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S1444aa...............................................by HEALTH AND WELFARE
RURAL HEALTH CARE - Repeals and adds to existing law to adopt the Idaho
Rural Health Care Access Program to provide grants to entities, based upon
applications, to improve the delivery of primary health care in rural
underserved areas.
02/17 Senate intro - 1st rdg - to printing
02/18 Rpt prt - to Health/Wel
02/24 Rpt out - to 14th Ord
03/15 Rpt out amen - to engros
03/16 Rpt engros - 1st rdg - to 2nd rdg as amen
03/17 2nd rdg - to 3rd rdg as amen
03/21 3rd rdg as amen - PASSED - 33-1-1
AYES--Andreason, Boatright, Branch, Bunderson, Burtenshaw, Cameron,
Crow, Danielson, Darrington, Davis, Deide, Dunklin, Frasure, Geddes,
Ingram, Ipsen, Keough, King-Barrutia, Lee, McLaughlin, Noh, Parry,
Richardson, Risch, Sandy, Schroeder, Sorensen, Stegner, Stennett,
Thorne, Wheeler, Whitworth, Williams
NAYS--Riggs
Absent and excused--Hawkins
Floor Sponsor - Ipsen
Title apvd - to House
03/22 House intro - 1st rdg as amen - to Health/Wel
03/29 Rpt out - rec d/p - to 2nd rdg as amen
04/03 3rd rdg as amen - PASSED - 57-7-6
AYES -- Alltus, Barraclough(Barraclough), Barrett, Bell, Bieter,
Black, Boe, Bruneel, Callister, Campbell, Chase, Crow, Cuddy, Deal,
Denney, Ellsworth, Field(13), Field(20), Gagner, Gould, Hadley,
Hammond, Hansen(23), Hansen(29), Henbest, Hornbeck, Jaquet, Jones,
Judd, Kellogg, Kempton, Lake, Loertscher(Loertscher), Mader, Marley,
Meyer, Montgomery, Mortensen, Moss, Pischner, Pomeroy, Reynolds,
Ridinger, Ringo, Robison, Sali, Schaefer, Sellman, Shepherd, Smylie,
Stevenson, Stoicheff, Stone, Tilman, Trail, Wood, Zimmermann
NAYS -- Cheirrett, Geddes, Kendell, Kunz, McKague, Pearce, Smith
Absent and excused -- Clark, Linford, Moyle, Taylor, Wheeler, Mr
Speaker
Floor Sponsor - Reynolds, Henbest
Title apvd - to Senate
04/04 To enrol - rpt enrol - Pres signed
04/05 Sp signed
04/06 To Governor
04/12 Governor signed
Session Law Chapter 262
Effective: 07/01/00
S1444
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-fifth Legislature Second Regular Session - 2000
IN THE SENATE
SENATE BILL NO. 1444, As Amended
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO HEALTH CARE IN RURAL, MEDICALLY UNDERSERVED AREAS; REPEALING CHAP-
3 TER 59, TITLE 39, IDAHO CODE; AMENDING TITLE 39, IDAHO CODE, BY THE ADDI-
4 TION OF A NEW CHAPTER 59, TITLE 39, IDAHO CODE, TO ADOPT THE IDAHO RURAL
5 HEALTH CARE ACCESS PROGRAM, TO PROVIDE A SHORT TITLE, TO CREATE THE RURAL
6 HEALTH CARE ACCESS FUND, TO DEFINE TERMS, TO CREATE THE RURAL HEALTH CARE
7 ACCESS GRANT REVIEW BOARD, TO DEFINE THE SCOPE OF GRANT SUPPORT, TO SPEC-
8 IFY CATEGORIES OF GRANTS, TO SPECIFY ELIGIBILITY FOR GRANTS, TO REQUIRE AN
9 APPLICATION, TO SPECIFY THE GRANT AWARD SCHEDULE, TO DEFINE AWARD CRITE-
10 RIA, TO AUTHORIZE NEGOTIATION, TO PROHIBIT FRAUDULENT INFORMATION ON A
11 GRANT APPLICATION AND TO PROVIDE FOR APPEALS.
12 Be It Enacted by the Legislature of the State of Idaho:
13 SECTION 1. That Chapter 59, Title 39, Idaho Code, be, and the same is
14 hereby repealed.
