SRC-TJG, LBB, VRA, TJG H.B. 2292 78(R)   BILL ANALYSIS


Senate Research Center   H.B. 2292
By: Wohlgemuth (Nelson)
Finance
5/8/2003
Engrossed


DIGEST AND PURPOSE 

To achieve the cost savings and revenue necessary to finance certain
health and human services, H.B. 2292 implements changes in health and
human service policy necessary to ensure that Texas continues to serve its
citizens who are most in need of health and human service assistance.
This bill also reorganizes and consolidates the health and human service
agencies, requires additional rebates for drug manufacturers purchasing
drugs under health and human service programs, increases fraud detection
and recovery, reforms the regulatory burden on providers of health and
human services, and consolidates certain transportation services and
enacts many other measures that are necessary to deal with the current
budget crisis. 

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the commissioner of health
and human services in SECTION 1.03 (Section 531.0055, Government Code),
SECTION 1.06 (Section 531.0163, Government Code), SECTION 1.08 (Sections
531.409, 531.429, and 531.449, Government Code), SECTION 1.09 (Sections
1001.028, 1001.052, and 1001.075, Health and Safety Code), SECTION 1.13
(Sections 161.028, 161.052, and 161.073, Human Resources Code), and
SECTION 2.25 (Section 231.113, Government Code) of this bill.  Rulemaking
authority is transferred to the commissioner of health and human services
in SECTION 1.03 (Section 531.0055, Government Code) of this bill. 

Rulemaking authority is expressly granted to the Health and Human Services
Commission in SECTION 1.07 (Section 531.0224, Government Code), SECTION
2.04 (Section 531.0335, Government Code), SECTION 2.06 (Section 531.063,
Government Code), SECTION 2.15 (Section 531.074, Government Code), SECTION
2.26 (Section 531.114, Government Code), and SECTION 2.93 (Section 32.028,
Human Resources Code) of this bill. 

Rulemaking authority is expressly granted to the Texas Department of Human
Services in SECTION 2.81 (Section 31.0032, Human Resources Code), SECTION
2.96 (Section 32.0321, Human Resources Code), and SECTION 2.98 (Section
32.0462, Human Resources Code) of this bill. 

Rulemaking authority is expressly granted to the Texas Department of
Mental Health and Retardation in SECTION 2.71 (Section 533.0355, Health
and Safety Code), to the Interagency Council on Early Childhood
Interaction in SECTION 2.105 (Section 73.0051, Human Resources Code), to
the Secretary of State in SECTION 2.109 (Section 33.158, Family Code), and
to the Texas State Board of Pharmacy in SECTION 2.117 (Section 562.1085,
Occupations Code) of this bill. 

Rulemaking authority is transferred to the commissioner of the Department
of Protective and Regulatory Services in SECTION 1.11 (Section 40.02,
Human Resources Code), to the Health and Human Services Commission in
SECTION 1.18, to the Department of Protective Services in SECTIONS 1.19
and 1.20, and to the Department of Supportive Services in SECTION 1.21 of
this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.01.  (a) Amends Section 531.001(4), Government Code, as amended
by Chapters  53, 957, and 1420, Acts of the 77th Legislature, Regular
Session, 2001, to reenact and amend it to add the Department of Supportive
Services and the Department of Health Services to the definition of
"health and human services agencies," and to reference the Department of
Protective Services rather than the Department of Protective and
Regulatory Services. 

(b) Amends Section 531.001(4), Government Code, as amended by Chapters 53,
957, and 1420, Acts of the 77th Legislature, Regular Session, 2001, to
reenact and amend it to redefine "health and human services agencies"
effective on the date the agencies listed in Section 1.25 of this article
are abolished as provided by that section. 
  
SECTION 1.02.  Amends Section 531.004, Government Code, to continue the
Health and Human Services Commission (HHSC) until September 1, 2009,
rather than 2007. 

SECTION 1.03.  Amends Section 531.0055, Government Code, as follows:

Sec. 531.0055.  New heading: COMMISSIONER:  GENERAL RESPONSIBILITY FOR
HEALTH AND HUMAN SERVICES AGENCIES.  (a) Redefines "agency director."
Deletes definition of "policymaking body." 
 
(b) Requires HHSC to take certain actions.
 
(c) Deletes existing text relating to the implementation of HHSC's duties
under Subsection (b) and existing text relating to certain sections as
added by Chapter 1045, Acts of the 75th Legislature, Regular Session,
1997.  Makes a nonsubtantive change. 
 
(d) Requires HHSC to plan and implement an efficient and effective
centralized system of administrative support services for health and human
services agencies. Provides that the performance of administrative support
services for health and human services agencies is the responsibility of
HHSC.  Provides that the term "administrative support services" includes,
but is not limited to, strategic planning and evaluation, audit, legal,
human resources, information resources, purchasing, contract management,
financial management, and accounting services. 
 
(e) Requires the commissioner of health and human services,
notwithstanding any other law, to adopt rules and policies for the
operation of and provision of health and human services by the health and
human services agencies.  Requires the commissioner of health and human
services, in addition and as necessary to perform the functions described
by Subsections (b), (c), and (d) in implementation of applicable, policies
established for an agency by the commissioner of health and human
services, rather than each agency's policymaking body, to perform certain
functions. 
  
(f) Provides that the operational authority and responsibility of the
commissioner of health and human services for purposes of Subsection (e)
at each health and human services agency includes authority over and
responsibility for certain actions, policies, and systems. 
  
(g) Provides that notwithstanding any other law, the operational authority
and responsibility of the commissioner of health and human services for
purposes of Subsection (e) at each health and human services agency
includes the authority and responsibility to adopt or approve, subject to
applicable limitations, any rate of payment or similar provision required
by law to be adopted or approved by the agency. 
 
(h) No change to this subsection.
 
(i) Provides that the agency director acts on behalf of the commissioner
of health and human services in performing the delegated function and
reports to the  commissioner of health and human services regarding the
delegated function and any matter affecting agency programs and
operations. 

(j) Requires, rather than authorizes, the commissioner of health and human
services to adopt rules to implement the commissioner's authority under
this section. 
 
(k) Requires the commissioner of health and human services and each agency
director to enter into a memorandum of understanding in the manner
prescribed by Section 531.0163 that clearly defines certain
responsibilities of the agency director and the commissioner of health and
human services. 
   
(l) Provides that the commissioner of health and human services, rather
than a policymaking body, has the authority to adopt policies and rules
governing the delivery of services to persons who are served by each
health and human services agency and the rights and duties of persons who
are served or regulated by each agency, notwithstanding any other law.
Deletes existing text relating to requiring the commissioner of health and
human services and each policymaking body to enter into a memorandum of
understanding that clearly defines the policymaking authority of the
policymaking body and the operational authority of the commissioner of
health and human services. 

SECTION 1.04.  Amends Section 531.0056, Government Code, as follows:

Sec. 531.0056.  New heading: APPOINTMENT OF AGENCY DIRECTOR BY GOVERNOR.
(a) Requires the governor to appoint an agency director for each health
and human services agency.  Deletes existing text relating to this section
only applying to an agency director employed by the commissioner of health
and human services. 

(b) Requires the agency director to serve for a term of one year.  Deletes
existing text relating to authorizing an agency director employed by the
commissioner of health and human services to be employed only with the
concurrence of the agency's policymaking body and the approval of the
governor. 

(c) Requires the memorandum of understanding required by that section to
clearly define the responsibilities of the agency director, in addition to
the requirements of Section 531.0055(k)(1).  Deletes existing text
relating to requiring the commissioner of health and human services and
agency director to enter into a memorandum of understanding and authorizes
establishing certain terms and conditions.  

 (d) Makes conforming changes.

(f) Requires the commissioner of health and human services to submit the
evaluation to the governor not later than January 1 of each even numbered
year. Deletes existing text relating to the commissioner of health and
human services submitting any recommendation regarding employment of the
agency director. Deletes existing Subsections (g) and (h). 

SECTION 1.05.  Amends Section 531.008, Government Code, as follows:
 
(a)-(b) Make conforming and nonsubstantive changes.

(c) Requires the commissioner of health and human services to establish
certain divisions and offices within HHSC. 

SECTION 1.06.  Amends Subchapter A, Chapter 531, Government Code, by
adding Sections 531.0161, 531.0162, and 531.0163 as follows: 

 Sec. 531.0161.  NEGOTIATED RULEMAKING AND ALTERNATIVE DISPUTE PROCEDURES.
(a) and (b)  Apply standard Sunset language regarding negotiated
rulemaking and alternate dispute procedures.  

Sec. 531.0162.  USE OF TECHNOLOGY.  (a) Applies standard Sunset language
regarding the use of technology. 
  
(b) Requires HHSC to develop and implement a policy described by
Subsection (a) in relation to HHSC's functions. 

Sec. 531.0163.  MEMORANDUM OF UNDERSTANDING.  (a) Requires the memorandum
of understanding under Section 531.0055(k) to be adopted by the
commissioner of health and human services, by rule, in accordance with the
procedures prescribed by Subchapter B, Chapter 2001, for adopting rules,
except that the requirements of Section 2001.033(a)(1)(A) or (C) do not
apply with respect to any part of the memorandum of understanding that
concerns only internal management or organization within or among health
and human services agencies and does not affect private rights or
procedures or relates solely to the internal personnel practices of health
and human services agencies. 

  (b) Authorizes the memorandum of understanding to be amended only by
following the procedures prescribed under Subsection (a). 

SECTION 1.07.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.0224, as follows: 
 
Sec. 531.0224.  PLANNING AND POLICY DIRECTION OF TEMPORARY ASSISTANCE FOR
NEEDY FAMILIES PROGRAM.  Requires HHSC to take certain actions, including
adopting rules and standards governing the financial assistance program
under Chapter 31, Human Resources Code (Financial Assistance and Service
Programs), in consultation with the policy councils of the agencies that
operate the program, including rules for determining eligibility for and
the amount and duration of an earned income disregard. 
   
SECTION 1.08.  Amends Chapter 531, Government Code, by adding Subchapters
K, L, and M as follows: 

SUBCHAPTER K.  HEALTH AND HUMAN SERVICES COUNCIL

 Sec. 531.401.  DEFINITION.  Defines "council."
 
Sec. 531.402.  HEALTH AND HUMAN SERVICES COUNCIL.  (a) Provides that the
Health and Human Services Council (council) is created to assist the
commissioner of health and human services in developing rules and policies
for HHSC. 
 
(b) Provides that the council is composed of nine members of the public
appointed by the governor with the advice and consent of the senate.
Requires a person, to be eligible for appointment to the council, to have
demonstrated an interest in and knowledge of problems and available
services related to the child health plan program, the financial
assistance program under Chapter 31, Human Resources Code, the medical
assistance program under Chapter 32 (Medical Assistance Programs), Human
Resources Code, or the nutritional assistance programs under Chapter 33
(Nutritional Assistance Programs), Human Resources Code. 

(c) Requires the council to study and make recommendations to the
commissioner of health and human services regarding the management and
operation of HHSC, including policies and rules governing the delivery of
services to persons who are served by HHSC and the rights and duties of
persons who are served or regulated by HHSC. 
 
(d) Provides that Chapter 551 (Open Meetings), Government Code, applies to
the council. 

(e) Provides that Chapter 2110 (State Agency Advisory Committees),
Government Code, does not apply to the council. 

(f) Provides that a majority of the members of the council constitute a
quorum for the transaction of business. 

Sec. 531.403.  APPOINTMENTS.  (a) and (b) Applies standard Sunset language
regarding appointments. 

Sec. 531.404.  TRAINING PROGRAM FOR COUNCIL MEMBERS.  (a) and (b) Applies
standard Sunset language regarding a training program for council members. 
  
Sec. 531.405.  TERMS.  Sets forth the terms for council members.

 Sec. 531.406.  VACANCY.  Requires the governor by appointment to fill the
unexpired  term of a vacancy on the council. 

Sec. 531.407.  PRESIDING OFFICER; OTHER OFFICERS; MEETINGS.  (a) - (c)
Apply standard Sunset language regarding the presiding officer, other
officers, and meetings.  
 
Sec. 531.408.  REIMBURSEMENT FOR EXPENSES.  Applies standard Sunset
language regarding reimbursement for expenses of council members. 

Sec. 531.409.  PUBLIC INTEREST INFORMATION AND COMPLAINTS.  Applies
standard Sunset language regarding public interest information and
complaints.   

Sec. 531.410.  PUBLIC ACCESS AND TESTIMONY. Applies standard Sunset
language regarding public access and testimony. 

Sec. 531.411.  POLICYMAKING AND MANAGEMENT RESPONSIBILITIES. Applies
standard Sunset language regarding the delineation of policymaking and
management responsibilties. 

[Reserves Sections 531.412-531.420 for expansion.]

SUBCHAPTER L.  COUNCIL FOR THE BLIND, DEAF,  AND HARD OF HEARING

 Sec. 531.421.  DEFINITION.  Defines "council."

Sec. 531.422.  COUNCIL FOR THE BLIND, DEAF, AND HARD OF HEARING.  (a)
Provides that the Council for the Blind, Deaf, and Hard of Hearing
(council) is created to advise the commissioner of health and human
services and the offices for the blind and for the deaf and hard of
hearing regarding programs and services for those populations. 

(b) Provides that the council is composed of nine members of the public
appointed by the governor.  Requires a person, to be eligible for
appointment to the council, to have demonstrated an interest in and
knowledge of problems and available services for persons who are blind,
deaf, or hard of hearing. 

 (c) Provides that Chapter 551 (Open Meetings) applies to the council.

(d) Provides that Chapter 2110 (State Agency Advisory Committees) does not
apply to the council. 

Sec. 531.423.  APPOINTMENTS.  (a)  Applies standard Sunset language
regarding  appointments to the council. 

Sec. 531.424.  TRAINING PROGRAM FOR COUNCIL MEMBERS.  (a) Applies standard
Sunset language regarding a training program for council members. 
  
Sec. 531.425.  TERMS.  Applies standard Sunset language regarding terms of
council members. 

Sec. 531.426.  VACANCY.  Requires the governor by appointment to fill the
unexpired term of a vacancy on the council. 

Sec. 531.427.  PRESIDING OFFICER; OTHER OFFICERS; MEETINGS.  Applies
standard Sunset language regarding the presiding officer, other officers,
and meetings. 

Sec. 531.428.  REIMBURSEMENT FOR EXPENSES.  Applies standard Sunset
language regarding reimbursement for expenses for council members. 

Sec. 531.429.  PUBLIC INTEREST INFORMATION AND COMPLAINTS.  Applies
standard Sunset language regarding public interest information and
complaints. 

Sec. 531.430.  PUBLIC ACCESS AND TESTIMONY.  Applies standard Sunset
language regarding public access and testimony. 

Sec. 531.431.  POLICYMAKING AND MANAGEMENT RESPONSIBILITIES. Applies
standard Sunset language regarding the delineation of policymaking and
management responsiblities. 

[Reserves Sections 531.432-531.440 for expansion.]

SUBCHAPTER M.  REHABILITATION COUNCIL

 Sec. 531.441.  DEFINITION.  Defines "council."

Sec. 531.442.  REHABILITATION COUNCIL.  (a) Provides that the
Rehabilitation Council (council) is created to advise the commissioner of
health and human services and the office of rehabilitation services
regarding programs and services for persons with disabilities other than
developmental delay and mental retardation. 

(b) Sets forth the composition of and eligibility for the council.

 (c)  Provides that Chapter 551 (Open Meetings) applies to the council.

(d)  Provides that Chapter 2110 (State Agency Advisory Committees) does
not apply to the council. 

Sec. 531.443.  APPOINTMENTS.  Applies standard Sunset language regarding
appointments to the council. 

Sec. 531.444.  TRAINING PROGRAM FOR COUNCIL MEMBERS.  Applies standard
Sunset language regarding a training program for council members. 
  
Sec. 531.445.  TERMS.  Sets forth the terms of council members.

Sec. 531.446.  VACANCY.  Requires the governor by appointment to fill the
unexpired term of a vacancy on the council. 

Sec. 531.447.  PRESIDING OFFICER; OTHER OFFICERS; MEETINGS.  (a) -(c)
Applies standard Sunset language regarding the presiding officer, other
officers, and meetings. 
 
Sec. 531.448.  REIMBURSEMENT FOR EXPENSES. Applies standard Sunset
language regarding reimbursement for expenses for council members. 

Sec. 531.449.  PUBLIC INTEREST INFORMATION AND COMPLAINTS.  Applies
standard Sunset language regarding public interest information and
complaints.   

Sec. 531.450.  PUBLIC ACCESS AND TESTIMONY. Applies standard Sunset
language regarding public access and testimony. 

Sec. 531.451.  POLICYMAKING AND MANAGEMENT RESPONSIBILITIES. Applies
standard Sunset language regarding the delineation of the policymaking and
management responsibilities. 

SECTION 1.09.  Amends the Health and Safety Code by adding Title 12 as
follows: 

TITLE 12.  HEALTH AND MENTAL HEALTH

CHAPTER 1001.  DEPARTMENT OF HEALTH SERVICES

SUBCHAPTER A.  GENERAL PROVISIONS

 Sec. 1001.001.  DEFINITIONS.  Defines "commission," "commissioner,"
"council," and  "department." 
  
Sec. 1001.002.  AGENCY.  Provides that the Department of Health Services
(department) is an agency of the state. 

Sec. 1001.003.  SUNSET PROVISION.  Continues the Department of Health
Services until September 1, 2009. 

[Reserves Sections 1001.004-1001.020 for expansion.]

SUBCHAPTER B.  ADMINISTRATIVE PROVISIONS

Sec. 1001.021.  HEALTH SERVICES COUNCIL.  (a)  Provides that the Health
Services Council (council) is created to assist the commissioner of health
and human services in developing rules and policies for the department. 

(b) Sets forth the composition of and eligibility for the council.

(c) Requires the council to study and make recommendations to the
commissioner of health and human services regarding the management and
operation of the department, including policies and rules governing the
delivery of services to persons who are served by the department and the
rights and duties of persons who are served or regulated by the
department. 

(d) Provides that Chapter 551 (Open Meetings), Government Code, applies to
the council. 

(e) Provides that Chapter 2110 (State Agency Advisory Committees),
Government Code, does not apply to the council. 

(f) Provides that a majority of the members of the council constitute a
quorum for the transaction of business. 

Sec. 1001.022.  APPOINTMENTS.  Applies standard Sunset language regarding
appointments. 

 Sec. 1001.023.  TRAINING PROGRAM FOR COUNCIL MEMBERS.  Applies standard
Sunset language regarding a training program for council members. 
   
Sec. 1001.024.  TERMS.  Sets forth the terms of council members.

Sec. 1001.025.  VACANCY.  Requires the governor by appointment to fill the
unexpired term of a vacancy on the council. 

Sec. 1001.026.  PRESIDING OFFICER; OTHER OFFICERS; MEETINGS.  (a) - (c)
Applies standard Sunset language regarding the presiding officer, other
officers, and meetings. 

Sec. 1001.027.  REIMBURSEMENT FOR EXPENSES. Applies standard Sunset
language regarding reimbursement for expenses of council members. 

Sec. 1001.028.  PUBLIC INTEREST INFORMATION AND COMPLAINTS.  Applies
standard Sunset language regarding public interest information and
complaints. 

Sec. 1001.029.  PUBLIC ACCESS AND TESTIMONY.  (a) - (b) Applies standard
Sunset language regarding public access and testimony. 

(c) Requires the commissioner of health and human services to consider
fully all written and oral submissions about a proposed rule. 

Sec. 1001.030.  POLICYMAKING AND MANAGEMENT RESPONSIBILITIES. Applies
standard Sunset language regarding the delineation of policymaking and
management responsibilities. 

Sec. 1001.031.  ANNUAL REPORT.  (a) Requires the commissioner of health
services to file annually with the governor, the presiding officer of each
house of the legislature, and the commissioner of health services a
complete and detailed written report accounting for all funds received and
disbursed by the department during the preceding fiscal year. 

(b) Requires the annual report to be in the form and be reported in the
time provided by the General Appropriations Act. 

Sec. 1001.032.  OFFICES.  Requires the department to maintain its central
office in Austin. Authorizes the department to maintain offices in other
areas of the state as necessary. 

