78R14948 KLA-D


By:  Wohlgemuth                                                   H.B. No. 3519

Substitute the following for H.B. No. 3519:                                   

By:  Wohlgemuth                                               C.S.H.B. No. 3519


A BILL TO BE ENTITLED
AN ACT
relating to health and human services. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 531.021, Government Code, is amended by adding Subsections (c) and (d) to read as follows: (c) In adopting rules and standards required by Subsection (b)(2), the commission may provide for payment of fees, charges, and rates in accordance with: (1) formulas, procedures, or methodologies prescribed by the commission's rules; (2) applicable state or federal law, policies, rules, regulations, or guidelines; (3) economic conditions that substantially and materially affect provider participation in the Medicaid program, as determined by the commissioner; or (4) available levels of appropriated state and federal funds. (d) Notwithstanding any other provision of Chapter 32, Human Resources Code, Chapter 533, or this chapter, the commission may adjust the fees, charges, and rates paid to Medicaid providers as necessary to achieve the objectives of the Medicaid program in a manner consistent with the considerations described by Subsection (c). SECTION 2. (a) Section 252.202(a), Health and Safety Code, is amended to read as follows: (a) A quality assurance fee is imposed on each facility for which a license fee must be paid under Section 252.034, [and] on each facility owned by a community mental health and mental retardation center, as described by Subchapter A, Chapter 534, and on each facility owned by the Texas Department of Mental Health and Mental Retardation. The fee: (1) is an amount established under Subsection (b) multiplied by the number of patient days as determined in accordance with Section 252.203; (2) is payable monthly; and (3) is in addition to other fees imposed under this chapter. (b) Not later than August 31, 2003, each facility owned by the Texas Department of Mental Health and Mental Retardation shall pay the quality assurance fee imposed by Section 252.202, Health and Safety Code, as amended by this section, for patient days occurring between September 1, 2002, and July 31, 2003. SECTION 3. Section 252.203, Health and Safety Code, is amended to read as follows: Sec. 252.203. PATIENT DAYS. For each calendar day, a facility shall determine the number of patient days by adding the following: (1) the number of patients occupying a facility bed immediately before midnight of that day; and (2) [the number of beds that are on hold on that day and that have been placed on hold for a period not to exceed three consecutive calendar days during which a patient is in a hospital; and [(3)] the number of beds that are on hold on that day and that have been placed on hold for a period not to exceed three consecutive calendar days during which a patient is on therapeutic [home] leave. SECTION 4. Section 252.204(b), Health and Safety Code, is amended to read as follows: (b) Each facility shall: (1) not later than the 20th [10th] day after the last day of a month file a report with the Health and Human Services Commission or the department, as appropriate, stating the total patient days for the month; and (2) not later than the 30th day after the last day of the month pay the quality assurance fee. SECTION 5. (a) Sections 252.207(a) and (c), Health and Safety Code, are amended to read as follows: (a) Subject to legislative appropriation and state and federal law, the [The] Health and Human Services Commission may [shall] use money in the quality assurance fund, together with any federal money available to match that money[, to]: (1) to offset [allowable] expenses incurred to administer the quality assurance fee under this chapter [under the Medicaid program]; [or] (2) to increase reimbursement rates paid under the Medicaid program to facilities or waiver programs for persons with mental retardation operated in accordance with 42 U.S.C. Section 1396n(c) and its subsequent amendments; or (3) for any other health and human services purpose approved by the governor and Legislative Budget Board[, subject to Section 252.206(d)]. (c) If money in the quality assurance fund is used to increase a reimbursement rate in the Medicaid program, the [The] Health and Human Services Commission shall ensure that the reimbursement methodology used to set that rate [formula devised under Subsection (b)] provides incentives to increase direct care staffing and direct care wages and benefits. (b) Section 252.207(b), Health and Safety Code, is repealed. SECTION 6. (a) Section 31.032(d), Human Resources Code, is amended to read as follows: (d) In determining whether an applicant is eligible for assistance, the department shall exclude from the applicant's available resources: (1) $1,000 [$2,000] for the applicant's household, including a household in which there is [or $3,000 if there is] a person with a disability or a person who is at least 60 years of age [in the applicant's household]; and (2) the fair market value of the applicant's ownership interest in a motor vehicle, but not more than the amount determined according to the following schedule: (A) $4,550 on or after September 1, 1995, but before October 1, 1995; (B) $4,600 on or after October 1, 1995, but before October 1, 1996; (C) $5,000 on or after October 1, 1996, but before October 1, 1997; and (D) $5,000 plus or minus an amount to be determined annually beginning on October 1, 1997, to reflect changes in the new car component of the Consumer Price Index for All Urban Consumers published by the Bureau of Labor Statistics. (b) Section 31.032(d), Human Resources Code, as amended by this section, applies to a person receiving financial assistance on or after the effective date of this Act, regardless of the date on which eligibility for financial assistance was determined. SECTION 7. (a) Section 32.024(w), Human Resources Code, is amended to read as follows: (w) The department shall set a personal needs allowance of not less than $45 [$60] a month for a resident of a convalescent or nursing home or related institution licensed under Chapter 242, Health and Safety Code, personal care facility, ICF-MR facility, or other similar long-term care facility who receives medical assistance. The department may send the personal needs allowance directly to a resident who receives Supplemental Security Income (SSI) (42 U.S.C. Section 1381 et seq.). This subsection does not apply to a resident who is participating in a medical assistance waiver program administered by the department. (b) Section 32.024(w), Human Resources Code, as amended by this section, applies only to a personal needs allowance paid on or after the effective date of this Act. SECTION 8. Notwithstanding any other statute of this state, each health and human services agency, as defined by Section 531.001, Government Code, is authorized to reduce expenditures by: (1) consolidating any reports or publications the agency is required to make and filing or delivering any of those reports or publications exclusively by electronic means; (2) extending the effective period of any license, permit, or registration the agency grants or administers through a regulatory board or other agency that is under the jurisdiction of the health and human services agency or administratively attached to the health and human services agency; and (3) providing that any communication between the agency and another person and any document required to be delivered to or by the agency, including any application, notice, billing statement, receipt, or certificate, may be made or delivered by electronic mail or through the Internet. SECTION 9. (a) Sections 32.024(i) and 32.027(b) and (e), Human Resources Code, are repealed. (b) The repeal by this Act of Sections 32.024(i) and 32.027(b) and (e), Human Resources Code, does not affect the provision of services under the medical assistance program to children in accordance with the requirements of federal law. SECTION 10. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted. SECTION 11. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2003.