BILL ANALYSIS

C.S.H.B. 639

By: White

County Affairs

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Emergency services districts are not currently authorized to implement mobile integrated health care community paramedicine programs. These programs may help reduce the costs that the districts and their taxpayers incur for unnecessary emergency medical transport and could simultaneously improve health care for at-risk individuals in Texas rural and suburban communities by providing such services as immunizations, screenings, checkups, and patient counseling. C.S.H.B. 639 seeks to expand an emergency services district's authority to provide for these programs, as was recommended by the House Committee on County Affairs in its interim report to the 86th Legislature.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 639 amends the Health and Safety Code to authorize an emergency services district, if approved by a commissioners court of each county in which the district is located, to do the following:

· provide certain preventive health care services to reduce reliance on 9-1-1 transports and systems for routine health care;

· contract with the state or a local government to provide those services; and

· charge a reasonable fee for performing those services for or on behalf of a person or entity.

The bill specifies that a reference in provisions governing emergency services districts to the district providing emergency services includes preventive health care services. The bill authorizes a district to make necessary improvements and to adopt rules and regulations for the purposes of the bill's provisions. The bill requires a district in a county with a population of less than 60,000 to obtain approval from the county commissioners court prior to providing preventive health care services.

C.S.H.B. 639 applies to a district that is licensed as or contracts with an emergency medical services provider or first responder organization under the Emergency Health Care Act. The bill defines "preventive health care services" as out-of-hospital routine health care services, including immunizations, screenings, checkups, and patient counseling, provided for the purpose of preventing illness, disease, or other health problems.

EFFECTIVE DATE

On passage, or, if the bill does not receive the necessary vote, September 1, 2021.

COMPARISON OF ORIGINAL AND SUBSTITUTE

While C.S.H.B. 639 may differ from the original in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

The substitute includes a provision, which was not included in the original, restricting the bill's applicability to an emergency services district that is licensed as or contracts with an emergency medical services provider or a first responder organization.

The substitute authorizes the provision of "preventive health care services," as defined by the bill, while the original authorized the provision of "public health services," defined by reference to the Local Public Health Reorganization Act. The substitute makes the authorization conditional on approval by the commissioners court of each applicable county, whereas the original did not include such a condition.

The substitute includes language not included in the original establishing that the purpose of providing the services is to reduce reliance on 9-1-1 transports and systems for routine health care.

The substitute includes a specific requirement that was not in the original for a district in a certain county to obtain approval from the commissioners court before providing the services.