88R2357 SRA-F
By: Hughes S.B. No. 746
A BILL TO BE ENTITLED
AN ACT
relating to the creation and operation of pediatric long-term care
access assurance programs in certain counties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapter 300B to read as follows:
CHAPTER 300B. COUNTY PEDIATRIC LONG-TERM CARE ACCESS ASSURANCE
PROGRAM IN CERTAIN COUNTIES
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 300B.0001. DEFINITIONS. In this chapter:
(1) "Paying facility" means a pediatric long-term care
facility required to make a mandatory payment under this chapter.
(2) "Pediatric long-term care facility" means a
facility licensed under Chapter 242 that maintains an average daily
occupancy rate of 80 percent or more children during the 12-month
period preceding the date the commissioners court of the applicable
county adopts an order under Section 300B.0003.
Sec. 300B.0002. APPLICABILITY. This chapter applies only
to a county that:
(1) is served by a pediatric long-term care facility;
(2) has a population of more than 36,000 and less than
41,000; and
(3) is adjacent to a county with a population of more
than 200,000 and less than 233,500.
Sec. 300B.0003. COUNTY PEDIATRIC LONG-TERM CARE ACCESS
ASSURANCE PROGRAM; PARTICIPATION IN PROGRAM. (a) A county
pediatric long-term care access assurance program authorizes a
county to collect a mandatory payment from each pediatric long-term
care facility located in the county to be deposited in a local
pediatric long-term care access assurance fund established by the
county. Money in the fund may be used by the county to fund certain
intergovernmental transfers as provided by this chapter.
(b) The commissioners court of a county may adopt an order
authorizing the county to participate in a county pediatric
long-term care access assurance program, subject to the limitations
provided by this chapter.
SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
Sec. 300B.0051. LIMITATION ON AUTHORITY TO REQUIRE
MANDATORY PAYMENT. The commissioners court of a county may require
a mandatory payment authorized under this chapter by a pediatric
long-term care facility in the county only in the manner provided by
this chapter.
Sec. 300B.0052. MAJORITY VOTE REQUIRED. The commissioners
court of a county may not authorize the county to collect a
mandatory payment authorized under this chapter without an
affirmative vote of a majority of the members of the commissioners
court.
Sec. 300B.0053. RULES AND PROCEDURES. After the
commissioners court of a county has voted to require a mandatory
payment authorized under this chapter, the commissioners court may
adopt rules relating to the administration of the mandatory
payment.
Sec. 300B.0054. PEDIATRIC LONG-TERM CARE FACILITY
REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
county that collects a mandatory payment authorized under this
chapter shall require each pediatric long-term care facility to
submit to the county information necessary for the county to ensure
mandatory payments are collected under this chapter in a manner
that is consistent with 42 U.S.C. Section 1396b(w) and 42 C.F.R.
Section 433.68.
(b) The commissioners court of a county that collects a
mandatory payment authorized under this chapter may inspect the
records of a pediatric long-term care facility to the extent
necessary to ensure compliance with the requirements of Subsection
(a).
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 300B.0101. HEARING. (a) Each year, the commissioners
court of a county that collects a mandatory payment authorized
under this chapter shall hold a public hearing on the amounts of any
mandatory payments that the commissioners court intends to require
during the year.
(b) Not later than the fifth day before the date of the
hearing required under Subsection (a), the commissioners court of a
county shall publish notice of the hearing in a newspaper of general
circulation in the county.
(c) A representative of a paying facility is entitled to
appear at the time and place designated in the public notice and to
be heard regarding any matter related to the mandatory payments
authorized under this chapter.
Sec. 300B.0102. DEPOSITORY. (a) The commissioners court
of each county that collects a mandatory payment authorized under
this chapter shall designate one or more banks located in the county
as the depository for mandatory payments received by the county.
(b) All income received by a county under this chapter,
including the revenue from mandatory payments remaining after
discounts and fees for assessing and collecting the payments are
deducted, shall be deposited with the county depository in the
county's pediatric long-term care access assurance fund and may be
withdrawn only as provided by this chapter.
(c) All money received under this chapter shall be secured
in the manner provided by law for securing county money.