[Reserves Sections 1001.033-1001.050 for expansion.]

SUBCHAPTER C.  PERSONNEL

Sec. 1001.051.  COMMISSIONER.  (a) Requires the governor to appoint a
commissioner of the department.  Provides that the commissioner of the
Department of Health Services (DHS commissioner) is to be selected
according to education, training, experience, and demonstrated ability. 

 (b) Provides that the DHS commissioner serves for a term of one year.

(c) Requires the DHScommissioner, subject to the control of the
commissioner of health and human services, to act as the department's
chief administrative officer and as a liaison between the department and
HHSC. 

(d) Requires the DHS commissioner to administer this chapter under
operational policies established by the commissioner of health and human
services and in accordance with the memorandum of understanding under
Section 531.0055(k), Government Code, between the DHS commissioner and the
commissioner of  health and human services, as adopted by rule. 

Sec. 1001.052.  PERSONNEL.  Applies standard Sunset language regarding
personnel. 

Sec. 1001.053.  INFORMATION ABOUT QUALIFICATIONS AND STANDARDS OF CONDUCT.
Applies standard Sunset language regarding information about
qualifications of conduct. 

Sec. 1001.054.  MERIT PAY. Applies standard Sunset language regarding
merit pay. 

Sec. 1001.055.  CAREER LADDER. Applies standard Sunset language regarding
a career ladder. 

Sec. 1001.056.  EQUAL EMPLOYMENT OPPORTUNITY POLICY.  Applies standard
Sunset language regarding an equal employment and opportunity policy. 

Sec. 1001.057.  STATE EMPLOYEE INCENTIVE PROGRAM. Applies standard Sunset
language regarding a state employee incentive program. 

[Reserves Sections 1001.058-1001.070 for expansion.]

SUBCHAPTER D.  POWERS AND DUTIES OF DEPARTMENT

Sec. 1001.071.  GENERAL POWERS AND DUTIES OF DEPARTMENT RELATED TO HEALTH
CARE.  Provides that the department is responsible for administering
certain human services programs regarding the public health. 

Sec. 1001.072.  GENERAL POWERS AND DUTIES OF DEPARTMENT RELATED TO MENTAL
HEALTH.  Provides that the department is responsible for administering
certain human services programs regarding mental health. 

Sec. 1001.073.  GENERAL POWERS AND DUTIES OF DEPARTMENT RELATED TO
SUBSTANCE ABUSE.  Provides that the department is responsible for
administering certain human services programs regarding substance. 

Sec. 1001.074.  INFORMATION REGARDING COMPLAINTS.  (a) Requires the
department to maintain a file on each written complaint filed with the
department. Requires the file to include certain information. 

(b) Requires the department to provide to the person filing the complaint
and to each person who is a subject of the complaint a copy of the
commissioner of health and human services' and the department's policies
and procedures relating to complaint investigation and resolution. 

(c) Requires the department, at least quarterly until final disposition of
the complaint, to notify the person filing the complaint and each person
who is a subject of the complaint of the status of the investigation
unless the notice would jeopardize an undercover investigation. 

Sec. 1001.075.  RULES.  Authorizes the commissioner of health and human
services to adopt rules reasonably necessary for the department to
administer this chapter, consistent with the memorandum of understanding
under Section 531.0055(k), Government Code, between the DHS commissioner
and the commissioner of health and human services, as adopted by rule. 

SECTION 1.10.  Amends Section 40.001, Human Resources Code, by adding
Subdivision (2-a) and amending Subdivision (4) to define "council" and
"commissioner." 

SECTION 1.11.  Amends Section 40.002, Human Resources Code, as follows:
  
Sec. 40.002.  New heading: DEPARTMENT OF PROTECTIVE SERVICES;    GENERAL
DUTIES OF DEPARTMENT.  (a) Provides that the Department of Protective
Services (department), rather than DPRS,  is composed of the council,
rather than board, the commissioner, rather than the executive director,
an administrative staff, and other officers and employees necessary to
efficiently carry out the purposes of this chapter. 
 
(b)  Requires the department,  notwithstanding any other law, to perform
certain tasks. 
  
(c) Provides that the department is the state agency designated to
cooperate with the federal government in the administration of programs
under certain federal guidelines. 
  
(d)  Requires the department to cooperate with the United States
Department of Health and Human Services and other federal and state
agencies in a reasonable manner and in conformity with the provisions of
federal law and this subtitle to the extent necessary to qualify for
federal assistance in the delivery of services. 
 
(e)  Authorizes the commissioner of protective services (DPS
commissioner), rather than the department,  if the department determines
that a provision of state law governing the department conflicts with a
provision of federal law, to adopt policies and rules necessary to allow
the state to receive and spend federal matching funds to the fullest
extent possible in accordance with the federal statutes, this subtitle,
and the state constitution and within the limits of appropriated funds. 
 
SECTION 1.12.  Amends Sections 40.004, 40.021, 40.022, 40.0226, 40.024,
40.025, 40.026, and 40.027, Human Resources Code, as follows: 
 
Sec. 40.004.  New heading:  PUBLIC INTEREST INFORMATION AND PUBLIC ACCESS.
(a)-(d)  Applies standard Sunset language regarding public interest
information and public access. 
 
Sec. 40.021.  New heading:  PROTECTIVE SERVICES COUNCIL.  (a)  Provides
that the Protective Services Council (council) is created to assist the
DPS commissioner in developing rules and policies for the department. 
 
  (b)  Sets forth the composition of and eligibility for council members. 
 
(c)  Requires the council to study and make recommendations to the DPS
commissioner regarding the management and operation of the department,
including policies and rules governing the delivery of services to persons
who are served by the department and the rights and duties of persons who
are served or regulated by the department. 
 
(d)  Provides that Chapter 551 (Open Meetings), Government Code, applies
to the council. 
 
(e)  Provides that Chapter 2110 (State Agency Advisory Committees),
Government Code, does not apply to the council. Deletes requirement of the
board to appoint without regard to race, color, disability, sex, religion,
age, or national origin. 
 
  (f)  Provides that a majority of the members of the council constitute a
quorum for   the transaction of business. 
 
Sec. 40.022.  New heading:  APPOINTMENTS  (a) and (b)  Applies standard
Sunset  language regarding appointments to the council. 

Sec. 40.0226.  New heading:  TRAINING PROGRAM FOR COUNCIL MEMBERS. Applies
standard Sunset language regarding a training program for council members.

Sec. 40.024.  New heading:  TERMS;  VACANCY.  (a)  Provides that members
of the council, rather than board, serve for staggered six-year terms,
with the terms of three members, rather than two members, expiring
February 1 of each odd-numbered year. 

(b)  Prohibits a member of the council from serving more than two
consecutive full terms as a council member. 
 
(c)  Requires the governor by appointment to fill the unexpired term of a
vacancy on the council. 
 
Sec. 40.025.  New heading:  REIMBURSEMENT FOR EXPENSES. Applies standard
Sunset language regarding reimbursement for expenses of council members. 
 
Sec. 40.026.  New heading:  PRESIDING OFFICER; OTHER OFFICERS.  (a) - (c)
Applies standard Sunset language regarding the presiding officer, officer,
and other officers. 
 
Sec. 40.027.  New heading:  COMMISSIONER.  (a)  Requires the governor,
rather than the commissioner of health and human services, to appoint a
DPS commissioner, who is to be selected according to education, training,
experience, and demonstrated ability. 
 
(b)  Provides that the DPS commissioner serves for a term of one year.

(c)  Requires the DPS commissioner, subject to the control of the
commissioner of health and human services, to act as the department's
chief administrative officer and as a liaison between the department and
commission. 
 
(d)  Requires the DPS commissioner to administer this chapter and other
laws relating to the department under operational policies established by
the commissioner of health and human services and in accordance with the
memorandum of understanding under Section 531.0055(k), Government Code,
between the protective services commissioner and the commissioner of
health and human services, as adopted by rule. 
 
SECTION 1.13.  Amends the Human Resources Code by adding Title 11, as
follows: 

TITLE 11. COMMUNITY-BASED AND LONG-TERM CARE SERVICES

CHAPTER 161.  DEPARTMENT OF SUPPORTIVE SERVICES

SUBCHAPTER A.  GENERAL PROVISIONS

Sec. 161.001.  DEFINITIONS.  Defines "commission," "commissioner,"
"council," and "department." 
  
Sec. 161.002.  AGENCY.  Provides that the Department of Supportive
Services (department) is an agency of the state. 
 
Sec. 161.003.  SUNSET PROVISION.  Applies standard Sunset language to
continue the department until September 1, 2009. 

[Reserves Sections 161.004-161.020 for expansion.]

SUBCHAPTER B.  ADMINISTRATIVE PROVISIONS
 
Sec. 161.021.  SUPPORTIVE SERVICES COUNCIL.  (a)  Provides that the
Supportive Services Council (council) is created to assist the
commissioner of health and human services in developing rules and policies
for the department. 
 
(b) and (c) Applies standard Sunset language regarding the composition of
and eligibility of council members. 
 
  (d)  Provides that Chapter 551, Government Code, applies to the council.
 
  (e)  Provides that Chapter 2110, Government Code, does not apply to the
council. 
 
  (f)  Provides that a majority of the members of the council constitute a
quorum for   the transaction of business. 
 
Sec. 161.022.  APPOINTMENTS.  Updates standard Sunset language relating
appointments to the council. 
 
Sec. 161.023.  TRAINING PROGRAM FOR COUNCIL MEMBERS.  Updates standard
Sunset language relating to a training program for council members. 
 
Sec. 161.024.  TERMS.  (a)  Sets forth the terms of council members.
 
Sec. 161.025.  VACANCY.  Requires the governor by appointment to fill the
unexpired term of a vacancy on the council. 
 
Sec. 161.026.  PRESIDING OFFICER; OTHER OFFICERS; MEETINGS.  (a) - (c)
Applies standard Sunset language regarding the presiding officer, other
officers, and meetings. 
 
Sec. 161.027.  REIMBURSEMENT FOR EXPENSES.  Applies standard Sunset
language relating to a reimbursement for expenses to a council member. 
 
Sec. 161.028.  PUBLIC INTEREST INFORMATION AND COMPLAINTS. Updates
standard Sunset language requiring information to be maintained on
complaints. 

Sec. 161.029.  PUBLIC ACCESS AND TESTIMONY.  Applies standard Sunset
language providing for public testimony at meetings under the jurisdiction
of the department. 

Sec. 161.030.  POLICYMAKING AND MANAGEMENT RESPONSIBILITIES. Applies
standard Sunset language regarding the delineation of policymaking and
management responsibilities. 
 
Sec. 161.031.  ANNUAL REPORT.  (a)  Requires the commissioner of
supportive services (CSS commissioner) to file annually with the governor,
the presiding officer of each house of the legislature, and the
commissioner of health and human services a complete and detailed written
report accounting for all funds received and disbursed by the department
during the preceding fiscal year. 
 
(b)  Requires the annual report to be in the form and be reported in the
time provided by the General Appropriations Act. 
 
Sec. 161.032.  OFFICES.  Requires the department to maintain its central
office in Austin. Authorizes the department to maintain offices in other
areas of the state as necessary. 

[Reserves Sections 161.033-161.050 for expansion.]

 SUBCHAPTER C.  PERSONNEL

Sec. 161.051.  COMMISSIONER.  (a)  Requires the governor to appoint a
commissioner of the department.  Provides that the CSS commissioner is to
be selected according to education, training, experience, and demonstrated
ability. 
 
(b)  Provides that the CSS commissioner serves for a term of one year.
 
(c)  Requires the CSS commissioner, subject to the control of the
commissioner of health and human services, the CSS commissioner to act as
the department's chief administrative officer and as a liaison between the
department and commission. 
 
(d)  Requires the CSS commissioner to administer this chapter under
operational policies established by the commissioner of health and human
services and in accordance with the memorandum of understanding under
Section 531.0055(k), Government Code, between the CSS commissioner and the
commissioner of health and human services, as adopted by rule. 
 
Sec. 161.052.  PERSONNEL.  (a)  Authorizes the department to employ,
compensate, and prescribe the duties of personnel necessary and suitable
to administer this chapter. 
 
(b)  Requires the commissioner of health and human services to prepare and
by rule adopt personnel standards. 
 
(c)  Authorizes a personnel position to be filled only by an individual
selected and appointed on a nonpartisan merit basis. 

(d)  Requires the commissioner of health and human services, with the
advice of the council, to develop and the department to implement policies
that clearly define the responsibilities of the staff of the department. 
 
Sec. 161.053.  INFORMATION ABOUT QUALIFICATIONS AND STANDARDS OF CONDUCT.
Applies standard Sunset language regarding information about
qualifications and standards of conduct. 

Sec. 161.054.  MERIT PAY. Applies standard Sunset language regarding merit
pay. 

Sec. 161.055.  CAREER LADDER. Applies standard Sunset language regarding a
career ladder. 
 
Sec. 161.056.  EQUAL EMPLOYMENT OPPORTUNITY POLICY.  Updates standard
Sunset language requiring the commissioner to develop an equal employment
opportunity program. 
 
Sec. 161.057.  STATE EMPLOYEE INCENTIVE PROGRAM.  Applies standard Sunset
language regarding a state employee incentive program. 
 
[Reserves Sections 161.058-161.070 for expansion.]
 
SUBCHAPTER D.  POWERS AND DUTIES OF DEPARTMENT
 
Sec. 161.071.  GENERAL POWERS AND DUTIES OF DEPARTMENT.  Provides that the
department is responsible for administering human services programs for
the aging and disabled, including certain services. 
  
Sec. 161.072.  INFORMATION REGARDING COMPLAINTS.  Updates standard
language requiring information to be maintained on complaints.  
 
Sec. 161.073.  RULES.  Authorizes the commissioner of health and human
services to  adopt rules reasonably necessary for the department to
administer this chapter, consistent with the memorandum of understanding
under Section 531.0055(k), Government Code, between the CSS commissioner
and the commissioner of health and human services, as adopted by rule. 
 
SECTION 1.14.  APPOINTMENT OF COMMISSIONERS.  (a)  Requires the governor,
as soon as possible, to appoint the commissioner of protective services,
the commissioner of supportive services and the commissioner of health
services. 
  
(b)  Requires the governor to make the appointments of the commissioners
required by this section so that the ethnic diversity of this state is
reflected in those appointments. 
 
SECTION 1.15.  APPOINTMENTS OF COUNCIL MEMBERS.  (a)  Requires the
governor, as soon as possible, to appoint the members of the Health
Services Council in accordance with Chapter 1001, Health and Safety Code,
as added by this article.  Provides that in making the initial
appointments, the governor must designate three members for terms expiring
February 1, 2005, three members for terms expiring February 1, 2007, and
three members for terms expiring February 1, 2009. 
 
(b)  Requires the governor, as soon as possible,  to appoint the members
of the Protective Services Council in accordance with Chapter 40, Human
Resources Code, as amended by this article.  Provides that in making the
initial appointments, the governor must designate three members for terms
expiring February 1, 2005, three members for terms expiring February 1,
2007, and three members for terms expiring February 1, 2009. 
 
(c)  Requires the governor, as soon as possible,  to appoint the members
of the Supportive Services Council in accordance with Chapter 161, Human
Resources Code, as added by this article.  Provides that in making the
initial appointments, the governor must designate three members for terms
expiring February 1, 2005, three members for terms expiring February 1,
2007, and three members for terms expiring February 1, 2009. 
 
(d)  Requires the governor to appoint the members of the Health and Human
Services Council in accordance with Chapter 531, Government Code, as
amended by this article. Provides that in making the initial appointments,
the governor must designate three members for terms expiring February 1,
2005, three members for terms expiring February 1, 2007, and three members
for terms expiring February 1, 2009. 
 
SECTION 1.16.  LIMITATION ON ACTIVITIES.  Authorizes a state agency
created under this article to perform, before the date specified in the
transition plan required under Section 1.23 of this article, only those
powers, duties, functions, programs, and activities that relate to
preparing for the transfer of powers, duties, functions, programs, and
activities to that agency in accordance with this article.  Prohibits a
state agency created under this article from operating all or any part of
a health and human services program before the date specified in the
transition plan required under Section 1.23 of this article. 
 
SECTION 1.17.  INITIAL COUNCIL MEETINGS.  Requires the presiding officer
of the council for each state agency created under this article and the
presiding officer of the Protective Services Council to call the initial
meeting of the council as soon as possible after the council members are
appointed. 
 
SECTION 1.18.  TRANSFERS TO THE HEALTH AND HUMAN SERVICES COMMISSION. (a)
Provides that on the date specified in the transition plan required under
Section 1.23 of this Article, certain powers, duties, functions, programs,
and activities are transferred to HHSC. 

 (b) - (e) Make conforming changes relating to the transfers to HHSC.
   
(f)  Provides that all powers, duties, functions, programs, and activities
relating to audits, including internal audits, transferred to HHSC under
Subsection (a)(1) of this section, and all powers, duties, functions,
programs, and activities relating to the Texas Department of  Human
Services office of inspector general transferred to HHSC under Subsection
(a)(2)(D) of this section, are required to be assumed by the HHSC's office
of inspector general.  Provides that notwithstanding any other provision
of law, a reference in law to the Texas Department of Human Services
office of inspector general means the HHSC's office of inspector general. 
 
SECTION 1.19.  TRANSFERS TO THE DEPARTMENT OF HEALTH SERVICES.  (a)
Provides that on the date specified in the transition plan required under
Section 1.23 of this article, certain powers, duties, functions, programs,
and activities, other than those related to rulemaking, policymaking, or
administrative support services such as strategic planning and evaluation,
audit, legal, human resources, information resources, accounting,
purchasing, financial management, and contract management services, are
transferred to the Department of Health Services. 
  
(b) - (e) Make conforming changes relating to the transfers to the
Department of Health Services. 
  
SECTION 1.20.  TRANSFERS TO THE DEPARTMENT OF PROTECTIVE SERVICES.  (a) On
the date specified in the transition plan required under Section 1.23 of
this article, certain powers, duties, functions, programs, and activities,
other than those related to rulemaking or policymaking or administrative
support services such as strategic planning and evaluation, audit, legal,
human resources, information resources, accounting, purchasing, financial
management, and contract management services, are transferred to the
Department of Protective Services 
  
(b) - (e) Make conforming changes relating to the transfers to the
Department of Protective  Services. 
   
SECTION 1.21.  TRANSFERS TO THE DEPARTMENT OF SUPPORTIVE SERVICES.  (a)
Provides that on the date specified in the transition plan required under
Section 1.23 of this article, certain powers, duties, functions, programs,
and activities, other than those related to rulemaking or policymaking or
administrative support services such as strategic planning and evaluation,
audit, legal, human resources, information resources, accounting,
purchasing, financial management, and contract management services, are
transferred to the Department of Supportive Services. 
  
(b) - (e) Make conforming changes relating to the transfers to the
Department of Supportive Services. 
  
SECTION 1.22.  FACILITATION OF TRANSFERS BY HEALTH AND HUMAN SERVICES
TRANSITION COUNCIL.  (a)  Provides that the Health and Human Services
Transition Council (council) is created to facilitate the transfer of
powers, duties, functions, programs, and activities among the state's
health and human services agencies and HHSC as provided by this article
with a minimal negative effect on the delivery of those services in this
state. 
 
 (b)  Provides that the council is composed of 10 certain members.
  
(c)  Provides that the commissioner of health and human services serves as
presiding officer.  Requires the members of the council to elect any other
necessary officers. 
 
(d)  Requires the council to meet at the call of the presiding officer.
 
(e)  Provides that a member of the council serves at the will of the
appointing official. 
 
(f)  Prohibits a member of the council from receiving compensation for
serving on the council but entitles the member to reimbursement for travel
expenses incurred by the member while conducting the business of the
council as provided by the General Appropriations Act. 
 
(g)  Requires the council, with assistance from HHSC and the health and
human services  agencies, to advise the ommissioner of health and human
services concerning certain matters. 
   
(h)  Requires the council to fully consider all written and oral
submissions made on any matter or issue under the council's jurisdiction. 
 
(i)  Provides that Chapter 551, Government Code, applies to the council.
 
(j)  Provides that the council is abolished December 31, 2004.
 
