Sunset is the regular assessment of the continuing need for a state agency or program to exist. The Sunset process works by setting an automatic termination (Sunset) date in state law on which an agency will be abolished unless the Legislature passes a bill to continue it, typically for another 12 years. This date determines when an agency is subject to Sunset review and provides the Legislature a unique opportunity and strong incentive to closely examine an agency’s mission, priorities, and performance and to take action to address problems identified.
Unlike other legislative oversight agencies that evaluate an agency’s financial accountability or compliance with state and federal laws, a Sunset review starts by asking a more fundamental question — is the state agency still needed? A Sunset review also evaluates the agency’s programs, rules, operations, and success in fulfilling its mission. As part of the review, Sunset also seeks public input to identify problems and opportunities for improving the agency. More detailed information on the sunset review process can be found at Sunset in Texas_2025_0.pdf
Health and Human Services Related Agencies Under Review for the 2026-27 Review Cycle, 90th Legislative Session
- Statewide Interagency Aging Services Coordinating Council
- Texas Civil Commitment Office
- Department of Family and Protective Services
- Health and Human Services Commission
- Texas Health Services Authority
- Department of State Health Services
- Maternal Mortality and Morbidity Review Committee, Texas
- Governor’s Committee on People with Disabilities
- Perinatal Advisory Council
- Public Health Funding and Policy Committee
Sunset shines a light on state agencies and programs to see if they are still relevant in a changing world. If the answer is yes, Sunset recommends improvements to make them more effective and efficient. If the answer is no, Sunset recommends abolishing the agency or transferring its functions to another agency with related functions. Learn how the Sunset process can have major impacts on state government.
Sunset Process
Agency performs a Self-Evaluation
- State agencies under review perform a self-evaluation following the instructions and format of the Sunset Commission identifying issues the agency believes are pertinent for review
Sunset Staff Evaluation
- Sunset staff performs extensive research and analysis to evaluate the need for, performance of, and improvements to the agency under review.
Sunset Commission Staff
- Reviews agency’s self-evaluation report
- Receives input from interested parties (public input is confidential and is published on the website.)
- Evaluates agency and identifies problems
- Develops recommendations
- Publishes staff report
Sunset Commission Deliberation
- The Sunset Commission conducts a public hearing to take testimony on the staff report and the agency overall. The Sunset Commission conducts a second meeting to vote on which changes to recommend to the Texas Legislature.
Public Hearings
- Sunset staff presents its report and recommendations
- Agency presents its response
- Sunset Commission hears public testimony and receives written comments
- Sunset Commission meets again to consider and vote on recommendations
Legislative Action
- The Texas Legislature considers Sunset’s recommendations and makes final decisions.
Texas Legislature
- Sunset bill on an agency is drafted and filed
- Sunset bills go through normal legislative process
- The Senate and the House conduct committee hearings and debate the bill
- Bill passes or fails adoption
- Governor signs, vetoes, or allows bill to become law without signature
The Public may participate in legislative process. The result is that the agency continues with improvements or the agency is abolished but may continue business for up to one year, or its functions are transferred to another agency.
Health and Human Services Commission Issues Identified in their Self Evaluation (Follow the link for the complete HHSC Self Evaluation and detail regarding the issues presented below Health and Human Services Commission Self-Evaluation Report_0.pdf)
Major Issue 1: Improve the Customer Experience : While prior Sunset recommendations helped consolidate and align like-services and functions, more work is to be done to transform how the public, clients, providers, and contractors navigate the health and human services (HHS) system.
Possible Solutions and Impact:
Engaging with the Public:
- Direct HHSC to create a designated stakeholder relations office to assist stakeholders in navigating HHSC and providing information to agency leadership.
- Consolidate advisory committees into broader, topical groups to streamline public input and more effectively impact agency decisions.
- Eliminate the HHS Executive Council and direct the above consolidated advisory committee structure to report recommendations to the Executive Commissioner biannually.
Receiving Essential Services:
- Further consolidate and streamline women’s health services to reduce confusion and maximize state dollars being spent on necessary client services.
