H.B. No. 2463
AN ACT
relating to the creation of a Medicaid health literacy pilot
program and health care funding districts in certain counties and
authorizing the districts to impose taxes on certain institutional
health care providers located in the districts.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapters 288, 289, and 290 to read as follows:
CHAPTER 288. HEALTH CARE FUNDING DISTRICTS IN CERTAIN COUNTIES
LOCATED ON TEXAS-MEXICO BORDER THAT ARE ADJACENT TO COUNTIES WITH
POPULATION OF 50,000 OR MORE
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 288.001. DEFINITIONS. In this chapter:
(1) "Commission" means the commission of a district
created under this chapter.
(2) "District" means a county health care funding
district created by this chapter.
(3) "District taxpayer" means a person or entity who
has paid a tax imposed under this chapter.
(4) "Institutional health care provider" means a
nonpublic hospital licensed under Chapter 241.
Sec. 288.002. CREATION OF DISTRICT. A district is created
in each county located on the Texas-Mexico border that has a
population of 500,000 or more and is adjacent to two or more
counties each of which has a population of 50,000 or more.
Sec. 288.003. DURATION OF DISTRICT. (a) Unless continued
in existence by the legislature, a district created by this chapter
is abolished September 1, 2007.
(b) Any money held by a district at the time the district is
abolished shall be used to pay any outstanding administrative
expenses of the district, and the commission shall direct the
secretary of the commission to return the pro rata share of any
remaining district money to each district taxpayer.
Sec. 288.004. POLITICAL SUBDIVISION. A district created by
this chapter is a political subdivision of this state.
Sec. 288.005. DISTRICT TERRITORY. The boundaries of each
district are coextensive with the boundaries of the county in which
the district is created.
[Sections 288.006-288.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 288.051. COMMISSION; APPOINTMENT. (a) Each district
is governed by a commission of five members appointed as provided by
this section.
(b) Each county commissioner on the commissioners court of
the county in which the district is located shall appoint one member
who meets the qualifications prescribed by Section 288.052 to serve
on the commission. The county judge of the county shall appoint any
remaining members who meet the qualifications prescribed by Section
288.052 to serve on the commission.
Sec. 288.052. QUALIFICATION OF MEMBERS OF COMMISSION. To
be eligible to serve as a member of the commission, a person must:
(1) be a United States citizen;
(2) be 18 years of age or older on the first day of the
term that the person is appointed to fill;
(3) have not been determined mentally incompetent by a
final judgment of a court;
(4) have not been finally convicted of a felony from
which the person has not been pardoned or otherwise released from
the resulting disabilities;
(5) have resided continuously in this state for 12
months and in the county in which the district is located for six
months immediately preceding the date of the appointment; and
(6) be a person knowledgeable in the field of health
care.
Sec. 288.053. TERM OF MEMBERS OF COMMISSION. The members of
the commission serve staggered two-year terms.
Sec. 288.054. VACANCY. (a) If a vacancy occurs on the
commission, the commissioners court of the county in which the
district is located shall appoint a qualified person to fill the
vacancy not later than the 30th day after the date the vacancy
occurs.
(b) If the commissioners court of the county in which the
district is located does not appoint a member to the commission to
fill a vacancy by the 30th day after the date the vacancy occurs,
the remaining members of the commission may, by vote of the
commission, appoint a replacement.
Sec. 288.055. OFFICERS. (a) Each commission shall elect a
chairperson and a secretary from among its members.
(b) The chairperson and secretary shall each serve in that
office until the expiration of their term as a member of the
commission.
Sec. 288.056. COMPENSATION; EXPENSES. A member of the
commission serves without compensation but may, on the approval of
the entire commission, be reimbursed for actual expenses incurred
in the performance of the member's official duties.
Sec. 288.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The
commission may employ an attorney, financial advisor, and
bookkeeper for the district or contract for those services.
Sec. 288.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION.
Except as otherwise provided by law, all district records,
including books, accounts, notices, minutes, and all other matters
of the district and the operation of its facilities, shall be:
(1) maintained at the district office; and
(2) open to public inspection at the district office
during reasonable hours.
[Sections 288.059-288.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 288.101. LIMITATION ON TAXING AUTHORITY. Each
district may impose taxes only in the manner provided by this
chapter.
