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.