SECTION 1.23.  TRANSITION PLAN.  (a)  Provides that the transfer of
powers, duties, functions, programs, and activities under Sections 1.18,
1.19, 1.20, and 1.21 of this article to HHSC, the Department of Health
Services, the Department of Protective Services, and the Department of
Supportive Services, respectively, must be accomplished in accordance with
a schedule included in a transition plan developed by the commissioner of
health and human services and submitted to the governor and the
Legislative Budget Board not later than December 1, 2003.  Requires the
commissioner of health and human services to provide to the governor and
the Legislative Budget Board transition plan status reports and updates on
at least a quarterly basis following submission of the initial transition
plan.  Requires the transition plan to be made available to the public. 
 
(b)  Requires HHSC not later than November 1, 2003, to hold a public
hearing and accept public comment regarding the transition plan required
to be developed by the commissioner of health and human services under
Subsection (a) of this section. 
 
(c)  Requires the commissioner of health and human services in developing
the transition plan, to hold public hearings in various geographic areas
in this state before submitting the plan to the governor and the
Legislative Budget Board as required by this section. 
 
SECTION 1.24.  APPLICABILITY OF FORMER LAW.  Provides that an action
brought or proceeding commenced before the date of a transfer prescribed
by this article in accordance with the transition plan required under
Section 1.23 of this article, including a contested case or a remand of an
action or proceeding by a reviewing court, is governed by the laws and
rules applicable to the action or proceeding before the transfer. 
 
SECTION 1.25.  WORK PLAN FOR HEALTH AND HUMAN SERVICES AGENCIES.  (a)
Requires HHSC, the Department of Protective Services, and each health and
human services agency created under this article to implement the powers,
duties, functions, programs, and activities assigned to the agency under
this article in accordance with a work plan designed by HHSC to ensure
that the transfer and provision of health and human services in this state
are accomplished in a careful and deliberative manner. 
 
(b)  Requires a work plan designed by HHSC under this section to include
certain phases. 
   
SECTION 1.26.  ABOLITION OF STATE AGENCIES AND ENTITIES.  (a)  Provides
for the abolition of certain state agencies and entities on the date on
which their respective powers, duties, functions, programs, and activities
are transferred under this article. 

(b)  Provides that the abolition of a state agency or entity listed in
Subsection (a) of this section and the transfer of its powers, duties,
functions, programs, activities, obligations, rights, contracts, records,
property, funds, and employees as provided by this article do not affect
or impair an act done, any obligation, right, order, permit, certificate,
rule, criterion, standard, or requirement existing, or any penalty accrued
under former law, and that law remains in effect for any action concerning
those matters. 
 
SECTION 1.27.  Provides that a reference in law to the Department of
Protective and Regulatory Services means the Department of Protective
Services. 
 
SECTION 1.28.  REPEAL.  Repealer:
   (1)  Sections 531.0057, 531.034, and 531.0345, Government Code;
  (2)  Sections 40.0225 and 40.023, Human Resources Code; and
  (3)  Article 2, Chapter 1505, Acts of the 76th Legislature, Regular
Session, 1999. 
 
SECTION 1.29.  EFFECTIVE DATE.  (a)  Effective date:  September 1, 2003,
except as provided by Subsection (b) of this section. 
 
(b)  Provides that the Department of Health Services and the Department of
Supportive Services are created on the date the governor appoints the
commissioner of the respective agency. 

ARTICLE 2.  ADMINISTRATION, OPERATION, AND FINANCING OF
HEALTH AND HUMAN SERVICES PROGRAMS AND PROVISION OF
HEALTH AND HUMAN SERVICES
 
SECTION 2.01.  Amends Section 531.001, Government Code, by adding
Subdivision (1-a) to define "child health plan program." 

SECTION 2.02.  (a)  Amends Subchapter A, Chapter 531, Government Code, by
adding Section 531.017 as follows: 
 
Sec. 531.017.  PURCHASING DIVISION.  (a)  Requires HHSC to establish a
purchasing division for the management of administrative activities
related to the purchasing functions of HHSC and the health and human
services agencies. 
 
(b)  Requires the purchasing division to seek to achieve targeted cost
reductions, increase process efficiencies, improve technological support
and customer services, and enhance purchasing support for each health and
human services agency; and if cost-effective, contract with private
entities to perform purchasing functions for HHSC and the health and human
services agencies. 
 
(b)  Requires HHSC not later than January 1, 2004, to develop and
implement a plan to consolidate the purchasing functions of HHSC and
health and human services agencies in a purchasing division under Section
531.017, Government Code, as added by this section. 
 
SECTION 2.03.  Amends Section 531.021, Government Code, by adding
Subsection (c) to require HHSC in its adoption of reasonable rules and
standards under Subsection (b)(2) to include financial performance
standards that, in the event of a proposed rate reduction, provide private
ICF-MR facilities and home and community-based services providers with
flexibility in determining how to use medical assistance payments to
provide services in the most costeffective manner. 
 
SECTION 2.04.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.0335 as follows: 
 
Sec. 531.0335.  PROHIBITION ON PUNITIVE ACTION FOR FAILURE TO IMMUNIZE.
(a) Defines "person responsible for a child's care, custody, or welfare"
and "punitive action." 
 
(b)  Requires the commissioner of health and human services by rule to
prohibit a health and human services agency from taking a punitive action
against a person responsible for a child's care, custody, or welfare for
failure of the person to ensure that the child receives the immunization
series prescribed by Section 161.004, Health and Safety Code. 
 
(c)  Provides that this section does not affect a law, including Chapter
31, Human Resources Code, that specifically provides a punitive action for
failure to ensure that a child receives the immunization series prescribed
by Section 161.004, Health and Safety Code. 
  
SECTION 2.05.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.0392, as follows: 
 
Sec. 531.0392.  RECOVERY OF CERTAIN THIRD-PARTY REIMBURSEMENTS UNDER
MEDICAID.  (a)  Defines "dually eligible individual." 
 
(b)  Requires HHSC to obtain Medicaid reimbursement from each fiscal
intermediary who makes a payment to a service provider on behalf of the
Medicare program, including a reimbursement for a payment made to a home
health services provider or nursing facility for services rendered to a
dually eligible individual. 
 
SECTION 2.06.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.063, as follows: 
 
Sec. 531.063.  CALL CENTER.  (a)  Requires HHSC, by rule, to establish a
call center for purposes of determining and certifying or recertifying a
person's eligibility and need for services related to the programs listed
under Section 531.008(c), if cost-effective. 

(b)  Requires HHSC to contract with at least one but not more than four
private entities for the operation of a call center required by this
section unless HHSC determines that contracting for the operation of the
center would not be costeffective. 
 
(c)  Requires call centers to provide translation services as required by
federal law for clients unable to speak, hear, or comprehend the English
language. 
 
(d)  Requires HHSC to develop consumer service and performance standards
for the operation of a call center required by this section.  Requires the
standards to address a certain aspects of a call center. 
  
(e)  Requires HHSC to make available to the public the standards developed
under Subsection (d). 
 
(f)  Requires HHSC to develop:

(1)  mechanisms for measuring consumer service satisfaction; and

(2)  performance measures to evaluate whether the call center meets the
standards developed under Subsection (d). 
 
(g)  Authorizes HHSC to inspect a call center and analyze its consumer
service performance through use of a consumer service evaluator who poses
as a consumer of the call center. 
 
(h)  Requires the commissioner of health and human services
notwithstanding Subsection (a), to develop and implement policies that
provide an applicant for services related to the programs listed under
Section 531.008(c) with an opportunity to appear in person to establish
initial eligibility or to comply with periodic eligibility recertification
requirements if the applicant requests a personal interview.  Provides
that this subsection does not affect a law or rule that requires an
applicant to appear in person to establish initial eligibility or to
comply with periodic eligibility recertification requirements. 
 
SECTION 2.07.  (a)  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.065, as follows: 
 
Sec. 531.065.  CONSOLIDATION AND COORDINATION OF HEALTH INSURANCE  PREMIUM
PAYMENT REIMBURSEMENT PROGRAMS. (a) Requires HHSC to develop and implement
a plan to consolidate and coordinate the administration of the health
insurance premium payment reimbursement programs prescribed by Section
62.059, Health and Safety Code, and Section 32.0422, Human Resources Code. 
 
(b)  Authorizes HHSC if cost-effective,  to contract with a private entity
to assist HHSC in developing and implementing a plan required by this
section. 
 
(b)  Repealer:  Section 62.059(i), Health and Safety Code, and Section
32.0422(m), Human Resources Code. 
 
(c)  Requires HHSC not later than January 1, 2004, to develop and
implement a plan to consolidate and coordinate the administration of
health insurance premium payment reimbursement programs as required by
Section 531.065, Government Code, as added by this section. 
 
SECTION 2.08.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.067 as follows: 
 
Sec. 531.067.  PUBLIC ASSISTANCE HEALTH BENEFIT REVIEW AND DESIGN
COMMITTEE.  (a) Requires HHSC to appoint a Public Assistance Health
Benefit Review and Design Committee (committee).  Provides that the
committee consists of nine representatives of health care providers
participating in the Medicaid program or the child health plan program, or
both. Requires the committee membership to include at least three
representatives from each program. 
 
(b)  Requires the commissioner of health and human services to designate
one member to serve as presiding officer for a term of two years. 
 
(c)  Requires the committee to meet at the call of the presiding officer.
 
(d)  Requires the committee to review and provide recommendations to HHSC
regarding health benefits and coverages provided under the state Medicaid
program, the child health plan program, and any other income-based health
care program administered by HHSC or a health and human services agency.
Requires the committee in performing its duties under this subsection, to
review prescription drug benefits provided under each of the programs; and
review procedures for addressing high utilization of benefits by
recipients. 
 
(e)  Requires HHSC to provide administrative support and resources as
necessary for the committee to perform its duties under this section. 
 
 (f)  Provides that Section 2110.008 does not apply to the committee.

(g)  Authorizes HHSC, in performing the duties under this section, to
design and implement a program to improve and monitor clinical and
functional outcomes of a recipient of services under the state child
health plan or medical assistance program.  Authorizes the program to use
financial, clinical, and other criteria based on pharmacy, medical
services, and other claims data related to the child health plan or the
state medical assistance program.  Requires HHSC to report to the
committee on the fiscal impact, including any savings associated with the
strategies utilized under this section. 
 
SECTION 2.09.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.068, as follows: 
 
Sec. 531.068.  MEDICAID OR OTHER HEALTH BENEFIT COVERAGE.  Provides that
in adopting rules or standards governing the state Medicaid program or
rules or standards for the development or implementation of health benefit
coverage for a  program administered by HHSC or a health and human
services agency, HHSC and each health and human services agency, as
appropriate, may take into consideration any recommendation made with
respect to health benefits provided under their respective programs or the
state Medicaid program by the Public Assistance Health Benefit Review and
Design Committee established under Section 531.067. 
 
SECTION 2.10.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.069, as follows: 
 
Sec. 531.069.  PERIODIC REVIEW OF VENDOR DRUG PROGRAM.  (a)  Requires HHSC
to periodically review all purchases made under the vendor drug program to
determine the cost-effectiveness of including a component for prescription
drug benefits in any capitation rate paid by the state under a Medicaid
managed care program or the child health plan program. 
 
(b)  Requires HHSC, in making the determination required by Subsection
(a), to consider the value of any prescription drug rebates received by
the state. 
 
SECTION 2.11.  (a)  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.070, as follows: 
 
Sec. 531.070.  SUPPLEMENTAL REBATES.  Defines "labeler," "manufacturer,"
and "wholesaler." 
 
(b)  Defines for purposes of this section "supplemental rebates."

(c)  Authorizes HHSC to enter into a written agreement with a manufacturer
to accept certain program benefits in lieu of supplemental rebates, as
such term is defined herein, only if certain conditions exist. 
   
(d)  Provides that for the purposes of this section, a program benefit may
mean disease management programs authorized under this title, drug product
donation programs, drug utilization control programs, prescriber and
beneficiary counseling and education, fraud and abuse initiatives, and
other services or administrative investments with guaranteed savings to a
program operated by a health and human services agency. 
 
(e)  Requires such program investments other than as required to satisfy
the provisions of this section, to be deemed an alternative to, and not
the equivalent of, supplemental rebates and to be treated in the state's
submissions to the federal government (including, as appropriate, waiver
requests and quarterly Medicaid claims) so as to maximize the availability
of federal matching payments. 
 
(f)  Provides that agreements by HHSC to accept program benefits as
defined by this section: may not prohibit HHSC from entering into similar
agreements related to different drug classes with other entities; shall be
limited to a time period expressly determined by HHSC; and may only cover
products that have received approval by the Federal Drug Administration at
the time of the agreement, and new products approved after the agreement
may be incorporated only under an amendment to the agreement. 
 
(g)  Authorizes HHSC, for the purposes of this section, to consider a
monetary contribution or donation to the arrangements described in
Subsection (b) for the purpose of offsetting expenditures to other state
health care programs, but which funding shall not be used to offset
expenditures for covered outpatient drugs as defined by 42 U.S.C. Section
1396r-8(k)(2) under the vendor drug program. Prohibits an arrangement
under this subsection from yielding less than the amount the state would
have benefited under a supplemental rebate.  Authorizes HHSC to consider
an arrangement under this section as satisfying the requirements related
to Section 531.072(b). 
 
(h)  Requires HHSC, subject to Subsection (i), to negotiate with
manufacturers and labelers, including generic manufacturers and labelers,
to obtain supplemental rebates for prescription drugs sold in this state. 
 
(i)  Authorizes HHSC to by contract authorize a private entity to
negotiate with manufacturers and labelers on behalf of HHSC. 
 
(j)  Authorizes a manufacturer or labeler that sells prescription drugs in
this state to voluntarily negotiate with HHSC and enter into an agreement
to provide supplemental rebates for prescription drugs provided under
certain programs. 
   
(k)  Requires HHSC, in negotiating terms for a supplemental rebate amount,
to consider certain factors. 
  
(l)  Requires HHSC to provide a written report to the legislature and the
governor each year.  Requires the report to cover certain information. 
   
(m)  Requires HHSC in negotiating terms for a supplemental rebate, to
utilize the average manufacturer price (AMP), as defined in Section
1396r-8(k)(1) of the Omnibus Budget Reconciliation Act of 1990, as the
cost basis for the product. 
 
(b)  Requires HHSC, not later than January 1, 2004, to implement Section
531.070, Government Code, as added by this section. 
 
SECTION 2.12.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.071, as follows: 
 
Sec. 531.071.  CONFIDENTIALITY OF INFORMATION REGARDING DRUG REBATES,
PRICING, AND NEGOTIATIONS.  (a)  Provides that notwithstanding any other
state law, information obtained or maintained by HHSC regarding
prescription drug rebate negotiations or a supplemental medical assistance
or other rebate agreement, including trade secrets, rebate amount, rebate
percentage, and manufacturer or labeler pricing, is confidential and not
subject to disclosure under Chapter 552, Government Code. 
 
(b)  Provides that information that is confidential under Subsection (a)
includes information described by Subsection (a) that is obtained or
maintained by HHSC in connection with the Medicaid vendor drug program,
the child health plan program, the kidney health care program, or the
children with special health care needs program. 
 
(c)  Provides that general information about the aggregate costs of
different classes of drugs is not confidential under Subsection (a). 
 
SECTION 2.13.  (a)  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.072, as follows: 
 
Sec. 531.072.  PREFERRED DRUG LISTS FOR MEDICAID AND CHILD HEALTH PLAN
PROGRAMS.  (a)  Requires HHSC, in a manner that complies with applicable
state and federal law, to adopt preferred drug lists for the Medicaid
vendor drug program and for prescription drugs purchased through the child
health plan program. 
 
(b)  Authorizes the preferred drug lists to contain only drugs provided by
a manufacturer or labeler that reaches an agreement with HHSC on
supplemental rebates under Section 531.070. 
 
(c)  Requires HHSC, in making a decision regarding the placement of a drug
on  each of the preferred drug lists, to consider certain factors. 
   
(d)  Requires HHSC to provide for the distribution of current copies of
the preferred drug lists to all appropriate health care providers in this
state by posting the list on the Internet.  Requires HHSC, in addition, to
mail copies of the lists to any health care provider on request of that
provider. 
 
(e)  Defines "labeler" and "manufacturer."  Requires HHSC to ensure that:
a manufacturer or labeler may submit written evidence supporting the
inclusion of a drug on the preferred drug lists before a supplemental
agreement is reached with HHSC; and any drug that has been approved or has
had any of its particular uses approved by the United States Food and Drug
Administration under a priority review classification will be reviewed by
the Pharmaceutical and Therapeutics Committee (PT committee) at the next
regularly scheduled meeting of the PT committee.  Requires HHSC, on
receiving notice from a manufacturer or labeler of the availability of a
new product, to the extent possible, to schedule a review for the product
at the next regularly scheduled meeting of the PT committee. 
 
(f)  Authorizes a recipient of drug benefits under the Medicaid vendor
drug program to appeal a denial of prior authorization under Section
531.073 of a covered drug or covered dosage through the Medicaid fair
hearing process. 
 
(b)  Requires HHSC, not later than March 1, 2004, to adopt the preferred
drug lists as required by Section 531.072, Government Code, as added by
this section. 
 
SECTION 2.14.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.073, as follows: 
 
Sec. 531.073.  PRIOR AUTHORIZATION FOR CERTAIN PRESCRIPTION DRUGS. (a)
Requires HHSC, in its rules and standards governing the Medicaid vendor
drug program and the child health plan program, to require prior
authorization for the reimbursement of a drug that is not included in the
appropriate preferred drug list adopted under Section 531.072, except for
any drug exempted from prior authorization requirements by federal law.
Requires HHSC to require that the prior authorization be obtained by the
prescribing physician. 
 
(a-1)  Requires HHSC to delay requiring a prior authorization for drugs
listed in Subsection (a-2) until HHSC has completed a study evaluating the
impact of a requirement of prior authorization on the recipients of
certain drug classes. 
 
(a-2)  Provides that drugs subject to the study in Subsection (a-1)
include drugs used in the treatment of: cancer and cancer-supportive care;
end-stage renal disease; chronic nonmalignant pain; hemophilia; and
multiple sclerosis. 
 
(b)  Requires HHSC to establish procedures for the prior authorization
requirement under the Medicaid vendor drug program to ensure that the
requirements of 42 U.S.C. Section 1396r-8(d)(5) and its subsequent
amendments are met.  Specifically, requires the procedures to ensure that:
a prior authorization requirement is not imposed for a drug before the
drug has been considered at a meeting of the PT committee established
under Section 531.074; there will be a response to a request for prior
authorization by telephone or other telecommunications device within 24
hours after receipt of a request for prior authorization; and a 72-hour
supply of the drug prescribed will be provided in an emergency or if HHSC
does not provide a response within the time required by Subdivision (2). 
 
(c)  Requires HHSC to ensure that a prescription drug prescribed before
implementation of a prior authorization requirement for that drug for a
recipient under the child health plan program, the Medicaid program, or
another state  program administered by HHSC or for a person who becomes
eligible under the child health plan program, the Medicaid program, or
another state program administered by HHSC is not subject to any
requirement for prior authorization under this section unless the
recipient has exhausted all the prescription, including any authorized
refills, or a period prescribed by HHSC has expired, whichever occurs
first. 
 
(d)  Requires HHSC to implement procedures to ensure that a recipient
under the child health plan program, the Medicaid program, or another
state program administered by HHSC or a person who becomes eligible under
the child health plan program, the Medicaid program, or another state
program administered by HHSC receives continuity of care in relation to
certain prescriptions identified by HHSC. 
 
(e)  Authorizes HHSC to by contract authorize a private entity to
administer the prior authorization requirements imposed by this section on
behalf of HHSC. 
 
(f)  Requires HHSC to ensure that the prior authorization requirements are
implemented in a manner that minimizes the cost to the state and any
administrative burden placed on providers. 
 
SECTION 2.15.  (a)  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.074, as follows: 
 
Sec. 531.074.  PHARMACEUTICAL AND THERAPEUTICS COMMITTEE.  (a) Provides
that the Pharmaceutical and Therapeutics Committee (PT committee) is
established for the purposes of developing recommendations for a preferred
drug list for the Medicaid vendor drug program and a preferred drug list
for the child health plan program. 
 
