BILL ANALYSIS

 

 

 

C.S.H.B. 583

By: Dukes

Human Services

Committee Report (Substituted)

 

 

 

BACKGROUND AND PURPOSE

 

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.

 

C.S.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

 

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

 

ANALYSIS

 

C.S.H.B. 583 amends Section 531.02413, Government Code, as added by Chapter 605 (H.B. 321), Acts of the 80th Legislature, Regular Session, 2007, to expand the electronic eligibility information pilot project created to determine the feasibility, costs, and benefits of accepting the direct importation of electronic information, for the purpose of establishing eligibility for benefits under state and federal health and human services programs, from a regional safety net provider collaborative organization, rather than from a regional indigent care collaborative system, and makes conforming changes.  The bill requires the Health and Human Services Commission (HHSC), if HHSC has implemented the Texas Integrated Eligibility Redesign System (TIERS) in the area selected for the expansion, to expand the pilot project to at least one additional urban area of Texas not later than September 1, 2010.  The bill clarifies requirements for HHSC in establishing the project to require HHSC to create a project in which regional indigent care networks interface with HHSC through TIERS or another state electronic eligibility system, as appropriate, to share with HHSC electronic applications for indigent care created by the care network, rather than requiring HHSC to focus on creating a project in which electronic applications for indigent care created by a regional indigent care network may be shared with HHSC.  The bill adds to HHSC's requirements in establishing the project the requirement that HHSC automatically import the electronic application information submitted by those networks with minimal human intervention to eliminate double data entry and data entry errors and to ensure the most appropriate use of HHSC's resources while maintaining program integrity.

 

C.S.H.B. 583 requires HHSC, in implementing the project, to review and process applications in a timely manner and, to the extent allowed by federal law and regulations, work directly with each collaborative organization to obtain missing documents and resolve issues that impede enrollment.  The bill requires that each organization be authorized by the applicant to receive information concerning the applicant directly from HHSC.  The bill requires HHSC to provide a monthly statistical report to each collaborative organization submitting an application and to the Legislative Budget Board on the number of applications processed, the timeliness of the application process, and the reasons for any delays.  The bill requires HHSC to work with the collaborative organizations to decrease delays in processing applications.

 

C.S.H.B. 583 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 their findings from the pilot project to the standing committees of the senate and house of representatives having primary jurisdiction over health and human services.

 

C.S.H.B. 583 requires a state agency that is affected by a provision of the bill to request a federal waiver or authorization if the agency determines that a waiver or authorization is necessary for the implementation of the provision, and it authorizes the agency to delay implementation until that federal waiver or authorization is obtained.

 

EFFECTIVE DATE

 

On passage, or, if the act does not receive the necessary vote, the act takes effect September 1, 2009.

 

COMPARISON OF ORIGINAL AND SUBSTITUTE

C.S.H.B. 583 differs from the original by requiring the Health and Human Services Commission (HHSC), not later than September 1, 2010, to expand the electronic eligibility pilot project to at least one additional urban area of Texas if HHSC has implemented the Texas Integrated Eligibility Redesign System (TIERS) in the area selected for the expansion, whereas the original did not include the condition that TIERS be implemented in the area selected for expansion and did not include a deadline for expansion.  The substitute differs from the original by referencing the importation of eligibility information from an electronic system operated by a regional safety net provider collaborative organization, rather than a regional indigent care collaborative systems, as in the original, and making conforming changes.

 

C.S.H.B. 583 differs from the original by requiring HHSC to create a project in which care networks interface with HHSC through TIERS or another state electronic eligibility system to share electronic applications and specifying that the application information is to be automatically imported with minimal human intervention, whereas in the original electronic applications are to be directly imported into TIERS, the System of Application, Verification, Eligibility, Referral, and Reporting (SAVERR), or another state electronic eligibility system.  The substitute adds provisions not in the original requiring the timely review and processing of applications by HHSC, working with each collaborative organization to obtain missing documents and resolve issues impeding enrollment and authorization to receive information concerning an applicant.  The substitute adds provisions not included in the original relating to a monthly statistical report to be provided by HHSC to each collaborative organization and to the Legislative Budget Board and the requirement that HHSC work to reduce application delays.

 

C.S.H.B. 583 omits a provision in the original requiring HHSC to take action to begin the expansion of the pilot project not later than the 30th day after the effective date of the bill.  The substitute differs from the original by requiring HHSC to make certain assessments and reports regarding the project not later than December 15, 2011, rather than not later than October 1, 2010, as in the original, and making clarifying changes.