Amend CSSB 23 (house committee printing) by adding the following appropriately numbered SECTION and renumbering subsequent SECTIONS of the bill accordingly:

SECTION ____.  COUNTY ELIGIBILITY TO RECEIVE STATE ASSISTANCE FOR HEALTH CARE EXPENDITURES. (a) Sections 61.037(a) and (b), Health and Safety Code, are amended to read as follows:

(a)  The department may distribute funds as provided by this subchapter to eligible counties to assist the counties in providing:

(1)  health care services under Sections 61.028 and 61.0285 to their eligible county residents; or

(2)  health care services provided by Medicaid as described by Subsection (b)(1).

(b)  Except as provided by Subsection (c), (d), (e), or (g), to be eligible for state assistance, a county must:

(1)  spend in a state fiscal year at least eight percent of the county general revenue levy for that year to provide health care services described by Subsection (a) to its eligible county residents who qualify for assistance under Section 61.023 and may include as part of the county's eight percent expenditure level any payment made by the county for health care services provided through Medicaid, including the county's direct reimbursement to health care providers and indirect reimbursement through transfers of funds to the state for health care services provided through Medicaid; and

(2)  notify the department, not later than the seventh day after the date on which the county reaches the expenditure level, that the county has spent at least six percent of the applicable county general revenue levy for that year to provide health care services described by Subsection (a)(1) [(a)] to its eligible county residents who qualify for assistance under Section 61.023 or health care services provided by Medicaid as described by Subdivision (1).

(b)  Section 61.038, Health and Safety Code, is amended to read as follows:

Sec. 61.038.  DISTRIBUTION OF ASSISTANCE FUNDS. (a) If the department determines that a county is eligible for assistance, the department shall distribute funds appropriated to the department from the indigent health care assistance fund or any other available fund to the county to assist the county in providing:

(1)  health care services under Sections 61.028 and 61.0285 to its eligible county residents who qualify for assistance as described by Section 61.037; or

(2)  health care services provided through Medicaid as described by Section 61.037(b)(1).

(b)  State funds provided under this section to a county must be equal to at least 90 percent of the actual payment for the health care services for the county's eligible residents, including any payments made by the county for health care services provided through Medicaid as described by Section 61.037(b)(1), during the remainder of the state fiscal year after the eight percent expenditure level is reached.