By Hightower                                          H.B. No. 1947
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the eligibility of certain small county hospitals to
    1-3  receive state reimbursement for providing indigent health care
    1-4  services.
    1-5        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-6        SECTION 1.  Section 61.002, Health and Safety Code, is
    1-7  amended by adding Subdivision (13) to read as follows:
    1-8              (13)  "Small county hospital" means a hospital owned
    1-9  and operated by a county with a population of less than 25,000.
   1-10        SECTION 2.  Section 61.021, Health and Safety Code, is
   1-11  amended to read as follows:
   1-12        Sec. 61.021.  Application of Subchapter.  Except as provided
   1-13  by Sections 61.036-61.041, this <This> subchapter applies to health
   1-14  care services and assistance provided to a person who does not
   1-15  reside in the service area of a public hospital or hospital
   1-16  district.
   1-17        SECTION 3.  Section 61.036, Health and Safety Code, is
   1-18  amended by adding Subsection (d) to read as follows:
   1-19        (d)  Expenditures made by a small county hospital may be
   1-20  credited toward eligibility for state assistance under this
   1-21  subchapter if:
   1-22              (1)  the person who received the health care services
   1-23  resides in the service area of the hospital and qualifies for
    2-1  assistance under Section 61.006; and
    2-2              (2)  the hospital complies with the department's
    2-3  application, documentation, and verification procedures.
    2-4        SECTION 4.  Sections 61.037, 61.038, 61.039, and 61.041,
    2-5  Health and Safety Code, are amended to read as follows:
    2-6        Sec. 61.037.  <County> Eligibility for State Assistance.  (a)
    2-7  The department may distribute funds as provided by this subchapter
    2-8  to eligible counties to assist the counties in providing mandatory
    2-9  health care services to their eligible county residents.  The
   2-10  department may also distribute funds as provided by this subchapter
   2-11  to eligible small county hospitals to assist the hospitals in
   2-12  providing mandatory health care services to residents of their
   2-13  service areas who qualify for assistance under Section 61.006.
   2-14        (b)  Except as provided by Subsection (c) or (d), to be
   2-15  eligible for state assistance, a county or small county hospital
   2-16  must:
   2-17              (1)  spend in a state fiscal year at least 10 percent
   2-18  of the county general revenue levy for that year to provide
   2-19  mandatory health care services to its eligible county residents or
   2-20  to residents of the hospital's service area who qualify for
   2-21  assistance under Section 61.006; and
   2-22              (2)  notify the department, not later than the seventh
   2-23  day after the date on which the county or small county hospital
   2-24  reaches the expenditure level, that the county or small county
   2-25  hospital has spent at least eight percent of the applicable county
    3-1  general revenue levy for that year to provide mandatory health care
    3-2  services to its eligible county residents or to residents of the
    3-3  hospital's service area who qualify for assistance under Section
    3-4  61.006.
    3-5        (c)  If a county and a health care provider signed a contract
    3-6  on or before January 1, 1985, under which the provider agrees to
    3-7  furnish a certain level of health care services to indigent
    3-8  persons, the value of services furnished in a state fiscal year
    3-9  under the contract is included as part of the computation of a
   3-10  county expenditure under this section if the value of services does
   3-11  not exceed the payment rate established by the department under
   3-12  Section 61.006.
   3-13        (d)  If a hospital district is located in part but not all of
   3-14  a county, that county's appraisal district shall determine the
   3-15  taxable value of the property located inside the county but outside
   3-16  the hospital district.  In determining eligibility for state
   3-17  assistance, the <that> county or small county hospital shall
   3-18  consider only the county general revenue levy resulting from the
   3-19  property located outside the hospital district.  A county or small
   3-20  county hospital is eligible for state assistance if:
   3-21              (1)  the county or small county hospital spends in a
   3-22  state fiscal year at least 10 percent of the county general revenue
   3-23  levy for that year resulting from the property located outside the
   3-24  hospital district to provide mandatory health care services to its
   3-25  eligible county residents or to residents of the hospital's service
    4-1  area who qualify for assistance under Section 61.006; and
    4-2              (2)  the county or small county hospital complies with
    4-3  the other requirements of this subchapter.
    4-4        (e)  If a county or small county hospital anticipates that it
    4-5  will reach the 10 percent expenditure level, the county or small
    4-6  county hospital must notify the department as soon as possible
    4-7  before the anticipated date on which the county or small county
    4-8  hospital will reach the level.
    4-9        (f)  The county or small county hospital must give the
   4-10  department all necessary information so that the department can
   4-11  determine if the county or small county hospital meets the
   4-12  requirements of Subsection (b) or (d).
   4-13        Sec. 61.038.  Distribution of Assistance Funds.  (a)  If the
   4-14  department determines that a county or small county hospital is
   4-15  eligible for assistance, the department shall distribute funds
   4-16  appropriated to the department from the indigent health care
   4-17  assistance fund or any other available fund to the county or small
   4-18  county hospital to assist the county or small county hospital in
   4-19  providing mandatory health care services to its eligible county
   4-20  residents or to residents of the hospital's service area who
   4-21  qualify for assistance under Section 61.006.
   4-22        (b)  State funds provided under this section to a county or
   4-23  small county hospital must be equal to at least 80 percent of the
   4-24  actual payment for mandatory health care services for the county's
   4-25  eligible residents or for residents of the hospital's service area
    5-1  during the remainder of the state fiscal year after the 10 percent
    5-2  expenditure level is reached.
    5-3        Sec. 61.039.  Failure To Provide State Assistance.  If the
    5-4  department fails to provide assistance to an eligible county or
    5-5  small county hospital as prescribed by Section 61.038, the county
    5-6  or small county hospital is not liable for payments for health care
    5-7  services provided to its eligible county residents or to residents
    5-8  of the hospital's service area after the county or small county
    5-9  hospital reaches the 10 percent expenditure level.
   5-10        Sec. 61.041.  <COUNTY> REPORTING.  (a)  The department shall
   5-11  establish reporting requirements for a county or small county
   5-12  hospital seeking state assistance and establish procedures
   5-13  necessary to determine if the county or small county hospital is
   5-14  eligible for state assistance.
   5-15        (b)  The department shall establish requirements relating to:
   5-16              (1)  documentation required to verify the eligibility
   5-17  of residents to whom the county or small county hospital provides
   5-18  assistance; and
   5-19              (2)  county or small county hospital expenditures for
   5-20  mandatory health care services.
   5-21        (c)  The department may audit county and small county
   5-22  hospital records to determine if the county or small county
   5-23  hospital is eligible for state assistance.
   5-24        SECTION 5.  This Act takes effect September 1, 1993, and
   5-25  applies only to health care assistance provided on or after that
    6-1  date.  Health care assistance provided before the effective date of
    6-2  this Act is governed by the law in effect when the assistance was
    6-3  provided, and that law is continued in effect for that purpose.
    6-4        SECTION 6.  The importance of this legislation and the
    6-5  crowded condition of the calendars in both houses create an
    6-6  emergency and an imperative public necessity that the
    6-7  constitutional rule requiring bills to be read on three several
    6-8  days in each house be suspended, and this rule is hereby suspended.