Sec. 288.102. MAJORITY VOTE REQUIRED. (a) A district may
not impose any tax authorized by this chapter, spend any money,
including for the administrative expenses of the district, or
conduct any other business of the commission without an affirmative
vote of a majority of the members of the commission.
(b) Before imposing a tax under this chapter in any one
year, the commission must obtain the affirmative vote required by
Subsection (a).
Sec. 288.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES.
(a) In addition to the majority vote required under Section
288.102, a district may not spend any money of the district unless
the district receives the approval of at least 95 percent of the
district taxpayers.
(b) This section does not apply to expenditures related to
the administrative matters of the district.
Sec. 288.104. RULES AND PROCEDURES. (a) The commission may
adopt rules governing the operation of the district, including
rules relating to the administration of a tax authorized by this
chapter.
(b) In order to implement the requirements of Sections
288.102 and 288.103, the commission shall adopt any necessary
procedures.
Sec. 288.105. PURCHASING AND ACCOUNTING PROCEDURES. (a)
The commission may prescribe the method and manner for making
purchases and expenditures by the district.
(b) The commission shall prescribe:
(1) all accounting and control procedures; and
(2) the method of purchasing necessary supplies,
materials, and equipment.
Sec. 288.106. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING; INSPECTION OF RECORDS. (a) A district shall require an
institutional health care provider to submit to the district a copy
of any financial and utilization data required by and reported to
the Department of State Health Services under Sections 311.032 and
311.033 and any rules adopted by the department to implement those
sections.
(b) A district may inspect the records of an institutional
health care provider to the extent necessary to ensure that the
provider has submitted all required data under this section.
Sec. 288.107. AUTHORITY TO SUE AND BE SUED. Each district
may sue and be sued in its own name in any court of this state as a
governmental agency.
[Sections 288.108-288.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 288.151. BUDGET. (a) Each year, the commission shall
prepare a budget for the following fiscal year that includes:
(1) proposed expenditures and disbursements;
(2) estimated receipts and collections; and
(3) the rates and amounts of any taxes that the
commission intends to impose during the year.
(b) The commission shall hold a public hearing on the
proposed budget. Not later than the 10th day before the date of the
hearing, the commission shall publish at least once notice of the
hearing in a newspaper of general circulation in the county in which
the district is located.
(c) Any district taxpayer is entitled to appear at the time
and place designated in the public notice and to be heard regarding
any item shown in the proposed budget.
Sec. 288.152. FISCAL YEAR. Each district's fiscal year
begins on September 1 and ends on August 31 of each year.
Sec. 288.153. ANNUAL AUDIT. (a) For each fiscal year, each
commission shall have an independent audit made of the district's
books and records.
(b) Not later than December 31 of each year, the audit made
for a district shall be filed with the comptroller and at the office
of the district.
Sec. 288.154. DEPOSITORY. (a) Each commission by
resolution shall designate one or more banks located in the
district as the depository for the district. A bank designated as
depository serves for two years or until a successor is designated.
(b) All income received by a district, including tax revenue
after deducting discounts and fees for assessing and collecting the
taxes, shall be deposited with the district depository and may be
withdrawn only as provided by this chapter.
(c) All district funds shall be secured in the manner
provided for securing county funds.
[Sections 288.155-288.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 288.201. TAX ON OUTPATIENT HOSPITAL SERVICES. (a) The
commission of a district may impose an annual tax to be assessed
quarterly on all outpatient hospital visits to an institutional
health care provider located in the district. In the first year in
which the tax is imposed, the tax is assessed on the total number of
outpatient hospital visits of an institutional health care provider
reported to the Department of State Health Services under Sections
311.032 and 311.033 in the fiscal year ending in 2003. The district
shall update this tax basis with the number of outpatient hospital
visits reported on a biennial basis.
(b) A tax imposed under this section must be imposed
uniformly on each institutional health care provider of outpatient
hospital services located in the district. A tax imposed under this
section also may not hold harmless any institutional health care
provider of outpatient hospital services, as required under 42
U.S.C. Section 1396b(w).
(c) The commission shall set the rate of the tax imposed
under this section. The rate may not exceed $100 for each
outpatient hospital visit.
(d) Subject to the maximum tax rate prescribed by Subsection
(c), the commission shall set the rate of the tax at a rate that will
generate sufficient revenue to cover the administrative expenses of
the district, to fund the nonfederal share of a Medicaid
supplemental payment program, and to pay for indigent programs,
except that the amount of tax revenue used for administrative
expenses of the district in a year may not exceed the lesser of four
percent of the total revenue generated from the tax or $20,000.
