1-1 By: Zaffirini S.B. No. 1096
1-2 (In the Senate - Filed March 9, 1995; March 14, 1995, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 April 5, 1995, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 7, Nays 0; April 5, 1995,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 1096 By: Zaffirini
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to certain health care service a county may provide under
1-11 the Indigent Health Care and Treatment Act.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Subsections (a) and (e), Section 61.006, Health
1-14 and Safety Code, are amended to read as follows:
1-15 (a) The department shall establish eligibility standards and
1-16 application, documentation, and verification procedures for
1-17 counties to use in determining eligibility under this chapter. The
1-18 standards and procedures must be consistent with the standards and
1-19 procedures used by the department to determine eligibility in the
1-20 AFDC-Medicaid program. The department shall also define the
1-21 services and establish the payment standards for the categories of
1-22 services listed in Sections <Section> 61.028(a) and 61.0281(a) in
1-23 accordance with department rules relating to the AFDC-Medicaid
1-24 program.
1-25 (e) Notwithstanding Subsection (a) or any other provision of
1-26 law, the department shall permit payment to a licensed dentist for
1-27 services provided under Sections 61.028(a)(3) and (a)(5) and
1-28 Sections 61.0281(a)(1)(C) and (a)(2) to the extent that these
1-29 services are required by Section 61.028(a)(5) or 61.0281(a), if the
1-30 dentist can provide those services within the scope of the
1-31 dentist's license.
1-32 SECTION 2. Subsection (b), Section 61.025, Health and Safety
1-33 Code, is amended to read as follows:
1-34 (b) The transfer agreement may transfer partial
1-35 responsibility to the county under which the municipal hospital
1-36 continues to provide health care services to eligible residents of
1-37 the municipality, but the county agrees to assume the hospital's
1-38 responsibility to reimburse other providers who provide:
1-39 (1) <mandatory> inpatient or outpatient services under
1-40 Sections 61.028(a) and 61.0281(a) to eligible residents that the
1-41 municipal hospital cannot provide; or
1-42 (2) emergency services to eligible residents.
1-43 SECTION 3. Subchapter B, Chapter 61, Health and Safety Code,
1-44 is amended by adding Section 61.0281 to read as follows:
1-45 Sec. 61.0281. OPTIONAL HEALTH CARE SERVICES. (a) In
1-46 addition to mandatory services provided under Section 61.028, a
1-47 county may, in accordance with department rules adopted under
1-48 Section 61.006, provide:
1-49 (1) primary and preventive services designed to meet
1-50 the needs of the community, including:
1-51 (A) immunizations;
1-52 (B) medical screenings;
1-53 (C) dental care; and
1-54 (D) annual physical examinations; and
1-55 (2) other medically necessary services or supplies
1-56 that the county determines to be cost-effective, including:
1-57 (A) ambulatory surgical center services;
1-58 (B) home and community health care services; and
1-59 (C) diabetic and colostomy medical supplies and
1-60 equipment.
1-61 (b) If the services are approved by the department under
1-62 Subsection (a), the county may credit the services toward
1-63 eligibility for state assistance under this subchapter. A county
1-64 may provide health care services that are not specified in
1-65 Subsection (a), or may provide the services specified in Subsection
1-66 (a) without department approval, but may not credit the services
1-67 toward eligibility for state assistance.
1-68 (c) A county may credit a premium payment made by the county
2-1 under Section 157.006, Local Government Code, toward eligibility
2-2 for state assistance under this subchapter.
2-3 SECTION 4. Section 61.034, Health and Safety Code, is
2-4 amended to read as follows:
2-5 Sec. 61.034. PAYMENT STANDARDS FOR <MANDATORY> HEALTH CARE
2-6 SERVICES. (a) A county is not liable for the cost of a
2-7 <mandatory> health care service under Section 61.028(a) or
2-8 61.0281(a) that is in excess of the payment standards for that
2-9 service established by the department under Section 61.006.
2-10 (b) A county may contract with a provider of assistance to
2-11 provide a health care service at a rate below the payment standard
2-12 set by the department.
