NOTE: This bill has been prepared for the signature of the appropriate legislative officers and the Governor. To determine whether the Governor has signed the bill or taken other action on it, please consult the legislative status sheet, the legislative history, or the Session Laws. HOUSE BILL 10-1300 BY REPRESENTATIVE(S) Pommer, Ferrandino, Lambert; also SENATOR(S) Keller, Tapia, White. Concerning a supplemental appropriation to the department of health care policy and financing. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. Part V of section 2 of chapter 464, Session Laws of Colorado 2009, is amended to read: Section 2. Appropriation. PART V DEPARTMENT OF HEALTH CARE POLICY AND FINANCING (1) EXECUTIVE DIRECTOR'S OFFICE (A) General Administration Personal Services 19,679,334 19,425,323 (275.0 FTE) Health, Life, and Dental 1,414,691 Short-term Disability 23,588 22,744 S.B. 04-257 Amortization Equalization Disbursement 317,902 307,014 S.B. 06-235 Supplemental Amortization Equalization Disbursement 197,328 190,523 Workers' Compensation 36,279 34,252 Operating Expenses 1,511,489 1,462,047 Legal Services and Third Party Recovery Legal Services for 13,089 hours 986,650 836,650 Administrative Law Judge Services 456,922 Purchase of Services from Computer Center 135,103 129,163 Management and Administration of OIT 482,756 414,321 Payment to Risk Management and Property Funds 83,182 78,487 Leased Space 394,236 Capitol Complex Leased Space 400,868 395,460 General Professional Services and Special Projects 3,384,105 3,305,800 29,504,433 12,360,725 (M) 1,040,182 a 1,679,562 b 14,423,964 28,867,633 12,076,120 (M) 1,006,235 a 1,685,164 b 14,100,114 a Of this amount, $254,605 $247,372 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., $159,572 $156,393 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S., $80,745 $62,556 shall be from estate recoveries, $56,060 $54,872 shall be from the Nursing Facility Cash Fund created in Section 25.5-6-203 (2) (a), C.R.S., $55,716 $54,581 shall be from the Primary Care Fund created in Section 24-22-117 (2) (b) (I), C.R.S., $33,895 $33,240 shall be from the Autism Treatment Fund created in Section 25.5-6-805, C.R.S., $31,497 $30,806 shall be from the Short-term Innovative Health Program Grant Fund created in Section 25-36-101 (1), C.R.S., $328,960 $328,325 shall be from the Coordinated Care for People with Disabilities Fund created in Section 25.5-6-111 (4), C.R.S., $24,019 $23,484 shall be from the Comprehensive Primary and Preventive Care Fund created in Section 25.5-3-207 (1), C.R.S., $11,280 $10,773 shall be from the Breast and Cervical Cancer Treatment and Prevention Fund created in Section 25.5-5-308 (8) (a), C.R.S., and $3,833 shall be from the Department of Health Care Policy and Financing Cash Fund created in Section 25.5-1-109, C.R.S. b Of this amount, $1,676,225 $1,681,827 shall be a transfer from the Department of Human Services, and $3,337 shall from Old Age Pension Fund moneys appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution. (B) Transfers to Other Departments Transfer to Department of Public Health and Environment Facility for Survey and Certification 5,001,243 1,502,513 (M) 3,498,730 5,011,213 1,505,903 (M) 3,505,310 Transfer to Department of Regulatory Agencies for Nurse Aide Certification 325,343 148,020 (M) 14,652 a 162,671 Transfer to Department of Regulatory Agencies for Reviews 14,000 6,500 (M) 500 b 7,000 Transfer to Department of Education for Public School Health Services Administration 211,312 211,312 150,000 150,000 5,551,898 5,500,556 a This amount shall be transferred from the Department of Regulatory Agencies. b This amount shall be from local funds. (C) Information Technology Contracts and Projects Information Technology Contracts 25,281,883 6,070,726 (M) 538,643 a 100,328 b 18,572,186 24,346,147 5,868,517 (M) 17,838,659 Fraud Detection Software Contract 250,000 62,500 (M) 187,500 Colorado Benefits Management System Medical Assistance Project 2,995,100 1,433,260 (M) 1,561,840 Centralized Eligibility Vendor Contract Project 100,000 47,850 (M) 52,150 28,626,983 24,696,147 a Of this amount, $284,899 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S., $251,859 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., and $1,885 shall be from the Autism Treatment Fund created in Section 25.5-6-805, C.R.S. b Of this amount, $97,981 