(b)  Provides that the PT committee consists of certain members appointed
by the governor. 
   
(c)  Requires the governor in making appointments to the PT committee
under Subsection (b), to ensure that the committee includes physicians and
pharmacists who meet certain requirements. 
   
(d)  Provides that a member of the PT committee is appointed for a
two-year term and may serve more than one term. 
 
(e)  Requires the governor to appoint a physician to be the presiding
officer of the PT committee.  The presiding officer serves at the pleasure
of the governor. 
 
(f)  Requires the PT committee to meet at least monthly during the
six-month period following establishment of the committee to enable the
committee to develop recommendations for the initial preferred drug lists.
Requires the PT committee after that period, to meet at least quarterly
and at other times at the call of the presiding officer or a majority of
the PT committee members. 
 
(g)  Prohibits a member of the PT committee from receiving compensation
for serving on the PT committee but entitles the member to reimbursement
for reasonable and necessary travel expenses incurred by the member while
conducting the business of the PT committee, as provided by the General
Appropriations Act. 
 
(h)  Requires the PT committee, in developing its recommendations for the
preferred drug lists, to consider the clinical efficacy, safety,
cost-effectiveness, and any program benefit associated with a product. 
 
 (i)  Requires HHSC to adopt rules governing the operation of the PT
committee, including rules governing the procedures used by the PT
committee for providing notice of a meeting and rules prohibiting the PT
committee from discussing confidential information described by Section
531.071 in a public meeting. Requires the PT committee to comply with the
rules adopted under this subsection. 
 
(j)  Requires the PT committee to the extent feasible, to review all drug
classes included in the preferred drug lists adopted under Section 531.072
at least once every 12 months and authorizes the committee to recommend
inclusions to and exclusions from the list to ensure that the list
provides for cost-effective medically appropriate drug therapies for
Medicaid recipients and children receiving health benefits coverage under
the child health plan program. 
 
(k)  Requires HHSC to provide administrative support and resources as
necessary for the PT committee to perform its duties. 
 
(l)  Provides that Chapter 2110 does not apply to the committee.
 
(b)  Requires the governor, not later than November 1, 2003, to appoint
members to the PT committee established under Section 531.074, Government
Code, as added by this section. 
 
(c)  Requires the PT committee established under Section 531.074,
Government Code, as added by this section, not later than January 1, 2004,
to submit recommendations for the preferred drug lists the PT committee is
required to develop under that section to HHSC. 
 
SECTION 2.16.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.075, as follows: 
 
Sec. 531.075.  PRIOR AUTHORIZATION FOR HIGH-COST MEDICAL SERVICES.
Authorizes HHSC to evaluate and implement, as appropriate, procedures,
policies, and methodologies to require prior authorization for high-cost
medical services and procedures and to contract with qualified service
providers or organizations to perform those functions.  Requires any such
program to recognize any prohibitions in federal law on limits in the
amount, duration, or scope of medically necessary services for children on
Medicaid. 
 
SECTION 2.17.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.076, as follows: 
 
Sec. 531.076.  UP TO SIX-BED FACILITY MODEL AUTHORIZED.  (a)  Requires
HHSC to develop a plan to permit the use of a residential program model of
a facility of up to six beds in the mental retardation Medicaid waiver
program under the authority of the Texas Department of Mental Health and
Mental Retardation. 
 
(b)  Requires the plan described in this section to provide for retaining
a three-bed facility model and a planned, organized transition from the
four-bed facility model to the six-bed facility model, which shall include
certain factors. 
   
(c)  Requires the plan to be developed with the assistance of a work group
which shall include members of the staff of HHSC, representatives of
public providers, private providers, and advocates.  Requires the plan to
be submitted to the Governor's Office of Budget and Planning, the House
Appropriations Committee, and the Senate Finance Committee not later than
September 1, 2004. 
 
SECTION 2.18.  Amends Subchapter B, Chapter 531, Government Code, by
adding Section 531.077, as follows: 
 
Sec. 531.077.  MEDICAID PROGRAM.  (a)  Requires the commissioner of health
and  human services to ensure that the state Medicaid program implements
42 U.S.C. Section 1396p(b)(1). 
 
(b)  Provides that the Medicaid account is an account in the general
revenue fund. Requires any funds recovered by implementing 42 U.S.C.
Section 1396p(b)(1) to be deposited in the Medicaid account.  Authorizes
money in the account to be appropriated only to fund long-term care,
including community-based care and facility-based care. 
 
SECTION 2.19.  (a)  Amends Section 531.101, Government Code, as follows:
 
Sec. 531.101.  AWARD FOR REPORTING MEDICAID FRAUD, ABUSE, OR OVERCHARGES.
(a) Authorizes HHSC to grant an award to an individual who reports
activity that constitutes fraud or abuse of funds in the state Medicaid
program or reports overcharges in the program if HHSC determines that the
disclosure results in the recovery of an administrative penalty imposed
under Section 32.039, Human Resources Code. Prohibits HHSC from granting
an award to an individual in connection with a report if HHSC or the
attorney general had independent knowledge of the activity reported by the
individual.  Deletes text regarding  overcharge or in the termination of
the fraudulent activity or abuse of funds. 
 
(b)  Requires HHSC to determine the amount of an award.  Prohibits the
award from exceeding five percent of the amount of the administrative
penalty imposed under Section 32.039, Human Resources Code, rather than
requiring it to be equal to not less than 10 percent of the savings to
this state that resulted from the individual's disclosure.  Requires HHSC,
in determining the amount of the award, to consider how important the
disclosure is in ensuring the fiscal integrity of the program.  Authorizes
HHSC to also consider whether the individual participated in the fraud,
abuse, or overcharge. 

Deletes existing text to Subsections (c) and (d) and redesignates
Subsection (e) as (c). 
 
(b)  Provides that Section 531.101, Government Code, as amended by this
section, applies only to a report that occurs on or after the effective
date of this section.  Provides that a report that occurs before the
effective date of this section is governed by the law in effect at the
time of the report, and the former law is continued in effect for that
purpose. 
 
SECTION 2.20.  (a)  Section 531.102, Government Code,  as follows:
 
Sec. 531.102.  New heading:  OFFICE OF INSPECTOR GENERAL.  (a)  Provides
that HHSC, through HHSC's office of inspector general (office) rather than
through investigations and enforcement, is responsible for the
investigation of fraud and abuse in the provision of health and human
services and the enforcement of state law relating to the provision of
those services.  Authorizes HHSC to obtain any information or technology
necessary to enable the office to meet its responsibilities under this
subchapter or other law. 
 
(a-1)  Requires the governor to appoint an inspector general to serve as
director of the office.  Provides that the inspector general serves a
one-year term that expires on February 1. 
 
(b)  Requires HHSC, in consultation with the inspector general, to set
clear objectives, priorities, and performance standards for the office
that emphasize: coordinating investigative efforts to aggressively recover
money; allocating resources to cases that have the strongest supportive
evidence and the greatest potential for recovery of money; and maximizing
opportunities for referral of cases to the office of the attorney general
in accordance with Section 531.103. 
 
 (c)  Requires HHSC to train office staff to enable the staff to pursue
priority Medicaid and other health and human services rather than welfare
fraud and abuse cases as necessary. 
 
(d)  Authorizes HHSC to require employees of health and human services
agencies to provide assistance to the office rather than to HHSC in
connection with the office's rather than HHSC's duties relating to the
investigation of fraud and abuse in the provision of health and human
services.  The office is entitled to access to any information maintained
by a health and human services agency, including internal records,
relevant to the functions of the office. 
 
(e)  Requires HHSC, in consultation with the inspector general, by rule to
set specific claims criteria that, when met, require the office to begin
an investigation. 
 
(f)(1)  Requires the office, if HHSC receives a complaint of Medicaid
fraud or abuse from any source, to conduct an integrity review to
determine whether there is sufficient basis to warrant a full
investigation.  Requires an integrity review to begin not later than the
30th day after the date HHSC receives a complaint or has reason to believe
that fraud or abuse has occurred.  Requires an integrity review to be
completed not later than the 90th day after it began. 
  
(2)  Requires the office to take certain action, as appropriate, if the
findings of an integrity review give the office reason to believe that an
incident of fraud or abuse involving possible criminal conduct has
occurred in the Medicaid program,  not later than the 30th day after the
completion of the integrity review. 
 
(g)(1)  Requires the office, in addition to other instances authorized
under state or federal law, to impose without prior notice a hold on
payment of claims for reimbursement submitted by a provider to compel
production of records or when requested by the state's Medicaid fraud
control unit, as applicable.  Requires the office to notify the provider
of the hold on payment not later than the fifth working day after the date
the payment hold is imposed. 
  
(2)  Requires the office to, in consultation with the state's Medicaid
fraud control unit, establish guidelines under which holds on payment or
program exclusions: may permissively be imposed on a provider or 
   are required to automatically be imposed on a provider.
  
(3)  Requires the office, whenever the office learns or has reason to
suspect that a provider's records are being withheld, concealed,
destroyed, fabricated, or in any way falsified, to immediately refer the
case to the state's Medicaid fraud control unit.  Provides, however, that
the criminal referral does not preclude the office from continuing its
investigation of the provider, which investigation may lead to the
imposition of appropriate administrative or civil sanctions. 
 
(h)  Authorizes the office, in addition to performing functions and duties
otherwise provided by law, to take certain actions. 
 
(i)  Provides that notwithstanding any other provision of law, a reference
in law or rule to HHSC's office of investigations and enforcement means
the office of inspector general established under this section. 
 
(b)  Requires the governor as soon as possible after the effective date of
this section, to appoint a person to serve as inspector general in
accordance with Section 531.102, Government Code, as amended by this
section.  Provides that the initial term of the person appointed in
accordance with this subsection expires February 1, 2005. 
 
 SECTION 2.21.  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.1021 as follows: 
 
Sec. 531.1021.  SUBPOENAS.  (a)  Authorizes the office of inspector
general to request that the commissioner of health and human services or
the commissioner's designee approve the issuance by the office of a
subpoena in connection with an investigation conducted by the office.
Authorizes the office, if the request is approved, to issue a subpoena to
compel the attendance of a relevant witness or the production, for
inspection or copying, of relevant evidence that is in this state. 
 
(b)  Authorizes a subpoena to be served personally or by certified mail.
 
(c)  Authorizes the office, if a person fails to comply with a subpoena,
acting through the attorney general, to file suit to enforce the subpoena
in a district court in this state. 
 
(d)  Requires the court on finding that good cause exists for issuing the
subpoena, to order the person to comply with the subpoena.  Authorizes the
court to punish a person who fails to obey the court order. 
 
(e)  Requires the office to pay a reasonable fee for photocopies
subpoenaed under this section in an amount not to exceed the amount the
office may charge for copies of its records. 
 
(f)  Provides that the reimbursement of the expenses of a witness whose
attendance is compelled under this section is governed by Section
2001.103. 
 
(g)  Provides that all information and materials subpoenaed or compiled by
the office in connection with an investigation are confidential and not
subject to disclosure under Chapter 552, and not subject to disclosure,
discovery, subpoena, or other means of legal compulsion for their release
to anyone other than the office or its employees or agents involved in the
investigation conducted by the office, except that this information may be
disclosed to the office of the attorney general and law enforcement
agencies. 
 
SECTION 2.22.  (a)  Amends Section 531.103, Government Code, as follows:
 
Sec. 531.103.  INTERAGENCY COORDINATION.  (a)  Requires HHSC, acting
through its office of inspector general, and the office of the attorney
general to enter into a memorandum of understanding to develop and
implement joint written procedures for processing cases of suspected
fraud, waste, or abuse, as those terms are defined by state or federal
law, or other violations of state or federal law under the state Medicaid
program or other program administered by HHSC or a health and human
services agency, including the financial assistance program under Chapter
31, Human Resources Code, a nutritional assistance program under Chapter
33, Human Resources Code, and the child health plan program.  Requires the
memorandum of understanding to require certain actions from certain
entities. 
   
(b)  Provides that an exchange of information under this section between
the office of the attorney general and HHSC, the office of inspector
general, or a health and human services agency does not affect whether the
information is subject to disclosure under Chapter 552. 
 
(c)  Requires HHSC and the office of the attorney general to jointly
prepare and submit a semiannual report to the governor, lieutenant
governor, speaker of the house of representatives, and comptroller
concerning the activities of those agencies in detecting and preventing
fraud, waste, and abuse under the state Medicaid program or other program
administered by HHSC or a health and human services agency.  Makes a
nonsubstantive change. 
 
(d)  No change to this subsection.

(e)  Requires the memorandum of understanding required by this section, in
addition to the provisions required by Subsection (a), to also ensure that
no barriers to direct fraud referrals to the office of the attorney
general's Medicaid fraud control unit or unreasonable impediments to
communication between Medicaid agency employees and the Medicaid fraud
control unit are imposed, and to include procedures to facilitate the
referral of cases directly to the office of the attorney general. Deletes
existing text relating to requiring HHSC to refer a case of suspected
fraud, waste, or abuse under the state Medicaid program to certain persons
under certain conditions and the subsequent actions to be taken. 

(f)  Authorizes a district attorney, county attorney, city attorney, or
private collection agency to collect and retain costs associated with a
case referred to the attorney or agency in accordance with procedures
adopted under this section and 20 percent of the amount of the penalty,
restitution, or other reimbursement payment collected. 

(b)  Requires the office of the attorney general and HHSC to amend the
memorandum of understanding required by Section 531.103, Government Code,
as necessary to comply with that section, as amended by this section, not
later than December 1, 2003. 

SECTION 2.23.  Amends Section 531.104(b), Government Code, to require the
memorandum of understanding to specify the type, scope, and format of the
investigative support provided to the attorney general under this section.
Deletes language stating that the commission is not required to provide
investigative support in more than 100 open investigations in a fiscal
year. 

SECTION 2.24.  (a)  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.1063, as follows: 

Sec. 531.1063.  MEDICAID FRAUD PILOT PROGRAM.  (a)  Requires HHSC, with
cooperation from TDHS, to develop and implement a front-end Medicaid fraud
reduction pilot program in one or more counties in this state to address
provider fraud and appropriate cases of third-party and recipient fraud. 
   
(b)  Requires the program to be designed to reduce the number of fraud
cases arising from authentication fraud and abuse; the total amount of
Medicaid expenditures; and the number of fraudulent participants. 

(c)  Requires the program to include:  participant smart cards and
biometric readers that reside at the point of contact with Medicaid
providers, recipients, participating pharmacies, hospitals, and
appropriate third-party participants; a secure finger-imaging system that
is HIPPA compliant and the use of any existing state database of
fingerprint images developed in connection with the financial assistance
program under Chapter 31, Human Resources Code, with fingerprint images
collected as part of the program to only be placed on the smart card; and
a monitoring system. 

(d)  Requires the program and all associated hardware and software to
easily integrate into participant settings and be initially tested in a
physician environment in this state and determined to be successful in
authenticating recipients, providers, and provider staff members before
the program is implemented throughout the program area, to ensure
reliability. 

(e)  Authorizes HHSCto extend the program to additional counties if it
determines that expansion would be cost-effective. 

(b)  Requires HHSC to begin implementation of the program required by
Section 531.1063, Government Code, as added by this section, not later
than January 1, 2004. 
 
(c)  Requires HHSC to report to certain persons regarding the program
required by Section 531.1063, Government Code, as added by this section,
not later than February 1, 2005.  Requires the report to include an
identification and evaluation of the benefits of the program and
recommendations regarding expanding the program statewide. 

SECTION 2.24A.  Amends Section 531.107(b), Government Code, to include a
representative of TDH, appointed by the commissioner of public health, to
the task force. 

SECTION 2.25.  (a)  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.113, as follows: 

Sec. 531.113.  MANAGED CARE ORGANIZATIONS:  SPECIAL INVESTIGATIVE UNITS OR
CONTRACTS.  (a)  Requires each managed care organization that provides or
arranges for the provision of health care services to an individual under
a governmentfunded program, including the Medicaid program and the child
health plan program, to perform certain functions. 

(b)  Requires each managed care organization subject to this section to
adopt a plan to prevent and reduce fraud and abuse and annually file that
plan with HHSC's office of inspector general for approval.  Requires the
plan to include certain information.   

  (c)  Requires the managed care organization to file with HHSC's office
of inspector general certain information, if a managed care organization
contracts for the investigation of fraudulent claims and other types of
program abuse by recipients and service providers under Subsection (a)(2). 
  
(d)  Authorizes HHSC's office of inspector general to review the records
of a managed care organization to determine compliance with this section. 

(e)  Requires the commissioner of health and human services to adopt rules
as necessary to accomplish the purposes of this section. 

(b)  Requires a managed care organization subject to Section 531.113,
Government Code, as added by this section, to comply with the requirements
of that section not later than September 1, 2004. 

SECTION 2.26.  (a)  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.114, as follows: 

Sec. 531.114.  FINANCIAL ASSISTANCE FRAUD.  (a)  Prohibits a person from
intentionally making a statement that the person knows is false or
misleading, misrepresenting, concealing, or withholding a fact, or
knowingly misrepresenting a statement as being true, for purposes of
establishing or maintaining the eligibility of a person and the person's
family for financial assistance under Chapter 31, Human Resources Code, or
for purposes of increasing or preventing a reduction in the amount of that
assistance.  

(b)  Requires HHSC to take certain actions, if after an investigation it
determines that a person violated Subsection (a). 

(c)  Provides that if a person waives the right to a hearing or if a
hearing officer at an administrative hearing held under this section
determines that a person violated Subsection (a), the person is ineligible
to receive financial assistance as provided by Subsection (d).  Authorizes
a person who a hearing officer determines violated Subsection (a) to
appeal that determination by filing a petition in the district court in
the county in which the violation occurred not later than the 30th day
after the date the hearing officer made the determination. 

 (d)  Provides that a person determined under Subsection (c) to have
violated Subsection (a) is not eligible for financial assistance:  before
the first anniversary of the date of that determination, if the person has
no previous violations; and permanently, if the person was previously
determined to have committed a violation. 

(e)  Provides that if a person is convicted of a state or federal offense
for conduct described by Subsection (a), or if the person is granted
deferred adjudication or placed on community supervision for that conduct,
the person is permanently disqualified from receiving financial
assistance. 

(f)  Provides that this section does not affect the eligibility for
financial assistance of any other member of the household of a person
ineligible as a result of Subsection (d) or (e). 

(g)  Requires HHSC to adopt rules as necessary to implement this section.

(b)  Makes application of Section 531.114, Government Code, as added by
this section, prospective.  

SECTION 2.27.  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.115, as follows: 

Sec. 531.115.  FEDERAL FELONY MATCH.  Requires HHSC to develop and
implement a system to cross-reference data collected for the programs
listed under Section 531.008(c) with the list of fugitive felons
maintained by the federal government. 

SECTION 2.28.  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.116, as follows: 

Sec. 531.116.  COMPLIANCE WITH LAW PROHIBITING SOLICITATION.  Provides
that a provider who furnishes services under the Medicaid program or child
health plan program is subject to Chapter 102, Occupations Code, and the
provider's compliance with that chapter is a condition of the provider's
eligibility to participate as a provider under those programs. 

SECTION 2.29.  Amends Subchapter A, Chapter 533, Government Code, by
adding Section 533.0025, as follows: 

Sec. 533.0025.  DELIVERY OF SERVICES.  (a)  Provides that in this section,
"medical assistance" has the meaning assigned by Section 32.003, Human
Resources Code. 

(b)  Requires HHSC, except as otherwise provided by this section and
notwithstanding any other law, to provide medical assistance for acute
care through the most cost-effective model of Medicaid managed care as
determined by HHSC.  Authorizes HHSC to provide medical assistance for
acute care in a certain part of this state or to a certain population of
recipients using certain health care models, if HHSC determines that it is
more cost-effective. 
  
(c)  Requires the commissioner of health and human services to consider
certain information in determining whether a model or arrangement
described by Subsection (b) is more cost-effective. 
  
(d)  Requires HHSC, if it determines that it is not more cost-effective to
use a Medicaid managed care model to provide certain types of medical
assistance for acute care in a certain area or to certain medical
assistance recipients as prescribed by this section, to provide medical
assistance for acute care through a traditional fee-for-service
arrangement. 

