Text: HSB00780                          Text: HSB00782
Text: HSB00700 - HSB00799               Text: HSB Index
Bills and Amendments: General Index     Bill History: General Index



House Study Bill 781

Bill Text

PAG LIN
  1  1    Section 1.  TOBACCO SETTLEMENT FUND – APPROPRIATIONS TO
  1  2 DEPARTMENTS.  There is appropriated from the tobacco
  1  3 settlement fund created in section 12.65 to the following
  1  4 departments for the fiscal year beginning July 1, 2000, and
  1  5 ending June 30, 2001, the following amounts, or so much
  1  6 thereof as is necessary, to be used for the purposes
  1  7 designated:
  1  8    1.  To the department of human services:
  1  9    a.  To increase the reimbursement rate for all
  1 10 noninstitutional medical assistance providers to the rate
  1 11 provided under the federal Medicare program for such providers
  1 12 for the fiscal year July 1, 2000, through June 30, 2001, and
  1 13 to implement the resource-based relative value system of
  1 14 reimbursement under the medical assistance program:  
  1 15 .................................................. $  6,000,000
  1 16    b.  To increase the reimbursement rate to 75 percent of the
  1 17 usual and customary rate for the fiscal year July 1, 2000,
  1 18 through June 30, 2001, for dental services under the medical
  1 19 assistance program:  
  1 20 .................................................. $  3,600,000
  1 21    c.  To provide a cost-of-living adjustment for the fiscal
  1 22 year July 1, 2000, through June 30, 2001, of 5 percent to
  1 23 rehabilitative treatment and support services providers under
  1 24 the medical assistance program:  
  1 25 .................................................. $  3,100,000
  1 26    d.  To provide a cost-of-living adjustment for the fiscal
  1 27 year July 1, 2000, through June 30, 2001, of 5 percent to
  1 28 adoption, independent living, shelter care, and home studies
  1 29 services providers:  
  1 30 .................................................. $    500,000
  1 31    e.  To increase the reimbursement rate for the fiscal year
  1 32 July 1, 2000, through June 30, 2001, for hospitals under the
  1 33 medical assistance program by 3 percent over the reimbursement
  1 34 rate in effect on June 30, 2000:  
  1 35 .................................................. $  2,300,000
  2  1    f.  To increase the reimbursement rate for the fiscal year
  2  2 July 1, 2000, through June 30, 2001, for home health care
  2  3 services under the medical assistance program to the rate
  2  4 provided for such services under the federal Medicare program:  
  2  5 .................................................. $  2,400,000
  2  6    g.  To increase the reimbursement rate for the fiscal year
  2  7 July 1, 2000, through June 30, 2001, for critical access
  2  8 hospitals under the medical assistance program to the rate
  2  9 provided for such hospitals under the federal Medicare
  2 10 program:  
  2 11 .................................................. $    250,000
  2 12    h.  To provide for expansion of home health care services
  2 13 and habilitative day care under the medical assistance program
  2 14 for children with special needs:  
  2 15 .................................................. $  4,400,000
  2 16    i.  To provide for expansion of respite care services
  2 17 provided through home and community-based waivers under the
  2 18 medical assistance program:  
  2 19 .................................................. $  1,200,000
  2 20    j.  To increase the reimbursement rate for the fiscal year
  2 21 July 1, 2000, through June 30, 2001, to service providers
  2 22 under the purview of the department of human services by 1
  2 23 percent over the rates in effect on June 30, 2000:  
  2 24 .................................................. $    550,000
  2 25    2.  To the department of human services for performance of
  2 26 the evaluation required under this subsection:  
  2 27 .................................................. $    35,000
  2 28    The department of human services shall seek a waiver from
  2 29 the health care financing administration of the United States
  2 30 department of health and human services to implement a pilot
  2 31 project in fiscal year 2000-2001 to study the effects of
  2 32 providing continuous eligibility for children under the
  2 33 medical assistance program.  If the waiver is approved, the
  2 34 pilot project shall be implemented in one rural and one urban
  2 35 county, and the department shall enter into a contract with an
  3  1 entity outside of the department to perform an evaluation of
  3  2 the pilot project.  The evaluating entity shall coordinate its
  3  3 efforts with efforts of the United States department of health
  3  4 and human services relating to evaluation of continuous
  3  5 eligibility.  The evaluating entity shall submit a report to
  3  6 the general assembly on or before December 15, 2000, regarding
  3  7 the findings of the pilot project including, but not limited
  3  8 to, any increased costs which may be incurred through
  3  9 continuous eligibility.  The report shall also include
  3 10 recommendations for discontinuation or expansion of the pilot
  3 11 project.
