80R3935 ABC-D
 
  By: Deuell S.B. No. 551
 
 
 
   
 
 
A BILL TO BE ENTITLED
AN ACT
relating to indigent health care.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
       SECTION 1.  Section 61.002, Health and Safety Code, is
amended by amending Subdivision (1) and adding Subdivision (4-a) to
read as follows:
             (1)  "Department" means the [Texas] Department of State
Health Services.
             (4-a)  "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
       SECTION 2.  Section 61.003(f), Health and Safety Code, is
amended to read as follows:
       (f)  For purposes of this chapter, a person who is an inmate
or resident of a state school or institution operated by the
department, the Texas Department of Criminal Justice
[Corrections], the [Texas] Department of Aging and Disability
Services [Mental Health and Mental Retardation], the Texas Youth
Commission, the Texas School for the Blind and Visually Impaired,
the Texas School for the Deaf, or any other state agency or who is an
inmate, patient, or resident of a school or institution operated by
a federal agency is not considered a resident of a hospital district
or of any governmental entity except the state or federal
government.
       SECTION 3.  The heading to Section 61.004, Health and Safety
Code, is amended to read as follows:
       Sec. 61.004.  [RESIDENCE OR] ELIGIBILITY DISPUTE.
       SECTION 4.  Sections 61.004(a) and (d), Health and Safety
Code, are amended to read as follows:
       (a)  If a provider of assistance and a governmental entity or
hospital district cannot agree on [a person's residence or] whether
a person is eligible for assistance under this chapter, the
provider or the governmental entity or hospital district may submit
the matter to the department.
       (d)  From the information submitted, the department shall
determine [the person's residence or] whether the person is
eligible for assistance under this chapter [, as appropriate,] and
shall notify each governmental entity or hospital district and the
provider of assistance of the decision and the reasons for the
decision.
       SECTION 5.  Section 61.006(c), Health and Safety Code, is
amended to read as follows:
       (c)  The department shall also define the services and
establish the payment standards for the categories of services
listed in Sections 61.028(a) and 61.0285 in accordance with Health
and Human Services Commission [Texas Department of Human Services]
rules relating to the Temporary Assistance for Needy
Families-Medicaid program.
       SECTION 6.  Section 61.007, Health and Safety Code, is
amended to read as follows:
       Sec. 61.007.  INFORMATION PROVIDED BY APPLICANT.  The
department by rule shall require each applicant to provide at least
the following information:
             (1)  the applicant's full name and address;
             (2)  the applicant's social security number, if
available;
             (3)  the number of persons in the applicant's
household, excluding persons receiving Temporary Assistance for
Needy Families, Supplemental Security Income, or Medicaid
benefits;
             (4)  the applicant's county of residence;
             (5)  the existence of insurance coverage or other
hospital or health care benefits for which the applicant is
eligible;
             (6)  any transfer of title to real property by [that]
the applicant [has made in the preceding 24 months];
             (7)  the applicant's annual household income, excluding
the income of any household member receiving Temporary Assistance
for Needy Families, Supplemental Security Income, or Medicaid
benefits; and
             (8)  the value [amount] of the applicant's liquid
resources, vehicles, [assets and the equity value of the
applicant's car] and real property.
       SECTION 7.  Section 61.008(a), Health and Safety Code, is
amended to read as follows:
       (a)  The executive commissioner [department] by rule shall
provide that in determining eligibility:
             (1)  a county may not consider the value of the
applicant's homestead;
             (2)  a county must consider the [equity] value of a
vehicle [car] that is in excess of the amount exempted under
department guidelines as a resource;
             (3)  a county must subtract the work-related and
dependent [child] care expense [allowance] allowed under
department guidelines;
             (4)  a county must consider as a resource real property
other than a homestead and, except as provided by Subsection (b),
must count that property in determining eligibility; and
             (5)  transferral of countable resources may not be more
restrictive than the resource requirements for the Temporary
Assistance for Needy Families-Medicaid program [if an applicant
transferred title to real property for less than market value to
become eligible for assistance under this chapter, the county may
