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Window on State Government

Health Care & Human Services Task Force

Dallas, April 27, 2000

Comptroller's Office Hears Healthcare Concerns in Dallas

The Internet is impacting the medical environment in a positive way, according to testimony heard at the health and human services task force public hearing in Dallas. More -->

Task Force Co-Leader Ruthie Ford
and Rogers Coleman, M.D. at the meeting in Dallas

Tom Saving, Task Force Commissioner

Health and human services (HHS) represent the second-largest budget category in Texas state government. Health and human service agencies account for about 28 percent of the state's budget, with appropriations totaling $13.9 billion for fiscal 2000. If health care for state employees, persons in the criminal justice system and indigents treated in public university facilities is included, the percentage rises to about 31.5 percent.

Fourteen Texas HHS agencies with more than 52,700 employees administer more than 200 programs. In any given month, these programs serve some 4 million Texans. Most of the dollars spent in this area provide health care services for low-income pregnant women and children and long-term care for the elderly and the disabled. The Texas Health and Human Service Commission (HHSC) holds oversight authority for the expenditure of HHS funds and the coordination of service delivery among a number of agencies.

Agencies under HHSC's "umbrella" include the Department of Aging, the Commission on Alcohol and Drug Abuse, the Commission for the Blind, the Cancer Council, the Children's Trust Fund of Texas Council, the Commission for the Deaf and Hard of Hearing, the Interagency Council of Early Childhood Intervention, the Department of Health, the Department of Human Services, the Department of Mental Health and Mental Retardation, the Department of Protective and Regulatory Services, the Texas Juvenile Probation Commission and the Rehabilitation Commission. Each agency has its own systems for administration, eligibility determination, enrollment and service delivery; its own complex rules and regulations; and separate reporting and tracking systems. Some services are delivered directly by the state, while contractors and local entities such as health clinics and community centers provide others. This complex, multilayered system has resulted in unnecessarily high administrative costs, duplicated effort, inefficiency and frustration for its users. Past attempts at reform have yet to produce substantial changes in this pattern.

As the year 2000 approaches, key health and human service issues include increasing demands for mental health services; the need for affordable, high-quality health and long-term care services; reform of the health care system to reduce costs and increase accountability; streamlining health-care administration through the use of technology, increased consumer choice; and initiatives to strengthen families and reduce child abuse, teen pregnancies and dropouts.

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