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78R4553 DLF-F
By: Puente H.B. No. 1981
A BILL TO BE ENTITLED
AN ACT
relating to indigent health care, including tertiary care.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 61.005(b), Health and Safety Code, is
amended to read as follows:
(b) The county, public hospital, or hospital district may
not deny or reduce assistance to an eligible resident who cannot [or
refuses to] contribute.
SECTION 2. Sections 61.006(b) and (c), Health and Safety
Code, are amended to read as follows:
(b) The minimum eligibility standards must incorporate a
net income eligibility level equal to 100 [21] percent of the
federal poverty level based on the federal Office of Management and
Budget poverty index.
(c) The department shall also define the services and
establish the payment standards for the categories of services
listed in Sections 61.028(a) and 61.0285 in accordance with Texas
Department of Human Services rules relating to the Temporary
Assistance for Needy Families-Medicaid program. The payment
standards established under this subsection must be based on
reasonable and customary compensation for the services.
SECTION 3. Section 61.028(a), Health and Safety Code, is
amended to read as follows:
(a) A county shall, in accordance with department rules
adopted under Section 61.006, provide the following basic health
care services:
(1) primary and preventative services designed to meet
the needs of the community, including:
(A) immunizations;
(B) medical screening services; and
(C) annual physical examinations;
(2) inpatient and outpatient hospital services;
(3) rural health clinics;
(4) laboratory and X-ray services;
(5) family planning services;
(6) physician services;
(7) emergency medical services;
(8) durable medical equipment;
(9) payment for not more than three prescription drugs
a month; and
(10) [(8)] skilled nursing facility services,
regardless of the patient's age.
SECTION 4. Section 61.0285(a), Health and Safety Code, is
amended to read as follows:
(a) In addition to basic health care services provided under
Section 61.028, a county may, in accordance with department rules
adopted under Section 61.006, provide other medically necessary
services or supplies that the county determines to be
cost-effective, including:
(1) ambulatory surgical center services;
(2) diabetic and colostomy medical supplies and
equipment;
(3) [durable medical equipment;
[(4)] home and community health care services;
(4) [(5)] services provided by licensed master
medical social workers--advanced clinical practitioners;
(5) [(6)] psychological counseling services;
(6) [(7)] services provided by physician assistants,
nurse practitioners, certified nurse midwives, clinical nurse
specialists, and certified registered nurse anesthetists;
(7) [(8)] dental care;
(8) [(9)] vision care, including eyeglasses;
(9) [(10)] services provided by federally qualified
health centers, as defined by 42 U.S.C. Section 1396d(l)(2)(B); and
(10) [(11) emergency medical services; and
[(12)] any other appropriate health care service
identified by board rule that may be determined to be
cost-effective.
SECTION 5. Sections 61.032(a) and (e), Health and Safety
Code, are amended to read as follows:
(a) If a nonmandated provider delivers emergency services
to a patient who the provider suspects might be eligible for
assistance under this subchapter, the provider shall notify the
patient's county of residence that emergency services have been or
will be provided to the patient. The notice shall be made:
(1) by telephone not later than the 30th day [72nd
hour] after the date the provider determines the patient's county
of residence; or [and]
(2) by mail postmarked not later than the 30th [fifth
working] day after the date on which the provider determines the
patient's county of residence.
(e) If the county and the provider disagree on the patient's
residence or eligibility:
(1) [,] the county or the provider may submit the
matter to the department as provided by Section 61.004; or
(2) the provider may bring an action against the
county to determine the residence or eligibility of the patient and
recover any amount owed.
SECTION 6. Section 61.033, Health and Safety Code, is
amended by amending Subsection (a) and adding Subsection (c) to
read as follows:
(a) To the extent prescribed by this chapter, a county is
liable for health care services provided under this subchapter by
any provider, including a public hospital or hospital district, to
an eligible county resident. A county is not liable for payment for
health care services provided:
(1) by any provider, including a public hospital or
hospital district, to a resident of that county who resides in the
service area of a public hospital or hospital district that is
actually operating and providing services to residents; or
(2) to an eligible resident of that county who does not
reside within the service area of a public hospital or hospital
district by a hospital having a Hill-Burton or state-mandated
obligation to provide free services and considered to be in
noncompliance with the requirements of the Hill-Burton or
state-mandated obligation.
(c) A county that is liable under this chapter for health
care services provided by any provider shall pay the provider in
accordance with Chapter 2251, Government Code. Chapter 2251,
Government Code, applies with respect to services rendered in
accordance with this chapter in the same manner as if a contract
were in effect between the county and the provider.