 (e)  Prohibits HHSC, notwithstanding Subsection (b)(1), from providing
medical assistance using a health maintenance organization model,
including Medicaid Star + Plus pilot programs, in Cameron County, Hidalgo
County, Webb County, or Maverick County. 

SECTION 2.30.  Amends Subchapter A, Chapter 533, Government Code, by
adding Section 533.0132, as follows: 

Sec. 533.0132.  STATE TAXES.  Requires HHSC to ensure that any experience
rebate or profit sharing for managed care organizations is calculated by
treating premium, maintenance, and other taxes under the Insurance Code
and any other taxes payable to this state as allowable expenses for
purposes of determining the amount of the experience rebate or profit
sharing. 

SECTION 2.31.  Amends Sections 403.105(a) and (c), Government Code, as
follows: 

 (a)  Makes a conforming change.

 (c)  Includes the provision of coordinated essential public health
services administered by  TDH as a service for which available earnings of
the fund may be appropriated to TDH. Makes conforming changes. 

SECTION 2.32.  Amends the heading to Section 403.105, Government Code, to
read as follows: 

Sec. 403.105.  PERMANENT FUND FOR HEALTH AND TOBACCO EDUCATION AND
ENFORCEMENT. 

SECTION 2.33.  Amends Section 403.1055(c), Government Code, to include
among the purposes for which available earnings of the fund may be
appropriated to TDH provisions of intervention services for children with
developmental delay or who have a high probability of developing
developmental delay and the families of those children. 

SECTION 2.34.  (a)  Provides that effective September 1, 2003, Section
466.408(b), Government Code, is amended require that if a claim is not
made for lottery prize money on or before the 180th day after the date on
which the winner was selected, the prize money be used in a certain order
of priority. 

(b)  Effective September 1, 2005, Section 466.408(b), Government Code, is
reenacted as follows: 

(b)  Requires the prize money to be deposited to the credit of the TDH
stateowned multicategorical teaching hospital account or the tertiary care
facility account in a certain manner if a claim is not made for prize
money on or before the 180th day after the date on which the winner was
selected.     

(c)  Provides that it is the intent of the legislature that HHSC, to the
extent possible, is required to take all action necessary to provide the
highest level of possible financial support to providing community care
services and support for the aging, as appropriate to reflect the
legislature's priority for those programs reflected in the General
Appropriations Act. 

SECTION 2.35.  Amends Section 533.005, Government Code, by adding
Subdivision (11) to require a managed care organization to pay an
out-of-network provider for emergency and all poststabilization services
at a certain rate. 
   
SECTION 2.36.  Amends Section 533.012(a), Government Code, to require each
managed care organization contracting with HHSC under this chapter to
submit to HHSC a description and breakdown of all funds paid to the
managed care organization, including a health maintenance organization,
primary care case management, and an exclusive provider organization,
necessary  for HHSC to determine the actual cost of administering the
managed care plan.  Makes conforming changes. 

SECTION 2.37.  Amends the heading to Subchapter C, Chapter 531, Government
Code,  to read as follows: 

SUBCHAPTER C. MEDICAID AND OTHER HEALTH AND HUMAN SERVICES
 FRAUD, ABUSE, OR OVERCHARGES

SECTION 2.37A.  Amends Subchapter C, Chapter 531, Government Code, by
adding Section 531.1011, as follows: 

Sec. 531.1011.  DEFINITIONS.  Defines "fraud," "hold on payment,"
"practitioner," "program exclusion," and "provider." 

SECTION 2.38.  (a)  Amends Subchapter B, Chapter 12, Health and Safety
Code, by adding Sections 12.0111 and 12.0112, as follows: 

Sec. 12.0111.  LICENSING FEES.  (a)  Provides that this section applies in
relation to each licensing program administered by the Texas Department of
Health (TDH) or administered by a regulatory board or other agency that is
under the jurisdiction of TDH or administratively attached to TDH.
Provides that in this section and Section 12.0112, "license" includes a
permit, certificate, or registration. 

(b)  Requires TDH to charge a fee for issuing or renewing a license that
is in an amount designed to allow TDH to recover from its license holders
all of TDH's direct and indirect costs in administering and enforcing the
applicable licensing program, notwithstanding other law. 

(c)  Requires each regulatory board or other agency that is under the
jurisdiction of TDH or administratively attached to TDH and that issues
licenses to charge a fee for issuing or renewing a license that is in an
amount designed to allow TDH and the regulatory board or agency to recover
from the license holders all of the direct and indirect costs to TDH and
to the regulatory board or agency in administering and enforcing the
applicable licensing program, notwithstanding other law 

(d)  Provides that if H.B. 1930 or S.B. 1556, Acts of the 78th
Legislature, Regular Session, 2003, is enacted and becomes law, this
section does not apply to a person regulated under Chapter 773. 

Sec. 12.0112.  TERM OF LICENSE.  Provides that, notwithstanding other law,
the term of each license issued by TDH, or by a regulatory board or other
agency that is under the jurisdiction of TDH or administratively attached
to TDH, is two years. 

(b)  Provides that Section 12.0111, Health and Safety Code, as added by
this section, applies only to a license, permit, certificate, or
registration issued or renewed by TDH, or by a regulatory board or other
agency that is under the jurisdiction of TDH or administratively attached
to TDH, on or after January 1, 2004. 

(c)  Provides that Section 12.0112, Health and Safety Code, as added by
this section, applies only to a license, permit, certificate, or
registration that is issued or renewed on or after January 1, 2005. 

SECTION 2.39.  Amends Sections 62.055(a), (d), and (e), Health and Safety
Code, as follows: 

(a)  Deletes "another entity, including the Texas Healthy Kids Corporation
under Subchapter F, Chapter 109, to obtain health benefit plan coverage
for children who are  eligible for coverage under the state child health
plan" as an entity HHSC is authorized to contract with in administering
the child health plan. 

 (d) and (e)  Make conforming changes.

SECTION 2.40.  (a)  Amends Subchapter B, Chapter 62, Health and Safety
Code, by adding Section 62.0582, as follows: 

Sec. 62.0582.  THIRD-PARTY BILLING VENDORS.  (a)  Prohibits a third-party
billing vendor from submitting a claim with HHSC for payment on behalf of
a health plan provider under the program unless the vendor has entered
into a contract with HHSC authorizing that activity. 

(b)  Requires the contract to contain provisions comparable to the
provisions contained in contracts between HHSC and health plan providers,
with an emphasis on provisions designed to prevent fraud or abuse under
the program, to the extent practical.  Requires, at a minimum, the
contract to require the thirdparty billing vendor to follow certain
requirements. 
  
(c)  Requires HHSC to send a remittance notice directly to the provider
referenced in the claim, on receipt of a claim submitted by a third-party
billing vendor. Requires the notice to include detailed information
regarding the claim submitted on behalf of the provider and  require the
provider to review the claim for accuracy and notify the commission
promptly regarding any errors. 

(d)  Requires HHSC to take all action necessary, including any
modifications of HHSC's claims processing system, to enable the commission
to identify and verify a third-party billing vendor submitting a claim for
payment under the program, including identification and verification of
any computer or telephone line used in submitting the claim, any relevant
user password used in submitting the claim, and any provider number
referenced in the claim. 

(e)  Requires HHSC to audit each third-party billing vendor subject to
this section at least annually to prevent fraud and abuse under the
program. 

(b)  Provides that Section 62.0582, Health and Safety Code, as added by
this section, takes effect January 1, 2004. 

SECTION 2.41.  Amends Section 62.002(4), Health and Safety Code, to
redefine "net family income."  

SECTION 2.42.  Amends Sections 62.101(b) and (c), Health and Safety Code,
as follows: 

(b)  Requires HHSC to 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 165, rather than
200, percent of the federal poverty level is eligible for health benefits
coverage under the program,  unless different income eligibility levels
are prescribed by the General Appropriations Act.  
 
(c)  Requires the commissioner of health and human services to take
certain actions, in the event that appropriated money is insufficient to
sustain enrollment at the authorized eligibility level or enrollment
exceeds the number of children authorized to be enrolled in the child
health plan under the General Appropriations Act.  

SECTION 2.43.  Amends Section 62.1015(b), Health and Safety Code, to
provide that a child enrolled in the child health plan under this section
is subject to the same requirements and restrictions relating to income
eligibility, continuous coverage, and enrollment, including  applicable
waiting periods, as any other child enrolled in the child health plan. 

SECTION 2.44.  Amends Section 62.102, Health and Safety Code, as follows:

Sec. 62.102.  CONTINUOUS COVERAGE.  Requires HHSC to provide that an
individual who is determined to be eligible for coverage under the child
health plan remains eligible for those benefits until the earlier of the
end of a period, not to exceed 180 days, rather than 12 months, following
the date of the eligibility determination or  the individual's 19th
birthday. 

SECTION 2.45.  Amends Section 62.151, Health and Safety Code, by amending
Subsection (b) and adding Subsections (e) and (f), as follows: 

 (b)  Replaces "the Texas Employees Uniform Group Insurance Benefits Act
(Article  3.50-2, Vernon's Texas Insurance Code"  with "Chapter 1551,
Insurance Code" relating to health maintenance organizations.  Deletes
language requiring the child health plan to provide certain benefits. 

(e)  Requires HHSC, in developing the covered benefits, to seek input from
the Public Assistance Health Benefit Review and Design Committee
established under Section 531.067, Government Code. 

(f)  Authorizes HHSC, if it determines the policy to be cost-effective, to
ensure that an enrolled child does not, unless authorized by HHSC in
consultation with the child's attending physician or advanced practice
nurse, receive under the child health plan more than four different
outpatient brand-name prescription drugs during a month or 
 more than a 34-day supply of a brand-name prescription drug at any one
time. 

SECTION 2.46.  Amends Section 62.153, Health and Safety Code, by amending
Subsection (b) and adding Subsection (d), as follows: 

 (b)  Provides an exception.

(d)  Authorizes cost-sharing provisions adopted under this section to be
determined based on the maximum level authorized under federal law and
applied to income levels in a manner that minimizes administrative costs. 

SECTION 2.47.  (a)  Amends the heading to Section 62.154, Health and
Safety Code, to read as follows: 

 Sec. 62.154.  WAITING PERIOD; CROWD OUT.

 (b)  Amends Sections 62.154(a), (b), and (d), Health and Safety Code, as
follows: 

  (a)  Makes a nonsubstantive change.

(b)  Provides that a child is not subject to a waiting period adopted
under Subsection (a) if the child has access to group-based health
benefits plan coverage and is required to participate in the health
insurance premium payment reimbursement program administered by HHSC.
Makes conforming changes. 

(d)  Requires the waiting period required by Subsection (a) to extend for
a period of 90 days after the date on which the applicant is enrolled
under the child health plan, rather than was covered under a health
benefits plan.  Deletes "apply to a child who was covered by a health
benefits plan at any time during the 90 days before the date of
application for coverage under the child health plan, other than a child
who was covered under a health benefits plan provided under Chapter 109." 

 SECTION 2.48.  Amends Sections 62.155(c) and (d), Health and Safety Code,
as follows: 
 
(c)  Authorizes HHSC to  give preference to a person who provides similar
coverage under the Medicaid program in selecting a health plan provider,
but not through the Texas Healthy Kids Corporation and requires HHSC to
provide for a choice of not more than, rather than at least, two health
plan providers in each service, rather than metropolitan area.  

(d)  Makes conforming changes.

SECTION  2.49.  Amends Subchapter D, Chapter 62, Health and Safety Code,
by adding Section 62.158, as follows: 

Sec. 62.158.  STATE TAXES.  Requires HHSC to ensure that any experience
rebate or profit-sharing for health plan providers under the child health
plan is calculated by treating premium, maintenance, and other taxes under
the Insurance Code and any other taxes payable to this state as allowable
expenses for purposes of determining the amount of the experience rebate
or profit-sharing. 

SECTION 2.50.  Amends Section 142.003(a), Health and Safety Code, to
include in the list of persons that need not be licensed under this
chapter a person who provides services under a home and community-based
services waiver program for persons with mental retardation adopted in
accordance with Section 1915(c) of the federal Social Security Act (42
U.S.C. Section 1396n), as amended, and that is funded wholly or partly by
MHMR. 

SECTION 2.51.  Amends Section 142.009(j), Health and Safety Code, to
remove Subsection (i) as an exception. 
 
SECTION 2.52.  (a)  Amends Section 242.047, Health and Safety Code, as
follows: 

Sec. 242.047.  New heading: ACCREDITATION REVIEW TO SATISFY INSPECTION OR
CERTIFICATION REQUIREMENTS.  (a)  Requires TDHS to accept an annual
accreditation review from the Joint Commission on Accreditation of Health
Organizations for a nursing home instead of an inspection for renewal of a
license under Section 242.033 and in satisfaction of the requirements for
certification by the department for participation in the medical
assistance program under Chapter 32, Human Resources Code, and the federal
Medicare program, but only if certain conditions apply. 
  
(b)  Requires TDHS to coordinate its licensing and certification
activities with HHSC. 
 
(c)  Requires TDHS and HHSC to sign a memorandum of agreement to implement
this section.  Requires the memorandum to provide that if all parties to
the memorandum do not agree in the development, interpretation, and
implementation of the memorandum, any area of dispute is to be resolved by
the Texas Board of Human Services. 

(d)  Provides that except as specifically provided by this section, this
section does not limit TDHS in performing any duties and inspections
authorized by this chapter or under any contract relating to the medical
assistance program under Chapter 32, Human Resources Code, and Titles
XVIII and XIX of the Social Security Act (42 U.S.C. Sections 1395 et seq.
and 1396 et seq.), including authority to take appropriate action relating
to an institution, such as closing the institution. 

(e)  Provides that this section does not require a nursing home to obtain
accreditation from HHSC. 

(b)  Requires TDHS, not later than October 1, 2003, to take certain
actions. 
 
(c)  Requires TDHS, not later than December 1, 2003, to report its
progress under Subsection (b) of this section to the governor and to the
presiding officer of each house of the legislature. 

SECTION 2.53.  (a)  Amends Section 242.063(d), Health and Safety Code, to
require, rather than authorizes, a suit for a temporary restraining order
or other injunctive relief to be brought in the county in which the
alleged violation occurs.  Deletes text relating to Chapter 15, Civil
Practice and Remedies Code, or Section 65.023, Civil Practice and Remedies
Code as providing exceptions to this subchapter.  Deletes existing text
relating to requiring a suit for a  temporary restraining order or other
injunctive relief to be brought in Travis County. 
 
(b)  Repealer: Section 242.063(e), Health and Safety Code.

(c)  Makes application of the changes in law made by this section to
Section 242.063(d), Health and Safety Code, prospective.  

SECTION 2.54.  Amends Section 242.065(b), Health and Safety Code, to
require the trier of fact to consider certain information, in determining
the amount of a penalty to be awarded under this section. 

SECTION 2.55.  (a)  Amends Section 242.070, Health and Safety Code, as
follows: 

Sec. 242.070.  APPLICATION OF OTHER LAW.  Prohibits TDHS from assessing
more than one monetary penalty under this chapter and Chapter 32, Human
Resources Code, for a violation arising out of the same act or failure to
act, except as provided by Section 242.0665(c).  Authorizes TDHS to assess
the greater of a monetary penalty under this chapter or, rather than and,
a monetary penalty under Chapter 32, Human Resources Code, for the same
act or failure to act. 

(b)  Makes application of the change in law made by this section to
Section 242.070, Health and Safety Code, prospective. 

SECTION 2.56.  Section 242.601(a), Health and Safety Code, to require an
institution to establish medication administration procedures.  Deletes
existing text relating to establishing medication administration
procedures to ensure certain conditions are met. 

SECTION 2.57.  Amends Section 242.603(a), Health and Safety Code, to
require an institution to store medications under appropriate conditions
of sanitation, temperature, light, moisture, ventilation, segregation, and
security.  Deletes existing text relating to the storage procedures for
certain poisons and medications. 

SECTION 2.58.  (a)  Amends Section 245.004(a), Health and Safety Code, to
provide that certain facilities need not be licensed under this chapter. 

(b)  Requires an office of a physician required by Section 245.004(a),
Health and Safety Code, as amended by this section, to be licensed under
Chapter 245, Health and Safety Code, to obtain that license not later than
January 1, 2004. 

SECTION 2.59.  (a)  Amends Section 252.202(a), Health and Safety Code, to
provide that a quality assurance fee is imposed on each facility for which
a license fee must be paid under Section 252.034, on each facility owned
by a community mental health and mental retardation center, as described
by Subchapter A, Chapter 534, and on each facility owned by the MHMR.
Provides that the fee is a certain amount, payable monthly, and is in
addition to other fees imposed under this chapter. 
  
(b)  Requires each facility owned by MHMR, not later than January 1, 2004,
to pay the quality assurance fee imposed by Section 252.202, Health and
Safety Code, as amended by this section, for patient days occurring
between September 1, 2002, and July 31, 2003. 

 SECTION 2.60.  Amends Section 252.203, Health and Safety Code, to delete
certain beds on hold from the formula for determining the number of
patient days. 
 
SECTION 2.61.  Amends Section 252.204(b), Health and Safety Code, to
require each facility to take certain actions by certain dates. 
  
SECTION 2.62.  Amends Sections 252.207(a) and (c), Health and Safety Code,
as follows: 

(a)  Authorizes, rather than requires HHSC, subject to legislative
appropriation and state and federal law, to use money in the quality
assurance fund, together with any federal money available to match that
money for certain purposes. 

(c)  Requires HHSC, if money in the quality assurance fund is used to
increase a reimbursement rate in the Medicaid program, to ensure that the
reimbursement methodology used to set that rate describes how the money in
the fund will be used to increase the rate and provides incentives to
increase direct care staffing and direct care wages and benefits.  Deletes
existing text relating to the formula devised under Subsection (b). 

SECTION 2.63.  Amends Section 253.008, Health and Safety Code, as follows:

Sec. 253.008.  VERIFICATION OF EMPLOYABILITY.  (a)  Requires an agency
licensed under Chapter 142, or a person exempt from licensing under
Section 142.003(a)(19), before hiring an employee, to search the employee
misconduct registry under this chapter and the nurse aide registry
maintained under the Omnibus Budget Reconciliation Act of 1987 (Pub. L.
No. 100-203) to determine whether the applicant for employment, rather
than the person, is designated in either registry as having abused,
neglected, or exploited a resident or consumer of a facility or an
individual receiving services from an agency licensed under Chapter 142 or
from a person exempt from licensing under Section 142.003(a)(19).  Makes
nonsubstantive changes. 
 
  (b)  Makes conforming and nonsubstantive changes.

SECTION 2.64.  Amends Section 253.009(a), Health and Safety Code, to make
conforming and nonsubstantive changes. 

SECTION 2.65.  (a) Amends Chapter 285, Health and Safety Code, by adding
Subchapter M as follows: 
 
SUBCHAPTER M.  PROVISION OF SERVICES

Sec. 285.201.  PROVISION OF MEDICAL AND HOSPITAL CARE.  Provides that as
authorized by 8 U.S.C. Section 1621(d), this chapter affirmatively
establishes eligibility for a person who would otherwise be ineligible
under 8 U.S.C. Section 1621(a), provided that only local funds are
utilized for the provision of nonemergency public health benefits.
Provides that a person is not considered a resident of a governmental
entity or hospital district if the person attempted to establish residence
solely to obtain health care assistance. 

 (b)  This sections effective date:  upon passage or September 1, 2003.

SECTION 2.66.  Amends Section 431.021(w), Health and Safety Code, to
provide that the act of or the causing of the acceptance by a person,
except as provided under Subchapter M of this chapter and Section
562.1085, Occupations Code, of an unused prescription or drug, in whole or
in part, for the purpose of resale, after the prescription or drug has
been originally dispensed, or sold is unlawful and prohibited. 

SECTION 2.67.  (a)  Amends Section 461.018(b), Health and Safety Code, to
require the Texas Commission on Alcohol and Drug Abuse to include certain
information. 
 
(b)  Repealer:  Section 466.251(b) (Tickets), Government Code, and Section
2001.417(b) (Toll-Free Help), Occupations Code. 

SECTION 2.68.  Amends Section 533.034, Health and Safety Code, as follows:

Sec. 533.034.  AUTHORITY TO CONTRACT FOR COMMUNITY-BASED SERVICES.  (a)
Creates this subsection from existing text. 

