By: Maxey H.B. No. 1715
73R6071 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the responsibility of certain counties to provide
1-3 health care services to eligible indigent residents.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 121, Health and Safety Code, is amended
1-6 by adding Subchapter F to read as follows:
1-7 SUBCHAPTER F. COUNTY HEALTH DEPARTMENTS IN CERTAIN COUNTIES
1-8 Sec. 121.061. APPLICATION OF SUBCHAPTER. This subchapter
1-9 applies only to a county with a population of at least 450,000 and
1-10 in which a hospital district is not located.
1-11 Sec. 121.062. COUNTY HEALTH DEPARTMENT; ASSUMPTION OF DUTIES
1-12 OF MUNICIPALITY. (a) A county subject to this subchapter may
1-13 establish a county health department to coordinate and provide
1-14 health care services to eligible indigent residents throughout the
1-15 county, including any portion of the county located within the
1-16 boundaries of a municipality, in accordance with an agreement made
1-17 under this section.
1-18 (b) The county and any municipality that is located in whole
1-19 or in part within the boundaries of the county and that provides
1-20 health care services may agree through negotiation and after a
1-21 majority vote of the governing body of the municipality and the
1-22 county commissioners court, for the county to provide any or all of
1-23 the health services previously provided by the municipality.
1-24 Sec. 121.063. PROVISION OF HEALTH CARE. (a) The county may
2-1 furnish, directly through the county health department or by
2-2 contract or other arrangement, medical and hospital care for the
2-3 county's eligible indigent residents. The county may, but is not
2-4 required to, provide mental health, mental retardation, or public
2-5 health services other than public health education services.
2-6 (b) The county may provide, finance, organize, and arrange
2-7 for the provision of health care to eligible indigent residents and
2-8 to other individuals, groups, or government entities who contract
2-9 with the county for health care services.
2-10 (c) The county may:
2-11 (1) authorize the county health department to perform
2-12 its powers and duties under this subchapter directly;
2-13 (2) contract or enter into an interlocal agreement
2-14 with a political subdivision or with a public or private provider,
2-15 without regard to the provider's location;
2-16 (3) purchase or provide insurance; and
2-17 (4) administer or enter into an agreement for the
2-18 administration of one or more managed care programs.
2-19 (d) This section does not affect the duty of a
2-20 nongovernmental entity in the county to provide medical or hospital
2-21 care to county residents. This section does not supersede or
2-22 contradict a provision of the Medical Practice Act (Article 4495b,
2-23 Vernon's Texas Civil Statutes).
2-24 Sec. 121.064. HEALTH CARE PRIORITY. In performing its
2-25 powers and duties under this subchapter, a county shall place
2-26 highest priority on the provision of primary care and public health
2-27 education services and on prevention of sickness and accidents in
3-1 the county.
3-2 Sec. 121.065. ELIGIBLE INDIGENT RESIDENTS. (a) The county
3-3 shall adopt eligibility standards for determining whether an
3-4 individual is an eligible indigent resident and shall adopt
3-5 application, documentation, and verification procedures.
3-6 (b) If a county resident would qualify as an eligible
3-7 indigent resident if the resident was not covered by government or
3-8 private health insurance coverage, the county shall furnish health
3-9 care to the resident to the extent the health care is not covered
3-10 by the health insurance coverage.
3-11 (c) The county may implement a sliding scale requiring
3-12 payment of a portion of the cost of health care provided to an
3-13 eligible indigent resident or other individual. The sliding scale
3-14 must be based on the individual's income and may not be set at a
3-15 level that would prevent an eligible indigent resident from
3-16 obtaining medical or hospital care.
3-17 Sec. 121.066. PAYMENT FOR HEALTH CARE SERVICES. (a) The
3-18 county may collect from a patient who is not an eligible indigent
3-19 resident, from a person liable for the patient's support, or from a
3-20 person liable for the patient's illness or injury the cost of
3-21 medical, hospital, or other health care provided to the patient by
3-22 the county under this subchapter.
3-23 (b) The county may not collect directly from an eligible
3-24 indigent patient an amount in excess of the amount due for the
3-25 service provided under a sliding scale adopted under Section
3-26 121.065.