  3 12    3.  To the Iowa department of public health:
  3 13    a.  For a tobacco use prevention and cessation program,
  3 14 including efforts at the state and local levels, as provided
  3 15 by the 2000 Session of the Seventy-eighth General Assembly:  
  3 16 .................................................. $  9,345,394
  3 17    b.  For additional substance abuse treatment under the
  3 18 substance abuse treatment program:  
  3 19 .................................................. $ 11,900,000
  3 20    (1)  The department shall use funds appropriated in this
  3 21 paragraph to enhance the quality of and to expand the capacity
  3 22 to provide 24-hour substance abuse treatment programs.
  3 23    (2)  The department shall use funds appropriated in this
  3 24 paragraph to expand the length of individual client substance
  3 25 abuse treatment plans, as necessary to reduce program
  3 26 recidivism.
  3 27    (3)  The department shall use funds appropriated in this
  3 28 paragraph to share research-based best practices for treatment
  3 29 with substance abuse treatment facilities.
  3 30    (4)  The department shall use funds appropriated in this
  3 31 paragraph to develop a results-based funding approach for
  3 32 substance abuse treatment services.
  3 33    (5)  The department shall use funds appropriated in this
  3 34 paragraph to develop a program to encourage individuals who
  3 35 are successfully managing their substance abuse problems to
  4  1 serve as role models.
  4  2    c.  For development of a healthy Iowans 2010 plan within
  4  3 the Iowa department of public health:  
  4  4 .................................................. $  1,800,000
  4  5    (1)  Of the funds appropriated in this paragraph, not more
  4  6 than $1,000,000 shall be used for core public health
  4  7 functions, including home health care and public health
  4  8 nursing services, contracted through a formula by local boards
  4  9 of health, to enhance disease and injury prevention services.
  4 10    (2)  Of the funds appropriated in this paragraph, not more
  4 11 than $400,000 shall be used for the implementation and support
  4 12 of a coordinated system of delivery of trauma and emergency
  4 13 medical services.
  4 14    (3)  Of the funds appropriated in this paragraph, not more
  4 15 than $400,000 shall be used for the establishment of a state
  4 16 poison control center.
  4 17    4.  To the department of corrections:  
  4 18 .................................................. $    610,000
  4 19    a.  Of the funds appropriated in this subsection, $127,217
  4 20 is allocated to the second judicial district department of
  4 21 correctional services to replace expired federal funding for
  4 22 day programming.
  4 23    b.  Of the funds appropriated in this subsection, $35,359
  4 24 is allocated to the third judicial district department of
  4 25 correctional services to replace expired federal funding for
  4 26 the drug court program.
  4 27    c.  Of the funds appropriated in this subsection, $191,731
  4 28 is allocated to the fourth judicial district department of
  4 29 correctional services for a drug court program.
  4 30    d.  Of the funds appropriated in this subsection, $255,693
  4 31 is allocated to the fifth judicial district department of
  4 32 correctional services to replace expired funding for the drug
  4 33 court program.