(b)  Authorizes MHMR to adopt a schedule of initial and annual renewal
compliance fees for persons that provide services under a home and
communitybased services waiver program for persons with mental retardation
adopted in accordance with Section 1915(c) of the federal Social Security
Act (42 U.S.C. Section 1396n), as amended, and that is funded wholly or
partly by MHMR and monitored by MHMR or by a designated local authority in
accordance with standards adopted by MHMR.  Provides that this subsection
expires September 1, 2005. 

SECTION 2.69.  Amends Section 533.035, Health and Safety Code, by amending
Subsection (c) and by adding Subsections (e), (f), and (g), as follows: 
 
(c)  Deletes language requiring a local health and mental retardation
authority to consider public input in determining whether to become a
provider of a service or to contract that service to another organization.
Makes a conforming change. 

(e)  Authorizes a local mental health and mental retardation authority to
serve as a provider of services only as a provider of last resort, in
assembling a network of service providers, and only if the authority
demonstrates to MHMR that the authority has made every reasonable attempt
to solicit the development of an available and appropriate provider base
that is sufficient to meet the needs of consumers in its service area and
there is not a willing provider of the relevant services in the
authority's service area or in the county where the provision of the
services is needed. 

(f)  Requires MHMR to review the appropriateness of a local mental health
and mental retardation authority's status as a service provider at least
annually. 

(g)  Requires MHMR, together with local mental health and mental
retardation authorities and other interested persons, to develop and
implement a plan to privatize all services by intermediate facilities for
persons with mental retardation and all related waiver services programs
operated by an authority.  Requires the transfer of services to private
providers to occur on or before August 31, 2004.  Requires the plan to
provide certain criteria.  

SECTION 2.70.  Amends Subchapter B, Chapter 533, Health and Safety Code,
by adding Section 533.0354, as follows: 

Sec. 533.0354.  DISEASE MANAGEMENT PRACTICES AND JAIL DIVERSION MEASURES
OF LOCAL MENTAL HEALTH AUTHORITIES.  (a)  Requires a local mental health
authority to provide assessment services, crisis services, and intensive
and comprehensive services using disease management practices for adults
with bipolar disorder, schizophrenia, or clinically severe depression and
for children with serious emotional illnesses.  Requires the local mental
health authority to engage an individual with certain treatment services.

(b)  Requires MHMR to require each local mental health authority to
incorporate jail diversion strategies into the authority's disease
management practices for managing adults with schizophrenia and bipolar
disorder to reduce the involvement of those client populations with the
criminal justice system. 

(c)  Requires MHMR to enter into performance contracts between MHMR and
each local mental health authority for the fiscal years ending August 31,
2004, and  August 31, 2005, that specify measurable outcomes related to
their success in using disease management practices to meet the needs of
the target populations. 

(d)  Requires MHMR to study the implementation of disease management
practices, including the jail diversion measures, and to submit to the
governor, the lieutenant governor, and the speaker of the house of
representatives a report on the progress in implementing disease
management practices and jail diversion measures by local mental health
authorities.  Requires the report to be delivered not later than December
31, 2004, and to include specific information on certain items. 
  
(e)  Authorizes MHMR to use the fiscal year ending August 31, 2004, as a
transition period for implementing the requirements of Subsections
(a)-(c). 

SECTION 2.71.  Amends Subchapter B, Chapter 533, Health and Safety Code,
by adding Section 533.0355, as follows: 

Sec. 533.0355.  ALLOCATION OF DUTIES UNDER CERTAIN MEDICAID WAIVER
PROGRAMS.  (a)  Defines "waiver program." 

(b)  Requires a provider of services under the waiver program to perform
certain functions. 
  
  (c)  Requires a local mental retardation authority to perform certain
functions. 

(d)  Requires MHMR to perform all administrative functions under the
waiver program that are not assigned to a service provider under
Subsection (b) or to a local mental retardation authority under Subsection
(c).  Provides that administrative functions performed by MHMR include any
surveying, certification, and utilization review functions required under
the waiver program. 

(e)  Requires MHMR to review case management fees paid under the waiver
program to a community center and administrative fees paid under the
waiver program to a service provider.  Requires the review to include a
comparison of fees paid before the implementation of this section with
fees paid after the implementation of this section.  Authorizes MHMR to
adjust fees paid based on that review. 

(f)  Requires MHMR to allocate the portion of the gross reimbursement
funds paid to a local authority and a service provider for client services
for the case management function in accordance with this section and to
the extent allowed by law. 

(g)  Authorizes MHMR to adopt rules governing the functions of a local
mental retardation authority or service provider under this section. 

SECTION 2.72.  (a)  Amends Subchapter B, Chapter 533, Health and Safety
Code, by adding Section 533.049, as follows: 

Sec. 533.049.  PRIVATIZATION OF STATE SCHOOL.  (a)  Authorizes MHMR, after
August 31, 2004, and before September 1, 2005, to contract with a private
service provider to operate a state school under certain circumstances. 

(b)  Requires MHMR, on or before April 1, 2004, to report to the
commissioner of health and human services whether MHMR has received a
proposal by a private service provider to operate a state school.
Requires the report to include an evaluation of the private service
provider's qualifications, experience, and financial strength, a
determination of whether the provider can operate the state school under
the same standard of care as MHMR, and an analysis of the  projected
savings under a proposed contract with the provider.  Requires the savings
analysis to include all MHMR costs to operate the state school, including
costs, such as employee benefits, that are not appropriated to MHMR. 

(c)  Requires MHMR, the Governor's Office of Budget and Planning, and the
Legislative Budget Board to identify sources of funding to be transferred
to MHMR to fund the contract, if MHMR contracts with a private service
provider to operate a state school. 

(d)  Authorizes MHMR to renew a contract under this section.  Provides
that the conditions listed in Subsections (a)(1)-(3) apply to the renewal
of the contract. 

(b)  Provides that Section 533.049, Health and Safety Code, as added by
this section, takes effect September 1, 2004. 

SECTION 2.73.  (a)  Amends Subchapter B, Chapter 533, Health and Safety
Code, by adding Section 533.050, as follows: 

Sec. 533.050.  PRIVATIZATION OF STATE MENTAL HOSPITAL.  (a)  Authorizes
MHMR, after August 31, 2004, and before September 1, 2005, to contract
with a private service provider to operate a state mental hospital owned
by MHMR under certain conditions. 
  
(b)  Requires MHMR, on or before April 1, 2004, to report to HHSC whether
MHMR has received a proposal by a private service provider to operate a
state mental hospital.  Requires the report to include an evaluation of
the private service provider's qualifications, experience, and financial
strength, a determination of whether the provider can operate the hospital
under the same standard of care as MHMR, and an analysis of the projected
savings under a proposed contract with the provider.  Requires the savings
analysis to include all MHMR costs to operate the hospital, including
costs, such as employee benefits, that are not appropriated to MHMR. 

(c)  Requires, if MHMR contracts with a private service provider to
operate a state mental hospital, MHMR, the Governor's Office of Budget and
Planning, and the Legislative Budget Board to identify sources of funding
to be transferred to MHMR to fund the contract. 

  (d)  Authorizes MHMR to renew a contract under this section.  Provides
that the   conditions listed in Subsections (a)(1)-(3) apply to the
renewal of the contract. 

(b)  Provides that Section 533.050, Health and Safety Code, as added by
this section, takes effect September 1, 2004. 

SECTION 2.74.  (a)  Amends Subchapter C, Chapter 533, Health and Safety
Code, by adding Sections 533.061 and 533.0611, as follows: 

Sec. 533.061.  REQUIRED CONTRACT PROVISIONS.  (a)  Requires MHMR to
include in a contract with an ICF-MR program provider a provision stating
that the contract terminates if MHMR imposes a vendor hold on payments
made to the facility under the medical assistance program under Chapter
32, Human Resources Code, three times during an 18-month period. 

(b)  Requires MHMR to ensure that each provision of a contract with an
intermediate care facility for the mentally retarded (ICF-MR) program
provider is consistent with MHMR and TDHS rules that govern the program. 

Sec. 533.0611.  SANCTIONS.  Requires, if TDHS recommends that a vendor
hold be imposed on payments made to an ICF-MR program provider or that the
contract with the  ICF-MR program provider be terminated, MHMR to
immediately impose the vendor hold or terminate the contract, as
appropriate, without conducting a further investigation or providing the
program provider an opportunity to take corrective action. 

(b)  Provides that a rule adopted by MHMR before September 1, 2003,
relating to the imposition of a vendor hold on payments made to an ICF-MR
program provider or the cancellation of a contract with an ICF-MR program
provider after the imposition of vendor holds, is repealed on September 1,
2003. 

(c)  Makes application of this Act prospective for Section 533.061, Health
and Safety Code, as added by this section. 

SECTION 2.75.  Amends Section 533.084, Health and Safety Code, by adding
Subsections (b-1) and (b-2), as follows: 

(b-1)  Provides that, notwithstanding Subsection (b) or any other law, the
proceeds from the disposal of any surplus real property by MHMR that
occurs before September 1, 2005,  are not required to be deposited to the
credit of MHMR in the Texas capital trust fund established under Chapter
2201, Government Code, and may be appropriated for any general
governmental purpose. 

 (b-2)  Provides that Subsection (b-1) and this subsection expire
September 1, 2005. 

SECTION 2.76.  Amends Subchapter D, Chapter 533, Health and Safety Code,
by adding Section 533.0844, as follows: 

Sec. 533.0844.  MENTAL HEALTH COMMUNITY SERVICES ACCOUNT.  (a) Provides
that the mental health community services account is an account in the
general revenue fund to be appropriated only for the provision of mental
health services by or under contract with MHMR. 

(b)  Requires MHMR to deposit to the credit of the mental health community
services account any money donated to the state for inclusion in the
account, including life insurance proceeds designated for deposit to the
account. 

(c)  Requires interest earned on the mental health community services
account to be credited to the account.  Provides that the account is
exempt from the application of Section 403.095 (Use of Dedicated Revenue),
Government Code. 

SECTION 2.77.  Amends Subchapter D, Chapter 533, Health and Safety Code,
by adding Section 533.0846, as follows: 

Sec. 533.0846.  MENTAL RETARDATION COMMUNITY SERVICES ACCOUNT. (a)
Provides that the mental retardation community services account is an
account in the general revenue fund to be appropriated only for the
provision of mental retardation services by or under contract with MHMR. 

(b)  Requires MHMR to deposit to the credit of the mental retardation
community services account any money donated to the state for inclusion in
the account, including life insurance proceeds designated for deposit to
the account. 

(c)  Requires that interest earned on the mental retardation community
services account  be credited to the account.  Provides that the account
is exempt from the application of Section 403.095, Government Code. 

SECTION 2.78.  Amends Section 534.001(b), Health and Safety Code, to make
a nonsubstantive change. 

SECTION 2.78A.  Amends Section 535.002(b), Health and Safety Code, to
change "authorities"  to "authority" and "the sole providers" to "a
provider." 
 
SECTION 2.79.  Amends Chapter 22, Human Resources Code, by adding Section
22.040, as follows: 

 Sec. 22.040.  THIRD-PARTY INFORMATION.  Authorizes TDHS, notwithstanding
any other provision of this code, to use information obtained from a third
party to verify the assets and resources of a person for purposes of
determining the person's eligibility and need for medical assistance,
financial assistance, or nutritional assistance.  Provides that
third-party information includes information obtained from certain
sources. 
  
SECTION 2.80.  (a)  Amends Section 31.0031, Human Resources Code, by
amending Subsection (g) and adding Subsection (h), as follows: 

 (g)  Defines "payee" and makes a nonsubstantive change.  

(h)  Requires TDHS to require each payee to sign a bill of
responsibilities that defines the responsibilities of the state and of the
payee.  Requires the responsibility agreement to require that a payee
comply with the requirements of Subsections (d)(1), (2), (5), (6), and
(7). 

SECTION 2.81.  (a)  Amends Sections 31.0032, 31.0033, and 31.0034, Human
Resources Code, as follows: 

Sec. 31.0032.  New heading:  PAYMENT OF ASSISTANCE AFTER PERFORMANCE. (a)
Prohibits, except as provided by Section 31.0033 and notwithstanding any
other law, a person for whom TDHS has made a determination of eligibility
for financial assistance and for whom an initial payment of that
assistance has been made from receiving any subsequent monthly payments of
assistance for the person or the person's family until the person
cooperates with the requirements of the responsibility agreement under
Section 31.0031.  Authorizes the person and the person's family to receive
a financial assistance payment each month only if the person cooperated
with those requirements during the previous month.  Deletes language
regarding investigations and penalties relating to the agreement.  
  
(b)  Requires TDHS to immediately notify the caretaker relative, second
parent, or payee receiving the financial assistance if TDHS will not make
the financial assistance payment for a one-month period because of a
person's failure to cooperate with the requirements of the responsibility
agreement during that month. 

(c)  Authorizes HHSC, or any health and human services agency, as defined
by Section 531.001, Government Code, to deny medical assistance for an
individual, to the extent allowed by federal law, who is eligible for
financial assistance but to whom that assistance is not paid because of
the individual's failure to cooperate. Prohibits medical assistance to the
person's family from being denied for the individual's failure to
cooperate.  Provides that this subsection prohibits the denial of medical
assistance to persons receiving assistance under this chapter under the
age of 19, pregnant adults, and any other person who may not be denied
medical assistance under federal law. 

(d)  Creates this subsection from existing text to provide that this
section does not prohibit the Texas Workforce Commission (TWC), HHSC, or
any health and human services agency, as defined by Section 531.001,
Government Code, rather than TDHS, from providing medical assistance,
child care, or any other social or support services for an individual who
is eligible for financial assistance but to whom that assistance is not
paid because of the individual's failure to cooperate.  

(e)  Requires TDHS by rule to establish procedures to determine whether a
person  has cooperated with the requirements of the responsibility
agreement during each one-month period. 

Sec. 31.0033.  New heading:  GOOD CAUSE HEARING FOR FAILURE TO COOPERATE.
(a)  Authorizes, if TDHS or Title IV-D agency determines that a person has
failed to cooperate with the requirements of the responsibility agreement
under Section 31.0031 during a one-month period, a person determined to
have failed to cooperate or, if different, the person receiving the
financial assistance to request a hearing to show good cause for failure
to cooperate not later than the 13th day after the date on which notice is
received under Section 31.0032.  Prohibits TDHS, if the person determined
to have failed to cooperate or, if different, the person receiving the
financial assistance requests a hearing to show good cause not later than
the 13th day after the date on which notice is received under Section
31.0032, from withholding or reducing the payment of financial assistance
until the 31st day after TDHS receives the request, provided TDHS
completes the hearing before the 31st day, or the date the hearing is
completed.  Authorizes, on a showing of good cause for failure to
cooperate, a person to receive a financial assistance payment for the
month in which the person failed to cooperate. 

(c)  Prohibits TDHS, if TDHS finds that good cause for the person's
failure to cooperate was not shown at a hearing, from making a financial
assistance payment in any amount to the person for the person or the
person's family for the month in which the person failed to cooperate. 

  (d)  Replaces "noncompliance" with "failure to cooperate."

(e)  Provides that, except as provided by a waiver or modification granted
under Section 31.0322, a person has good cause for failing or refusing to
cooperate with the requirement of the responsibility agreement under
Section 31.0031(d)(1) only if the person's cooperation would be harmful to
the physical, mental, or emotional health of the person or the person's
dependent child. 

Sec. 31.0034.  ANNUAL REPORT.  Includes in the information to be included
in TDHS's annual report  the number of persons who were eligible to
receive financial assistance under this chapter for each one-month period
but to whom that financial assistance was not paid because the person
failed to cooperate with the requirements of the responsibility agreement
under Section 31.0031.  Removes reference to "sanctions" and replaces
"comply" with "cooperate."  Makes nonsubstantive changes. 

(b)  Amends Subchapter A, Chapter 31, Human Resources Code, by adding
Section 31.00331, as follows: 

Sec. 31.00331.  PENALTY FOR FAILURE TO COOPERATE.  (a)  Prohibits a person
who, during a one-month period, fails to cooperate with the requirements
of the responsibility agreement under Section 31.0031 without good cause
from receiving a financial assistance payment for the person or the
person's family for that month. 

(b)  Requires TDHS, when TDHS is notified by TWC that a client failed to
cooperate with work requirements, to suspend the case for 13 days to allow
the client to appeal that finding.  Requires the case to be denied if the
client fails to request an appeal within that 13-day period.  Requires the
case to be denied immediately, if the client requests an appeal and the
appeal is denied.  Requires, if the appeal is upheld, the case be
reinstated, if the appeal is upheld. 

(c)  Provides that a person who fails to cooperate with the responsibility
agreement for two consecutive months becomes ineligible for financial
assistance for the person or the person's family.  Authorizes the person
to reapply for financial assistance, but requires cooperation with the
requirements of the responsibility agreement for a one-month period before
receiving an assistance  payment for that month. 

(c)  Makes application of this Act prospective for the changes in law made
by this section applying to a person receiving financial assistance under
Chapter 31, Human Resources Code. 

SECTION 2.82.  Amends Subchapter A, Chapter 31, Human Resources Code, by
adding Section 31.0038, as follows: 

Sec. 31.0038.  TEMPORARY EXCLUSION OF NEW SPOUSE'S INCOME.  (a) Prohibits
income earned by an individual who marries an individual receiving
financial assistance at the time of the marriage from being considered by
TDHS during the sixmonth period following the date of the marriage for
purposes of determining the amount of financial assistance granted to an
individual under this chapter for the support of dependent children or
whether the family meets household income and resource requirements for
financial assistance under this chapter, subject to the limitations
prescribed by Subsection (b). 

(b)  provides that to be eligible for the income disregard provided by
Subsection (a), the combined income of the individual receiving financial
assistance and the new spouse cannot exceed 200 percent of the federal
poverty level for their family size. 

SECTION 2.83.  Amends Sections 31.012(b) and (c), Human Resources Code, as
follows: 

 (b)  Makes a conforming change.

(c)  Deletes language referring to a single person who is the caretaker of
a child and the requirement that the person participate in a program under
this section. 

SECTION 2.84.  Amends Subchapter A, Chapter 31, Human Resources Code, by
adding Section 31.015, as follows: 

Sec. 31.015.  HEALTHY MARRIAGE DEVELOPMENT PROGRAM.  (a)  Requires TDHS,
subject to available federal funding, to develop and implement a healthy
marriage development program for recipients of financial assistance under
this chapter. 

(b)  Requires the healthy marriage development program to promote and
provide three instructional courses on certain topics. 

(c)  Requires TDHS to provide to a recipient of financial assistance under
this chapter additional financial assistance of not more than $20 for the
recipient's participation in a course offered through the healthy marriage
development program up to a maximum payment of $60 a month. 

(d)  Authorizes TDHS to provide the courses or  contract with any person,
including a community or faith-based organization, for the provision of
the courses.  Requires TDHS to provide all participants with an option of
attending courses in a non-faith-based organization. 

(e)  Requires TDHS to develop rules as necessary for the administration of
the healthy marriage development program. 

(f)  Requires TDHS to ensure that the courses provided by TDHS and courses
provided through contracts with other organizations will be sensitive to
the needs of individuals from different religions, races, and genders. 

SECTION 2.85.  (a)  Amends Section 32.021, Human Resources Code, by adding
Subsections (q), (r), and (s), as follows: 
 
(q)  Requires TDHS to include in its contracts for the delivery of medical
assistance by nursing facilities clearly defined minimum standards that
relate directly to the quality of care for residents of those facilities.
Requires TDHS to consider the recommendations made by the nursing facility
quality assurance team under Section 32.060 in establishing the standards.
Requires TDHS to include certain provisions in each contract. 
  
(r)  Prohibits TDHS from awarding a contract for the delivery of medical
assistance to a nursing facility that does not meet the minimum standards
that would be included in the contract as required by Subsection (q).
Requires TDHS to terminate a contract for the delivery of medical
assistance by a nursing facility that does not meet or maintain the
minimum standards included in the contract in a manner consistent with the
terms of the contract. 

