The House Committee on Appropriations 
         79th Legislature 
         March 15, 2005 
         7:00 a.m. 
         Capitol Extension, E1.030 
          
         Pursuant to a notice posted on March 9, 2005, and revised on  
         March 14, 2005, the House Committee on Appropriations met in a  
         public hearing and was called to order by the chair,  
         Representative Pitts, at 7:08 a.m. 
          
         The roll was answered as follows: 
          
         Present:   Representatives Pitts; Luna; Berman; Brown, Betty;  
                    Brown, Fred; Chisum; Crownover; Davis, John; Edwards;  
                    Guillen; Haggerty; Hamric; Hegar; Hopson; Isett;  
                    Martinez; Pickett; Smith, Todd; Truitt (19). 
          
         Absent:    Representatives Branch; Dukes; Gattis; Hope; King,  
                    Tracy; Kolkhorst; McClendon; Menendez; Pena; Turner  
                    (10). 
          
         A quorum was present. 
          
         (Representative Turner now present.) 
          
         The chair recognized Representative John Davis to give an  
         overview of the Health and Human Services Subcommittee  
         recommendations. 
          
         (Representative McClendon now present.) 
          
         The chair recognized Representative Isett to lay out the  
         recommendations for the Department of Assistive and  
         Rehabilitative Services. 
          
         The chair recognized Representative John Davis to lay out the  
         recommendations for the Department of Aging and Disability  
         Services. 
          
         The chair recognized Legislative Budget Board staff to explain  
         the recommendations of the Health and Human Services  
         Subcommittee. 
          
         Testimony was taken.  (See attached witness list.) 
          
         (Representative Hope now present.)  (Representative Branch now  
         present.)  (Representative Dukes now present.)  (Representative  
         Kolkhorst now present.)  (Representative King, Tracy now  
         present.) 
          
         The chair recognized Representative John Davis to lay out the  
         proposed riders for the Department of Aging and Disability  
         Services. 
          
         The chair recognized Representative Hopson to lay out the  
         proposed riders for the Department of State Health Services. 
          
         (Representative Luna in chair.) 
          
         The chair recognized Representative Dukes to lay out the  
         recommendations for the Department of Family and Protective  
         Services. 
          
         (Representative Pitts in chair.) 
          
         At 9:58 a.m., on the motion of the chair and without objection,  
         the meeting was recessed until adjournment of the house. 
          
         The committee reconvened at 12:04 p.m. and was called to order  
         by the chair, Representative Pitts. The roll was answered as  
         follows: 
          
         Present:   Representatives Pitts; Luna; Berman; Brown, Fred;  
                    Davis, John; Dukes; Edwards; Guillen; Haggerty;  
                    Hamric; Hegar; Hope; Hopson; Isett; King, Tracy;  
                    Martinez; Pena; Pickett; Truitt (19). 
          
         Absent:    Representatives Branch; Brown, Betty; Chisum;  
                    Crownover; Gattis; Kolkhorst; McClendon; Menendez;  
                    Smith, Todd; Turner (10). 
          
         A quorum was present. 
          
         (Representative Smith, Todd now present.) 
          
         The chair recognized Representative Truitt to lay out the  
         recommendations for the Health and Human Services Commission. 
          
         (Representative Crownover now present.)  (Representative Branch  
         now present.)  (Representative Brown, Betty now present.)   
         (Representative Chisum now present.) 
          
         The chair recognized Representative John Davis to lay out the  
         recommendations for the Special Provisions Relating to All  
         Health and Human Services Agencies. 
          
         (Representative Turner now present.)  (Representative Kolkhorst  
         now present.)  (Representative McClendon now present.) 
          
         Representatives John Davis, Isett, Hopson, Dukes and Truitt  
         moved the adoption of the Legislative Budget Board  
         recommendations for the Department of Assistive and  
         Rehabilitative Services [hereinafter: "DARS"], Department of  
         State Health Services [hereinafter: "DSHS"], Department of  
         Family and Protective Services [hereinafter: "DFPS"], Department  
         of Aging and Disability Services [hereinafter: "DADS"], Health  
         and Human Services Commission [hereinafter: "HHSC"], and Special  
         Provisions Relating to All Health and Human Services Agencies  
         [hereinafter: "Special Provisions"] with the following changes: 
 
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         House Committee on Appropriations 
         3/15/2005 
          
         Proposed Fiscal Changes: 
          