  4 34    Sec. 2.  PURCHASE OF SERVICE CONTRACT PROVIDERS –
  4 35 REIMBURSEMENT INCREASE.  There is appropriated from the
  5  1 tobacco settlement fund created in section 12.65 to the
  5  2 property tax relief fund created in section 426B.1 for the
  5  3 fiscal year beginning July 1, 2000, and ending June 30, 2001,
  5  4 the following amount, or so much thereof as is necessary, to
  5  5 be used for the purposes designated:
  5  6    For assistance to certain counties with limited county
  5  7 mental health, mental retardation, and developmental
  5  8 disabilities services fund balances to pay reimbursement
  5  9 increases in accordance with this section:  
  5 10 .................................................. $  2,000,000
  5 11    1.  For the purposes of this section unless the context
  5 12 otherwise requires:
  5 13    a.  "Basic eligibility for risk pool assistance", "risk
  5 14 pool", and "risk pool board" mean the same as used in section
  5 15 426B.5, subsection 3.
  5 16    b.  "Purchase of service provider" or "POS provider" means
  5 17 a provider of sheltered work, work activity, supported
  5 18 employment, job placement, enclave services, adult day care,
  5 19 transportation, supported community living services, or adult
  5 20 residential services paid by a county from the county's
  5 21 services fund created in section 331.424A under a state
  5 22 purchase of services or county contract.
  5 23    2.  a.  For the fiscal year beginning July 1, 2000, the
  5 24 counties receiving state payments from the property tax relief
  5 25 fund shall provide a reimbursement increase for the fiscal
  5 26 year to eligible POS providers.  The purpose of the
  5 27 reimbursement increase is to assist POS providers that have
  5 28 increased the compensation of their service staff.
  5 29    b.  In order to be eligible, a POS provider's actual costs
  5 30 of providing services must be in excess of the reimbursement
  5 31 rate paid to the provider by the county as of June 30, 2000,
  5 32 and the excess costs must be attributable, at least in part,
  5 33 to service staff compensation.  The documentation used in
  5 34 determining whether a provider has increased its actual costs
  5 35 shall be the applicable amounts submitted in the provider's
  6  1 annual financial and statistical report for the fiscal year
  6  2 beginning July 1, 1998, as compared to the applicable amount
  6  3 submitted in that report for the fiscal year beginning July 1,
  6  4 1999.
  6  5    c.  The county shall increase the POS provider's
  6  6 reimbursement rate by the amount indicated in the
  6  7 documentation, subject to a maximum of 5 percent over the
  6  8 reimbursement rates paid by the county to that provider as of
  6  9 June 30, 2000.
  6 10    3.  a.  If a county projects that payment of the
  6 11 reimbursement increase required pursuant to this section will
  6 12 cause the county to meet the requirements for basic
  6 13 eligibility for risk pool assistance during the fiscal year,
  6 14 the county may apply to the risk pool board for assistance
  6 15 from the moneys appropriated in this section.  The board may
  6 16 accept or reject an application for assistance in whole or in
  6 17 part.  The decision of the board is final.
  6 18    b.  The risk pool board shall adopt rules providing for
  6 19 application procedures and deadlines, and other provisions for
  6 20 distributing assistance moneys to such counties.  The risk
  6 21 pool board may adopt the rules on an emergency basis under
  6 22 section 17A.4, subsection 2, and section 17A.5, subsection 2,
  6 23 paragraph "b", to implement the procedures and requirements
  6 24 and the rules shall be effective immediately upon filing
  6 25 unless a later date is specified in the rules.  Any rules
  6 26 adopted in accordance with this paragraph shall also be
  6 27 published as a notice of intended action as provided in
  6 28 section 17A.4.
  6 29    c.  If moneys appropriated in this section are insufficient
  6 30 to pay the total amount of assistance to all counties that are
  6 31 determined by the risk pool board to be eligible for
  6 32 assistance under this subsection, the total amount of
  6 33 assistance shall be prorated among the eligible counties by
  6 34 the risk pool board.  Moneys appropriated in this section that
  6 35 remain unencumbered or unobligated at the close of the fiscal
  7  1 year shall revert to the tobacco settlement fund.
