HBA-JRA S.B. 358 76(R)    BILL ANALYSIS


Office of House Bill AnalysisS.B. 358
By: Madla
Public Health
5/4/1999
Engrossed



BACKGROUND AND PURPOSE 

The Texas Department of Mental Health and Mental Retardation (MHMR),
created in 1965, is responsible for planning, policy development, and
oversight of 11 mental health and mental retardation services in the state.
It also operates 11 state schools for persons with mental retardation and
eight state hospitals for persons with mental illness, as well as two state
centers and ten stateoperated community services.  To carry out these
duties, MHMR has a budget of $1.6 billion and 23,119 employees for the 1999
fiscal year.  MHMR serves most of its clientele in the community, as
opposed to institutions, by passing the majority of its appropriation to
its 38 community MHMR centers through performance contracts.  These centers
are governed by local boards, usually appointed by county commissioners'
courts and provide or contract for services in the community. 

MHMR is subject to the Sunset Act and will be abolished on September 1,
1999, unless continued by the legislature.  After review of MHMR, the
Sunset Advisory Commission recommended its continuance, as well as
statutory modifications.  S.B. 358 continues MHMR in existence until
September 1, 2011, unless it is abolished as provided by the Texas Sunset
Act.  This bill also does the following: 

_sets forth a training program for a member of the Texas Board of Mental
Health and Mental Retardation (board); 
_requires the commissioner of mental health or the commissioner's designee
to prepare and maintain a written policy statement that implements, rather
than a policy that assures implementation of, a program of equal employment
opportunity to ensure that all personnel decisions, rather than
transactions, are made without regard to certain factors; 
_requires MHMR to develop a report containing recommendations and
information regarding the most efficient long-term use of MHMR's
campus-based facilities on a biennial basis; 
_requires the board to enter into an agreement with the Texas
Rehabilitation Commission that defines the roles and responsibilities of
each agency regarding the agencies' shared client populations; 
_requires MHMR to adopt a long-range plan for state-operated institutions,
and in developing the plan, to solicit input from local community centers,
community representatives, and other interested persons; 
_requires the board, by rule, to establish criteria regarding the use of
MHMR's campus-based facilities to ensure that they offer a full continuum
of services;  
_requires the board, by rule, to establish standards of care for mental
health services provided by a state agency or its contractors; 
_sets forth the Local Authority Advisory Committee; and
_addresses joint efforts between MHMR and the Texas Commission of Alcohol
and Drug Abuse. 


RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Board of Mental Health and
Mental Retardation in SECTION 6 (Section 533.0325, Health and Safety Code),
the Texas Department of Mental Health and Mental Retardation in  SECTIONS 7
and 8 (Sections 533.0345 and 533.0351, Health and Safety Code), the Texas
Board of Mental Health and Mental Retardation and the Texas Commission on
Alcohol and Drug Abuse jointly in SECTION 9 (Section 533.0356, Health and
Safety Code), and the Texas Commission on Alcohol and Drug Abuse in SECTION
16 (Section 461.0128, Health and Safety Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 532.002, Health and Safety Code, to abolish the
Texas Department of Mental Health and Mental Retardation (MHMR) and have
Chapter 532 (Organization of Texas Department of Mental Health and Mental
Retardation) expire September 1, 2011, rather than September 1, 1999,
unless continued in existence as provided by Chapter 325 (Texas Sunset
Act), Government Code. 

SECTION 2.  Amends Chapter 532, Health and Safety Code, by adding Section
532.0035, as follows: 

Sec. 532.0035.  BOARD TRAINING.  (a)  Prohibits a person appointed to and
qualifying for office as a member of the Texas Board of Mental Health and
Mental Retardation (board) from voting, deliberating, or being counted in
attendance at a board meeting until the person completes a training program
that complies with this section. 

(b)  Provides that the training program must provide the person with
information regarding certain programs, roles, functions, and rules of MHMR
and the legislation that created it, as well as MHMR's current budget and
the results of the most recent formal audit of MHMR.  Additionally, the
program must include information about laws regarding open meetings, public
information,  administrative procedure, and other laws relating to public
officials, including conflict-of-interest laws, and any applicable ethics
policies adopted by MHMR or the Texas Ethics Commission. 

