79R3342 UM-D

By:  Villarreal                                                   H.B. No. 691



A BILL TO BE ENTITLED

AN ACT

relating to a Medicaid health literacy pilot program.                         
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 531, Government Code, is 
amended by adding Section 531.02131 to read as follows:
	Sec. 531.02131.  MEDICAID HEALTH LITERACY PILOT PROGRAM.  
(a)  In order to prevent unnecessary emergency room visits and 
health costs for Medicaid recipients, the commission shall develop 
and implement a Medicaid health literacy pilot program in Bexar 
County under which Medicaid recipients with young children receive 
health information materials and training designed to improve their 
health care decision-making.
	(b)  The commission shall request proposals from health 
maintenance organizations serving Medicaid recipients in Bexar 
County for operation of the health literacy pilot program.
	(c)  The pilot program must:                                            
		(1)  establish a statistically significant test group 
and control group of Medicaid recipients with young children served 
by the health maintenance organization;
		(2)  provide the test group with health information 
materials in English and Spanish that:
			(A)  are developed with consideration of the 
literacy level of the test group; and
			(B)  provide the test group with information to 
guide their health care decisions, including information about 
common health problems, prevention, home treatment, and 
circumstances in which it is appropriate to contact a health care 
professional;
		(3)  provide training to the test group on how to use 
the health information materials;
		(4)  provide follow-up reminders to the test group 
regarding use of the health information materials approximately six 
months after the date the materials are initially provided;
		(5)  track the health care costs, utilization of 
services, and emergency room visits for the test group and the 
control group for a period of one year; and
		(6)  provide for reports to the commission on the 
status of the pilot program:
			(A)  after the program has been operating for six 
months; and       
			(B)  after the program has been operating for one 
year.             
	(d)  Notwithstanding any other provision of this section, 
the commission is not required to develop and implement the pilot 
program if a suitable contractor is not available to operate the 
pilot program.
	(e)  The executive commissioner shall adopt rules necessary 
for implementation of this section.
	(f)  This section expires September 1, 2007.                            
	SECTION 2.  (a) Not later than October 1, 2005, the Health 
and Human Services Commission shall request proposals for operation 
of the Medicaid health literacy pilot program.
	(b)  Not later than November 1, 2005, the Health and Human 
Services Commission shall select a health maintenance organization 
to operate the pilot program.
	(c)  Not later than January 1, 2006, the health maintenance 
organization selected by the Health and Human Services Commission 
shall distribute the health literacy materials and begin the pilot 
program.
	(d)  Not later than August 1, 2006, the Health and Human 
Services Commission, with the assistance of the health maintenance 
organization operating the pilot program, shall report to the 
governor, the lieutenant governor, and the speaker of the house of 
representatives regarding the preliminary results of the pilot 
program.  The report must include:
		(1)  a description of the status of the program;                              
		(2)  an evaluation of the effects of the program on 
emergency room visits by program participants; and
		(3)  a report summarizing the health care costs, 
utilization of services, and emergency room visits for the test 
group and control group established under the program.
	(e)  Not later than January 1, 2007, the Health and Human 
Services Commission, with the assistance of the health maintenance 
organization operating the pilot program, shall report the final 
results of the pilot program to the governor, the lieutenant 
governor, and the speaker of the house of representatives and make a 
recommendation for revising or expanding the program.
	SECTION 3.  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 4.  This Act takes effect September 1, 2005.