Office of House Bill AnalysisH.B. 2602
By: Coleman
Public Health


In 1999, the 76th Legislature passed legislation that updated the state
Indigent Health Care and Treatment Act of 1985.  This legislation shifted
the focus of county indigent health care programs to primary and preventive
care, and gave counties more flexibility to administer local programs
tailored to meet local needs. The legislation lowered the spending
threshold that a county must surpass to receive state financial assistance,
created a list of optional services a county may provide and receive credit
toward its threshold, and allowed counties to use less restrictive
eligibility standards.  The legislation also increased accountability by
allowing providers to collect eligibility information from patients,
allowing the Texas Department of Health to resolve eligibility disputes and
improve reporting.  House Bill 2602 ensures proper implementation of the
reforms enacted in 1999 by clarifying various provisions of the Indigent
Health Care and Treatment Act. 


It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate rulemaking authority to a state officer, department,
agency, or institution. 


House Bill 2602 amends the Health and Safety and Government codes to update
statutory references and make clarifying changes to the Indigent Health
Care and Treatment Act. 

The bill provides that if a county and health care provider or a public
hospital and health care provider disagree on a patient's eligibility, they
are authorized to submit the matter to the Texas Department of Health
(TDH). The bill authorizes rather than requires TDH to adopt rules
governing the distribution of state assistance that establish a maximum
annual allocation for each county eligible for assistance.  The bill
specifies that the amount in the tertiary care account that is not held in
reserve for reimbursement of unpaid tertiary medical services be allocated
as follows: 

_not more than five percent may be used for the costs of administering the

_five percent is required to be allocated for the payment of state
assistance; and  

_the remaining amount is required to be allocated to tertiary care
facilities and level IV trauma centers for unreimbursed tertiary medical
services and stabilization services. 

The bill provides that minimum eligibility standards for indigent health
care must incorporate a net income eligibility level equal to 21 rather
than 25 percent of the federal poverty level.  


June 15, 2001.  Provisions that modify the Indigent Health Care and
Treatment Act take effect September 1, 2001.