(c)  Entitles a person appointed to the board to reimbursement provided by
the General Appropriations Act for travel expenses incurred in attending
the training program, regardless of whether the person qualified for office
before or after attending the program. 

SECTION 3.  Amends Sections 532.016(d) and (e), Health and Safety Code, as
follows: 

(d)  Requires the commissioner of mental health (commissioner) or the
commissioner's designee to prepare and maintain a written policy statement
that implements, rather than a policy that assures implementation of, a
program of equal employment opportunity to ensure that all personnel
decisions, rather than transactions, are made without regard to certain
factors.  Requires the policy statement to show the intent of MHMR to avoid
unlawful employment practices described by Chapter 21 (Employment
Discrimination), Labor Code.  Further requires the statement to include an
analysis of the extent to which the composition of MHMR's personnel is in
accordance with state and federal law, and a description of reasonable
methods to achieve compliance with these laws.  Deletes existing
Subdivision (2), which states that the policy statement must include a
comprehensive analysis of MHMR work force that meets federal and state
guidelines. Makes nonsubstantive changes. 

(e)  Deletes the requirement that the policy statement cover an annual
period, and requires it to be reviewed by the state Commission on Human
Rights for compliance with policies regarding recruitment, evaluation,
selection, training, and promotion of personnel that show MHMR's intent to
avoid unlawful employment practices.  Redesignates existing Subdivision (2)
to Subdivision (1). Makes nonsubstantive changes.   

SECTION 4.  Amends Subchapter A, Chapter 533, Health and Safety Code, by
adding Section 533.013, as follows: 

Sec. 533.013.  DUPLICATION OF REHABILITATION SERVICES.  Requires the board
to enter into an agreement with the Texas Rehabilitation Commission (TRC)
that defines the  roles and responsibilities of each agency regarding the
agencies' shared client populations. Provides that the agreement must
establish methods to prevent the duplication and fragmentation of
employment services. 

SECTION 5.  Amends Section 533.032, Health and Safety Code, as follows:

Sec. 533.032.  New title:  LONG-RANGE PLANNING. (a) Created from existing
text. Requires MHMR's long-range plan to include at least the provisions
required by Sections 531.022 and 531.023, Government Code (Coordinated
Strategic Plan for Health and Human Services, and Submission of Plans and
Updates by Agencies, respectively), rather than Section 10, Article
4413(502), V.T.C.S., although the provisions of Chapter 2056 (Strategic
Plans of Operation), Government Code, continue to be required.  Provides
that the plan must cover the provision of services in and policies for
state-operated institutions and ensure that the medical needs of the most
medically fragile person MHMR serves are met. 

(b)  Requires MHMR, in developing the plan, to solicit input from local
authorities for mental health and mental retardation, community
representatives, consumers of mental health and mental retardation services
and their family members, and other interested persons; and consider the
report developed under Subsection (c). 

(c)  Requires MHMR to develop a report containing information and
recommendations regarding the most efficient long-term use and management
of MHMR's campus-based facilities.   Provides that the plan must: include
projections regarding bed requirements for state schools and maintenance
costs for institutional facilities; document the methodology used to
develop the projection of the bed requirements; recommend strategies to
maximum the use of institutional facilities, and specify how each state
school and hospital will serve and support communities and consumers in its
service area, as well as fulfill statewide needs for specialized services.  

(d)  Requires MHMR, in developing the report, to consider the medical needs
of the most medically fragile of its clients and the provision of services
to clients with severe and profound mental retardation. 

(e)  Requires MHMR to attach the report to its legislative appropriations
request for each biennium, present the report to the governor, governor's
budget office, lieutenant governor, speaker of the house of
representatives, Legislative Budget Board, and Health and Human Services
Commission,  and update its long-range plan biennially. 

SECTION 6.  Amends Subchapter B, Chapter 533, Health and Safety Code, by
adding Section 533.0325, as follows: 

Section 533.0325.  CONTINUUM OF SERVICES IN CAMPUS FACILITIES.  Requires
the board, by rule, to establish criteria regarding the use of MHMR's
campus-based facilities to ensure that they offer a full continuum of
services. 

