BG H.B. 2984 75(R)BILL ANALYSIS


PUBLIC HEALTH
H.B. 2984
By: Hunter
4-16-97
Committee Report (Unamended)


BACKGROUND 

Chronically ill children constitute one of the highest cost groups for
numerous state programs, including public assistance and education.  The
number of children in need of continuous long term medical care is
expected to  increase as is the cost of care and special educational
requirements.  A highly regarded non-profit entity, The House That Kerry
Built,  has developed a cost-effective model for care and education of
such children and their families.  Before the state adopts a long term
health and education program for such children, it needs reliable
information. A limited term pilot program under oversight of the Board of
Health could provide the legislature the information needed for this long
term plan. 

PURPOSE

HB 2984 establishes a limited term pilot program to address the needs of
medically fragile children in this state and provide reliable information
to the legislature for future establishment of cost efficient methods of
providing for the health and education needs of these children and their
families. 

RULEMAKING AUTHORITY

It is the committee's opinion that this bill expressly grants additional
rulemaking authority to the Board of Health in Section 1 (Section 35.019,
Health and Safety Code).  

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 35, Health and Safety Code, by adding Sections
35.014 - 35.019 as follows: 

Sec. 35.014.  CARE OF MEDICALLY FRAGILE; POLICY.  Provides the policy and
background of legislative acknowledgment of the expanding demographics of
chronically ill children and their need for long term medical care.
Establishes legislative recognition for cost effective medical care,
education, and public assistance for such children and that such care
should be community based and family centered.  Specifies the legislative
finding that research is needed as to the unique needs of "medically
fragile children" and their families. 

Sec. 35.015. PILOT PROGRAM. Requires the Board of Health (board) to
establish a pilot program and to select a non-profit private entity to
operate the program.  Allows the board to grant the pilot program an
amount not exceeding $400,000 for each fiscal year. 

Sec. 35.016.  PROGRAM CRITERIA.  Requires the board to require the pilot
program to include certain programs, services and other criteria as
specified. 

Sec. 35.017.  SELECTION.  Requires the board to consider cost efficiency,
ability to provide services on a regional basis, and demonstrated track
record in selecting a private non-profit entity to operate the pilot
program. 

Sec. 35.018.  TERM: REPORT AND REVIEW.  Establishes that the selection of
the operating entity is effective for five years.  Requires the board to
monitor and review the  pilot program and deliver a report to the Sunset
Commission by September 1, 2000. Requires the commission to make
legislative recommendations as specified. Requires the board and the
commission to address in the review and reports, the benefits of the
program as specified, the overall  cost savings as specified, and provide
recommendations as specified. 

Sec. 35.019.  RULES. Allows the board to adopt rules to implement and
oversee the program and to obtain the necessary reports as specified. 

SECTION 2.  Amends Section 35.002, Health and Safety Code as follows:

Subsection (9) defines "medically fragile child."

Subsections (10) - (17) make renumbering changes to conform. 

SECTION 3.  Provides that the effective date of the Act is September 1,
1997.  Requires the board to select the entity to run the program by
January 1, 1998. 

SECTION 4.  Emergency clause.