HBA-LJP C.S.H.B. 2456 77(R) BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 2456 By: Gray Ways & Means 4/20/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE In 1985, the 69th Texas Legislature enacted the Indigent Health Care and Treatment Act to provide for a county to fund medical indigence health care through the general revenue fund of the county which is comprised of property and sales and use taxes. If the county spends at least eight percent of the general revenue fund on medical indigence health care, the county is then eligible for state assistance. However, only counties with a population of 50,000 or less are authorized to adopt or abolish the sales and use tax for county health services by election and the rate of these taxes can not exceed one-half percent. Because of the limit on the imposition of sales and use taxes for county health services that the county uses to fund the County Indigent Health Care program (program), other health care services in the county may need to become responsible for services that the program provides to the indigent population in the county. C.S.H.B. 2456 creates the indigent health care pilot program which is adopted by a county, on voter approval, and authorizes certain counties to fund the pilot program by a sales and use tax for county health services at a rate of one percent. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 2456 amends the Tax Code to create the indigent health care program as a pilot program (pilot program) adopted by a county to provide indigent health care services that are funded by sale and use tax for county health services. The bill provides that pilot program only applies to counties with a population of more than 200,000 in which a hospital district is not located and in which a public medical school or health science center is located. The bill authorizes the commissioners court of a county whose voters approve a sales and use tax imposed for county health services to implement the pilot program to provide secondary and tertiary level services to residents of the county according to the state medical assistance program whose family income is not greater than 100 percent of the federal poverty level and to provide primary level services and preventive medical services according to the Indigent Health Care Act to residents of the county whose family income is not greater than 200 percent of the federal poverty level. The bill provides that as part of the pilot program, the county is authorized to provide case management services, utilization review, patient outreach, patient education, and patient transportation. The bill also requires a county to prescribe appropriate goals and performance measures for the program. The bill authorizes a county that has adopted a pilot program to adopt or abolish the sales and use tax for county health services at an election held in the county and provides that the rate of the tax is one percent. The bill authorizes the commissioners court of the county that has adopted a pilot program to adopt or abolish the sales and use tax for county health services at an election held in the county. The bill requires the commissioners court to call an election to adopt or abolish the tax if the commissioners court receives a petition signed by a number of petitioners equal to at least five percent of the number of registered voters in the county. The bill also sets forth provisions regarding the ballot of an election to adopt or abolish the sales and use tax. The bill provides that the revenue from the imposed sales and use tax may only be used to provide funding for a pilot program created by a county. The bill sets forth that any other provisions regulating the sales and use tax imposed by a county, including taxes imposed for county health services, are not applicable to the sales and use tax imposed for a pilot program. The bill sets forth provisions relating to the reauthorization by election of the pilot program and the sales and use tax before the sixth anniversary that the sales and use tax took effect. The bill requires a county to notify the comptroller of public accounts (comptroller) of a scheduled expiration not later than the 10th day after the county determines that the tax will expire. The bill authorizes the comptroller to delay the scheduled expiration date if more time is required and provides that the comptroller must provide a new expiration date that is not later than the last day of the first calendar quarter following the notification to the comptroller by the county. The bill also authorizes the state auditor to review any pilot program adopted and to report the results of the pilot program to the legislature. EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 2456 amends the original to provide that the indigent health care pilot program (pilot program) applies only to counties with a population of more than 200,000 in which a hospital district is not located and in which a public medical school or health science center is located. The substitute also requires a county, rather than authorizing a commissioners court, to prescribe appropriate goals and performance measures for the pilot program. C.S.H.B. 2456 authorizes the commissioners court of a county to implement a pilot program only if the voters approve, by election, of a sales and use tax imposed for county health services and the substitute sets forth provisions regarding the election to approve of or abolish the tax. The substitute removes the provision that the rate of the sales and use tax for county health services is one-half percent and may not exceed one percent. The substitute provides that the sales and use tax rate is one percent. The substitute provides that the revenue from the imposed sales and use tax may only be used to provide funding for a pilot program. The substitute also provides that any other provisions regulating the sales and use tax imposed by a county, including taxes imposed for county health services, are not applicable to the sales and use tax imposed for a pilot program. C.S.H.B. 2456 removes provisions regarding the sunset of any pilot program and sets forth provisions relating to the reauthorization by election of a pilot program and the imposed sales and use tax by the sixth anniversary that the tax took effect. The substitute also authorizes, rather than requires, the state auditor to have the right to review any pilot program adopted and to report the results of the pilot program to the legislature.