3-27 (c) If the county finances or provides health care to a sick
4-1 or injured patient who does not reside in the county but for whom
4-2 there is a county, municipality, or public hospital that is
4-3 responsible for the patient's care under Chapter 61, the
4-4 responsible county, municipality, or public hospital shall
4-5 reimburse the county for the health care provided.
4-6 (d) If the county finances or provides health care to a sick
4-7 or injured patient who is confined in a jail facility and who is
4-8 not a resident of the county, the sheriff or police chief of the
4-9 county or municipality that operates the jail facility shall
4-10 reimburse the county for the health care provided.
4-11 Sec. 121.067. RESPONSIBILITY OF MUNICIPALITY. If an
4-12 agreement between a county and a municipality is made under Section
4-13 121.062(b), the municipality may not, except as provided by that
4-14 agreement, provide health care services to county residents,
4-15 regardless of whether the individuals are also residents of the
4-16 municipality.
4-17 Sec. 121.068. TRANSFER OF FUNCTIONS. (a) Not later than
4-18 the 90th day after the date a county determines that it has become
4-19 subject to this subchapter and initiates negotiations under Section
4-20 121.062(b), the county and each municipality located in the county
4-21 shall identify all money the municipality expends on health-related
4-22 matters within that portion of the municipality located in the
4-23 county.
4-24 (b) Not later than the 90th day after the initiation of
4-25 negotiations and at 90-day intervals thereafter, the county shall
4-26 report to the municipality and the municipality shall report to the
4-27 county their respective positions with respect to the negotiations.
5-1 (c) If the county and the municipality do not agree on the
5-2 amount of money expended by the municipality on health-related
5-3 matters, the county and municipality shall submit the dispute to
5-4 binding arbitration. Either party may compel the arbitration in
5-5 accordance with Article 225, Revised Statutes.
5-6 (d) After an agreement has been reached under Section
5-7 121.062(b), the county and the municipality may provide for the
5-8 transfer to the county of municipal employees engaged in the
5-9 provision of health care or related services in that part of the
5-10 municipality. Municipal employees transferred to a county under
5-11 this subsection are entitled, on transfer, to at least the same
5-12 wages paid by the municipality and to comparable employment
5-13 benefits.
5-14 (e) Each municipality may transfer to the county any real
5-15 property that is:
5-16 (1) owned by the municipality;
5-17 (2) located in the county; and
5-18 (3) predominantly dedicated to the provision of health
5-19 care or related services to county residents.
5-20 (f) To the extent permitted by the terms of a lease
5-21 contract, the municipality may also transfer to the county the
5-22 rights of the municipality under any lease relating to real
5-23 property that is:
5-24 (1) located in the county; and
5-25 (2) predominantly dedicated to the provision of health
5-26 care or related services to county residents.
5-27 (g) If an agreement between a county and a municipality is
6-1 made under Section 121.062(b), the municipality may not, except as
6-2 provided by that agreement, enter into or renew a contract with any
6-3 person for the provision of health care and related services for
6-4 county residents after the date of the agreement. If each party to
6-5 the contract agrees, the municipality's rights under a contract may
6-6 be transferred to the county.
6-7 Sec. 121.069. MUNICIPAL TAX ROLLBACK. (a) If an agreement
6-8 between a county and a municipality is made under Section
6-9 121.062(b), the municipality shall designate a portion of the
6-10 amount identified under Section 121.068(a) as attributable to any
6-11 sales and use taxes imposed by the municipality and the remaining
6-12 portion as attributable to property tax revenues.
6-13 (b) Notwithstanding Chapter 321, Tax Code, the municipality
6-14 shall reduce its sales and use tax rate as necessary to reduce the
6-15 municipality's tax collections in an amount equal to the amount
6-16 attributed to its sales and use taxes under Subsection (a). The
6-17 municipality shall send notice of the tax change to the comptroller
6-18 in accordance with Section 321.405(b), Tax Code. The change takes
6-19 effect as provided by Section 321.102(a), Tax Code.
