SRC- MSY, LBB S.B. 342 78(R) BILL ANALYSIS
Senate Research Center S.B. 342
78R3934 JTS-DBy: Shapleigh
State Affairs
2/24/2003
As Filed
DIGEST AND PURPOSE
Currently, certain statistics and figures indicate that the health
infrastructure in the border region is weak in comparison to other regions
in Texas and the United States.
As proposed, S.B. 342 enacts a number of changes to existing laws with the
aim of building the health infrastructure in that region of the state.
The bill requires Texas Building and Procurement Commission and all state
agencies to consider whether a company offers health insurance to the
company's employees when awarding contracts. The bill expands a program
to educate physicians on immunization programs, and changes the
immunization registry program to an opt-out system. It expands on current
vaccination programs by including vaccine providers outside of the
Vaccines for Children Program, pending sufficient funding, and provides
coverage by state regulated health plans for certain recommended vaccines.
In addition, S.B. 342 creates a number of new entities. First, the bill
establishes the Border Health Foundation within the Texas Department of
Health to raise money from private sources to finance health programs on
the border. It creates a Border Health Corps from what is currently the
Texas Health Service Corps in order to provide loan repayment assistance
for doctors and nurses who choose to practice in the border region, while
preserving the Physicians Education Loan Repayment Program for other
Health Profession Shortage Areas in the state.
Finally, the bill enacts a number of changes aimed towards expanding the
effectiveness of a program that uses community health workers who serve as
bilingual liaisons between health care providers and their patients.
RULEMAKING AUTHORITY
Rulemaking authority previously granted to the Texas Department of Health
is modified in SECTION 2.02 (Section 161.007, Health and Safety Code) of
this bill.
Rulemaking authority is expressly granted to the commissioner of public
health, in consultation with the commissioner of insurance, in SECTION
2.05 (Section 3, Article 21.53F, Insurance Code) and to the Texas Higher
Education Coordinating Board in SECTION 6.01 (Section 61.552, Education
Code) of this bill.
SECTION BY SECTION ANALYSIS
ARTICLE 1. SHORT TITLE AND PURPOSE
SECTION 1.01. SHORT TITLE. Provides that this Act may be known as the
Texas Health Improvement Act.
SECTION 1.02. PURPOSE. Provides that the purpose of this Act is to
promote development of the health infrastructure that serves the citizens
of Texas and to improve the health of Hispanic Texans.
ARTICLE 2. IMMUNIZATIONS
SECTION 2.01. UNIVERSAL VACCINE PURCHASE PROGRAM. Requires the
comptroller of public accounts (comptroller) to study the feasibility of
implementing a universal vaccine purchase program in this state, and sets
forth specific determinations to be made by the comptroller. Requires the
comptroller to consult with certain federal, state, and local agencies, as
well as private entities involved in the administration of vaccines, while
performing the study.
SECTION 2.02. IMMUNIZATION REGISTRY. Amends Chapter 161A, Health and
Safety Code, by amending Section 161.007 and adding Sections 161.0071,
161.0072, 161.0073, and 161.0074, as follows:
Sec. 161.007. IMMUNIZATION REGISTRY; REPORTS TO DEPARTMENT. (a)
Modifies the rulemaking authority previously granted to the Texas
Department of Health (TDH) to require TDH to protect the confidentiality
of registrants in accordance with state and federal law rather than in
accordance with Section 159.002, Occupations Code. Requires the
guidelines to permit the written consent of a parent, managing
conservator, or guardian of a registrant to choose in writing to have the
registrant excluded from the registry, rather than to require the written
consent of such a person before information is included in the registry.
Deletes language permitting a parent, managing conservator, or guardian
to withdraw consent for the patient to be included in the registry. Makes
conforming changes.
(b) Provides that the childhood immunization registry must contain
certain information except as provided by Section 161.0071. Makes
conforming changes.
(c) Requires that an immunization history report submitted to TDH contain
the elements prescribed by TDH. Authorizes the report to be submitted in
writing or by electronic means. Makes conforming changes
(d) Requires the report to contain the elements, rather than be in a
format, prescribed by TDH. Authorizes the submission of the report to be
in writing or by electronic means and deletes the option by voice. Makes
conforming changes.
(e) Requires notices from TDH, regarding overdue immunizations, to
contain instructions for the parent, managing conservator, or guardian to
request the child's immunization record to be removed from the registry
and any other registry-related record identifying the child and to request
that no future notices be sent. Requires notices to describe the
procedure for reporting violations if a child is included in the registry
after a written request for exclusion.
