By:  Zaffirini, Moncrief                              S.B. No. 1096
                                 A BILL TO BE ENTITLED
                                        AN ACT
    1-1  relating to certain health care service a county may provide under
    1-2  the Indigent Health Care and Treatment Act.
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  Subsections (a) and (e), Section 61.006, Health
    1-5  and Safety Code, are amended to read as follows:
    1-6        (a)  The department shall establish eligibility standards and
    1-7  application, documentation, and verification procedures for
    1-8  counties to use in determining eligibility under this chapter.  The
    1-9  standards and procedures must be consistent with the standards and
   1-10  procedures used by the department to determine eligibility in the
   1-11  AFDC-Medicaid program.  The department shall also define the
   1-12  services and establish the payment standards for the categories of
   1-13  services listed in Sections <Section> 61.028(a) and 61.0281(a) in
   1-14  accordance with department rules relating to the AFDC-Medicaid
   1-15  program.
   1-16        (e)  Notwithstanding Subsection (a) or any other provision of
   1-17  law, the department shall permit payment to a licensed dentist for
   1-18  services provided under Sections 61.028(a)(3) and (a)(5) and
   1-19  Sections 61.0281(a)(1)(C) and (a)(2) to the extent that these
   1-20  services are required by Section 61.028(a)(5) or 61.0281(a), if the
   1-21  dentist can provide those services within the scope of the
   1-22  dentist's license.
   1-23        SECTION 2.  Subsection (b), Section 61.025, Health and Safety
    2-1  Code, is amended to read as follows:
    2-2        (b)  The transfer agreement may transfer partial
    2-3  responsibility to the county under which the municipal hospital
    2-4  continues to provide health care services to eligible residents of
    2-5  the municipality, but the county agrees to assume the hospital's
    2-6  responsibility to reimburse other providers who provide:
    2-7              (1)  <mandatory> inpatient or outpatient services under
    2-8  Sections 61.028(a) and 61.0281(a) to eligible residents that the
    2-9  municipal hospital cannot provide; or
   2-10              (2)  emergency services to eligible residents.
   2-11        SECTION 3.  Subchapter B, Chapter 61, Health and Safety Code,
   2-12  is amended by adding Section 61.0281 to read as follows:
   2-13        Sec. 61.0281.  OPTIONAL HEALTH CARE SERVICES.  (a)  In
   2-14  addition to mandatory services provided under Section 61.028, a
   2-15  county may, in accordance with department rules adopted under
   2-16  Section 61.006, provide:
   2-17              (1)  primary and preventive services designed to meet
   2-18  the needs of the community, including:
   2-19                    (A)  immunizations;
   2-20                    (B)  medical screenings;
   2-21                    (C)  dental care; and
   2-22                    (D)  annual physical examinations; and
   2-23              (2)  other medically necessary services or supplies
   2-24  that the county determines to be cost-effective, including:
   2-25                    (A)  ambulatory surgical center services;
    3-1                    (B)  home and community health care services; and
    3-2                    (C)  diabetic and colostomy medical supplies and
    3-3  equipment.
    3-4        (b)  If the services are approved by the department under
    3-5  Subsection (a), the county may credit the services toward
    3-6  eligibility for state assistance under this subchapter.  A county
    3-7  may provide health care services that are not specified in
    3-8  Subsection (a), or may provide the services specified in Subsection
    3-9  (a) without department approval, but may not credit the services
   3-10  toward eligibility for state assistance.
   3-11        (c)  A county may credit a premium payment made by the county
   3-12  under Section 157.006, Local Government Code, toward eligibility
   3-13  for state assistance under this subchapter.
   3-14        SECTION 4.  Section 61.034, Health and Safety Code, is
   3-15  amended to read as follows:
   3-16        Sec. 61.034.  PAYMENT STANDARDS FOR <MANDATORY> HEALTH CARE
   3-17  SERVICES.  (a)  A county is not liable for the cost of a
   3-18  <mandatory> health care service under Section 61.028(a) or
   3-19  61.0281(a) that is in excess of the payment standards for that
   3-20  service established by the department under Section 61.006.
   3-21        (b)  A county may contract with a provider of assistance to
   3-22  provide a health care service at a rate below the payment standard
   3-23  set by the department.
