1-1 By: Hirschi (Senate Sponsor - Carriker) H.B. No. 2790
1-2 (In the Senate - Received from the House May 17, 1993;
1-3 May 19, 1993, read first time and referred to Committee on
1-4 Intergovernmental Relations; May 25, 1993, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 7, Nays
1-6 0; May 25, 1993, sent to printer.)
1-7 COMMITTEE VOTE
1-8 Yea Nay PNV Absent
1-9 Armbrister x
1-10 Leedom x
1-11 Carriker x
1-12 Henderson x
1-13 Madla x
1-14 Moncrief x
1-15 Patterson x
1-16 Rosson x
1-17 Shapiro x
1-18 Wentworth x
1-19 Whitmire x
1-20 COMMITTEE SUBSTITUTE FOR H.B. No. 2790 By: Carriker
1-21 A BILL TO BE ENTITLED
1-22 AN ACT
1-23 relating to county responsibility for indigent health care
1-24 services.
1-25 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-26 SECTION 1. Section 61.028, Health and Safety Code, is
1-27 amended to read as follows:
1-28 Sec. 61.028. MANDATORY AND OPTIONAL HEALTH CARE SERVICES.
1-29 (a) A county shall, in accordance with department rules adopted
1-30 under Section 61.006, provide:
1-31 (1) inpatient and outpatient hospital services;
1-32 (2) rural health clinics;
1-33 (3) laboratory and X-ray services;
1-34 (4) family planning services;
1-35 (5) physician services;
1-36 (6) payment for not more than three prescription drugs
1-37 a month; and
1-38 (7) skilled nursing facility services, regardless of
1-39 the patient's age.
1-40 (b) A county may provide the following optional health care
1-41 services and credit the assistance toward eligibility for state
1-42 assistance:
1-43 (1) durable medical supplies and equipment; and
1-44 (2) primary health care services as defined under
1-45 Section 31.002(a).
1-46 (c) The county may provide <additional> health care services
1-47 in addition to the mandatory and optional services, but may not
1-48 credit the assistance toward eligibility for state assistance.
1-49 SECTION 2. Sections 61.037(a), (b), and (d), Health and
1-50 Safety Code, are amended to read as follows:
1-51 (a) The department may distribute funds as provided by this
1-52 subchapter to eligible counties to assist the counties in providing
1-53 mandatory and optional health care services to their eligible
1-54 county residents.
1-55 (b) Except as provided by Subsection (c) or (d), to be
1-56 eligible for state assistance, a county must:
1-57 (1) spend in a state fiscal year at least 10 percent
1-58 of the county general revenue levy for that year to administer a
1-59 county indigent health care program and provide mandatory and
1-60 optional health care services to its eligible county residents who
1-61 qualify for assistance under Section 61.006; and
1-62 (2) notify the department, not later than the seventh
1-63 day after the date on which the county reaches the expenditure
1-64 level, that the county has spent at least eight percent of the
1-65 applicable county general revenue levy for that year to provide
1-66 mandatory and optional health care services to its eligible county
1-67 residents who qualify for assistance under Section 61.006.
1-68 (d) If a hospital district is located in part but not all of
2-1 a county, that county's appraisal district shall determine the
2-2 taxable value of the property located inside the county but outside
2-3 the hospital district. In determining eligibility for state
2-4 assistance, that county shall consider only the county general
2-5 revenue levy resulting from the property located outside the
2-6 hospital district. A county is eligible for state assistance if:
2-7 (1) the county spends in a state fiscal year at least
2-8 10 percent of the county general revenue levy for that year
2-9 resulting from the property located outside the hospital district
2-10 to provide mandatory and optional health care services to its
2-11 eligible county residents who qualify for assistance under Section
2-12 61.006; and
2-13 (2) the county complies with the other requirements of
2-14 this subchapter.
2-15 SECTION 3. Section 61.038(b), Health and Safety Code, is
2-16 amended to read as follows:
2-17 (b) State funds provided under this section to a county must
2-18 be equal to at least 80 percent of the actual payment for mandatory
2-19 and optional health care services for the county's eligible
2-20 residents during the remainder of the state fiscal year after the
2-21 10 percent expenditure level is reached.
2-22 SECTION 4. Section 61.041(b), Health and Safety Code, is
2-23 amended to read as follows:
2-24 (b) The department shall establish requirements relating to:
2-25 (1) documentation required to verify the eligibility
2-26 of residents to whom the county provides assistance; and
2-27 (2) county expenditures for mandatory and optional
2-28 health care services.
