1-1     By:  Kitchen, et al. (Senate Sponsor - Barrientos)    H.B. No. 2807
 1-2           (In the Senate - Received from the House May 10, 2001;
 1-3     May 10, 2001, read first time and referred to Committee on Health
 1-4     and Human Services; May 11, 2001, reported favorably by the
 1-5     following vote:  Yeas 7, Nays 0; May 11, 2001, sent to printer.)
 1-6                            A BILL TO BE ENTITLED
 1-7                                   AN ACT
 1-8     relating to a demonstration project to extend Medicaid coverage to
 1-9     certain low-income individuals.
1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11           SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is
1-12     amended by adding Section 32.053 to read as follows:
1-13           Sec. 32.053.  DEMONSTRATION PROJECT FOR PROVISION OF MEDICAL
1-14     ASSISTANCE TO CERTAIN LOW-INCOME INDIVIDUALS. (a)  The Health and
1-15     Human Services Commission shall establish a demonstration project
1-16     to provide medical assistance under this chapter to an adult
1-17     individual who:
1-18                 (1)  has a family income that is less than or equal to
1-19     the income eligibility limit established under Subsection (b);
1-20                 (2)  is not otherwise eligible for medical assistance
1-21     at the time the individual's eligibility for participation in the
1-22     demonstration project is determined; and
1-23                 (3)  is not covered by a health benefits plan offering
1-24     adequate coverage, as determined by the commission.
1-25           (b)  The Health and Human Services Commission, in conjunction
1-26     with local governmental entities that make funds available to the
1-27     commission in accordance with this section, shall establish a
1-28     family income eligibility limit for individuals participating in
1-29     the demonstration project so that only an individual whose family
1-30     income is at or below 200 percent of the federal poverty level is
1-31     eligible for participation in the demonstration project.
1-32           (c)  The Health and Human Services Commission, in conjunction
1-33     with local governmental entities that make funds available to the
1-34     commission in accordance with this section, shall design the
1-35     components of the demonstration project, including the adoption of
1-36     procedures for the reporting and monitoring of:
1-37                 (1)  utilization patterns of participants in the
1-38     demonstration project;
1-39                 (2)  prevention activities related to health status and
1-40     engaged in by participants in the demonstration project; and
1-41                 (3)  prescription drug usage by participants in the
1-42     demonstration project.
1-43           (d)  In establishing the demonstration project, the Health
1-44     and Human Services Commission shall ensure that:
1-45                 (1)  the demonstration project is financed using funds
1-46     made available by certain local governmental entities, which may
1-47     include a county indigent health care program, to the commission
1-48     for matching purposes to maximize federal funds for the medical
1-49     assistance program; and
1-50                 (2)  a participant in the demonstration project is not
1-51     subject to a limitation imposed on prescription drug benefits under
1-52     the medical assistance program.
1-53           (e)  The manner in which a local governmental entity makes
1-54     funds available for matching purposes under Subsection (d)(1) must
1-55     include an option for the entity to be able to certify the amount
1-56     of funds considered available instead of sending the funds to the
1-57     state.
1-58           (f)  The Texas Department of Health shall administer the
1-59     demonstration project at the direction of the Health and Human
1-60     Services Commission.
1-61           (g)  The Health and Human Services Commission shall select
1-62     one or more municipalities or counties in which to implement the
1-63     demonstration project, and at least one selected county must have a
1-64     population of more than 725,000 or at least one selected
 2-1     municipality must have a population of more than 600,000.  The
 2-2     demonstration project may be implemented in a multi-county region
 2-3     and may include local funds made available through a county
 2-4     indigent health care program.
 2-5           (h)  The Health and Human Services Commission shall appoint
 2-6     an advisory committee to assist the commission and the Texas
 2-7     Department of Health in establishing and implementing the
 2-8     demonstration project.  The advisory committee must include health
 2-9     care providers and local government officials.
2-10           (i)  Not later than December 1 of each even-numbered year,
2-11     the Texas Department of Health shall evaluate the effectiveness,
2-12     including the cost-effectiveness, of the demonstration project in
2-13     providing health care services to project participants.  If the
2-14     results of the evaluation indicate that the demonstration project
2-15     is cost-effective, the department shall incorporate a request for
2-16     funding for the continuation or expansion of the demonstration
2-17     project in the department's budget request for the next state
2-18     fiscal biennium.
2-19           (j)  Not later than December 1 of each even-numbered year,
2-20     the Texas Department of Health shall submit a report to the
2-21     legislature regarding the operation and  cost-effectiveness of the
2-22     demonstration project established under this section.
2-23           SECTION 2. If the Health and Human Services Commission
2-24     determines that a waiver or authorization from a federal agency is
2-25     necessary for implementing any provision of this Act, the
2-26     commission shall request the waiver or authorization not later than
2-27     September 1, 2001, and may delay implementing that provision until
2-28     the waiver or authorization is granted.
2-29           SECTION 3. Not later than January 1, 2002, the Texas
2-30     Department of Health shall implement the demonstration project
2-31     required by Section 32.053, Human Resources Code, as added by this
2-32     Act.
2-33           SECTION 4.  This Act takes effect immediately if it receives
2-34     a vote of two-thirds of all the members elected to each house, as
2-35     provided by Section 39, Article III, Texas Constitution.  If this
2-36     Act does not receive the vote necessary for immediate effect, this
2-37     Act takes effect September 1, 2001.
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