Department of State Health Services

Final Results of Last Sunset Review

The following material summarizes results of the Sunset review of DSHS, including management actions directed to DSHS that do not require statutory changes. For additional information see the Department of State Health Services Staff Report with Final Results.

Deregulation and Transfers of Regulatory Programs

• Discontinues the state licensure, certification, and registration related to bottled and vended water, contact lens dispensers, opticians, personal emergency response systems, bedding, indoor air quality in state buildings, rendering, and tanning bed facilities. (S.B. 202)
• Transfers the following 13 regulatory programs from DSHS to TDLR in two phases over four years, and reconstitutes associated independent boards as advisory boards: athletic trainers, dietitians, dyslexia therapists and practitioners, fitters and dispensers of hearing instruments, midwives, orthotists and prosthetists, speech-language pathologists and audiologists, code enforcement officers, laser hair removal, massage therapists, mold assessors and remediators, offender education providers, and sanitarians. (S.B. 202)
• Transfers the following four regulatory programs from DSHS to the Texas Medical Board, creates associated boards and committees, and requires fingerprint background checks: medical physicists, medical radiologic technologists, perfusionists, and respiratory care practitioners. (S.B. 202)

State Mental Health Hospital System

• Requires an updated, locally driven process for allocating and reviewing utilization of state mental health hospital beds among regions, with input from key stakeholders. (S.B. 1507)
• Directs DSHS to review current methods for allocating regional mental health funding and determine whether allocations match the prevalence of mental illness in associated regional populations. (management action – nonstatutory)
• Requires DSHS to work with the Court of Criminal Appeals to develop training to inform the judiciary about alternatives to inpatient mental health treatment. (S.B. 1507)
• Directs DSHS to develop a guide for alternatives to inpatient mental health treatment in the state mental health hospital system. (management action – nonstatutory)
• Directs DSHS and HHSC to immediately review and streamline hiring processes and improve other personnel actions needed to ensure state mental health hospitals are appropriately staffed. (management action – nonstatutory)
• Directs DSHS to continue expanding state mental health hospital system capacity for both forensic and civil patients by contracting with mental health providers in local communities whenever possible. (management action – nonstatutory)

Community Behavioral Health Programs

• Requires DSHS to integrate mental health and substance abuse hotline, screening, assessment, and referral functions, while allowing continued participation by existing providers. (S.B. 1507)
• Requires DSHS, in collaboration with HHSC, to conduct a review to identify improvements to performance measurement, contract processing, and payment mechanisms for behavioral health services contracts with DSHS, and authorizes the use of a third party with expertise in health purchasing. (H.B. 1 – DSHS Rider 82)
• Requires DSHS to conduct a comprehensive review of contract funding requirements and standards governing community-based crisis and treatment facilities for persons with mental health and substance abuse disorders. (H.B. 1 – DSHS Rider 80)
• Directs DSHS to examine certain services for homeless individuals with mental illness. (management action – nonstatutory)

Emergency Medical Services (EMS) Regulation

• Requires an EMS provider to have a physical location for its business establishment to obtain a license. (S.B. 1899)
• Requires an EMS provider to provide proof of ownership or a long-term lease agreement for all equipment necessary for safe operation of an EMS company, such as ambulances, stretchers, and defibrillators. (S.B. 1899)
• Authorizes DSHS to require jurisprudence examinations for all EMS licensees. (S.B. 1899)
• Clearly authorizes DSHS to take disciplinary action against EMS providers or personnel based on findings by a governmental entity with delegated authority to conduct inspections. (S.B. 1899)
• Requires DSHS to develop a formal process to refer nonjurisdictional complaints relating to EMS to appropriate organizations. (S.B. 1899)
• Requires DSHS to collect, maintain, and make publicly available detailed statistical information on complaints regarding EMS licensees while protecting the privacy of individual licensees. (S.B. 1899)

Public Health System

• Requires DSHS to develop a comprehensive inventory of the roles, responsibilities, and capacity relating to public health services delivered by DSHS and local health entities. Requires DSHS to establish statewide priorities for improving the state’s public health system and to create a public health action plan to effectively use state funds to achieve these priorities. (H.B. 1 – DSHS Rider 81)
• Directs DSHS to develop a system to categorize different types of local health departments based on the services they provide. (management action – nonstatutory)

Vital Statistics

• Requires all local registrars to submit a self-assessment report to DSHS annually. (S.B. 200)
• Directs DSHS to develop a formal desk audit policy and increase the use of desk audits in monitoring local registrars’ offices. (management action – nonstatutory)
• Requires identity verification through notarization for all mail-in vital records orders. (S.B. 200)
• Expands DSHS’ authority to require fingerprint-based criminal history background checks for anyone with access to the state’s electronic registration system. (S.B. 200)
• Directs DSHS to prioritize and regularly report on its progress implementing the Texas Electronic Vital Events Registrar system. (management action – nonstatutory)
• Directs DSHS to conduct a feasibility study for creating a single registry for births, deaths, marriages, and divorces in Texas. (management action – nonstatutory)

Texas Health Care Information Collection Program

• Continues the Texas Health Care Information Collection Program and aligns its future Sunset review with DSHS, scheduled for 2023. (S.B. 200)
• Directs DSHS to improve how healthcare data is used by the agency and displayed for consumers, particularly outpatient data. (management action – nonstatutory)
• Directs DSHS to replace the current data certification process with an optional data validation process. (management action – nonstatutory)
• Directs DSHS to provide data to the state’s Medicaid External Quality Review Organization so that HHSC can expand the Medicaid evaluation system to include the healthcare data collected by DSHS no later than September 1, 2015. (management action – nonstatutory)

Advisory Committees

• Removes eight DSHS advisory committees from statute. (S.B. 277)
• Directs DSHS to re-establish active committee functions in rule as needed. (management action – nonstatutory)
• Directs HHSC to establish an enterprise-wide behavioral health advisory committee to provide regular input and recommendations to the HHSC executive commissioner regarding behavioral health programs across the health and human services system. (management action – nonstatutory)
• Directs DSHS to review and revise its internal advisory committee policies and to regularly evaluate all of its advisory groups. (management action – nonstatutory)