Print Friendly SENATE BILL NO. 1183 – Preventive health care program
SENATE BILL NO. 1183
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S1183................................................by JUDICIARY AND RULES
PREVENTIVE CARE PROGRAM - Adds to existing law to define terms; to
establish the Idaho Primary and Preventive Care Grant Program; to provide
for service grant applications and awards, and use of service grant moneys;
to provide for reports; to provide for a program board and duties of the
board and the Department of Health and Welfare; and to create the Primary
and Preventive Care Fund.
02/27 Senate intro - 1st rdg - to printing
02/28 Rpt prt - to Health/Wel
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-sixth Legislature First Regular Session - 2001
IN THE SENATE
SENATE BILL NO. 1183
BY JUDICIARY AND RULES COMMITTEE
1 AN ACT
2 RELATING TO THE PRIMARY AND PREVENTIVE CARE GRANT PROGRAM; AMENDING TITLE 39,
3 IDAHO CODE, BY THE ADDITION OF A NEW CHAPTER 82, TITLE 39, IDAHO CODE, TO
4 DEFINE TERMS, TO ESTABLISH THE IDAHO PRIMARY AND PREVENTIVE CARE GRANT
5 PROGRAM, TO PROVIDE FOR SERVICE GRANT APPLICATIONS AND AWARDS, PERMISSIBLE
6 USES OF SERVICE GRANT MONEYS AND TO PROVIDE FOR ANNUAL REPORTS, TO PROVIDE
7 FOR A PROGRAM BOARD, TO PROVIDE FOR THE CREATION OF THE PRIMARY AND PRE-
8 VENTIVE CARE FUND AND TO PROVIDE FOR DUTIES OF THE PROGRAM BOARD AND THE
9 DEPARTMENT OF HEALTH AND WELFARE.
10 Be It Enacted by the Legislature of the State of Idaho:
11 SECTION 1. That Title 39, Idaho Code, be, and the same is hereby amended
12 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap-
13 ter 82, Title 39, Idaho Code, and to read as follows:
14 CHAPTER 82
15 IDAHO PRIMARY AND PREVENTIVE CARE GRANT PROGRAM
16 39-8201. DEFINITIONS. As used in this chapter:
17 (1) "Department" means the Idaho department of health and welfare.
18 (2) "Free clinic" means a health clinic which provides primary care ser-
19 vices without charge to uninsured or medically indigent patients and which:
20 (a) Has a community board of directors that includes at least one (1)
21 individual representing patients who use free clinics; and
22 (b) Serves a designated medically underserved area or population, as pro-
23 vided in section 330(b) of the federal public health service act, 42
24 U.S.C. section 254b.
25 (3) "Idaho qualified health center" or "qualified health center" means an
26 entity which provides primary care services and which:
27 (a) Accepts all patients without regard to a patient's ability to pay;
28 (b) Uses a sliding fee schedule for payments;
29 (c) Has a community board of directors that includes at least two (2)
30 individuals who represent patients who use such centers;
31 (d) Serves a designated medically underserved area or population, as pro-
32 vided in section 330(b) of the federal public health service act, 42
33 U.S.C. section 254b; and
34 (e) Provides or arranges for the provision of primary care services to
35 persons of all ages.
36 (4) "Medically underserved area" means an area designated by the secre-
37 tary of the United States department of health and human services as an area
38 with a shortage of health care professionals or health services.
39 (5) "Medically underserved population" means a population group desig-
40 nated by the secretary of the United States department of health and human
41 services as having a shortage of health care professionals or health services.
42 (6) "Primary care" means the basic entry level of health care provided by
1 health care practitioners which is generally provided in an outpatient set-
2 ting. Primary care includes, but is not limited to, providing or arranging for
3 the provision of the following services: primary health care; dental care;
4 maternity care, including prenatal care; preventive, developmental and diag-
5 nostic services for infants and children; adult preventive services; diagnos-
6 tic laboratory and radiology services; emergency care for minor trauma; phar-
7 maceutical services; and coordination and follow-up for hospital care. Primary
8 care may also include optional services based on a patient's needs.
9 (7) "Program" means the Idaho primary and preventive care grant program
10 as provided for in this chapter.
11 (8) "Service grant" means a grant by the department to an Idaho qualified
12 health center or free clinic in accordance with this chapter.
