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 -------------------------------------------------------------------