SRC-AXB, DBM, JXG S.B. 374 76(R)BILL ANALYSIS Senate Research CenterS.B. 374 By: Zaffirini Health Services 7/20/1999 Enrolled DIGEST S.B. 374 sets forth provisions for certain long-term care services, and the consolidation and continuation of certain agencies. PURPOSE As enrolled, S.B. 374 sets forth provisions for certain long-term care services, and the consolidation and continuation of certain agencies. RULEMAKING AUTHORITY Rulemaking authority is granted to the Health and Human Services Commission in SECTION 1.04 (Section 22.035(j), Human Resources Code); to the secretary of state in SECTION 1.24; and to the Texas Department of Health in SECTION 3.15, of this bill. SECTION BY SECTION ANALYSIS ARTICLE 1. LONG-TERM CARE SERVICES; TEXAS DEPARTMENT ON AGING SECTION 1.01. Amends Chapter 531B, Government Code, by adding Section 531.02481, as follows: Sec. 531.02481. COMMUNITY-BASED SUPPORT AND SERVICE DELIVERY SYSTEMS FOR LONG-TERM CARE SERVICES. Requires the Health and Human Services Commission (commission), the Texas Department of Human Services (DHS), and the Texas Department on Aging (TDA), to assist Texas communities in developing longterm care service-delivery systems. Requires the commission, to provide resources to assist a community which requests assistance, to accomplish certain goals, and sets forth the goals. Requires a health and human services (HHS) agency to provide resources and assistance to a community, upon the commission's request. Requires an HHS agency to submit a certain initiative to the commission for review and approval. Sets forth review guidelines and requirements for the commission. Requires the commission to consider other service delivery models in the implementation of this section. Requires the commissioner of health and human services (commissioner) to assure the maintenance of no fewer than 28 area agencies on aging in order to assure the continuation of a local system of access and assistance that is sensitive to the aging population. Authorizes certain entities to make a proposal. Sets forth entities included in a community-based organization. SECTION 1.02. Amends Chapter 22, Human Resources Code, by adding Section 22.0011, as follows: Sec. 22.0011. DEFINITION. Defines "long-term care services." SECTION 1.03. Amends Section 22.018, Human Resources Code, as follows: Sec. 22.018. New heading: COOPERATION WITH STATE OFFICE OF ADMINISTRATIVE HEARINGS. Requires DHS and the chief administrative law judge of the State Office of Administrative Hearings (SOAH), to adopt a memorandum of understanding under which SOAH, on behalf of DHS, conducts all contested case hearings authorized or required by law to be conducted by DHS under the administrative procedure law, rather than to establish and maintain a hearings division that is separate from the legal division to administer each hearing. Requires the memorandum of understanding to require the chief administrative law judge, DHS, and the commissioner to cooperate in connection with a contested case hearing and may authorize SOAH to perform any administrative act that is required to be performed by DHS or commissioner. Requires the memorandum of understanding to address whether the administrative law judge who conducts a contested case hearing for SOAH on behalf of DHS shall enter the final decision in the case after the completion of the hearing, or propose a decision to DHS or the commissioner for final consideration. Requires DHS by interagency contract to reimburse SOAH for the costs incurred in conducting contested case hearing for DHS. Authorizes DHS to pay an hourly fee for the costs of conducting those hearings or a fixed annual fee negotiated biennially by DHS and SOAH to coincide with DHS' legislative appropriations request. Provides that a reference in law to the hearings division of DHS is considered to be a reference to SOAH when used in relation to a contested case hearing under the administrative procedure law, Chapter 2001, Government Code. Deletes text regarding DHS or DHS' legal division. SECTION 1.04. Amends Chapter 22, Human Resources Code, by adding Sections 22.034 and 22.035, as follows: Sec. 22.034. WORK GROUP ON LONG-TERM CARE SERVICES. Defines "long-term care services." Provides that a work group is created to assist DHS and the Texas Department of Mental Health and Mental Retardation (TXMHMR) to study the coordination of planning between the two agencies. Provides that the work group is composed of 20 members and sets forth their specific qualifications. Provides that a work group member serves at the will of the appointing agency. Requires the members of the work group to elect certain officers. Requires the work group to meet at the call of the presiding officer. Provides that a work group member receives no additional compensation for services, but will be reimbursed for travel and participation expenses as provided in the