15 SECTION 2. That Title 39, Idaho Code, be, and the same is hereby amended
16 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap-
17 ter 59, Title 39, Idaho Code, and to read as follows:
18 CHAPTER 59
19 IDAHO RURAL HEALTH CARE ACCESS PROGRAM
20 39-5901. SHORT TITLE. This act shall be known and cited as the "Idaho
21 Rural Health Care Access Program."
22 39-5902. RURAL HEALTH CARE ACCESS FUND. (1) There is hereby created in
23 the state treasury a fund known as the "Rural Health Care Access Fund." Sub-
24 ject to appropriation by the legislature, moneys in the fund shall be used
25 exclusively for the purpose of grants for improving access to primary care
26 medical services in areas designated as primary care health professional
27 shortage areas and medically underserved areas and their administration pursu-
28 ant to this chapter.
29 39-5903. DEFINITIONS. As used in this chapter:
30 (1) "Applicant" means an entity submitting documents required by the
31 rural health care access program for the purpose of requesting a grant from
32 the rural health care access fund.
33 (2) "Application period" means the time period from January 15 to May 15
34 prior to the state fiscal year for which funding is requested.
35 (3) "Approval" means written notification that the application will be
36 awarded funding through the rural health care access fund.
37 (4) "Board" means the rural health care access program review board.
38 (5) "Department" means the department of health and welfare.
39 (6) "Director" means the director of the department of health and wel-
2
1 fare.
2 (7) "Grant period" means the time immediately following the application
3 period from July 1 through June 30 (state fiscal year) for which funding is
4 granted.
5 (8) "Nurse practitioner" means a health care provider licensed pursuant
6 to chapter 14, title 54, Idaho Code.
7 (9) "Physician assistant" means a health care provider licensed pursuant
8 to chapter 18, title 54, Idaho Code.
9 (10) "Primary care" means the provision of professional comprehensive
10 health services that includes health education and disease prevention, initial
11 assessment of health problems, treatment of acute care and chronic health
12 problems, and the overall management of an individual's or family's health
13 care services as provided by an Idaho licensed internist, obstetrician, gyne-
14 cologist, pediatrician, family practitioner, general practitioner, nurse prac-
15 titioner or physician assistant. It provides the initial contact for health
16 services and referral for secondary and tertiary care.
17 (11) "Primary care health professional shortage area" means a geographic
18 area or population group which the U.S. secretary of health and human services
19 has determined is underserved by primary care health professional(s).
20 (12) "Medically underserved area" means a geographic area which the U.S.
21 secretary of health and human services has determined is underserved by pri-
22 mary care health professional(s).
23 (13) "Rural health care access grant" means a grant awarded pursuant to
24 this chapter.
25 (14) "Rural health care access program" means the program that administers
26 the rural health care access fund.
27 39-5904. RURAL HEALTH CARE ACCESS GRANT REVIEW BOARD. (1) The director
28 shall appoint the members of a board to be known as the rural health care
29 access grant review board, who shall serve at the pleasure of the director.
30 Board members shall not be compensated, but shall be reimbursed for travel
31 expenses incurred for attendance at board meetings.
32 (2) The board shall meet at least annually, for the purposes described in
33 this chapter.
34 (3) The board shall be composed of the following: a representative from
35 the Idaho academy of family physicians, a representative from the nurse prac-
36 titioner conference group, a rural hospital administrator, a representative
37 from the physician assistant association, the health resources section super-
38 visor from the division of health, a faculty member from one (1) of the Idaho
39 family residency programs, an Idaho medical association representative, an
40 Idaho hospital association representative, and an Idaho primary care associa-
41 tion representative.
42 (4) Appointments to the board shall be for three (3) years. Board members
43 may be reappointed at the end of each three (3) year period. Initial appoint-
44 ments shall be staggered in such a manner that approximately one-third (1/3)
45 are appointed for one (1) year, one-third (1/3) are appointed for two (2)
46 years, and one-third (1/3) are appointed for three (3) years.
