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Legislative Tracking: 84th Texas Legislature
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84th Legislative Session Wrap-Up

July, 2015

 

With Texas’ 84th legislative session in the past, we should take some time and reflect on the decisions and indecisions made that impact professional social work and the populations we serve. This legislative wrap-up includes the outcomes of items from the NASW/TX legislative agenda and some of the bills related to areas where social workers have a presence. This list is not exhaustive, but provides information on the issue areas we tracked on engage this session: http://cqrcengage.com/socialworkerstx/home.  All bills and related actions from the 84th Legislative Session can be found at www.capitol.state.tx.us.  Each bill below is hyperlinked, and there are links throughout the document when more info is needed.

 

*In many instances only one author has been identified

 

NASW/TX Legislative Agenda Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 233

Farrar (D)

Adds school social worker to the Texas Education Code

Passed out of House Pub Ed – Died in Calendars

HB 841

Naishtat (D)

Would create a Social Work Center for Workforce Studies

Referred to House Human Services - Died in Committee

HB 1116

Sheffield (R)

Companion bill to SB 378

Substituted for SB 378

HB 3672

Naishtat (D)/ Raymond (D)

Companion bill to SB 1402

Passed out of House – Died in Committee in the Senate

SB 378

Rodríguez (D)

Adds liability protection language for social workers who volunteer with charitable organizations and in state disasters

Signed by the Governor – effective 9/1/2015

SB 675

Rodríguez (D)

 

Companion bill to HB 233

Referred to Senate Education – Died in Committee

SB 1402

Rodríguez (D)

Expedited credentialing for LCSW’s under Medicaid

Referred to Senate Health and Human Services – Substituted for HB 3672

 

Bills Related to NASW/TX Legislative Agenda:

 

Bill Number

Author

Bill Description

Outcome

HB 1434

McClendon (D)*

Would place a psychologist, LPC, LCSW or school counselor in the position of mental health specialist

Referred to House Public Ed – Died in Committee

SB 239

Schwertner (R)*

Loan repayment (includes LCSW’s)

Signed by the Governor -effective 9/1/2015

SB 358

West (D)*

Loan repayment assistance for CPS workers

Referred to Senate Health and Human Services – Died in Committee

SB 760

Schwertner (R)*

Network adequacy and expedited credentialing

Signed by the Governor -effective 9/1/2015

 

Bills Related to Sunset:

 

Bill Number

Author

Bill Description

Outcome

SB 200

Nelson (R)*

HHS Sunset Bill - Brings client services, regulatory, and facility operations to HHSC; Executive Commissioner will develop a transition plan to assess the continuing need for DFPS and DSHS as standalone entities; Continues HHSC for 12 years, DSHS and DFPS for eight years, and provides for limited-scope Sunset review of OIG in six years

Signed by Governor (effective dates in bill)

 

 

SB 202

 

 

Nelson (R)*

DSHS Sunset Bill - Final version almost exclusively specific to DSHS Regulatory Licensing.

Signed by Governor (effective dates in bill)

SB 204

Hinojosa (D)*

DADS Sunset Bill

Passed out of Senate. Failed to pass House

SB 206

Schwertner (R)*

DFPS Sunset Bill - addresses the key goals of CPS Transformation, to allow caseworkers to spend more time with children and families and improve the safety, permanency, and well-being of children in CPS cases. Reduces unnecessary administrative tasks and paperwork, reduces workload where possible, and provides DFPS with the flexibility to make its processes more efficient and adapt to changing best practices.

Signed by Governor (effective dates in bill)

SB 207

Hinojosa (D)*

OIG Sunset Bill

Signed by the Governor – effective 9/1/2015

SB 208

Campbell (R)*

TWC Sunset Bill

Signed by Governor (effective dates in bill)

HB 2463

Raymond (D)*

DARS Sunset Bill

Signed by Governor (effective dates in bill)

 

Additional info Related to the Sunset process for HHSC:

All of the Advisory Councils at HHS were abolished through legislation.  A new HHSC Executive Council was created, composed of: Executive Commissioner (Chair), division directors, commissioners of remaining HHS agencies, and other individuals appointed by the Executive Commissioner.  The Executive Council will create a new set of advisory committees, and the agency is required to have this list available by Nov. 1st, 2015.  By 2016, DADS and DARS (excluding the programs transferring to Texas Workforce Commission) will move to HHSC, and the administrative and prevention services will be transferred as well.  By 2018, the DSHS and DFPS study will be due.

