HBA-MPM C.S.H.B. 2602 77(R) BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 2602 By: Coleman Public Health 4/11/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE In 1999, the 76th Legislature passed legislation that updated the state Indigent Health Care and Treatment Act of 1985. This legislation shifted the focus of county indigent health care programs to primary and preventive care, and gave counties more flexibility to administer local programs tailored to meet local needs. The legislation lowered the spending threshold that a county must surpass to receive state financial assistance, created a list of optional services a county may provide and receive credit toward its threshold, and allowed counties to use less restrictive eligibility standards. The legislation also increased accountability by allowing providers to collect eligibility information from patients, allowing the Texas Department of Health to resolve eligibility disputes and improve reporting. C.S.H.B. 2602 ensures proper implementation of the reforms enacted in 1999 by clarifying various provisions of the Indigent Health Care and Treatment Act. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 2602 amends the Health and Safety and Government codes to update statutory references and make clarifying changes to the Indigent Health Care and Treatment Act. The bill provides that if a county and health care provider or a public hospital and health care provider disagree on a patient's eligibility, they are authorized to submit the matter to the Texas Department of Health (TDH). The bill deletes existing law that requires TDH to adopt rules governing the distribution of state assistance under the Indigent Health Care and Treatment Act and related rulemaking provisions. The bill includes payments of state assistance as provided in the Indigent Health Care and Treatment Act in the payments for which the tertiary care account shall be allocated. The bill provides that minimum eligibility standards for indigent health care must incorporate a net income eligibility level equal to 21 rather than 25 percent of the federal poverty level. The bill repeals provisions in the Indigent Health Care and Treatment Act specifying that effective January 1, 2001 through December 31, 2001, minimum eligibility standards must incorporate a net income eligibility level equal to 21 percent of the federal poverty level. EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001. Provisions that modify the Indigent Health Care and Treatment Act take effect September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 2602 differs from the original bill to make modifications to the Government Code in addition to the Health and Safety Code to specify that the tertiary care account shall allocate payments of state assistance as provided in the Indigent Health Care and Treatment Act. The substitute also repeals provisions in the Indigent Health Care and Treatment Act specifying that effective January 1, 2001 through December 31, 2001 minimum eligibility standards must incorporate a net income eligibility level equal to 21 percent of the federal poverty level. The substitute removes provisions in the original that specified that an eligible county resident who qualifies for assistance under the Indigent Health Care and Treatment Act is subject to general eligibility criteria provided in state law rather than county eligibility requirements.