2001 Legislation
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SENATE BILL NO. 1270 – Approp, H&W, Medical Assistance

SENATE BILL NO. 1270

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S1270............................................................by FINANCE
APPROPRIATIONS - DEPARTMENT OF HEALTH AND WELFARE - MEDICAL ASSISTANCE
SERVICES - Appropriates $809,515,600 to the Department of Health and
Welfare for Medical Assistance Services for fiscal year 2002; authorizes
the State Controller to make transfers to the Cooperative Welfare Fund;
reappropriates unexpended and unencumbered fund balances of the Cooperative
Welfare Fund for nonrecurring expenditures; authorizes expenditure of all
receipts collected as noncognizable funds; provides intent regarding the
Children's Health Insurance Program; provides intent regarding state
veterans homes; provides intent regarding private intermediate care
facilities for the mentally retarded; provides intent regarding use of
generic drugs; provides intent regarding rates paid for durable medical
equipment; provides intent with regard to a regional comprehensive
utilization management plan; provides intent regarding cost-sharing by
Medicaid clients; provides intent regarding day treatment services to
clients with mental illness; provides intent regarding reduction of
outreach efforts; authorizing an additional 7 full-time equivalent
positions for fiscal year 2002; and appropriates an additional $112,358,900
to the Department of Health and Welfare for Medical Services for fiscal
year 2001.
                                                                        
03/28    Senate intro - 1st rdg - to printing
    Rpt prt - to Fin
    Rpt out - rec d/p - to 2nd rdg
    Rls susp - PASSED - 28-7-0
      AYES -- Andreason, Boatright, Branch, Brandt, Bunderson, Burtenshaw,
      Cameron, Danielson, Darrington, Deide, Frasure, Geddes, Goedde,
      Ingram, Ipsen, Keough, King-Barrutia, Lee, Lodge, Noh, Risch, Sandy,
      Sims, Sorensen, Stegner, Thorne, Wheeler, Williams,
      NAYS -- Davis, Dunklin, Hawkins, Richardson, Schroeder, Stennett,
      Whitworth
      Absent and excused -- None
    Floor Sponsor -- Cameron
    Title apvd - to House
03/29    House intro - 1st rdg - to 2nd rdg
    Ret'd to Approp

Bill Text


                                                                        
                                                                        
  ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
 Fifty-sixth Legislature                   First Regular Session - 2001
                                                                        
                                                                        
                                       IN THE SENATE
                                                                        
                                    SENATE BILL NO. 1270
                                                                        
                                    BY FINANCE COMMITTEE
                                                                        
  1                                        AN ACT
  2    APPROPRIATING MONEYS TO THE DEPARTMENT  OF  HEALTH  AND  WELFARE  FOR  MEDICAL
  3        ASSISTANCE  SERVICES  FOR  FISCAL YEAR 2002; PROVIDING THAT THE STATE CON-
  4        TROLLER SHALL MAKE TRANSFERS FROM THE GENERAL FUND;  REAPPROPRIATING  CER-
  5        TAIN  UNEXPENDED  AND  UNENCUMBERED  BALANCES  OF  MONEYS; AUTHORIZING THE
  6        EXPENDITURE OF ALL RECEIPTS COLLECTED; EXPRESSING LEGISLATIVE INTENT  WITH
  7        REGARD  TO  THE  CHILDREN'S HEALTH INSURANCE PROGRAM; EXEMPTING STATE VET-
  8        ERANS HOMES FROM COST LIMITS; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO
  9        CAPPING THE NUMBER OF BEDS IN MEDICAID FUNDED  PRIVATE  INTERMEDIATE  CARE
 10        FACILITIES  FOR  THE MENTALLY RETARDED; EXPRESSING LEGISLATIVE INTENT WITH
 11        REGARD TO CAPPING RATES FOR INTERMEDIATE CARE FACILITIES FOR THE  MENTALLY
 12        RETARDED  AT  FISCAL  YEAR 2000 LEVELS; EXPRESSING LEGISLATIVE INTENT WITH
 13        REGARD TO GENERIC DRUGS; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO CAP-
 14        PING RATES FOR DURABLE MEDICAL  EQUIPMENT  AT  FISCAL  YEAR  2000  LEVELS;
 15        EXPRESSING  LEGISLATIVE  INTENT  WITH  REGARD  TO  UTILIZATION MANAGEMENT;
 16        EXPRESSING LEGISLATIVE INTENT WITH REGARD TO COPAYMENTS  AND  OTHER  COST-
 17        SHARING  METHODS;  EXPRESSING LEGISLATIVE INTENT WITH REGARD TO DAY TREAT-
 18        MENT SERVICES PROVIDED TO CLIENTS WITH MENTAL ILLNESS;  REDUCING  OUTREACH
 19        EFFORTS  TO  THE  MINIMUM  ALLOWED BY FEDERAL LAW; AUTHORIZING SEVEN ADDI-
 20        TIONAL FULL-TIME EQUIVALENT POSITIONS; APPROPRIATING ADDITIONAL MONEYS  TO
 21        THE  DEPARTMENT  OF HEALTH AND WELFARE FOR MEDICAL ASSISTANCE SERVICES FOR
 22        FISCAL YEAR 2001; AND DECLARING AN EMERGENCY FOR SECTION 16 OF THIS ACT.
                                                                        