         HHSC - Medicaid Caseload and Cost  
         DFPS - Foster Care Caseload Growth 
         DFPS - Foster Care--Replace Crime Victims Fund Funding 
         DFPS - Adoption Subsidies Caseload Growth 
         DFPS - APS--Replace Crime Victims Fund Funding 
         DADS - LTC Caseload Growth  
         DADS - LTC Functional Eligibility  
         HHSC - CHIP Caseload Growth and Cost  
         HHSC - Apply New CHIP Cost Sharing  
         HHSC -Add CHIP Hospice Benefit 
         DSHS - Civil Commitment Program 
         DADS - LTC Waiver Cost 
         DSHS - HIV Program  
         DSHS - State Mental Health Hospital Capacity Growth  
         DFPS - CPS Reform  
         DFPS - Maintain  APS MH/MR Current Caseload per Worker 
         DADS - Promoting Independence 
         DSHS - MH Hospitals  
         DSHS - Maintain Service Levels  
              Strategies Restored: 
              1.1.1 Coordinated Public Health Services 
              1.1.3.  Maintain Vital Records 
              1.1.4 Special Health Initiatives 
              1.1.5 Registries, Information and Analysis 
              1.2.5 Infectious Disease Epidemiology/Surveillance 
              1.3.1 Cardiovascular Disease, Diabetes, and Injury  
         Prevention 
              1.3.2 Abstinence Education 
              1.3.5 Epilepsy, Hemophilia, and Alzheimer's 
              1.4.1 Laboratory Services 
              2.1.3 Family Planning Services 
              2.1.5 Community Primary Care Services 
              2.2.4 Substance Abuse Prevention 
              2.2.5 Substance Abuse Intervention 
              2.2.6 Substance Abuse Prevention 
              2.3.2 FQHC Infrastructure Grants 
              3.1.1 Texas Center for Infectious Disease 
              4.1.1. Food (Meat) and Drug Safety 
              4.1.2. Environmental Health 
              4.1.3. Radiation Control 
              4.1.4. Health Care Professionals 
              4.1.5. Health Care Facilities 
              5.1.1 Central Administration 
              5.1.2 Information Technology Program Support 
              5.1.3 Other Support Services 
              5.1.4 Regional Administration 
         HHSC - Reduce HHS Waiting List Demographic Growth 
         DFPS - Restore Foster Care Rates to FY02-03 
         DFPS - Increase Foster Care Rates over FY02-03 
         DSHS - Childhood Vaccinations (Hepatitis A) 
         DFPS - Increase Monitoring of Licensed Facilities 
 
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         House Committee on Appropriations 
         3/15/2005 
          
         HHSC - Medicaid Buy-In 
          DSHS - Newborn Screening 
         DSHS - Childhood Vaccines (PCV-7) 
         HHSC - Expand Family Violence Services 
         HHSC - 2-1-1 Information and Referral 
         DADS - State School Cost Allocation Issue  
         HHSC - Maintain Program Admin and Support 
         HHSC - Maintain Technology Critical for Agency Functions 
         HHSC - Maintain Support of Integrated Eligibility 
         DFPS - Fund Technology (MLPP) 
         DFPS - Fund IMPACT 
         DFPS - Fund Statewide Intake Technology Needs (MLPP) 
         DFPS - Fund Stemmons Office Relocation 
         HHSC- Improve HHS Contract Management and Oversight 
         DADS - Critical State School Renovations  
         DADS -  Technology and Equipment (includes MLPP) 
         DADS - Critical Accountability and Oversight 
         DSHS - MH Hospital Critical Renovations  
         DSHS - Laboratory Information System  
         DSHS - Technology and Equipment (includes MLPP) 
         DFPS - Restore Prevention Services FY04-05 (TANF) 
         DFPS - Restore Prevention Services FY02-03 (TANF) 
         DADS - Title XX Community Care Services (Title XX) 
         DSHS - Cancer Registry 
         Technical Adjustments and Movements of Appropriations to Conform  
         to Subcommittee Recommendations: 
          
         DSHS--align dedicated tobacco to BRE  
         DSHS--bond refunding  
         DSHS--add FTEs to MH State Hospitals  
         DSHS--shift funding from Health Care Facility Strategy 
         DSHS--shift funding from Parkland Senior Care 
         DSHS--increase for FQHC 
         FPS--APS Reform Plan  
         FPS--back out unavailable CCDF from CPS Reform 
         FPS--back-out Crime Victim Fund  
         HHSC - Deferral of Medicaid August 2007 Payment to HMOs 
         HHSC - Deferral of CHIP August 2007 Payment to HMOs 
         DADS--Title XX for Guardianship 
         DARS--increase in GR-D for BET 
         DARS--Increase in IAC and FF for transition services 
         DFPS--One Month Deferral for Foster Care 
         DADS--Deferral for Com. MR and Reduction for Cash Accounting 
         FTE Changes: 
          
         Increase the FTE cap for DADS, DFPS, DSHS, and HHSC. 
          
         Align funding decisions among agency strategies and adjust FTE  
         levels and make technical adjustments to measure targets,  
         capital budgets, and riders to reflect funding decisions.  Also  
         align funding among agencies for decisions that impact more than  
         one agency. 
          