shall be from Old Age Pension Fund moneys appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution, and $2,347 shall be a transfer from the Department of Public Health and Environment pursuant to Section 24-22-117 (2) (d) (II), C.R.S. (D) Eligibility Determinations and Client Services Medical Identification Cards 120,000 48,444 (M) 10,759 a 1,593 b 59,204 Contracts for Special Eligibility Determinations 2,418,712 918,770 (M) 34,576 c 1,465,366 2,332,042 888,544 (M) 24,717 c 1,418,781 County Administration 30,986,377 9,794,550 (M) 5,738,771 d 15,453,056 Administrative Case Management 539,744 269,872 (M) 269,872 Customer Outreach 3,573,001 1,752,987 (M) 33,514 a 1,786,500 37,637,834 37,551,164 a These amounts shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. b This amount shall be from Old Age Pension Fund moneys appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution. c Of this amount, $29,576 $19,717 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S., and $5,000 shall be from the Colorado Autism Treatment Fund created in Section 25.5-6-805, C.R.S. d Of this amount, $5,332,531 shall be from local funds and $406,240 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. (E) Utilization and Quality Review Contracts Professional Services Contracts 4,576,355 1,359,148 (M) 54,949 a 3,162,258 4,661,755 1,362,527 (M) 3,244,279 a This amount shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. (F) Provider Audits and Services Professional Audit Contracts 2,272,266 919,283 (M) 1,352,983 1,838,566 919,283 (G) Recoveries and Recoupment Contract Costs Estate Recovery 700,000 350,000 a 350,000 a This amount shall be from estate recoveries. 108,869,769 103,815,821 (2) MEDICAL SERVICES PREMIUMS8 Services for 38,279 38,444 Supplemental Security Income Adults 65 and Older (SSI 65+) at an average cost of $21,808.23 $21,429.19 834,605,726 823,823,898 Services for 6,614 6,991 Supplemental Security Income Adults 60 to 64 Years of Age (SSI 60 - 64) at an average cost of $17,962.63 $17,248.63 118,804,809 120,585,185 Services for 16,329 15,940 Qualified Medicare Beneficiaries (QMBs) and Special Low-Income Medicare Beneficiaries (SLIMBs) at an average cost of $1,287.54 $1,286.63 21,024,234 20,508,902 Services for 52,254 53,014 Supplemental Security Income Disabled Individuals at an average cost of $14,531.24 $14,108.64 759,315,244 747,955,387 Services for 57,097 58,991 Categorically Eligible Low-income Adults at an average cost of $4,089.14 $3,809.48 233,477,584 224,725,149 Services for 7,391 7,131 Baby Care Program Adults at an average cost of $8,826.48 $8,741.51 65,236,532 62,335,715 Services for 321 416 Breast and Cervical Cancer Treatment Clients at an average cost of $22,417.91 $20,365.00 7,196,149 8,471,839 Services for 16,015 16,922 Expansion Health Care Low-Income Adult Clients at an average cost of $2,541.80 $2,412.29 40,706,967 40,820,748 Services for 259,414 276,647 Eligible Children at an average cost of $1,702.47 $1,690.00 441,663,841 467,532,630 Services for 18,663 18,373 Foster Children at an average cost of $3,728.57 $3,775.80 69,586,371 69,372,850 Services for 4,255 3,616 Non-Citizens at an average cost of $15,118.48 $16,359.97 64,329,153 59,157,649 2,655,946,610 1,191,399,790 (M) 130,451,629 a 2,746,329 b 1,331,348,862 2,645,289,952 1,176,526,640 (M) 135,972,797 a 2,874,450 b 1,329,916,065 a Of this amount, $84,016,715(H) $82,212,607(H) shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S., $22,418,342 (H) $15,429,100(H) shall be from the Nursing Facility Cash Fund created in Section 25.5-6-203 (2) (a), C.R.S., $22,107,094 $22,229,571 represents public funds certified as expenditures incurred by public hospitals and agencies that are eligible for federal financial participation under the Medicaid program, $7,000,000 shall be from the Tobacco Eduction Programs Fund created in section 24-22-117 (2) (c) (I), C.R.S., $7,000,000 shall be from the Prevention, Early Detection, and Treatment Fund created in Section 24-22-117 (2) (d) (I), C.R.S., $874,603 $1,144,308 shall be from the Breast and Cervical Cancer Prevention and Treatment Fund created in section 25.5-5-308 (8) (a), C.R.S., $784,875 (H) $697,198 (H) shall be from the Colorado Autism Treatment Fund created in Section 25.5-6-805, C.R.S., and $250,000(H) shall be from the Coordinated Care for People with Disabilities Fund created