BILL ANALYSIS
Senate Research Center H.B. 583
81R27478 ALB-D By: Dukes (Deuell)
AUTHOR'S / SPONSOR'S STATEMENT OF INTENT
At present, local and regional indigent care networks determine eligibility of new clients to assess the local, state, or federal programs for which they are eligible. When the client is determined to be eligible for certain state and federal programs, administered through the Health and Human Services Commission (HHSC), the client must then provide much of the same information and documentation that was just reviewed by the care network to the state in order to complete enrollment in the HHSC administered programs. Not only does this duplicate effort on the part of the client and the local caregiver, it ignores a valuable resource for enhancing eligibility processes by leveraging the work of the local service provider by more efficiently feeding data into the state eligibility system. Finally, HHSC currently has no way to electronically accept supporting eligibility documentation from local care networks, resulting in reliance on cumbersome and time-consuming tasks matching paper documents correctly with applications and scanning faxed documents.
The 80th Legislature, Regular Session, 2007, enacted H.B. 321 to establish a pilot program to determine the feasibility of simplifying the eligibility process by allowing HHSC to import state eligibility information collected by local care networks. The bill required selection of a clearly established care network that is using electronic eligibility assessment workers who are already involved with determining eligibility for their institutions. Finally, the bill required that the participating pilot network have data systems compatible with the eligibility system at HHSC.
A report about the pilot program was issued by HHSC on December 1, 2008, which concluded that the basic technology and operational systems are in place to process imported electronic eligibility information from a regional indigent care provider, but that technology infrastructure built to support the pilot needs to be further developed and enhanced.
H.B. 583 expands the electronic eligibility information pilot project created to determine the feasibility, costs, and benefits of accepting the direct importation of electronic information from a regional safety net provider collaborative organization for the purpose of establishing eligibility for benefits under state and federal health and human services programs by requiring HHSC to establish the project in at least two urban areas in Texas.
RULEMAKING AUTHORITY
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 531.02413, Government Code, as added by Chapter 605 (H.B. 321), Acts of the 80th Legislature, Regular Session, 2007, as follows:
Sec. 531.02413. ELECTRONIC ELIGIBILITY INFORMATION PILOT PROJECT. (a) Requires the Health and Human Services Commission (HHSC) to establish a pilot project in at least one urban area of this state to determine the feasibility, costs, and benefits of accepting, for the purpose of establishing eligibility for benefits under state and federal health and human services programs administered by HHSC, the direct importation of electronic eligibility information from an electronic system operated by a regional safety net provider collaborative organization, rather than a regional indigent care collaborative system.
(a-1) Requires HHSC, not later than September 1, 2010, to expand the pilot project to at least one additional urban area of this state if HHSC has implemented the Texas Integrated Eligibility Redesign System (TIERS) in the area selected for the expansion.
(b) Makes conforming changes.
(c) Requires HHSC, in establishing a pilot project under this section, to:
(1) create a project in which regional indigent care networks interface with HHSC through TIERS or another state electronic eligibility system, as appropriate, to share electronic applications for indigent care created by the care network with HHSC to facilitate enrollment in health and human services programs administered by HHSC;
(2) automatically import the application information submitted under Subdivision (1) with minimal human intervention to eliminate double data entry and data entry errors and to ensure most appropriate use of HHSC resources while maintaining program integrity;
(3) redesignates Subdivision (2) as Subdivision (3);
(4) redesignates Subdivision (3) as Subdivision (4);
(5) redesignates Subdivision (4) as Subdivision (5); and
Deletes existing text related to requiring HHSC in establishing a pilot project under this section, to focus on creating a project in which electronic applications for indigent care created by a regional indigent care network is authorized to be shared with HHSC to facilitate enrollment in health and human services programs administered by HHSC.
(d) Requires HHSC, in implementing the project under Subsection (c), to review and process applications in a timely manner and, to the extent allowed by federal law and regulations, work directly with each organization to obtain missing documents and resolve issues that impede enrollment. Requires each organization to be authorized by the applicant to receive information concerning the applicant directly from HHSC.
(e) Requires HHSC to provide a monthly statistical report to each safety net provider collaborative organization that submits an application under Subsection (d) and to the Legislative Budget Board on the number of applications processed, the timeliness of the application process, and the reasons for any delays. Requires HHSC to work with the safety net provider collaborative organizations to decrease delays in processing applications.
SECTION 2. Requires HHSC, not later than December 15, 2011, to assess the cost-effectiveness, efficacy, efficiency, and benefits of using electronic eligibility information imported from electronic systems operated by regional safety net provider collaborative organizations, and to report its findings resulting from the pilot project established under Section 531.02413, Government Code, as added by Chapter 605 (H.B. 321), Acts of the 80th Legislature, Regular Session, 2007, and amended by this Act, to the standing committees of the senate and house of representatives having primary jurisdiction over health and human services issues.
SECTION 3. Requires HHSC, if necessary for implementation of a provision of this Act, to request a waiver or authorization from a federal agency, and authorizes delay of implementation until such waivers or authorizations are granted.
SECTION 4. Effective date: upon passage or September 1, 2009.