         Items for Future Consideration: 
 
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         House Committee on Appropriations 
         3/15/2005 
          
         HHSC - Restore Optional Medicaid Services 
          HHSC - Maintain Technology Critical for Agency Functions 
         HHSC - Maintain Program Admin and Support 
         HHSC - Reduce Waiting/Interest Lists  
         HHSC - Office of Inspector General Staff Increases 
         DADS - LTC Acuity Cost Increase  
         DADS - LTC - Rate Restoration to FY03 
         DADS - LTC - Rebase and Rate Increase 
         DADS - LTC- TILES to RUGS  
         HHSC - Medically Needy 
         HHSC - Medicaid & CHIP Provider Rate Restorations 
         HHSC - Fund Urban-Non Public Upper Payment Limit (UPL) Program 
         HHSC - Graduate Medical Education (GME)  
         HHSC - Provide Funding Hospital Financing  
         HHSC - Provide Medicaid & CHIP Rate Increases  
         HHSC - Revise TEFRA Rider 
         HHSC - State Facilities HR Staff 
         DSHS - Parkland Senior Care Project 
         DARS- Expand Independent Living Centers 
         FPS - Critical Accountability & Oversight 
          
         Motions, Riders and Rider Revisions for DARS: 
          
         Technical 
         28.  GR-Dedicated Account No. 492 Business Enterprises of Texas 
         4. Reimbursement of Advisory Council Members. 
         New or Modified Riders 
         2. Capital Budget 
         9. Amend Reporting on Early Childhood Intervention Rider  
         30. GR-Dedicated Account No. 107 Comprehensive Rehabilitation  
         Fund 
         31. Contingency for House Bill 2 
          
         Motions, Riders and Rider Revisions for DADS: 
          
         Technical 
         Adjust Informational Item           
         8. Accounting of Support Costs           
         36. Revolving Fund Services:  Canteen Services and Sheltered  
         Workshops       
         46. Contingency Appropriation out of the Quality Assurance  
         Account         
         44. Reimbursement of Advisory Council Members           
         New or Modified Riders 
         5. Nursing Home Program Provisions       
         7. Appropriations Limited to Revenue Collections        
         17. Survey of Nursing Facility Residents           
         Delete 22. Community Care Waiver Slots        
         32. Disposition of Construction Appropriation Related to Mental  
         Retardation          
         Delete 43. Area Agencies on Aging        
         Retain Struck Rider 72.  Pilot Project for Persons with  
         developmental Disabilities          
 
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         House Committee on Appropriations 
         3/15/2005 
          
         New Rider - Dual Diagnosis Pilot         
         New Rider - Additional Program of All-Inclusive Care for the  
         Elderly (PACE) Sites           
          New Rider - Contingency Appropriation for Senate Bill 6 -  
         Transfer of Guardianship Contracts       
         New Rider - Cost Comparison Report       
         New Rider - HCSSA Monitoring and Oversight Study        
         New Rider - Use of State Schools         
         New Rider - Study of the Utilization Review and Level of Need  
         Determination Processes for Home and  
         Community-based Services, Texas Home Living Waiver Programs, and  
         Intermediate Care  
         Facilities/Mental Retardation Program. 
         New Rider - Study of Community Care Services Eligibility  
         Determination and Hours Allocation. 
          
         Motions, Riders and Rider Revisions for DSHS: 
          
         Technical 
         Fully appropriate interest earnings in permanent tobacco  
         endowments to conform to Biennial 
         Revenue Estimate.    
         Adjust FTES to conform to State Hospital restoration.   
         Adjust Bond Debt Service due to refunding of revenue bonds.  
         16. Transfers of Appropriations - State Owned Hospitals                
         18. Community Hospital Funding for Galveston Community Hospital             
         25. New Generation Medications                
         Delete 27. Expenditures on Bond Homes              
         30. Use of Timber Receipts for Capital Projects              
         45. Reimbursement of Advisory Council Members                
         47. Unexpended Balances - Preparedness and Prevention and  
         Consumer Protection Services 
         69. Estimated Appropriation and Unexpended Balance                
         79. Nuisance Surveys for the Economically Disadvantaged  
         Communities Program            
         80. Medically Fragile Children                
         New or Modified Riders 
         2. Capital Budget              
         Delete 4. Priority Populations Defined             
         Delete 5. Youth at Risk of Selling Controlled Substances               
         Delete 6. Coordination of Support Services              
         10.  Limitation of Specific Strategy Transfers               
         36. Medical Treatment               
         44. Reimbursement of Advisory Committee Members              
         59. Rabies Control             
         62. Use of Community Primary Care Services, FQHC, and Special  
         Health Initiatives Funds 
         65. Emergency Care Attendant (ECA) Training             
         Delete 76. Small Urban Hospitals              
         82. Renovations at the Texas Center for Infectious Disease             
         142. Estimated Appropriation:  Perpetual Care Account             
         New Rider - Contingent Appropriation of Additional Fee Revenue              
         New Rider - Exemption from Article IX,  Section 11.04, Efficient  
         Use of State Owned and Leased Space                
 