not credit toward eligibility for state assistance an expenditure
for that applicant made during a two-year period beginning on the
date on which the property is transferred].
       SECTION 8.  Section 61.009, Health and Safety Code, is
amended by amending Subsection (a) and adding Subsection (c) to
read as follows:
       (a)  The department shall establish uniform reporting
requirements for governmental entities that own, operate, or lease
public hospitals providing assistance under this chapter and for
counties and hospital districts.
       (c)  The reports must be sent to the department at least
annually.
       SECTION 9.  Section 61.025(b), Health and Safety Code, is
amended to read as follows:
       (b)  The transfer agreement may transfer partial
responsibility to the county under which the municipal hospital
continues to provide health care services to eligible residents of
the municipality, but the county agrees to assume the hospital's
responsibility to reimburse other providers who provide:
             (1)  basic [mandatory] inpatient or outpatient
services to eligible residents that the municipal hospital cannot
provide; or
             (2)  emergency services to eligible residents.
       SECTION 10.  Sections 61.0285(a) and (b), Health and Safety
Code, are amended to read as follows:
       (a)  In addition to basic health care services provided under
Section 61.028, a county may, in accordance with [department] rules
adopted by the executive commissioner under Section 61.006, provide
other medically necessary services or supplies that the county
determines to be cost-effective, including:
             (1)  freestanding ambulatory surgical center services;
             (2)  diabetic and colostomy medical supplies and
equipment;
             (3)  durable medical equipment;
             (4)  home and community health care services;
             (5)  social work services;
             (6)  psychological counseling services;
             (7)  services provided by physician assistants, nurse
practitioners, certified nurse midwives, clinical nurse
specialists, and certified registered nurse anesthetists;
             (8)  dental care;
             (9)  vision care, including eyeglasses;
             (10)  services provided by federally qualified health
centers, as defined by 42 U.S.C. Section 1396d(l)(2)(B);
             (11)  emergency medical services; and
             (12)  any other appropriate health care service
identified by [board] rule that may be determined to be
cost-effective.
       (b)  A county must notify the department of the county's
intent to provide services specified by Subsection (a). The [If
the services are approved by the department under Section 61.006,
or if the department fails to notify the county of the department's
disapproval before the 31st day after the date the county notifies
the department of its intent to provide the services, the] county
may credit the services toward eligibility for state assistance
under this subchapter.
       SECTION 11.  Section 61.032(e), Health and Safety Code, is
amended to read as follows:
       (e)  If the county and the provider disagree on the patient's
[residence or] eligibility, the county or the provider may submit
the matter to the department as provided by Section 61.004.
       SECTION 12.  Section 61.042(a), Health and Safety Code, is
amended to read as follows:
       (a)  A county may establish procedures consistent with those
used by the Health and Human Services Commission [Texas Department
of Human Services] under Chapter 31, Human Resources Code, for
administering an employment services program and requiring an
applicant or eligible resident to register for work with the Texas
Workforce [Employment] Commission.
       SECTION 13.  Section 61.066, Health and Safety Code, is
amended to read as follows:
       Sec. 61.066.  PREVENTION AND DETECTION OF FRAUD.  (a)  A
hospital district or public hospital may adopt reasonable
procedures for minimizing the opportunity for fraud, for
establishing and maintaining methods for detecting and identifying
situations in which a question of fraud may exist, and for
administrative hearings to be conducted on disqualifying persons in
cases where fraud appears to exist.
       (b)  Procedures established by a hospital district or public
hospital for administrative hearings conducted under this section
shall provide for appropriate due process, including procedures for
appeals.
       SECTION 14.  Section 61.023(c), Health and Safety Code, is
repealed.
       SECTION 15.  Notwithstanding Section 61.025(e), Health and
Safety Code, a county and municipality may amend an agreement under
Section 61.025, Health and Safety Code, to conform to changes in law
made by this Act to Section 61.025(b), Health and Safety Code.
       SECTION 16.  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, 2007.