 23    Be It Enacted by the Legislature of the State of Idaho:
                                                                        
 24        SECTION 1.  There is hereby appropriated to the Department of  Health  and
 25    Welfare  for  Medical Assistance Services the following amounts to be expended
 26    according to the designated expense classes from the various funds listed  for
 27    the period July 1, 2001, through June 30, 2002:
 28                                                         FOR
 29                             FOR          FOR        TRUSTEE AND
 30                          PERSONNEL    OPERATING       BENEFIT
 31                            COSTS     EXPENDITURES     PAYMENTS      TOTAL
 32    MEDICAL ASSISTANCE SERVICES:
 33    FROM:
 34    General
 35     Fund                $ 4,775,000   $ 3,147,800   $221,388,500  $229,311,300
 36    Medical Assistance
 37     Fund                                                   2,500         2,500
 38    Liquor Control
 39     Fund                                                 639,200       639,200
                                                                        
                                           2
                                                                        
  1                                                         FOR
  2                             FOR          FOR        TRUSTEE AND
  3                          PERSONNEL    OPERATING       BENEFIT
  4                            COSTS     EXPENDITURES     PAYMENTS      TOTAL
  5    Cooperative Welfare
  6     Fund
  7     (Federal)             6,875,300    10,819,200    538,109,300   555,803,800
  8    Cooperative Welfare
  9     Fund
 10     (Dedicated)                                       23,758,800    23,758,800
 11      TOTAL              $11,650,300   $13,967,000   $783,898,300  $809,515,600
                                                                        
 12        SECTION  2.  As appropriated, the State Controller shall make transfers of
 13    the General Fund to the Cooperative Welfare Fund, periodically,  as  requested
 14    by  the  director  of the Department of Health and Welfare and approved by the
 15    Board of Examiners.
                                                                        
 16        SECTION 3.  There is hereby reappropriated to the Department of Health and
 17    Welfare for Medical Assistance Services any unexpended and  unencumbered  bal-
 18    ances  of  the Cooperative Welfare Fund as appropriated for Medical Assistance
 19    Services for fiscal year 2001, to be used for nonrecurring  expenditures  only
 20    for  the period July 1, 2001, through June 30, 2002. The reappropriation shall
 21    be computed by the Department of Health and Welfare from available moneys.
                                                                        
 22        SECTION 4.  Notwithstanding the provisions of  Section  67-3516(2),  Idaho
 23    Code,  the Department of Health and Welfare for Medical Assistance Services is
 24    hereby authorized to expend all receipts collected as noncognizable funds  for
 25    the period July 1, 2001, through June 30, 2002.
                                                                        
 26        SECTION  5.  It  is  the  intent of the Idaho Legislature that the federal
 27    Title XXI Children's Health Insurance Program, as appropriated in Section 1 of
 28    this act, not exceed $4,600,000 in General Fund expenditures  for  the  period
 29    July  1, 2001, through June 30, 2002. In addition, the director of the Depart-
 30    ment of Health and Welfare is hereby authorized to control  program  costs  by
 31    lowering  or  raising income eligibility criteria in order to stay within bud-
 32    get; however, under no circumstance shall the department  exceed  one  hundred
 33    fifty  percent (150%) of the federal poverty level that is used in determining
 34    eligibility without prior legislative approval.
                                                                        
 35        SECTION 6.  It is the intent of the Idaho Legislature that for the  period
 36    July  1,  2001,  through  June  30, 2002, the cost limits described in Section
 37    56-102(7) and (11), Idaho Code, shall not apply to state homes for veterans.
                                                                        
