By: Coleman H.B. No. 4140
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to issues affecting counties and certain other
  governmental entities and residents.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 264, Health and Safety
  Code, is amended by adding Section 264.004 to read as follows:
         Sec. 264.004.  DISSOLUTION. (a) The commissioners court of
  a county by order may dissolve an authority created by the
  commissioners court if the commissioners court and the authority
  provide for the sale or transfer of the authority's assets and
  liabilities to the county.
         (b)  The dissolution of an authority and the sale or transfer
  of the authority's assets and liabilities may not:
               (1)  violate a trust indenture or bond resolution
  relating to the outstanding bonds of the authority; or
               (2)  diminish or impair the rights of the holders of
  outstanding bonds, warrants, or other obligations of the authority.
         (c)  An order dissolving an authority takes effect on the
  31st day after the date the commissioners court adopts the order.
         (d)  All records of the authority remaining when the
  authority is dissolved shall be transferred to the county clerk of
  the county in which the authority is located.
         SECTION 2.  Subtitle D, Title 4, Health and Safety Code, is
  amended by adding Chapter 291A to read as follows:
  CHAPTER 291A. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
  CERTAIN COUNTIES BORDERING OR INCLUDING THE SAM RAYBURN RESERVOIR
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 291A.001.  DEFINITIONS. In this chapter:
               (1)  "Institutional health care provider" means a
  nonpublic hospital that provides inpatient hospital services.
               (2)  "Paying hospital" means an institutional health
  care provider required to make a mandatory payment under this
  chapter.
               (3)  "Program" means the county health care provider
  participation program authorized by this chapter.
         Sec. 291A.002.  APPLICABILITY. This chapter applies only to
  a county that:
               (1)  is not served by a hospital district or a public
  hospital;
               (2)  has a population of more than 75,000; and
               (3)  borders or includes a portion of the Sam Rayburn
  Reservoir.
         Sec. 291A.003.  COUNTY HEALTH CARE PROVIDER PARTICIPATION
  PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
  provider participation program authorizes a county to collect a
  mandatory payment from each institutional health care provider
  located in the county to be deposited in a local provider
  participation fund established by the county. Money in the fund may
  be used by the county to fund certain intergovernmental transfers
  and indigent care programs as provided by this chapter.
         (b)  The commissioners court of a county may adopt an order
  authorizing a county to participate in the program, subject to the
  limitations provided by this chapter.
  SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
         Sec. 291A.051.  LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
  PAYMENT. The commissioners court of a county may require a
  mandatory payment authorized under this chapter by an institutional
  health care provider in the county only in the manner provided by
  this chapter.
         Sec. 291A.052.  MAJORITY VOTE REQUIRED. The commissioners
  court of a county may not authorize the county to collect a
  mandatory payment authorized under this chapter without an
  affirmative vote of a majority of the members of the commissioners
  court.
         Sec. 291A.053.  RULES AND PROCEDURES. After the
  commissioners court of a county has voted to require a mandatory
  payment authorized under this chapter, the commissioners court may
  adopt rules relating to the administration of the mandatory
  payment.
         Sec. 291A.054.  INSTITUTIONAL HEALTH CARE PROVIDER
  REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
  county that collects a mandatory payment authorized under this
  chapter shall require each institutional health care provider to
  submit to the county a copy of any financial and utilization data
  required by and reported to the Department of State Health Services
  under Sections 311.032 and 311.033 and any rules adopted by the
  executive commissioner of the Health and Human Services Commission
  to implement those sections.
         (b)  The commissioners court of a county that collects a
  mandatory payment authorized under this chapter may inspect the
  records of an institutional health care provider to the extent
  necessary to ensure compliance with the requirements of Subsection
  (a).
  SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
         Sec. 291A.101.  HEARING. (a) Each year, the commissioners
  court of a county that collects a mandatory payment authorized
  under this chapter shall hold a public hearing on the amounts of any
  mandatory payments that the commissioners court intends to require
  during the year and how the revenue derived from those payments is
  to be spent.
         (b)  Not later than the 10th day before the date of the
  hearing required under Subsection (a), the commissioners court of
  the county shall publish notice of the hearing in a newspaper of
  general circulation in the county.
         (c)  A representative of a paying hospital is entitled to
  appear at the time and place designated in the public notice and to
  be heard regarding any matter related to the mandatory payments
  authorized under this chapter.
         Sec. 291A.102.  DEPOSITORY. (a) The commissioners court of
  each county that collects a mandatory payment authorized under this
  chapter by resolution shall designate one or more banks located in
  the county as the depository for mandatory payments received by the
  county. A bank designated as a depository serves for two years or
  until a successor is designated.
