1-1 By: Zaffirini S.B. No. 509
1-2 (In the Senate - Filed February 8, 1995; February 9, 1995,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; February 15, 1995, reported favorably by the following
1-5 vote: Yeas 9, Nays 0; February 15, 1995, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to clarifying the authority of the Health and Human
1-9 Services Commission to delegate to a health and human services
1-10 agency the authority to operate all or part of the Medicaid program
1-11 and to the powers and duties of that agency.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. CLARIFICATION OF EFFECT OF LEGISLATION.
1-14 (a) Chapter 15, Acts of the 72nd Legislature, 1st Called Session,
1-15 1991 (H.B. 7), as amended by Chapter 747, Acts of the 73rd
1-16 Legislature, 1993 (H.B. 1510), designated the Health and Human
1-17 Services Commission as the single state agency to administer
1-18 medical assistance (Medicaid) funds and authorized the commission
1-19 to review programs and to implement the transfer of health and
1-20 human services functions, programs, and activities among the
1-21 state's health and human services agencies. In making this
1-22 designation and authorization, the legislature gave the commission
1-23 the authority to delegate to any health and human services agency
1-24 the authority to operate or assist in the operation of any Medicaid
1-25 program.
1-26 (b) Pursuant to this authority, the commission implemented
1-27 the transfer to various health and human services agencies of the
1-28 functions, powers, duties, funds, and obligations related to the
1-29 operation of various Medicaid programs, subject to the
1-30 administrative authority of the commission. Specifically, as that
1-31 authority relates to the Texas Department of Mental Health and
1-32 Mental Retardation, the commission implemented the transfer of the
1-33 functions, powers, duties, funds, and obligations of the following
1-34 Medicaid programs:
1-35 (1) case management for the mentally ill;
1-36 (2) case management for the mentally retarded;
1-37 (3) diagnostic services;
1-38 (4) home and community-based services for persons with
1-39 mental retardation;
1-40 (5) home and community-based services--Omnibus Budget
1-41 Reconciliation Act (OBRA), Pub. L. 100-203;
1-42 (6) rehabilitative services;
1-43 (7) intermediate care facilities for persons with
1-44 mental retardation;
1-45 (8) intermediate care facilities for persons with
1-46 related conditions; and
1-47 (9) intermediate care facilities dental program.
1-48 (c) The legislature declares that:
1-49 (1) the transfer of Medicaid programs and the related
1-50 functions, powers, duties, funds, and obligations to various state
1-51 agencies, including the Texas Department of Mental Health and
1-52 Mental Retardation, were valid transfers;
1-53 (2) all actions taken in reliance on those transfers
1-54 are valid; and
1-55 (3) the transfer of the powers and duties relating to
1-56 the operation of a Medicaid program included a transfer of all
1-57 applicable powers and duties provided by Chapters 21, 22, and 32,
1-58 Human Resources Code, that relate to the operation of the Medicaid
1-59 program, including the power and duty to set rates.
1-60 SECTION 2. CLARIFYING AMENDMENT. Section 32.003, Human
1-61 Resources Code, is amended to read as follows:
1-62 Sec. 32.003. DEFINITIONS <DEFINITION OF MEDICAL ASSISTANCE>.
1-63 In this chapter:
1-64 (1) "Board" means the Health and Human Services
1-65 Commission or the governing body of an agency operating part of the
1-66 medical assistance program, as appropriate.
1-67 (2) "Commissioner" means the Health and Human Services
1-68 Commission or the commissioner or executive director of an agency
2-1 operating part of the medical assistance program, as appropriate.
2-2 (3) "Department" means the Health and Human Services
2-3 Commission or an agency operating part of the medical assistance
2-4 program, as appropriate.
2-5 (4) "Medical<, "medical> assistance" includes all of
2-6 the health care and related services and benefits authorized or
2-7 provided under federal law for needy individuals of this state.
