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. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is 1-6 amended by adding Section 32.053 to read as follows: 1-7 Sec. 32.053. DEMONSTRATION PROJECT FOR PROVISION OF MEDICAL 1-8 ASSISTANCE TO CERTAIN LOW-INCOME INDIVIDUALS. (a) The Health and 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.