(e) An institutional health care provider may not add a tax
imposed under this section as a surcharge to a patient.
Sec. 288.202. ASSESSMENT AND COLLECTION OF TAXES. (a)
Except as provided by Subsection (b), the county tax
assessor-collector shall collect a tax imposed under this
subchapter unless the commission employs a tax assessor and
collector for the district. The county tax assessor-collector
shall charge and deduct from taxes collected for the district a fee
for collecting the tax in an amount determined by the commission,
not to exceed the county tax assessor-collector's usual and
customary charges for the collection of similar taxes.
(b) If determined by the commission to be appropriate, the
commission may contract for the assessment and collection of taxes
in the manner provided by Title 1, Tax Code, for the assessment and
collection of ad valorem taxes.
(c) Revenue from a fee charged by a county tax
assessor-collector for collecting the tax shall be deposited in the
county general fund and, if appropriate, shall be reported as fees
of the county tax assessor-collector.
Sec. 288.203. USE OF TAX REVENUE. Revenue generated by a
district from a tax imposed under this subchapter may be used only
to:
(1) provide the nonfederal share of a Medicaid
supplemental payment program;
(2) subsidize indigent programs; and
(3) pay administrative expenses of the district.
Sec. 288.204. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on taxes imposed under this
subchapter are governed by the law applicable to county ad valorem
taxes.
Sec. 288.205. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
from a tax imposed by the district to provide the nonfederal share
of a Medicaid supplemental payment program.
(b) To the extent any provision or procedure under this
chapter causes a tax under this chapter to be ineligible for federal
matching funds, the district may provide by rule for an alternative
provision or procedure that conforms to the requirements of the
federal Centers for Medicare and Medicaid Services.
Sec. 288.206. ELECTION REQUIRED FOR CERTAIN PROVISIONS OR
PROCEDURES. (a) In order to amend any provision or procedure set
out in this chapter, the district must obtain the approval of at
least 95 percent of the institutional health care providers
potentially subject to the tax.
(b) This section does not apply to rules or procedures
related to the daily administrative matters of the district.
CHAPTER 289. COUNTY HEALTH CARE FUNDING DISTRICTS IN CERTAIN
COUNTIES LOCATED ON TEXAS-MEXICO BORDER THAT HAVE POPULATION OF
LESS THAN 200,000
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 289.001. DEFINITIONS. In this chapter:
(1) "Commission" means the commission of a district
created under this chapter.
(2) "District" means a county health care funding
district created by this chapter.
(3) "District taxpayer" means a person or entity who
has paid a tax imposed under this chapter.
(4) "Institutional health care provider" means a
nonpublic hospital licensed under Chapter 241.
Sec. 289.002. CREATION OF DISTRICT. A district is created
in each county located on the Texas-Mexico border that has a
population of less than 200,000 and contains one or more
municipalities with a population of 100,000 or more.
Sec. 289.003. DURATION OF DISTRICT. (a) Unless continued
in existence by the legislature, a district created by this chapter
is abolished September 1, 2007.
(b) Any money held by a district at the time the district is
abolished shall be used to pay any outstanding administrative
expenses of the district, and the commission shall direct the
secretary of the commission to return the pro rata share of any
remaining district money to each district taxpayer.
Sec. 289.004. POLITICAL SUBDIVISION. A district created by
this chapter is a political subdivision of this state.
Sec. 289.005. DISTRICT TERRITORY. The boundaries of each
district are coextensive with the boundaries of the county in which
the district is created.
[Sections 289.006-289.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 289.051. COMMISSION; APPOINTMENT. (a) Each district
is governed by a commission of five members appointed as provided by
this section.
(b) Each county commissioner on the commissioners court of
the county in which the district is located shall appoint one member
who meets the qualifications prescribed by Section 289.052 to serve
on the commission. The county judge of the county shall appoint any
remaining members who meet the qualifications prescribed by Section
289.052 to serve on the commission.