Doing Business with the State:
- Continue to evaluate the current landscape of state and federal requirements for long-term care, acute care, and childcare providers to streamline regulations necessary to protect the health and safety of Texans by identifying and eliminating outdated, redundant, or unnecessary regulations.
- Modernize and integrate provider-facing systems, including creating a unified provider portal and “smart application” that guides users through processes based on their specific needs. Streamlining and standardizing workflows across divisions would reduce duplication and improve consistency. Equally important is reviewing and streamlining the underlying program requirements themselves. Aligning and simplifying enrollment, credentialing, and contracting criteria across programs would reduce complexity and administrative burden for providers. Providing real-time application status updates, creating a centralized provider support unit and comprehensive training resources would help providers better navigate agency requirements. Section IX – Page 1025 Finally, regularly engaging providers through feedback loops will ensure ongoing improvements are informed by real-world experience.
- Amend statute to lengthen and/or standardize licensure periods, as appropriate.
- Review, streamline, and align provider enrollment and credentialing requirements and processes, where feasible.
- Advertise the state’s GPO process to local businesses and create a support mechanism to assist local service providers in registering as GPOs.
- Exempt legislatively directed Medicaid rate changes from the rulemaking process required by the Administrative Procedures Act (APA).
Major Issue 2: Increase Agency Flexibility: Current procurement laws restrict HHSC’s ability to be nimble and move swiftly to procure vital client services, information technology (IT) systems, and outside expertise.
Possible Solutions and Impact:
- Evaluate state procurement laws, including CMBL, CAT, re-procurement, RFO, and DBIT requirements, and grant HHSC broad authority to procure statutorily directed services.
- Increase the minimum threshold for CAT to review HHSC contracts.
- Increase DBITS contract caps and simplify vendor solicitation rules to accelerate IT project delivery and reduce costs.
- Create a flexible, multi-year funding pool for IT projects authorized by the Legislature and approved by DIR to help HHSC complete large-scale IT projects more efficiently.
- Establish a consultant pool, pre-approved by CPA, to allow agencies to procure short-term, outside expertise when specialized skillsets are not available in-house.
Major Issue 3: Enhance Data and Analytics Capabilities: Despite making significant strides since its last Sunset review, HHSC’s data and analytic capabilities are limited due to inconsistent and poor data quality and the absence of a universal governance strategy that prioritizes data connectivity and sharing.
Possible Solutions and Impact:
Enhance HHSC’s ability to leverage data for strategic decision-making by providing a dedicated focus on improving and maintaining data quality at the source through data stewardship; promoting data sharing; and strengthening strategic alignment and coordination between data governance, IT governance, and project management approaches.
Strengthen data stewardship and fully leverage HHSC’s data to inform decision-making. To build on current efforts, HHSC requested funding during the 89th Legislative Session to support an agency-wide data stewardship program. In addition to maintaining base resources for PMAS, this initiative would establish a core of data experts embedded within individual HHSC programs. These experts would be dedicated to:
- Understanding and documenting how program functions, policies, and operational nuances affect data collection, interpretation, and analytics;
- Evaluating program system data to identify data quality concerns, anticipate technical adjustments needed due to policy changes, and recommend solutions;
- Leveraging new and existing technologies to manage and monitor system data, ensuring its reliability for both ad hoc and recurring analytics; and
- Guiding, supporting, and coordinating efforts of program staff who are responsible for enhancing documentation and improving data quality within the source systems they use regularly.
Direct HHSC to adopt a strategy that proactively prepares program data for both current and future connectivity while identifying and removing institutional barriers to data sharing. This effort should include a thorough review of existing obstacles and the development of a plan to reduce these barriers. To achieve this, HHSC should:
- Document available data resources and assess benefits of increased connectivity;
- Identify and categorize barriers to data sharing, including technological limitations, program policy restrictions, statutory constraints, and federal funding requirements; and
- Evaluate the resources and actions needed to address these barriers.