   3-24        SECTION 5.  Subsections (a), (b), and (d), Section 61.037,
   3-25  Health and Safety Code, are amended to read as follows:
    4-1        (a)  The department may distribute funds as provided by this
    4-2  subchapter to eligible counties to assist the counties in providing
    4-3  <mandatory> health care services mandated under Section 61.028(a)
    4-4  or approved or authorized under Section 61.0281(a) or (c) to their
    4-5  eligible county residents.
    4-6        (b)  Except as provided by Subsection (c) or (d), to be
    4-7  eligible for state assistance, a county must:
    4-8              (1)  spend in a state fiscal year at least 10 percent
    4-9  of the county general revenue levy for that year to provide
   4-10  <mandatory> health care services mandated under Section 61.028(a)
   4-11  or approved or authorized under Section 61.0281(a) or (c) to its
   4-12  eligible county residents who qualify for assistance under Section
   4-13  61.006; and
   4-14              (2)  notify the department, not later than the seventh
   4-15  day after the date on which the county reaches the expenditure
   4-16  level, that the county has spent at least eight percent of the
   4-17  applicable county general revenue levy for that year to provide
   4-18  <mandatory> health care services mandated under Section 61.028(a)
   4-19  or approved or authorized under Section 61.0281(a) or (c) to its
   4-20  eligible county residents who qualify for assistance under Section
   4-21  61.006.
   4-22        (d)  If a hospital district is located in part but not all of
   4-23  a county, that county's appraisal district shall determine the
   4-24  taxable value of the property located inside the county but outside
   4-25  the hospital district.  In determining eligibility for state
    5-1  assistance, that county shall consider only the county general
    5-2  revenue levy resulting from the property located outside the
    5-3  hospital district.  A county is eligible for state assistance if:
    5-4              (1)  the county spends in a state fiscal year at least
    5-5  10 percent of the county general revenue levy for that year
    5-6  resulting from the property located outside the hospital district
    5-7  to provide <mandatory> health care services mandated under Section
    5-8  61.028(a) or approved or authorized under Section 61.0281(a) or (c)
    5-9  to its eligible county residents who qualify for assistance under
   5-10  Section 61.006; and
   5-11              (2)  the county complies with the other requirements of
   5-12  this subchapter.
   5-13        SECTION 6.  Section 61.038, Health and Safety Code, is
   5-14  amended to read as follows:
   5-15        Sec. 61.038.  DISTRIBUTION OF ASSISTANCE FUNDS.  (a)  If the
   5-16  department determines that a county is eligible for assistance, the
   5-17  department shall distribute funds appropriated to the department
   5-18  from the indigent health care assistance fund or any other
   5-19  available fund to the county to assist the county in providing
   5-20  <mandatory> health care services mandated under Section 61.028(a)
   5-21  and approved or authorized under Section 61.0281(a) or (c) to its
   5-22  eligible county residents who qualify for assistance under Section
   5-23  61.006.
   5-24        (b)  State funds provided under this section to a county must
   5-25  be equal to at least 80 percent of the actual payment for
    6-1  <mandatory> health care services mandated under Section 61.028(a)
    6-2  and approved or authorized under Section 61.0281(a) or (c) for the
    6-3  county's eligible residents during the remainder of the state
    6-4  fiscal year after the 10 percent expenditure level is reached.
    6-5        SECTION 7.  Subsection (b), Section 61.041, Health and Safety
    6-6  Code, is amended to read as follows:
    6-7        (b)  The department shall establish requirements relating to:
    6-8              (1)  documentation required to verify the eligibility
    6-9  of residents to whom the county provides assistance; and
   6-10              (2)  county expenditures for <mandatory> health care
   6-11  services mandated under Section 61.028 and approved or authorized
   6-12  under Section 61.0281(a) or (c).
   6-13        SECTION 8.  This Act takes effect September 1, 1995, and
   6-14  applies to health care provided or a premium payment made on or
   6-15  after that date.  Health care provided or a premium payment made
   6-16  before that date is governed by the law in effect when the care was
   6-17  provided or the payment was made, and that law is continued in
   6-18  effect for that purpose.
   6-19        SECTION 9.  The importance of this legislation and the
   6-20  crowded condition of the calendars in both houses create an
   6-21  emergency and an imperative public necessity that the
   6-22  constitutional rule requiring bills to be read on three several
   6-23  days in each house be suspended, and this rule is hereby suspended.