(f) Deletes reference to section and replaces with subchapter.
(g) Includes an insurance company, a health maintenance organization,
or another organization that pays or reimburses a claim for immunization
in the list of entities not liable under certain conditions for any civil
damages. Makes conforming changes.
(h) Deletes existing text regarding the confidential nature of and
disclosure of information obtained by TDH. Redesignates existing
Subsection (i) as Subsection (h). Makes conforming changes.
Sec. 161.0071. NOTICE OF RECEIPT OF REGISTRY DATA; EXCLUSION FROM
REGISTRY. (a) Requires TDH to send a written notification to the
child's parent, managing conservator, or guardian disclosing certain
information the first time TDH receives registry data for a child.
(b) Requires TDH to delete a child's immunization records from the
registry and any other registry-related department record that
individually identifies the child not later than 30 days after TDH
receives a written request to exclude the child from the registry by the
child's parent, managing conservator, or guardian. Requires TDH to
maintain only those records necessary to ensure continued exclusion of the
child from the registry and prohibits the release of an identity of a
child excluded from the registry.
(c) Requires TDH to send to a parent, managing conservator, or guardian
making a written request under Subsection (b) a written confirmation of
the receipt of the request for exclusion and the exclusion of the child's
records from the registry.
(d) Provides that TDH commits a violation if TDH fails to exclude a child
from the registry within the required period.
(e) Requires TDH to accept a written statement from a parent, managing
conservator, or guardian communicating to TDH that a child should be
excluded from the registry, including a statement on the child's birth
certificate, as a request for exclusion.
Sec. 161.0072. REGISTRY CONFIDENTIALITY. (a) Provides that the
information that individually identifies a child for the immunization
registry is confidential and may be used by TDH for registry purposes
only.
(b) Prohibits TDH from releasing registry information without consent,
unless specifically authorized under this subchapter.
(c) Prohibits a person required to report information to TDH for registry
purposes or authorized to receive information from the registry from
disclosing the individually identifiable information to any other person
without the proper consent.
(d) Provides that registry information is not subject to any means of
legal compulsion for release to any person or entity except as provided by
this subchapter and is not admissible in any civil, administrative, or
criminal proceeding.
Sec. 161.0073. REPORT TO LEGISLATURE. (a) Requires TDH to report to
certain persons and entities not later than September 30th of each
even-numbered year.
(b) Requires TDH to use the report to develop ways to increase
immunization
rates using state and federal resources.
(c) Requires the report to include certain information and follow
particular guidelines.
Sec. 161.0074. IMMUNITY FROM LIABILITY. Provides that certain persons
are not civilly or criminally liable for furnishing the required
information under this subchapter when acting in compliance with certain
requirements.
SECTION 2.03. IMMUNIZATION REGISTRY; RELEASE OF INFORMATION. Amends
Section 161.008, Health and Safety Code, by amending Subsections (c) and
(d) and adding Subsections (e)-(g), as follows:
(c) Deletes language regarding the requirement that TDH obtain consent of
a child's parent, managing conservator, or guardian in order to obtain
certain data. Includes an insurance company, a health maintenance
organization, or any other organization that pays or reimburses a claim
for immunization, or any health care provider licensed or otherwise
authorized to administer vaccines in the list of entities that TDH may
obtain data from regarding an immunization record for a child.
(d) Requires TDH to enter the child into the registry and release data
constituting an immunization record for the child to certain entities
after the 30th day after the date notice was sent by TDH to the child's
parent, managing conservator, or guardian if TDH has not received a
written request to exclude the child from the registry.
(e) Redesignated from existing Subsection (d).
(f) Authorizes TDH to release nonidentifying summary statistics related
to the registry that do not individually identify a child.
(g) Prohibits TDH from releasing certain individually identifiable
information to an entity outside this state.
SECTION 2.04. IMMUNIZATION REGISTRY; OFFENSE. Amends Section 161.009(a),
Health and Safety Code, to include Sections 161.0071 and 161.0072 in the
list of sections under which a person commits an offense by negligent
release or disclosure of immunization registry information.
SECTION 2.05. REQUIRED BENEFITS FOR IMMUNIZATIONS. Amends Section 3,
Article 21.53F, Insurance Code, as follows:
(a) Creates this subsection from existing text. Increases the age to
which a child will be provided coverage for immunization against certain
diseases from six years of age to eighteen years of age. Includes in the
list of covered immunizations, any other immunization recommended as of
January 1, 2003, by the federal Advisory Committee on Immunization
Practices of the Centers for Disease Control and Prevention.
