Amend Amendment No. 86 by Zerwas to CSSB 1 (pages 251-252, prefiled amendment packet) by striking the text of the amendment and substituting the following:

Amend CSSB 1 (house committee printing) by adding the following appropriately numbered ARTICLE to the bill and renumbering subsequent ARTICLES and SECTIONS of the bill accordingly:

ARTICLE ____. TEXAS HEALTH OPPORTUNITY POOL TRUST FUND

SECTION ____.01.  (a) Subsections (b), (c), and (d), Section 531.502, Government Code, are amended to read as follows:

(b)  The executive commissioner may include the following federal money in the waiver:

(1)  [all] money provided under the disproportionate share hospitals or [and] upper payment limit supplemental payment program, or both [programs];

(2)  money provided by the federal government in lieu of some or all of the payments under one or both of those programs;

(3)  any combination of funds authorized to be pooled by Subdivisions (1) and (2); and

(4)  any other money available for that purpose, including:

(A)  federal money and money identified under Subsection (c);

(D)  if approved in the waiver, federal money obtained through the use of certified public expenditures.

(c)  The commission shall seek to optimize federal funding by:

(1)  identifying health care related state and local funds and program expenditures that, before September 1, 2011 [2007], are not being matched with federal money; and

(2)  exploring the feasibility of:

(A)  certifying or otherwise using those funds and expenditures as state expenditures for which this state may receive federal matching money; and

(B)  depositing federal matching money received as provided by Paragraph (A) with other federal money deposited as provided by Section 531.504, or substituting that federal matching money for federal money that otherwise would be received under the disproportionate share hospitals and upper payment limit supplemental payment programs as a match for local funds received by this state through intergovernmental transfers.

(d)  The terms of a waiver approved under this section must:

(1)  include safeguards to ensure that the total amount of federal money provided under the disproportionate share hospitals or [and] upper payment limit supplemental payment program [programs] that is deposited as provided by Section 531.504 is, for a particular state fiscal year, at least equal to the greater of the annualized amount provided to this state under those supplemental payment programs during state fiscal year 2011 [2007], excluding amounts provided during that state fiscal year that are retroactive payments, or the state fiscal years during which the waiver is in effect; and

(2)  allow for the development by this state of a methodology for allocating money in the fund to:

(A)  be used to supplement Medicaid hospital reimbursements under a waiver that includes terms that are consistent with, or that produce revenues consistent with, disproportionate share hospital and upper payment limit principles [offset, in part, the uncompensated health care costs incurred by hospitals];

(B)  reduce the number of persons in this state who do not have health benefits coverage; and

(C)  maintain and enhance the community public health infrastructure provided by hospitals.

SECTION ____.02.  Section 531.504, Government Code, is amended to read as follows:

Sec. 531.504.  DEPOSITS TO FUND. (a) The comptroller shall deposit in the fund:

(1)  [all] federal money provided to this state under the disproportionate share hospitals supplemental payment program or [and] the hospital upper payment limit supplemental payment program, or both, other than money provided under those programs to state-owned and operated hospitals, and all other non-supplemental payment program federal money provided to this state that is included in the waiver authorized by Section 531.502; and

(2)  state money appropriated to the fund.

(b)  The commission and comptroller may accept gifts, grants, and donations from any source, and receive intergovernmental transfers, for purposes consistent with this subchapter and the terms of the waiver. The comptroller shall deposit a gift, grant, or donation made for those purposes in the fund. Any intergovernmental transfer received, including associated federal matching funds, shall be used, if feasible, for the purposes intended by the transferring entity and in accordance with the terms of the waiver.

SECTION ____.03.  Section 531.508, Government Code, is amended by adding Subsection (d) to read as follows:

SECTION ____.04.  Subsection (g), Section 531.502, Government Code, is repealed.