BILL ANALYSIS H.B. 866 By: MAXEY 02-28-95 Committee Report (Amended) BACKGROUND Children of economically disadvantaged families in Texas often lack the most basic preventative health care, a situation that contributes to poor performance in the classroom, increased dropout rates and falling attendance ratios. School-based clinics can provide basic health care in a convenient and familiar setting. Schools currently operating such facilities in Texas report significantly increased attendance, improved student performance and lower school dropout rates. In 1993, the Texas Department of Health (TDH) began awarding Title V Maternal and Child Health Block Grant funds to create school-based, health-center projects. The limited amount of Title V money being used for this program may no longer be available if changes in federal funding are made as expected. To date, the program has concentrated on the start-up of clinics with little technical support provided or emphasis placed on the perpetuation of the clinics once grant funds are exhausted. PURPOSE H.B. 866 encourages the development of school-based clinics, especially in economically disadvantaged areas, by directing the Texas Department of Health in its administration of a grant program for school-based health clinics. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Subtitle C, Title 4, Health and Safety Code, is amended by adding Chapter 266, as follows:. Sec. 266.001. DEFINITIONS. Sec. 266.002. DUTY OF DEPARTMENT TO SELECT SCHOOL DISTRICTS. Directs the Texas Department of Health (TDH) to award at least 17 grants for establishing school-based clinics. Sec. 266.003 DUTY OF SCHOOL DISTRICT TO ESTABLISH CLINIC. If a district is awarded a grant under this chapter, it must establish a school health clinic. Sec. 266.004. SCHOOL DISTRICT ELIGIBILITY. School district applicants must demonstrate that the district has community support of $125,000 the first year TDH funding is received under the grant. This commitment must include an agreement with a community-based health service agency to provide at least 25 percent of the revenue to operate the clinic each year funding is received under the grant. The district also must have access to an approved billing system, and must have projected clinic costs and revenues. Sec. 266.005. PREFERENCE IN SELECTION. Grant preference is given to school districts in which at least 60 percent of the student population is economically disadvantaged, and to those that can demonstrate the ability to establish a school health clinic in a short period. Sec. 266.006. FUNDING UNDER GRANT. Grants are for two years and may not exceed $100,000 the first year and $50,000 the second year. Sec. 266.007 IMPLEMENTATION. TDH must provide each school district that applies with a list of at least four approved billing system vendors, and it must contract with an institution of higher education to develop a process for establishing a school-based clinic and to provide technical support. Priority for technical support is given to economically disadvantaged districts, as defined in this chapter. Sec. 266.008. AGREEMENT WITH TEXAS DEPARTMENT OF HUMAN SERVICES. TDH and the Texas Department of Human Services must jointly amend the eligibility requirements of the state's emergency assistance plan under Title IV-A of the Social Security Act so that these funds can be used to supplement other financial support for school-based clinics. SECTION 2. The heading of Subtitle C, Title 4, Health and Safety Code, is amended to read as follows: SUBTITLE C. LOCAL HOSPITALS AND CLINICS. SECTION 3. Emergency clause. EXPLANATION OF AMENDMENTS An amendment adding Sec. 266.007(3) under Section 1 of the bill directs the Department of Health to withhold a portion of federal Medicaid funds and use them to fund the school-based clinics provided for in the bill. SUMMARY OF COMMITTEE ACTION H.B. 866 was considered by the Public Health Committee in a public hearing on February 28, 1995. The following person testified for the bill: Lisa McGiffert, representing Consumer's Union. The committee considered 1 amendment to the bill. The amendment was adopted without objection. The bill was reported favorably as amended with the recommendation that it do pass and be printed, by a record vote of 5 Ayes, 0 Nays, 0 PNV, and 4 Absent.