Code Red The Critical Condition of Health in Texas 2008 Noor Malik The University of Texas School of Public Health Dallas Campus

House Bill 1630 Caption: Relating to the eligibility of certain individuals for child health plan coverage or medical assistance on release from certain facilities or other settings Caption: Relating to the eligibility of certain individuals for child health plan coverage or medical assistance on release from certain facilities or other settings Author and Coauthor: Elliott Naishtat of Travis County and Marc Veasey of Tarrant County Author and Coauthor: Elliott Naishtat of Travis County and Marc Veasey of Tarrant County Sponsor: Watson Sponsor: Watson Companion Bill: Senate Bill 2031 by Watson Companion Bill: Senate Bill 2031 by Watson Filed: 02/23/2009 Filed: 02/23/2009 Enrolled: 05/23/2009 Enrolled: 05/23/2009 Signed: 05/23/2009 Signed: 05/23/2009 Effective: 06/19/2009 Effective: 06/19/2009

House Bill 1630 Original Intent Original Intent To allow for suspensions of individuals receiving child health coverage if they are placed, detained, or committed under Title 3, Family Code To allow for suspensions of individuals receiving child health coverage if they are placed, detained, or committed under Title 3, Family Code To provide health coverage for an individual who is eligible until the end of 12 months, excluding any time which the person was suspended as provided by Section To provide health coverage for an individual who is eligible until the end of 12 months, excluding any time which the person was suspended as provided by Section Addition of Section , which suspends health coverage of a child that is placed, detained, or committed under Title 3, Family Code, and automatically reinstates coverage once the child is released from the facility Addition of Section , which suspends health coverage of a child that is placed, detained, or committed under Title 3, Family Code, and automatically reinstates coverage once the child is released from the facility Bill was later amended to include suspension and reinstatement of health coverage for Medicaid and Child Health Program recipients, and to develop an understanding of suspension and reinstatement with the Texas Youth Commission Bill was later amended to include suspension and reinstatement of health coverage for Medicaid and Child Health Program recipients, and to develop an understanding of suspension and reinstatement with the Texas Youth Commission

House Bill 1630 Read for the first time March 3 rd, 2009 Read for the first time March 3 rd, 2009 Referred to House Human Services Committee Referred to House Human Services Committee Considered for public hearing April 2 nd, 2009, heard same day, and left pending in committee Considered for public hearing April 2 nd, 2009, heard same day, and left pending in committee Reported favorably without amendments April 9 th, 2009 Reported favorably without amendments April 9 th, 2009 Considered in Calendars April 29 th, 2009 Considered in Calendars April 29 th, 2009 Placed on General State Calendar and amended May 2 nd, 2009 Placed on General State Calendar and amended May 2 nd, 2009 Read third time and passed May 4 th, 2009 Read third time and passed May 4 th, 2009 Referred to Senate Health and Human Services Committee May 6 th, 2009 Referred to Senate Health and Human Services Committee May 6 th, 2009 Reported favorably without amendments and recommended for local & uncontested calendar May 13 th, 2009 Reported favorably without amendments and recommended for local & uncontested calendar May 13 th, 2009 Laid before Senate and passed May 21 st, 2009 Laid before Senate and passed May 21 st, 2009 Signed by House and Senate May 23 rd, 2009 Signed by House and Senate May 23 rd, 2009 Signed by governor and effective immediately June 19 th, 2009 Signed by governor and effective immediately June 19 th, 2009