         (b)  All income received by a county under this chapter,
  including the revenue from mandatory payments remaining after
  discounts and fees for assessing and collecting the payments are
  deducted, shall be deposited with the county depository in the
  county's local provider participation fund and may be withdrawn
  only as provided by this chapter.
         (c)  All funds under this chapter shall be secured in the
  manner provided for securing county funds.
         Sec. 291A.103.  LOCAL PROVIDER PARTICIPATION FUND;
  AUTHORIZED USES OF MONEY. (a) Each county that collects a mandatory
  payment authorized under this chapter shall create a local provider
  participation fund.
         (b)  The local provider participation fund of a county
  consists of:
               (1)  all revenue received by the county attributable to
  mandatory payments authorized under this chapter, including any
  penalties and interest attributable to delinquent payments;
               (2)  money received from the Health and Human Services
  Commission as a refund of an intergovernmental transfer from the
  county to the state for the purpose of providing the nonfederal
  share of Medicaid supplemental payment program payments, provided
  that the intergovernmental transfer does not receive a federal
  matching payment; and
               (3)  the earnings of the fund.
         (c)  Money deposited to the local provider participation
  fund may be used only to:
               (1)  fund intergovernmental transfers from the county
  to the state to provide the nonfederal share of a Medicaid
  supplemental payment program authorized under the state Medicaid
  plan, including through the Medicaid managed care program, under
  the Texas Healthcare Transformation and Quality Improvement
  Program waiver issued under Section 1115 of the federal Social
  Security Act (42 U.S.C. Section 1315), or under a successor waiver
  program authorizing similar Medicaid supplemental payment
  programs;
               (2)  subsidize indigent programs;
               (3)  pay the administrative expenses of the county
  solely for activities under this chapter;
               (4)  refund a portion of a mandatory payment collected
  in error from a paying hospital; and
               (5)  refund to paying hospitals the proportionate share
  of money received by the county from the Health and Human Services
  Commission that is not used to fund the nonfederal share of Medicaid
  supplemental payment program payments.
         (d)  Money in the local provider participation fund may not
  be commingled with other county funds.
         (e)  An intergovernmental transfer of funds described by
  Subsection (c)(1) and any funds received by the county as a result
  of an intergovernmental transfer described by that subsection may
  not be used by the county or any other entity to expand Medicaid
  eligibility under the Patient Protection and Affordable Care Act
  (Pub. L. No. 111-148) as amended by the Health Care and Education
  Reconciliation Act of 2010 (Pub. L. No. 111-152).
  SUBCHAPTER D. MANDATORY PAYMENTS
         Sec. 291A.151.  MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
  NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
  commissioners court of a county that collects a mandatory payment
  authorized under this chapter may require an annual mandatory
  payment to be assessed on the net patient revenue of each
  institutional health care provider located in the county. The
  commissioners court may provide for the mandatory payment to be
  assessed quarterly. In the first year in which the mandatory
  payment is required, the mandatory payment is assessed on the net
  patient revenue of an institutional health care provider as
  determined by the data reported to the Department of State Health
  Services under Sections 311.032 and 311.033 in the fiscal year
  ending in 2015 or, if the institutional health care provider did not
  report any data under those sections in that fiscal year, as
  determined by the institutional health care provider's Medicare
  cost report submitted for the 2015 fiscal year or for the closest
  subsequent fiscal year for which the provider submitted the
  Medicare cost report. The county shall update the amount of the
  mandatory payment on an annual basis.
         (b)  The amount of a mandatory payment authorized under this
  chapter must be uniformly proportionate with the amount of net
  patient revenue generated by each paying hospital in the county. A
  mandatory payment authorized under this chapter may not hold
  harmless any institutional health care provider, as required under
  42 U.S.C. Section 1396b(w).
         (c)  The commissioners court of a county that collects a
  mandatory payment authorized under this chapter shall set the
  amount of the mandatory payment. The amount of the mandatory
  payment required of each paying hospital may not exceed an amount
  that, when added to the amount of the mandatory payments required
  from all other paying hospitals in the county, equals an amount of
  revenue that exceeds six percent of the aggregate net patient
  revenue of all paying hospitals in the county.
         (d)  Subject to the maximum amount prescribed by Subsection
  (c), the commissioners court of a county that collects a mandatory
  payment authorized under this chapter shall set the mandatory
  payments in amounts that in the aggregate will generate sufficient
  revenue to cover the administrative expenses of the county for
  activities under this chapter, to fund the nonfederal share of a
  Medicaid supplemental payment program as described by Section
  291A.103(c)(1), and to pay for indigent programs, except that the
  amount of revenue from mandatory payments used for administrative
  expenses of the county for activities under this chapter in a year
  may not exceed the lesser of four percent of the total revenue
  generated from the mandatory payment or $20,000.