(b) Authorizes the commissioner of public health, in consultation with
the commissioner of insurance, to require, by rule, coverage for an
immunization recommended after January 1, 2003, or remove the requirement
of coverage for an immunization no longer recommended by the federal
Advisory Committee on Immunization Practices or its successor committee.
SECTION 2.06. TRANSITION. (a) Requires the comptroller to submit by
January 15, 2005, a report detailing the findings of the universal vaccine
purchase program study required by this Act to the lieutenant governor and
the speaker of the house of representatives.
(b) Provides that Section 2.01 of this Act expires September 1, 2005.
(c) Requires the Texas Board of Health to adopt certain rules and make
available a form for requesting exclusion from the immunization registry
as soon as possible and no later than August 1, 2004.
(d) Prohibits the report required under this Act and the data obtained or
released under Section 161.008, Health and Safety Code, from being
released until TDH has adopted the rules and prescribed the forms required
by this Act.
(e) Makes the changes made by this Act to Section 3, Article 21.53F,
Insurance Code prospective.
ARTICLE 3. PROMOTORAS
SECTION 3.01. COMPENSATION. Amends Section 48.003(c), Health and Safety
Code, to require the Health and Human Services Commission to require
health and human services agencies to compensate certified promotoras to
assist with certain programs for recipients of medical assistance.
SECTION 3.02. TRANSITION. Requires the classification officer to ensure
that a classification system, including a supervisory and salary
structure, is provided for promotoras as appropriate under the state's
position classification plan under Chapter 654, Government Code, as soon
as practicable.
ARTICLE 4. PREFERENCE FOR VENDORS THAT PROVIDE HEALTH BENEFITS COVERAGE
FOR EMPLOYEES
SECTION 4.01. BEST VALUE CONSIDERATION. Amends Section 2155.074(b),
Government Code, to add to the list of relevant factors in determining
the best value for the state in preference for vendors whether the vendor
provides health benefits coverage to employees. Redesignates existing
Subsection (9) as Subsection (10).
SECTION 4.02. STATE AGENCY PREFERENCE. Amends Chapter 2155H, Government
Code, by adding Section 2155.451, as follows:
Sec. 2155.451. PREFERENCE FOR VENDORS THAT PROVIDE HEALTH BENEFITS
COVERAGE. Requires the Texas Building and Procurement Commission and all
state agencies procuring goods or services to give preference to goods or
services of a vendor that demonstrates that the vendor provides health
benefits coverage to the vendor's employees if the goods or services meet
certain state specifications and the cost of the good or service does not
exceed that of vendors not demonstrating that they provide health benefits
coverage.
ARTICLE 5. BORDER HEALTH FOUNDATION
SECTION 5.01. BORDER HEALTH FOUNDATION. Amends Title 2E, Health and
Safety Code, by adding Chapter 112, as follows:
CHAPTER 112. BORDER HEALTH FOUNDATION
Sec. 112.001. DEFINITIONS. Defines "board of directors" and
"foundation."
Sec. 112.002. CREATION OF FOUNDATION. (a) Requires TDH to establish
the Border Health Foundation as a nonprofit corporation that complies with
specific requirements.
(b) Requires TDH to ensure that the foundation operates independently of
any state agency or political subdivision of this state.
Sec. 112.003. POWERS AND DUTIES. (a) Requires the foundation to raise
money from other foundations, governmental entities, and other sources to
finance health programs in this state in areas adjacent to the border with
the United Mexican States.
(b) Requires the foundation to locate potential partners in the private
sector to help the state maintain or increase existing levels of financing
of health programs and activities, make the office known to potential
partners, and perform any other function necessary to carry out the
purposes of the foundation.
(c) Requires TDH to review programs from all agencies under its control
to determine which projects should be available to receive money.
(d) Provides that the foundation has the powers necessary and convenient
to carry out its duties.
Sec. 112.004. ADMINISTRATION. (a) Provides that the foundation is
governed by a board of five directors appointed by the Texas Board of
Health from individuals recommended by the commissioner of public health.
(b) Sets forth the terms of members of the board of directors.
(c) Requires appointments to the board of directors to be made without
regard to the race, color, disability, sex, religion, age, or national
origin of the appointees.
(d) Requires the board of directors to ensure that the foundation remains
listed as an exempt organization for purpose of federal income tax.
Sec. 112.005. RESTRICTIONS ON BOARD APPOINTMENT, MEMBERSHIP, AND
EMPLOYMENT. (a) Defines "Texas trade association."
