HBA-MPM C.S.H.B. 3505 76(R)BILL ANALYSIS


Office of House Bill AnalysisC.S.H.B. 3505
By: Solis, Jim
Public Health
4/12/1999
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

Counties with a hospital district or public hospital provide care to
indigent patients through that district or hospital.  These hospital
districts may receive additional compensation for indigent health care
services through the disproportionate share hospital program, which is
established under Medicaid and provides federal funds to match state and
local expenditures.  Counties without a hospital district or public
hospital must provide care to indigent patients and pay the cost of this
care from general revenue.  This may pose a hardship for counties with many
low-income residents, because the tax base is lower and the county has no
opportunity to recoup any of the cost of indigent health care. 

C.S.H.B. 3505 allows counties and hospital districts to pool resources in
providing health care for indigent residents through the formation of a
health services district (district).  This bill provides such a district
with contracting and bonding authority, and provides the counties with the
opportunity to pool their resources and function as one unit for the
purpose of providing indigent health care. 

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. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subtitle D, Title 4, Health and Safety Code, by adding
Chapter 287, as follows: 

CHAPTER 287.  HEALTH SERVICES DISTRICTS

SUBCHAPTER A.  GENERAL PROVISIONS

Sec. 287.001.  DEFINITIONS.  Defines "board," "district," " and "director"
for purposes of this chapter. 

Sec. 287.002.  DISTRICT AUTHORIZATION.  Authorizes a health services
district (district) to be created and established.  Provides that if
created, the district is required to be maintained, operated, and financed
as provided by this chapter. 

SUBCHAPTER B.  CREATION OF DISTRICT

Sec. 287.021.  CREATION BY CONCURRENT ORDERS.  (a)  Authorizes a county or
hospital district and one or more other counties or hospital districts of
this state, except as provided in Subsection (b), to create a district by
adopting concurrent orders. 

(b)  Prohibits a county in the service area of a hospital district from
being a party to the creation of a district or to a contract with a
district.  Authorizes the hospital district serving the county to create
and contract with the district for its service area. 

(c)  Provides that a concurrent order to create a district must to meet
certain criteria,  including being coextensive with the combined boundaries
of each creating county and hospital district. 

Sec. 287.022.  CONTRACT TERMS. (a)  Requires a county or hospital district
creating a district under this chapter to contract with the district to
provide at minimum the health care services the county or hospital district
is required to provide by law or under the constitution. Provides that a
contract with a county or hospital district that created the district under
this chapter must contain certain information. 

(b)  Makes Chapter 791 (Interlocal Cooperation Contracts), Government Code,
inapplicable to a contract made under this chapter. 

Sec. 287.023.  PURPOSE AND DUTIES.  Requires a district to provide health
care services to certain categories of persons in a certain manner; manage
funds; acquire, construct, manage and operate land, buildings,
improvements, equipment, and other assets for which the district is
responsible; and plan and coordinate with public and private health care
providers and entities.  Requires the district to ensure the provision of
quality health care by health care providers employed by or under contract
with the district. 

Sec. 287.024.  FUNDING.  (a)  Requires each county or hospital district
contracting with the district to contribute for its operation certain
funding. 

(b) Requires the district to maintain an accounting of the funds received
from each county or hospital district contracting with the district. 

(c)  Authorizes the district to commingle and administer the financial
contributions of all parties to the contract for district purposes. 

SUBCHAPTER C.  DISTRICT ADMINISTRATION

Sec. 287.041.  BOARD OF DIRECTORS.  (a)  Requires each county or hospital
district creating the district to appoint two directors to the board. 

(b)  Requires the counties or hospital districts to agree on and
collectively appoint one additional director, in addition to the two
directors appointed. 

(c)  Provides that directors serve staggered, two-year terms, with as near
as possible to one-half of the terms expiring each year. 

Sec. 287.042.  QUALIFICATIONS FOR OFFICE.  (a)  Provides that in order to
be eligible to serve as a director, an individual must meet certain
criteria. 

(b)  Prohibits an employee of the district from serving as a director.

Sec. 287.043.  BOND.  (a)  Provides that before assuming the duties of
office, each director is required to execute a bond for $5,000 payable to
the district, conditioned on the faithful performance of the person's
duties as director. 

(b)  Requires the bond to be kept in the district's permanent records.

(c)  Authorizes the board to pay for directors' bonds with district funds.

