BILL ANALYSIS



S.B. 1096
By: Zaffirini, et al. (Berlanga)
05-12-95
Committee Report (Unamended)


BACKGROUND

The County Indigent Health Care Program was established to provide
acute care medical services to persons not eligible for Medicaid.
Since its inception in 1985, the program has undergone few changes,
and many persons previously ineligible for Medicaid coverage have
since gained coverage. Additionally, under current law, counties
are not authorized to provide preventive health care services, yet
the services are needed.

PURPOSE

S.B. 1096 would authorize a county to provide certain optional
health care services for credit toward eligibility for state
assistance.

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. Amends Sections 61.006(a) and (e), Health and Safety
Code, to add references to Section 61.0281, which is added by this
bill. These subsections cover eligibility standards and payment for
services. 
     SECTION 2.     Amends Section 61.025(b), Health and Safety Code, to add
a reference to Sections 61.028 and 61.0281, the latter of which is
added by this bill. The word mandatory is deleted from a reference
to "mandatory inpatient or outpatient services." This section
(61.025) covers the transfer agreement with regard to the
hospital's responsibility to reimburse specified providers.

SECTION 3. Adds Section 61.0281 to Chapter 61B, Health and Safety
Code, as follows:

     Sec. 61.0281.  OPTIONAL HEALTH CARE SERVICES. (a) Authorizes
     a county to provide, in addition to mandatory services under
     Section 61.028 and in accordance with department rules under
     Section 61.006, primary and preventive services designed to
     meet the specified needs of the community, and other medically
     necessary specified services or supplies that the county
     determines to be cost-effective.
     
     (b) Authorizes the county, if the services are approved
       under Subsection (a), to credit the services toward
       eligibility for state assistance under this subchapter.
       Authorizes a county to provide health care services that are
       not specified in Subsection (a), or provide services
       specified in Subsection (a) without department approval, but
       prohibits the county from crediting the services toward
       eligibility for state assistance.
       
       (c) Authorizes a county to credit a premium payment made by
       the county under Section 157.006, Local Government Code,
       toward the eligibility for state assistance under this
       subchapter.
       
       SECTION 4.   Amends Section 61.034, Health and Safety Code, by
deleting the word "mandatory" from the heading, and stating that a
county is not liable for the cost of a health care service under
Section 61.028(a) or 61.0281(a), rather than the deleted
"mandatory" health care service, that is in excess of certain
payment standards.

SECTION 5. Amends Sections 61.037(a), (b), and (d), Health and
Safety Code, to add references to Sec. 61.0281, which is added by
this bill, and clarify references to health care services mandated
under Sec. 61.028. References to "mandatory" health care services
are deleted. This section concerns funding.

SECTION 6. Amends Section 61.038, Health and Safety Code, to add
references to Sec. 61.0281, which is added by this bill and clarify
references to health care services mandated under Sec. 61.028.
References to "mandatory" health care services are deleted. This
section concerns the distribution of assistance funds.

SECTION 7. Amends Section 61.041(b), Health and Safety Code, to add
a reference to Sec. 61.0281, which is added by this bill and
clarify a reference to health care services mandated under Sec.
61.028. The reference to "mandatory" health care services is
deleted. This subsection concerns the requirements established by
the department regarding county expenditures.

SECTION 8. Effective date: September 1, 1995. States that this Act
applies to health care provided or a premium payment made on or
after that date, and that these specified services made before that
date are governed by the law in effect at that time, and that law
is continued in effect for that purpose.

SECTION 9. Emergency clause.

SUMMARY OF COMMITTEE ACTION

S.B. 1096 was considered by the Public Health Committee in a formal
meeting on May 12, 1995. The bill was reported favorably without
amendment, with the recommendation that it do pass and be printed,
by the record vote of 5 AYES, 0 NAYS, 0 PNV, and 4 ABSENT.