1-1 By: Barrientos S.B. No. 710
1-2 (In the Senate - Filed March 9, 1993; March 9, 1993, read
1-3 first time and referred to Committee on Intergovernmental
1-4 Relations; April 6, 1993, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 7, Nays 0;
1-6 April 6, 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 S.B. No. 710 By: Wentworth
1-21 A BILL TO BE ENTITLED
1-22 AN ACT
1-23 relating to the responsibility of certain counties to provide
1-24 health care services to eligible residents and to transfers of
1-25 health care functions from municipalities to counties.
1-26 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-27 SECTION 1. Chapter 121, Health and Safety Code, is amended
1-28 by adding Subchapter F to read as follows:
1-29 SUBCHAPTER F. COUNTY HEALTH DEPARTMENTS IN CERTAIN COUNTIES
1-30 Sec. 121.061. APPLICATION OF SUBCHAPTER. (a) This
1-31 subchapter applies only to a county with a population of at least
1-32 450,000 in which a hospital district is not located.
1-33 (b) The provisions of this subchapter shall not be construed
1-34 to alter the obligations of any municipality, county, public
1-35 hospital, or hospital district under Chapter 61 or other state or
1-36 federal law, except as provided in an agreement made by a county
1-37 and a municipality under Section 121.063(b), or to alter the
1-38 obligations of any hospital under any state or federal laws that
1-39 relate to the provision of emergency services.
1-40 Sec. 121.062. DEFINITION. In this subchapter, "county
1-41 residents" means individuals living throughout the county, even if
1-42 the individuals are also residents of a municipality within the
1-43 county.
1-44 Sec. 121.063. COUNTY HEALTH DEPARTMENT; ASSUMPTION OF
1-45 SERVICES OF MUNICIPALITY. (a) A county subject to this subchapter
1-46 may establish a county health department to coordinate and provide
1-47 health care services to eligible county residents.
1-48 (b) The county and each municipality that is located in
1-49 whole or in part within the boundaries of the county and that
1-50 provides health care services may agree through negotiation and
1-51 after a majority vote of the governing body of the municipality and
1-52 a majority vote of the county commissioners court for the county to
1-53 provide any or all of the health services previously provided by
1-54 the municipality, without regard to whether the municipality is
1-55 obligated to provide those services or is voluntarily providing
1-56 them.
1-57 Sec. 121.064. PROVISION OF HEALTH CARE. (a) The county may
1-58 furnish, directly through the county health department or by
1-59 contract or other arrangement, medical and hospital care for the
1-60 eligible county residents. The county may provide mental health,
1-61 mental retardation, or public health services including public
1-62 health education services.
1-63 (b) The county may provide, finance, organize, and arrange
1-64 for the provision of health care to eligible county residents and
1-65 to other individuals, groups, or government entities who contract
1-66 with the county for health care services.
1-67 (c) The county may:
1-68 (1) authorize the county health department to perform
2-1 its powers and duties under this subchapter directly;
2-2 (2) contract or enter into an interlocal agreement
2-3 with a political subdivision or with a public or private provider,
2-4 without regard to the provider's location;
2-5 (3) purchase or provide insurance; and
2-6 (4) administer or enter into an agreement for the
2-7 administration of one or more managed care programs.
2-8 (d) This section does not affect the duty of any
2-9 nongovernmental entity in the county to provide medical or hospital
2-10 care to county residents. This section shall be construed so that
2-11 it does not supersede or contradict any provision of the Medical
2-12 Practice Act (Article 4495b, Vernon's Texas Civil Statutes).
2-13 Sec. 121.065. HEALTH CARE PRIORITY. In performing its
2-14 powers and duties under this subchapter, a county shall place
2-15 highest priority on the provision of primary care, public health
2-16 education services, and prevention of sickness and accidents in the
2-17 county.
2-18 Sec. 121.066. ELIGIBLE COUNTY RESIDENTS. (a) If an
2-19 agreement between a county and a municipality is made under Section
2-20 121.063(b), the county shall adopt eligibility standards for
2-21 determining whether an individual is an eligible county resident
2-22 for receipt of health care services and shall adopt application,
2-23 documentation, and verification procedures. These eligibility
2-24 standards shall not exclude from eligibility any individual who
2-25 would have been eligible for health care services from that
2-26 municipality or that county prior to an agreement that is made
2-27 under Section 121.063(b).
2-28 (b) If a county resident who is covered by governmental or
2-29 private health insurance would qualify as an eligible county
2-30 resident if the resident was not covered by government or private
2-31 health insurance coverage, the county may furnish health care to
2-32 the resident to the extent the health care is not covered by the
2-33 health insurance coverage if an agreement between a county and a
2-34 municipality is made under Section 121.063(b).