Sec. 287.044.  BOARD VACANCY.  Requires a vacancy in the office of a
director to be filled for the unexpired term in the same manner as the
original appointment. 

Sec. 287.045.  OFFICERS.  (a)  Requires the board to elect from its members
a president and vice president. 

(b)  Requires the board to appoint a secretary who need not be a director.
 
Sec. 287.046.  OFFICERS' TERMS; VACANCY.  (a)  Provides that each officer
of the board serves for a one-year term. 

(b)  Requires the board to fill a vacancy for the unexpired term.

Sec. 287.047.  COMPENSATION.  (a)  Provides that directors and officers
serve without compensation, however, authorizes them to be reimbursed or
actual expenses incurred in the performance of official duties. 

(b)  Provides that expenses reimbursed under this section must be reported
in a certain manner and approved by the board. 

Sec. 287.048.  VOTING REQUIREMENT.  Provides that a majority of board
members voting must concur in a matter relating to the district's business. 

Sec. 287.049.  ADMINISTRATOR AND ADDITIONAL STAFF.  (a)  Authorizes the
board to appoint qualified persons as administrator of the district and as
additional staff members as necessary. 

(b) Provides that the individuals listed in Subsection (a) serve at the
board's will. 

(c) Entitles individuals in Subsection (a) to compensation as determined by
the board. 

(d)  Requires the administrator, before assuming duties, to execute a bond
payable to the district for no less than $5,000 as determined by the board,
conditioned on the faithful performance of the administrator's duties under
this chapter.  Authorizes the board to pay for the bond with district
funds. 

Sec. 287.050.  APPOINTMENTS TO STAFF.  Authorizes the board to appoint to
the staff any doctors it considers necessary for the efficient operation of
the district and make temporary appointments as necessary. 

Sec. 287.051.  TECHNICIANS, NURSES, AND OTHER DISTRICT EMPLOYEES.  (a)
Authorizes the district to employ technicians, nurses, fiscal agents,
accountants, architects, attorneys, and other necessary employees. 

(b)  Authorizes the board to delegate to the administrator the authority to
employ persons for the district. 

Sec. 287.052.  GENERAL DUTIES OF ADMINISTRATOR.  Requires the administrator
to supervise the work and activities of the district and direct the
district's general affairs, subject to limitations prescribed by the board. 

Sec. 287.053.  RETIREMENT BENEFITS.  Authorizes the board to provide
retirement benefits for district employees by establishing or administering
a retirement program or electing to participate in certain statewide
retirement systems. 

SUBCHAPTER D.  POWERS AND DUTIES

Sec. 287.071.  RESPONSIBILITY OF GOVERNMENTAL ENTITY.  Requires a county or
hospital district where the district is located to transfer certain
operations to the district upon its creation. 

Sec. 287.072.  DISTRICT RESPONSIBILITIES.  Provides that upon creation of a
district, the district assumes the duties required by Section 287.023,
Health and Safety Code, and any additional duties specified in the contract
with the counties and hospital districts that created the district. 

 Sec. 287.073.  MANAGEMENT, CONTROL, AND ADMINISTRATION.  Requires the
board to manage, control, and administer the health care system and the
funds and resources of the district that are transferred under Section
287.071, Health and Safety Code. 

Sec. 287.074.  DISTRICT RULES.  Authorizes the board to adopt rules
governing the district's operation, and the duties, functions and
responsibilities of district staff and employees. 

Sec. 287.075.  METHODS AND PROCEDURES.  Authorizes the board to prescribe
the method of making purchases and expenditures and accounting and control
procedures or the district. 

Sec. 287.076.  HEALTH CARE PROPERTY, FACILITIES, AND EQUIPMENT.  (a)
Requires the board to determine the type, number, and location of buildings
required to establish and maintain an adequate health care system and the
type of equipment necessary for health care. 

(b)  Authorizes the board to make additional determinations, including
those related to: 

_acquisition of property, facilities, and equipment;
_a mortgage or pledge of the property, facilities, or equipment; 
_transfer by lease to certain individuals and entities;
_sale or disposal of properties, facilities, or equipment; and
_contracts with a state agency to provide facilities and health care
services. 

Sec. 287.077.  CONSTRUCTION CONTRACTS. (a)  Authorizes the board to enter
into construction contracts for the district. 

