By:  Van de Putte                                      S.B. No. 616
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the establishment of a medical assistance pilot program
 1-3     for the management of children's asthma.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Subchapter B, Chapter 531, Government Code, is
 1-6     amended by adding Section 531.021912 to read as follows:
 1-7           Sec. 531.021912.  MEDICAID DISEASE MANAGEMENT PILOT PROGRAM
 1-8     FOR CHILDREN'S ASTHMA.  (a)  The commission by rule shall develop a
 1-9     Medicaid disease management pilot program for children's asthma for
1-10     implementation in counties, selected by the Texas Department of
1-11     Health, with a high incidence of children's asthma and a high rate
1-12     of hospital emergency room care for the treatment of children's
1-13     asthma.
1-14           (b)  The pilot program shall provide continuous care, case
1-15     management, and asthma education to Medicaid recipients younger
1-16     than 19 years of age who have been hospitalized or received
1-17     emergency care services for asthma.  The program shall also provide
1-18     health care provider education to ensure the appropriate use of
1-19     specialized asthma treatments for those recipients.  In developing
1-20     the program, the commission shall consider the disease management
1-21     pilot programs for Medicaid recipients with asthma operated in
1-22     Virginia and Florida.
1-23           (c)  The Texas Department of Health shall administer the
1-24     pilot program under the direction of the commission, and the
1-25     commission and the department shall implement the program not later
 2-1     than November 1, 2001.  In implementing the program, the commission
 2-2     and the department, to the extent possible, shall use the services
 2-3     of local health care professionals.
 2-4           (d)  Not later than December 1, 2004, the commission shall
 2-5     submit a report to the lieutenant governor and the speaker of the
 2-6     house of representatives on the effectiveness, including the
 2-7     cost-effectiveness, of the pilot program.  The report must include:
 2-8                 (1)  an evaluation of the effects of the program on
 2-9     hospitalization rates and emergency room admissions of program
2-10     participants; and
2-11                 (2)  recommendations for changes in or expansion of the
2-12     program.
2-13           (e)  This section expires September 1, 2005.
2-14           SECTION 2.  If before implementing this Act the Health and
2-15     Human Services Commission determines that a waiver or authorization
2-16     from a federal agency is necessary for implementation, the
2-17     commission shall request the waiver or authorization and may delay
2-18     implementing this section until the waiver or authorization is
2-19     granted.
2-20           SECTION 3.  This Act takes effect September 1, 2001.