47 (5) A majority of the board members constitutes a quorum for the transac-
48 tion of business. A majority vote is required by the quorum in finalizing
49 decisions.
50 39-5905. SCOPE OF GRANT SUPPORT. The board may award grants, in accor-
51 dance with the procedures and criteria in this chapter, to governmental and
52 nonprofit entities for the purpose of improving access to primary health care
53 services to rural and underserved areas.
3
1 (1) Individual grant awards will be limited to a total of thirty-five
2 thousand dollars ($35,000), direct and indirect costs, per year.
3 (2) Applicants may propose projects for funding for up to three (3)
4 years.
5 (a) Continued funding for projects beyond the first grant year, years two
6 (2) and three (3), shall be subject to the appropriation of funds and
7 grantee performance.
8 (b) No project may be funded for more than a total of three (3) years.
9 (c) Any unused grant funds shall be returned to the rural health care
10 access fund by the applicant no later than June 10 of the grant period.
11 (3) No funds awarded under a grant may be used for purchase, construc-
12 tion, renovation or improvement of real property or for projects which are
13 solely or predominantly designed for the purchase of equipment. Use of funds
14 for the purchase of equipment may be allowed when such equipment is an essen-
15 tial component of a program. However, the purchase of equipment may not repre-
16 sent more than forty percent (40%) of the total annual share of a proposal.
17 Indirect costs shall not exceed fifteen percent (15%) of the total project.
18 39-5906. CATEGORIES OF GRANTS. There are four (4) categories of grant
19 assistance:
20 (1) Recruitment and retention of primary care providers -- Grant funds
21 may be used for loan repayment for primary care providers, recruitment incen-
22 tive, and/or reimbursement of relocation expenses for primary care providers.
23 (2) Telehealth projects -- Grant funds may be used for projects that
24 involve the use of telecommunications technologies for distance learning and
25 for projects to improve access to care for rural communities.
26 (3) Community development projects -- Grant funds may be used for health
27 needs assessments, marketplace analysis, financial analysis and strategic
28 planning activities.
29 (4) Other -- Communities may choose to apply for funds for activities
30 that they have identified and determined will help to improve access to pri-
31 mary care in rural areas.
32 39-5907. ELIGIBILITY FOR GRANTS. Applicants must meet the following
33 requirements:
34 (1) The geographical area to be benefitted must be located in a current
35 primary care health professional shortage area or a medically underserved
36 area.
37 (2) Applicant must be a governmental entity or a nonprofit entity regis-
38 tered with the Idaho secretary of state.
39 39-5908. APPLICATION REQUIRED. (1) A completed rural health care access
40 grant application must be submitted by the applicant for the purpose of
41 requesting a grant, on or before the conclusion of the application period
42 specified for the appropriate grant cycle.
43 (2) Each application shall include:
44 (a) Geographical area of need;
45 (b) Individual or entity requesting funds;
46 (c) Narrative description of the methods to be used to address needs and
47 demonstrate the potential of the project to improve access to health care
48 services in the community;
49 (d) Identification of measurable goals, objectives to be used to reach
50 the goals, and the resources necessary to complete each activity;
51 (e) Estimation of how long it will take to accomplish the individual
52 activities of the project;
4
1 (f) Demonstrated community and organizational support for the project;
2 (g) County or local governmental endorsement;
3 (h) Operating budget including:
4 (i) Proportion of operating budget, if any, the applicant proposes
5 to match with the rural health care access grant funds;
6 (ii) Documentation of one (1) or more vendor price quotes for all
7 proposed equipment purchases;
8 (iii) Contact person for verification of fiscal information;
9 (i) Federal tax identification number; and
10 (j) Other information required by the board.
11 (3) All applications must include the required information.
12 (4) The grant application and any attachments submitted by the applicant
13 shall be the primary source of information for awarding a grant. Additionally,
14 the board may request and/or use other information known to them in making
15 their decision.
16 39-5909. GRANT AWARD SCHEDULE. The board shall conduct the grant process
17 in accordance with the following schedule:
18 (1) The rural health care access director will generate, and make avail-
19 able, a list of areas eligible for potential grant assistance no later than
20 November 15 prior to the application period.
21 (2) The rural health care access director shall develop an application
22 form and make guidance available no later than January 15 which shall initiate
23 the application period prior to the grant period.
