Sunset Legislation Update

Senate Bills 200, 202, 203, 204, 205, 206, 210, 211, 212, and 219 have been filed to complete the proposed consolidation of the five health and human services agencies and various councils. For a complete listing of senate and house sunset legislation, go to this link: https://www.sunset.texas.gov/84th-legislative-session

Update—As of March 18, 2015 – Senator Nelson is proposing changes to the Sunset legislation that aims to consolidate the health and human services agencies. However, other aspects of the bill remain the same. It is our understanding that the Prevention and Early Intervention program is proposed to move to HHSC upon passage of SB 200. At this time, we understand that legislators are proposing to incorporate PEI funding/programs into a division at HHSC that oversees other prevention services.

Senator Nelson’s proposed changes:

• Continue the Health and Human Services Commission (HHSC) for 12 years with a limited-scope Sunset review in 8 years;
• Consolidate the system’s administrative functions such as information technology, contracting, legal, audit and rate-setting functions into one Administrative Division at HHSC, in accordance with current law;
• Placing Medicaid programs and client services in a new Medical and Social Services Division at HHSC;
• Moving regulatory functions from three agencies into one Regulatory Division at HHSC;
• Establish a Policy and Performance Office to assist in the re-organization and serve as a “think tank” to promote coordination across the system;
• Abolish and transfer functions of the Department of Assistive and Rehabilitative Services to HHSC in 2016;
• Abolish and transfer functions of the Department of Aging and Disability Services to HHSC in 2016;
• Abolish and transfer functions of the Department of Family and Protective Services, and the Department of State Health Services in 2019;
• Create a Transition Legislative Oversight Committee of 4 Senators appointed by the Lieutenant Governor, 4 Representatives appointed by the Speaker, and 3 public members appointed by the Governor to oversee the transformation.

Major Points of introduced version of Senate Bill 200:

1. The following agencies / councils are abolished:

• Department of Family and Protective Services
• Department of Aging and Disability Services
• Department of Assistive and Rehabilitative Services
• Department of State Health Services
• The Family and Protective Services Council
• The Aging and Disability Services Council
• The Assistive and Rehabilitative Services Council
• The Health and Human Services Council
• The State Health Services Council
• The Office of Prevention of Developmental Disabilities
• The Texas Council on Autism and Pervasive Developmental Disorders.

2. The bill creates the Health and Human Services Transition Legislative Oversight Committee. It will be composed of 11 members: 4 members of the Senate appointed by the Lieutenant Governor, 4 member of the House, appointed by the Speaker, and 3 members of the public, appointed by the governor. The executive commissioner of HHS Commission is a nonvoting member and the House and Senate leadership will each designate a co-chair.

3. The duties of the Committee are: (1) facilitate transfer of duties of abolished agencies to HHSC, (2) advise the executive commissioner of HHSC about: the powers, duties and functions programs and activities to be transferred and the funds, property, records, and obligations that are related to each. The committee will also advise the commissioner about reorganization of the commission’s administrative structure.

4. The committee will meet at least quarterly when first established until August 31, 2016. Then will meet annually or at the call of the chair between September 1, 2016 and August 31, 2023. The committee is abolished September 1, 2023.

5. The committee will submit a report to the governor, lieutenant governor, and the speaker by December 1 of each even-numbered year. The report must include the following: an update on the progress of issues related to the transfer of power, duties, functions, and programs, activities from the state agencies and entities that were abolished and the reorganization of the HHSC administrative structure.

6. The bill gives the executive commissioner of HHSC significant control about the transition and the workplan about how it will be accomplished. The workplan will be created by the executive commissioner of HHSC and will include an outline of the reorganized structure including the divisions described in the bill and other laws enacted by the current legislature. The plan will be broad and will identify the date which each state agency or entity that was created at HHSC and when its respective director would be appointed. All transfers would be required to be accomplished by September 1, 2016.