2-35 (c) The county may implement a sliding scale requiring
2-36 payment of a portion of the cost of health care provided to an
2-37 eligible resident or other individual. The sliding scale must be
2-38 based on the individual's family income and may not be set at a
2-39 level that would prevent an eligible indigent county resident from
2-40 obtaining medical or hospital care. A county may contract with a
2-41 municipality, another county, or another political subdivision to
2-42 provide health care services for individuals residing outside that
2-43 county but residing within the boundaries of that municipality,
2-44 county, or political subdivision.
2-45 Sec. 121.067. PAYMENT FOR HEALTH CARE SERVICES. (a) The
2-46 county may collect the charges for medical, hospital, or other
2-47 health care provided to the individual by the county under this
2-48 subchapter from an individual who is not an eligible county
2-49 resident, from a person liable for the individual's support, or
2-50 from a person liable for the individual's illness or injury.
2-51 (b) The county may not collect directly from an eligible
2-52 individual an amount in excess of the amount due for the service
2-53 provided under a sliding scale adopted under Section 121.066.
2-54 (c) If the county finances or provides health care to a sick
2-55 or injured individual who does not reside in the county but for
2-56 whom there is another county, municipality, or public hospital that
2-57 is responsible for the individual's care under Chapter 61, the
2-58 responsible county, municipality, or public hospital shall
2-59 reimburse the county for the health care provided.
2-60 (d) If the county finances or provides health care to a sick
2-61 or injured individual who is confined in a jail facility that is
2-62 not operated by the county and who was not a resident of the county
2-63 before the confinement, the official that operates the jail
2-64 facility shall reimburse the county for the charges for the health
2-65 care services provided. If the county finances or provides health
2-66 care to a sick or injured individual who is confined in a jail
2-67 facility that is operated by the county and who was not a resident
2-68 of the county before the confinement, the official that operates
2-69 the jail facility may collect and shall reimburse the county for
2-70 any health care charges that the official collects from other
3-1 jurisdictions for these individuals.
3-2 Sec. 121.068. RESPONSIBILITY OF MUNICIPALITY. If an
3-3 agreement between a county and a municipality is made under Section
3-4 121.063(b), except as provided by that agreement, the municipality
3-5 may not provide health care services as defined in that agreement
3-6 to eligible county residents even if the individuals are also
3-7 residents of the municipality. Unless specifically provided by the
3-8 agreement, a municipality is not prohibited from continuing to
3-9 provide hospital care to county residents who are not eligible
3-10 indigent county residents or from funding a municipal hospital
3-11 authority that provides hospital care to county residents who are
3-12 not eligible indigent county residents.
3-13 Sec. 121.069. TRANSFER OF FUNCTIONS. (a) Not later than
3-14 the 90th day after the date a county to which this subchapter
3-15 applies initiates negotiations under Section 121.063(b), the county
3-16 and each municipality that is located in the county and provides
3-17 health care services shall identify all money the municipality
3-18 expends on health-related matters within that portion of the
3-19 municipality to be covered by the agreement with the county made
3-20 under Section 121.063(b) and all money the county expends on
3-21 health-related matters within the county.
3-22 (b) Not later than the 90th day after the initiation of
3-23 negotiations and at 90-day intervals thereafter, the county shall
3-24 report to the municipality and the municipality shall report to the
3-25 county their respective positions with respect to the negotiations.
3-26 (c) If the county and the municipality do not agree on the
3-27 amount of money expended by the county and the municipality on
3-28 health-related matters, the county and municipality shall submit
3-29 the dispute to binding arbitration. Either party may compel the
3-30 arbitration in accordance with the Texas General Arbitration Act
3-31 (Article 224 et seq., Vernon's Texas Civil Statutes), as amended,
3-32 as if the dispute were an agreement described in that Act.
3-33 (d) After an agreement has been reached under Section
3-34 121.063(b), the county and the municipality may provide for the
3-35 transfer to the county of municipal employees engaged in the
3-36 provision of health care or related services in that part of the
3-37 municipality. Municipal employees transferred to a county under
3-38 this subsection are entitled, on transfer, to at least the same
3-39 wages paid by the municipality and to comparable employment
3-40 benefits.
3-41 (e) Each municipality may transfer to the county any real or
3-42 personal property that is:
3-43 (1) owned by the municipality;
3-44 (2) located in the county; and
3-45 (3) predominately dedicated to the provision of health
3-46 care or related services to county residents.
3-47 (f) If the terms of the lease permit assignment and the
3-48 county agrees to the assignment, the municipality may also transfer
3-49 to the county the rights and obligations of the municipality under
3-50 any lease relating to real property that is:
3-51 (1) located in the county; and
3-52 (2) predominately dedicated to the provision of health
3-53 care or related services to county residents.