(b)  Authorizes the board to enter into construction contracts of more than
$10,000 only after competitive bidding as provided by Subchapter B
(Competitive Bidding on Certain Public Works Contracts), Chapter 271
(Purchasing and Contracting Authority of Municipalities, Counties, and
Certain Other Local Governments), Local Government Code. 

(c)  Makes Chapter 2253 (Public Work Performance and Payment Bonds),
Government Code, as it relates to performance and payment bonds, applicable
to construction contracts let by the district. 

Sec. 287.078.  DISTRICT OPERATING AND MANAGEMENT CONTRACTS. Authorizes the
board to enter into operating or management contracts relating to health
care facilities owned by the district or for which the district assumes
responsibility for managing and operating under the terms of the contract
with the counties and hospital districts that created the district. 

Sec. 287.079.  EMINENT DOMAIN.  (a)  Authorizes a district to exercise the
power of eminent domain to acquire a fee simple or other interest in
property located in the district's territory if the property interest is
necessary to the exercise of the rights or authority conferred by this
chapter. 

(b)  Provides that a district must exercise the power of eminent domain as
provided in Chapter 21 (Eminent Domain), Property Code.  Does not require
the district to deposit in the trial court money or a bond as provided by
Section 21.021(a) (Possession Pending Litigation), Property Code, which,
after an award in a condemnation proceeding has been made, authorizes the
condemnor to take possession of the condemned property pending the results
of further litigation under certain conditions. 

(c)  Provides that in a condemnation proceeding brought by a district, the
district is not required to pay certain costs or give certain bonds
associated with the proceeding. 

 Sec. 287.080.  EXPENSES FOR MOVING FACILITIES OF RAILROADS OR UTILITIES.
Provides that the district, in exercising the power of eminent domain, must
bear the actual costs of relocating, raising, lowering, rerouting, changing
the grade, or altering the construction to provide comparable replacement
without enhancement of a facility, after deducting the net salvage value
derived from the old facility with respect to any of the following: 

_railroad
_highway
_pipeline
_electric transmission and electric distribution
_telegraph
_telephone lines
_conduits
_poles
_facilities

Sec. 287.081.  PAYMENT FOR HEALTH CARE SERVICES.  (a)  Requires the
district to supply without charge to a patient residing in the district the
care and treatment for which the patient, the patient's guardian out of the
estate of the patient, or relative legally responsible for the patient's
support cannot pay.  Prohibits a district from considering that the patient
or the patient's relative who is responsible for the patient's support
cannot pay for the care and treatment of the patient in determining the
type and degree of care and treatment required by the patient. 

(b)  Requires the district to adopt an application procedure to determine
eligibility for assistance that complies with Section 61.053 (Application
Procedure), Health and Safety Code, no later than the first day of each
operating year. 

(c)  Authorizes the administrator of the district to have an inquiry made
into the financial circumstances of certain individuals obligated to
provide for the patient, including the estates of those individuals. 

(d)  Authorizes the board to adopt a sliding-fee scale for health care
services provided to a patient who can pay for some, but not all, of the
care and treatment provided by the district.  Provides that the fees for
health care services provided to a patient described by this subsection
must be based on the income level and size of the estate of the patient or
relative of the patient who is legally responsible for the patient. 

(e) Authorizes a county that created and contracted with the district to
credit a district expenditure for the care and treatment of an eligible
county resident to the same extent and in the same manner the county would
be able to claim the expenditure under Chapter 61 if the county made the
expenditure. 

(f) Requires the board to adopt rules regarding the collection of money
that is owed to the district for health care services provided to a patient
who is determined to be able to pay for all or any part of the services
from a patient, a patients's estate, or a relative who is legally
responsible for the patient's support. 

Sec. 287.082.  REIMBURSEMENT FOR SERVICES.  (a)  Requires the board to
mandate reimbursement from a county, municipality, or public hospital
located outside the district's boundaries for the district's care and
treatment of a sick, diseased, or injured person of that service area as
provided by Chapter 61 (Indigent Health Care and Treatment Act), Health and
Safety Code. 

(b)  Requires the board to mandate reimbursement from the sheriff or police
chief of a county or municipality for the district's care and treatment of
a person confined in a jail of that area who is not a resident of the
district. 

 (c)  Authorizes the board to contract with the state or federal government
for those entities to reimburse the district for treatment of a sick,
diseased, or injured person. 