SECTION 7. Subchapter D, Chapter 502, Transportation Code,
is amended by adding Section 502.1711 to read as follows:
Sec. 502.1711. ADDITIONAL FEE FOR TRAUMA CENTERS. (a) In
addition to the registration fee for registration of a motor
vehicle under this chapter, a fee of $5 shall be collected.
(b) On the first Monday of each month, the county
assessor-collector shall send the fee collected under Subsection
(a) to the comptroller for deposit in the tertiary care account
under Section 46.003, Health and Safety Code.
(c) The county assessor-collector may retain an amount
equal to not more than 10 percent of each fee collected under
Subsection (a). The assessor-collector shall deposit any amount
retained under this subsection in the county treasury to the credit
of the general fund and shall petition the commissioners court for
the amount necessary to administer this section. The commissioners
court may allocate money deposited in the county treasury under
this subsection that is not allocated to the assessor-collector to
administer this section for general purposes of the county.
SECTION 8. Section 502.102(a), Transportation Code, is
amended to read as follows:
(a) Except as provided by Sections 502.103, [and] 502.104,
and 502.1711, this section applies to all fees collected by a county
assessor-collector under this chapter.
SECTION 9. Subchapter A, Chapter 102, Code of Criminal
Procedure, is amended by adding Article 102.0181 to read as
follows:
Art. 102.0181. ADDITIONAL COSTS ATTENDANT TO INTOXICATION
CONVICTIONS: TRAUMA CENTERS. (a) In addition to the costs on
conviction imposed by Articles 102.016 and 102.018, a person
convicted of an offense under Chapter 49, Penal Code, other than an
offense under Section 49.02 or 49.031, Penal Code, shall pay $100 on
conviction of the offense.
(b) Costs imposed under this article are imposed without
regard to whether the defendant is placed on community supervision
after being convicted of the offense.
(c) Costs imposed under this article are collected in the
same manner as other costs collected under Article 102.075.
(d) The officer collecting the costs under this article
shall keep separate records of the money collected and shall pay the
money to the custodian of the county treasury.
(e) The custodian of the county treasury shall:
(1) keep records of the amount of money collected
under this article that is deposited with the treasury under this
article; and
(2) not later than the last day of the first month
following each calendar quarter:
(A) pay the money collected under this article
during the preceding calendar quarter to the comptroller, except as
provided by Subsection (f); or
(B) if, in the calendar quarter, the custodian of
the county treasury did not receive any money attributable to costs
paid under this article, file a report with the comptroller stating
that fact.
(f) A county that complies with Subsection (e) may retain
not more than 10 percent of the money collected under this article
for administration of collection of the money.
(g) The comptroller may audit the collection of money under
this article.
(h) The comptroller shall deposit the funds received under
this article to the credit of the tertiary care account established
under Section 46.003, Health and Safety Code.
(i) Section 403.095, Government Code, does not apply to
funds deposited to the tertiary care account under this article.
SECTION 10. Sections 61.032(f) and 61.035, Health and
Safety Code, are repealed.
SECTION 11. The tertiary care account under Section 46.003,
Health and Safety Code, is re-created as a dedicated account in the
general revenue fund.
SECTION 12. The change in law made by Sections 1-6 of this
Act apply only to health care services provided on or after January
1, 2004. Health care services provided before January 1, 2004, are
governed by the law as it existed before the effective date of this
Act, and that law is continued in effect for that purpose.
SECTION 13. Sections 7 and 8 of this Act take effect January
1, 2004, and apply only to the registration of a motor vehicle that
is applied for on or after that date, but only if the constitutional
amendment proposed by the 78th Legislature, Regular Session, 2003,
authorizing the use of motor vehicle registration fees to support
trauma centers is approved by the voters. If that amendment is not
approved by the voters, Sections 7 and 8 of this Act have no effect.
SECTION 14. (a) Article 102.0181, Code of Criminal
Procedure, as added by this Act, takes effect January 1, 2004, and
applies only to an offense committed on or after that date. For
purposes of this section, an offense is committed before January 1,
2004, if any element of the offense occurs before that date.
(b) An offense committed before January 1, 2004, is governed
by the law in effect at the time the offense was committed, and the
former law is continued in effect for that purpose.
SECTION 15. Except as provided by Sections 13 and 14 of this
Act, this Act takes effect September 1, 2003.