(s)  Requires TDHS, not later than November 15 of each even-numbered year,
to submit a report to the legislature regarding nursing facilities that
contract with TDHS to provide medical assistance under this chapter and
other nursing facilities with which TDHS was prohibited to contract as
provided by Subsection (r).  Authorizes TDHS to include the report
required under this section with the report made by the long-term care
legislative oversight committee as required by Section 242.654, Health and
Safety Code.  Requires the report to include certain information. 

(b)  Makes application of this Act prospective to May 1, 2004 for Section
32.021(q), Human Resources Code, as added by this section. 

SECTION 2.86.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.0212, as follows: 

Sec. 32.0212.  DELIVERY OF MEDICAL ASSISTANCE.  Requires TDHS to provide
medical assistance for acute care through the Medicaid managed care system
implemented under Chapter 533, Government Code, notwithstanding any other
law and subject to Section 533.0025, Government Code. 

SECTION 2.87.  (a)  Amends Section 32.024, Human Resources Code, by adding
Subsections  
(t-1), (z), and (z-1), as follows:

(t-1)  Prohibits TDHS, in its rules governing the medical transportation
program, from prohibiting a recipient of medical assistance from receiving
transportation services through the program on the basis that the
recipient resides in a nursing facility. 

(z)  Authorizes TDHS, in its rules and standards governing the vendor drug
program, to the extent allowed by federal law and if TDHS determines the
policy to be cost-effective, to ensure that a recipient of prescription
drug benefits under the medical assistance program does not, unless
authorized by TDHS in consultation with the recipient's attending
physician or advanced practice nurse, receive certain amounts of
prescription drugs under the medical assistance program. 

(z-1)  Provides that Subsection (z) does not affect any other limit on
prescription medications otherwise prescribed by department rule. 

(b)  Makes application of this Act prospective for Section 32.024(z),
Human Resources Code, as added by this section. 

SECTION 2.88.  Amends Section 32.026(e), Human Resources Code, to require
TDHS to permit a recertification review of the eligibility and need for
medical assistance of a child under 19 years of age to be conducted by a
person-to-person telephone interview or through a combination of a
telephone interview and mail correspondence instead of through a personal
appearance at a TDHS office. 

SECTION 2.89.  Amends Section 32.0261, Human Resources Code, as follows:
 
Sec. 32.0261.  CONTINUOUS ELIGIBILITY.  Replaces "first anniversary of
the" with "six months from" in relation to the date on which a child's
eligibility was determined. 

SECTION 2.90.  Amends Section 32.0315(a), Human Resources Code, to make
this section subject to appropriated state funds.  

SECTION 2.91.  Amends Section 10(c), Chapter 584, Acts of the 77th
Legislature, Regular Session, 2001, to change the date of June 1, 2003, to
June 1, 2004 in relation to the effective date of the rules. 

SECTION 2.92.  Amends Section 32.028, Human Resources Code, by amending
Subsection (g) and adding Subsection (i), as follows: 

(g)  Requires HHSC, subject to Subsection (i), to ensure that the rules
governing the determination of rates paid for nursing home services
improve the quality of care by providing a program offering incentives for
increasing direct care staff and direct care wages and benefits, but only
to the extent that appropriated funds are available after money is
allocated to base rate reimbursements as determined by the Health and
Human Services Commission's nursing facility rate setting methodologies. 

(i)  Requires HHSC to ensure that rules governing the incentives program
described by Subsection (g)(1) provide that participation in the program
by a nursing home is voluntary, do not impose on a nursing home not
participating in the program a minimum spending requirement for direct
care staff wages and benefits and do not set a base rate for a nursing
home participating in the program that is more than the base rate for a
nursing home not participating in the program. 

SECTION 2.93.  Amends Section 32.028, Human Resources Code, by adding
Subsections (j), (k), and (l), as follows: 

(j)  Requires HHSC to adopt rules governing the determination of the
amount of reimbursement or credit for restocking drugs under Section
562.1085, Occupations Code, that recognize the costs of processing the
drugs, including the cost of reporting the drug's prescription number and
date of original issue verifying whether the drug's expiration date or the
drug's recommended shelf life exceeds 120 days determining the source of
payment and  preparing credit records.  

(k)  Requires HHSC  to provide an electronic system for the issuance of
credit for returned drugs that complies with the Health Insurance
Portability and Accountability Act of 1996, Pub. L. No. 104-191, as
amended.  Provides that, to ensure a cost-effective system, only drugs for
which the credit exceeds the cost of the restocking fee by at least 100
percent are eligible for credit. 

(l)  Requires HHSC to establish a task force to develop the rules
necessary to implement Subsections (j) and (k).  Requires the task force
to include representatives of nursing facilities and long-term care
facilities. 

SECTION 2.94.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.0291, as follows: 

Sec. 32.0291.  PREPAYMENT REVIEWS AND POSTPAYMENT HOLDS.  (a) Authorizes
TDHS, notwithstanding any other law, to:  perform a prepayment review of a
claim for reimbursement under the medical assistance program to determine
whether the claim involves fraud or abuse; and as necessary to perform
that review, withhold payment of the claim for not more than five working
days without notice to the person submitting the claim. 

(b)  Authorizes TDHS, notwithstanding any other law, to impose a
postpayment hold on payment of future claims submitted by a provider if
TDHS has reliable  evidence that the provider has committed fraud or
wilful misrepresentation regarding a claim for reimbursement under the
medical assistance program. Requires TDHS to notify the provider of the
postpayment hold not later than the fifth working day after the date the
hold is imposed. 

SECTION 2.95.  Amends Section 32.032, Human Resources Code, as follows:

Sec. 32.032.  New heading:  PREVENTION AND DETECTION OF FRAUD AND ABUSE.
Makes conforming changes. 

SECTION 2.96.  Amends Section 32.0321, Human Resources Code, as follows:

Sec. 32.0321.  SURETY BOND.  (a)  Requires TDHS by rule to require a
provider of medical assistance to file with TDHS a surety bond in a
reasonable amount if TDHS identifies a pattern of suspected fraud or abuse
involving criminal conduct relating to the provider's services under the
medical assistance program that indicates the need for protection against
potential future acts of fraud or abuse. 

  (b)  Makes a conforming change.

(c)  Authorizes TDHS, subject to Subsection (d) or (e),  by rule to
require each provider of medical assistance that establishes a resident's
trust fund account to post a surety bond to secure any shortages in the
account.  Requires the bond to be payable to TDHS to compensate residents
of the bonded provider for trust funds that are lost, stolen, or otherwise
unaccounted for if the provider does not repay any deficiency in a
resident's trust fund account to the person legally entitled to receive
the funds. 

(d)  Prohibits TDHS from requiring the amount of a surety bond posted for
a single facility provider under Subsection (c) to exceed the average of
the total average monthly balance of all the provider's resident trust
fund accounts for the 12-month period preceding the bond issuance or
renewal date, excluding the amounts of the residents' personal needs
allowances. 

(e)  Prohibits TDHS from requiring the amount of a surety bond posted for
a multiple facility provider under Subsection (c) to exceed the average of
the total average monthly balance of all the provider's resident trust
fund accounts in all of the provider's facilities for the 12-month period
preceding the bond issuance or renewal date, excluding the amounts of the
residents' personal needs allowances. 

SECTION 2.97.  (a)  Amends Subchapter B, Chapter 32, Human Resources Code,
by adding Section 32.0423, as follows: 

Sec. 32.0423.  RECOVERY OF REIMBURSEMENTS FROM HEALTH COVERAGE PROVIDERS.
Requires, to the extent allowed by federal law, a health care service
provider to seek reimbursement from available third-party health coverage
or insurance that the provider knows about or should know about before
billing the medical assistance program. 

(b)  Makes application of this Act prospective for Section 32.0423, Human
Resources Code, as added by this section. 

SECTION 2.98.  (a)  Amends Subchapter B, Chapter 32, Human Resources Code,
by adding Section 32.0462, as follows: 

Sec. 32.0462.  MEDICATIONS AND MEDICAL SUPPLIES.  Authorizes TDHS to adopt
rules establishing procedures for the purchase and distribution of
medically necessary, over-the-counter medications and medical supplies
under the medical assistance program that were previously being provided
by prescription if TDHS  determines it is more cost-effective than
obtaining those medications and medical supplies through a prescription. 

(b)  Requires HHSC, not later than January 1, 2004, to submit a report to
the clerks of the standing committees of the senate and house of
representatives with jurisdiction over the state Medicaid program
describing the status of any cost savings generated by purchasing
over-the-counter medications and medical supplies as provided by Section
32.0462, Human Resources Code, as added by this section.  Requires the
report to be updated not later than January 1, 2005. 

SECTION 2.99.  Amends Section 32.050, Human Resources Code, by adding
Subsection (d) to require a nursing facility, a home health services
provider, or any other similar long-term care services provider that is
Medicare-certified and provides care to individuals who are eligible for
Medicare to seek reimbursement from Medicare before billing the medical
assistance program for services provided to an individual identified under
Subsection (a) and as directed by TDHS, appeal Medicare claim denials for
payment services provided to an individual identified under Subsection
(a). 

SECTION 2.100.  (a)  Amends Subchapter B, Chapter 32, Human Resources
Code, by adding Section 32.060, as follows: 

Sec. 32.060.  NURSING FACILITY QUALITY ASSURANCE TEAM.  (a)  Provides that
the nursing facility quality assurance team (team) is established to make
recommendations to TDHS designed to promote high-quality care for
residents of nursing facilities. 

(b)  Provides that the team is composed of nine particular members
appointed by the governor.   

(c)  Requires the governor to designate a member of the team to serve as
presiding officer.  Requires the members of the team to elect any other
necessary officers. 

  (d)  Requires the team to meet at the call of the presiding officer.

  (e)  Provides that a member of the team serves at the will of the
governor. 

(f)  Prohibits a member of the team from receiving compensation for
serving on the team but entitles the to reimbursement for travel expenses
incurred by the member while conducting the business of the team as
provided by the General Appropriations Act. 

(g)  Requires the team to develop and recommend clearly defined minimum
standards to be considered for inclusion in contracts between TDHS and
nursing facilities for the delivery of medical assistance under this
chapter that are designed to:  ensure that the care provided by nursing
facilities to residents who are recipients of medical assistance meets or
exceeds the minimum acceptable standard of care; and encourage nursing
facilities to provide the highest quality of care to those residents; and
to develop and recommend improvements to consumers' access to information
regarding the quality of care provided by nursing facilities that contract
with TDHS to provide medical assistance, including certain improvements. 

(h)  Requires the team, in developing minimum standards for contracts as
required by Subsection (g)(1), to perform certain tasks. 
  
(i)  Requires TDHS to ensure the accuracy of information provided to the
team for use by the team in performing the team's duties under this
section.  Requires HHSC to provide administrative support and resources to
the team and request additional administrative support and resources from
health and human services  agencies as necessary. 

(b)  Requires the governor to appoint the members of the team established
under Section 32.060, Human Resources Code, as added by this section, not
later than January 1, 2004. 

(c)  Requires the team to develop and make the recommendations required by
Section 32.060, Human Resources Code, as added by this section, not later
than May 1, 2004. 

(d)  Requires team to report on its work and recommendations to the
governor and the Legislative Budget Board no later than October 1, 2004,
for consideration by the 79th Legislature. 

SECTION 2.101.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.061, as follows: 

Sec. 32.061.  COMMUNITY ATTENDANT SERVICES PROGRAM. Requires any home and
community-based services that TDHS provides under Section 1929, Social
Security Act (42 U.S.C. Section 1396t) and its subsequent amendments to
functionally disabled individuals who have income that exceeds the limit
established by federal law for Supplemental Security Income (SSI) (42
U.S.C. Section 1381 et seq.) and its subsequent amendments to be provided
through the community attendant services program. 

SECTION 2.102.  (a)  Amends Subchapter B, Chapter 32, Human Resources
Code, by adding Section 32.063, as follows: 

Sec. 32.063.  THIRD-PARTY BILLING VENDORS.  (a)  Prohibits a third-party
billing vendor from submitting a claim with TDHS for reimbursement on
behalf of a provider of medical services under the medical assistance
program unless the vendor has entered into a contract with TDHS
authorizing that activity. 

(b)  Requires, to the extent practical, the contract to contain provisions
comparable to the provisions contained in contracts between TDHS and
providers of medical services, with an emphasis on provisions designed to
prevent fraud or abuse under the medical assistance program.  Requires, at
a minimum, the contract to require the third-party billing vendor to
perform certain functions. 

(c)  Requires TDHS, on receipt of a claim submitted by a third-party
billing vendor, to send a remittance notice directly to the provider
referenced in the claim.  Requires the notice to include detailed
information regarding the claim submitted on behalf of the provider and
require the provider to review the claim for accuracy and notify TDHS
promptly regarding any errors. 

(d)  Requires TDHS to take all action necessary, including any
modifications of TDHS' claims processing system, to enable TDHS to
identify and verify a thirdparty billing vendor submitting a claim for
reimbursement under the medical assistance program, including
identification and verification of any computer or telephone line used in
submitting the claim, any relevant user password used in submitting the
claim, and any provider number referenced in the claim. 

(e)  Requires TDHS to audit each third-party billing vendor subject to
this section at least annually to prevent fraud and abuse under the
medical assistance program. 

(b)  Provides that Section 32.063, Human Resources Code, as added by this
section, takes effect January 1, 2004. 

SECTION 2.103.  (a)  Amends Subchapter B, Chapter 32, Human Resources
Code, by adding Section 32.064, as follows: 

 Sec. 32.064.  COST SHARING.  (a)  Requires HHSC, to the extent permitted
under Title XIX, Social Security Act (42 U.S.C. Section 1396 et seq.), as
amended, and any other applicable law or regulations, to adopt provisions
requiring recipients of medical assistance to share the cost of medical
assistance, including provisions requiring recipients to pay certain
costs. 
  
(b)  Requires cost-sharing provisions adopted under this section to ensure
that families with higher levels of income are required to pay
progressively higher percentages of the cost of the medical assistance,
subject to Subsection (d). 

(c)  Requires HHSC to specify the manner in which the premium is paid, if
costsharing provisions imposed under Subsection (a) include requirements
that recipients pay a portion of the plan premium.  Authorizes HHSC to
require that the premium be paid to HHSC,  an agency operating part of the
medical assistance program, or the Medicaid managed care plan. 

(d)  Authorizes cost-sharing provisions adopted under this section to be
determined based on the maximum level authorized under federal law and
applied to income levels in a manner that minimizes administrative costs. 

(b)  Makes application of this Act prospective for Section 32.064, Human
Resources Code.  

SECTION 2.104.  Amends Section 48.401(1), Human Resources Code, to
redefine "agency."  

SECTION 2.105.  Amends Section 73.0051, Human Resources Code, by adding
Subsection (l) to authorize the Interagency Council on Early Childhood
Intervention by rule to establish a system of payments by families of
children receiving services under this chapter, including a schedule of
sliding fees, in a manner consistent with 34 C.F.R. Sections
303.12(a)(3)(iv), 303.520, and 303.521. 

SECTION 2.106.  (a)  Amends Sections 91.027(a) and (b), Human Resources
Code, as follows: 

(a)  Requires HHSC, to the extent that funds are available under Sections
521.421(f), as added by Chapter 510, Acts of the 75th Legislature, Regular
Session, 1997, and 521.422(b), Transportation Code, to operate, rather
than develop, a Blindness Education, Screening, and Treatment Program to
provide certain services. 
  
(b)  Requires HHSC to include transition services along with other
services. Deletes language requiring HHSC to implement the program only to
the extent that funds are available under Section 521.421(f),
Transportation Code. 

(b)  Requires the Texas Commission for the Blind to establish the
consolidated program under Section 91.027, Human Resources Code, as
amended by this section, not later than the 90th day after the effective
date of this section. 

SECTION 2.107.  (a)  Amends Section 111.052, Human Resources Code,  as
follows: 

Sec. 111.052.  GENERAL FUNCTIONS.  (a)  Deletes "an extended
rehabilitation services program"  as a program established to provide
rehabilitative services. 

(b) Includes assessing the statewide need for services necessary to
prepare students with disabilities for a successful transition to
employment, establish collaborative relationships with each school
district with education service centers to the maximum extent possible
within available resources, and develop strategies to assist vocational
rehabilitation counselors in identifying and reaching students in need of
transition planning to the authority of HHSC.  Deletes "contract with a
public or private agency to provide and pay for rehabilitative services
under the  extended rehabilitation services program, including alternative
sheltered employment or community integrated employment for a person
participating in the program" from HHSC's authority. 

(b)  Repealer:  Sections 111.002(7) (Definitions), 111.0525(a)
(Coordination with State Agencies), and 111.073(Transition Planning),
Human Resources Code. 

SECTION 2.108.  Amends Section 111.060, Human Resources Code, by adding
Subsection (d) to authorize any money in the comprehensive rehabilitation
fund to be used for general governmental purposes under certain
conditions. 
  
SECTION 2.109.  (a)  Provides that Subchapter I, Chapter 264, Family Code,
is transferred to Chapter 33, Education Code, redesignated as Subchapter
E, Chapter 33, Education Code, and amended as follows: 

SUBCHAPTER E.  COMMUNITIES IN SCHOOLS PROGRAM

Sec. 33.151.  DEFINITIONS.  Defines "department," "communities in schools
program," "delinquent conduct," and "student at risk of dropping out of
school." 

Sec. 33.152.  STATEWIDE OPERATION OF PROGRAM.  Includes "as that chapter
existed on August 31, 1999" in reference to Chapter 305, Labor Code.
Replaces "department" with "agency." 

Sec. 33.153.  STATE DIRECTOR.  Requires the commissioner of education,
rather than the executive director of the department, to designate a state
director for the Communities In Schools program. 

 Sec. 33.154.  DUTIES OF STATE DIRECTOR.  No changes to this section.

Sec. 33.155.  New heading:  DEPARTMENT COOPERATION; MEMORANDUM OF
UNDERSTANDING.  

(b)  Deletes the term "mutually" as a modifier to "agree" in reference to
a memorandum of understanding. Makes conforming and nonsubstantive
changes. 

Sec. 33.156.  FUNDING; EXPANSION OF PARTICIPATION.  (a)  Makes a
conforming change.  

Sec. 33.157.  PARTICIPATION IN PROGRAM.  Requires an elementary or
secondary school receiving funding under Section 33.156 to participate in
a local Communities In Schools program if the number of students enrolled
in the school who are at risk of dropping out of school is equal to at
least 10 percent of the number of students in average daily attendance at
the school, as determined by the Texas Education Agency.  Makes a
conforming change. 

 Sec. 33.158.  DONATIONS TO PROGRAM.  Makes conforming changes.

 (b)  Amends Section 302.062(g), Labor Code, to make conforming changes.

 (c)  Provides that on September 1, 2003:

(1)  all powers, duties, functions, and activities relating to the
Communities In Schools (CIS) program assigned to or performed by the
Department of Protective Services (DPS) immediately before September 1,
2003, are transferred to the Texas Education Agency (TEA); 

(2)  all funds, rights, obligations, and contracts of the DPS related to
the CIS program are transferred to the TEA for the CIS program; 
 
(3)  all property and records in the custody of the DPS related to the CIS
program and all funds appropriated by the legislature for the CIS program
are transferred to the TEA for the CIS program; and 

(4)  all employees of the DPS who primarily perform duties related to the
CIS program become employees of the TEA, to be assigned duties related to
the CIS program. 

(d)  Provides that for the 2003 and 2004 state fiscal years, all full-time
equivalent positions (FTEs) authorized by the General Appropriations Act
for the CIS program are transferred to the TEA and are not included in
determining the agency's compliance with any limitation on the number of
full-time equivalent positions (FTEs) imposed by the General
Appropriations Act. 

(e)  Provides that a reference in law or administrative rule to the DPS
that relates to the CIS program means the TEA.  Provides that a reference
in law or administrative rule to the executive director of the DPS that
relates to the CIS program means the commissioner of education. 

(f)  Provides that a rule of the DPS relating to the CIS program continues
in effect as a rule of the commissioner of education until superseded by
rule of the commissioner of education.  Provides that the secretary of
state is authorized to adopt rules as necessary to expedite the
implementation of this subsection. 

