HBA-DMH C.S.H.B. 896 77(R)    BILL ANALYSIS


Office of House Bill AnalysisC.S.H.B. 896
By: Coleman
Public Health
5/15/2001
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

Recent advancements in HIV and AIDS treatment have brought renewed health
to many people living with HIV and AIDS.  However, treatment is expensive.
When limited income individuals with HIV or AIDS do not receive appropriate
treatment, they debilitate physically to the point where they qualify for
disability related Medicaid, one of the most expensive categories of
Medicaid coverage.  Investing up front in appropriate maintenance care for
this population would reduce such costs.  In 1997, the legislature directed
the Health and Human Services Commission (HHSC) to maximize federal funding
under Medicaid for treatment of HIV and AIDS.  C.S.H.B. 896 requires HHSC
to develop a demonstration project to offer pharmaceutical treatment and
medical services under Medicaid to HIV and AIDS patients, and requires HHSC
to report on the cost-effectiveness of the project. 

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. 896 amends the Human Resources Code to require the Health and
Human Services Commission (HHSC) to establish in at least two counties with
a high prevalence of HIV infection or AIDS a demonstration project
(project) to provide persons with HIV infection or AIDS with medical
services, drug treatments and medications, vaccinations, hospitalization,
and diagnostic testing and services through the medical assistance program.
The bill requires HHSC to ensure that the project is financed using funds
made available by the counties in which HHSC establishes the project.  The
bill establishes eligibility requirements for project participants,
provides that project participation does not entitle a participant to other
services provided under the medical assistance program, requires HHSC to
establish an enrollment process for the project, and sets forth provisions
regarding enrollment and eligibility. 

The bill requires HHSC to submit a biennial report to the legislature no
later than December 1 of each even numbered year, and to evaluate the
project's cost-effectiveness no later than December 1, 2006.  If the
evaluation results indicate that the project is cost-effective, HHSC is
required to incorporate a request for funding for the expansion of the
project in its request for the next state fiscal biennium.  The project
expires September 1, 2007. 

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. 896 differs from the original bill by removing the provision that
demonstration project (project) participants are not subject to the monthly
three-prescription limit under the medical assistance program and by
providing that project participation does not entitle a participant to
other services provided under  the medical assistance program.  The
substitute modifies the eligibility requirements for the project, includes
provisions relating to an enrollment process for participants, and requires
the Health and Human Services Commission to ensure that county funds are
used to finance the project.  The substitute modifies the types of services
and medications that the project is required to provide.  The substitute
modifies requirements for requesting a federal waiver or authorization and
modifies the effective date of the Act.