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A BILL TO BE ENTITLED
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AN ACT
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relating to eligibility for and information regarding the child |
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health plan program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 62.002(4), Health and Safety Code, is |
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amended to read as follows: |
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(4) "Net [Gross] family income" means the [total] |
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amount of income established for a family after reduction for |
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offsets for child care expenses, in accordance with standards |
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applicable under the Medicaid [without consideration of any
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reduction for offsets that may be available to the family under any
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other] program. |
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SECTION 2. Subchapter B, Chapter 62, Health and Safety |
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Code, is amended by adding Section 62.056 to read as follows: |
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Sec. 62.056. COMMUNITY OUTREACH CAMPAIGN; TOLL-FREE |
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HOTLINE. (a) The commission shall conduct a community outreach and |
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education campaign to provide information relating to the |
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availability of health benefits for children under this chapter. |
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The commission shall conduct the campaign in a manner that promotes |
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enrollment in, and minimizes duplication of effort among, all |
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state-administered child health programs. |
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(b) The community outreach campaign must include: |
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(1) outreach efforts that involve school-based health |
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clinics; |
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(2) a toll-free telephone number through which |
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families may obtain information about health benefits coverage for |
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children; and |
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(3) information regarding the importance of each |
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conservator of a child promptly informing the other conservator of |
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the child about the child's health benefits coverage. |
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(c) The commission shall contract with community-based |
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organizations or coalitions of community-based organizations to |
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implement the community outreach campaign and shall also promote |
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and encourage voluntary efforts to implement the community outreach |
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campaign. The commission shall procure the contracts through a |
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process designed by the commission to encourage broad participation |
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of organizations, including organizations that target population |
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groups with high levels of uninsured children. |
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(d) The commission may direct that the Department of State |
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Health Services perform all or part of the community outreach |
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campaign. |
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(e) The commission shall ensure that information provided |
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under this section is available in both English and Spanish. |
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SECTION 3. Section 62.101, Health and Safety Code, is |
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amended by amending Subsection (b) and adding Subsection (b-1) to |
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read as follows: |
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(b) The commission shall establish income eligibility |
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levels consistent with Title XXI, Social Security Act (42 U.S.C. |
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Section 1397aa et seq.), as amended, and any other applicable law or |
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regulations, and subject to the availability of appropriated money, |
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so that a child who is younger than 19 years of age and whose net |
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[gross] family income is at or below 200 percent of the federal |
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poverty level is eligible for health benefits coverage under the |
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program. In addition, the commission may establish eligibility |
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standards regarding the amount and types of allowable assets for a |
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family whose net [gross] family income is above 150 percent of the |
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federal poverty level. |
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(b-1) The eligibility standards adopted under Subsection |
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(b) related to allowable assets: |
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(1) must allow a family to own at least $10,000 in |
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allowable assets; and |
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(2) may not in calculating the amount of allowable |
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assets under Subdivision (1) consider: |
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(A) the value of one vehicle that qualifies for |
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an exemption under commission rule based on its use; |
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(B) the value of a second or subsequent vehicle |
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that qualifies for an exemption under commission rule based on its |
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use if: |
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(i) the vehicle is worth $18,000 or less; or |
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(ii) the vehicle has been modified to |
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provide transportation for a household member with a disability; |
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(C) if no vehicle qualifies for an exemption |
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based on its use under commission rule, the first $18,000 of value |
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of the highest valued vehicle; or |
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(D) the first $7,500 of value of any vehicle not |
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described by Paragraph (A), (B), or (C). |
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SECTION 4. Subchapter C, Chapter 62, Health and Safety |
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Code, is amended by adding Section 62.1011 to read as follows: |
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Sec. 62.1011. VERIFICATION OF INCOME. The commission shall |
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continue employing methods of verifying the net income of the |
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individuals considered in the calculation of an applicant's net |
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family income. The commission shall verify income under this |
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section unless the applicant reports a net family income that |
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exceeds the income eligibility level established under Section |
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62.101(b). |
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SECTION 5. Section 62.102, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 62.102. CONTINUOUS COVERAGE. (a) Subject to a review |
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under Subsection (b), the [The] commission shall provide that an |
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individual who is determined to be eligible for coverage under the |
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child health plan remains eligible for those benefits until the |
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earlier of: |
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(1) the end of a period not to exceed 12 months, |
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beginning the first day of the month [the six-month period] |
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following the date of the eligibility determination; or |
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(2) the individual's 19th birthday. |
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(b) During the sixth month following the date of initial |
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enrollment or reenrollment of an individual whose family income |
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exceeds 150 percent of the federal poverty level, the commission |
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shall: |
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(1) review the individual's family income and may use |
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electronic technology if available and appropriate; and |
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(2) continue to provide coverage if the individual's |
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family income remains within the income eligibility limits |
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prescribed by this chapter. |
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(c) If, during the review required under Subsection (b), the |
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commission determines that the individual's family income exceeds |
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the income eligibility limits prescribed by this chapter, the |
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commission may not disenroll the individual until: |
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(1) the commission has provided the family an |
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opportunity to demonstrate that the family's family income is |
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within the income eligibility limits prescribed by this chapter; |
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and |
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(2) the family fails to demonstrate such eligibility. |
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(d) The commission shall provide written notice of |
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termination of eligibility to the individual not later than the |
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30th day before the date the individual's eligibility terminates. |
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SECTION 6. Sections 62.154(a) and (d), Health and Safety |
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Code, are amended to read as follows: |
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(a) To the extent permitted under Title XXI of the Social |
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Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any |
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other applicable law or regulations, the child health plan must |
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include a waiting period and[. The child health plan] may include |
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copayments and other provisions intended to discourage: |
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(1) employers and other persons from electing to |
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discontinue offering coverage for children under employee or other |
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group health benefit plans; and |
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(2) individuals with access to adequate health benefit |
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plan coverage, other than coverage under the child health plan, |
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from electing not to obtain or to discontinue that coverage for a |
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child. |
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(d) The waiting period required by Subsection (a) must: |
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(1) extend for a period of 90 days after[:
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[(1)] the last date on [first day of the month in] |
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which the applicant was covered under a health benefits plan; and |
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(2) apply to a child who was covered by a health |
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benefits plan at any time during the 90 days before the date of |
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application for coverage under the child health plan [is enrolled
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under the child health plan, if the date of enrollment is on or
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before the 15th day of the month; or
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[(2) the first day of the month after which the
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applicant is enrolled under the child health plan, if the date of
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enrollment is after the 15th day of the month]. |
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SECTION 7. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |
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