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 The Sunset Advisory Commission met to make decisions on and modifications to staff reports for multiple agencies as well as to hear staff presentations and receive agency responses for additional agencies. This report focuses only on discussion of the following agencies:
 
Texas Council on Developmental Disabilities;
Governor’s Committee on people with Disabilities;
Texas Council on Purchasing from People with Disabilities;
Texas Health Services Authority;
Texas Health and Human Services Commission; and
Office of the Inspector General

Commission Decisions
 
No modifications were made to recommendations for the Texas Council on Developmental Disabilities or the Governor’s Committee on people with Disabilities. The recommendations were adopted.
 
Texas Council on Purchasing from People with Disabilities
 
Issue 1.4

  • Sen. Donna Campbell recommended a modification to direct the Comptroller to include participation of the central non-profit agency when conducting the study of the cost to the state of administering the State Use Program; this will ensure all unique facets of the program will be considered in the right context
  • Adopted
  • Rep. Larry Gonzales noted he was concerned about the loss of expertise and empathy moving administration of the State Use Program to the Comptroller’s Office ; would rather not see this recommendation go forward but will not make a motion

 
Texas Health Services Authority
 
Issue 15.1

  • Chair Jane Nelson noted that because the program is still fledgling she would prefer THSA retain their authority for the next six years; also makes some tweaks to board structure
  • Adopted

 
Texas Health and Human Services Commission
 
Issue 1

  • Rep. Four Price noted a work group was formed to consider modifications to Issue 1; the modifications provide clarity on what is to be in statute and what expectations will be for the Executive Commissioner; puts into statute that the EC should consider reorganizing the agency around 7 divisions; provides greater detail regarding the relationship between the EC and the legislative oversight committee; the committee will be statutorily required to review the transition plan and must hold public hearings; HHSC must hold public hearings in various geographic areas around the state; legislative oversight committee membership will have expanded spots for legislative members; committee must meet at least quarterly through 2016 and will disband in 2023
  • Sen. Charles Schwertner noted the transition is extremely important and will impact many Texans; will be monitoring the process to ensure individuals are not slipping through the cracks and that continuity of care remains
  • Adopted

 
Issue 13.1

  • Price noted modifications would require EC to seek public input regarding reorganization of and need for advisory committees; rules should be adopted by March 2016
  • Adopted

Issue 1.1

  • Rep. Richard Raymond wants to ensure the Texas Office for the Prevention of Developmental Disabilities will be allowed to accept public and private donations and will make it clear what the money will be used for
  • Adopted

 
Issue 4.2-4.4

  • Schwertner recommended modifications to ensure initiatives in these recommendations are completed in a timely manner by setting deadlines
  • Adopted

 
Issue 4.2

  • Schwertner recommended a modification that HHSC must report to Sunset with recommendations to improve network adequacy within the Medicaid system; also directs HHSC to report data on non-emergency utilization of emergency departments
  • Adopted

 
Issue 4.6

  • Schwertner recommended a modification to have two non-voting members representing MCOs to the combined P&T/DUR committee; one being a pharmacist and one being a physician
  • Adopted

 
Issue 5.3

  • Schwertner recommended requiring in statute that the OIG will adopt criminal history guidelines by a certain deadline
  • Adopted

 
Issue 6.1

  • Commission member Tom Luce recommended a modification direct HHSC to coordinate initiatives for improving quality of healthcare to ensure consistency and to align performance metrics
  • Adopted

 
Issue 8.1

  • Nelson recommended a modification that would combine the expanded primary health program and the Texas women’s health program and use a fee-for-service payment system; maintain the family planning program and direct HHSC to work with legislature on eligibility, benefits and payment systems for the family planning program
  • Adopted

 
Issue 9.1

  • Sen. Brian Birdwell recommended a modification would allow the 7 NorthSTAR counties to be able to submit a local plan to DSHS for indigent services without a competitive RFP process; maintains recommendation to combine physical and mental health care services; clarifies that there is a deadline for counties to determine if they want to enact a local plan; directs EC to dedicate a liaison to assist local communities in developing their local plans
  • Adopted

 
The HHSC report was adopted aside from Issues 10, 11 which will be taken up with OIG discussion
 
Office of the Inspector General
 
Issue 10.11

  • Sen. Juan Hinojosa recommended a modification to add a management action for OIG to notify a provider if any state employee or OIG employee were to be found engaging in fraudulent activity that affected or harmed providers
  • Adopted

 
Issue 11

  • Hinojosa recommended a modification that would require SOAH to hold a hearing within 45 days of a request; amend the statutory definition of fraud to clarify that the term does not include unintentional errors; require OIG to pay costs of overpayment hearings at SOAH; prohibit CAF payment holds on providers that have received prior authorizations from HHSC except under extenuating circumstances
  • Adopted
  • Raymond recommended a modification to provide that all pharmacies audited by OIG and not accused of Medicaid fraud should be provided due process including full discovery and access to an evidentiary hearing
  • Adopted

 
Nelson established a workgroup to study Schwertner’s modification recommendation based on the DFPS report requested by Sunset

  • Schwertner noted the DFPS report contained nearly 200 suggested changes; pared down to 111 proposed changes in the modification his office has prepared; agency needs flexibility to transition with the HHSC enterprise; need to strike a balance between flexibility, accountability and transparency