(g)  Provides that the transfer of the CIS program and associated powers,
duties, functions, and activities under this section does not affect or
impair any act done, any obligation, right, order, license, permit, rule,
criterion, standard, or requirement existing, any investigation begun, or
any penalty accrued under former law, and that law remains in effect for
any action concerning those matters. 

 (h) Makes application of this Act prospective.

SECTION 2.110.  (a) Amends Sections 2(a) and (c), Article 4.11, Insurance
Code, to redefine 
"carrier" and "gross premiums." 

(b)  Provides that the change in law made by this section applies only to
a tax report originally due on or after January 1, 2004. 

 (c)  Provides that the change in law made by this section expires
December 31, 2007. 

SECTION 2.111.  (a)  Amends Article 4.17(a), Insurance Code, to delete
references to "this state" in relation to gross premiums.  Deletes "for
the purpose of providing welfare benefits to designated welfare recipients
or for insurance contracted for by this state or the United States." 

(b)  Provides that the change in law made by this section applies only to
a tax report originally due on or after January 1, 2004. 

 (c)  Provides that the change in law made by this section expires
December 31, 2007. 

SECTION 2.112.  (a)  Amends Section 20A.33(d), Texas Health Maintenance
Organization Act (Article 20A.33, Vernon's Texas Insurance Code), to make
conforming changes. 

(b)  Provides that the change in law made by this section applies only to
a tax report originally due on or after January 1, 2004. 

 (c)  Provides that the change in law made by this section expires
December 31, 2007. 

SECTION 2.113.  Amends Section 2, Article 21.52K, Insurance Code, by
amending Subsections (c) and (d) and adding Subsection (g), as follows: 
 
(c)  Includes on receipt of "request" in relation to enrolling in the
plan.  Makes conforming changes. 

 (d)  Makes conforming changes.

(g)  Requires the issuer of a group health benefit plan to permit an
individual who is otherwise eligible for enrollment in the plan to enroll
in the plan without regard to any enrollment period restriction if the
individual becomes ineligible for medical assistance under the state
Medicaid program or enrollment in the state child health plan under
Chapter 62, Health and Safety Code, after initially establishing
eligibility and provides a written request for enrollment in the group
health benefit plan not later than the 30th day after the date the
individual's eligibility for the state Medicaid program or the state child
health plan terminated. 

SECTION 2.114.  (a)  Amends Article 21.53F, Insurance Code, as added by
Chapter 683, Acts of the 75th Legislature, Regular Session, 1997, by
adding Section 9, as follows: 

Sec. 9.  OFFER OF COVERAGE REQUIRED; CERTAIN THERAPIES FOR CHILDREN WITH
DEVELOPMENTAL DELAYS.  (a)  Provides that for purposes of this section,
rehabilitative and habilitative therapies include certain evaluations and
services. 
  
(b)  Requires the issuer of a health benefit plan to offer coverage that
complies with this section.  Authorizes the individual or group policy or
contract holder to reject coverage required to be offered under this
subsection. 

(c)  Prohibits a health benefit plan that provides coverage for
rehabilitative and habilitative therapies under this section from
prohibiting or restricting payment for covered services provided to a
child and determined to be necessary to and provided in accordance with an
individualized family service plan issued by the Interagency Council on
Early Childhood Intervention under Chapter 73, Human Resources Code. 

(d)  Requires rehabilitative and habilitative therapies described by
Subsection (c) of this section be covered in the amount, duration, scope,
and service setting established in the child's individualized family
service plan. 

(e)  Prohibits, under the coverage required to be offered under this
section, a health benefit plan issuer from performing certain actions. 

 (b)  Makes application of this section prospective to January 1, 2004.

SECTION 2.115.  Amends Article 27.05, Insurance Code, as follows:

 Art. 27.05.  EXEMPTION FROM PREMIUM TAX. Provides that a health benefit
plan  be approved under Article 27.03 of this code. 

SECTION 2.116.  Amends Chapter 27, Insurance Code, by adding Article
27.07, as follows: 

Art. 27.07.  INAPPLICABILITY TO CERTAIN PLANS. Provides that this chapter
does not apply to a health benefit plan provided under the state Medicaid
program or the state child health plan. 

SECTION 2.117.  Amends Subchapter C, Chapter 562, Occupations Code, by
adding Sections 562.1085 and 562.1086, as follows: 

Sec. 562.1085.  UNUSED DRUGS RETURNED BY CERTAIN PHARMACISTS. (a)
Authorizes a pharmacist who practices in or serves as a consultant for a
health care facility in this state to return to a pharmacy certain unused
drugs, other than a controlled  substance as defined by Chapter 481,
Health and Safety Code, purchased from the pharmacy as provided by board
rule.  Requires the unused drugs to be approved by the federal Food and
Drug Administration and meet certain other requirements. 

  (b)  Requires a pharmacist for the pharmacy to examine a drug returned
under this section to ensure the integrity of the drug product.  Prohibits
a health care facility from returning certain drugs. 

(c)  Authorizes the pharmacy  to restock and redistribute unused drugs
returned under this section. 

(d)  Requires the pharmacy to reimburse or credit the state Medicaid
program for an unused drug returned under this section. 

(e)  Requires the Texas State Board of Pharmacy (TSBP) to adopt the rules,
policies, and procedures necessary to administer this section, including
rules that require a health care facility to inform HHSC of medicines
returned to a pharmacy under this section. 

Sec. 562.1086.  LIMITATION ON LIABILITY. (a) Provides that a pharmacy that
returns unused drugs and a manufacturer that accepts the unused drugs
under Section 562.1085 and the employees of the pharmacy or manufacturer
are not liable for harm caused by the accepting, dispensing, or
administering of drugs returned in strict compliance with Section 562.1085
unless the harm is caused by wilful or wanton acts of negligence,
conscious indifference or reckless disregard for the safety of others or
intentional conduct. 

(b)  Provides that this section does not limit, or in any way affect or
diminish, the liability of a drug seller or manufacturer under Chapter 82,
Civil Practice and Remedies Code. 

(c)  Provides that this section does not apply if harm results from the
failure to fully and completely comply with the requirements of Section
562.1085. 

(d)  Provides that this section does not apply to a pharmacy or
manufacturer that fails to comply with the insurance provisions of Chapter
84, Civil Practice and Remedies Code. 

SECTION 2.118.  Amends Section 455.0015, Transportation Code, by amending
Subsection (b) and adding Subsections (c) and (d), as follows: 

(b)  Provides that the legislature likewise recognizes the potential cost
savings and other benefits for utilizing existing private sector
transportation resources.  Provides that the Texas Department of
Transportation (TxDOT) will contract with and promote the use of private
sector transportation resources to the maximum extent feasible consistent
with the goals of this subsection. 

(c)  Requires the TDH and HHSC to contract with TxDOT  for TxDOT to assume
all responsibilities of TDH and HHSC relating to the provision of
transportation services for clients of eligible programs. 

(d)  Authorizes TxDOT to contract with any public or private
transportation provider or with any regional transportation broker for the
provision of public transportation services. 

SECTION 2.119.  Amends Section 40.002, Human Resources Code, by adding
Subsection (f), to authorize HHSC to contract with TxDOT for TxDOT to
assume all responsibilities of HHSC relating to the provision of
transportation services for clients of eligible programs. 

SECTION 2.120.  Amends Section 22.001, Human Resources Code, by adding
Subsection (e), to  require HHSC to contract with TxDOT for TxDOT to
assume all responsibilities of HHSC relating to the provision of
transportation services for clients of eligible programs. 

SECTION 2.121.  Amends Section 91.021, Human Resources Code, by adding
Subsection (g) to require HHSC to contract with TxDOT  for TxDOT to assume
all responsibilities of HHSC relating to the provision of transportation
services for clients of eligible programs. 

SECTION 2.122.  Amends Section 101.0256, Human Resources Code, as follows:

Sec. 101.0256.  COORDINATED ACCESS TO LOCAL SERVICES.  (a)  Creates this
subsection from existing text.   

(b)  Makes a conforming change.

SECTION 2.123.  Amends Section 111.0525, Human Resources Code, by adding
Subsection (d), to make a conforming change. 

SECTION 2.124.  Amends Section 461.012(a), Health and Safety Code, as
follows: 

(a)  Includes to "contract with TxDOT for TxDOT  to assume all
responsibilities of HHSC relating to the provision of transportation
services for clients of eligible programs" as a required duty of HHSC.
Makes a nonsubstantive change. 

SECTION 2.125.  Amends Section 533.012, Health and Safety Code, as follows:

Sec. 533.012.  COOPERATION OF STATE AGENCIES.  (a)  Creates this
subsection from existing text.  

(b)  Requires MHMR to contract with TxDOT for TxDOT to assume all
responsibilities of MHMR relating to the provision of transportation
services for clients of eligible programs. 

SECTION 2.126.  (a)  Amends Section 1551.159, Insurance Code, as effective
June 1, 2003, by amending Subsection (a) and adding Subsection (h), as
follows: 

(a)  Replaces "the program established by the state to implement Title
XXI, Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended"
with "the state child health plan established under Chapter 62, Health and
Safety Code" in relation to a child's insurance coverage.  

(h)  Provides that a child enrolled in dependent child coverage under this
section is subject to the same requirements and restrictions relating to
income eligibility, continuous coverage, and enrollment, including
applicable waiting periods, as a child enrolled in the state child health
plan under Chapter 62, Health and Safety Code. 

(b)  Makes application of this section prospective as applies to a child
enrolled in dependent child coverage under the state employees group
benefits program.  

SECTION 2.127.  Amends Section 31.03, Penal Code, by adding Subsection (j)
to provide that with the consent of the appropriate local county or
district attorney, the attorney general has concurrent jurisdiction with
that consenting local prosecutor to prosecute an offense under this
section that involves the state Medicaid program. 

SECTION 2.128.  Amends Section 32.45, Penal Code, by adding Subsection (d)
to provide that with the consent of the appropriate local county or
district attorney, the attorney general has concurrent jurisdiction with
that consenting local prosecutor to prosecute an offense under this
section that involves the state Medicaid program. 

 SECTION 2.129.  Amends Section 32.46, Penal Code, by adding Subsection
(e) to provide that with the consent of the appropriate local county or
district attorney, the attorney general has concurrent jurisdiction with
that consenting local prosecutor to prosecute an offense under this
section that involves the state Medicaid program. 

SECTION 2.130.  Amends Section 37.10, Penal Code, by adding Subsection (i)
to provide that 
with the consent of the appropriate local county or district attorney, the
attorney general has concurrent jurisdiction with that consenting local
prosecutor to prosecute an offense under this section that involves the
state Medicaid program. 

SECTION 2.131.  Amends Section 57.046, Utilities Code, by adding
Subsection (c) to authorize 
the Telecommunications Infrastructure Fund Board to use money in the
account to award grants to HHSC for technology initiatives of Public
Utility Commission, in addition to the purposes for which the qualifying
entities account may be used. 

SECTION 2.132.  Amends Articles 59.01(1) and (2), Code of Criminal
Procedure, to redefine "attorney representing the state" and "contraband." 

SECTION 2.133.  Amends Article 59.06, Code of Criminal Procedure, by
adding Subsection (p) to require the attorney representing the state to
transfer to HHSC all forfeited property defined as contraband under
Article 59.01(2)(B)(vii), notwithstanding Subsection (a), and to the
extent necessary to protect the commission's ability to recover amounts
wrongfully obtained by the owner of the property and associated damages
and penalties to which the commission is otherwise authorized to be
entitled by law.  Authorizes the attorney representing the state to, if
approved by the commission, sell the property and deliver to the
commission the proceeds from the sale, minus costs attributable to the
sale, if the forfeited property consists of property other than money or
negotiable instruments.  Requires the sale to be conducted in a manner
that is reasonably expected to result in receiving the fair market value
for the property. 

SECTION 2.134.  STUDY.  (a)  Requires the Medicaid and Public Assistance
Fraud Oversight Task Force, with the participation of the TDH's bureau of
vital statistics and other agencies designated by the comptroller, to
study procedures and documentation requirements used by the state in
confirming a person's identity for purposes of establishing entitlement to
Medicaid and other benefits provided through health and human services
programs. 

(b)  Requires, not later than December 1, 2004, the Medicaid and Public
Assistance Fraud Oversight Task Force, with assistance from the agencies
participating in the study required by Subsection (a) of this section, to
submit a report to the legislature containing recommendations for
improvements in the procedures and documentation requirements described by
Subsection (a) of this section that would strengthen the state's ability
to prevent fraud and abuse in the Medicaid program and other health and
human services programs. 

[Reserves SECTION 2.135 for expansion.]

SECTION 2.136.  STUDY:  REVENUE ENHANCEMENT RELATED TO MEDICAID VENDOR
DRUG REBATE.  (a) Provides that a task force is created to study the
prescription drug rebate system established and operated under the medical
assistance program and other related programs. 

(b)  Requires HHSC to establish a task force, composed of appropriate
legislators, state agency personnel, and other appropriate personnel to
study the prescription drug rebate system established and operated under
the medical assistance program and other related programs. 

 (c)  Requires the study to include certain information.

(d)  Requires the study to be completed by December 1, 2004, and presented
to the governor and the presiding officers of each house, the House
Committee on  Appropriations, and the Senate Finance Committee. 

SECTION 2.137.  LEGISLATIVE INTENT REGARDING PROVISION OF HEALTH AND HUMAN
SERVICE TRANSPORTATION THROUGH THE TEXAS DEPARTMENT OF TRANSPORTATION.
Sets forth legislative intent. 

SECTION 2.138.  (a)  Provides that a change in law made by this article to
Section 242.047, Health and Safety Code, that requires TDH to accept an
annual accreditation review from the Joint Commission on Accreditation of
Health Organizations for a nursing home in satisfaction of the
requirements for certification:  applies only to a nursing home that
participates in the medical assistance program under Chapter 32, Human
Resources Code, before September 1, 2003;  and may be implemented only as
a pilot program. 

(b)  Provides that a pilot program operated in accordance with this
section expires September 1, 2007. 

SECTION 2.139.  (a)  Requires the TSBP to adopt the rules required by
Section 562.1085, Occupations Code, as added by this Act, not later than
December 1, 2003. 

(b)  Provides that, notwithstanding Section 562.1085, Occupations Code, as
added by this Act, a pharmacy is not required to accept unused drugs from
a health care facility before January 1, 2004. 

SECTION 2.140.  Requires HHSC to adopt the rules required by Sections
32.028(i) and (j), Human Resources Code, as added by this Act, not later
than December 1, 2003. 

SECTION 2.141.  TRANSFER OF MEDICAL TRANSPORTATION PROGRAM.  (a) Provides
that on September 1, 2004, or on an earlier date specified by HHSC,
certain actions will occur relating to the transfer to HHSC. 

(b)  Requires HHSC to take all action necessary to provide for the
transfer of the medical transportation program to HHSC as soon as possible
after the effective date of this section but not later than September 1,
2004. 

SECTION 2.142.  CONSOLIDATION OF CERTAIN DIVISIONS AND ACTIVITIES.  (a)
Requires HHSC to consolidate the Medicaid post-payment third-party
recovery divisions or activities of  TDHS, the Medicaid vendor drug
program, and the state's Medicaid claims administrator with the Medicaid
post-payment third-party recovery function, not later than March 1, 2004. 

(b)  Requires HHSC to use HHSC's Medicaid post-payment third-party
recovery contractor  for the consolidated division. 

 (c)  Requires HHSC to update its computer system to facilitate the
consolidation. 

SECTION 2.143.  ABOLITION OF ADVISORY COMMITTEES.  (a)  Provides that,
notwithstanding any other provision of state law, each advisory committee,
as that term is defined by Section 2110.001, Government Code, created
before the effective date of this section that advises a health and human
services agency is abolished on the effective date of this section unless
the committee:  is required by federal law; or advises an agency with
respect to certification or licensing programs, the regulation of entities
providing health and human services, or the implementation of a duty
prescribed under this article, as determined by the commissioner of HHSC. 

(b)  Requires the commissioner of health and human services to certify
which advisory committees are exempt from abolition under Subsection (a)
of this section and  publish that certification in the Texas Register. 

(c)  Requires an advisory committee that is created on or after the
effective date of this  section or that is exempt under Subsection (b) of
this section from abolition to make recommendations to the executive
director of the health and human services agency the advisory committee
was created to advise and to the commissioner of health and human services
to assist with eliminating or minimizing overlapping functions or required
duties between the health and human services agencies or between those
agencies and HHSC. 

SECTION 2.144.  Authorizes community mental health centers to coordinate
with local community health centers, federally qualified health centers
(FQHC), and/or disproportionate share hospitals for the purpose of
accessing local, state, and federal programs that could result in lower
cost pharmaceuticals.  Authorizes community mental health centers to form
a referral relationship with community health centers, FQHC,
disproportionate share hospitals, and/or other eligible entities for the
purpose of obtaining federal 340B pricing for pharmaceuticals. Authorizes
community mental health centers to form a referral relationship with
community health centers, FQHC, disproportionate share hospitals, and/or
other eligible entities for the purpose of taking advantage of 340B or
other lower cost drug programs regardless of any statewide preferred drug
list or vendor drug program which may be adopted. 

SECTION 2.145.  CHILD HEALTH PLAN PROGRAM WAIVER.  Requires HHSC to
request and actively pursue any necessary waivers from a federal agency or
any other appropriate entity to allow families enrolled in the state
Medicaid program to opt into the child health plan program under Chapter
62, Health and Safety Code, while retaining the appropriate federal match
rate and the child's entitlement to Medicaid coverage, not later than
October 1, 2003.  Requires the waiver to, on at least an annual basis,
allow families eligible for Medicaid who have previously opted to enroll
their children in the child health plan program under Chapter 62, Health
and Safety Code, to return those children to the Medicaid program. 

SECTION 2.146.  STATE CHILD HEALTH PLAN AMENDMENT.  (a)  Provides that in
this section, "group plan" means the group health benefit plan under the
health insurance premium payment reimbursement program established under
Section 62.059, Health and Safety Code. 

(b)  Requires HHSC, as soon as possible after the effective date of this
section, to submit for approval a plan amendment relating to the state
child health plan under 42 U.S.C. Section 1397ff, as amended, as necessary
to include the employers' share of required premiums for coverage of
individuals enrolled in the group plan as expenditures for the purpose of
determining the state children's health insurance expenditures, as that
term is defined by 42 U.S.C. Section 1397ee(d)(2)(B), as amended, for
federal match funding for the child health plan program provided under
Chapter 62, Health and Safety Code. 

SECTION 2.147.  STATE MEDICAID PLAN AMENDMENT.  (a)  Provides that in this
section, "group plan" means the group health benefit plan under the health
insurance premium payment reimbursement program for Medicaid recipients
established under Section 32.0422, Human Resources Code. 

(b)  Requires HHSC, as soon as possible after the effective date of this
section, to submit an amendment to the state Medicaid plan as necessary to
allow this state to include the employers' share of required premiums for
coverage of individuals enrolled in the group plan as expenditures for the
purpose of determining this state's Medicaid program expenditures for
federal match funding for the state Medicaid program. 

SECTION 2.148.  REPEAL.  (a)  Repealer:  Sections 62.055(b) and (c),
62.056, 62.057, 142.006(d), (e), and (f), 142.009(i), 142.0176,
252.206(d), and 252.207(b), Health and Safety Code. 

(b)  Provides that an advisory committee established under Section 62.057,
Health and Safety Code, is abolished on the effective date of this
section. 

SECTION 2.149.  Provides that in the event of a conflict between a
provision of this Act and another Act passed by the 78th Legislature,
Regular Session, 2003, that becomes law, this Act prevails and controls
regardless of the relative dates of enactment. 
 
SECTION 2.150.  FEDERAL AUTHORIZATION OR WAIVER.  Authorizes a state
agency to delay implementing a provision of this Act until a requested
federal waiver or authorization necessary to implement that provision is
granted.  

SECTION 2.151.  Requires any funds that are used by TxDOT to implement the
transportation services provided in Sections 2.118, 2.119, 2.120, 2.121,
2.122, 2.123, 2.124, and 2.125 of this Act be accounted for and budgeted
separately from other funds appropriated to TxDOT for any other public
transportation program or budget strategy. 

SECTION 2.152.  EFFECTIVE DATE.  Effective date:  September 1, 2003,
except as otherwise provided by this article.