By Nanette Forbes
TAC Legislative Staff
During the 82nd Legislative Session, 10 joint resolutions were passed proposing amendments to the state constitution. Four of these are of specific interest to counties. On Tuesday, Nov. 8, 2011, voters will go to the polls to vote for or against the proposed amendments. The four propositions are listed as follows:
Proposition No. 1 – (SJR 14, Article 8) by Van de Putte (C. Anderson)
“The constitutional amendment authorizing the legislature to provide for an exemption from ad valorem taxation of all or part of the market value of the residence homestead of the surviving spouse of a 100 percent or totally disabled veteran.”
Proposition No. 1 would authorize the surviving spouse of a 100 percent or totally disabled veteran to receive a property tax exemption of all or part of the market value of a residence homestead property to which the disabled veteran’s exemption applied, as well as a subsequent homestead property in an amount equal to the dollar amount of the previous exemption from the previous year, under certain circumstances.
Proposition No. 4 – (HJR 63, Article 8) by Pickett (Wentworth)
“The constitutional amendment authorizing the legislature to permit a county to issue bonds or notes to finance the development or redevelopment of an unproductive, underdeveloped, or blighted area and to pledge for repayment of the bonds or notes increases in ad valorem taxes imposed by the county on property in the area. The amendment does not provide authority for increasing ad valorem tax rates.”
Proposition No. 4 would amend the Texas Constitution, Art. 8, sec. 1-g(b) to add counties to the political entities authorized to pledge increased property taxes to bonds issued for redeveloping property in a particular area. This would enhance counties’ ability to designate transportation reinvestment zones, providing an important financing tool to expand and improve transportation options.
Proposition No. 5 – (SJR 26, Article 11) by West (Turner)
“The constitutional amendment authorizing the legislature to allow cities or counties to enter into interlocal contracts with other cities or counties without the imposition of a tax or the provision of a sinking fund.”
Proposition No. 5 permits local governments to enter into extended interlocal contracts for joint projects. Under current law, multi-year agreements between counties and cities for joint projects require imposition of a tax or the creation of a sinking fund. This limits local governments from jointly financing and operating extended consolidated services — such as criminal justice buildings, animal shelters and equipment maintenance facilities. The proposition would change that to allow such consolidated projects, which could save taxpayers money. By pledging the revenues from these programs, the cities and counties will not need to levy additional taxes to secure these programs.
Proposition No. 10 – (SJR 37, Article 16) by Van de Putte (Van Taylor)
“The constitutional amendment to change the length of the unexpired term that causes the automatic resignation of certain elected county or district officeholders if they become candidates for another office.”
Certain district and county officers who announce their candidacy for an office they do not currently hold when they have more than one year remaining in their term will force an automatic resignation from office. Proposition 10 would extend the “resign-to-run” provision to not exceed one year and 30 days.
“Amendments Proposed for November 2011 Ballot,” a publication by the House Research Organization (HRO), provides a digest of each proposition on the ballot, including information from supporters and opponents.
Another good source for information on the proposed constitutional amendments is a publication produced by the Texas Legislative Council, “Analyses of Proposed Constitutional Amendments.”
By Ender Reed
TAC Legislative Staff
As mentioned in a previous edition of County Issues, counties that want to maintain their goods-in-transit authority must adopt a resolution stating their intention before Dec. 31. The Conference of Urban Counties has prepared a sample resolution to assist counties. For additional questions, please contact the TAC Legislative Department at (800) 456-5974.
By Rick Thompson
TAC Legislative Staff
On Sept. 15, the House Committee on County Affairs heard invited testimony on the progress of a state initiative to expand managed care programs to new counties across the state. The testimony included representatives from the Health and Human Services Commission (HHSC), teaching hospitals, hospital districts, mental health advocates, rural and community hospital associations and the County Judges and Commissioners Association.
The 82nd Legislature directed the HHSC to expand managed care statewide to achieve state budget savings and preserve hospital access to funding consistent with Upper Payment Limit funds (UPL). In order to achieve this, HHSC submitted a proposal to the federal Centers for Medicare and Medicaid Services (CMS) in July creating a Section 1115 Demonstration Waiver.
