By: Hall	S.B. No. 1979

	A BILL TO BE ENTITLED
	AN ACT
	relating to the study of the fiscal impact on local governments in
	Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties of
	restructuring the NorthSTAR behavioral health system and the
	effective implementation the Sunset Commission Health and Human
	Services Commission Issue 9 recommendation.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  The Texas Health and Human Services Commission
	shall contract with a private entity approved by the North Texas
	Behavioral Health Authority through a majority vote of the
	authority's board of directors to undertake a comprehensive study
	of the potential impact on local governments and continuity of
	services in Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall
	Counties if the present behavioral health managed care structure,
	known as the NorthSTAR system, were to be dismantled in accordance
	with the recommendations in Issue 9 of the Health and Human Services
	Sunset Commission report.
	SECTION 2.  The scope of the study shall encompass but not be
	limited to
	a)  Defining the initial and expected impact on
	county and municipal budgets of any system that
	might replace the present configuration
	b)  Defining the likelihood of and anticipated
	impact of recidivism resulting from increased
	acuity in the indigent population presently
	served in the current system if care is disrupted
	c)  Defining the potential impact on network
	access
	d)  Defining the impact on integrated care
	e)  Defining the overall impact on quality of care
	outcomes
	f)  Defining the overall impact on the cost of
	care
	g)  Defining the initial and expected impact on
	local medical and surgical hospitals
	SECTION 3.  The findings of this study will be reported back
	to the North Texas Behavioral Health Authority and the Texas Health
	and Human Services Commission no later than June 30, 2016.
	SECTION 4.
	Collin County may exit NorthSTAR on or by October 1, 2016.
	The present deadline for any other changes to the NorthSTAR
	model shall be changed to September 1, 2017. This
	modification shall be made in order to align the current
	contract cycle with the State of Texas fiscal year and allow
	the next Legislature the ability to make an appropriately
	informed deliberation on the future of public behavioral
	health care in Dallas, Ellis, Hunt, Kaufman, Navarro and
	Rockwall Counties.
	SECTION 5. In the interim period the North Texas
	Behavioral Health Authority and the Texas Health and Human
	Services Commission shall solicit local stakeholder and
	community input, and incorporating the findings of the impact
	study, shall work with the representatives designated by the
	affected county governments in the development of a system
	that incorporates
	a)  Local control and governance of the system by
	member counties through their designated voting
	representatives on the North Texas Behavioral
	Health Authority
	b)  True integration and coordination of mental
	health services, substance use disorder services,
	crisis services and physical health care
	c)  Equal care for non-Medicaid and Medicaid
	behavioral health populations
	d)  Open access
	e)  Braided local, state, and federal funding
	f)  Connectivity and coordination of coverage
	which preserves the principles of 'no wrong door'
	g)  Choice of providers
	h)  Waiver of Institute of Mental Disease (IMD)
	Exclusion
	i)  Separation of authority and provider
	functions
	j)  Serving all those meeting state criteria for
	behavioral health services in one system:
	i.  Income at or below 200% of Federal
	Poverty Level,
	ii.  All individuals meeting state
	behavioral health clinical criteria;
	iii.  Individuals meeting state Medicaid
	requirements
	k)  Comprehensive evaluation and transparent
	publication of data
	l)  Status as a public local behavioral health
	authority entity eligible to put up non-federal
	dollars to match federal DSRIP funds
	m)  Provider payment plan and mechanisms to ensure
	a competitive provider market and an adequate
	network of providers capable of providing broad
	access to services;
	n)  Plan to ensure quality of services provided to
	clients and
	o)  Incentives of inclusion of local
	participation or match requirements
	p)  Option for Dallas, Ellis, Hunt, Kaufman,
	Navarro or Rockwall Counties to continue in the
	plan or choose an alternate model and for counties
	contiguous to present or future NorthSTAR
	counties to join the model if the county
	governments of those contiguous counties should
	so choose
	SECTION 6.  This Act takes effect immediately.