Sec. 300B.0103. PEDIATRIC LONG-TERM CARE ACCESS ASSURANCE
FUND; AUTHORIZED USES OF MONEY. (a) Each county that collects a
mandatory payment authorized under this chapter shall create a
pediatric long-term care access assurance fund.
(b) The pediatric long-term care access assurance fund of a
county consists of:
(1) all revenue received by the county attributable to
mandatory payments authorized under this chapter, including any
penalties and interest attributable to delinquent payments;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
county to the state for the purpose of providing the nonfederal
share of Medicaid payment programs, provided that the
intergovernmental transfer does not receive a federal matching
payment; and
(3) the earnings of the fund.
(c) Money deposited to the pediatric long-term care access
assurance fund of a county may be used only to:
(1) fund intergovernmental transfers from the county
to the state to provide the nonfederal share of a Medicaid payment
program authorized under the state Medicaid plan, the Texas
Healthcare Transformation and Quality Improvement Program waiver
issued under Section 1115 of the federal Social Security Act (42
U.S.C. Section 1315), or a successor waiver program authorizing
similar Medicaid payment programs;
(2) pay the administrative expenses of the county
solely for activities under this chapter;
(3) refund a portion of a mandatory payment collected
in error from a paying facility; and
(4) refund to paying facilities the proportionate
share of money received by the county that is not used to fund the
nonfederal share of a Medicaid payment program.
(d) Money in the pediatric long-term care access assurance
fund of a county may not be commingled with other county money.
(e) An intergovernmental transfer of money described by
Subsection (c)(1) and any money received by a county as a result of
an intergovernmental transfer described by that subdivision may not
be used by the county or any other entity to expand Medicaid
eligibility under the Patient Protection and Affordable Care Act
(Pub. L. No. 111-148) as amended by the Health Care and Education
Reconciliation Act of 2010 (Pub. L. No. 111-152).
SUBCHAPTER D. MANDATORY PAYMENTS
Sec. 300B.0151. MANDATORY PAYMENTS BASED ON PAYING FACILITY
NET PATIENT REVENUE. (a) Subject to Subsection (e), the
commissioners court of a county that collects a mandatory payment
authorized under this chapter may require an annual mandatory
payment to be assessed on the net patient revenue of each pediatric
long-term care facility located in the county. The commissioners
court may provide for the mandatory payment to be assessed
quarterly. The county shall update the amount of the mandatory
payment on an annual basis.
(b) The amount of a mandatory payment authorized under this
chapter must be uniformly proportionate with the amount of net
patient revenue generated by each paying facility in a county. A
mandatory payment authorized under this chapter may not hold
harmless any pediatric long-term care facility, as required under
42 U.S.C. Section 1396b(w).
(c) The commissioners court of a county that collects a
mandatory payment authorized under this chapter shall set the
amount of the mandatory payment. The amount of the mandatory
payment required of each paying facility may not exceed six percent
of the paying facility's net patient revenue.
(d) Subject to the maximum amount prescribed by Subsection
(c), the commissioners court of a county that collects a mandatory
payment authorized under this chapter shall set the mandatory
payments in amounts that in the aggregate will generate sufficient
revenue to cover the administrative expenses of the county for
activities under this chapter and to fund an intergovernmental
transfer described by Section 300B.0103(c)(1), except that the
amount of revenue from mandatory payments used for administrative
expenses of the county for activities under this chapter in a year
may not exceed the lesser of four percent of the total revenue
generated from the mandatory payment or $20,000.
(e) A paying facility may not add a mandatory payment
authorized under this section as a surcharge to a patient.
Sec. 300B.0152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. The county may collect or contract for the assessment and
collection of mandatory payments authorized under this chapter.
Sec. 300B.0153. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on mandatory payments
authorized under this chapter are governed by the law applicable to
county ad valorem taxes.
Sec. 300B.0154. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
by collecting from pediatric long-term care facilities a mandatory
payment to be used to provide the nonfederal share of a Medicaid
payment program.
(b) To the extent any provision or procedure under this
chapter causes a mandatory payment authorized under this chapter to
be ineligible for federal matching funds, a county may provide by
rule for an alternative provision or procedure that conforms to the
requirements of the federal Centers for Medicare and Medicaid
Services.
SECTION 2. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 3. 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.