7. The bill requires that the executive commissioner when developing the plan must hold public hearings in various parts of the state before submitting the plan to the HHS Transition Legislative Oversight Committee, the Governor, and the LBB. The plan must include detail about the movement and specific timelines for the transfer of programs administered by the abolished agencies. The committee must approve the plan before its implementation.

8. The bill provides a very aggressive timeline about the consolidation of functions and the transition. It requires the executive commissioner to submit the transition plan to the legislative oversight committee, the Governor, and the LBB by December 1, 2015.

TNOYS Note –This is only six months after the current legislative session ends. This is a very aggressive timeline and identical to the time provided in the 2003 consolidation.

Update as of March 23, 2015: Sen. Nelson is proposing to delay consolidation of DFPS and DSHS until 2019.

Questions to ask –

• How will state-wide public input be taken and incorporated into the workplan in less than 6 months?
• How will public input be considered and incorporated into the workplan?
• The timeline is identical to what occurred in 2003. Understanding what programs, services, and populations were adversely impacted by the last consolidation should be considered in this plan. How will the proposed process ensure they are not adversely impacted again?

9. The bill creates advisory committees to issue and solicit public input about:

• Medicaid and other social services programs,
• Healthcare quality initiatives,
• Aging,
• Persons with disabilities, including autism,
• Rehabilitation, including persons with brain injuries,
• Children,
• Public Health,
• Behavioral health,
• Regulatory matters,
• Prevention efforts, and
• Faith-and community-based initiatives.

The executive commissioner will adopt rules relating to the committees’ purpose, tasks, reporting requirements, membership and qualifications, representation criteria, and term lengths.

TNOYS Note — These are very broad topics for committees and multiple and diverse health and human services programs serving diverse population that would fall into these categories.)

 Question to ask—

• How will the services I deliver as a provider or the clients I serve be impacted by not having a voice on an advisory committee?

10. The bill identifies that the executive commissioner may organize the new health and human services commission along functional lines based on:

• Medical and social services,
• State institution and facility functions,
• Family and protective services,
• Public health services,
• Regulatory functions,
• Centralized administrative services,
• Inspector General responsibilities.

The bill also says the following divisions within HHSC will be established:

• Child health plan program
• Financial assistance program under Chapter 31 Human Resource Code,
• Medical assistance program under Chapter 32 Human Resources Code,
• Nutritional assistance program under chapter 33 Human Resources Code,
• Long term care services,
• Community-based support services identified in Section 531.02481, and other health and human services program,
• Office of the Inspector General, and
• Office of the Ombudsman.

The bill also establishes the Office of Policy and Performance at the executive level that will be charged with coordinating policy and performance efforts across divisions within the commission. It will be created by October 1, 2015. Some of its functions include to:

• develop a performance management system,
• provide oversight for major policy changes,
• central body of experts for program evaluation and process improvement expertise,
• gather, measure and evaluate performance measures and accountability systems,
• establish a system that is capable of measuring and communication performance and achievement of goals by the commission to both internal and public audiences,
• ensure individuals receiving services from or participating in programs from the commission do not lose visibility to attention during the implementation of new policy and organizational change.

(Note that this is an item to follow because this new entity may have the responsibility of establishing performance measures for providers and determining how providers and programs’ success will be measured and tracked.)

Things to be aware of…

1. Budget podcast – How much money does the state have to spend every two years? Spend 9 minutes to find out how this amount is determined, who is responsible for the estimate, and why the biennial revenue estimate or BRE is important.

2. Texas Appleseed recently issued a report about decriminalizing truancy in Texas. The report explores causes of truancy, evaluates the current approaches to addressing truancy, highlights the disproportionate impacts of truancy charges on certain groups of students, and makes recommendations for ways that the Texas Legislature, the Texas Education Agency (TEA), and school districts can increase attendance and help children in a meaningful way. A copy of the executive summary can be found here.