SRC-JRN S.B. 1165 75(R)   BILL ANALYSIS


Senate Research Center   S.B. 1165
By: Zaffirini
Health & Human Services
4-7-97
As Filed


DIGEST 

Currently, children with special health care needs are given no special
consideration and must enroll along with all Medicaid-eligible patients in
the Medicaid managed care pilot programs that are being rolled out across
the state.  The Senate Committee on Health and Human Services recommended
in a report that the Health and Human Services Commission give special
consideration to children with special health care needs to ensure that
these children are being adequately served by state Medicaid program.  To
accomplish this goal, this bill requires the Commission to develop a
standard operational definition of children with special health care
needs, to develop a pilot program for children with special health care
needs to determine the best way to serve these children in a managed care
setting, and to allow the children with special health care needs to
voluntarily enroll in Medicaid managed care. 

PURPOSE

As proposed, S.B. 1165 sets forth the provisions and exceptions of managed
care under the state Medicaid program for children with special health
care needs. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Health and Human Services
Commission in SECTION 1.01 (Article 4413(502), V.T.C.S.) of this bill. 

SECTION BY SECTION ANALYSIS

ARTICLE 1

SECTION 1.01.  Amends Section 16A, Article 4413(502), V.T.C.S., by
amending Subsection (n) and adding Subsections (o) and (p), to prohibit
the Health and Human Services (commission) from requiring a child with
special health care needs who is eligible for medical assistance under
Chapter 32, Human Resources Code, to enroll in a managed care plan to
receive health care services. Requires the commission to perform certain
duties in cooperation with the Texas Department of Health.  Requires the
commission, by rule, to prescribe qualifications for classification of a
child as a "child with special health care needs" for purposes of
Subsection (n) of this section.  Sets forth types of disabilities the
commission must include in prescribing qualifications for children.  Makes
a conforming change. 

ARTICLE 2

SECTION 2.01.  Amends Chapter 532B, Government Code, by adding Section
532.112, as follows: 

Sec. 532.112. CHILDREN WITH SPECIAL HEALTH CARE NEEDS.  Requires this
section to expire September 1, 2001.  Makes conforming and nonsubstantive
changes. 

ARTICLE 3

SECTION 3.01.  Provides that Article 1 of this Act takes effect only if
H.B. 1845 or S.B. 898 does not take effect. 

 SECTION 3.02.  Provides that Article of this Act takes effect only if
H.B. 1845 or S.B. 989 takes effect. 

SECTION 3.03.  Effective date: September 1, 1997.

SECTION 3.04.  Emergency clause.