 

Bills Related to Medicaid Providers:

 

Bill Number

Author

Bill Description

Outcome

HB 839

Naishtat (D)*

Relating to the presumptive eligibility for the Medicaid and child health plan programs for children leaving the Texas Dept. of Juvenile Justice.

Passed on 6/18/2015 without the Governor’s signature. Effective immediately.

HB 2084

Muñoz Jr. (D)*

Relating to transparency in the Medicaid managed care and STAR Medicaid rate-setting process

Vetoed by Governor: explanation

 

Bills Related to the Affordable Care Act (ACA) and Medicaid Expansion:

There were no bills this session on Medicaid expansion that received a hearing.  The prevailing tone in both the Senate and the House, promoted by leadership from the Governor and Lt. Governor, was that the ACA’s provision to expand Medicaid to cover the neediest Texans is not a step that Texas should take, and so no compromises or attempts to customize a solution were put forward.  Despite support from the Texas Hospital Association, a variety of business groups, judges, city councils and a myriad of organizations, there was no movement in this area.

 

Bills Related to Child Welfare/Adult Protective Services:

 

Bill Number

Author

Bill Description

Outcome

HB 781

Burkett (R)*

Clean up bill, but also ensures that agencies utilize risk assessments and authorized training curriculums for staff, and mandates that each caregiver receive a minimum of 35 hours of training. Kinship caregivers are excluded.

Signed by the Governor – effective 9/1/2015

SB 125

West (D)*

Requires a comprehensive assessment no later than 45 days after entry into care. The assessment must include a trauma screening and interviews with individuals knowledgeable about the child. CPS will use the CANS

Signed by the Governor – effective 9/1/2015

SB 358

West (D)*

Expansion of the Title IV-E program to FBSS and Investigative caseworkers as well. It would also create a loan repayment program for frontline and first tier supervisors in INV, CVS and FBSS incentivized for those who do not qualify for IV-E.

Referred to House Human Services - Died in Committee

SB 830

Kolkhorst (R)

Creates an independent ombudsman’s office outside of DFPS that foster youth can report to. Other complaints will still be handled by DFPS

Signed by the Governor – effective 9/1/2015

SB 949

Uresti (D)*

Requires DFPS to produce an annual report of all child fatalities investigated by DFPS

Signed by the Governor – effective 9/1/2015

SB 1407

Schwertner (R)*

Normalcy for foster youth - strengthens the right of children in foster care to participate in normal activities and experiences by empowering substitute caregivers to approve participation in activities based on a prudent parent standard

Signed by the Governor – effective 9/1/2015

SB 1889

Zaffarini (D)*

The finding of Neglect is removed from a family whose child enters care due to a serious emotional disturbance that the family was unable to find treatment for, and those persons previously given a disposition of Neglect shall be removed from the registry.

Signed by the Governor – effective 9/1/2015

 

LGBT Related Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 71

González, M (D)*

Would allow the “Romeo & Juliet Defense” to apply to persons of the same gender

Passed out of House State Affairs - Died on the floor

HB 537

Anchia (D)*

Would place the names of both adoptive parents, regardless of gender, on a supplementary birth certificate

Passed out of Criminal Jurisprudence- Died on the floor during 2nd reading

HB 623

Bell (R)*

A state employee who issues a marriage license to a same-sex couple would lose their salary, benefits and pension.