Sec. 287.083.  SERVICE CONTRACTS.  Authorizes the board to contract with a
municipality, county, special district, or other county or hospital
district of the state or with a state or federal agency for the district to
furnish a mobile emergency medical service or provide for the investigatory
or welfare needs of inhabitants of the district. 

Sec. 287.084.  GIFTS, GRANTS, AND ENDOWMENTS.   Authorizes the board, on
behalf of the district, to accept gifts, grants, and endowments to be held
in trust for any purpose and under any direction, limitation, or provision
prescribed in writing by the donor that is consistent with the proper
management of the district. 

Sec. 287.085.  AUTHORITY TO SUE AND BE SUED.  Authorizes the board to sue
and be sued on the district's behalf. 

SUBCHAPTER E.  DISSOLUTION OF DISTRICT

Sec. 287.101.  DISSOLUTION.  Requires the district to be dissolved if the
contract with the counties or hospital districts that created the district
expires and is not renewed. 

Sec. 287.102.  TRANSFER OF ASSETS AFTER DISSOLUTION.  (a)  Requires the
board, after the district is dissolved, to perform certain functions with
respect to district property. 

(b) Provides that if the district transfers its lands, buildings,
improvements, equipment, and other assets to a county or other governmental
entity, the county or entity assumes all debts and obligations related to
this property, and the district is dissolved. 

Sec. 287.103.  ADMINISTRATION OF PROPERTY, DEBTS, AND ASSETS AFTER
DISSOLUTION.  (a) Requires the board, if the district does not transfer its
property to a county or other governmental entity, to continue to control
and administer the property, debts, and assets of the district until all
funds have been exhausted and the district's debts have been paid or
settled. 

(b)  Requires the district, if, after administering the property and assets
and determining that these are insufficient to pay the district's debts, to
transfer the remaining debts to the counties and hospital districts that
created the district in proportion to the funds contributed to the district
by each county or hospital district. 

(c) Requires the board, if after administering the property and assets and
determining that unused funds remain, to transfer these funds to the
counties ad hospital districts that created the district in proportion to
the funds contributed to the district by the county or hospital district. 

Sec. 287.104.  ACCOUNTING.  Requires the board, after the district has paid
all debts and disposed of all assets and funds, to provide an accounting to
each county and hospital district that created and contracted with the
district.  Provides that the accounting must show the manner in which the
assets and debts of the district were distributed. 

SUBCHAPTER F.  DISTRICT FINANCES

Sec. 287.121.  FISCAL YEAR.  (a)  Provides that the district operates on
the fiscal year established by the board. 

(b)  Prohibits the fiscal year from being changed if revenue bonds of the
district are outstanding or more than once in a 24-month period. 

Sec. 287.122.  ANNUAL AUDIT.  (a)  Requires the board to annually audit the
financial condition of the district. 
 
(b)  Provides that a copy of the audit must be provided to each county and
hospital district that created and contracted with the district. 

Sec. 287.123.  DISTRICT AUDIT AND RECORDS.  Provides that the annual audit
and other district records are open for inspection during regular business
hours and at the principal office of the district. 

Sec. 287.124.  ANNUAL BUDGET. (a)  Requires the district administrator to
prepare a proposed budget for the district. 

(b)  Provides that the budget is required to contain a complete financial
statement, including certain information regarding the district's financial
status. 

Sec. 287.125.  NOTICE; HEARING; ADOPTION OF BUDGET.  (a)  Requires the
board to hold a public hearing on the proposed annual budget. 

(b)  Requires the board to publish notice of the hearing in a newspaper of
general circulation in the district no later than the 10th day before the
hearing. 

(c) Entitles any resident of the district to attend and participate in the
meeting. 

(d)  Authorizes the board, at the conclusion of the hearing, to adopt a
budget by acting on the budget proposed by the administrator.  Authorizes
the board to make any changes in the budget that, in its judgment, the
interests of the district residents demand. 

(e)  Provides that the budget is effective only after the board adopts it.

Sec. 287.126.  AMENDING BUDGET.  Authorizes the budget to be amended on the
board's approval after its adoption. 

Sec. 287.127.  LIMITATION OF EXPENDITURES.  Prohibits money from being
spent for an expense not included in the annual budget or an amendment to
it.  Prohibits the annual budget for administrative expenses from exceeding
10 percent of the total annual budget of the district except after formal
adoption of an amendment to increase the budget for administrative
expenses. 