General Appropriations Act. Requires the work group to study and report on the coordination of certain agencies' efforts to provide long-term care services. Sets forth requirements for a study regarding consistent and standardized regulations, rate-setting processes, contractor monitoring, management procedures, and administration. Requires the work group to report annually to certain entities. Requires the report to include certain recommendations. Provides that the work group is not subject to Chapter 2110, Government Code. Sec. 22.035. WORK GROUP ON CHILDREN'S LONG-TERM CARE AND HEALTH PROGRAMS Provides that a work group is created to assist the commissioner, DHS, and the Texas Department of Health (TDH) in the creation of a system for families and children to administer long-term care and health programs for children. Sets forth the names of the required members of the work group. Requires DHS and TDH to equally provide administrative support to the work group. Provides that a member of the work group serves at the will of the commissioner. Requires the commissioner to appoint a member of the work group to serve as a presiding officer. Requires the work group to meet at the call of the presiding officer. Provides that a member of the work group receives no additional compensation for serving on the work group. Requires persons serving on the work group to be reimbursed for travel and other expenses necessary for the participation as provided in the General Appropriations Act. Sets forth the areas of recommendation for the work group. Requires the work group to report on its findings and recommendations to the commissioner, no later than September 1 of each even-numbered year. Authorizes the commission to adopt rules to implement guidelines for providing long-term care and health services to children, after evaluating and considering recommendations reported under Subsection (i). Provides that the work group is not subject to Chapter 2110, Government Code. SECTION 1.05. Amends Chapter 113, Human Resources Code, by transferring it to Chapter 22, and redesignating it as Section 22.036, as follows: Sec. 22.036. PROGRAMS FOR DEAF-BLIND MULTI HANDICAPPED INDIVIDUALS AND THEIR PARENTS. Provides that DHS, rather than the Texas Rehabilitation Commission, has certain responsibilities. Makes conforming changes. SECTION 1.06. Amends Section 32.024(t), Human Resources Code, to set forth rule requirements. Makes conforming changes. SECTION 1.07. Amends Section 101.001, Human Resources Code, to set forth the required members of the Texas Board on Aging (board). Deletes text regarding board meetings. Makes a conforming change. SECTION 1.08. Amends Section 101.0011, Human Resources Code, to provide that it is a ground for removal of a member from the board if certain conditions exist. Requires the executive director to notify the presiding officer of the board of the potential ground, if the executive director has knowledge that a potential ground for removal exists. Requires the presiding officer to then notify the governor and the attorney general. Requires the executive director to notify the next highest ranking officer of the board, who shall then notify the governor and the attorney general that a potential ground for removal exists, if the potential ground for removal involves the presiding officer. Makes conforming changes. SECTION 1.09. Amends Chapter 101A, Human Resources Code, by adding Section 101.0012, as follows: Sec. 101.0012. TRAINING PROGRAM FOR BOARD MEMBERS. Adds standard language developed by the Sunset Advisory Commission regarding training. SECTION 1.10. Amends Section 101.002, Human Resources Code, to extend the existence of the TDA to September 1, 2004. SECTION 1.11. Amends Section 101.003, Human Resources Code, as follows: Sec. 101.003. New heading: PRESIDING OFFICER. Requires the governor to designate a presiding officer, rather than a chairman. Makes conforming changes. SECTION 1.12. Amends Section 101.0031, Human Resources Code, to add standard language developed by the Sunset Advisory Commission regarding restrictions on board membership and employment. SECTION 1.13. Amends Section 101.0061(d), Human Resources Code, to add standard language developed by the Sunset Advisory Commission regarding the executive director. SECTION 1.14. Amends Section 101.022, Human Resources Code, to require TDA to provide expertise, advice, and recommendations to certain entities to meet the needs of Texas' elderly population. Requires cooperation in conducting studies and surveys regarding transportation, insurance, and legal rights. Requires TDA to conduct research and planning on issues that affect elderly individuals. Requires TDA to make certain recommendations to certain authorities. Makes conforming changes. SECTION 1.15. Amends Sections 101.024(a) and (d), Human Resources Code, to clarify that certain programs recruit