Referred to House State Affairs - Died in Committee

HB 679

Turner, S (D)*

Commissions the Department to conduct a study on homeless youth due 12/1/2016

Signed by the Governor – effective 9/1/2015

HB 1523

Farrar (D)

Would repeal 21.06 of the Penal Code (the prohibition against “homosexual conduct”); declared unconstitutional by the Supreme Court but still in the law

Referred to Criminal Jurisprudence - Died in Committee

HB 1747

Riddle (R)*

Makes it a crime for a individual who identifies as transgendered to use the restroom of their choosing

Referred to House State Affairs - Died in Committee

HB 1748

Riddle (R)*

Makes it a state jail felony for most business owners to repeatedly allow a person who has at least one “Y” chromosome to enter a space designated for women, or a person with no “Y” chromosome to enter a space designated for men; Makes it a Class “A” misdemeanor for a person with at least one “Y” chromosome to enter a space designated for women or a person without a “Y” chromosome to enter a space designated for men (such as a school locker room).

Referred to House State Affairs - Died in Committee

HB 2553

White, M (R)*

Allows a private business owner to choose whether to provide goods or services based on religiously held beliefs

Referred to Business and Industry- Died in Committee

HB 2555

White, M (R)*

Would exempt Texas from the Constitution of the United States should same-sex marriage be declared a right

Referred to House State Affairs - Died in Committee

HB 3495

Israel (D)

Would disallow the use of conversion therapy, and allows for regulatory action to be taken

Referred to House State Affairs - Died in Committee

HB 3567

Sanford (R)*

Allows a person authorized to perform at weddings to decline to marry couples based on religiously held beliefs

Voted out of House State Affairs - Died on the floor

HB 3602

Bell (R)*

Would allow an employee to sue the government or businesses that reprimands a worker for providing a hostile environment towards a person identifying as LGBT based on religiously held beliefs

Referred to House State Affairs - Died in Committee

HB 3864

Sanford (R)*

Would allow anyone connected to the child welfare arena to discriminate against children, couples or other persons based on religiously held beliefs, and would allow foster families to place a child in the religious schooling of their choice with no departmental oversight

Voted out of House Juvenile Justice and Family Issues - Died on the floor

HB 4105

Bell (R)*

Would strip all marriage license fees from counties that issue same-sex marriage licenses, and would require that those licenses not be entered into vital statistics but turned over to the Attorney General

Voted out of House State Affairs - Died on the floor

SB 407

Rodríguez (D)

Would allow an individual who identifies as transgendered to receive a waiver to vote if they do not possesses a state ID

Si Referred to Senate State Affairs - Died in Committee

 

Mental Health Related Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 19

King, S (R)*

Strengthens DSHS and DFPS preventive services programs and mental health programs for veterans and military families, as well as increases state support for local programs

Signed by the Governor – effective 6/4/2015

HB 440

Gonzales, L (D)*

Relating to adapting the public school physical education curriculum to accommodate the needs of students with mental disabilities.

Signed by the Governor – effective 5/23/2015

HB 764

King, S (R)*

Relating to the use, collection, and security of health care data collected by the Department of State Health Services.

Signed by the Governor – effective 9/1/2015

HB 1083

Márquez (D)*

Before an inmate is placed in administrative segregation they must receive a mental health evaluation, and if this discipline is found to be detrimental to their medical or mental condition it is not allowed.

 

Signed by the Governor – effective 9/1/2015

HB 1286

Simmons (R)*

Increases the definition of a person with disabilities to include autism spectrum disorder, a developmental disability, an intellectual disability, a severe emotional disturbance or a traumatic brain injury in regards to the prosecution and punishment for an injury committed against said person

Signed by the Governor – effective 9/1/2015

HB 1338

Naishtat (D)

Relating to training for peace officers and first responders on certain persons affected with a traumatic brain injury

Signed by the Governor – effective 9/1/2015

HB 1430

King, S (R)

Includes mental health in the public services endorsement on a public school diploma and in information about health science career pathways.

Signed by the Governor – effective 5/23/2015

HB 1541

Burkett (R)*

Relating to peer specialists, peer services, and the provision of those services under the medical assistance program.

Passed House – Died in Senate Health and Human Services

HB 2186

Cook (R)*

Relating to suicide prevention training for educators in public schools.

