By: Barrientos S.B. No. 710 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.