elderly, rather than retired, persons to perform services under the National Senior Service Corps, rather than Foster Grandparent Programs. Clarifies that certain funds are allowed to compensate participants in the Foster Grandparent and Senior Companion Programs. SECTION 1.16. Amends Section 101.0255, Human Resources Code, to require certain entities to work to ensure consistency in reimbursement rates, contract terms, and performance standards. Requires TDA to use the billing system if it is cost-effective. Requires TDA to reimburse DHS through an interagency contract for the cost of any use if required by DHS. Requires TDA and DHS to coordinate the monitoring of providers who contract with the respective agency to provide the same or a substantially similar service. Deletes text regarding a deadline, and makes nonsubstantive changes. SECTION 1.17. Amends Chapter 101B, Human Resources Code, by adding Section 101.0256, as follows: Sec. 101.0256. COORDINATED ACCESS TO LOCAL SERVICES. Requires TDA and DHS to develop standardized assessment procedures to share information on common clients served in a similar service region. SECTION 1.18. Amends Chapter 101B, Human Resources Code, by adding Section 101.033, as follows: Sec. 101.033. OLDER AMERICANS ACT; STATE PLAN. Requires TDA and DHS to jointly develop this state's plan on aging, as required by the federal Older Americans Act of 1965 (42 U.S.C. Section 3001 et seq.) and its subsequent amendments. Requires TDA and DHS to jointly conduct a statewide needs assessment for long-term care services, and sets forth assessment requirements. SECTION 1.19. Amends Chapter 531B, Government Code, by adding Section 531.0235, as follows: Sec. 531.0235. BIENNIAL DISABILITY REPORTS. Requires the commissioner to require certain entities to prepare a joint biennial report on the state of services to persons with disabilities in Texas. Provides that the Texas Planning Council for Developmental Disabilities will serve as the lead agency in convening working meetings and in coordinating and completing the report. Requires the agencies to submit the report to the commissioner, governor, lieutenant governor, and speaker of the house of representatives, no later than December 1 of each even-numbered year. Sets forth the provisions for the recommendations. Requires cooperation from certain agencies for the preparation of the report. SECTION 1.20. Amends Section 242.309, Health and Safety Code, as added by Section 1.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective until federal determination of failure to comply with federal regulations), to require the Texas Board of Nursing Facility Administrators (TBNFA) to issue a provisional license to an applicant currently licensed in another jurisdiction who seeks a license in this state and who meet certain conditions. Authorizes TBNFA to waive the requirement of Subsection (a)(3) for an applicant if TBNFA determines that compliance with that subsection would be a hardship to the applicant. Requires TBNFA to issue a license under this subchapter to the provisional license holder if certain conditions exist. Requires TBNFA to approve or deny a provisional license holder's application for a license no later than the 180th day after the date the provisional license is issued. Authorizes TBNFA to extend the 180-day period if the results of an examination have not been received by TBNFA before the end of that period. Authorizes TBNFA to establish a fee for provisional licenses in an amount reasonable and necessary to cover the cost of issuing the license. Deletes text regarding the national examination or other examination administered or graded by an outside organization. Makes conforming changes. SECTION 1.21. Amends Section 242.310, Health and Safety Code, as added by Section 1.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective until federal determination of failure to comply with federal requirements), to authorize a person who is otherwise eligible to renew a license to renew an unexpired license by paying the required renewal fee to DHS before the expiration date of the license. Prohibits a person whose license has expired from engaging in activities that require a license until the license has been renewed. Authorizes a person whose license has been expired for 90 days or less to renew the license by paying DHS a renewal fee that is equal to 1-1/2 times the normally required renewal fee, rather than one half of the examination fee for the license. Authorizes a person whose license has been expired for more than 90 days but less than one year to renew the license by paying DHS a renewal fee that is equal to two times the normally required renewal fee, rather than all unpaid renewal fees and a fee that is equal to the examination fee for the license. Authorizes the person to obtain a new original license by complying with the requirements and procedures, including the examination requirements. Authorizes a person who was licensed in this state, and is currently licensed and has been in practice in the other state for the two years preceding the date of application to obtain a new license without reexamination. Requires DHS to send written notice of the impending expiration to the person at the person's last known address, no later than the 31st day before the date a person's license is scheduled to expire. Makes conforming changes. SECTION 1.22. Amends Section 242.314, Health and Safety Code, as added by Section 2.