Sec. 289.052. QUALIFICATION OF MEMBERS OF COMMISSION. To
be eligible to serve as a member of the commission, a person must:
(1) be a United States citizen;
(2) be 18 years of age or older on the first day of the
term that the person is appointed to fill;
(3) have not been determined mentally incompetent by a
final judgment of a court;
(4) have not been finally convicted of a felony from
which the person has not been pardoned or otherwise released from
the resulting disabilities;
(5) have resided continuously in this state for 12
months and in the county in which the district is located for six
months immediately preceding the date of the appointment; and
(6) be a person knowledgeable in the field of health
care.
Sec. 289.053. TERM OF MEMBERS OF COMMISSION. The members of
the commission serve staggered two-year terms.
Sec. 289.054. VACANCY. (a) If a vacancy occurs on the
commission, the commissioners court of the county in which the
district is located shall appoint a qualified person to fill the
vacancy not later than the 30th day after the date the vacancy
occurs.
(b) If the commissioners court of the county in which the
district is located does not appoint a member to the commission to
fill a vacancy by the 30th day after the date the vacancy occurs,
the remaining members of the commission may, by vote of the
commission, appoint a replacement.
Sec. 289.055. OFFICERS. (a) Each commission shall elect a
chairperson and a secretary from among its members.
(b) The chairperson and secretary shall each serve in that
office until the expiration of their term as a member of the
commission.
Sec. 289.056. COMPENSATION; EXPENSES. A member of the
commission serves without compensation but may, on the approval of
the entire commission, be reimbursed for actual expenses incurred
in the performance of the member's official duties.
Sec. 289.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The
commission may employ an attorney, financial advisor, and
bookkeeper for the district or contract for those services.
Sec. 289.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION.
Except as otherwise provided by law, all district records,
including books, accounts, notices, minutes, and all other matters
of the district and the operation of its facilities, shall be:
(1) maintained at the district office; and
(2) open to public inspection at the district office
during reasonable hours.
[Sections 289.059-289.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 289.101. LIMITATION ON TAXING AUTHORITY. Each
district may impose taxes only in the manner provided by this
chapter.
Sec. 289.102. MAJORITY VOTE REQUIRED. (a) A district may
not impose any tax authorized by this chapter, spend any money,
including for the administrative expenses of the district, or
conduct any other business of the commission without an affirmative
vote of a majority of the members of the commission.
(b) Before imposing a tax under this chapter in any one
year, the commission must obtain the affirmative vote required by
Subsection (a).
Sec. 289.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES.
(a) In addition to the majority vote required under Section
289.102, a district may not spend any money of the district unless
the district receives the approval of at least 95 percent of the
district taxpayers.
(b) This section does not apply to expenditures related to
the administrative matters of the district.
Sec. 289.104. RULES AND PROCEDURES. (a) The commission may
adopt rules governing the operation of the district, including
rules relating to the administration of a tax authorized by this
chapter.
(b) In order to implement the requirements of Sections
289.102 and 289.103, the commission shall adopt any necessary
procedures.
Sec. 289.105. PURCHASING AND ACCOUNTING PROCEDURES. (a)
The commission may prescribe the method and manner for making
purchases and expenditures by the district.
(b) The commission shall prescribe:
(1) all accounting and control procedures; and
(2) the method of purchasing necessary supplies,
materials, and equipment.
Sec. 289.106. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING; INSPECTION OF RECORDS. (a) A district shall require an
institutional health care provider to submit to the district a copy
of any financial and utilization data required by and reported to
the Department of State Health Services under Sections 311.032 and
311.033 and any rules adopted by the department to implement those
sections.
(b) A district may inspect the records of an institutional
health care provider to the extent necessary to ensure that the
provider has submitted all required data under this section.
Sec. 289.107. AUTHORITY TO SUE AND BE SUED. Each district
may sue and be sued in its own name in any court of this state as a
governmental agency.
[Sections 289.108-289.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 289.151. BUDGET. (a) Each year, the commission shall
prepare a budget for the following fiscal year that includes:
(1) proposed expenditures and disbursements;
(2) estimated receipts and collections; and
(3) the rates and amounts of any taxes that the
commission intends to impose during the year.
(b) The commission shall hold a public hearing on the
proposed budget. Not later than the 10th day before the date of the
hearing, the commission shall publish at least once notice of the
hearing in a newspaper of general circulation in the county in which
the district is located.
(c) Any district taxpayer is entitled to appear at the time
and place designated in the public notice and to be heard regarding
any item shown in the proposed budget.
Sec. 289.152. FISCAL YEAR. Each district's fiscal year
begins on September 1 and ends on August 31 of each year.
