77R11346 CLG-D                           
         By Kitchen                                            H.B. No. 2807
         Substitute the following for H.B. No. 2807:
         By Uresti                                         C.S.H.B. No. 2807
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to a demonstration project to extend Medicaid coverage to
 1-3     certain low-income individuals.
 1-5           SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is
 1-6     amended by adding Section 32.053 to read as follows:
 1-9     Human Services Commission shall establish a demonstration project
1-10     to provide medical assistance under this chapter to an adult
1-11     individual who:
1-12                 (1)  has a family income that is less than or equal to
1-13     the income eligibility limit established under Subsection (b);
1-14                 (2)  is not otherwise eligible for medical assistance
1-15     at the time the individual's eligibility for participation in the
1-16     demonstration project is determined; and
1-17                 (3)  is not covered by a health benefits plan offering
1-18     adequate coverage, as determined by the commission.
1-19           (b)  The Health and Human Services Commission, in conjunction
1-20     with local governmental entities that make funds available to the
1-21     commission in accordance with this section, shall establish a
1-22     family income eligibility limit for individuals participating in
1-23     the demonstration project so that only an individual whose family
1-24     income is at or below 200 percent of the federal poverty level is
 2-1     eligible for participation in the demonstration project.
 2-2           (c)  The Health and Human Services Commission, in conjunction
 2-3     with local governmental entities that make funds available to the
 2-4     commission in accordance with this section, shall design the
 2-5     components of the demonstration project, including the adoption of
 2-6     procedures for the reporting and monitoring of:
 2-7                 (1)  utilization patterns of participants in the
 2-8     demonstration project;
 2-9                 (2)  prevention activities related to health status and
2-10     engaged in by participants in the demonstration project; and
2-11                 (3)  prescription drug usage by participants in the
2-12     demonstration project.
2-13           (d)  In establishing the demonstration project, the Health
2-14     and Human Services Commission shall ensure that:
2-15                 (1)  the demonstration project is financed using funds
2-16     made available by certain local governmental entities to the
2-17     commission for matching purposes to maximize federal funds for the
2-18     medical assistance program; and
2-19                 (2)  a participant in the demonstration project is not
2-20     subject to a limitation imposed on prescription drug benefits under
2-21     the medical assistance program.
2-22           (e)  The manner in which a local governmental entity makes
2-23     funds available for matching purposes under Subsection (d)(1) must
2-24     include an option for the entity to be able to certify the amount
2-25     of funds considered available instead of sending the funds to the
2-26     state.
2-27           (f)  The Texas Department of Health shall administer the
 3-1     demonstration project at the direction of the Health and Human
 3-2     Services Commission.
 3-3           (g)  The Texas Department of Health shall select one or more
 3-4     municipalities or counties in which to implement the demonstration
 3-5     project, and at least one selected county must have a population of
 3-6     more than 725,000 or at least one selected municipality must have a
 3-7     population of more than 600,000.  The demonstration project may be
 3-8     implemented in a multi-county region, in which at least one county
 3-9     has a population of more than 725,000.
3-10           (h)  Not later than December 1 of each even-numbered year,
3-11     the Texas Department of Health shall evaluate the effectiveness,
3-12     including the cost-effectiveness, of the demonstration project in
3-13     providing health care services to project participants.  If the
3-14     results of the evaluation indicate that the demonstration project
3-15     is cost-effective, the department shall incorporate a request for
3-16     funding for the continuation or expansion of the demonstration
3-17     project in the department's budget request for the next state
3-18     fiscal biennium.
3-19           (i)  Not later than December 1 of each even-numbered year,
3-20     the Texas Department of Health shall submit a report to the
3-21     legislature regarding the operation and  cost-effectiveness of the
3-22     demonstration project established under this section.
3-23           SECTION 2. If the Health and Human Services Commission
3-24     determines that a waiver or authorization from a federal agency is
3-25     necessary for implementing any provision of this Act, the
3-26     commission shall request the waiver or authorization not later than
3-27     September 1, 2001, and may delay implementing that provision until
 4-1     the waiver or authorization is granted.
 4-2           SECTION 3. Not later than January 1, 2002, the Texas
 4-3     Department of Health shall implement the demonstration project
 4-4     required by Section 32.053, Human Resources Code, as added by this
 4-5     Act.
 4-6           SECTION 4.  This Act takes effect immediately if it receives
 4-7     a vote of two-thirds of all the members elected to each house, as
 4-8     provided by Section 39, Article III, Texas Constitution.  If this
 4-9     Act does not receive the vote necessary for immediate effect, this
4-10     Act takes effect September 1, 2001.