Signed by the Governor – effective 6/19/2015

HB 2523

Collier (D)*

Relating to continuing Medicaid services for persons leaving incarceration

Passed out of House Public Health and died on the floor

HB 2789

Raymond (D)*

Relating to trauma-informed care training for certain employees of state supported living centers and intermediate care facilities.

Signed by the Governor – effective 9/1/2015

HB 3999

Naishtat (D)*

Requires that all persons in a social work position be licensed.

Referred to House Public Health – died in Committee

SB 133

Schwertner (R)*

Relating to mental health first aid training for school resource officers and employees who regularly interact with students.

Signed by the Governor – effective 6/17/2015

SB 359

West (D)*

Allows a peace officer to apprehend a person for emergency detention and authorizes hospitals and physicians to temporarily detain a person with mental illness.

Vetoed by the Governor – explanation

SB 674

Campbell (R)*

Instructions regarding mental health, substance abuse, and youth suicide in educator training programs.

Signed by the Governor – effective 9/1/2015

SB 1129

Zaffarini (D)

Amends the law to reduce restraints on a person with a mental illness when they are being detained or transported.

Signed by the Governor – effective 6/17/2015

SB 1507

Garcia (D)*

Creates a Forensic Director position at DSHS. Requires regional allocation of mental health beds with input from an advisory panel. Proscribes alternative treatment training for attorneys and judges.

Signed by the Governor – effective 5/28/2015

SB 1624

Rodríguez (D)*

Requires that certain entering students at a general academic teaching institution receive information regarding mental health and suicide prevention services.

Signed by the Governor – effective 9/1/2015

 

Guardian Rights and Supported Decision Making Related Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 39

Smithee (R)*

Contains alternatives, services and supports, residence decisions and other good reforms related to supported decision-making

Signed by the Governor – effective 9/1/2015

HB 1438

Thompson, S (D)*

Relating to probate matters, including guardianships and other matters related to incapacitated persons.

Signed by the Governor – effective 9/1/2015

HB 3930

Hughes (R)*

Relating to the duties of a guardian

Referred to House Judiciary and Civil Jurisprudence – Died in Committee

SB 1881

Zaffarini (D)*

Relating to supported decision making, and to substitutes for guardianships for certain adults with disabilities.

Signed by the Governor – effective 9/1/2015

SB 1882

Zaffarini (D)*

The bill of rights for persons under guardianship.

Signed by the Governor – effective 9/1/2015

 

Women’s Health & Issues Related Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 90

González, M (D)*

Would lower the age requirement to be eligible for the Texas Women’s Health Program from 18 to 15.

Referred to House Public Health – no hearing

HB 1140

Israel (D)*

Requires jails to notify the commission of any changes to policies regarding pregnant individuals or when a pregnant woman is placed in solitary confinement or administrative segregation

Signed by the Governor – effective 9/1/2015

HB 3994

Morrison (R)*

Increases the restrictions on a minor seeking a judicial bypass to receive an abortion. Creates a provision that any woman in Texas seeking an abortion must show identification to the provider.

Signed by the Governor – effective 1/1/2016

HB 786

Walle (D)*

Relating to the right of a public employee to express breast milk in the workplace.

Signed by the Governor – effective 9/1/2015

 

 

Additional Info Related to Women’s Health:

There were four bills that would have required that medically accurate information be taught in sex education class in public schools.  None of them received a hearing in committee.  A bill that would have given emergency contraceptive information to survivors of sexual assault did not receive a hearing.  Bills allowing minors to consent to contraceptive procedures and including contraception under a child’s health plan likewise were denied hearings, as was one that would have created a great deal more transparency for pregnancy crisis centers. 

 

Making it further though, a bill removing language from HIV/AIDS prevention programs indicating that sex before marriage could cause psychological and physical harm passed out of committee and died on the floor.  One that would have removed language nullifying the end of life directives from a pregnant woman likewise got a hearing, but did not make it out of committee. 