Sec. 289.153. ANNUAL AUDIT. (a) For each fiscal year, each
commission shall have an independent audit made of the district's
books and records.
(b) Not later than December 31 of each year, the audit made
for a district shall be filed with the comptroller and at the office
of the district.
Sec. 289.154. DEPOSITORY. (a) Each commission by
resolution shall designate one or more banks located in the
district as the depository for the district. A bank designated as
depository serves for two years or until a successor is designated.
(b) All income received by a district, including tax revenue
after deducting discounts and fees for assessing and collecting the
taxes, shall be deposited with the district depository and may be
withdrawn only as provided by this chapter.
(c) All district funds shall be secured in the manner
provided for securing county funds.
[Sections 289.155-289.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 289.201. TAX ON OUTPATIENT SERVICES. (a) The
commission of a district may impose an annual tax to be assessed
quarterly on all outpatient hospital visits to an institutional
health care provider located in the district. In the first year in
which the tax is imposed, the tax is assessed on the total number of
outpatient hospital visits of an institutional health care provider
reported to the Department of State Health Services under Sections
311.032 and 311.033 in the fiscal year ending in 2003. The district
shall update this tax basis with the number of outpatient hospital
visits reported on a biennial basis.
(b) A tax imposed under this section must be imposed
uniformly on each institutional health care provider of outpatient
hospital services located in the district. A tax imposed under this
section also may not hold harmless any institutional health care
provider of outpatient hospital services, as required under 42
U.S.C. Section 1396b(w).
(c) The commission shall set the rate of the tax imposed
under this section. The rate may not exceed $100 for each
outpatient hospital visit.
(d) Subject to the maximum tax rate prescribed by Subsection
(c), the commission shall set the rate of the tax at a rate that will
generate sufficient revenue to cover the administrative expenses of
the district, to fund the nonfederal share of a Medicaid
supplemental payment program, and to pay for indigent programs,
except that the amount of tax revenue used for administrative
expenses of the district in a year may not exceed the lesser of four
percent of the total revenue generated from the tax or $20,000.
(e) An institutional health care provider may not add a tax
imposed under this section as a surcharge to a patient.
Sec. 289.202. ASSESSMENT AND COLLECTION OF TAXES. (a)
Except as provided by Subsection (b), the county tax
assessor-collector shall collect a tax imposed under this
subchapter unless the commission employs a tax assessor and
collector for the district. The county tax assessor-collector
shall charge and deduct from taxes collected for the district a fee
for collecting the tax in an amount determined by the commission,
not to exceed the county tax assessor-collector's usual and
customary charges for the collection of similar taxes.
(b) If determined by the commission to be appropriate, the
commission may contract for the assessment and collection of taxes
in the manner provided by Title 1, Tax Code, for the assessment and
collection of ad valorem taxes.
(c) Revenue from a fee charged by a county tax
assessor-collector for collecting the tax shall be deposited in the
county general fund and, if appropriate, shall be reported as fees
of the county tax assessor-collector.
Sec. 289.203. USE OF TAX REVENUE. Revenue generated by a
district from a tax imposed under this subchapter may be used only
to:
(1) provide the nonfederal share of a Medicaid
supplemental payment program;
(2) subsidize indigent programs; and
(3) pay administrative expenses of the district.
Sec. 289.204. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on taxes imposed under this
subchapter are governed by the law applicable to county ad valorem
taxes.
Sec. 289.205. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
from a tax imposed by the district to provide the nonfederal share
of a Medicaid supplemental payment program.
(b) To the extent any provision or procedure under this
chapter causes a tax under this chapter to be ineligible for federal
matching funds, the district may provide by rule for an alternative
provision or procedure that conforms to the requirements of the
federal Centers for Medicare and Medicaid Services.
Sec. 289.206. ELECTION REQUIRED FOR CERTAIN PROVISIONS OR
PROCEDURES. (a) In order to amend any provision or procedure set
out in this chapter, the district must obtain the approval of at
least 95 percent of the institutional health care providers
potentially subject to the tax.
(b) This section does not apply to rules or procedures
related to the daily administrative matters of the district.
CHAPTER 290. COUNTY HEALTH CARE FUNDING DISTRICTS IN CERTAIN
COUNTIES WITH POPULATION OF 1.4 MILLION OR LESS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 290.001. DEFINITIONS. In this chapter:
(1) "Commission" means the commission of a district
created under this chapter.
