR OUTPATIENT HEALTH
CARE SERVICES.  (a)  Requires the Texas Department of Health (TDH) to
contract for the construction of a new physical facility for outpatient
health care services out of appropriated funds. Provides that the facility
is required to be located at the site of the South Texas Hospital or
colocated with the Regional Academic Health Center at a common site in
Harlingen, Texas, and adjacent to the center. 

(b)  Provides that the contract for the facility must specify that it be
designed and constructed to provide for all outpatient health care
services, including outpatient tuberculosis services, provided at the South
Texas Hospital on the effective date of this Act. 
 
(c)  Provides that if the facility is colocated with the Regional Academic
Health Center, the contract must specify that, to the maximum extent
possible, that facility and the Regional Academic Health Center must be
designed and constructed together to save construction costs and long-term
maintenance and operations costs by using common central utility plants,
cafeterias, and laundry, maintenance, and other support facilities.
Requires the board of regents of The University of Texas System (board) to
cooperate with TDH to coordinate the structure and design of the physical
facilities of the facility and the Regional Academic Health Center to
achieve a maximally efficient use of resources. 

SECTION 2.  OUTPATIENT HEALTH CARE SERVICES.  (a) Requires the provision of
all outpatient health care services provided by the South Texas Hospital on
the effective date of this Act to be transferred to the new facility upon
its completion. 

(b) Authorizes TDH to contract with a political subdivision for the
management and operation of the facility and for provision of outpatient
health care services at the facility. 

SECTION 3.  INPATIENT HEALTH CARE AND LABORATORY SERVICES.  (a)  Requires
TDH to contract with any public or private health care provider or entity
for the provision of inpatient health care services, including inpatient
tuberculosis services and laboratory services provided by the South Texas
Hospital on the effective date of this Act out of appropriated funds to TDH
for that purpose. 

(b)  Requires the South Texas Hospital to cease to provide inpatient health
care services after entering into contracts required by Subsection (a) of
this section. 

SECTION 4.  INTERIM RENOVATION OF PHYSICAL FACILITIES OF THE SOUTH TEXAS
HOSPITAL.  Requires TDH, out of funds appropriated for that purpose, to
contract for minimally necessary structural and design renovations to the
physical facilities of the South Texas Hospital required for
reaccreditation during 1999 by the Joint Commission on Accreditation of
Healthcare Organizations, required for compliance with certain state and
federal standards, regarding accessibility for the disabled, and required
for the continued operation of the hospital to provide services until
construction of the new facility and the provision of those services is
complete. 

SECTION 5.  FUTURE OF THE SOUTH TEXAS HOSPITAL.  (a)  Requires the South
Texas Hospital to close after the person with whom TDH has contracted with
for the provision of services under Section 3 of this Act has begun
providing those services and the provision of inpatient services is
transferred to the new facility required by Section 2 of this Act. 

(b)  Requires TDH and the General Services Commission to collaborate to
prepare leasing and other options for potential future uses of the physical
facilities of the South Texas Hospital. 

SECTION 6.  CONTINUATION OF SUPPORT SERVICES.  (a)  Requires TDH and the
Texas Department of Mental Health and Mental Retardation (TDMHMR) to enter
into an interagency contract to provide for continuation of support
services for the facility operated by TDMHMR that is colocated with the
South Texas Hospital, if the new facility required by Section 1 of this Act
is colocated with the Regional Academic Health Center. 

(b)  Authorizes the contract to include a provision requiring TDH to
continue providing employees for support facilities at the site. 

SECTION 7.  DISPLACED EMPLOYEES OF THE SOUTH TEXAS HOSPITAL.  (a)  Requires
TDH to reassign a member of the employee class of TDH who is employed at
the South Texas Hospital and whose position is displaced as a result of the
contract entered into by TDH under this Act or the closing of the South
Texas Hospital to an open position within TDH for which the member is
qualified to the extent possible out of funds appropriated to TDH. 

(b)  Provides that a contract awarded by TDH under this Act is required to
include a  provision that, to the maximum extent possible as determined by
the contracting entity, the entity is required to offer an employee of the
South Texas Hospital whose position is displaced as a result of the
contract a similar employment position with the entity. 

SECTION 8.  TIME FRAME.  Requires TDH to enter into the contracts required
by this Act no later than September 1, 2000. 

SECTION 9.  AMENDMENT.  Amends Subchapter B, Chapter 814, Government Code,
by adding Section 814.1043, as follows: 

Sec. 814.1043.  TEMPORARY SERVICE RETIREMENT OPTION FOR MEMBERS AFFECTED BY
THE TRANSFER OF SERVICES FROM THE SOUTH TEXAS HOSPITAL.  (a)  Makes this
section applicable to members of the employee class whose positions with
TDH at the South Texas Hospital are eliminated as a result of contracts
with public or private health care providers or entities or as a result of
the closing of the hospital and who separate from state service at that
time. 

(b)  Makes an eliminated employee 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 under Section 814.104(a) (Eligibility of Member for Service
Retirement), Government Code, which states that a member who has service
credit in the retirement system is eligible to retire and receive a service
retirement annuity if the member is at least 60 years old and has 5 years
of service credit in the employee class, or if the sum of the member's age
and amount of service credit in the employee class, including months of age
and credit, equals the number 80.  Provides that the annuity of a person
retiring under this section is computer based on the person's accrued
service credit increased by three years. 

(c)  Provides that an eliminated employee becomes eligible to retire and
receive a service retirement annuity on the date on which the member would
have met age and service requirements for service retirement under Section
814.104(a), Government Code, 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 under that section.  Provides that the
annuity of a person retiring under this subsection is computed based on the
person's accrued service credit. 

(d)  Provides that if a member described by Subsection (c) is reemployed by
the state before retirement, the time between the member's separation from
state service and reemployment is authorized to be used only to compute
eligibility for service retirement and is prohibited from being used to
compute the amount of any service retirement annuity. 

(e)  Requires a member applying to retire under this section and TDH to
provide documentation required by the retirement system to establish
eligibility to retire under this section. 

(f)  Makes this section applicable only to positions eliminated on or after
the effective date of this section as a result of a contract with a public
or private health care provider or entity entered into on or before
September 1, 2000 or the closing of the South Texas Hospital. 

SECTION 10.  Requires TDH to enter into the contracts required by this Act
no later than September 1, 2000. 

SECTION 11.Emergency clause.
  Effective date: upon passage.