(b) Provides the circumstances under which a person may not be a member
of the board of directors or a particular foundation employee.
(c) Prohibits a person that is required to register as a lobbyist on
behalf of a profession related to the operation of the foundation from
being a member of the board of directors or as general counsel to the
board of directors.
Sec. 112.006. REMOVAL OF BOARD MEMBER. (a) Provides grounds for
removal
from the board of directors.
(b) Provides that the validity of an action of the board of directors
is not affected
by the fact that it is taken when a ground for removal of a board member
exists.
(c) Requires the foundation, in its articles or bylaws, to establish the
manner in which a board member may be removed.
Sec. 112.007. VACANCY. Provides the manner in which a vacancy on the
board of directors shall be filled.
Sec. 112.008. OFFICERS. Requires the board of directors to elect
necessary officers.
Provides that the presiding officer and assistant presiding officer serve
for one year and
may be reelected.
Sec. 112.009. MEETINGS. Requires a minimum number of annual meetings.
Sec. 112.010. TAX EXEMPTION. Provides that all income, property, and
other assets of the foundation are exempt from taxation by this state and
its political subdivisions.
Sec. 112.011. MEMORANDUM OF UNDERSTANDING. Requires the foundation and
TDH to enter into a memorandum of understanding relating to reporting,
staff functions, and financial contributions.
Sec. 112.012. FUNDING. (a) Authorizes TDH and certain other entities
to contract with the foundation to finance certain health programs.
(b) Authorizes the foundation to apply for and accept funds and to
solicit funds from private sources. Provides that the foundation may only
accept solicited funds that are consistent with the purposes of the
foundation.
(c) Requires the board of directors of the foundation to manage and
approve disbursements of any kind that are the property of the foundation.
(d) Requires the board of directors of the foundation to manage any
capital improvements constructed, owned, or leased by the foundation and
any real property acquired.
Sec. 112.013. RECORDS. (a) Requires the foundation to maintain
financial records and reports independently from those of TDH.
(b) Requires the foundation to comply with all filing requirements of the
secretary of state and the Internal Revenue Service.
Sec. 112.014. REPORT TO DEPARTMENT. Requires the foundation to submit a
yearly report detailing all activities of the foundation during the
preceding fiscal year by a certain time.
SECTION 5.02. TRANSITION. Requires TDH to create the Border Health
Foundation as required by this Act by June 1, 2004.
ARTICLE 6. EDUCATION AND RECRUITMENT OF HEALTH CARE PROFESSIONALS
SECTION 6.01. BORDER HEALTH CORPS. Amends Chapter 61, Education Code, by
adding Subchapter J-1, as follows:
SUBCHAPTER J-1. BORDER HEALTH CORPS
Sec. 61.551. DEFINITIONS. Defines "health professional shortage area"
and "TexasMexico border region."
Sec. 61.552. BORDER HEALTH CORPS. (a) Requires The Texas Higher
Education Coordinating Board (THECB) to establish a program to encourage
the training, recruitment, and retention of health care professionals and
practitioners in health professional shortage areas in the Texas-Mexico
border region. Provides that individuals participating in the program may
be referred to as the Border Health Corps. Requires the THECB to adopt
rules as necessary to administer the program.
(b) Specifies the practitioners eligible to participate in the program.
Authorizes
THECB to include other health care professions in the program as needed.
(c) Requires THECB, in granting loan repayment assistance or other
benefits to
individuals in the program, to give priority to certain professional areas
and individuals.
Sec. 61.553. EDUCATION LOAN REPAYMENT ASSISTANCE. (a) Requires THECB
to provide assistance in the repayment of education loans to individuals
in the program, to the extent that funding is available. Provides the
requirements an individual must agree to, to receive loan payment
assistance.
(b) Prohibits an individual from receiving more than $10,000 in
assistance in any year. Prohibits the amount of assistance an individual
receives from exceeding a certain amount.
(c) Requires THECB to follow certain guidelines in relation to paying
the
loan repayment assistance. Requires THECB to take necessary actions to
recover any amount for which the promised practice is not performed,
subject to certain conditions.
(d) Requires THECB to make loan repayment assistance awards to allow
individuals in the program to qualify for matching federal loan repayment
assistance, to the extent consistent with the purposes of the program.
Sec. 61.554. FUNDING. (a) Provides that the program is funded by
appropriations, gifts, grants, and other money available for purposes of
the program. Authorizes THECB to solicit and accept gifts and grants from
any public or private source for the program.
(b) Requires THECB to take any action necessary to permit federal funds
available for loan repayment assistance to be available to individuals in
the program who are in private practice.