(2) "District" means a county health care funding
district created by this chapter.
(3) "District taxpayer" means a person or entity who
has paid a tax imposed under this chapter.
(4) "Institutional health care provider" means a
nonpublic hospital licensed under Chapter 241.
Sec. 290.002. CREATION OF DISTRICT. A district is created
in each county that has a population of 1.4 million or less and in
which a municipality with a population of 1.1 million or more is
predominantly located.
Sec. 290.003. DURATION OF DISTRICT. (a) Unless continued
in existence by the legislature, a district created by this chapter
is abolished September 1, 2007.
(b) Any money held by a district at the time the district is
abolished shall be used to pay any outstanding administrative
expenses of the district, and the commission shall direct the
secretary of the commission to return the pro rata share of any
remaining district money to each district taxpayer.
Sec. 290.004. POLITICAL SUBDIVISION. A district created by
this chapter is a political subdivision of this state.
Sec. 290.005. DISTRICT TERRITORY. The boundaries of each
district are coextensive with the boundaries of the county in which
the district is created.
[Sections 290.006-290.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 290.051. COMMISSION; APPOINTMENT. (a) Each district
is governed by a commission of five members appointed as provided by
this section.
(b) Each county commissioner on the commissioners court of
the county in which the district is located shall appoint one member
who meets the qualifications prescribed by Section 290.052 to serve
on the commission. The county judge of the county shall appoint any
remaining members who meet the qualifications prescribed by Section
290.052 to serve on the commission.
Sec. 290.052. QUALIFICATION OF MEMBERS OF COMMISSION. To
be eligible to serve as a member of the commission, a person must:
(1) be a United States citizen;
(2) be 18 years of age or older on the first day of the
term that the person is appointed to fill;
(3) have not been determined mentally incompetent by a
final judgment of a court;
(4) have not been finally convicted of a felony from
which the person has not been pardoned or otherwise released from
the resulting disabilities;
(5) have resided continuously in this state for 12
months and in the county in which the district is located for six
months immediately preceding the date of the appointment; and
(6) be a person knowledgeable in the field of health
care.
Sec. 290.053. TERM OF MEMBERS OF COMMISSION. The members of
the commission serve staggered two-year terms.
Sec. 290.054. VACANCY. (a) If a vacancy occurs on the
commission, the commissioners court of the county in which the
district is located shall appoint a qualified person to fill the
vacancy not later than the 30th day after the date the vacancy
occurs.
(b) If the commissioners court of the county in which the
district is located does not appoint a member to the commission to
fill a vacancy by the 30th day after the date the vacancy occurs,
the remaining members of the commission may, by vote of the
commission, appoint a replacement.
Sec. 290.055. OFFICERS. (a) Each commission shall elect a
chairperson and a secretary from among its members.
(b) The chairperson and secretary shall each serve in that
office until the expiration of their term as a member of the
commission.
Sec. 290.056. COMPENSATION; EXPENSES. A member of the
commission serves without compensation but may, on the approval of
the entire commission, be reimbursed for actual expenses incurred
in the performance of the member's official duties.
Sec. 290.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The
commission may employ an attorney, financial advisor, and
bookkeeper for the district or contract for those services.
Sec. 290.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION.
Except as otherwise provided by law, all district records,
including books, accounts, notices, minutes, and all other matters
of the district and the operation of its facilities, shall be:
(1) maintained at the district office; and
(2) open to public inspection at the district office
during reasonable hours.
[Sections 290.059-290.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 290.101. LIMITATION ON TAXING AUTHORITY. Each
district may impose taxes only in the manner provided by this
chapter.
Sec. 290.102. MAJORITY VOTE REQUIRED. (a) A district may
not impose any tax authorized by this chapter, spend any money,
including for the administrative expenses of the district, or
conduct any other business of the commission without an affirmative
vote of a majority of the members of the commission.
(b) Before imposing a tax under this chapter in any one
year, the commission must obtain the affirmative vote required by
Subsection (a).
Sec. 290.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES.
(a) In addition to the majority vote required under Section
290.102, a district may not spend any money of the district unless
the district receives the approval of at least 95 percent of the
district taxpayers.
(b) This section does not apply to expenditures related to
the administrative matters of the district.