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective upon federal determination of failure to comply with federal regulations), to require TBNFA to issue a provisional license to an applicant currently licensed in another jurisdiction who seeks a license in this state and who meets certain conditions. Authorizes TBNFA to waive the requirement of Subsection (a)(3) for an applicant if TBNFA determines that compliance would be a hardship to the applicant. Authorizes TBNFA to extend the 180-day period if the results of an examination have not been received by TBNFA before the end of that period. Makes conforming and nonsubstantive changes. SECTION 1.23. Amends Section 242.315, Health and Safety Code, as added by Section 2.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective upon federal determination of failure to comply with federal regulations), to authorize a person who is otherwise eligible to renew a license by paying the required renewal fee to TBNFA before the expiration date of the license. Prohibits a person whose license has expired from engaging in activities that require a license until the license has been renewed. Makes conforming changes. SECTION 1.24. Provides that on September 1, 1999, the licensing and regulation of home and community support services agencies and home health medication aides, funds, obligations, contracts, property and records, and employees of TDH are transferred to DHS. Provides that a rule or form adopted by TDH that relates to a function listed in Subsection (a) of this section is a rule or form of DHS and remains in effect until altered by DHS. Authorizes the secretary of state to adopt rules as necessary to expedite the implementation of this subsection. Provides that the transfer of the functions of this section does not affect or impair certain matters. Provides that an action brought or proceeding commenced before the transfer is governed by the law and rules applicable to the action or proceeding before the date of the transfer. Provides that a reference in law to TDH or the Texas Board of Health that relates to a function listed in Subsection (a) of this section means DHS and the Texas Board of Human Services, after the transfer required by this Section is effected. SECTION 1.25. Provides that on September 1, 1999, several responsibilities and functions are transferred from TDH to DHS. Provides that on October 1, 1999, funds, obligations, contracts, property, and records of TDH are transferred to DHS. SECTION 1.26. Makes application of Section 22.018, Human Resources Code, prospective to January 1, 2000. Authorizes the commissioner of human services and the chief administrative law judge of SOAH to agree to transfer contested cases pending before DHS to SOAH before January 1, 2000. SECTION 1.27. Requires certain entities to appoint members of the work group created by Section 22.035, Human Resources Code, by December 1, 1999. SECTION 1.28. Provides that all powers, duties, functions, rules or forms of TDH, and activities relating to the Waiver Program for Medically Dependent Children of TDH, are transferred to DHS by September 1, 2001. Provides that on October 1, 2001, all funds, obligations, contracts, property, and records of TDH are transferred to DHS. SECTION 1.29. Requires the executive director on aging and the commissioners of DHS, TXMHMR, and the commission to appoint the members of the work group created by Section 22.034, Human Resources Code, no later than December 1, 1999. Requires the work group to report on the study and recommendations required by Section 22.034(h), Human Resources Code, to the commissioners of DHS, TXMHMR, no later than September 1, 2000. SECTION 1.30. Requires the commission to study the feasibility of a subacute care pilot project. Requires certain entities to cooperate with TDH's study, and sets forth the required considerations for the study. Requires this study to be submitted to the governor, lieutenant governor, speaker of the house, and chair of each committee regarding long-term care, by September 1, 2000. Provides that this section expires September 1, 2001. SECTION 1.31. Requires the commissioner to evaluate and report to certain authorities the results of service coordination between TDA and DHS, by November 1, 2000, and sets forth requirements for the