BILL ANALYSIS


                                                    C.S.S.B. 1096
                                                    By: Zaffirini
                                        Health and Human Services
                                                           4-6-95
                                   Committee Report (Substituted)
BACKGROUND

The County Indigent Health Care Program was established to provide
acute 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.  Under current law, however, counties are not
authorized to provide preventive health care services.

PURPOSE

As proposed, C.S.S.B. 1096 authorizes a county to provide certain
optional health care service 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 require the Texas Department of Health (department) to
define the services and establish the payment standards for the
categories of services listed in Sections 61.028(a) and 61.0281(a)
in accordance with department rules relating to the AFDC-Medicaid
program.

     (e) Requires the department to permit payment to a licensed 
     dentist for services provided under Sections 61.028(a)(3) and
     (a)(5) and Sections 61.0281(a)(1)(C) and (a)(2), to the extent
     that these services are required by Section 61.028(a)(5) or
     61.0281(a), if the dentist can provide these services within
     the scope of the dentist's license.
     
     SECTION 2.     Amends Section 61.025(b), Health and Safety Code, to
authorize the transfer agreement to transfer partial responsibility
to the county under which the municipal hospital provides health
care services, but the county agrees to assume the hospital's
responsibility to reimburse other providers who provide inpatient
or outpatient services under Sections 61.028(a) and 61.0281(a) to
eligible residents that the municipal hospital cannot provide.

SECTION 3. Amends Chapter 61B, Health and Safety Code, by adding
Section 61.0281, 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 needs of the community, and other medically necessary
     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 services specified in
       Subsection (a) without department approval, but may not
       credit 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, as
follows:

     Sec. 61.034.  New heading: PAYMENT STANDARDS FOR HEALTH CARE
     SERVICES.  Provides 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 a 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, as follows:

     (a) Authorizes the department to distribute funds to eligible
     counties to assist the counties in providing health care
     services mandated under Section 61.028(a), or approved or
     authorized under Section 61.0281(a) or (c), rather than
     mandatory health care services, to eligible county residents.
     
     (b) and (d) Make conforming changes.
SECTION 6. Amends Section 61.038, Health and Safety Code, to make
conforming changes.

SECTION 7. Amends Section 61.041(b), Health and Safety Code, to
make a conforming change.

SECTION 8. Effective date: September 1, 1995.
           Makes application of this Act prospective.

SECTION 9. Emergency clause.