  7  2    d.  If a county receiving assistance under this section
  7  3 does not levy the maximum amount allowed for the county's
  7  4 mental health, mental retardation, and developmental
  7  5 disabilities services fund under section 331.424A for the
  7  6 fiscal year beginning July 1, 2000, the county shall repay the
  7  7 assistance provided to the county under this section in the
  7  8 succeeding fiscal year.  The repayment amount shall be limited
  7  9 to the amount by which the actual amount levied was less than
  7 10 the maximum amount allowed.  Repayments shall be credited to
  7 11 the tobacco settlement fund.
  7 12    Sec. 3.  SAVINGS ACCOUNT FOR HEALTHY IOWANS.  There is
  7 13 appropriated from the tobacco settlement fund created in
  7 14 section 12.65 to the savings account for healthy Iowans, for
  7 15 the fiscal year beginning July 1, 2000, and ending June 30,
  7 16 2001:  
  7 17 .................................................. $  5,000,000
  7 18    Sec. 4.  REVERSION.  Any moneys appropriated under this Act
  7 19 which are unexpended or unencumbered at the end of the fiscal
  7 20 year beginning July 1, 2000, and ending June 30, 2001, shall
  7 21 revert to the tobacco settlement fund.
  7 22    Sec. 5.  Section 12.65, Code 1999, is amended by adding the
  7 23 following new unnumbered paragraph:
  7 24    NEW UNNUMBERED PARAGRAPH.  A savings account for healthy
  7 25 Iowans is created within the tobacco settlement fund.  Moneys,
  7 26 appropriated annually, shall be deposited in the account and
  7 27 shall be invested to provide an ongoing source of investment
  7 28 earnings.
  7 29    Sec. 6.  Section 249A.3, subsection 1, Code Supplement
  7 30 1999, is amended by adding the following new paragraph after
  7 31 paragraph k:
  7 32    NEW PARAGRAPH.  kk.  Is an infant whose income is not more
  7 33 than two hundred percent of the federal poverty level, as
  7 34 defined by the most recently revised income guidelines
  7 35 published by the United States department of health and human
  8  1 services.
  8  2    Sec. 7.  NEW SECTION.  249A.20  NONINSTITUTIONAL HEALTH
  8  3 PROVIDERS – REIMBURSEMENT.
  8  4    Beginning July 1, 2000, the department shall reimburse all
  8  5 applicable noninstitutional providers, excluding providers of
  8  6 anesthesia services, that on June 30, 2000, are reimbursed on
  8  7 a fee-for-service basis under the medical assistance program
  8  8 in an equitable manner that utilizes a methodology which
  8  9 reflects the federal Medicare resource-based relative value
  8 10 scale system to the greatest extent possible.  The
  8 11 reimbursement system required to be used by this section shall
  8 12 be adjusted, annually, on July 1.
  8 13    Sec. 8.  Section 514I.8, subsection 1, Code 1999, is
  8 14 amended to read as follows:
  8 15    1.  Effective July 1, 1998, and notwithstanding any medical
  8 16 assistance program eligibility criteria to the contrary,
  8 17 medical assistance shall be provided to, or on behalf of, an
  8 18 eligible child under the age of nineteen whose family income
  8 19 does not exceed one hundred thirty-three percent of the
  8 20 federal poverty level, as defined by the most recently revised
  8 21 poverty income guidelines published by the United States
  8 22 department of health and human services.  Additionally,
  8 23 effective July 1, 2000, and notwithstanding any medical
  8 24 assistance program eligibility criteria to the contrary,
  8 25 medical assistance shall be provided to, or on behalf of, an
  8 26 eligible infant whose family income does not exceed two
  8 27 hundred percent of the federal poverty level, as defined by
  8 28 the most recently revised poverty income guidelines published
  8 29 by the United States department of health and human services.
