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County Affairs Committee Hears Testimony on Medicaid 1115 Waiver

By Rick Thompson,
TAC Legislative Staff
The House Committee on County Affairs met July 17 to hear testimony on its interim charges, including the committee’s oversight of the Medicaid 1115 Waiver.
In testimony, Health and Human Services Commissioner Tom Suehs, who retires Aug. 31, stated that 20 regional health plans (RHP) have been created and all entities involved are working hard to meet the Sept. 1 deadline to submit RHP plans.
Jim Allison, general counsel for the County Judges and Commissioners Association of Texas, testified that in looking for local funds for the federal match from counties, a couple of efforts are going well. For example, the county funding that is used for Upper Payment Limit (UPL) payments will transition into the uncompensated care program. Funds that counties make available through contract such as those for mental health and EMS services are shifting smoothly into Delivery System Reform Incentive Payments (DSRIP) projects.
Difficulties have arisen, however, when it comes to new money available for match, because counties are already in the budget process and the development of the DSRIP projects is still underway. Counties are unable to work in new dollars to fund DSRIP projects; therefore, counties will be looking for ways to leverage monies already in the budget.
Allison also discussed the use of county indigent healthcare funds to leverage federal dollars, indicating that there are a couple of problems. For instance, the county indigent health care program is set up on a fee per service basis and an Intergovernmental Transfer (IGT) has to be a lump sum transfer for a DSRIP project. Another concern raised is that money contributed as IGT would not satisfy the requirements laid out in chapter 61 of the Health and Safety Code.
Video of the hearing and handouts distributed to the committee are available online.