77R10336 KKA-D
By Coleman, Kitchen H.B. No. 896
Substitute the following for H.B. No. 896:
By Glaze C.S.H.B. No. 896
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to a demonstration project to provide certain services and
1-3 medications through the medical assistance program to persons with
1-4 HIV infection or AIDS.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is
1-7 amended by adding Section 32.053 to read as follows:
1-8 Sec. 32.053. DEMONSTRATION PROJECT FOR PERSONS WITH HIV
1-9 INFECTION OR AIDS. (a) In this section, "AIDS" and "HIV" have the
1-10 meanings assigned by Section 81.101, Health and Safety Code.
1-11 (b) The department shall establish a demonstration project
1-12 to provide a person with HIV infection or AIDS with the following
1-13 services and medications through the medical assistance program:
1-14 (1) services provided by a physician, physician
1-15 assistant, advanced practice nurse, or other health care provider
1-16 specified by the department;
1-17 (2) medications not included in the formulary for the
1-18 HIV medication program operated by the department, but determined
1-19 to be necessary for treatment of a condition related to HIV
1-20 infection or AIDS;
1-21 (3) vaccinations for hepatitis B and pneumonia;
1-22 (4) pap smears, colposcopy, and other diagnostic
1-23 procedures necessary to monitor gynecologic complications resulting
1-24 from HIV infection or AIDS in women;
2-1 (5) hospitalization;
2-2 (6) laboratory and other diagnostic services,
2-3 including periodic testing for CD4+ T-cell counts, viral load
2-4 determination, and phenotype or genotype testing if clinically
2-5 indicated; and
2-6 (7) other laboratory and radiological testing
2-7 necessary to monitor potential toxicity of therapy.
2-8 (c) The department shall establish the demonstration project
2-9 in at least two counties with a high prevalence of HIV infection
2-10 and AIDS. The department shall ensure that the demonstration
2-11 project is financed using funds made available by the counties in
2-12 which the department establishes the demonstration project.
2-13 (d) A person is eligible to participate in the demonstration
2-14 project if the person:
2-15 (1) has been diagnosed with HIV infection or AIDS by a
2-16 physician;
2-17 (2) is under 65 years of age;
2-18 (3) has a net family income that is at or below 200
2-19 percent of the federal poverty level;
2-20 (4) is a resident of a county included in the project
2-21 or, subject to guidelines established by the department, is
2-22 receiving medical care for HIV infection or AIDS through a facility
2-23 located in a county included in the project;
2-24 (5) is not covered by a health benefits plan offering
2-25 adequate coverage, as determined by the department; and
2-26 (6) is not otherwise eligible for medical assistance
2-27 at the time the person's eligibility for participation in the
3-1 demonstration project is determined.
3-2 (e) Participation in the demonstration project does not
3-3 entitle a participant to other services provided under the medical
3-4 assistance program.
3-5 (f) The department shall establish an appropriate enrollment
3-6 limit for the demonstration project and may not allow participation
3-7 in the project to exceed that limit. Once the limit is reached,
3-8 the department:
3-9 (1) shall establish a waiting list for enrollment in
3-10 the demonstration project; and
3-11 (2) may allow eligible persons on the waiting list to
3-12 enroll solely in the HIV medication program operated by the
3-13 department.
3-14 (g) The department shall ensure that a participant in the
3-15 demonstration project is also enrolled in the HIV medication
3-16 program operated by the department.
3-17 (h) Notwithstanding any other provision of this section, the
3-18 department shall provide each participant in the project with a
3-19 six-month period of continuous eligibility for participation in the
3-20 project.
3-21 (i) Not later than December 1 of each even-numbered year,
3-22 the department shall submit a biennial report to the legislature
3-23 regarding the department's progress in establishing and operating
3-24 the demonstration project.
3-25 (j) Not later than December 1, 2006, the department shall
3-26 evaluate the cost-effectiveness of the demonstration project,
3-27 including whether the services and medications provided offset
4-1 future higher costs for project participants. If the results of
4-2 the evaluation indicate that the project is cost-effective, the
4-3 department shall incorporate a request for funding for the
4-4 expansion of the project into additional counties or throughout the
4-5 state, as appropriate, in the department's budget request for the
4-6 next state fiscal biennium.
4-7 (k) This section expires September 1, 2007.
4-8 SECTION 2. The state agency responsible for implementing the
4-9 demonstration project required by Section 32.053, Human Resources
4-10 Code, as added by this Act, shall request and actively pursue any
4-11 necessary waivers or authorizations from the Health Care Financing
4-12 Administration or other appropriate entities to enable the agency
4-13 to implement the demonstration project not later than September 1,
4-14 2002. The agency may delay implementing the demonstration project
4-15 until the necessary waivers or authorizations are granted.
4-16 SECTION 3. This Act takes effect immediately if it receives
4-17 a vote of two-thirds of all the members elected to each house, as
4-18 provided by Section 39, Article III, Texas Constitution. If this
4-19 Act does not receive the vote necessary for immediate effect, this
4-20 Act takes effect September 1, 2001.