Round One of Senate Interim Charges Released by Lt. Governor Patrick

24th Oct 2017

Lieutenant Governor Dan Patrick released  Round One of Senate Interim Charges.   Below are the interim charges related to health and human services.  As in the past, the Senate often releases interim charges in phases.  There will be another release of additional charges at a later date.

Finance.

Trauma Funding:  Review revenue sources currently funding the state’s trauma system and the impact of declining revenues and balances in General Revenue – Dedicated accounts. Evaluate the impact of statutory changes affecting trauma system funding, including efforts to eliminate the Driver Responsibility Program. Examine ways to ensure sustainability of the trauma system in Texas.

Monitoring:  Monitor the implementation of the following funding initiatives:

  • CPS Critical Needs – Monitor the impact of salary increases and additional caseworkers allocated to Child Protective Services last interim.
  • Health Care Costs Across State Agencies – Monitor coordination efforts among state agencies to improve health care and reduce costs pursuant to Article IX, Section 10.06 and Section 10.07.
  • Behavioral Health – Monitor the state’s progress in coordinating behavioral health services and expenditures across state government, pursuant to Article IX section 10.04, including the impact of new local grant funding provided by the 85th Legislature.
  • Sporting Goods Sales Tax – Identify state and local park needs and determine whether the Sporting Goods Sales Tax is meeting those needs.
Health and Human Services.

Child Welfare:  Review the efficacy and quality of services offered to ensure family preservation while in the Family-Based Social Services (FBSS) stage of service at the Department of Family and Protective Services. Make recommendations to better track quality of services and link payments to providers of these services to outcomes for families and children.

Analyze the Department of Family and Protective Services’ progress in meeting statutory requirements related to timely visits to children involved in a reported case of abuse or neglect. Make recommendations to further improve the timeliness of these visits.

Review services and supports provided to children in Permanent Managing Conservatorship of the state, and the level of preparedness given to youth aging out of state care. Examine the impact of recent legislation related to these populations, and make recommendations to ensure youth in care are ready for adulthood and to reduce the likelihood of intergenerational perpetuation of child maltreatment.

Assess the effectiveness of public and private agency efforts to recruit and retain foster parents. Identify barriers to entry and obstacles that prevent interested families from continuing to provide foster care. Recommend solutions to increase foster recruitment and address non-renewals, especially in first-time foster parents.

Substance Abuse/Opioids:  Review substance use prevention, intervention, and recovery programs operated or funded by the state and make recommendations to enhance services, outreach, and agency coordination. Examine the adequacy of substance use, services for pregnant and postpartum women enrolled in Medicaid or the Healthy Texas Women Program and recommend ways to improve substance use related health outcomes for these women and their newborns. Examine the impact of recent legislative efforts to curb overprescribing and doctor shopping via the prescription monitoring program and recommend ways to expand on current efforts.

Medicaid Managed Care Quality and Compliance:  Review the Health and Human Services Commission’s efforts to improve quality and efficiency in the Medicaid program, including pay-for-quality initiatives in Medicaid managed care. Compare alternative payment models and value-based payment arrangements with providers in Medicaid managed care, the Employees Retirement System, and the Teachers Retirement System, and identify areas for cross-collaboration and coordination among these entities.

Evaluate the commission’s efforts to ensure Medicaid managed care organizations’ compliance with contractual obligations and the use of incentives and sanctions to enforce compliance. Assess the commission’s progress in implementing competitive bidding practices for Medicaid managed care contracts and other initiatives to ensure the best value for taxpayer dollars used in Medicaid managed care contracts.

Health Care Cost Transparency:  Study efforts by the Department of State Health Services and the Texas Department of Insurance to increase health care cost transparency, including a review of the Texas Health Care Information Collection (THCIC) system, and the Consumer Guide to Healthcare. Recommend ways to make provider and facility fees more accessible to consumers to improve health care cost transparency, increase quality of care, and create a more informed health care consumer base.

Monitoring Charge:  Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 85th Legislature and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to:

  • Initiatives to increase capacity and reduce waitlists in the mental health system, including the construction of state hospitals and new community grant programs;
  • Initiatives to better understand the causes of maternal mortality and morbidity, including the impact of legislation passed during the first special session of the 85th Legislature. Recommend ways to improve health outcomes for pregnant women and methods to better collect data related to maternal mortality and morbidity;
  • Initiatives intended to improve child safety, Child Protective Services workforce retention, and development of additional capacity in the foster care system. Make additional recommendations to ensure children with high levels of medical or mental health needs receive timely access to services in the least restrictive setting;
  • Efforts to transfer case management of foster children and families to Single Source Continuum Contractors (SSCCs). Monitor the progress of this transition and make recommendations to ensure the process provides continuity of services for children and families and ongoing community engagement;
  • Initiatives to strengthen oversight of long-term care facilities to ensure safety and improve quality for residents and clients of these entities; and
  • Abortion complications and other reporting legislation that was passed by the 85th Legislature.
Veterans Affairs and Border Security.

Veterans Health:  Study the effectiveness of veterans’ health and mental health initiatives in Texas and recommend ways to improve access and delivery. Explore the state of the federal VA Choice Program, including potential expiration, continuation, or expansion of the program. Consider the impact of the VA Choice Program on improving the delivery of healthcare, and determine ways to raise awareness and increase participation among Texas veterans. Consider the potential connection between chronic pain and mental health and identify strategies to improve the prevention of veteran suicide.

Thomas Valentine

Texas Insight