Sec. 290.104. RULES AND PROCEDURES. (a) The commission may
adopt rules governing the operation of the district, including
rules relating to the administration of a tax authorized by this
chapter.
(b) In order to implement the requirements of Sections
290.102 and 290.103, the commission shall adopt any necessary
procedures.
Sec. 290.105. PURCHASING AND ACCOUNTING PROCEDURES. (a)
The commission may prescribe the method and manner for making
purchases and expenditures by the district.
(b) The commission shall prescribe:
(1) all accounting and control procedures; and
(2) the method of purchasing necessary supplies,
materials, and equipment.
Sec. 290.106. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING; INSPECTION OF RECORDS. (a) A district shall require an
institutional health care provider to submit to the district a copy
of any financial and utilization data required by and reported to
the Department of State Health Services under Sections 311.032 and
311.033 and any rules adopted by the department to implement those
sections.
(b) A district may inspect the records of an institutional
health care provider to the extent necessary to ensure that the
provider has submitted all required data under this section.
Sec. 290.107. AUTHORITY TO SUE AND BE SUED. Each district
may sue and be sued in its own name in any court of this state as a
governmental agency.
[Sections 290.108-290.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 290.151. BUDGET. (a) Each year, the commission shall
prepare a budget for the following fiscal year that includes:
(1) proposed expenditures and disbursements;
(2) estimated receipts and collections; and
(3) the rates and amounts of any taxes that the
commission intends to impose during the year.
(b) The commission shall hold a public hearing on the
proposed budget. Not later than the 10th day before the date of the
hearing, the commission shall publish at least once notice of the
hearing in a newspaper of general circulation in the county in which
the district is located.
(c) Any district taxpayer is entitled to appear at the time
and place designated in the public notice and to be heard regarding
any item shown in the proposed budget.
Sec. 290.152. FISCAL YEAR. Each district's fiscal year
begins on September 1 and ends on August 31 of each year.
Sec. 290.153. ANNUAL AUDIT. (a) For each fiscal year, each
commission shall have an independent audit made of the district's
books and records.
(b) Not later than December 31 of each year, the audit made
for a district shall be filed with the comptroller and at the office
of the district.
Sec. 290.154. DEPOSITORY. (a) Each commission by
resolution shall designate one or more banks located in the
district as the depository for the district. A bank designated as
depository serves for two years or until a successor is designated.
(b) All income received by a district, including tax revenue
after deducting discounts and fees for assessing and collecting the
taxes, shall be deposited with the district depository and may be
withdrawn only as provided by this chapter.
(c) All district funds shall be secured in the manner
provided for securing county funds.
[Sections 290.155-290.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 290.201. TAX ON EMERGENCY ROOM SERVICES. (a) The
commission of a district may impose an annual tax to be assessed
quarterly on all emergency room visits to an institutional health
care provider located in the district. In the first year in which
the tax is imposed, the tax is assessed on the total number of
emergency room visits of an institutional health care provider
reported to the Department of State Health Services under Sections
311.032 and 311.033 in the fiscal year ending in 2003. The district
shall update this tax basis with the number of emergency room visits
reported on a biennial basis.
(b) A tax imposed under this section must be imposed
uniformly on each institutional health care provider of emergency
room services located in the district. A tax imposed under this
section also may not hold harmless any institutional health care
provider of emergency room services, as required under 42 U.S.C.
Section 1396b(w).
(c) The commission shall set the rate of the tax imposed
under this section. The rate may not exceed $100 for each emergency
room visit.
(d) Subject to the maximum tax rate prescribed by Subsection
(c), the commission shall set the rate of the tax at a rate that will
generate sufficient revenue to cover the administrative expenses of
the district, to fund the nonfederal share of a Medicaid
supplemental payment program, and to pay for indigent programs,
except that the amount of tax revenue used for administrative
expenses of the district in a year may not exceed the lesser of four
percent of the total revenue generated from the tax or $20,000.
(e) An institutional health care provider may not add a tax
imposed under this section as a surcharge to a patient.
Sec. 290.202. ASSESSMENT AND COLLECTION OF TAXES. (a)
Except as provided by Subsection (b), the county tax
assessor-collector shall collect any tax imposed under this
subchapter unless the commission employs a tax assessor and
collector for the district. The county tax assessor-collector
shall charge and deduct from taxes collected for the district a fee
for collecting the tax in an amount determined by the commission,
not to exceed the county tax assessor-collector's usual and
customary charges for the collection of similar taxes.