2-8 SECTION 3. CLARIFYING AMENDMENT. Subsection (o), Section
2-9 32.024, Human Resources Code, is amended to read as follows:
2-10 (o) The department, in its rules and standards governing the
2-11 scope of hospital and long-term services, shall establish a swing
2-12 bed program in accordance with federal regulations to provide
2-13 reimbursement for skilled nursing patients who are served in
2-14 hospital settings provided that the length of stay is limited to 30
2-15 days per year and the hospital is located in a county with a
2-16 population of 100,000 or less. If the swing beds are used for more
2-17 than one 30-day length of stay per year, per patient, the hospital
2-18 must comply with the Minimum Licensing Standards as mandated by
2-19 Chapter 242, Health and Safety Code <413, Acts of the 53rd
2-20 Legislature, Regular Session, 1953 (Article 4442(c), Vernon's Texas
2-21 Civil Statutes)>, and the Medicaid standards for nursing home
2-22 certification, as promulgated by the department <Texas Department
2-23 of Human Services>.
2-24 SECTION 4. CLARIFYING AMENDMENT. Subsection (c), Section
2-25 32.029, Human Resources Code, is amended to read as follows:
2-26 (c) If the department elects to make direct vendor payments,
2-27 the payments shall be made by vouchers and warrants drawn by the
2-28 comptroller on the proper account <of the Texas Department of Human
2-29 Services fund>. The department shall furnish the comptroller with
2-30 a list of those vendors entitled to payments and the amounts to
2-31 which each is entitled. When the warrants are drawn, they must be
2-32 delivered to the department, which <commissioner, who> shall
2-33 supervise the delivery to vendors.
2-34 SECTION 5. CLARIFYING AMENDMENT. Subsections (a) and (c),
2-35 Section 32.030, Human Resources Code, are amended to read as
2-36 follows:
2-37 (a) The medical assistance fund is a special fund in the
2-38 treasury and constitutes a separate account <in the Texas
2-39 Department of Human Services fund>. The fund may be expended only
2-40 for the purpose of carrying out the provisions of this chapter.
2-41 (c) The disproportionate share fund is a <special fund and>
2-42 separate account <in the Texas Department of Human Services fund>
2-43 that provides reimbursement each year to hospitals that render a
2-44 high volume of services to medically indigent persons in the state.
2-45 Payments from the fund shall be not less than $5 million annually
2-46 in state funds in excess of the amounts contained in the general
2-47 appropriations bill as introduced for the 1990-1991 biennium.
2-48 SECTION 6. CLARIFYING AMENDMENT. Subsection (e), Section
2-49 32.031, Human Resources Code, is amended to read as follows:
2-50 (e) Public hospitals, including hospitals owned, operated,
2-51 or leased by a governmental entity, including a municipality,
2-52 county, hospital district, or this state, and specifically
2-53 including a state teaching hospital, may transfer funds to the
2-54 department <Texas Department of Human Services> for use as state
2-55 share under the Medicaid disproportionate share program.
2-56 SECTION 7. CLARIFYING AMENDMENT. Subsection (a), Section
2-57 32.041, Human Resources Code, is amended to read as follows:
2-58 (a) Beginning September 1, 1991, the department <Texas
2-59 Department of Human Services> in consultation with the Medicaid
2-60 analysis and cost control unit of the Legislative Budget Board
2-61 shall initiate the planning for a Medicaid managed care
2-62 demonstration project.
2-63 SECTION 8. APPLICATION TO FUND OR ACCOUNT. (a) A fund or
2-64 account, the existence of which is derived from a statute amended
2-65 by this Act and which is abolished under Section 403.094,
2-66 Government Code, before the effective date of this Act, is not
2-67 revived or reenacted by this Act.
2-68 (b) The application of Sections 403.094 and 403.095,
2-69 Government Code, to a fund or account or to the permissible uses of
2-70 revenue of fund balances is not affected by this Act.
3-1 SECTION 9. EMERGENCY. The importance of this legislation
3-2 and the crowded condition of the calendars in both houses create an
3-3 emergency and an imperative public necessity that the
3-4 constitutional rule requiring bills to be read on three several
3-5 days in each house be suspended, and this rule is hereby suspended,
3-6 and that this Act take effect and be in force from and after its
3-7 passage, and it is so enacted.
3-8 * * * * *