By Clemons H.B. No. 2776
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the establishment of an Emergency Medical Services and
1-3 Trauma Systems Development Fund; providing for the payment of funds
1-4 to service providers by the Texas Department of Health;
1-5 establishing criteria for the payment of such funds; and declaring
1-6 an emergency.
1-7 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-8 SECTION 1. Section 5.01, Article 5, Chapter 773, Texas
1-9 Health and Safety Code, is amended to read as follows:
1-10 "Sec. 5.01. LEGISLATIVE FINDINGS. The legislature finds
1-11 that death caused by injury is the leading cause of death for
1-12 persons one through 44 years of age, and the third overall cause of
1-13 death of all ages. Motor vehicle accidents account for more than
1-14 half of all state-wide trauma deaths and more than half of those
1-15 deaths occurred on rural highways. Effective emergency medical
1-16 services responses and resuscitation systems, medical care systems,
1-17 and medical facilities reduce the occurrence of unnecessary
1-18 mortality. It is estimated that trauma costs more than $63 million
1-19 a day nationally, which includes lost wages, medical expenses, and
1-20 indirect costs. Proportionally, this cost to Texas would be more
1-21 than $4 million a day. Many hospitals provide emergency medical
1-22 care to patients who are unable to pay for catastrophic injuries
1-23 directly or through an insurance or entitlement program. It is
2-1 estimated that the direct costs of such uncompensated trauma care
2-2 in Texas for pre-hospital, hospital and rehabilitation services
2-3 alone exceed $213 million annually. The cost of such uncompensated
2-4 trauma care is borne by both rural and urban hospitals, and such
2-5 costs are inhibiting the development of comprehensive and
2-6 coordinated emergency medical services and trauma systems and is
2-7 discouraging many Texas hospitals from continuing to provide trauma
2-8 care where it is available today. In order to improve the health
2-9 of the people of this state, it is necessary to improve the quality
2-10 of emergency and medical care to the people of Texas who are
2-11 victims of <unintentional>, life-threatening injuries by
2-12 encouraging hospitals to provide trauma care and increasing the
2-13 availability of emergency medical services <.> through the
2-14 development of comprehensive and coordinated emergency medical
2-15 services and trauma systems, including the designation of qualified
2-16 hospitals as trauma facilities. To encourage the development and
2-17 maintenance of comprehensive and coordinated emergency medical
2-18 services and trauma systems across the entire state, it is
2-19 necessary for the State of Texas to establish a special fund to
2-20 further support such emergency medical services and trauma care
2-21 systems."
2-22 SECTION 2. Article 5, Subchapter B, Chapter 773, Texas
2-23 Health and Safety Code is amended by adding Subsection 5.04 to read
2-24 as follows:
2-25 "Sec. 5.04. Emergency Medical Services and Trauma
3-1 Systems Development Fund
3-2 (a) The Emergency Medical Services and Trauma Systems
3-3 Development Fund is created in the state treasury. It is to be
3-4 system-focused and patient-specific. Money in the fund may be
3-5 appropriated to the department only for the purposes provided in
3-6 subsection (d) of this section. Disbursements under this act
3-7 should be made to each qualified recipient of an emergency medical
3-8 services and trauma system based on a proportionate share of their
3-9 uncompensated cost for the individual treated.
3-10 (b) The board by rule shall establish:
3-11 (1) criteria for the eligibility of individual injured
3-12 patients utilizing comprehensive case management;
3-13 (2) upper and lower limits for funding disbursements;
3-14 (3) standards for the administration and disbursement
3-15 of funds; and
3-16 (4) methods to adjust payments so that the total
3-17 amount of payments made in each fiscal year does not exceed the
3-18 amount available in the fund for that fiscal year.
3-19 The criteria adopted by the board shall not authorize
3-20 the payment of funds under this section for the purchase, rental or
3-21 acquisition of any equipment involved in the delivery of emergency
3-22 medical services or trauma care, except as specifically approved by
3-23 the board. In adopting such rules, the board shall consider:
3-24 (1) the need of a geographic area for the provision of
3-25 emergency medical services and trauma care through a comprehensive
4-1 system and the extent to which the payment of funds would meet the
4-2 identified need;
4-3 (2) the existence or developmental stage of an
4-4 emergency medical services and trauma system;
4-5 (3) the availability of professional and support
4-6 personnel and training programs;
4-7 (4) the degree to which any prospective recipient has
4-8 provided uncompensated emergency medical services and trauma care
4-9 services;
4-10 (5) the requirements of federal law for federal
4-11 assistance for emergency medical services and trauma systems,
4-12 including Title III, Public Health Services Act (42 U.S. Code 201
4-13 et seq), as amended; and
4-14 (6) the goal of providing the highest quality
4-15 emergency medical services and trauma care services.
