Department of State Health Services Riders and Special Provisions SB 1 DSHS Riders 43. Mentally Ill Offender Screening. Pursuant to Health and Safety Code, Section 614.013 & 614.017, the Department of State Health Services and community centers, as defined in the Texas Health and Safety Code Sec. 534.001(b). shall through a memorandum of understanding, identify offenders with mental impairments in the criminal justice system, collect and report prevalence data, and accept and disclose information relating to a special needs offender if the disclosure serves the purpose of Chapter 614, Health and Safety Code. The Department shall report to the Legislative Budget Board no later than September 1 of each fiscal year its efforts to facilitate the exchange. 58. Behavioral Health Data Collection and Reporting. Out of funds appropriated above in Goal B, Community Health Services, the Department of State Health Services shall improve the measurement, collection, and reporting of outcome data for medically indigent and Medicaid clients who receive publicly-funded behavioral health services according to criteria developed by the LBB. A comparative analysis of the findings will be filed with the LBB and Governor by December 1, 2014. 66. Outpatient Competency Restoration Pilot Programs. Out of the funds appropriated above in Strategy B.2.3. Community Mental Health Crisis Services, the Department of State Health Services shall allocate out of the General Revenue Fund $4,000,000 for the state fiscal year ending August 31, 2014 and $4,000,000 for the state fiscal year ending August 31, 2035, to support outpatient competency restoration pilot programs. It is the intent of the Legislature that the department use the money to fund existing pilot programs. 70. Local Service Area Planning. Pursuant to Health and Safety Code, Section 533.0352, the Department of State Health Services shall develop performance agreements with Local Mental Health Authorities out of funds allocated in Strategies B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, and B.2.3, Community Mental Health Crisis Services, that give regard to priorities identified by the community through a local needs 1
assessment process and expressed in a local service plan. DSHS is granted flexibility to transfer funds between these Strategies in the approval of the local service plan. 74. Alternatives to Inpatient Services for Forensic Cases. Contingent on the passage of S.B./H.B. or similar legislation relating to the use of alternatives to inpatient services for certain individuals under forensic commitment, the Department of State Health Services may use funds appropriated above in Goal C, Hospital Facilities and Services, to establish alternatives to inpatient services for individuals under forensic commitment, including: a) The planning, piloting, and operation of jail-based competency restoration programs for individuals found incompetent to stand trial who are ordered by the courts to receive state-sponsored jail-based competency restoration. Programs may not result in an increase in overall spending on state-funded mental health treatment. b) The planning, piloting, and operation of a conditional release program for individuals under forensic commitment who are ordered by the courts to participate in a state-sponsored conditional release program. The program may not result in an increase in overall spending on state-funded mental health treatment. 75. Third Party Health Insurance Exchange Reporting Requirement. Out of funds appropriated to the Department of State Health Services in strategies B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, B.2.3, Community Mental Health Crisis Services, B.2.4, NorthSTAR Behavioral Health Waiver C.1.3, Mental Health State Hospitals and C.2.1, Mental Health Community Hospitals the Department of State Health Services shall submit a report containing the following information: a) The fiscal impact of the third party health insurance exchange on the above strategies; b) The caseload impact of the third party health insurance exchange on the above strategies; and c) Contingent on the enactment of House Bill or Senate Bill, or similar legislation by the Eighty-third Legislature, Regular Session, 2013, the Department of State Health Services shall report on (1) the number of attestation forms distributed by each above strategy, (2) a description of third party health insurance exchange consumer awareness efforts that were implemented by each above strategy and, (3) an overall analysis of these policies with recommendations for maximizing alternative sources of coverage for clients served in the above strategies. The Department of State Health Services shall submit the report to the Governor s Office and the Legislative Budget Board by December 1, 2014. 76. Administration of Third Party Insurance Exchange Savings and Revenue Gains. *Note: Estimated Reductions in B.2.1, B.2.2. and B.2.3 are reflected in Texas Council Status of Appropriations DSHS Special Provisions Relating To All Health And Human Services Agencies 32. Limit on Spending New Generation Medication Funds a) It is the intent of the Legislature that DSHS and DADS utilize funds appropriated for New Generation Medications (NGM) for no other purpose than the provision, prescribing, and monitoring of New Generation Medications. This limitation shall apply to funds appropriated for NGM in the following strategies at DSSHS: B.2.1, 2
Mental Health Services for Adults, B.2.2, Mental Health Services for Children, B.2.4, NorthSTAR Behavioral Health Waiver, and C.1.3., Mental Health State Hospitals, and the following strategy at DADS: A.8.1, State Supported Living Centers. b) Notwithstanding the limitation described above, the department shall allow a local mental health authority or DADS local authority to expend an amount not to exceed 15 percent of its NGM funds on support programs that are related to administration of NGM, provided, however, than an authority using its NGM funds for support services must meet its contracted performance target for persons served with NGM and the availability of NGM funds to expend on services must result from cost efficiencies achieved by the authority. c) To the extent that the local authorities or state contracted managed care organizations are able to obtain cost savings associated with cost effective purchasing arrangements, private sector donations of medication for clients and/or financial contributions for the purchase of NGM in DSHS Strategies B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, and B.2.4, NorthSTAR Behavioral Health Waiver, and they meet or exceed their contracted performance targets for persons served with NGM, they may expend up to an equivalent amount from these strategies on direct services to clients. HB 1. DSHS Riders 43. Mentally Ill Offender Screening. Pursuant to Health and Safety Code, Section 614.013 & 614.017, the Department of State Health Services and community centers, as defined in the Texas Health and Safety Code Sec. 534.001(b). shall through a memorandum of understanding, identify offenders with mental impairments in the criminal justice system, collect and report prevalence data, and accept and disclose information relating to a special needs offender if the disclosure serves the purpose of Chapter 614, Health and Safety Code. The Department shall report to the Legislative Budget Board no later than September 1 of each fiscal year its efforts to facilitate the exchange. 