Quick recap

The meeting focused on reviewing and discussing recommendations for the HHSC contract administration and procurement process as part of the Sunset review. Noelle presented the current recommendations, which included enhancing transparency, streamlining processes, and maintaining multi-year contracts, while participants provided feedback and suggested specific additions. Jennifer emphasized the need for clearer language around transparency and highlighted the importance of diversity in service providers, particularly for specialized services like substance use disorder treatment. The group discussed concerns about administrative costs and inefficiencies introduced by intermediary vendors, with specific examples shared about reduced funding availability due to overhead costs. Participants also reviewed recommendations regarding CMBHS system improvements and legislative changes that need to be reflected in licensing rules, with Duane and Sherri providing guidance on relevant statutes and bill citations. The conversation ended with updates on ongoing conversations with HHSC about the Be Well subcontracting situation and potential changes to the procurement process.

Next steps

• Guillermo: Ask WeWill's CFO to provide details on the actual allocation and percentage of funds retained as administrative/indirect costs by intermediary entities, and report back to the group.

• Katie: Send Noelle a comparison of the administrative costs of handling an HHSC fee-for-service contract versus a cost reimbursement grant, including specific examples if available.

• Duane: Look for and add the correct statutory citation for the 8-hour to 2-hour training requirement to the document.

• Sherri: Review Senate Bill 1560 and related legislation to determine if the statutory changes (e.g., consent to treatment, screening/assessment definitions) have been codified in rules, and report findings to the group.

• Noelle/Document Team: Incorporate feedback from the group into the Sunset document, including points about diversity of community needs, administrative cost increases due to intermediaries, and specific CMBHS/interoperability issues as examples are provided.

• All Members: Review the draft Sunset document and provide specific comments, examples, or recommendations (especially regarding CMBHS, contracting models, and legislative changes) to Noelle/Anna as soon as possible, ideally before April 1st.

• Noelle/Anna: Consider sending the document directly via email (not just as a link) to members to improve accessibility and encourage feedback.

• Sherri: Compare current rules to Senate Bill 1560 to confirm if the changes regarding consent to treatment and screening/assessment have been properly codified.

• Noelle: Add language to the recommendations regarding conflicts of interest when providers who also manage contracts are considered for major HHSC contracts.

• Noelle: Reach out to members and board to identify potential new members in the Houston area during her May 1-10 visit.

Summary

HHSC Contract Administration Recommendations

The meeting focused on discussing recommendations for the HHSC contract administration and procurement process as part of the Sunset review. Noelle presented the current recommendations, which included enhancing transparency, streamlining processes, and reducing administrative burden. Jennifer suggested adding more specific details about transparency and emphasizing the importance of diverse service providers, particularly for specialized services like substance use disorder treatment. The group discussed concerns about intermediary entities taking significant portions of funding (potentially 15-45%) and the time delays associated with subcontracting processes. The team agreed to gather more concrete examples and data to support their recommendations, with a deadline of April 1st to finalize the document before meeting with Sunset committee members.

Contracting Model Improvement Recommendations

Noelle presented recommendations for improving the contracting model, including balancing flexibility with stability through multi-year contracts and strengthening contract management guidance. The team discussed the need for more structured opportunities for provider feedback during procurement processes and agreed to add recognition of progress made in these areas. They also addressed issues with the CMBHS system, particularly regarding interoperability and integration challenges, and decided to include specific examples when requesting a comprehensive review of system functionality. Finally, they noted that legislative changes have not been fully incorporated into CDTF licensing rules and discussed the need to update these rules to reflect statutory changes, particularly regarding training requirements and patient solicitation laws.

Legislative Citations and Training Requirements

The team discussed several legislative citations and training requirements, with Duane seeking information about intake and screening training statutes. They reviewed Senate Bill 1560 from the 84th session, which addressed consent to treatment forms and clarified definitions between screening and assessment processes. The group also discussed a recommendation regarding HHSC's reimbursement rates, which HHSC had already supported. Noelle requested feedback on the recommendations and asked the team to provide any additional comments within the next week, as they aim to complete the document by then.

Sunset Process and Legislation Updates

The team discussed the importance of providing input for recommendations during the sunset process, with Sherri emphasizing the need for active participation despite the time-consuming nature of the task. Duane shared information about relevant legislation, including House Bill 3146, which changed requirements regarding patient intake forms and physician involvement. Noelle provided updates on ongoing conversations with HHSC regarding subcontracting with Be Well and potential changes to the funding process, suggesting a move toward zero contracts and rolling contracts for future procurement cycles.