3-54 (g) If each party to the contract and assignment agrees,
3-55 each municipality may assign its rights and obligations under any
3-56 contract to which the municipality is a party and which is
3-57 predominately dedicated to the provision of health care or related
3-58 supplies or services to the residents of the municipality if the
3-59 municipality complied with Chapter 252, Local Government Code, in
3-60 awarding the contract, and the county may accept the rights and
3-61 obligations under these contracts without complying with Chapter
3-62 262, Local Government Code.
3-63 (h) If an agreement between a county and a municipality is
3-64 made under Section 121.063(b), the municipality may not, except as
3-65 provided by that agreement, enter into or renew any contract with
3-66 any person for the provision of health care and related supplies or
3-67 services for county residents after the commencement date of the
3-68 agreement.
3-69 Sec. 121.070. MUNICIPAL TAX ROLLBACK. (a) If an agreement
3-70 between a county and a municipality is made under Section
4-1 121.063(b), the municipality shall designate in the agreement the
4-2 portion of the amount identified under Section 121.069(a) as
4-3 attributable to any sales and use taxes imposed by the municipality
4-4 and the remaining portion as attributable to property tax revenues.
4-5 (b) Notwithstanding Chapter 321, Tax Code, within 30 days
4-6 after approval of an agreement between a county and a municipality
4-7 is made under Section 121.063(b) by both the county and the
4-8 municipality, the municipality shall pass a resolution or order
4-9 that reduces its sales and use tax rate as necessary to reduce the
4-10 municipalities' tax collections in an amount equal to the amount
4-11 attributed to its sales and use taxes under Subsection (a) so that
4-12 the reduction takes effect on a date agreed on and specified in the
4-13 agreement made under Section 121.063(b). A resolution or order
4-14 under this subsection shall state the date of the approval of the
4-15 agreement under Section 121.063(b), the date of the resolution, the
4-16 amount of the reduction in the sales and use tax rate, if any, the
4-17 effective date of the sales and use tax reduction, if any, and that
4-18 the reduction, if any, results from the requirement for a reduction
4-19 in tax collections under this subsection. If the resolution
4-20 results in a reduction in the sales and use tax rate, the municipal
4-21 clerk shall send a copy of the resolution or order along with a map
4-22 of the municipality that clearly shows its boundaries to the
4-23 comptroller by United States certified or registered mail within
4-24 seven days after the resolution or order is approved by the
4-25 municipality.
4-26 (c) The municipality shall reduce its last year's
4-27 maintenance and operations expense in calculating its property
4-28 rollback tax rate to reduce the municipality's maximum potential
4-29 tax collections in an amount equal to the amount attributed to its
4-30 property tax revenue under Subsection (a). Section 26.041(a), Tax
4-31 Code, governs the reduction of the property rollback tax rate under
4-32 this subsection.
4-33 Sec. 121.071. DEDICATION OF COUNTY TAX INCREASE. If an
4-34 agreement between a county and a municipality is made under Section
4-35 121.063(b), during the first year of the agreement, the county
4-36 shall dedicate a portion of its total tax revenues for the
4-37 provision of health care services to eligible county residents that
4-38 is at least equal to the amount that the county and the
4-39 municipality identified under Section 121.069(a).
4-40 Sec. 121.072. TIMELY AGREEMENT. An agreement under Section
4-41 121.063(b) must be made before January 1, 1995. An agreement made
4-42 under Section 121.063(b) after January 1, 1995, has no force or
4-43 effect.
4-44 Sec. 121.073. EXPIRATION OF SUBCHAPTER. If an agreement has
4-45 not been made before January 1, 1995, this subchapter shall expire
4-46 January 2, 1995.
4-47 SECTION 2. Subtitle C, Title 3, Tax Code, is amended by
4-48 adding Chapter 325 to read as follows:
4-49 CHAPTER 325. HEALTH SERVICES SALES AND USE TAX FOR
4-50 CERTAIN COUNTIES
4-51 SUBCHAPTER A. GENERAL PROVISIONS
4-52 Sec. 325.001. COUNTY SALES AND USE TAX ACT APPLICABLE;
4-53 EXCEPTION. Subchapters A, C, D, and F, Chapter 323, apply to the
4-54 tax authorized by this chapter in the same manner as that chapter
4-55 applies to the tax authorized by that chapter.
4-56 SUBCHAPTER B. IMPOSITION OF TAX
4-57 Sec. 325.021. APPLICATION. This chapter applies to a county
4-58 with a population of at least 450,000 in which a hospital district
4-59 is not located and that has entered into an agreement with a
4-60 municipality under Subchapter F, Chapter 121, Health and Safety
4-61 Code.
4-62 Sec. 325.022. TAX AUTHORIZED. The commissioners court of a
4-63 county to which this chapter applies may adopt or abolish the sales
4-64 and use tax authorized by this chapter by order or resolution.
4-65 Sec. 325.023. TAX RATE. The rate of the tax authorized by
4-66 this chapter is the rate prescribed by the resolution or order of
4-67 the county commissioners court.