in Section 25.5-6-111 (4), C.R.S., and $10,013 shall be from the Supplemental Tobacco Litigation Settlement Moneys Account in the Pediatric Speciality Hospital Fund created in section 24-22-117 (2) (e) (II). b Of this amount, $2,000,000 shall be transferred from the Department of Public Health and Environment pursuant to Section 24-22-117 (2) (d) (IV.5), C.R.S., and $746,329 $874,450 shall be transferred from the Department of Public Health and Environment pursuant to Section 24-22-117 (2) (d) (II) (D), C.R.S. (3) MEDICAID MENTAL HEALTH COMMUNITY PROGRAMS Mental Health Capitation Payments9, 10 231,044,723 106,522,999 (M) 8,977,613 a 9,208 b 115,534,903 226,510,979 104,060,275 (M) 9,169,599 a 10,248 b 113,270,857 Medicaid Mental Health Fee for Service Payments 1,731,529 865,765 (M) 865,764 2,537,069 1,268,535 (M) 1,268,534 232,776,252 229,048,048 a Of this amount, $8,904,928 (H) $9,155,770(H) shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S., $62,657 (H) shall be from the Colorado Autism Treatment Fund created in Section 25.5-6-805, C.R.S., and $10,028 $13,829 shall be from the Breast and Cervical Cancer Prevention and Treatment Fund created in Section 25.5-5-308 (8) (a), C.R.S. b This amount shall be transferred from the Department of Public Health and Environment for the Breast and Cervical Cancer Prevention and Treatment Program created pursuant to Section 24-22-117 (2) (d) (II) (D), C.R.S. (4) INDIGENT CARE PROGRAM Safety Net Provider Payments 310,715,422 13,090,782 (M) 142,266,929 a 155,357,711 295,081,102 5,273,622 (M) 147,540,551 Colorado Health Care Services Fund 15,000,000 15,000,000 The Children's Hospital, Clinic Based Indigent Care 27,767,760 3,059,880 (M) 10,824,000 b 13,883,880 Health Care Services Fund Programs 8,352,000 4,176,000 b 4,176,000 Pediatric Speciality Hospital 15,032,712 6,656,997 (M) 355,359 c 504,000 d 7,516,356 H.B. 05-1262 Appropriation from General Fund to Pediatric Speciality Hospital Fund 504,000 504,000 e H.B. 05-1262 Appropriation from Tobacco Tax Cash Fund to the General Fund 504,000 504,000 f Primary Care Fund Program 31,920,000 31,920,000 g H.B. 97-1304 Children's Basic Health Plan Trust 2,500,000 2,500,000 2,502,919 2,502,919 Children's Basic Health Plan Administration 5,537,590 2,473,301 h 3,064,289 5,401,117 2,417,022 h 2,984,095 Children's Basic Health Plan Premium Costs11 145,664,212 48,696,353 i 2,500,000 j 94,467,859 Children's Basic Health Plan Dental Benefit Costs12 10,948,462 3,831,962 k 7,116,500 Comprehensive Primary and Preventive Care Grants 866,075 866,075 l Comprehensive Primary and Preventive Care Rural and Public Hospital Grant Program 6,041,096 3,020,548 l 3,020,548 581,353,329 565,585,455 a This amount represents public funds certified as representing expenditures incurred by hospitals that are eligible for federal financial participation under the Medicaid upper payment limit and the Medicaid Disproportionate Share Payments to Hospitals program. b These amounts shall be from the Health Care Services Fund created in Section 25.5-3-112 (1) (a), C.R.S. c This amount shall be from the Supplemental Tobacco Litigation Settlement Moneys Account in the Pediatric Specialty Hospital Fund created in Section 24-22-117 (2) (e) (II), C.R.S. d This amount shall be from the Pediatric Specialty Hospital Fund created in Section 24-22-117 (2) (e), C.R.S. e This amount is not subject to the limitation on state fiscal year spending imposed by Article X, Section 20 of the State Constitution. This amount is also not subject to the statutory limitation on General Fund appropriation growth or any other spending limitation existing in law pursuant to Article X, Section 21 (8) of the State Constitution. f This amount shall be from the Tobacco Tax Cash Fund created in Section 24-22-117 (l) (a), C.R.S. This appropriation partially meets the requirement to appropriate a portion of the revenues collected from imposition of additional state cigarette and tobacco taxes to the General Fund pursuant to Section 21 of Article X of the State Constitution. g This amount shall be from the Primary Care Fund created in Section 24-22-117 (2) (b) (I), C.R.S. h Of this amount, $1,933,301 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., and $540,000 $483,721 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. i Of this amount, $25,296,193 