88R2357 SRA-F     By: Dean H.B. No. 1185       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.