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.