81R9536 KLA-D

By: Turner of Harris H.B. No. 2376

A BILL TO BE ENTITLED

AN ACT

relating to eligibility for and strengthening outreach activities under the child health plan program.

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

SECTION 1. Section 62.056, Health and Safety Code, is amended by amending Subsection (a) and adding Subsections (f) and (g) to read as follows:

(a) The commission shall strengthen the [conduct a] community outreach and education campaign in a manner that is designed to aggressively and proactively [to] provide information relating to the availability of health benefits for children under this chapter. The commission shall conduct the campaign in a manner that:

(1) promotes enrollment in, and minimizes duplication of effort among, all state-administered child health programs; and

(2) initially prioritizes enrolling in the program children whose net family income is at or below 200 percent of the federal poverty level and, after the commission establishes the income eligibility level in accordance with Section 62.101(b-2), subsequently prioritizes enrolling in the program children whose net family income is at or below 300 percent of the federal poverty level.

(f) To strengthen the community outreach and education campaign as required by Subsection (a), the commission shall establish a partnership with stakeholders who will provide outreach and benefits application assistance that is supplemental to the outreach conducted by contractors under Subsection (c) by:

(1) fostering the exchange of information regarding, and promoting, best practices for obtaining health benefits coverage for children;

(2) conducting the outreach in a manner consistent with the priorities stated in Subsection (a)(2); and

(3) disseminating successful outreach models across this state under which entities such as hospitals, school districts, and local businesses partner to identify children without health benefits coverage.

(g) The partnership established under Subsection (f) must include entities that contract with the commission to perform eligibility determination and enrollment functions, community-based organizations that contract with the commission, health benefit plan providers, Texas Health Steps program contractors, health care providers, consumer advocates, and other interested stakeholders.

SECTION 2. Section 62.101, Health and Safety Code, is amended by amending Subsections (b) and (c) and adding Subsections (b-2) and (d) to read as follows:

(b) Subject to Subsection (b-2), the [The] commission shall establish income eligibility levels consistent with Title XXI, Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any other applicable law or regulations, and subject to the availability of appropriated money, so that a child who is younger than 19 years of age and whose net family income is at or below 200 percent of the federal poverty level is eligible for health benefits coverage under the program. In addition to the income eligibility levels established under this subsection or Subsection (b-2), the commission may establish eligibility standards regarding the amount and types of allowable assets for a family whose net family income is above 150 percent of the federal poverty level.

(b-2) As soon as possible after the date the commission determines that 80 percent or more of children in this state who are eligible for health benefits coverage under the child health plan program are enrolled in the program or in other adequate health benefits plan coverage, the commission shall establish income eligibility levels consistent with Title XXI, Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any other applicable law or regulations, and subject to the availability of appropriated money, so that a child who is younger than 19 years of age and whose net family income is at or below 300 percent of the federal poverty level is eligible for health benefits coverage under the program.

(c) The commissioner shall evaluate enrollment levels and program impact [every six months during the first 12 months of implementation and] at least annually [thereafter] and shall submit a finding of fact to the Legislative Budget Board and the Governor's Office of Budget and Planning as to:

(1) the adequacy of funding and the ability of the program to sustain enrollment at the eligibility level established by Subsection (b); and

(2) the percentage of children in this state who are eligible for health benefits coverage under the child health plan program and who are enrolled in the program or in other adequate health benefits plan coverage.

(d) In the event that appropriated money is insufficient to sustain enrollment at the authorized eligibility level, the commissioner shall:

(1) suspend enrollment in the child health plan;

(2) establish a waiting list for applicants for coverage; and

(3) establish a process for periodic or continued enrollment of applicants in the child health plan program as the availability of money allows.

SECTION 3. Section 62.1011, Health and Safety Code, is amended to read as follows:

Sec. 62.1011. VERIFICATION OF INCOME. The commission shall continue employing methods of verifying the net income of the individuals considered in the calculation of an applicant's net family income. The commission shall verify income under this section unless the applicant reports a net family income that exceeds the income eligibility level established under Section 62.101(b) or, if applicable, Section 62.101(b-2).

SECTION 4. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.

SECTION 5. This Act takes effect September 1, 2009.