24 (3) The completed application shall be submitted no later than May 15 of
25 the application period.
26 (4) The board shall issue notification to every applicant regarding the
27 disposition of their grant request by June 7 prior to the grant period.
28 (5) Funds for approved grants shall be disbursed during July of that
29 grant period or over the course of the current grant year as funds become
30 available.
31 39-5910. AWARD CRITERIA. The board shall award grants based on the fol-
32 lowing weighted criteria:
33 (1) Background of bidding organization. The applicant must show adequate
34 experience, knowledge, and qualifications to adequately perform the scope of
35 work: weight = 10%;
36 (2) Community and organizational support. The applicant must demonstrate
37 community and organizational support for the project: weight = 15%;
38 (3) Specificity and clarity of scope of project. The proposal will be
39 evaluated based on the extent to which the goals and objectives are specific,
40 measurable, and relevant to the purpose of the proposal and the activities
41 planned to accomplish those objectives are germane and can be sustained beyond
42 the grant time frame. Additionally, there must be a demonstrated need for and
43 lack of availability of funds from other sources to address the primary health
44 care needs of the defined area of service: weight = 35%;
45 (4) Monitoring and evaluation. The proposal will be evaluated based on
46 the extent to which the monitoring and evaluation system will document program
47 or activity progress and measure effectiveness: weight = 15%;
48 (5) Budget. The proposal will be evaluated based on the extent to which a
49 detailed itemized budget and justification are consistent with stated objec-
50 tives and planned program activities: weight = 25%;
51 39-5911. NEGOTIATION. The board shall have the authority to negotiate the
52 amount of the grant award and any potential continuation, not to exceed a
5
1 total of three (3) years.
2 39-5912. FRAUDULENT INFORMATION ON GRANT APPLICATION. Providing false
3 information on any application or document submitted under this statute is a
4 misdemeanor and grounds for declaring the applicant ineligible. Any and all
5 funds determined to have been acquired on the basis of fraudulent information
6 must be returned to the rural health care access fund. This section shall not
7 limit other remedies which may be available for the filing of false or fraudu-
8 lent applications.
9 39-5913. ADMINISTRATIVE APPEALS. Applicants aggrieved by the award or
10 failure to award a grant pursuant to this chapter shall be afforded the reme-
11 dies provided in chapter 52, title 67, Idaho Code.
AS1444
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-fifth Legislature Second Regular Session - 2000
Moved by Ipsen
Seconded by Darrington
IN THE SENATE
SENATE AMENDMENT TO S.B. NO. 1444
1 AMENDMENTS TO SECTION 2
2 On page 1 of the printed bill, delete line 26 and insert: "medical ser-
3 vices in areas".
4 On page 3, delete lines 37 and 38; and in line 39 delete "(3)" and insert:
5 "(2)".
STATEMENT OF PURPOSE
RS10017
This proposed legislation is designed to replace the Health Professional Loan
Repayment Program with the Idaho Rural Health Care Access Program. The
proposal repeals Chapter 59, Title 39, Idaho Code and creates a new chapter 59
which will be used exclusively for the purpose of grants for improving access to
primary care medical services in rural or frontier counties. The legislation will
allow for grants of up to $35,000 per year for three years to be awarded to
medically underserved communities for the purpose of recruitment and retention
of primary care providers (including loan repayment as a tool), telehealth projects,
community development projects and other projects communities may develop to
help improve access to primary care.
FISCAL IMPACT
The dollars ($248,000 per year) allocated to the Health Professional Loan
Repayment Program are contained in the Department of Health and Welfare base
and therefore do not require legislative appropriations each year. Funding for the
Idaho Rural Health Care Access Program would use the same dollars with no
additional resources required. As there are existing loans committed to health
professionals, there will be a transition period before all the funds are available for
the new program.
CONTACT
Name: Steven A. Millard
President
Idaho Hospital Association
Phone: 338-5100, extension 203
STATEMENT OF PURPOSE/FISCAL IMPACT S 1444