The Legislative Budget Board met on August 20 to hear from the Texas Medical Board concerning key aspects of their Legislative Appropriations Request for the 86th Session and on exceptional items being requested. The TMB was asked questions by a joint panel of representatives from the Governor’s Office, Lieutenant Governor’s Office, the Legislative Budget Board, and legislative committees. (Link to TMB LAR)
This report is intended to give you an overview and highlight of the discussions on the various topics the committee took up. It is not a verbatim transcript of the hearing, but is based upon what was audible or understandable to the observer and the desire to get details out as quickly as possible with few errors or omissions.
Agency Presentation
Brint Carlton, Texas Medical Board
- 3 main exceptional items
- IT Project – Looking at items not funded last session (received ~half funding last session)
- Primarily licensing fees for Microsoft enterprise software due to SB 202 increased staff, 29 FTEs, @$40k/year
- Hardware replacement, normal rotation of items, portions in FY20 and FY21
- Cybersecurity, @$115,400 for FY20 and @$40,400 for FY21, servers, hardware, ongoing monitoring
- Additional Staff – TMB has taken more licensee types since SB 202, requesting 4 additional licensure FTEs
- Also asking for an additional physician investigator to handle rising numbers of investigations, brings total to 3
- 1 Human Resources Specialist – As staff has grown, HR department has stayed the same size, will help process paperwork for hiring and help keep up with TWC requirements
- 2 Call center staff, authorized for 4 last session with 2 granted, brings total back to 4 to help handle significantly increased call volume
- 1 Communications Officer to help handle strategic communications (e.g. online info, licensee outreach)
- Enhanced Employee Retention – many employees transfer to different agencies with higher salaries, many are lost to Board of Nursing, would like comparable salaries to other state agencies
- Independent surveyor of salaries determined 170 positions in TMB that were 9.7% below competitive market value, @~$890k/year
- Most concerned about IT and attorney positions, difficult to get these at current salaries
- TMB is bringing in $33 million in revenue collections for FY 19, total costs are ~$18 million or 59% of revenue collections, remainder to GR
- Fully funded requests would mean 65% of revenue collected is used for TMB costs
- Regarding GR-D fund projections, last session saw change for use, expecting ending balance in FY21 of $315k, currently $1.5 million
Questions from Joint Legislative/LBB Panel
- Question – With respect to Rider 5 on contingency behavioral Health funds, can you provide a brief background of TMB’s participation in statewide behavioral health strategic plan
- Megan Goode, TMB – TMB has been included along with other Art VIII agencies since the inception of the rider
- At outset, asked what involvement TMB has with behavioral health services, TMB runs peer assistance for mental health/substance abuse/etc., broader than behavioral or mental health as it can include any physical impairment that can impede practice
- Discovered that funding & peer assistance are not directly linked in the same way as larger Art II agencies, TMB is not providing direct mental health services
- Funding portion could also not be used or spent in other areas of government, practitioners are essentially paying a fee for participation in this
- Requesting to be taken out of rider for those reasons
- Question – Is it participation in the Strategic Council or the contingent nature of the funds that is problematic, both?
- Really both, happy to participate as needed; because the nature of the peer assistance programs is different, it does not seem linked to original intent of funding for direct mental and behavioral health services
- Have seen some confusion over this as well, many assume it is a GR appropriation item
- Question – Sunset asked for an expedited out of state licensing program, are you able to do that with existing licensing personnel or is the exceptional item request part of this mission?
- Carlton, TMB – Will do our best without additional staff, but have been working on what this would look like
- Interstate Compact wasn’t wanted by legislature, but some interesting ideas within the document
- Additional staff would definitely help with this
- Question – What is TMB’s turnover rate on the whole, also for IT and attorney positions? And is the 9.7% salary deficit across private and public sector?
- 7% was derived from look across state agencies and private industry, removed top and bottom pay before deriving numbers
- Do not have exact turnover numbers, but significant portion of employees have been with agency for less than 2 years
- Question – Do you have numbers for how your salaries compare to other Art VIII agencies?
- Not with us, but can look at survey and bring data back
- Question – Within the 9.7%, what would the proper number be to support retention?
- Not sure what the exact number would be, but would try to close gap; did look at numbers and make adjustments
- At the beginning, before adjustments, projected need was a little over $1 million