report. SECTION 1.32. Provides that the changes in law made by Section 101.001, Human Resources Code, does not affect the entitlement of certain Texas Board on Aging members to continue to serve for the term to which they were appointed. Requires the governor to make appointments to the board of the Texas Board on Aging, as soon as possible, to achieve the membership plan prescribed by Section 101.001, Human Resources Code. SECTION 1.33. Requires the commission to evaluate the feasibility of establishing an integrated local system of access and services for elderly persons and persons with disabilities. Requires the commission to report to certain authorities regarding the evaluation study by November 1, 2000, and requires the report to include the commission's recommendation on how best to achieve integration. SECTION 1.34. Provides that this article takes effect September 1, 1999. SECTION 1.35. Makes application of certain sections of the, Health and Safety Code, relating to the qualifications for a license issued by DHS prospective. ARTICLE 2. LONG-TERM CARE SERVICES; DEPARTMENT OF AGING AND DISABILITY SERVICES. SECTION 2.01. Amends Sections 11.001(1)-(3), Human Resources Code, to redefine "board," "department," and "commissioner." SECTION 2.02. Amends Section 101.001, Human Resources Code, as follows: Sec. 101.001. New heading: DEFINITIONS. Defines "board" and "department." Deletes existing Section regarding the Texas Board on Aging. SECTION 2.03. Amends Chapter 101A, Human Resources Code, by adding Section 101.0015, as follows: Sec. 101.0015. AGING POLICY COUNCIL. Requires the appointment of an advisory committee known as the Aging Policy Council (council). Requires the council to provide advice on certain matters. Provides that the council consists of nine members, and sets forth eligibility requirements. Requires the council to submit a report to certain authorities by December 1 of each even-numbered year, and sets forth requirements for the report. SECTION 2.04. Amends Section 101.030(a), Human Resources Code, to delete text regarding the Texas Department on Aging. SECTION 2.05. Amends Section 101.059, Human Resources Code, to delete text regarding the Department of Human Services. Makes conforming changes. SECTION 2.06. Amends Chapter 21, Human Resources Code, by adding Section 21.0033, as follows: Sec. 21.0033. TRAINING PROGRAM FOR BOARD MEMBERS. Prohibits a person who is appointed to and qualifies for office as a member of the Texas Board of Aging and Disability Services (TBADS) from voting, deliberating, or being counted as a member in attendance at a meeting of TBADS until the person completes a training program that complies with this section. Sets forth the requirements for the training program. Entitles a person appointed to TBADS to reimbursement, as provided by the General Appropriations Act, for travel expenses incurred in attending the training program regardless of whether the attendance at the program occurs before or after the person qualifies for office. Defines "independent living philosophy." SECTION 2.07. Amends Chapter 22, Human Resources Code, by adding Section 22.0245, as follows: Sec. 22.0245. OLDER AMERICANS ACT; STATE PLAN. Requires the Texas Department of Aging and Disability Services (DAGS) to develop the state's plan on aging, as required by the federal Older Americans Act of 1965 (42 U.S.C. Section 3001 et seq.) and its subsequent amendments. Requires DAGS to conduct a statewide needs assessment for long-term services. Requires the assessment to include input from area agencies on aging, regional and local state agency staff, and community-based organizations. SECTION 2.08. Repealers: (1) Section 101.0011, Human Resources Code (Removal of Board Members). (2) Section 101.0012, Human Resources Code, as added by this Act (Training Program for Board Members). (3) Section 101.002, Human Resources Code (Sunset Provision). (4) Section 101.003, Human Resources Code (Chairman of the Board). (5) Section 101.0031, Human Resources Code (Restrictions on Board Membership and Employment). (6) Section 101.004, Human Resources Code (Executive Director of Aging; Other Personnel). (7) Section 101.006, Human Resources Code (Divisions of the Department). (8) Section 101.0061, Human Resources Code (Personnel Matters). (9) Section 101.007, Human Resources Code (Merit System). (10) Section 101.008, Human Resources Code (Finances). (11) Section 101.021, Human Resources Code (Rules). (12) Section 101.0221, Human Resources Code (Public Interest Information; Complaints). (13) Section 101.0255, Human Resources Code (Service Standards and Agreements). (14) Section 101.0256, Human Resources Code, as added by this Act (Coordinated Access to Local Services). (15) Section 101.033, Human Resources Code, as added by this Act (Older Americans Act; State Plan). (16) Section 101.043(b), Human Resources Code (regarding duplication