According to testimony provided by Billy Millwee, associate commissioner for Medicaid and CHIP, the proposal includes plans for statewide expansion of Medicaid managed care, while protecting federal supplemental hospital payment funds, creation of Regional Healthcare Partnerships (RHPs), transition to quality-based payment systems for managed care and hospitals and diversion of savings generated by the proposed changes into a pool to cover uncompensated care costs for hospitals and other providers.
The purpose of the waiver is to protect hospital supplemental payments (i.e. UPL), expand allowed reimbursement for uncompensated care, incentivize delivery system improvements and improve access and system coordination and allow RHPs, which will be partnerships anchored by public hospitals in coordination with local governments and other stakeholders.
During Millwee’s testimony, House Committee on County Affairs Chairman Garnet Coleman asked several questions regarding county involvement, including whether the plan will turn into a system where counties are operating in place of the state in the Medicaid program.
Millwee responded, “No, this (waiver) does not fundamentally change the structure of the Medicaid program or impose any unfunded mandates on counties. All it does is take those UPL dollars and put them into the Opportunity Pool so if a county wants to participate and has the Intergovernmental Transfer (IGT) to participate and draw down those dollars, [it can].”
Millwee said he couldn’t see a situation where he would require the counties to provide the IGT, since it’s a voluntary program.
Coleman also asked if counties would be liable for new clients eligible under the Patient Protection and Affordable Care Act. Millwee replied the state responsibility to fund Medicaid has not changed and it’s not mandated in the waiver for counties to pick up that cost.
“Stranger things have happened,” Coleman said. “I’m just trying to make sure counties are not on the hook for funding the Medicaid program in perpetuity and when the dollars actually drop, somebody doesn’t turn and say 'y’all have to come up with those dollars with your ad valorem tax.'”
Millwee replied that those requirements are not in the waiver.
Jim Allison, general counsel to the County Judges and Commissioners Association of Texas, offered testimony to the committee. After outlining the county healthcare structures in place, Allison warned to be careful moving forward because of the issues that could impact counties, including intergovernmental transfers, which are local government taxes commonly set by the commissioners court that maintain a county’s ability to contract with providers.
TAC will continue to monitor and report on the progress of the waiver, which is expected to be approved in early October. As one person testified, “this is an airplane being built while we are flying it.”
Supporting Documents:
Presentation to House County Affairs Committee on Texas Healthcare Transformation and Quality Improvement Program 1115 Waiver
1115 Waiver Proposal and Information
County Affairs Hearing Video
From Staff Reports
The 82nd Legislature directed the Health and Human Services Commission (HHSC) to expand managed care statewide to achieve state budget savings and preserve hospital access to funding consistent with Upper Payment Limit funds (UPL). As a result, small urban regions and rural areas will now be transitioning to the managed care model of Medicaid with certain regions beginning the transition in September 2011 and full implementation expected in March 2012. HHSC has published an implementation timeline with service area maps.
There are two models operating in Medicaid managed care: STAR, which provides services primarily to pregnant women and children, and STAR+Plus, which provides services to persons with disabilities. However, STAR+Plus will not be implemented in rural counties; the traditional Department of Aging and Disability Services (DADS) programs will continue to serve people in those areas.
Medicaid recipients will still receive the same health benefits under the managed care program in addition to case work, care coordination, disease management, provider locating and transportation assistance.
HMO Member Benefits include:
Traditional Medicaid benefit package
Provider directories – physicians, specialists, and LTSS
PCP to coordinate health care of patient (Medicaid only)
Member services helpline (through their health plan)
Member handbooks and health education
Service coordination
Value added services – vary by health plan
Traditional Medicaid providers will now have to enroll to provide services under the managed care plans. Most providers should have received contact from those health plans, but a provider can see who is operating in their area by visiting the HHSC map. Providers who have previously accepted Medicaid may qualify as significant traditional providers and the health plans are obligated to offer to contract with those providers and offer them the opportunity to be included in the network.
More Info
Providers can receive additional information about the Medicaid program.