2-13 SECTION 5. Subsections (a), (b), and (d), Section 61.037,
2-14 Health and Safety Code, are amended to read as follows:
2-15 (a) The department may distribute funds as provided by this
2-16 subchapter to eligible counties to assist the counties in providing
2-17 <mandatory> health care services mandated under Section 61.028(a)
2-18 or approved or authorized under Section 61.0281(a) or (c) to their
2-19 eligible county residents.
2-20 (b) Except as provided by Subsection (c) or (d), to be
2-21 eligible for state assistance, a county must:
2-22 (1) spend in a state fiscal year at least 10 percent
2-23 of the county general revenue levy for that year to provide
2-24 <mandatory> health care services mandated under Section 61.028(a)
2-25 or approved or authorized under Section 61.0281(a) or (c) to its
2-26 eligible county residents who qualify for assistance under Section
2-27 61.006; and
2-28 (2) notify the department, not later than the seventh
2-29 day after the date on which the county reaches the expenditure
2-30 level, that the county has spent at least eight percent of the
2-31 applicable county general revenue levy for that year to provide
2-32 <mandatory> health care services mandated under Section 61.028(a)
2-33 or approved or authorized under Section 61.0281(a) or (c) to its
2-34 eligible county residents who qualify for assistance under Section
2-35 61.006.
2-36 (d) If a hospital district is located in part but not all of
2-37 a county, that county's appraisal district shall determine the
2-38 taxable value of the property located inside the county but outside
2-39 the hospital district. In determining eligibility for state
2-40 assistance, that county shall consider only the county general
2-41 revenue levy resulting from the property located outside the
2-42 hospital district. A county is eligible for state assistance if:
2-43 (1) the county spends in a state fiscal year at least
2-44 10 percent of the county general revenue levy for that year
2-45 resulting from the property located outside the hospital district
2-46 to provide <mandatory> health care services mandated under Section
2-47 61.028(a) or approved or authorized under Section 61.0281(a) or (c)
2-48 to its eligible county residents who qualify for assistance under
2-49 Section 61.006; and
2-50 (2) the county complies with the other requirements of
2-51 this subchapter.
2-52 SECTION 6. Section 61.038, Health and Safety Code, is
2-53 amended to read as follows:
2-54 Sec. 61.038. DISTRIBUTION OF ASSISTANCE FUNDS. (a) If the
2-55 department determines that a county is eligible for assistance, the
2-56 department shall distribute funds appropriated to the department
2-57 from the indigent health care assistance fund or any other
2-58 available fund to the county to assist the county in providing
2-59 <mandatory> health care services mandated under Section 61.028(a)
2-60 and approved or authorized under Section 61.0281(a) or (c) to its
2-61 eligible county residents who qualify for assistance under Section
2-62 61.006.
2-63 (b) State funds provided under this section to a county must
2-64 be equal to at least 80 percent of the actual payment for
2-65 <mandatory> health care services mandated under Section 61.028(a)
2-66 and approved or authorized under Section 61.0281(a) or (c) for the
2-67 county's eligible residents during the remainder of the state
2-68 fiscal year after the 10 percent expenditure level is reached.
2-69 SECTION 7. Subsection (b), Section 61.041, Health and Safety
2-70 Code, is amended to read as follows:
3-1 (b) The department shall establish requirements relating to:
3-2 (1) documentation required to verify the eligibility
3-3 of residents to whom the county provides assistance; and
3-4 (2) county expenditures for <mandatory> health care
3-5 services mandated under Section 61.028 and approved or authorized
3-6 under Section 61.0281(a) or (c).
3-7 SECTION 8. This Act takes effect September 1, 1995, and
3-8 applies to health care provided or a premium payment made on or
3-9 after that date. Health care provided or a premium payment made
3-10 before that date is governed by the law in effect when the care was
3-11 provided or the payment was made, and that law is continued in
3-12 effect for that purpose.
3-13 SECTION 9. The importance of this legislation and the
3-14 crowded condition of the calendars in both houses create an
3-15 emergency and an imperative public necessity that the
3-16 constitutional rule requiring bills to be read on three several
3-17 days in each house be suspended, and this rule is hereby suspended.
3-18 * * * * *