         (e)  A paying hospital may not add a mandatory payment
  required under this section as a surcharge to a patient.
         Sec. 291A.152.  ASSESSMENT AND COLLECTION OF MANDATORY
  PAYMENTS. The county may collect or contract for the assessment and
  collection of mandatory payments authorized under this chapter.
         Sec. 291A.153.  INTEREST, PENALTIES, AND DISCOUNTS.
  Interest, penalties, and discounts on mandatory payments required
  under this chapter are governed by the law applicable to county ad
  valorem taxes.
         Sec. 291A.154.  PURPOSE; CORRECTION OF INVALID PROVISION OR
  PROCEDURE. (a) The purpose of this chapter is to generate revenue by
  collecting from institutional health care providers a mandatory
  payment to be used to provide the nonfederal share of a Medicaid
  supplemental payment program.
         (b)  To the extent any provision or procedure under this
  chapter causes a mandatory payment authorized under this chapter to
  be ineligible for federal matching funds, the county may provide by
  rule for an alternative provision or procedure that conforms to the
  requirements of the federal Centers for Medicare and Medicaid
  Services.
         SECTION 3.  Subchapter C, Chapter 775, Health and Safety
  Code, is amended by adding Section 775.0341 to read as follows:
         Sec. 775.0341.  APPOINTMENT OF BOARD IN CERTAIN DISTRICTS
  LOCATED IN MORE THAN ONE COUNTY. (a) This section applies only to a
  district that was authorized to have a board of emergency services
  commissioners appointed under former Section 776.0345 and that is
  located:
               (1)  partly in a county with a population of less than
  22,000; and
               (2)  partly in a county with a population of more than
  54,000.
         (b)  A five-member board of emergency services commissioners
  appointed under this section serves as the district's governing
  body. A commissioner serves a two-year term.
         (c)  The commissioners court of the smallest county in which
  the district is located shall appoint two commissioners to the
  board. The commissioners court of the largest county in which the
  district is located shall appoint three commissioners to the board.
         (d)  To be eligible for appointment as an emergency services
  commissioner under this section, a person must be at least 18 years
  of age and reside in the district. Two commissioners must reside in
  the smallest county in which the district is located, and three
  commissioners must reside in the largest county in which the
  district is located.
         (e)  On January 1 of each year, a commissioners court shall
  appoint a successor for each emergency services commissioner
  appointed by that commissioners court whose term has expired.
         (f)  The appropriate commissioners court shall fill a
  vacancy on the board for the remainder of the unexpired term.
         SECTION 4.  Section 775.035, Health and Safety Code, is
  amended by adding Subsection (j) to read as follows:
         (j)  This section does not apply to a district described by
  Section 775.0341.
         SECTION 5.  Section 775.036, Health and Safety Code, is
  amended by adding Subsection (a-1) to read as follows:
         (a-1)  Notwithstanding Subsection (a)(1), the board for a
  district located wholly in a county with a population of 75,000 or
  less may by resolution determine to hold the board's regular
  meetings less frequently than prescribed by that subsection. The
  resolution must require the board to meet either quarterly or every
  other month. The board shall meet as required by the resolution.
         SECTION 6.  Subchapter Z, Chapter 271, Local Government
  Code, is amended by adding Section 271.909 to read as follows:
         Sec. 271.909.  PURCHASES: DEVICES THAT UTILIZE ELECTRONIC
  CAPTURE. As it relates to purchases by local governmental entities
  and notwithstanding any provision under Texas law, devices that
  utilize electronic capture to produce a physical record shall be
  considered interchangeable with devices that utilize electronic
  capture to produce an electronic record.
         SECTION 7.  Section 81.001(b), Local Government Code, is
  amended to read as follows:
         (b)  If present, the county judge is the presiding officer of
  the commissioners court. This subsection does not apply to a
  meeting held under Section 551.127, Government Code, if the county
  judge is not located at the physical space made available to the
  public for the meeting.
         SECTION 8.  (a) All governmental acts and proceedings of an
  emergency services district to which former Section 776.0345,
  Health and Safety Code, applied before that section was repealed
  and that relate to the selection of emergency services
  commissioners of the district and that were taken between January
  1, 2012, and the effective date of this Act are validated, ratified,
  and confirmed in all respects as if they had been taken as
  authorized by law.
         (b)  This section does not apply to any matter that on the
  effective date of this Act:
               (1)  is involved in litigation if the litigation
  ultimately results in the matter being held invalid by a final court
  judgment; or
               (2)  has been held invalid by a final court judgment.
         SECTION 9.  Section 250.006(b), Local Government Code, is
  repealed.
         SECTION 10.  If before implementing any provision of Chapter
  291A, Health and Safety Code, as added by 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 11.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect September 1, 2021.