MINUTES 
          
                     SENATE INTERIM COMMITTEE ON HOME HEALTH 
                         AND ASSISTED LIVING FACILITIES 
                           Tuesday, February 17, 1998 
                                     9:30 am 
                University of Texas-M. D. Anderson Cancer Center 
                                Hickey Auditorium 
                             1515 Holcombe Boulevard 
            Houston, Texas 77030 
          
                                      ***** 
          
         Pursuant to a notice posted in accordance with Senate Rule  
         11.11, a public hearing of the Senate Interim Committee on  
         Home Health and Assisted Living Facilities was held on  
         Tuesday, February 17, 1998 in Houston, Texas.   
          
                                      ***** 
          
         MEMBERS PRESENT:                        MEMBERS ABSENT: 
         Senator Mike Moncrief, Chair            Senator Drew Nixon  
         Senator Jane Nelson                      
         Senator Gonzalo Barrientos 
         Senator Mario Gallegos, Jr.              
          
                                      ***** 
          
         The Chair called the meeting to order at 9:43 am.  The  
         following business was transacted.   
          
         The following members arrived after the roll was called:   
         Senator Gonzalo Barrientos 
         Senator Mario Gallegos, Jr. 
          
         The Chair introduced and welcomed Senator Jon Lindsay from  
         District 7 and Representative Scott Hochberg from District  
         132, Houston, Texas. 
          
         The Chair made opening remarks, welcomed invited speakers,  
         state agency staff and the public.   
         The Chair announced that the purpose of the hearing was to  
         sort through the process of state and federal policies  
         relating to fraud, waste and abuse and its impact on home  
         health care.  
          
         The Chair then called Eric M. Bost, Commissioner, Texas  
         Department of Human Services, 
         to brief Committee Members on the investigation of a fire at  
         an unlicensed personal care home in which a death occurred and  
         to respond to questions from the Committee.  The Chair thanked  
         and dismissed the witness. 
          
         The Chair then called a panel to testify about Medicaid  
  
         program integrity.  The panel members were: 
          
              Michael McKinney, M. D., Commissioner, Texas Health and  
         Human Services Commission 
              Aurora LeBrun, Associate Commissioner for Operations,  
         Texas Health and Human Services 
                   Commission 
              Jackie Johnson, Assistant Deputy Commissioner for Long  
         Term Care Services, Texas          Department of Human  
         Services 
              Robin Herskowitz, Texas Performance Review, Texas  
         Comptroller of Public Accounts 
          
         A report was given by Drew Beckley, Electronic Data Systems,  
         regarding the Texas Medicaid Fraud and Abuse Detection System.   
         Mr. Beckley responded to questions from the Committee.  The  
         Chair thanked and dismissed the witness.  
          
         The panel testified and responded to questions from Members of  
         the Committee.  The Chair thanked and dismissed the panel. 
          
         The Chair then called a panel to testify about federal  
         perspectives regarding home health fraud, 
         waste and abuse.  The panel members were: 
          
              Judy Brown, Chief of Program Integrity, Health Care  
         Financing Administration 
              Nance Stearman, Director, Health Facility Compliance  
         Division, Texas Department of 
                   Health 
              Kathy Johnson, Surveyor, Texas Department of Health 
          
         At 12:20 p.m. there being a quorum present, Senator Nelson  
         moved that the reading of the minutes from the last two  
         hearings, December 2, 1997 and January 27, 1998, be dispensed  
         with and approved by unanimous consent.  There being no  
         objection, the minutes were approved. 
          
         Senator Barrientos introduced and welcomed Dr. Jack Harris, a  
         former colleague, to the hearing. 
          
         The panel testified and responded to questions from Members of  
         the Committee.  The Chair  
         thanked and dismissed the panel. 
          
         The Chair recessed at 12:52 p.m.  
         The Chair reconvened the hearing at 1:58 p.m. and called a  
         panel regarding professional licensing 
         and home health fraud, waste and abuse.  The panel members  
         were: 
          
              Julia R. Beechinor, Director, Health Facility Licensing  
         Division, Texas Department of Health 
              Katherine Thomas, M.N., R.N., Executive Director, Board  
         of Nurse Examiners for the State  
  
                   of Texas 
              Anthony Diggs, Board of Nurse Examiners 
              Kathleen Davies, Supervising Investigator, Board of  
         Vocational Nurse Examiners 
              Bruce Levy, M. D., Executive Director, Texas State Board  
         of Medical Examiners 
          
         The following persons were called by the Chair to respond to  
         questions from Committee Members 
         about licensing and enforcement activities for the Texas  
         Department of Health: 
          
              Derek J. Jakovich, Texas Department of Health 
              Ron Mansolo, Associate Commissioner for Health Care,  
         Quality and Standards, Texas 
                   Department of Health 
              Denise Donnelly, Office of the Attorney General, State of  
         Texas 
          
         The panel testified and responded to questions from Members of  
         the Committee.  The Chair thanked and dismissed the panel. 
          
         The Chair then called a panel to testify about provider  
         perspectives regarding home health fraud, waste and abuse.   
         The panel members were: 
              Anita Bradberry, Executive Director, Texas Association of  
         Home Care 
              Paul Handel, M.D., President-Elect of the Harris County  
         Medical Society, Representative of  
                   the Texas Medical Association 
              Janet Moll, R.N., Texas Nurses Association 
              Bobbe Graham, L.V.N., Licensed Vocational Nurses  
         Association of Texas 
              Florence D. Taylor, L.V.N., President, Licensed  
         Vocational Nurses Association of Texas 
          
         The panel testified and responded to questions from Members of  
         the Committee.  The Chair thanked and dismissed the panel. 
          
         At 5:17 p.m., Senator Moncrief announced that the Committee  
         would stand recessed until 9:30 a.m., 
         Wednesday, February 18, 1998.  Without objection, it was so  
         ordered. 
          
         ______________________ 
         Senator Mike Moncrief, Chair 
          
         ______________________ 
         Judy Daugherty, Clerk