4-68 Sec. 325.024. SALES AND USE TAX EFFECTIVE DATE. (a) The
4-69 adoption or abolition of the tax takes effect on the first day of
4-70 the first calendar quarter occurring after the expiration of the
5-1 first complete calendar quarter occurring after the date on which
5-2 the comptroller receives a notice of the order of resolution of the
5-3 county commissioners court.
5-4 (b) If the comptroller determines that the effective date
5-5 provided by Subsection (a) will occur before the comptroller can
5-6 reasonably take the action required to begin collecting the tax or
5-7 to implement the abolition of the tax, the effective date may be
5-8 extended by the comptroller until the first day of the next
5-9 succeeding calendar quarter.
5-10 Sec. 325.025. EFFECT ON OTHER TAXES. Notwithstanding any
5-11 other law, the imposition or abolition of a sales use tax under
5-12 this chapter does not affect the validity or rate of any other tax
5-13 imposed by another political subdivision that has jurisdiction over
5-14 territory located within the boundaries of the county.
5-15 SUBCHAPTER C. USE OF TAX REVENUE
5-16 Sec. 325.061. USE OF TAX REVENUE. Revenue from a tax
5-17 imposed under this chapter may be used only to provide health
5-18 services to county residents. The county imposing the tax may
5-19 allocate part of the revenue to carrying out the county's duties
5-20 under an agreement made with a municipality under Subchapter F,
5-21 Chapter 121, Health and Safety Code.
5-22 SECTION 3. Section 26.04, Tax Code, is amended by adding
5-23 Subsections (k) and (l) to read as follows:
5-24 (k) This subsection applies to a taxing unit that
5-25 discontinues operating a distinct department, function, or activity
5-26 if the operation of that department, function, or activity in all
5-27 or a majority of the territory of the taxing unit is continued by
5-28 another existing taxing unit or by a new taxing unit. The rollback
5-29 tax rate of a taxing unit to which this subsection applies in the
5-30 first tax year in which a budget is adopted that does not allocate
5-31 revenue to the discontinued department, function, or activity is
5-32 calculated as otherwise provided by this section, except that last
5-33 year's levy used to calculate the effective maintenance and
5-34 operations rate of the unit is reduced by the amount of maintenance
5-35 and operations tax revenue spent by the taxing unit to operate the
5-36 department, function, or activity in the last fiscal year in which
5-37 the taxing unit operated that department, function, or activity for
5-38 the entire fiscal year.
5-39 (l) This subsection applies to a taxing unit that operates a
5-40 distinct department, function, or activity if the operation of a
5-41 substantially similar department, function, or activity in all or a
5-42 majority of the territory of the taxing unit has been discontinued
5-43 by another taxing unit, including a dissolved taxing unit. The
5-44 rollback tax rate of a taxing unit to which this subsection applies
5-45 in the first tax year after the other taxing unit discontinued the
5-46 substantially similar department, function, or activity in which a
5-47 budget is adopted that allocates revenue to the department,
5-48 function, or activity is calculated as otherwise provided by this
5-49 section, except that last year's levy used to calculate the
5-50 effective maintenance and operations rate of the unit is increased
5-51 by the amount of maintenance and operations tax revenue spent by
5-52 the taxing unit that discontinued operating the substantially
5-53 similar department, function, or activity to operate that
5-54 department, function, or activity in the last fiscal year in which
5-55 that taxing unit operated the discontinued department, function, or
5-56 activity for the entire fiscal year.
5-57 SECTION 4. The importance of this legislation and the
5-58 crowded condition of the calendars in both houses create an
5-59 emergency and an imperative public necessity that the
5-60 constitutional rule requiring bills to be read on three several
5-61 days in each house be suspended, and this rule is hereby suspended,
5-62 and that this Act take effect and be in force from and after its
5-63 passage, and it is so enacted.
5-64 * * * * *
5-65 Austin,
5-66 Texas
5-67 April 6, 1993
5-68 Hon. Bob Bullock
5-69 President of the Senate
5-70 Sir:
6-1 We, your Committee on Intergovernmental Relations to which was
6-2 referred S.B. No. 710, have had the same under consideration, and I
6-3 am instructed to report it back to the Senate with the
6-4 recommendation that it do not pass, but that the Committee
6-5 Substitute adopted in lieu thereof do pass and be printed.
6-6 Armbrister,
6-7 Chairman
6-8 * * * * *
6-9 WITNESSES
6-10 FOR AGAINST ON
6-11 ___________________________________________________________________
6-12 Name: Barbara Wilson x
6-13 Representing: Travis County
6-14 City: Austin
6-15 -------------------------------------------------------------------
6-16 Name: Judge Bill Aleshire x
6-17 Representing: Travis County
6-18 City: Austin
6-19 -------------------------------------------------------------------