 

Misc. Related Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 910

Phillips (R)*

Open carry bill

Signed by the Governor – see bill for effective dates

HB 984

Deshotel (D)*

Would provide an adopted child with their original birth certificate upon turning 18

Passed out of the House – Died on the Senate floor

HB 2398

White, J (R)*

Decriminalizes truancy

Signed by the Governor – effective 9/1/2015

SB 11

Birdwell (R)*

Campus carry bill

Signed by the Governor – effective 8/1/2016

SB 267

Perry (R)*

Removes a city’s ability to create an ordinance prohibiting housing discrimination based on method of payment.

Signed by the Governor – effective 9/1/2015

  

 

Budget Related Bills:

 

Bill Number

Author

Bill Description

Outcome

HB 1

Otto (R)

The General Revenue portion of this budget was $6.4 billion under available revenue The tax cut plan includes a $10,000 increase in the school property tax homestead exemption (about $10 per household per month) and a 25% franchise tax cut that accounts for two-thirds of the tax cut total. One-third of this cut benefits out of state shareholders.

Signed by the Governor with some line-item vetoes. – effective 9/1/2015

 

Additional Budget Information:

 

Child Welfare: Non-competitive pay is among the many reasons that CPS has high employee turnover, costing the state more than $72 million in 2013 alone. A cost-of-living (COL) adjustment up to $1,200 per month for workers living in high cost areas where there is excessive turnover was approved. 

 

$8.8 million for overtime pay for caseworkers was authorized, as well as merit pay to 25% of caseworkers at $1,250 every 6 months.

 

The legislature approved an additional $442 million in 2016-17 for 91 CPS direct delivery staff; including Investigative, FBSS and CVS caseworkers. This is an overall increase of 15% above 2014-15. The additional funds will maintain caseloads for Investigative caseworkers and lower caseloads for FBSS and CVS caseworkers.

 

$32.6 million for enhancements was included to IMPACT to help implement Transformation efforts and also allow caseworkers more efficiency in performing tasks, and expands the number of caseworker support centers. IMPACT modifications include enhancements to support Structured Decision Making, batch process for printing and mailing large volumes of letters, and vendor portal for service providers to timely report delivery of services.

 

Expanding CPS candidate outreach to recruit new caseworkers was a priority, and $7 million was earmarked to improve candidate testing and screening process and increase learning systems to support changing business needs of department and workers. It also creates a stipend program to support mentoring and training of new caseworkers.

 

The Office of Child Safety was given $3.3 million to continue to analyze data, identify high risk areas of the state, and make safety recommendations through programs and services.  Caseworkers received $1.2 million through the funding of the worker safety office to provide ongoing support to workers who have experienced traumatic events.

 

Finally, an additional $3.3 million was targeted to fund master conservatorship supervisors and specialists, master investigator supervisors, and administrative support. It also includes funding for interregional specialist caseworkers and supervisors to conduct face to face visits and document child updates for primary caseworkers.

 

Health: $62.1 billion All Funds ($25.1 GR and GR-D) were dedicated to Medicaid, which will cover 4.2 million persons by fiscal 2017.  No funds for Medicaid cost growth are part of the budget, and there is a cost containment rider that requires mandated ways to cut spending.  CMS has already alerted Texas that our 1115 transformation waiver under Medicaid may be in jeopardy since funds through this program were not meant to apply to individuals that would be covered by the ACA.  But since HB 1 did not provide much help for rural hospitals, and only allocated $247 million GR ($574 AF) towards hospital rates, and with a potential decrease in Medicaid rates for pediatricians looming, the state may soon find its healthcare system in dire straits.

 

Under the CHIP program 405, 626 children would be seen under a budget of $1.78 billion AF.

 

Mental Health:  $2.6 billion GR and GR-D in 2014-15 to $2.8 billion this session.  $2 billion of that would go to DSHS, and that includes increases in outpatient and inpatient services.  Behavioral health and substance abuse services in the 2016–17 biennium are provided $3.6 billion in All Funds, including $2.8 billion in General Revenue Funds and General Revenue–Dedicated Funds, an increase of $150.7 million in All Funds over the 2014–15 biennium (not including Medicaid mental health services).  $2.6 billion of that is GR and GR-D, with $2 billion of that going to DSHS. This includes increases in outpatient and inpatient services

 

Women’s Health: The HHS Women’s Health Programs received $4.1 billion in funding: $36 million GR for the Texas Women’s Health Program; $21.6 million AF for the Family Planning Program; $50 million GR for the expanded Primary Healthcare Program; $1.5 million AF for Title V Prenatal; $3.7 billion AF for Medicaid Women’s Services; $205 million for CHIP perinatal; $12.3 million AF for Breast and Cervical Cancer Screening; $91.2 AF for Medicaid for Breast and Cervical Cancer Screening. 