SECTION 6.02. MEDICAL EDUCATION PREPARATION. Amends Chapter 61C,
Education Code, by adding Sections 61.0902 and 61.0903, as follows:
Sec. 61.0902. EXTENDED UNDERGRADUATE MEDICAL EDUCATION PREPARATION
PROGRAM. Requires THECB to examine the use of certain undergraduate
programs to determine the feasability and effectiveness of the programs in
the education and training of physicians or other health care
professionals in this state and to work with higher education institutions
to implement and conduct those programs.
Sec. 61.0903. RECRUITING AND RETAINING UNDERREPRESENTED STUDENTS. (a)
Requires THECB , in coordination with institutions of higher education, to
develop a strategy coordinated to recruit and retain students from
underrepresented ethnic or racial backgrounds.
(b) Requires THECB and institutions of higher education to follow certain
guidelines in their coordinating efforts.
SECTION 6.03. PUBLIC SCHOOL PROGRAMS. Amends Chapter 29F, Education
Code, by adding Sections 29.187 and 29.188, as follows:
Sec. 29.187. HEALTH SCIENCE TECHNOLOGY AND COLLEGE PREPARATION PROGRAMS
IN BORDER REGION. (a) Defines "Texas-Mexico border region."
(b) Requires the Texas Education Agency (TEA) to periodically assess the
adequacy of existing health science technology and college preparatory
courses and programs in secondary schools in the Texas-Mexico border
region. Requires TEA to encourage and assist school districts to
establish additional courses and programs and to improve the quality of
existing courses and programs in schools in which TEA determines the need
exists.
(c) Requires TEA to encourage and assist in the operation of mentoring
programs between students and health care professionals in the
Texas-Mexico border region. Requires TEA to assist in the administration
of the mentoring programs to ensure the programs are effective in
fostering student awareness of the health professions and encouraging the
pursuit of careers in the health professions in the Texas-Mexico border
region by these students. Requires TEA and participating school districts
to track students participating in the mentoring program and monitor their
success.
(d) Requires TEA to report to the governor, the lieutenant governor, and
the speaker of the house of representatives not later than September 1,
2004, on TEA's activities. Requires the report to include the TEA's
recommendations on certain items. Provides that this subsection expires
January 1, 2005.
Sec. 29.188. SUMMER STUDY SCIENCE PROGRAMS FOR UNDERREPRESENTED
STUDENTS. Requires TEA to establish a statewide network of summer study
science instruction programs for underrepresented students from ethnic or
racial groups in the fields of science and medicine.
SECTION 6.04. REPEALER AND TRANSITION. (a) Repealer: Chapter 487,
Government Code (Texas Health Service Corps Program for Medically
Underserved Areas).
(b) Authorizes the Office of Rural Community Affairs to continue to
administer the Texas Health Service Corps with respect to an award or
stipend awarded before the repeal of Chapter 487G. Prohibits an award
after the effective date of this Act.
(c) Provides that the legislature intends that the Border Health Corps
established under Chapter 61J-1, Education Code, as added by this Act, be
funded primarily from revenue that would have been appropriated to the
Texas Health Service Corps. Requires all money and appropriations
available or designated to the Texas Health Service Corps on the effective
date of this Act to be reallocated or reappropriated to THECB to
administer the Border Health Corps under Chapter 61J-1, as added by this
Act. Provides an exception.
ARTICLE 7. OFFICE OF STATE-FEDERAL RELATIONS
SECTION 7.01. REPORT. Requires the Office of State-Federal Relations to
report on its efforts and actions of the federal government to increase
federal Medicaid funding to the border region and to increase matching
funds for other health care programs in the border region, as part of its
report under Section 751.022(c), Government Code. Provides that this
section expires January 1, 2005.
SECTION 7.02. FEDERAL HEALTH CARE FUNDS AVAILABLE TO BORDER REGION.
Amends Chapter 751B, Government Code, by adding Section 751.025, as
follows:
Sec. 751.025. FEDERAL HEALTH CARE FUNDS TO BORDER REGION. (a) Defines
"Texas-Mexico border region."
(b) Requires the Office of State-Federal Relations (office) to achieve
equity in reimbursement rates between health care professionals in the
Texas-Mexico border region and other health care professionals in the
state. Requires the office to increase the Federal Medical Assistance
Percentage for the Texas-Mexico border region.
ARTICLE 8. EFFECTIVE DATE
SECTION 8.01. EFFECTIVE DATE. Effective date: September 1, 2003.