By: Frank H.B. No. 3317
A BILL TO BE ENTITLED
AN ACT
relating to the operation and financing of the federally qualified
health center primary care access program to provide primary care
access to persons in this state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle C, Title 2, Health and Safety Code, is
amended by adding Chapter 76 to read as follows:
CHAPTER 76 FEDERALLY QUALIFIED HEALTH CENTER PRIMARY CARE ACCESS
PROGRAM
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 76.001. PURPOSE. The purpose of this chapter is to:
(1) increase access to primary care services for
low-income or at-risk Texans at federally qualified health centers;
(2) improve the health of employees of participating
employers and their dependents by improving the employees' and
their dependents' access to health care;
(3) contribute to economic development by helping
small businesses remain competitive with a healthy workforce and
health care benefits that will attract employees; and
(4) encourage innovative solutions for providing and
funding health care services and benefits.
Sec. 76.002. DEFINITIONS. In this chapter:
(1) "Employee" means an individual employed by an
employer. The term includes a partner of a partnership and the
proprietor of a sole proprietorship.
(2) "Federally qualified health center" means an
entity as defined by 42 U.S.C. Section 1396d(l)(2)(B).
(3) "Federally qualified health center primary care
access program" means a program established by a federally
qualified health center offering primary care services for the
benefit of the employees of participating employers and their
dependents under Subchapter B.
(4) "Participating employer" means an employer who
meets the qualifications of the program and has agreed to
participate in a federally qualified health center primary care
access program.
SUBCHAPTER B. FEDERALLY QUALIFIED HEALTH CENTER PRIMARY CARE
ACCESS PROGRAM
Sec. 76.051. ESTABLISHMENT OF PROGRAM. A federally
qualified health center may establish or participate in a federally
qualified health center primary care access program under this
subchapter.
Sec. 76.052. GOVERNANCE OF PROGRAM. A federally qualified
health center primary care access program shall be operated subject
to the direction of the governing board of the participating
federally qualified health center.
Sec. 76.053. OPERATION OF PROGRAM. (a) A federally
qualified health center primary care access program provides
primary health care services to:
(1) the employees of participating employers who
reside in or whose employer is located within the service area of a
participating federally qualified health center. A federally
qualified health center primary care access program may also
provide services or benefits to the dependents of those employees.
(2) other uninsured or underinsured groups as
determined by the federally qualified health center.
Sec. 76.054. PARTICIPATION BY EMPLOYERS; SHARE OF COST.
(a) A federally qualified health center may establish criteria for
participation in a federally qualified health center primary care
access program by employers, the employees of the participating
employers, and their dependents. The criteria may require that
participating employers and employees who receive care through a
federally qualified health center primary care access program pay a
share of the premium or other cost of the program.
(b) The federally qualified health center will ensure
employees and their dependents are screened for eligibility for
other state programs and federal subsidies in the Health Insurance
Marketplace and assist in enrolling employees in programs that
offer health insurance coverage.
(c) The federally qualified health center may utilize a
health foundation, non-profit, or other funding to support the
employer and/or patient share of the program.
Sec. 76.055. ADDITIONAL FUNDING. (a) A federally
qualified health center may accept and use state money made
available through an appropriation from the general revenue fund or
a gift, grant, or donation from any source to operate the federally
qualified health center primary care access program and to provide
services or benefits under the program.
(b) A federally qualified health center shall actively
solicit gifts, grants, and donations to:
(1) fund services and benefits provided under the
federally qualified health center primary care access program; and
(2) reduce the cost of participation in the program
for participating employers and their employees.
SUBCHAPTER C. HEALTH CARE SERVICES AND BENEFITS
Sec. 76.101. PROGRAM OBJECTIVES. (a) Federally qualified
health center primary care access programs must be developed, to
the extent practicable, to:
(1) reduce the number of individuals without primary
care access who reside in or whose employer is located within the
service area of the federally qualified health center;
(2) address rising health care costs and reduce the
cost of health care services for small employers and their
employees who reside in or whose employer is located within the
service area of the federally qualified health center;
(3) promote preventive care and reduce the incidence
of preventable health conditions, such as heart disease, cancer,
and diabetes and low birth weight in infants;
(4) promote efficient and collaborative delivery of
health care services;
(5) serve as a model for the innovative use of health
information technology to promote efficient delivery of health care
services, reduce health care costs, and improve the health of the
community; and
(6) provide fair payment rates for health care
providers.
Sec. 76.102. HEALTH CARE SERVICES. (a) A federally
qualified health center primary care access program shall provide
primary health care services directly to the employees of
participating employers and the dependents of those employees.
(b) A federally qualified health center may require that
participating employees and dependents obtain primary health care
services provided under a federally qualified health center primary
care access program only from health care providers at the
federally qualified health center.
(c) A federally qualified health center that operates a
federally qualified health center primary care access program under
this section is not an insurer or health maintenance organization
and the program is not subject to regulation by the Texas Department
of Insurance.
SUBCHAPTER E. GRANTS FOR DEMONSTRATION PROJECTS
Sec. 76.201. GRANT PROGRAM. (a) The Texas Department of
Insurance, in collaboration with the Texas Health and Human
Services, shall develop a grant program to support the initial
establishment and operation of federally qualified health center
primary care access programs as demonstration projects, subject to
the appropriation of money for this purpose.
(b) In selecting grant recipients, the Texas Department of
Insurance shall consider the extent to which the federally
qualified health center primary care access program proposed by the
applicant accomplishes the purposes of this chapter and meets the
objectives established under Section 76.101.
(c) The Texas Department of Insurance shall establish
performance objectives for a grant recipient and shall monitor the
performance of the grant recipient.
(d) In addition to money appropriated by the legislature,
the Texas Department of Insurance may accept gifts, grants, or
donations from any source to administer and finance the federally
qualified health center primary care access program.
Sec. 76.202. REVIEW OF DEMONSTRATION PROJECT; REPORT. Not
later than December 1, 2026, the Texas Department of Insurance
shall complete a review of each federally qualified health center
primary care access program that receives a grant under this
subchapter and shall submit to the governor, the lieutenant
governor, and the speaker of the house of representatives a report
that includes:
(1) an evaluation of the success of the federally
qualified health center primary care access program in
accomplishing the purposes of this chapter; and
(2) the Texas Department of Insurance's
recommendations for any legislation needed to facilitate or improve
the federally qualified health center primary care access program.
SECTION 2. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2023.