6-20 (c) The municipality shall reduce its property tax rate to
6-21 reduce the municipality's tax collections in an amount equal to the
6-22 amount attributed to its property tax revenue under Subsection (a).
6-23 Section 26.041(a), Tax Code, governs the reduction of the property
6-24 tax rate under this subsection. For purposes of determining the
6-25 "sales tax gain rate" under Section 26.041(a), Tax Code, the
6-26 municipality shall treat the amount designated as attributable to
6-27 property tax revenues under Subsection (a) as "the revenue that
7-1 will be generated by the additional sales and use tax."
7-2 Sec. 121.070. TIMELY AGREEMENT. An agreement under Section
7-3 121.062(b) must be made before September 1, 1994. An agreement
7-4 made under Section 121.062(b) after September 1, 1994, has no force
7-5 or effect.
7-6 SECTION 2. Subtitle C, Title 3, Tax Code, is amended by
7-7 adding Chapter 325 to read as follows:
7-8 CHAPTER 325. HEALTH SERVICES SALES AND USE TAX FOR
7-9 CERTAIN COUNTIES
7-10 SUBCHAPTER A. GENERAL PROVISIONS
7-11 Sec. 325.001. COUNTY SALES AND USE TAX ACT APPLICABLE;
7-12 EXCEPTION. (a) Except to the extent that a provision of this
7-13 chapter applies, Chapter 323 applies to the tax authorized by this
7-14 chapter in the same manner as that chapter applies to the tax
7-15 authorized by that chapter.
7-16 SUBCHAPTER B. IMPOSITION OF TAX
7-17 Sec. 325.021. APPLICATION. This chapter applies to a county
7-18 with a population of at least 450,000 in which a hospital district
7-19 is not located and that has entered into an agreement with a
7-20 municipality under Subchapter F, Chapter 121, Health and Safety
7-21 Code.
7-22 Sec. 325.022. TAX AUTHORIZED. The commissioners court of a
7-23 county to which this chapter applies may adopt or abolish the sales
7-24 and use tax authorized by this chapter by order or resolution.
7-25 Sec. 325.023. TAX RATE. (a) The rate of the tax authorized
7-26 by this chapter is the rate prescribed by the resolution or order
7-27 of the county commissioners court.
8-1 (b) Section 323.101(d) does not apply to the tax authorized
8-2 by this chapter.
8-3 Sec. 325.024. SALES AND USE TAX EFFECTIVE DATE. (a) The
8-4 adoption or abolition of the tax takes effect on the first day of
8-5 the first calendar quarter occurring after the expiration of the
8-6 first complete calendar quarter occurring after the date on which
8-7 the comptroller receives a notice of the order or resolution of the
8-8 county commissioners court.
8-9 (b) If the comptroller determines that the effective date
8-10 provided by Subsection (a) will occur before the comptroller can
8-11 reasonably take the action required to begin collecting the tax or
8-12 to implement the abolition of the tax, the effective date may be
8-13 extended by the comptroller until the first day of the next
8-14 succeeding calendar quarter.
8-15 Sec. 325.025. EFFECT ON OTHER TAXES. Notwithstanding any
8-16 other law, the imposition or abolition of a sales and use tax under
8-17 this chapter does not affect the validity or rate of any other tax
8-18 imposed by another political subdivision that has jurisdiction over
8-19 territory located within the boundaries of the county.
8-20 SUBCHAPTER C. USE OF TAX REVENUE
8-21 Sec. 324.061. USE OF TAX REVENUE. Revenue from a tax
8-22 imposed under this chapter may be used only to provide health
8-23 services in the county. The county imposing the tax may allocate
8-24 part of the revenue to carrying out the county's duties under an
8-25 agreement made with a municipality under Subchapter F, Chapter 121,
8-26 Health and Safety Code.
8-27 SECTION 3. The importance of this legislation and the
9-1 crowded condition of the calendars in both houses create an
9-2 emergency and an imperative public necessity that the
9-3 constitutional rule requiring bills to be read on three several
9-4 days in each house be suspended, and this rule is hereby suspended,
9-5 and that this Act take effect and be in force from and after its
9-6 passage, and it is so enacted.