House Bill 1630 Bill passed, perhaps because funding was not necessary for the bill to succeed Bill passed, perhaps because funding was not necessary for the bill to succeed Witnesses for House Committee on Health Services included interest groups such as Texans Care for Children and The Roman Catholic Bishops of Texas; healthcare groups including Texas Hospital Association and Childrens Hospital Association of Texas; mental health advocacy groups such as Mental Health America of Texas and The Arc of Texas; and institutional organizations such as Texas Criminal Justice Coalition and Tarrant County Juvenile Services Witnesses for House Committee on Health Services included interest groups such as Texans Care for Children and The Roman Catholic Bishops of Texas; healthcare groups including Texas Hospital Association and Childrens Hospital Association of Texas; mental health advocacy groups such as Mental Health America of Texas and The Arc of Texas; and institutional organizations such as Texas Criminal Justice Coalition and Tarrant County Juvenile Services Witnesses for Senate Committee on Health and Human Services included interest groups such as Texas Catholic Conference; healthcare groups including Texas Medical Association and Texas Hospital Association; mental health advocacy groups such as National Alliance on Mental Health Illness, Texas and Mental Health America of Greater Dallas; and institutional organizations such as Texas Juvenile Probation Commission Witnesses for Senate Committee on Health and Human Services included interest groups such as Texas Catholic Conference; healthcare groups including Texas Medical Association and Texas Hospital Association; mental health advocacy groups such as National Alliance on Mental Health Illness, Texas and Mental Health America of Greater Dallas; and institutional organizations such as Texas Juvenile Probation Commission

House Bill 1630 Bill related to Code Red recommendations Bill related to Code Red recommendations Policy Implications Policy Implications

House Bill 1630 Designated agencies: Department of Family and Protective Services Designated agencies: Department of Family and Protective Services Fiscal implications Fiscal implications Funding Funding Outcome measurability? Outcome measurability?

House Bill 676 Caption: Relating to eligibility of the child health plan Caption: Relating to eligibility of the child health plan Author: Craig Eiland of Chambers and Galveston County and Norma Chavez of El Paso County Author: Craig Eiland of Chambers and Galveston County and Norma Chavez of El Paso County Sponsor: None Sponsor: None Companion Bill: None Companion Bill: None Filed: 01/01/2009 Filed: 01/01/2009 Enrolled: N/A Enrolled: N/A Signed: N/A Signed: N/A Effective: N/A Effective: N/A

House Bill 676 Original Intent Original Intent to amend Section 1, Section b, the Health and Safety Code, so that a child who is younger than 19 years of age and whose net family income is at or below 300 percent of the federal poverty level is eligible for health benefits under the program. This increases eligibility from those at or below 200 percent of the federal poverty level to those at or below 300 percent of the federal poverty level. to amend Section 1, Section b, the Health and Safety Code, so that a child who is younger than 19 years of age and whose net family income is at or below 300 percent of the federal poverty level is eligible for health benefits under the program. This increases eligibility from those at or below 200 percent of the federal poverty level to those at or below 300 percent of the federal poverty level. Read for the first time on February 18 th, 2009 Read for the first time on February 18 th, 2009 Referred to House Human Services Committee Referred to House Human Services Committee Scheduled for public hearing on March 19 th, 2009 and considered same day Scheduled for public hearing on March 19 th, 2009 and considered same day Left pending in House Human Services Committee March 19 th, 2009 Left pending in House Human Services Committee March 19 th, 2009

House Bill 676 Bill may have failed due to lack of sponsors and costliness associated with implementation of the bill Bill may have failed due to lack of sponsors and costliness associated with implementation of the bill Witnesses: Witnesses: Self represented individuals Self represented individuals Healthcare associations, including Seton Family of Hospitals, Texas Association of Health Plans, and Texas Academy of Family Physicians Healthcare associations, including Seton Family of Hospitals, Texas Association of Health Plans, and Texas Academy of Family Physicians Interest groups, including AARP, Texas PIRG, League of Women Voters in Texas, American Federation of Teachers, and Catholic Health Association of Texas Interest groups, including AARP, Texas PIRG, League of Women Voters in Texas, American Federation of Teachers, and Catholic Health Association of Texas Code Red recommendations & policy implications Code Red recommendations & policy implications

House Bill 676 Designated agency: Department of Family and Protective Services Designated agency: Department of Family and Protective Services Fiscal implications Fiscal implications Funding Funding Outcome measurability? Outcome measurability?

House Bills 1630 and 676 Extension of health coverage to individuals in Texas? Extension of health coverage to individuals in Texas? Extension of SCHIP to children in Texas? Extension of SCHIP to children in Texas?

References Brotzen, Frank Code Red: The Critical Condition of Health in Texas. Code Red: The Critical Condition of Health in Texas. [Online.] No author st Legislature Regular Session – Texas Legislature Online. Texas Legislature Online. [Online.]