 

As of April 1, 2015, all of the HHSC and DSHS women’s health programs were consolidated under the newly created Office of Women’s Health at DSHS.  This includes the: Texas Women’s Health Program, all Family Planning, Expanded Primary Health Care and all Breast and Cervical Cancer Services.  Also, SB 200 directs the Executive Commissioner of HHSC to create a Women’s Health Advisory Committee charged with providing recommendations on the consolidation of the programs.

 

Pregnant women eligible for Medicaid will be shifted to the Texas Women’s Health Program (TWHP) after delivery as of April 2016.  Also, Long-Acting Reversible Contraception (LARC) were added to the coverage plans of Medicaid and TWHP, allowing pharmacies to prescribe additional contraceptives to women, and ensuring that hospitals and FQHC’s receive reimbursement.

 

No Family Planning (FP) funds are to be used to pay abortion providers or affiliates, and to receive FP funds, an entity must not be affiliated with an entity that performs abortions. This effectively shuts Planned Parenthood out from any state dollars.

 

Education: Pre-K is currently funded as a half day for children (which means each child counts as half a student in the formulary), and Rider 58 under TEA adds $30 million over the biennium to the program.  HB 4, the Pre-K bill, also added $59 million per year.  These funds will improve Pre-K programs already in existence, and does not increase the number of children receiving services.

 

$40.9 billion in AF was allocated to the Foundation School Program, with an additional $1.4 billion for facilities.  This is just over a 1% increase in funds, and covers the dollars lost to the tax decreases through the increased homestead exemption and the franchise tax cut.  The basic allotment per child is set at $5,140 for 2016-17.

 

Charges for the 84th Interim

 

Goal: To develop a Medicaid Behavioral Healthcare System that is accessible, has a robust network of providers and reimburses providers at a level that encourages participation and tenure within the system.

 

1.) Analyze the differences between the actuarial amounts paid to the MCO’s for the provision of mental and behavioral health services, and the (reimbursement) amounts received by providers. 

 

    •  The current shortage of mental and behavioral health providers and questions about network adequacy have raised concerns about the ability of Medicaid enrollees to access services.  With Medicaid re-credentialing of providers required by the state by March 1st, 2016, the current network may lose even more providers.  The Medicaid reimbursement rates set by HHSC are cited as a potential barrier to attracting mental health professionals, but an equally large concern is the discrepancy between the amount paid by the state to the MCO’s and the amounts actually being paid out for services.  Texas needs to ensure that it is receiving the best return on its investment in mental and behavioral health. By undertaking a cost analysis of the actual dollars reaching providers it can ensure that it is supporting an adequate network as well as the best and most qualified providers.

 

2.) Explore the development of a system that would equalize Medicaid reimbursement rates for mental and behavioral health across services and disciplines through a tiered system based on tenure, experience, certifications, and training.

 

    • Within Medicaid there is no parity in pay: the same service is paid at different rates for different disciplines, even if the exact same billing code is used.  Research shows that the most significant factor upon positive outcomes is the strength of the therapist/client relationship, and not the level of professional degree attained.  A system that follows the Texas Department of Insurance rules for insurance companies’ reimbursement for providers would ensure that equity is applied to all services (§1451.104). This would put the focus on treatment and not the providers.

 

o   A tiered system of reimbursement would take into account the length of time a provider remains in the Medicaid system, the various specialized trainings and certifications received as well as any other unique qualifications that a provider attains within their career.  By creating a baseline for reimbursement and adjusting the specific rates for each provider, the system would incentivize both active, continued participation in Medicaid, as well as the attainment of continuing education and skills that promote best practices.

 

 

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