(b) If determined by the commission to be appropriate, the
commission may contract for the assessment and collection of taxes
in the manner provided by Title 1, Tax Code, for the assessment and
collection of ad valorem taxes.
(c) Revenue from a fee charged by a county tax
assessor-collector for collecting the tax shall be deposited in the
county general fund and, if appropriate, shall be reported as fees
of the county tax assessor-collector.
Sec. 290.203. USE OF TAX REVENUE. Revenue generated by a
district from a tax imposed under this subchapter may be used only
to:
(1) provide the nonfederal share of a Medicaid
supplemental payment program;
(2) subsidize indigent programs; and
(3) pay administrative expenses of the district.
Sec. 290.204. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on taxes imposed under this
subchapter are governed by the law applicable to county ad valorem
taxes.
Sec. 290.205. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
from a tax imposed by the district to provide the nonfederal share
of a Medicaid supplemental payment program.
(b) To the extent any provision or procedure under this
chapter causes a tax under this chapter to be ineligible for federal
matching funds, the district may provide by rule for an alternative
provision or procedure that conforms to the requirements of the
federal Centers for Medicare and Medicaid Services.
Sec. 290.206. ELECTION REQUIRED FOR CERTAIN PROVISIONS OR
PROCEDURES. (a) In order to amend any provision or procedure set
out in this chapter, the district must obtain the approval of at
least 95 percent of the institutional health care providers
potentially subject to the tax.
(b) This section does not apply to rules or procedures
related to the daily administrative matters of the district.
SECTION 2. (a) Subchapter B, Chapter 531, Government Code,
is amended by adding Section 531.0316 to read as follows:
Sec. 531.0316. 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 pilot program must:
(1) establish a statistically significant test group
and control group of Medicaid recipients with young children; and
(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.
(c) The commission shall establish the pilot program
through a local governmental entity in Bexar County that chooses to
participate. The commission shall request participation by the
Bexar County Hospital District with the hospital district's
subsidiary, Community First Health Plans.
(d) The commission shall ensure that the pilot program is
financed using:
(1) money provided to the commission for purposes of
the program by the participating local governmental entity to
maximize federal matching money under the medical assistance
program; and
(2) any corresponding federal matching money.
(e) The participating local governmental entity may provide
money to the commission by certification or intergovernmental
transfer to finance the pilot program as described by Subsection
(d)(1).
(f) Not later than January 1, 2007, the commission shall
evaluate the pilot program and report to the 80th Legislature on the
effectiveness of the program and the feasibility of expanding the
program statewide.
(g) This section expires September 1, 2009.
(b) If before implementing any provision of this section 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 3. (a) Not later than October 1, 2005:
(1) the commissioners court of each county to which
Chapter 288, Health and Safety Code, as added by this Act, applies
shall each appoint the initial members of a commission in
accordance with Section 288.051, Health and Safety Code, as added
by this Act, for a county health care funding district created by
Chapter 288, Health and Safety Code, as added by this Act, in that
county;
(2) the commissioners court of each county to which
Chapter 289, Health and Safety Code, as added by this Act, applies
shall each appoint the initial members of a commission in
accordance with Section 289.051, Health and Safety Code, as added
by this Act, for a county health care funding district created by
Chapter 289, Health and Safety Code, as added by this Act, in that
county; and
(3) the commissioners court of each county to which
Chapter 290, Health and Safety Code, as added by this Act, applies
shall each appoint the initial members of a commission in
accordance with Section 290.051, Health and Safety Code, as added
by this Act, for a county health care funding district created by
Chapter 290, Health and Safety Code, as added by this Act, in that
county.
(b) For each county health care funding district created by
Chapters 288, 289, and 290, Health and Safety Code, as added by this
Act, the initial commission members appointed under Subsection (a)
of this section shall draw lots to determine which two commission
members shall serve one-year terms and which three commission
members shall serve two-year terms.
SECTION 4. 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, 2005.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 2463 was passed by the House on May
10, 2005, by the following vote: Yeas 139, Nays 1, 3 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 2463 on May 27, 2005, by the following vote: Yeas 137, Nays 3,
2 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 2463 was passed by the Senate, with
amendments, on May 25, 2005, by the following vote: Yeas 31, Nays
0.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor