80R7335 MSE-F

By: Farabee H.B. No. 2811

A BILL TO BE ENTITLED

AN ACT

relating to the implementation of pilot programs to provide for regional systems of indigent health care.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. PURPOSE. The purpose of this Act is to implement pilot programs to regionalize indigent health care among counties, hospital districts, and public hospitals as a collaborative approach to leveraging regional resources. Pilot programs implemented under this Act must:

(1) expand health care coverage for the indigent within the region served by the pilot program;

(2) focus on providing more preventive and primary care services beyond the services currently required;

(3) receive support through a combination of local and state money and financial incentives; and

(4) improve health care delivery and management of health care costs and provide efficient access to health care for this state's indigent population.

SECTION 2. PILOT PROGRAMS. (a) The Department of State Health Services shall implement at least three pilot programs designed to test the feasibility of providing indigent health care through regional systems that incorporate counties, hospital districts, and public hospitals within the region. The department shall ensure that both rural and urban areas of this state are represented in the pilot programs.

(b) The Department of State Health Services shall select the three pilot programs through a competitive bidding process that also evaluates the bidder's experience with regional health care delivery collaboration. To participate in a pilot program each public hospital and hospital district that provides indigent health care within the region must agree to participate.

(c) A pilot program implemented by the Department of State Health Services under this section must:

(1) establish, for all counties participating in the program, a standard of eligibility for county indigent health care programs that is less restrictive than the standard in effect on January 1, 2007;

(2) seek the participation of all entities that provide health care services to indigent patients in the region;

(3) use health care information technology infrastructure to improve access to and quality of care and efficiencies in the indigent health care system;

(4) participate in a health information exchange that includes the uninsured, if available;

(5) measure outcomes; and

(6) in addition to the basic health care services required under Section 61.028, Health and Safety Code, offer two or more of the following services through a collaborative approach across the counties participating in the program:

(A) a 24-hour call center;

(B) health care coordination;

(C) nonemergency transportation;

(D) patient education;

(E) a health insurance product; or

(F) patient access to more than three prescription drugs or to other alternative prescription drug programs.

SECTION 3. INCENTIVES FOR PARTICIPATION. (a) In accordance with rules adopted by the executive commissioner of the Health and Human Services Commission and the General Appropriations Act, the Department of State Health Services may provide grant funding for the operation of a pilot program and may also provide the following financial incentives:

(1) the treatment of expenditures for additional services provided through the pilot program, including services provided under Section 2(c)(6) of this Act, as an expenditure for health care services for purposes of achieving a county's eight percent expenditure level requirement under Section 61.037, Health and Safety Code;

(2) matching dollars for expenditures for additional services provided through the pilot program or expansion of indigent health care eligibility as described by Section 2(c);

(3) funding for health information technology infrastructure, including infrastructure for participation in a health information exchange; or

(4) grant funding for additional capacity for providing primary and specialty care services.

(b) Grants and other financial incentives provided under this section may not:

(1) result in reductions in services provided or eligibility standards for an existing county indigent health care program; or

(2) harm or otherwise reduce existing funding available to a local community through participating partners.

SECTION 4. EVALUATION. Each pilot program implemented by the Department of State Health Services under this Act shall operate for a specified period of time, as determined by the executive commissioner of the Health and Human Services Commission, and is subject to a return-on-investment evaluation that includes an evaluation of the program's performance and outcomes.

SECTION 5. EFFECTIVE DATE. This Act takes effect September 1, 2007.