2-29 SECTION 5. Subchapter B, Chapter 61, Health and Safety Code,
2-30 is amended by adding Sections 61.042-61.044 to read as follows:
2-31 Sec. 61.042. EMPLOYMENT SERVICES PROGRAM. (a) A county may
2-32 establish procedures consistent with those used by the department
2-33 under Chapter 31, Human Resources Code, for administering an
2-34 employment services program and requiring an applicant or eligible
2-35 resident to register for work with the Texas Employment Commission.
2-36 (b) The county shall notify all persons with pending
2-37 applications and eligible residents of the employment service
2-38 program requirements not less than 30 days before the program is
2-39 established.
2-40 Sec. 61.043. PREVENTION AND DETECTION OF FRAUD. (a) The
2-41 county may adopt reasonable procedures for minimizing the
2-42 opportunity for fraud, for establishing and maintaining methods for
2-43 detecting and identifying situations in which a question of fraud
2-44 may exist, and for administrative hearings to be conducted on the
2-45 possibility of disqualifying a person if fraud is found.
2-46 (b) Procedures established by a county for administrative
2-47 hearings conducted under this section shall provide for appropriate
2-48 due process, including procedures for appeals.
2-49 Sec. 61.044. SUBROGATION. (a) The filing of an application
2-50 for or receipt of services constitutes an assignment of the
2-51 applicant's or recipient's right of recovery from:
2-52 (1) personal insurance;
2-53 (2) other sources; or
2-54 (3) another person for personal injury caused by the
2-55 other person's negligence or wrong.
2-56 (b) A person who applies for or receives services shall
2-57 inform the county, at the time of application or at any time during
2-58 eligibility, of any unsettled tort claim that may affect medical
2-59 needs and of any private accident or sickness insurance coverage
2-60 that is or may become available. An applicant or eligible resident
2-61 shall inform the county of any injury that is caused by the act or
2-62 failure to act of some other person. An applicant or eligible
2-63 resident shall inform the county as required by this subsection
2-64 within 10 days of the date the person learns of the person's
2-65 insurance coverage, tort claim, or potential cause of action.
2-66 (c) A claim for damages for personal injury does not
2-67 constitute grounds for denying or discontinuing services under this
2-68 chapter.
2-69 (d) A separate and distinct cause of action in favor of the
2-70 county is hereby created, and the county may, without written
3-1 consent, take direct civil action in any court of competent
3-2 jurisdiction. A suit brought under this section need not be
3-3 ancillary to or dependent on any other action.
3-4 (e) The county's right of recovery is limited to the amount
3-5 of the cost of services paid by the county. Other subrogation
3-6 rights granted under this section are limited to the cost of the
3-7 services provided.
3-8 (f) An applicant or eligible resident who knowingly and
3-9 intentionally fails to disclose the information required by
3-10 Subsection (b) commits a Class C misdemeanor.
3-11 (g) An applicant or eligible resident is subject to denial
3-12 of services under this chapter following an administrative hearing.
3-13 SECTION 6. This Act takes effect September 1, 1993, and
3-14 applies to services provided on or after that date.
3-15 SECTION 7. The importance of this legislation and the
3-16 crowded condition of the calendars in both houses create an
3-17 emergency and an imperative public necessity that the
3-18 constitutional rule requiring bills to be read on three several
3-19 days in each house be suspended, and this rule is hereby suspended.
3-20 * * * * *
3-21 Austin,
3-22 Texas
3-23 May 25, 1993
3-24 Hon. Bob Bullock
3-25 President of the Senate
3-26 Sir:
3-27 We, your Committee on Intergovernmental Relations to which was
3-28 referred H.B. No. 2790, have had the same under consideration, and
3-29 I am instructed to report it back to the Senate with the
3-30 recommendation that it do not pass, but that the Committee
3-31 Substitute adopted in lieu thereof do pass and be printed.
3-32 Armbrister,
3-33 Chairman
3-34 * * * * *
3-35 WITNESSES
3-36 FOR AGAINST ON
3-37 ___________________________________________________________________
3-38 Name: John H. Dombroski x
3-39 Representing: Tx Department of Health
3-40 City: Austin
3-41 -------------------------------------------------------------------
3-42 Name: Karen Norris x
3-43 Representing: Tx Assoc. of Counties
3-44 City: Austin
3-45 -------------------------------------------------------------------
3-46 Name: Jim Allison x
3-47 Representing: County Judges & Commis. Assoc
3-48 City: Austin
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