13 (9) "Sliding fee schedule" means a schedule of patient fees that is
14 adjusted according to the patient's income. A fee schedule must be established
15 that is consistent with local prevailing rates or charges. The fee schedule
16 must provide for a full discount to individuals and families with annual
17 incomes at or below one hundred percent (100%) of the federal poverty level as
18 set forth in the most recent poverty income guidelines, except that nominal
19 fees may be collected from the patient for services. No discount shall be
20 offered to individuals and families with annual incomes greater than two hun-
21 dred percent (200%) of the federal poverty level. Individuals and families
22 with annual incomes between one hundred fifty percent (150%) and two hundred
23 percent (200%) of the federal poverty level will be charged at least seventy-
24 five percent (75%) of local prevailing rates or charges.
25 (10) "Uninsured or medically indigent patient" means a patient receiving
26 services from an Idaho qualified health center or free clinic:
27 (a) Who is not eligible for medicaid, medicare or any other type of gov-
28 ernmental health insurance;
29 (b) Who is not receiving third-party payments through an employer for
30 health care costs; and
31 (c) Whose household income, as defined in section 63-701, Idaho Code, is
32 at or below two hundred percent (200%) of the federal poverty level.
33 39-8202. IDAHO PRIMARY AND PREVENTIVE CARE GRANT PROGRAM ESTABLISHED. The
34 "Idaho Primary and Preventive Care Grant Program" is hereby established, under
35 the direction and administration of the department, for the purpose of making
36 service grants to Idaho qualified health centers and free clinics for their
37 use in providing care to uninsured or medically indigent patients in Idaho.
38 The program shall be established with such state funds as may be appropriated
39 annually by the legislature.
40 39-8203. SERVICE GRANT APPLICATIONS AND AWARDS -- USES OF SERVICE GRANT
41 MONEYS -- ANNUAL REPORTS. (1) Any Idaho qualified health center or free
42 clinic, as defined in section 39-8201, Idaho Code, desiring to participate in
43 the program shall make application for a service grant to the department in a
44 form prescribed by the department. All applications shall be submitted and
45 reviewed in accordance with the provisions of grant procedures, criteria and
46 standards promulgated by rule by the department. All service grants shall be
47 awarded within thirty (30) days after approval by the department.
48 (2) Service grants awarded to Idaho qualified health centers and free
49 clinics shall only be used by such centers to:
50 (a) Increase access to primary care services to uninsured or medically
51 indigent patients who are not otherwise served;
52 (b) Create new services or augment existing services provided to unin-
53 sured or medically indigent patients; or
1 (c) Establish new center sites that offer primary care services in medi-
2 cally underserved areas of the state or to medically underserved popula-
4 (3) Grants received by Idaho qualified health centers and free clinics
5 pursuant to this chapter shall not be used:
6 (a) To replace federal funds traditionally received by such centers, but
7 may be used to supplement such federal funds;
8 (b) For land or real estate investment;
9 (c) To finance or satisfy any existing debt; or
10 (d) To supplant the services of existing practitioners.
11 (4) No later than December 15 of each year, an Idaho qualified health
12 center or free clinic receiving a service grant shall provide an annual report
13 to the board and to the department which details the number of additional
14 uninsured and medically indigent patients that are cared for and the types of
15 services that are provided.
16 39-8204. PRIMARY AND PREVENTIVE CARE GRANT PROGRAM BOARD. (1) The primary
17 and preventive care grant program board (hereinafter referred to as "program
18 board") is hereby established to manage the program, review and award service
19 grants, and assess grantee effectiveness. The program board shall be composed
20 of the following nine (9) members:
21 (a) One (1) member of the house of representatives, appointed by and
22 serving at the pleasure of the speaker of the house of representatives;
23 (b) One (1) member of the senate, appointed by and serving at the pleas-
24 ure of the president pro tempore of the senate;
25 (c) One (1) employee of the department who is knowledgeable in primary
26 and preventive health care issues;
27 (d) One (1) representative of a nonprofit organization representing pri-
28 mary health care providers serving uninsured, medically indigent Idahoans;
29 (e) One (1) representative of an Idaho qualified health center;
30 (f) Two (2) physicians, with consideration given to physicians who have
31 training and expertise in providing primary care services to medically
32 underserved populations;
33 (g) One (1) individual who has received health care services from an
34 Idaho qualified health center or free clinic; and
35 (h) One (1) rural hospital administrator.
36 (2) The director of the department shall appoint nonlegislative members
37 of the board after consultation with applicable organizations in the state
38 and, in making such appointments, shall give consideration for geographic rep-
39 resentation of the state.