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         House Committee on Appropriations 
         3/15/2005 
          
         New Rider - Federal Funds and Capital Budget Expenditures              
         New Rider - Contingent Appropriation and Authority to Expend  
         Funds for Texas Cancer Registry               
          
          Motions, Riders and Rider Revisions for DFPS: 
          
         Technical 
         23. Reimbursement of Advisory Council Members           
         New or Modified Riders 
         Delete 8. Fund Transfers for Funds Consolidation        
         13. Appropriation Transfer Between Fiscal Years         
         16. Use of Personal Cellular Telephones       
         New Rider - Reporting Requirement on Minority Child Removals           
         New Rider - Prevention and Early Intervention Program Grants           
         New Rider - Funding for At-Risk Prevention Services          
          
         Motions, Riders and Rider Revisions for HHSC: 
          
         Technical 
         Make Method of Finance substitution of tobacco for General  
         Revenue Match for Medicaid in order to fully reflect available  
         Tobacco funds in accordance with the Biennial Revenue Estimate.   
         Replace General Revenue Match for Medicaid with GR Dedicated  
         Permanent Fund Tobacco  
         Education and Enforcement to align with Biennial Revenue  
         Estimate.  
         4. Reimbursement of Advisory Committee Members.              
         47. Reimbursement of Advisory Council Members.               
         New or Modified Riders 
         16. Risk Stabilization Reserve                
         Delete 24. Medicaid Reimbursement Rates for Texas State Veterans  
         Homes                
         Delete 30. Evaluation of Mental Retardation Services              
         57. Collection of Rebates on Physician Administered Drugs              
         58. Medicaid Quality Initiative Pilot Project                
         New Rider - Medicaid Provider Reimbursement             
         New Rider - Review Process for Injectable Drugs              
         New Rider - Medicaid Reimbursement for Immunizations              
         28. Medicaid Support and Information Services                
         New Rider - Unexpended Balance Authority for Eligibility  
         Determination Services              
         Motions, Riders and Rider Revisions for Special Provisions: 
          
         Technical 
         26. Texas Capital Trust Account No. 543       
         37. Collection of Fees from the Copyright of Training Materials  
         and Patent of Technologies 
         39. Maximum Security Salaries       
         49. Efficiencies at Local Mental Health and Mental Retardation  
         Authorities          
         New or Modified Riders 
         11. Medicaid Managed Care Contracts           
         13. Limitation on Transfer Authority          
         17. Limitation on Use of Tobacco Funds        
 
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         House Committee on Appropriations 
         3/15/2005 
          
         20. Rate Analysis and Reporting Requirements       
         29. Funding Equity Among Local Mental Health and Mental  
         Retardation Authorities        
         Delete 30. Report on Local Authorities        
         44. Professional Trainees and Interns         
          45. Limit on Spending New Generation Medication Funds        
         New Rider - Limitation on Appropriations for Long-term Care  
         Waiver Slots.             
         Substitute New Rider 50. Appropriation Reduction for Care  
         Management of the Medicaid  
         Aged/Blind/Disabled Population 
          
         Various: Motion and Riders 
          
         Motion and Riders to implement: deferral of one month for Foster  
         Care, shift to cash-basis accounting for nursing home and other  
         Medicaid strategies at DADS, deferral of one month for MR  
         Community, deferral of one month for Medicaid HMOs, and deferral  
         of one month for CHIP HMOs. 
          
         Riders for the Items for Future Consideration for HHSC: 
          
         New or Modified Riders 
         19. Payments to Rural Hospitals Under Managed Care.     
         New Rider - State Facilities Human Resources Staff      
         New Rider - Direct Care Staff and Assisted Living Facilities      
          
         Riders for the Items for Future Consideration for Special  
         Provisions: 
          
         50. Appropriation Reduction for STAR+PLUS Expansion. 
          
         Without objection, the motion was adopted. 
          
         Testimony was taken.  (See attached witness list.) 
          
         (Representative Luna in chair.) 
          
         (Representative Pitts in chair.) 
          
         At 2:47 p.m., on the motion of the chair and without objection,  
         the meeting was adjourned until 7:00 a.m., March 16, 2005. 
          
         ________________________ 
         Rep. Pitts, Chair 
          
         ________________________ 
         Cristina Self, Clerk 
          
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         House Committee on Appropriations 
         3/15/2005 
          
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