Sec. 287.128.  SWORN STATEMENT.  Requires the administrator to prepare for
the board a sworn statement of the amount of money that belongs to the
district and an account of the disbursements of that money as soon as
practicable after the close of the fiscal year. 

Sec. 287.129.  SPENDING AND INVESTMENT LIMITATIONS.  (a) Prohibits the
district from  incurring a debt payable from revenues of the district other
than those on hand or to be on hand in the current and immediately
following fiscal year of the district except for construction contracts
under Section 287.077(a), Health and Safety Code or as provided by Sections
287.142 and 287.143, Health and Safety Code. 

(b)  Authorizes the board to invest operating, depreciation, or building
reserves only in funds or securities specified by Articles 836 or 837,
V.T.C.S. (Investments and Secondary Investments, respectively). 

Sec. 287.130.  DEPOSITORY.  (a)  Requires the board to name at least one
bank to serve as a depository for district funds. 

(b)  Requires these funds, other than those invested as provided by Section
287.129(b), Health and Safety Code, and those transmitted to a bank of
payment for bonds or obligations issued or assumed by the district to be
deposited as soon as they are received with the depository bank, where they
must remain on deposit.  Provides that this subsection does not limit the
board's power to place a portion of the funds on time deposit  or to
purchase certificates of deposit. 

(c)  Provides that before the district deposits funds in a bank in an
amount that exceeds the maximum amount secured by the Federal Deposit
Insurance Corporation, the bank is required to execute a bond or other
security in an amount sufficient to secure from loss the district funds
that exceed the amount secured. 

Sec. 287.131.  AD VALOREM TAXATION.  Prohibits a district from imposing an
ad valorem tax. 

SUBCHAPTER G.  BONDS

Sec. 287.141.  GENERAL OBLIGATION BONDS.  Prohibits a district from issuing
general obligation bonds. 

Sec. 287.142.  REVENUE BONDS.  (a)  Authorizes the board to issue revenue
bonds for certain purposes. 

(b)  Provides that the bonds are required to be payable from and secured by
a pledge of all or part of the revenues derived from the operation of the
district's health care system. Authorizes the bonds to be additionally
secured by a mortgage or deed of trust lien on all or part of district
property. 

(c) Provides that the bonds must be issued as provided by Sections 264.042,
264.043, 264.046, 264.047, 264.048, and 264.049, Health and Safety Code,
for issuance of revenue bonds by county hospital authorities.  These
sections are titled, respectively: Form and Procedure, Terms,  Junior Lien
Bonds; Parity Bonds, Bond Proceeds; Investment of Funds, Refunding Bonds,
and Approval and Registration of Bonds. 
 
Sec. 287.143.  REFUNDING BONDS.  (a)  Authorizes refunding bonds to be
issued to refund an outstanding indebtedness the district has issued or
assumed. 

(b)  Provides that the bonds are required to be issued as provided by
Article 717k-3, V.T.C.S. (Chapter 784, Acts of the 61st Legislature,
Regular Session, 1969) (State, County, Municipality or Political
Subdivision; Issuer of Bonds, Notes, etc.). 

(c)  Provides the refunding bonds are authorized to be sold and the
proceeds applied to the payment of outstanding debts or exchanged in whole
or part for no less than a similar principal amount of outstanding debt.
Provides if the bonds are to be sold and the proceeds applied to the
payment of outstanding debts, the bonds are required to be issued and
payments made as provided by Article 717k, V.T.C.S. (Chapter 503, Acts of
the 54th Legislature, Regular Session, 1955). 

Sec. 287.144.  INTEREST AND MATURITY.  Provides that district bonds are
required to mature no later than the 50th anniversary of the date of
issuance and bear interest at a rate not to exceed that provided by Article
717k-2, V.T.C.S. (Chapter 3, Acts of the 61st Legislature, Regular Session,
1969) (Public Insecurities; Issuance by Public Agencies; Interest Rate). 

Sec. 287.145.  EXECUTION OF BONDS.  Requires the board's president to
execute the bonds in the name of the district.  Requires the board's
secretary to countersign the bonds as provided by Article 717j-1, V.T.C.S.
(Texas Uniform Facsimile Signature of Public Officials Act). 