  8 30    Sec. 9.  Section 514I.8, subsection 2, paragraph c, Code
  8 31 1999, is amended to read as follows:
  8 32    c.  Is a member of a family whose adjusted gross income
  8 33 does not exceed one two hundred eighty-five percent of the
  8 34 federal poverty level, as defined in 42 U.S.C. } 9902(2),
  8 35 including any revision required by such section.
  9  1    Sec. 10.  Section 514I.10, Code 1999, is amended to read as
  9  2 follows:
  9  3    514I.10  COST SHARING.
  9  4    1.  Cost sharing for eligible children whose family
  9  5 adjusted gross income is at or below one hundred fifty percent
  9  6 of the federal poverty level shall not exceed the standards
  9  7 permitted under 42 U.S.C. } 1396(o)(a)(3) or } 1396(o)(b)(1).
  9  8    2.  Cost sharing for eligible children whose family
  9  9 adjusted gross income is between one hundred fifty percent and
  9 10 one two hundred eighty-five percent of the federal poverty
  9 11 level shall include a premium or copayment amount which is at
  9 12 least a minimum amount but which does not exceed five percent
  9 13 of the annual family adjusted gross income.  The amount of the
  9 14 premium or the copayment amount shall be based on a sliding
  9 15 fee scale established by rule which is based on family
  9 16 adjusted gross income and the size of the family.  
  9 17                           EXPLANATION
  9 18    This bill relates to and makes appropriations from the
  9 19 tobacco settlement fund.
  9 20    The bill appropriates $24,300,000 in the fund to the
  9 21 department of human services for all of the following:
  9 22    1.  Increasing the reimbursement rate for all
  9 23 noninstitutional providers to the rate paid under the federal
  9 24 Medicare program, and implementing the resource-based relative
  9 25 value system, for the fiscal year beginning July 1, 2000, and
  9 26 ending June 30, 2001.
  9 27    2.  Increasing the reimbursement rate for dental services
  9 28 to 75 percent of the usual and customary rate for the fiscal
  9 29 year beginning July 1, 2000, and ending June 30, 2001.
  9 30    3.  Providing a cost-of-living adjustment of 5 percent to
  9 31 rehabilitative treatment services providers, for the fiscal
  9 32 year beginning July 1, 2000, and ending June 30, 2001.
  9 33    4.  Providing a cost-of-living adjustment of 5 percent to
  9 34 adoption, independent living, shelter care, and home studies
  9 35 services providers, for the fiscal year beginning July 1,
 10  1 2000, and ending June 30, 2001.
 10  2    5.  Increasing the reimbursement rate for hospitals by 3
 10  3 percent over the rate in effect on June 30, 2000, for the
 10  4 fiscal year beginning July 1, 2000, and ending June 30, 2001.
 10  5    6.  Increasing the reimbursement rate to home health
 10  6 agencies to the rate provided to such agencies under the
 10  7 federal Medicare program, for the fiscal year beginning July
 10  8 1, 2000, and ending June 30, 2001.
 10  9    7.  Increasing the reimbursement rate for critical access
 10 10 hospitals to the rate provided such hospitals under the
 10 11 federal Medicare program, for the fiscal year beginning July
 10 12 1, 2000, and ending June 30, 2001.
 10 13    8.  To provide for expansion of home health care services
 10 14 under the medical assistance program for children with special
 10 15 needs.
 10 16    9.  To provide for expansion of respite care services
 10 17 provided through home and community-based waiver services
 10 18 under the medical assistance program.
 10 19    10.  To provide an increased reimbursement rate of 1
 10 20 percent to service providers under the purview of the
 10 21 department of human services.
