Texas 2023 - 88th Regular

Texas Senate Bill SB746 Compare Versions

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1	1	88R2357 SRA-F
2	2	By: Hughes S.B. No. 746
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and operation of pediatric long-term care
8	8	access assurance programs in certain counties.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
11	11	amended by adding Chapter 300B to read as follows:
12	12	CHAPTER 300B. COUNTY PEDIATRIC LONG-TERM CARE ACCESS ASSURANCE
13	13	PROGRAM IN CERTAIN COUNTIES
14	14	SUBCHAPTER A. GENERAL PROVISIONS
15	15	Sec. 300B.0001. DEFINITIONS. In this chapter:
16	16	(1) "Paying facility" means a pediatric long-term care
17	17	facility required to make a mandatory payment under this chapter.
18	18	(2) "Pediatric long-term care facility" means a
19	19	facility licensed under Chapter 242 that maintains an average daily
20	20	occupancy rate of 80 percent or more children during the 12-month
21	21	period preceding the date the commissioners court of the applicable
22	22	county adopts an order under Section 300B.0003.
23	23	Sec. 300B.0002. APPLICABILITY. This chapter applies only
24	24	to a county that:
25	25	(1) is served by a pediatric long-term care facility;
26	26	(2) has a population of more than 36,000 and less than
27	27	41,000; and
28	28	(3) is adjacent to a county with a population of more
29	29	than 200,000 and less than 233,500.
30	30	Sec. 300B.0003. COUNTY PEDIATRIC LONG-TERM CARE ACCESS
31	31	ASSURANCE PROGRAM; PARTICIPATION IN PROGRAM. (a) A county
32	32	pediatric long-term care access assurance program authorizes a
33	33	county to collect a mandatory payment from each pediatric long-term
34	34	care facility located in the county to be deposited in a local
35	35	pediatric long-term care access assurance fund established by the
36	36	county. Money in the fund may be used by the county to fund certain
37	37	intergovernmental transfers as provided by this chapter.
38	38	(b) The commissioners court of a county may adopt an order
39	39	authorizing the county to participate in a county pediatric
40	40	long-term care access assurance program, subject to the limitations
41	41	provided by this chapter.
42	42	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
43	43	Sec. 300B.0051. LIMITATION ON AUTHORITY TO REQUIRE
44	44	MANDATORY PAYMENT. The commissioners court of a county may require
45	45	a mandatory payment authorized under this chapter by a pediatric
46	46	long-term care facility in the county only in the manner provided by
47	47	this chapter.
48	48	Sec. 300B.0052. MAJORITY VOTE REQUIRED. The commissioners
49	49	court of a county may not authorize the county to collect a
50	50	mandatory payment authorized under this chapter without an
51	51	affirmative vote of a majority of the members of the commissioners
52	52	court.
53	53	Sec. 300B.0053. RULES AND PROCEDURES. After the
54	54	commissioners court of a county has voted to require a mandatory
55	55	payment authorized under this chapter, the commissioners court may
56	56	adopt rules relating to the administration of the mandatory
57	57	payment.
58	58	Sec. 300B.0054. PEDIATRIC LONG-TERM CARE FACILITY
59	59	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
60	60	county that collects a mandatory payment authorized under this
61	61	chapter shall require each pediatric long-term care facility to
62	62	submit to the county information necessary for the county to ensure
63	63	mandatory payments are collected under this chapter in a manner
64	64	that is consistent with 42 U.S.C. Section 1396b(w) and 42 C.F.R.
65	65	Section 433.68.
66	66	(b) The commissioners court of a county that collects a
67	67	mandatory payment authorized under this chapter may inspect the
68	68	records of a pediatric long-term care facility to the extent
69	69	necessary to ensure compliance with the requirements of Subsection
70	70	(a).
71	71	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
72	72	Sec. 300B.0101. HEARING. (a) Each year, the commissioners
73	73	court of a county that collects a mandatory payment authorized
74	74	under this chapter shall hold a public hearing on the amounts of any
75	75	mandatory payments that the commissioners court intends to require
76	76	during the year.
77	77	(b) Not later than the fifth day before the date of the
78	78	hearing required under Subsection (a), the commissioners court of a
79	79	county shall publish notice of the hearing in a newspaper of general
80	80	circulation in the county.
81	81	(c) A representative of a paying facility is entitled to
82	82	appear at the time and place designated in the public notice and to
83	83	be heard regarding any matter related to the mandatory payments
84	84	authorized under this chapter.
85	85	Sec. 300B.0102. DEPOSITORY. (a) The commissioners court
86	86	of each county that collects a mandatory payment authorized under
87	87	this chapter shall designate one or more banks located in the county
88	88	as the depository for mandatory payments received by the county.
89	89	(b) All income received by a county under this chapter,
90	90	including the revenue from mandatory payments remaining after
91	91	discounts and fees for assessing and collecting the payments are
92	92	deducted, shall be deposited with the county depository in the
93	93	county's pediatric long-term care access assurance fund and may be
94	94	withdrawn only as provided by this chapter.
95	95	(c) All money received under this chapter shall be secured
96	96	in the manner provided by law for securing county money.
97	97	Sec. 300B.0103. PEDIATRIC LONG-TERM CARE ACCESS ASSURANCE
98	98	FUND; AUTHORIZED USES OF MONEY. (a) Each county that collects a
99	99	mandatory payment authorized under this chapter shall create a
100	100	pediatric long-term care access assurance fund.
