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. 2-38 * * * * *