 38        SECTION 7.  It is the intent of the Idaho Legislature that the  number  of
 39    beds  in private intermediate care facilities for the mentally retarded funded
 40    by Medicaid, be capped at four hundred eighty-six (486)  beds,  including  any
 41    beds planned or under construction.
                                                                        
 42        SECTION  8.  Notwithstanding the provisions of Section 56-113, Idaho Code,
 43    it is the intent of the Idaho Legislature that for the period  July  1,  2001,
 44    through  June 30, 2002, rates, including special rates of private intermediate
 45    care facilities for the mentally retarded,  shall  not  exceed  the  rates  in
 46    effect in state fiscal year 2000.
                                                                        
 47        SECTION  9.  It is the intent of the Idaho Legislature that the Department
                                                                        
                                           3
                                                                        
  1    of Health and Welfare require the use of generic drugs to the extent  feasible
  2    and  allowed  by  law  in  the  state's Medicaid Program. The department shall
  3    develop a process of prior approval when the physician prescribes drugs  other
  4    than generic. The department is further directed to investigate and report, by
  5    January  15,  2002, the feasibility of requiring the return of unused Medicaid
  6    prescriptions for credit. In addition, the department is directed  to  prepare
  7    and  report,  by January 2002, the feasibility of implementing a Medicaid pre-
  8    ferred drug list.
                                                                        
  9        SECTION 10.  It is the intent of the Idaho Legislature that for the period
 10    July 1, 2001, through June 30, 2002, the rates paid for durable medical equip-
 11    ment provided to clients of the state's Medicaid Program shall not exceed  the
 12    rates in effect in state fiscal year 2000.
                                                                        
 13        SECTION 11.  It is the intent of the Idaho Legislature that the Department
 14    of  Health and Welfare continue designing a regional comprehensive utilization
 15    management plan that  rectifies  current  weaknesses  without  giving  up  the
 16    strengths  inherent  in the system as outlined in the Lewin Group Report (page
 17    57). Further, it is legislative intent that the Department of Health and  Wel-
 18    fare  shall continue such program design and development in collaboration with
 19    providers, advocates, and consumers and their families  utilizing  its  estab-
 20    lished Quality Improvement Subcommittees of the Quality Improvement Council as
 21    a  forum. The department shall use the established Quality Improvement Council
 22    and subcommittees to assist in the development of  negotiated  rulemaking  for
 23    utilization management of Medicaid covered developmental disability and mental
 24    health  services that shall apply to facility and community-based settings and
 25    at state-run institutions providing such services.  The  department  shall  be
 26    allowed  twelve (12) full-time positions for the express purpose of conducting
 27    the continued activities as expressed in this intent language. The  department
 28    shall  incorporate  related  aspects of the Jeff D. lawsuit in the development
 29    process.
 30        It is further legislative intent that the Department of  Health  and  Wel-
 31    fare,  by  July 1, 2001, and monthly thereafter until the legislature convenes
 32    in January 2002, present a written progress report  to  the  Chairmen  of  the
 33    House  Health  and Welfare Committee and the Senate Health and Welfare Commit-
 34    tee. Further, the department shall make an  oral  presentation  to  the  Joint
 35    Finance-Appropriations  Committee  at its interim 2001 meetings. New contracts
 36    or modifications to existing contracts relative to the utilization  management
 37    project  that are necessary for the implementation of any final program, shall
 38    be facilitated by the Department of Administration after approval by the Joint
 39    Finance-Appropriations Committee at their fall meeting.
 40        The Department of Health and Welfare shall present to the  Second  Regular
 41    Session of the Fifty-sixth Idaho Legislature, the proposed negotiated rule and
 42    statutory  changes  needed  to  implement  the  utilization management program
 43    described herein on a statewide basis.
                                                                        
 44        SECTION 12.  It is the intent of the Idaho Legislature that the Department
 45    of Health and Welfare investigate the use of waivers or existing law and  rule
 46    to  implement cost-effective programs for requiring client copayments for Med-
 47    icaid prescriptions and services. The Department of Health and Welfare is fur-
 48    ther directed to prepare and report, by January  15,  2002,  its  progress  in
 49    implementing a cost-sharing program.
                                                                        
 50        SECTION  13.  It is the intent of the Idaho Legislature that day treatment
 51    services provided to clients with mental illness through the state's  Medicaid
                                                                        
                                           4
                                                                        
  1    Program shall be limited to aiding in the transition from acute care to lesser
  2    levels of care and to stabilization as a means of preventing hospitalization.
                                                                        