Sec. 287.146.  APPROVAL AND REGISTRATION OF BONDS.  (a)  Provides that
district bonds are subject to the same requirements with regard to approval
by the attorney general and registration by the comptroller of public
accounts (comptroller) as provided by law for approval and registration of
bonds issued by counties. 

 (b) Provides that on approval by the attorney general and registration by
the comptroller, the bonds are incontestable for any cause. 

Sec. 287.147.  BONDS AS INVESTMENTS.  Provides that district bonds and
debts assumed by the district are legal and authorized investments for
certain individuals and entities. 

Sec. 287.148.  BONDS AS SECURITY FOR DEPOSITS.  Provides that district
bonds are eligible to secure deposits of public funds of the state and of
municipalities, counties, school districts, and other counties or hospital
districts of the state.  Provides that the bonds are lawful and sufficient
security for deposits to the extent of their value if accompanied by all
unmatured coupons. 

Sec. 287.149.  TAX STATUS OF BONDS.  Provides that because the district
created under this chapter is a public entity performing an essential
public function, bonds issued by the district, any transaction relating to
the bonds, and profits made in the sale of the bonds are free from state
taxes or taxation by any municipality, county, special districts, or other
county or hospital district of this state. 

SECTION 2.  Effective date: September 1, 1999.

SECTION 3.  Emergency clause.


COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.H.B. 3505 modifies the original in SECTION 1 (proposed Section 281.021)
of this bill, by authorizing a health services district, as described by
this Act, to be created by concurrent orders of a county or hospital
district and one or more other counties or hospital districts, rather than
two or more political subdivisions of this state.   

C.S.H.B. 3505 modifies the original in SECTION 1 (proposed Sections
287.021, 287.022, 287.024, 287.041, 287.072, 287.078, 287.083, 287.101,
287.103, 287.104, 287.121, 287.143, 287.148, and 287.149) of this bill, by
providing that the authority granted and obligations created under the Act
are expressly conferred to counties and hospital districts, rather than
political subdivisions. 

C.S.H.B. 3505 modifies the original in SECTION 1 (proposed Sections
287.021, 287.071, 287.073, 287.076, 287.078, 287.142) of this bill, by
providing that the concurrent orders described and authorized by this act
creates a health care district, rather than a hospital district, and the
authority granted and obligations created under the Act are expressly
conferred on the health care district or health care facilities, rather
than the hospital district and hospital facilities.  

C.S.H.B. 3505 modifies the original in SECTION 1 (proposed Section 287.049)
of this bill, by authorizing  the board to appoint an administrator of the
district and additional staff members, rather than an administrator,
assistant administrator, and attorney for the district.  Makes conforming
in the section title and changes regarding the appointment of attorneys and
additional staff members. 

C.S.H.B. 3505 modifies the original in SECTION 1 (proposed Section 287.081)
of this bill, by authorizing the health care district to inquire into and
consider funds available to the patient's guardian out of the estate of the
patient and the obligated relative's estate, if applicable, in determining
whether the district will provide for all or part of the services provided
to the patient free of charge.  In proposed subsection (a), prohibits a
district from considering that the patient or the patient's relative who is
responsible for the patient's support cannot pay for the care and treatment
of the patient in determining the type and degree of care and treatment
required by the patient.  Adds a new subsection (e) authorize the county to
credit a district expenditure in the manner and amount authorized under
Chapter 61.  Adds a new Subsection (f) to require the board to adopt rules
regarding collection of the amount the board determines the patient,
patient's estate, or patient's obligated relative is able to pay.  Removes
the requirement in proposed Subsection (a) of the original that the
administrator prepare a report regarding the financial ability of the
patient to be presented  to the board and the requirement that the board,
after reviewing and approving the report, issue an order directing the
patient or obligated person to pay the amount determined to be due.
Deletes proposed Subsection (g), which provided the express authorization
to collect the payment in the manner provided by law for collection of
expenses in the last illness of a deceased person.  Deletes proposed
Subsection (h) which established the procedure regarding disputes or
confusion relating to an individual's ability to pay that require the board
to call witnesses, hear and resolve the question, and issue a final order.
Deletes the provision regarding an appeal from the final order of the
board. 

C.S.H.B. 3505 modifies the original in SECTION 1 (proposed Section 287.127)
of this bill, by adding a new Subsection (b) to prohibiting the annual
budget for administrative expenses from exceeding 10 percent of the total
annual budget of the district except after adoption of an amendment to
increase the budget for administrative expenses.