 10 22    The bill requires the department of human services to seek
 10 23 a waiver from the health care financing administration to
 10 24 implement a pilot project relating to continuous eligibility
 10 25 under the medical assistance program.  The bill also provides
 10 26 for an evaluation of the pilot project and appropriates
 10 27 $35,000 from the tobacco settlement fund to the department for
 10 28 the evaluation.
 10 29    The bill appropriates $9,345,394 to the Iowa department of
 10 30 public health for a tobacco use prevention and cessation
 10 31 program and $11,900,000 for additional substance abuse
 10 32 treatment.  Under this appropriation, the department is
 10 33 directed to enhance the quality of and to expand capacity to
 10 34 provide 24-hour substance abuse treatment programs for
 10 35 children; to expand the length of individual client substance
 11  1 abuse treatment plans, as necessary to reduce recidivism; to
 11  2 share research-based best practices for treatment with
 11  3 substance abuse treatment facilities; to develop a results-
 11  4 based funding approach for substance abuse treatment services;
 11  5 and to develop a program to encourage individuals who are
 11  6 successfully managing their substance abuse problems to serve
 11  7 as role models.
 11  8    The bill appropriates $1.8 million to the Iowa department
 11  9 of public health for development of a healthy Iowans 2010 plan
 11 10 including the use of up to the following amounts for the
 11 11 following purposes:  $1,000,000 for core public health
 11 12 functions including home health care and public health nursing
 11 13 services contracted through a formula by local boards of
 11 14 health, to enhance disease and injury prevention services;
 11 15 $400,000 for the implementation and support of a coordinated
 11 16 system of delivery of trauma and emergency medical services;
 11 17 and $400,000 for establishment of a poison control center.
 11 18    The bill appropriates $610,000 to the department of
 11 19 corrections to replace federal funding for day programming and
 11 20 for the drug court program, in certain judicial districts and
 11 21 to provide funds for a drug court program in the fourth
 11 22 judicial district.
 11 23    The bill also makes an appropriation from the tobacco
 11 24 settlement fund to the property tax relief fund and requires
 11 25 counties to increase reimbursements to certain purchase of
 11 26 services providers.  The services are provided to persons with
 11 27 mental illness, mental retardation, or developmental
 11 28 disabilities.  The appropriation is to assist certain counties
 11 29 with insufficient mental health, mental retardation, and
 11 30 developmental disabilities services fund balances to pay the
 11 31 reimbursement increases.  These counties may in some
 11 32 circumstances apply for risk pool assistance and the decision
 11 33 granting such assistance is to be made by the risk pool board.
 11 34    The bill also establishes a savings account for healthy
 11 35 Iowans and appropriates $5 million from the tobacco settlement
 12  1 fund to the account for the fiscal year beginning July 1,
 12  2 2000, and ending June 30, 2001.  The bill also provides that
 12  3 if any moneys appropriated under the bill are not expended or
 12  4 otherwise encumbered, all moneys are to revert to the tobacco
 12  5 settlement fund.
 12  6    The bill provides for reimbursement of certain providers
 12  7 that are receiving reimbursement on a fee-for-service basis on
 12  8 June 30, 2000, to be reimbursed under the federal Medicare
 12  9 resource-based relative value scale methodology beginning July
 12 10 1, 2000.  The bill provides for adjustment of the
 12 11 reimbursement on an annual bases.
 12 12    The bill provides for changes in current law to increase
 12 13 the income limit from 185 percent of the federal poverty level
 12 14 to 200 percent of the federal poverty level for children under
 12 15 19 years of age under the HAWK-I program and provides for
 12 16 eligibility for an infant under the medical assistance program
 12 17 whose family income does not exceed 200 percent of the federal
 12 18 poverty level.  
 12 19 LSB 7173YC 78
 12 20 pf/cls/14.4
     

Text: HSB00780                          Text: HSB00782
Text: HSB00700 - HSB00799               Text: HSB Index
Bills and Amendments: General Index     Bill History: General Index

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