101	101	(b) The pediatric long-term care access assurance fund of a
102	102	county consists of:
103	103	(1) all revenue received by the county attributable to
104	104	mandatory payments authorized under this chapter, including any
105	105	penalties and interest attributable to delinquent payments;
106	106	(2) money received from the Health and Human Services
107	107	Commission as a refund of an intergovernmental transfer from the
108	108	county to the state for the purpose of providing the nonfederal
109	109	share of Medicaid payment programs, provided that the
110	110	intergovernmental transfer does not receive a federal matching
111	111	payment; and
112	112	(3) the earnings of the fund.
113	113	(c) Money deposited to the pediatric long-term care access
114	114	assurance fund of a county may be used only to:
115	115	(1) fund intergovernmental transfers from the county
116	116	to the state to provide the nonfederal share of a Medicaid payment
117	117	program authorized under the state Medicaid plan, the Texas
118	118	Healthcare Transformation and Quality Improvement Program waiver
119	119	issued under Section 1115 of the federal Social Security Act (42
120	120	U.S.C. Section 1315), or a successor waiver program authorizing
121	121	similar Medicaid payment programs;
122	122	(2) pay the administrative expenses of the county
123	123	solely for activities under this chapter;
124	124	(3) refund a portion of a mandatory payment collected
125	125	in error from a paying facility; and
126	126	(4) refund to paying facilities the proportionate
127	127	share of money received by the county that is not used to fund the
128	128	nonfederal share of a Medicaid payment program.
129	129	(d) Money in the pediatric long-term care access assurance
130	130	fund of a county may not be commingled with other county money.
131	131	(e) An intergovernmental transfer of money described by
132	132	Subsection (c)(1) and any money received by a county as a result of
133	133	an intergovernmental transfer described by that subdivision may not
134	134	be used by the county or any other entity to expand Medicaid
135	135	eligibility under the Patient Protection and Affordable Care Act
136	136	(Pub. L. No. 111-148) as amended by the Health Care and Education
137	137	Reconciliation Act of 2010 (Pub. L. No. 111-152).
138	138	SUBCHAPTER D. MANDATORY PAYMENTS
139	139	Sec. 300B.0151. MANDATORY PAYMENTS BASED ON PAYING FACILITY
140	140	NET PATIENT REVENUE. (a) Subject to Subsection (e), the
141	141	commissioners court of a county that collects a mandatory payment
142	142	authorized under this chapter may require an annual mandatory
143	143	payment to be assessed on the net patient revenue of each pediatric
144	144	long-term care facility located in the county. The commissioners
145	145	court may provide for the mandatory payment to be assessed
146	146	quarterly. The county shall update the amount of the mandatory
147	147	payment on an annual basis.
148	148	(b) The amount of a mandatory payment authorized under this
149	149	chapter must be uniformly proportionate with the amount of net
150	150	patient revenue generated by each paying facility in a county. A
151	151	mandatory payment authorized under this chapter may not hold
152	152	harmless any pediatric long-term care facility, as required under
153	153	42 U.S.C. Section 1396b(w).
154	154	(c) The commissioners court of a county that collects a
155	155	mandatory payment authorized under this chapter shall set the
156	156	amount of the mandatory payment. The amount of the mandatory
157	157	payment required of each paying facility may not exceed six percent
158	158	of the paying facility's net patient revenue.
159	159	(d) Subject to the maximum amount prescribed by Subsection
160	160	(c), the commissioners court of a county that collects a mandatory
161	161	payment authorized under this chapter shall set the mandatory
162	162	payments in amounts that in the aggregate will generate sufficient
163	163	revenue to cover the administrative expenses of the county for
164	164	activities under this chapter and to fund an intergovernmental
165	165	transfer described by Section 300B.0103(c)(1), except that the
166	166	amount of revenue from mandatory payments used for administrative
167	167	expenses of the county for activities under this chapter in a year
168	168	may not exceed the lesser of four percent of the total revenue
169	169	generated from the mandatory payment or $20,000.
170	170	(e) A paying facility may not add a mandatory payment
171	171	authorized under this section as a surcharge to a patient.
172	172	Sec. 300B.0152. ASSESSMENT AND COLLECTION OF MANDATORY
173	173	PAYMENTS. The county may collect or contract for the assessment and
174	174	collection of mandatory payments authorized under this chapter.
175	175	Sec. 300B.0153. INTEREST, PENALTIES, AND DISCOUNTS.
176	176	Interest, penalties, and discounts on mandatory payments
177	177	authorized under this chapter are governed by the law applicable to
178	178	county ad valorem taxes.
179	179	Sec. 300B.0154. PURPOSE; CORRECTION OF INVALID PROVISION OR
180	180	PROCEDURE. (a) The purpose of this chapter is to generate revenue
181	181	by collecting from pediatric long-term care facilities a mandatory
182	182	payment to be used to provide the nonfederal share of a Medicaid
183	183	payment program.
184	184	(b) To the extent any provision or procedure under this
185	185	chapter causes a mandatory payment authorized under this chapter to
186	186	be ineligible for federal matching funds, a county may provide by
187	187	rule for an alternative provision or procedure that conforms to the
188	188	requirements of the federal Centers for Medicare and Medicaid
189	189	Services.
190	190	SECTION 2. If before implementing any provision of this Act
191	191	a state agency determines that a waiver or authorization from a
192	192	federal agency is necessary for implementation of that provision,
193	193	the agency affected by the provision shall request the waiver or
194	194	authorization and may delay implementing that provision until the
195	195	waiver or authorization is granted.
196	196	SECTION 3. This Act takes effect immediately if it receives
197	197	a vote of two-thirds of all the members elected to each house, as
198	198	provided by Section 39, Article III, Texas Constitution. If this
199	199	Act does not receive the vote necessary for immediate effect, this
200	200	Act takes effect September 1, 2023.