SECTION 7.  Amends Subchapter B, Chapter 533, Health and Safety Code, by
adding Section 533.0345, as follows: 

Sec. 533.0345.  STATE AGENCY SERVICE STANDARDS.  Requires MHMR, by rule, to
develop model program standards for mental health services and provide them
to each state agency that provides or pays for mental health services.
Provides that the standards must be designed to improve the consistency of
mental health services provided by or through a state agency.  Requires
MHMR to review the standards biennially and determine whether each standard
is necessary to ensure consistent quality of care. 

SECTION 8.  Amends Subchapter B, Chapter 533, Health and Safety Code, by
adding Section 533.0351, as follows: 

Sec. 533.0351.  LOCAL AUTHORITY ADVISORY COMMITTEE.  Defines "local
authority" in this section as a local mental health or mental retardation
facility.  Requires the commissioner to establish a nine-member local
authority advisory committee (committee). Sets forth the composition of the
committee.  Requires the committee to perform certain duties.  Requires
MHMR to provide the committee a written response regarding any action taken
on a recommendation the committee makes to MHMR, or the reason for MHMR's
inaction on the recommendation.  Provides that the committee is subject to
Chapter 2110 (State Agency Advisory Committees), Government Code.  Requires
MHMR, by rule, to provide that the committee is abolished on September 1,
2007, in accordance with Section 2110.008 (Duration of Advisory
Committees), Government Code, unless the board votes to continue its
existence. 

SECTION 9.  Amends Subchapter B, Chapter 533, Health and Safety Code, by
adding Section 533.0356, as follows: 

Sec. 533.0356.  LOCAL BEHAVIORAL HEALTH AUTHORITIES.  (a)  Defines
"commission" as the Texas Commission on Alcohol and Drug Abuse (TCADA).   

(b)  Authorizes MHMR and TCADA to jointly designate a local behavioral
health authority (authority) in a local service area to provide mental
health and mental dependency services in that area.  Authorizes MHMR and
TCADA to delegate to an authority the authority and responsibility for
planning, policy development, coordination, resource allocation, and
resource development for and oversight of mental health and chemical
dependency services in that service area.  Requires an authority to perform
certain duties with respect to mental health and substance abuse services.

(c)  Requires the authority to give proportionate priority to mental health
services and chemical dependency services. 

(d)  Authorizes a local mental health authority to apply to MHMR and TCADA
for designation as  an authority. 

(e)  Authorizes MHMR and TCADA to disburse money, including federal money,
to an authority for services. 

(f)  Requires an authority to use such money to ensure that mental health
and chemical dependency services are provided in the local service area at
the same level as the level of services previously provided through the
local mental health authority and TCADA. 

(g)  Requires MHMR and TCADA to solicit and consider written comments from
any interested person in determining whether to designate an authority for
a service area and in determining the functions of such an authority. 

(h)  Requires an authority to consider ultimate costs and benefits and
client care issues to ensure consumer choices of services and the best use
of public money in assembling a network of service providers and
determining whether to become a provider of a service or to contract that
service to another organization. 

(i)  Requires an authority to demonstrate to MHMR and TCADA compliance with
relevant state standards in the delivery of services involving state funds. 

(j)  Authorizes the Texas Board of Mental Health and Mental Retardation
(board) and TCADA to jointly adopt rules to govern the operations of
authorities.  Authorizes MHMR and TCADA to jointly assign the authority the
duty of providing a single point of entry for mental health and chemical
dependency services. 

SECTION 10.  Amends Section 533.038, Health and Safety Code, by adding
Subsection (d), as follows: 

 (d)  Requires a person with mental retardation, or the person's
representative, seeking residential services, to receive a clear
explanation of programs and services for which the person is determined to
be eligible.  Requires the person's choice of programs and services to be
documented.  Requires the person to receive assistance in gaining access to
alternative services if the chosen programs and services are unavailable. 