4-16 (c) The department shall authorize payments from the
4-17 fund only for the purposes provided by subsection (d) of this
4-18 section and shall authorize no payments which exceed the amount of
4-19 money available in the Fund. No general revenues may be used for
4-20 payments under this Act.
4-21 (d) In accordance with the criteria established by the
4-22 board, the department shall authorize the payment of funds to
4-23 qualified recipients according to its criteria only for the
4-24 following purposes:
4-25 (1) to compensate emergency medical services and
5-1 trauma systems, facilities, and health care providers who provide
5-2 uncompensated care to trauma patients, including their
5-3 rehabilitative services;
5-4 (2) to assist in the development of emergency medical
5-5 services and trauma systems;
5-6 (3) to assist in the funding of programs educating or
5-7 training medical professionals and support personnel involved in
5-8 the delivery of emergency medical services and trauma care;
5-9 (4) to assist in the funding of programs to educate
5-10 the public regarding the emergency medical services and trauma
5-11 systems and the prevention of trauma; and
5-12 (5) to compensate for the administrative costs of
5-13 providing the above-listed services and program, not to exceed 5%
5-14 of those funds available from the Fund for payment in any state
5-15 fiscal year.
5-16 (e) During fiscal years 1992 through 1995 only, the
5-17 department shall authorize the payment of not more than twenty
5-18 percent (20%) of funds available from the Fund in any state fiscal
5-19 year for any purpose other than to compensate qualified recipients
5-20 for uncompensated emergency medical services and trauma care,
5-21 including rehabilitation services, as provided under subdivision
5-22 (d)(1) of this section. From such funds as are not authorized for
5-23 compensating qualified recipients under subdivision (d)(1) of this
5-24 section, the board may authorize the department to transfer funds
5-25 from the Emergency Medical Services and Trauma Systems Development
6-1 Fund to the grant fund program authorized by Section 5.02 of this
6-2 Act for use as authorized by that Section.
6-3 SECTION 3. Section 15, Article III of Article 6687b
6-4 (Vernon's Revised Civil Statutes) is amended to read as follows:
6-5 "(a) All fees and charges required by this Act and collected
6-6 by an officer or agent of the Department shall be remitted without
6-7 deduction to the Department in Austin, Texas.
6-8 "(b) Except as provided in subsection (c) of this section,
6-9 all fees and charges required by this Act and submitted to the
6-10 Department shall be deposited in the General Revenue Fund.
6-11 "(c) One dollar of each fee collected and remitted to the
6-12 Department under the authority of Section 19 of this Act shall be
6-13 forwarded to the comptroller of public accounts who shall deposit
6-14 the funds received by him or her in the Emergency Medical Services
6-15 and Trauma Systems Fund."
6-16 SECTION 4. Section 19, Article III. of Article 66871
6-17 (Vernon's Revised Civil Statutes) is amended to read as follows:
6-18 "Sec. 19 (a) The fees provided for in this Act shall
6-19 be as follows:
6-20 (1) All Classes of Licenses - originals issued for
6-21 four (4) years, <Sixteen> Seventeen Dollars <($16.00)> ($17.00),
6-22 except as provided for in Subdivision (2) of this subsection:
6-23 (2) Class M License - originals issued for four (4)
6-24 years, <Sixteen> Seventeen Dollars <($16.00)> ($17.00); renewals
6-25 issued for four (4) years, <Twenty-one> Twenty-two Dollars
7-1 <($21.00)> ($22.00);
7-2 (3) Provisional and Instruction (Learner's) License -
7-3 computed on basis of annual pro-rated cost of type license obtained
7-4 multiplied by number of full years of validity; provided that a
7-5 minimum one year fee of <Five> Six Dollars <($5.00)> ($6.00) shall
7-6 be paid for an instruction permit and by those obtaining such
7-7 licenses after their seventeenth (17th) birthday;
7-8 (4) Occupational License - <Ten> Eleven Dollars
7-9 <($10.00)> ($11.00) for one (1) year.
7-10 (b) An applicant who is changing from a lower to a higher
7-11 class license or adding a class of vehicle to the license shall pay
7-12 a fee of <Five> Six Dollars <($5.00)> ($6.00) for the examinations.
7-13 (c) Five Dollars ($5.00) of each Class M License renewal fee
7-14 shall be deposited in the motorcycle education fund in the State
7-15 Treasury.
7-16 (d) One Dollar ($1.00) of each original and renewal license
7-17 fee shall be deposited in the Emergency Medical Services and Trauma
7-18 Systems Fund in the State Treasury."
7-19 SECTION 5. This Act takes effect September 1, 1991.
7-20 SECTION 6. The importance of this legislation and the
7-21 crowded condition of the calendars in both houses create an
7-22 emergency and an imperative public necessity that the
7-23 constitutional rule requiring bills to be read on three several
7-24 days in each house be suspended, and this rule is hereby suspended.