of services). SECTION 2.09. Authorizes a Texas Board on Aging member to continue to serve until the original term of service expires. SECTION 2.10. (a) Provides that a reference in a law or rule to DHS means the Texas Department of Aging and Disability Services. (b) Provides that a reference in a law or rule to the Texas Board of Human Services means the Texas Board of Aging and Disability Services. (c) Provides that a reference in law to the commissioner of the Texas Department of Human Services means the commissioner of the Texas Department of Aging and Disability Services. SECTION 2.11. (a) Abolishes the Texas Department on Aging. (b) Provides that on the effective date of this article, certain aspects of the Texas Department on Aging are transferred to the Texas Department of Aging and Disability Services. (c) Requires funds, obligations, contracts, property, and records of the Texas Department on Aging to be transferred to the Texas Department of Aging and Disability Services. SECTION 2.12. Effective date for this article: September 1, 2003. ARTICLE 3. CHILDREN WITH SPECIAL HEALTH CARE NEEDS SECTION 3.01. Amends Section 35.001, Health and Safety Code, to authorize this chapter to be cited as the Children with Special Health Care Needs Services Act. SECTION 3.02. Amends Chapter 35, Health and Safety Code, by adding Sections 35.0021 and 35.0022, as follows: Sec. 35.0021. DEFINITIONS. Defines "case management services," "child with special health care needs," "dentist," "facility," "family support services," "other benefit," "physician," "program," "provider," "rehabilitation services," "services," "specialty center," and "support." Sec. 35.0022. CHILD WITH SPECIAL HEALTH CARE NEEDS. Defines "child with special health care needs." Describes "child with special health care needs." SECTION 3.03. Amends Section 35.003, Health and Safety Code, as follows: Sec. 35.003. New heading: SERVICES PROGRAM FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. Provides that the program is in TDH to provide services to eligible children with special health care needs, rather than chronically ill and disabled children. Sets forth the requirements for the program. Authorizes a waiting list of eligible person to be established if necessary for the program to remain within the budgetary limitations. Requires TDH to collect from each applicant for services who is placed on a waiting list appropriate information to facilitate contacting the applicant when service become available and to allow efficient enrollment of the applicant in those services. Sets forth the information requirements. Sets forth some provisions for the program. Provides that the program is separate from the financial or medical assistance program established by Chapters 31 and 32, Human Resources Code. Makes conforming changes. SECTION 3.04. Amends Chapter 35, Health and Safety Code, by adding Sections 35.0031, 35.0032, 35.0033, 35.0034, and 35.0035, as follows: Sec. 35.0031. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN ELIGIBLE CHILDREN. Requires TDH to obtain coverage under a health benefits plan for a child who meets certain conditions. Sec. 35.0032. BENEFITS COVERAGE REQUIRED. Requires the health benefits plan required by Section 35.0031 to provide benefits comparable to the benefits provided under the state child health plan established by this state to implement Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, to the extent possible. Sec. 35.0033. HEALTH BENEFITS PLAN PROVIDER. Sets forth the benefits requirements for a health benefits plan provider. Provides that a health benefits plan provider under this chapter is not subject to a law that requires coverage or the offer of coverage of a health care service or benefit, except as required by TDH. Sec. 35.0034. COST-SHARING PAYMENTS. Prohibits TDH from requiring a child who is provided health benefits plan coverage under Section 35.0031 and who meets the income eligibility requirement of the medical assistance program under Chapter 32, Human Resources Code, to pay a premium, deductible, coinsurance, or other cost-sharing payment as a condition of health benefits plan coverage under this chapter, except as provided by Subsection (b). Authorizes TDH to require a child described by Subsection (a) to pay a copayment as a condition of the health benefits plan coverage under Section 35.0031 that is equal to any copayment required under the state child health plan established by this state to implement Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended. Authorizes TDH to require a child who is provided health benefits plan coverage under Section 35.0031 and who meets the income eligibility requirement of a program established under Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, to pay a premium, deductible, coinsurance, or other cost-sharing payment as a condition of health benefits plan