Direct HHSC to continue accelerating efforts to facilitate data sharing by developing streamlined processes, including creating a metadata repository that documents all datasets. Additionally, HHSC should develop a data sharing process that allows programs to request data from designated owners for specific purposes. This process should support streamlined program and service delivery, enhance efficiencies, and improve client outcomes.
Direct HHSC to adopt a unified approach to data and analytics governance that all technology projects resulting in tools – such as operational dashboards, databases, data marts, ad hoc data reporting tools, and AI analytics – are reviewed by a governance committee and incorporated into PMAS. Analytics solutions under the PMAS umbrella should encompass a broad range of tools and prioritize, where feasible, integration into the agency’s overarching cloud-based data and analytics infrastructure.
Major Issue 4: Increase Regulatory Efficiency and Address Gaps: The state’s “one-size-fits-all” approach to regulating a growing healthcare industry ties HHSC’s hands from efficiently managing its resources and prioritizing oversight of providers who present the highest risk to the health and safety of the individuals they serve. Additionally, HHSC lacks clear statutory authority to regulate certain long-term care providers or to require some healthcare providers to screen and conduct background checks of employees.
Possible Solutions and Impact:
- Regulatory Efficiency: Provide authority for HHSC to apply a risk-based approach to determine the frequency and priority of surveys and inspections of providers. HHSC would operationalize this approach by creating a risk assessment tool for each provider type which considers compliance history, including past incidents of ANE, to determine the frequency and timing of surveys and inspections. Additionally, amend statute to ensure all providers are surveyed at least once within a longer, defined period.
- Regulatory Gaps: Formalize the HCS “certification” process in statute, which would have the same effect as requiring a license and require providers to register with HHSC prior to serving waiver or non-waiver recipients. Additionally, direct HHSC to receive non-ANE complaints related to HCS through the agency’s Complaint & Incident Intake line. Finally, authorize HHSC to create a formal enforcement structure with a range of enforcement options to address non-compliance issues, such as requiring the closure of specific homes, suspension or emergency suspension, or probation.
- Background Checks: Authorize HHSC to require certain healthcare provider types to conduct criminal background checks of prospective employees as a condition of licensure. Additionally, mandate that these healthcare facilities screen prospective employees through EMR prior to being hired.
Major Issue 5: Improve IDD Coordination: While the Texas Legislature and HHSC has made great strides to better coordinate services for people with an IDD, including designating a point of contact for IDD issues and establishing the IDD System Redesign Advisory Committee, barriers still exist in ensuring services are delivered collaboratively and the needs for this vulnerable population are addressed.
Possible Solutions and Impact:
- Review the IDD landscape and identify opportunities for improved coordination.
- Consolidate HCS and TxHmL eligibility and enrollment functions to minimize touchpoints, improve workflow, and ensure successful progression with enrollments and transfers.
- Strengthen existing IDD coordination by establishing a governance structure that reports directly to HHSC leadership, and is responsible for articulating the scope, priority, and needs impacted divisions. This entails creating a high-level, dedicated role leading a team of designated IDD points of contact within all impacted chief offices, that reports directly to the executive commissioner.
- Authorize HHSC to designate other SSLCs to accept new forensic admissions to help alleviate wait times and make admissions from state hospitals or other settings more expedient.
Major Issue 6: Ensure Effective Contract Management: The state’s universal approach to contracts combined with HHSC’s size and scope present unique challenges to managing contracts effectively.
Possible Solutions and Impact:
- Direct HHSC to develop a risk-based quality and compliance tool to assess contract management compliance and effectiveness on an agency-wide level.
- Identify additional tools to support HHSC’s contract management workforce, including automating additional forms and processes, providing renewal calendaring and status tools, creating dashboards, adding alerts and reports, and integrating DocuSign into CAPPS.
- Direct HHSC to create agency-specific training and a professional development program for contract managers.
- From a structural and staffing perspective, evaluate whether HHSC is organizationally setup in a way to effectively manage contracts.
- Review and recommend changes to statute so that state requirements are tailored to the types of services HHSC provides and how those services are delivered.
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