More than a dozen Texas state agencies are under review by the Sunset Advisory Commission – including several of the state’s major health agencies.
State agencies — which include committees, commissions and even entire departments — typically go through the sunset review process every 12 years. The process takes a close look at an agency’s purpose, priorities and performance.
The current cycle includes a list of 16 government agencies, a large portion of which focus on health and social services – such as the Health and Human Services Commission, Department of State Health Services, Department of Family and Protective Services and Maternal Mortality Review Committee.
Advocates said because so many health agencies are under review, this cycle could have an impact on services and access moving forward.
The sunset review process
Texas state law establishes an “expiration date” for state agencies, meaning those agencies will automatically be abolished on that date unless lawmakers pass legislation to continue them.
Robert Lowry, a political science professor at the University of Texas at Dallas, said the process begins with some fundamental questions.
“Does this agency need to exist?” Lowry said. “Is it serving a useful purpose? Is it doing it reasonably well? Is it redundant with some other agency?”
Even if it’s highly unlikely the organization will be eliminated, Lowry said the process starts with a self-evaluation. Almost all the agencies on the list were required to submit their self-evaluations in September.
“They may come up with their own suggestions for ways they can improve, although those may require legislation,” he said. “In that sense, they may try to sort of enlist the Sunset Commission as an ally.”
For example, in this cycle, the Texas Juvenile Justice Department in its self-evaluation raised concerns about provider shortages and the weak behavioral health infrastructure in the state. That means “finite resources are often directed to the highest-risk, deep-end” environments instead of in prevention and early intervention, the agency noted.
The sunset review staff are expected to release their evaluations by the end of the year. The staff may talk to various stakeholders to inform their report. If a major issue, like provider shortages or health infrastructure, appears in both reports, that means lawmakers are more likely to take notice of the issue, Lowry said.
Once both reports are available, 10 state lawmakers – five from each chamber – and two members appointed by the lieutenant governor and speaker of the House review the reports and hold public hearings. This is where members of the public can contribute to the conversation in front of lawmakers.
“The Sunset Commission isn't going to rule on their specific complaint,” Lowry said. “They're not going to say, 'you were right, they were wrong.' But they will sort of take notice of whether there are several people complaining about the same sort of thing. And therefore, whether there might be some sort of systematic problem.”
What this means for health and social services
Advocates said the self-evaluations for the state agencies could have a significant effect on health and social services in Texas.
Diana Forester, director of policy for the advocacy group Texans Care for Children, said she’s been impressed by the reports – especially Health and Human Services Commission’s self-evaluation.
“I was really excited to see in HHSC's, the top issue they listed was improving customer service for Texans that are trying to access benefits,” Forester said. “The fact that they were openly admitting that it's really confusing, that their processes aren't family friendly, that their notices are confusing – I mean that was all stuff that we have been saying for years.”
Forester said even without the staff report, that recognition from the state agency validates the experiences people in these programs have been sharing for a decade.
“We will have families come and talk about it, and [the legislature is] like, ‘well, the agency hasn't told us this is happening,’” Forester said. “It gives them a little bit of an out.”
By having the agency aligned with advocate concerns, Forester said it’s much more likely that something may change.
In addition, Forester said there can be a benefit from the sunset commission evaluating these agencies at the same time. From data management to provider shortages, many agencies highlighted the same issues and serve the same populations.
“Reviewing these at a high level at the same time does kind of give you that lens into like these bigger issues that are impacting families,” she said.
The fundamental questions the commission starts with can be transformed into questions that open a more nuanced conversation, according to Forester.
“Is this the right way to address it and could this be done better?” she said. “Should we have multiple agencies kind of addressing this same issue in different ways? Could we be more coordinated in addressing this?”
However, for some state agencies, this review cycle is unique because of changes at the federal level. The Department of State Health Services provides public health services and resources such as vaccine, educational and outreach programs, and it funds local health initiatives.
Forester said its self-evaluation focused on the confusion created by federal cuts.
“They essentially were like, ‘We're 60% federally funded, so we have no idea kind of what the future of our programs looks like with the uncertainty at the federal level,’” Forester said.
Forester said the review process for agencies with this concern might have to focus on what portion of federal funding the state can make up for.
“If these cuts at the federal level continue, it does make it a lot harder for them to continue to serve Texans,” Forester said. “It means that the state's going to have to pick up a lot more of that funding if we want to continue.”
Abigail Ruhman is KERA’s health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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