SGN C.S.S.B. 203 75(R) BILL ANALYSIS CORRECTIONS C.S.S.B. 203 By: Shapiro (Staples) 4-7-97 Committee Report (Substituted) BACKGROUND Prison health care costs continue to rise. Much of this trend is attributed to high utilization rates within the prison system. Texas inmates make three times as many outpatient visits to a medical professional as compared to state employees. Many inmates may choose to initiate medical visits due to boredom or to seek relief from work-detail. To combat this practice, many counties in Texas and numerous states have instituted a co-pay system requiring inmates to contribute toward the cost of their health care. County jails charge prisoners for medical expenses under authority of Vernon's Ann.C.C.P. Art. 104.002. Currently, there is no law allowing for this practice at the state prison level. PURPOSE As proposed, C.S.S.B. 203 requires the Texas Department of Criminal Justice to charge inmates a $3 co-payment, to be deducted from the inmate's trust account, for all self-initiated nonemergency health care visits. Provisions are included to insure no inmate would be denied health care if unable to pay. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1: Amends Subchapter B, Chapter 501, Government Code, by adding Section 501.061, as follows: Sec. 501.061. INMATE COPAYMENTS FOR CERTAIN HEALTH CARE VISITS. (a) Requires an inmate confined in a facility, other than a halfway house, operated by or under contract with the Texas Department of Criminal Justice (department), who initiates a visit to a health care provider, to make a co-payment to the department in the amount of $3. Requires the payment to be deducted from the inmate's trust fund. Requires, if the balance in the fund is insufficient to cover the co-payment, 50 percent of each deposit to the fund be applied to the balance owed until the total amount owed is paid. (b) Prohibits the department from charging a co-payment for health care provided in response to a life-threatening or emergency situation; initiated by the department; initiated by the health care provider or consisting of routine follow-up, prenatal, or chronic care; or, provided under contract established under the Interstate Corrections Compact or under an agreement with another state precluding a co-payment. (c) Requires the department to adopt policies to ensure an inmate is informed about the co-payment before the inmate initiates a visit to a health care provider. Provides that an inmate against whom a co-payment has been charged, may submit a grievance under the Inmate Grievance System on the basis that Subsection (b) prohibits the imposition of the charge. (d) Prohibits the department from denying an inmate access to health care based on failure or inability to make a co-payment. (e) Requires the department to deposit money received under this section in an account in the general revenue fund to be used only for the cost of administering this section. Requires the Comptroller, at the beginning of each fiscal year, to transfer any surplus from the previous fiscal year to the credit of the general revenue fund in the state treasury. SECTION 2: Amends Section 501.014, Government Code, by adding Subsection (g) to require the department to allow the institutional division to withdraw money from an inmate's trust fund for court ordered child support, restitution, fines, and court costs before applying a deposit to the inmate trust fund toward any unpaid balance owed to the department by the inmate under Section 501.061. SECTION 3: Effective date: January 1, 1998. SECTION 4: Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute bill defines the affected facilities as those operated by or under contract with the department, whereas the original bill defined them as an institution of the TDCJ. The substitute adds prenatal and chronic care to the list of health care exempt from a co-payment. C.S.S.B. 203 adds a Subsection requiring the department to adopt policies to inform inmates about the copayment before they initiate a health care visit and allows for an inmate to submit a grievance regarding the imposition of the charge. The substitute transfers any surplus revenue from the preceding year to the credit of the general revenue fund instead of to the Crime Victims' Compensation Fund. The substitute also adds a Subsection clarifying inmate trust fund withdrawals giving priority to court ordered child support, restitution, fines, and court costs before deposits are applied toward unpaid balances for inmate health care co-payments.