58. Behavioral Health Data Collection and Reporting. Out of funds appropriated above in Goal B, Community Health Services, the Department of State Health Services shall improve the measurement, collection, and reporting of outcome data for medically indigent and Medicaid clients who receive publicly-funded behavioral health services according to criteria developed by the LBB. A comparative analysis of the findings will be filed with the LBB and Governor by December 1, 2014. 66. Outpatient Competency Restoration Pilot Programs. Out of the funds appropriated above in Strategy B.2.3. Community Mental Health Crisis Services, the Department of State Health Services shall allocate out of the General Revenue Fund $4,000,000 for the state fiscal year ending August 31, 2014 and $4,000,000 for the state fiscal year ending August 31, 2035, to 3
support outpatient competency restoration pilot programs. It is the intent of the Legislature that the department use the money to fund existing pilot programs. 70. Local Service Area Planning. Pursuant to Health and Safety Code, Section 533.0352, the Department of State Health Services shall develop performance agreements with Local Mental Health Authorities out of funds allocated in Strategies B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, and B.2.3, Community Mental Health Crisis Services, that give regard to priorities identified by the community through a local needs assessment process and expressed in a local service plan. DSHS is granted flexibility to transfer funds between these Strategies in the approval of the local service plan. 74. Alternatives to Inpatient Services for Forensic Cases. Contingent on the passage of S.B./H.B. or similar legislation relating to the use of alternatives to inpatient services for certain individuals under forensic commitment, the Department of State Health Services may use funds appropriated above in Goal C, Hospital Facilities and Services, to establish alternatives to inpatient services for individuals under forensic commitment, including: a) The planning, piloting, and operation of jail-based competency restoration programs for individuals found incompetent to stand trial who are ordered by the courts to receive state-sponsored jail-based competency restoration. Programs may not result in an increase in overall spending on state-funded mental health treatment. b) The planning, piloting, and operation of a conditional release program for individuals under forensic commitment who are ordered by the courts to participate in a state-sponsored conditional release program. The program may not result in an increase in overall spending on state-funded mental health treatment. 75. Third Party Health Insurance Exchange Reporting Requirement. Out of funds appropriated to the Department of State Health Services in strategies B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, B.2.3, Community Mental Health Crisis Services, B.2.4, NorthSTAR Behavioral Health Waiver C.1.3, Mental Health State Hospitals and C.2.1, Mental Health Community Hospitals the Department of State Health Services shall submit a report containing the following information: a) The fiscal impact of the third party health insurance exchange on the above strategies; bthe caseload impact of the third party health insurance exchange on the above strategies; and c) Contingent on the enactment of House Bill or Senate Bill, or similar legislation by the Eighty-third Legislature, Regular Session, 2013, the Department of State Health Services shall report on (1) the number of attestation forms distributed by each above strategy, (2) a description of third party health insurance exchange consumer awareness efforts that were implemented by each above strategy and, (3) an overall analysis of these policies with recommendations for maximizing alternative sources of coverage for clients served in the above strategies. The Department of State Health Services shall submit the report to the Governor s Office and the Legislative Budget Board by December 1, 2014. 76. Administration of Third Party Insurance Exchange Savings and Revenue Gains. *Note: Estimated Reductions in B.2.1, B.2.2. and B.2.3 are reflected in Texas Council Status of Appropriations - DSHS 4
Special Provisions Relating To All Health And Human Services Agencies 32. Limit on Spending New Generation Medication Funds a) It is the intent of the Legislature that DSHS and DADS utilize funds appropriated for New Generation Medications (NGM) for no other purpose than the provision, prescribing, and monitoring of New Generation Medications. This limitation shall apply to funds appropriated for NGM in the following strategies at DSSHS: B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, B.2.4, NorthSTAR Behavioral Health Waiver, and C.1.3., Mental Health State Hospitals, and the following strategy at DADS: A.8.1, State Supported Living Centers. b) Notwithstanding the limitation described above, the department shall allow a local mental health authority or DADS local authority to expend an amount not to exceed 15 percent of its NGM funds on support programs that are related to administration of NGM, provided, however, than an authority using its NGM funds for support services must meet its contracted performance target for persons served with NGM and the availability of NGM funds to expend on services must result from cost efficiencies achieved by the authority. c) To the extent that the local authorities or state contracted managed care organizations are able to obtain cost savings associated with cost effective purchasing arrangements, private sector donations of medication for clients and/or financial contributions for the purchase of NGM in DSHS Strategies B.2.1, Mental Health Services for Adults, B.2.2, Mental Health Services for Children, and B.2.4, NorthSTAR Behavioral Health Waiver, and they meet or exceed their contracted performance targets for persons served with NGM, they may expend up to an equivalent amount from these strategies on direct services to clients. 5