coverage. Requires the payment to be equal to any premium, deductible, coinsurance, or other cost-sharing payment required under the state child health plan established by this state to implement Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended. Sec. 35.0035. DISALLOWANCE OF MATCHING FUNDS FROM FEDERAL GOVERNMENT. Prohibits expenditures made to provide health benefits plan coverage under Section 35.0031 from being included for the purpose of determining the state children's health insurance expenditures, as that term is defined by 42 U.S.C. Section 1397ee(d)(2)(B), as amended. SECTION 3.05. Amends Section 35.004, Health and Safety Code, by adding Subsection (j), to provide that this section does not apply to services for which coverage is provided under the health benefits plan established under Section 35.0031. SECTION 3.06. Amends Section 35.005, Health and Safety Code, to prohibit the Texas Board of Health from establishing an exclusive list of coverable medical conditions, or consider as a source of support to provide services assets legally owned or available to a child's household, in defining medical and financial criteria for eligibility under Subsection (a). Provides that a child is not eligible to recover rehabilitation services unless the child has a family income that is less than or equal to 200 percent of the federal poverty level. Provides that a child with special health care needs who has a family income that is greater than 200 percent of the federal poverty level and who meets all other eligibility criteria established by this section and by Texas Board of Health rules is eligible for services if TDH determines that the child's family is or will be responsible for medical expenses that are equal to or greater than the amount by which the family's income exceeds 200 percent of the federal poverty level. Makes conforming changes. SECTION 3.07. Amends Chapter 35, Health and Safety Code by adding Section 35.0061, as follows: Sec. 35.0061. REFERRAL FOR BEHAVIORAL OR EMOTIONAL CONDITIONS. Requires TDH to refer the child to that provider for those services, if a child with special health care needs who is eligible for services under this chapter has a behavioral or emotional condition and the child is eligible for services from another provider of services that would address the behavioral or emotional condition. SECTION 3.08. Amends Section 35.007(e), Health and Safety Code, to authorize TDH to collect the cost of services provided under this chapter directly in accordance with Title XVIII, Title XIX, or Title XXI of the Social Security Act (42 U.S.C. Sections 1395 et seq., 1396 et seq., and 1397aa et seq.), as amended. Makes a conforming change. SECTION 3.09. Amends Sections 35.012(a) and (b), Health and Safety Code, to make conforming changes. SECTION 3.10. Amends the heading of Chapter 35, Health and Safety Code, as follows: CHAPTER 35. CHILDREN WITH SPECIAL HEALTH CARE NEEDS SECTION 3.11. Amends Section 33.031, Health and Safety Code, as follows: Sec. 33.031. New heading: COORDINATION WITH CHILDREN WITH SPECIAL HEALTH CARE NEEDS SERVICES. Makes conforming changes. SECTION 3.12. Amends Section 109.066, Health and Safety Code, to make conforming changes. SECTION 3.13. Amends Section 14(b)(2), Article 21.58A, Insurance Code, to make a conforming change. SECTION 3.14. Repealer: Section 35.002, Health and Safety Code (Definition). SECTION 3.15. Makes application of Chapter 35, Health and Safety Code, prospective to July 1, 2001. Requires TDH to implement the health benefits plan required by Section 35.0031, Health and Safety Code, as added by this article, no later than July 1, 2001. Authorizes the Texas Board of Health to adopt all rules necessary to implement the changes in law made by this article no later than July 1, 2001. SECTION 3.16. Provides that a state agency is required to implement the article related to children with special health care needs only if the legislature appropriates money specifically for that purpose. Provides that an agency may, but is not required to, implement the article using other appropriations available for the purpose, if the legislature does not appropriate money specifically for that purpose. ARTICLE 4. EFFECTIVE DATE; EMERGENCY SECTION 4.01. Effective date: September 1, 1999, except as otherwise provided by this Act. SECTION 4.02. Requires DHS or other state agency to request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted, if, before implementing any provision of this Act, DHS or another state agency determines that a waiver or authorization from a federal agency is necessary for implementation. SECTION 4.03. Requires the agency affected by the provision to request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted, if, before implementing any provision of this Act, a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision. SECTION 4.04. Emergency clause.