  3        SECTION 14.  It is the intent of the Idaho Legislature that the Department
  4    of Health and Welfare conduct its outreach efforts in all programs to the min-
  5    imum level allowed by federal law.
                                                                        
  6        SECTION  15.  In  addition to the authorization provided to the Department
  7    of Health and Welfare in Section 5, Senate Bill No. 1213, as  amended  by  the
  8    House, as enacted by the First Regular Session of the Fifty-sixth Idaho Legis-
  9    lature,  there  is  hereby authorized seven (7) full-time equivalent positions
 10    for the period July 1, 2001, through June 30, 2002.
                                                                        
 11        SECTION 16.  In addition to the appropriation made in Section  1,  Chapter
 12    409,  Laws  of  2000, there is hereby appropriated to the Department of Health
 13    and Welfare for Medical  Assistance  Services  the  following  amounts  to  be
 14    expended  according  to the designated expense class from the listed funds for
 15    the period July 1, 2000, through June 30, 2001:
 16    FOR:
 17    Trustee and Benefit Payments                                      $112,358,800
 18    FROM:
 19    General Fund                                                      $ 33,057,700
 20    Cooperative Welfare Fund (Dedicated)                                 1,960,400
 21    Cooperative Welfare Fund (Federal)                                  77,340,700
 22      TOTAL                                                           $112,358,800
                                                                        
 23        SECTION 17.  An emergency existing therefor,  which  emergency  is  hereby
 24    declared to exist, Section 16 of this act shall be in full force and effect on
 25    and after passage and approval.

Statement of Purpose / Fiscal Impact


Statement of Purpose
RS11311

This bill appropriates $809,515,600 to the Department of Health and Welfare for Medical Assistance Services for fiscal year 2002. Of this amount, $229,311,300 is from the General Fund, $24,400,500 is from dedicated funds, and $555,803,800 is from matching federal funds. In addition, the bill includes a supplemental appropriation of $112,358,800 for fiscal year 2001. Of this amount, $33,057,700 is from the General Fund, $1,960,400 is from dedicated funds, and $77,340,700 is from matching federal funds.

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Fiscal Note
FTP  Gen  Ded  Fed  Total 


FY 2001 Original Appropriation 174.92  171,888,300  22,853,100  412,268,600  607,010,000 


Reappropriations 0.00  42,300  42,300 
Medical Assistance Services          
 1. Benefit Payments – Supplemental 0.00  33,057,700  1,960,400  77,340,700  112,358,800 
Recover Gain Sharing (Neg Supp) 0.00  (109,000)  (156,800)  (265,800) 


FY 2001 Total Appropriation 174.92  204,837,000  24,855,800  489,452,500  719,145,300 
Expenditure Adjustments 10.48  12,500  61,300  73,800 


FY 2001 Estimated Expenditures 185.40  204,849,500  24,855,800  489,513,800  719,219,100 
Base Adjustments 0.00  (102,000)  (42,300)  (374,800)  (519,100) 
Other Base Adjustments 12.00  109,000  156,800  265,800 


FY 2002 Base 197.40  204,856,500  24,813,500  489,295,800  718,965,800 
Personnel Cost Rollups 0.00  9,800  14,100  23,900 
Inflationary Adjustments 0.00  3,343,900  430,600  8,351,600  12,126,100 
Replacement Items 0.00 
Nonstandard Adjustments 0.00  21,472,300  2,868,600  50,728,200  75,069,100 
Change in Employee Compensation 0.00  191,800  275,500  467,300 
Fund Shifts 0.00  (1,397,100)  (3,712,200)  5,109,300 


FY 2002 Program Maintenance 197.40  228,477,200  24,400,500  553,774,500  806,652,200 



Enhancements          
Medical Assistance Services          
 1. Surveyor Positions 0.00 
 2. Personal Needs Allowance Increase 0.00  107,400  253,900  361,300 
 3. Capital Request – Additional Items 0.00 
 4. Seriously Emotionally Disturbed Children 0.00  726,700  1,775,400  2,502,100 


FY 2002 Total 197.40  229,311,300  24,400,500  555,803,800  809,515,600 
Chg from FY 2001 Orig Approp 22.48  57,423,000  1,547,400  143,535,200  202,505,600 
% Chg from FY 2001 Orig Approp. 12.9%  33.4%  6.8%  34.8%  33.4% 

Contact: Dick Burns 334-4742

Legislative Services Office, Budget & Policy Analysis

Statement of Purpose/Fiscal Note Bill No. S1270