40 (3) Appointments of nonlegislative members to the program board shall be
41 for terms of three (3) years; provided however, that initial appointments
42 shall be staggered in such a manner that approximately one-third (1/3) are
43 appointed for one (1) year, one-third (1/3) are appointed for two (2) years,
44 and one-third (1/3) are appointed for three (3) years. Program board members
45 may be reappointed at the end of each three (3) year period.
46 (4) A majority of the program board members constitutes a quorum for the
47 transaction of business. A majority vote is required by the quorum in finaliz-
48 ing decisions relating to the program.
49 (5) Members of the program board shall serve and shall be compensated as
50 provided by section 59-509(b), Idaho Code.
51 39-8205. IDAHO PRIMARY AND PREVENTIVE CARE FUND CREATED. (1) There is
52 hereby created in the state treasury a fund to be known as the "Idaho Primary
53 and Preventive Care Fund." Moneys in the fund may be expended pursuant to
1 appropriation by the legislature, and may be utilized for service grants and
2 for the payment of program administrative costs which are reasonably incurred
3 by the department or the program board; provided however, in no event shall
4 more than one and one-half percent (1.5%) or forty-five thousand dollars
5 ($45,000) annually, whichever is less, be used to administer the program and
6 pay expenses incurred by the program board.
7 (2) Moneys in the fund may consist of appropriations, contributions,
8 grants, gifts, bequests or other sources received. All interest from idle
9 moneys in the fund shall be returned to the fund. Any unexpended balance in
10 the fund at the end of each fiscal year shall remain in the fund.
11 39-8206. DUTIES OF THE PROGRAM BOARD. The program board shall:
12 (1) Develop assessment criteria for the awarding of grants. Assessment
13 criteria shall include, but not be limited to:
14 (a) A demonstrated need for expanded access or services;
15 (b) A description of the program's effect on other practitioners in the
16 applicable community;
17 (c) A demonstrated community support for the program;
18 (d) A demonstrated support from providers of primary care services;
19 (e) A demonstrated record of providing cost-effective health care;
20 (f) A program operating budget; and
21 (g) A description of measures that will be used to assess the effective-
22 ness of the program.
23 (2) Consider the need for geographic expansion based upon medically
24 underserved areas or populations;
25 (3) Develop a plan to ensure that grants are equitably distributed to
26 eligible qualified health centers and free clinics; and
27 (4) In cooperation with the department, prepare and submit to the legis-
28 lature an annual report describing the program's effectiveness in increasing
29 access to health care services for medically uninsured patients in Idaho.
30 39-8207. DUTIES OF THE DEPARTMENT. The department shall:
31 (1) Promulgate rules and forms to govern grant applications and awards;
33 (2) Develop a reporting process to assure that grant moneys are used to
34 provide and expand care to uninsured and medically indigent patients.
STATEMENT OF PURPOSE
This legislation would create the Idaho Primary and Preventive Care
Grant Program that would provide money to Idaho qualified health
centers located in medically underserved areas to treat uninsured
patients. Approximately 160,000 Idahoans will go without health
insurance this year because they cannot afford it. The service
grants could be used to 1) increase access to primary care services
for uninsured people, 2) create new services or augment existing
services provided to uninsured patients, and 3) establish new center
sites that offer primary care services in medically underserved areas
of the state or to medically underserved populations.
The grant program would be administratively housed in the Idaho
Department of Health & Welfare. The legislation creates a Program
Board to manage the program, review and award service grants, and
assess effectiveness. In addition, the legislation provides for
annual reporting of grant expenditures which details the number of
additional uninsured patients who are cared for and the types of
If the legislation passes both houses, a request for an appropriation
would be heard by JFAC. Each appropriation of $1 million from the
state general fund would provide approximately 12,500 primary care
visits to 4,167 Idahoans. It would be desirable to have an
appropriation of $2 million to $4 million in order to significantly
expand service to the uninsured.
The use of Idaho qualified health centers as medical homes for these
patients could reduce the impact on both the county indigent programs
and the Catastrophic Health Care Fund for treatment of the chronically
The estimated cost of the semi-annual board meetings is $2,000 and
will be included in the administrative costs of the department, which
are limited to 1.5% of the appropriation or $45,000, whichever is less.
CONTACT: Rep. Max Black 332-1139
Bill Foxcroft/Sarah LaPlante
Idaho Primary Care Association 345-2335
STATEMENT OF PURPOSE/FISCAL NOTE S 1183