SECTION 11.  Amends Subchapter B, Chapter 533, Health and Safety Code, by
adding Section 533.039, as follows: 

Sec. 533.039.  CLIENT SERVICES OMBUDSMAN.  Requires the commissioner to
employ an ombudsman to assist a person or the parent or guardian of a
person who has been denied service by MHMR, an MHMR program or facility, or
a local mental health or mental retardation facility.  Requires the
ombudsman to perform certain duties in this capacity. 

SECTION 12.  Amends Section 534.004(a), Health and Safety Code, to make a
conforming change. 

SECTION 13.  Amends Section 534.005, Health and Safety Code, to delete the
text prohibiting a person appointed as a member of a board of trustees by a
local agency or organizational combination of local agencies primarily
located in only one county from serving more than four consecutive and
complete two-year terms. 

SECTION 14.  Amends Section 534.007, Health and Safety Code, as follows:

Sec. 534.007.  New title:  PROHIBITED ACTIVITIES BY FORMER OFFICERS OR
EMPLOYEES; OFFENSE.  (a)  Prohibits a former officer or employee of a
community center who ceases, rather than terminates, service or employment
with the center from representing any person or receiving compensation for
services rendered on behalf of any person regarding a matter in which the
former officer or employee participated during the period of employment,
either through personal involvement or because the case or proceeding was a
matter within the officer's of employee's official responsibility.  Deletes
text prohibiting the former officer or employee, for one year after the
date on which the officer or employee terminates service or employment,
from directly or indirectly attempting or aiding in the attempt to procure
a contract with the community center where the individual served or was
employed, if the contract relates to a program or service in which the
individual was directly concerned or for which the individual had
administrative responsibility. 

(b)  Makes this section inapplicable to a former employee who is
compensated on the last date of service or employment below the amount
prescribed by the General Appropriations Act for salary group 17, Schedule
A, or salary group 9, Schedule B, rather than for step 1, salary group 17,
of the position classification salary schedule, or a former officer or
employee who is employed by a state agency or another community center. 

(c) Makes Subsection (a) inapplicable to a proceeding related to policy
development that was concluded before the officer's or employee's service
or employment ceased. 

(d)  Created from existing text.  Makes no changes.

(e)  Defines "participated" as to have taken action as an officer or
employee through decision, approval, disapproval, recommendation, giving
advice, investigation, or similar action; and "particular matter" as a
specific investigation, application, request for a ruling or determination,
proceeding related to the development of policy, contract, claim, charge,
accusation, arrest, or judicial or other proceeding. 

SECTION 15.  Amends Section 534.065(b), Health and Safety Code, to
authorize, rather than require, a mental health or mental retardation
authority to renew a contract only if the contract meets the criteria
provided by Sections 2155.074 and 2155.144 (Best Value Standard for
Purchase of Goods or Services, and Health Care Purchasing, respectively),
Government Code.  Deletes existing text regarding specific circumstances
under which the authority may renew the contract. 
 
SECTION 16.  Amends Chapter 461, Health and Safety Code, by adding Section
461.0128, as follows: 

Sec. 461.0128.  STATE AGENCY SERVICES STANDARDS.  (a) Requires TCADA, by
rule, to establish standards of care for substance abuse services provided
by a state agency or its contractors.  Provides that these standards must
ensure that the quality of services provided by or through a state agency
is consistent with that provided by TCADA.  Requires TCADA to review the
standards biennially and determine whether each standard is necessary to
ensure consistent quality of care. 

SECTION 17.  Amends Chapter 461, Health and Safety Code, by adding Section
461.0129, as follows: 

Sec. 461.0129.  LOCAL BEHAVIORAL HEALTH AUTHORITIES.  Authorizes TCADA, to
designate and provide services through local behavioral health authorities
as provided by Section 533.0356 and rules adopted jointly with the board. 

SECTION 18.  (a)  Makes application of Section 532.0035 prospective to a
member of the Texas Board of Mental Health and Mental Retardation appointed
on or after the date of this Act.  

(b)  Makes application of Section 534.007 prospective to a person who
ceases employment on or after the effective date of this Act.  

(c)  Makes application of Section 534.065(b) prospective to a contract
considered for renewal on or after the effective date of the Act.  

SECTION 19.  Effective date:  September 1, 1999.

SECTION 20.  Emergency clause.