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S., $21,177,045 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S.,$1,761,388 shall be from the Children's Basic Health Plan Trust and Supplemental Tobacco Litigation Settlement Moneys Account created in Section 25.5-8-105 (1), C.R.S., and $461,727 shall be from the Colorado Immunization Fund created in Section 25-4-2301, C.R.S. j This amount is General Fund that is appropriated into the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. k Of this amount, $2,525,196 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. and $1,306,766 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. l This amount shall be from the Comprehensive Primary and Preventive Care Fund created in Section 25.5-3-207 (1), C.R.S. (5) OTHER MEDICAL SERVICES Services for 4,517 Old Age Pension State Medical Program clients 15,368,483 12,848,483 a 2,520,000 b Transfer of Tobacco Tax Cash Fund into the Supplemental Old Age Pension State Medical Fund 2,520,000 2,520,000 c Commission on Family Medicine Residency Training Programs 1,932,052 966,026 (M) 966,026 1,738,846 869,423 (M) 869,423 State University Teaching Hospitals - Denver Health and Hospital Authority 1,831,714 915,857 (M) 915,857 State University Teaching Hospitals - University of Colorado Hospital Authority 700,935 350,468 (M) 350,467 676,785 338,393 (M) 338,392 Enhanced Prenatal Care Training and Technical Assistance 119,006 58,752 (M) 60,254 Nurse Home Visitor Program 3,010,000 1,505,000 (H)d 1,505,000 Medicare Modernization Act of 2003 State Contribution Payment 88,808,586 88,808,586 86,570,177 86,570,177 Public School Health Services 20,004,856 10,472,200 e 9,532,656 20,504,636 10,737,184 e 9,767,452 Public School Health Services Contract Administration 525,200 525,200 134,295,632 132,864,847 a Of this amount, $9,998,483 shall be from the Old Age Pension Health and Medical Care Fund, pursuant to Section 7 (C) of Article 24 of the State Constitution, and $2,850,000 shall be from the Supplemental Old Age Pension Health and Medical Care Fund created in Section 25.5-2-101 (2), C.R.S. b This amount shall be a transfer of funds from the Tobacco Tax Cash Fund created in Section 24-22-117 (1) (a), C.R.S., into the Supplemental Old Age Pension Health and Medical Care Fund and shall be in addition to the amount appropriated from this fund as cash funds. c This amount shall be from the Tobacco Tax Cash Fund created in Section 24-22-117 (1) (a), C.R.S. This appropriation meets the requirement to appropriate a portion of the revenues collected from the imposition of additional state cigarette and tobacco taxes to the Old Age Pension program for health related purposes pursuant to Section 21 of Article X of the State Constitution. d This amount shall be transferred from the Department of Public Health and Environment. e This amount represents funds certified as expenditures incurred by school districts that are eligible for federal financial participation under Medicaid. (6) DEPARTMENT OF HUMAN SERVICES MEDICAID-FUNDED PROGRAMS (A) Executive Director's Office - Medicaid Funding13 13,011,981 6,659,567 (M) 388 a 6,352,026 12,803,933 6,555,482 (M) 6,248,063 (B) Office of Information Technology Services - Medicaid Funding Colorado Benefits Management System 8,957,494 4,427,478 (M) 28,758 b 31,995 a 4,469,263 9,044,020 4,470,352 (M) 28,571 b 32,608 a 4,512,489 CBMS SAS-70 Audit 57,075 28,231 (M) 144 b 203 a 28,497 CBMS Client Services Improvement Project 1,242,581 616,172 (M) 5,515 c 620,894 Other Office of Information Technology Services line items 399,192 199,597 (M) 199,595 372,909 186,455 (M) 186,454 9,413,761 10,716,585 a These amounts shall be from moneys in the Old Age Pension Fund appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution. b These amounts shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. c Of this amount, $2,972 shall be from moneys in the Old Age Pension Fund appropriated to the Department of HumanServices, pursuant to Article 24 of the State Constitution and $2,543 shall be from the Children's Basic Health Plan Trust created in Section 25.5-8-105 (1), C.R.S. (C) Office of Operations - Medicaid Funding 5,503,619 2,751,809 (M) 2,751,810 5,432,376 2,716,189 (M) 2,716,187 (D) Division of Child Welfare - Medicaid Funding Administration 135,195 67,598 (M) 67,597 133,419 66,710 (M) 66,709 Child Welfare Services 18,746,950 9,373,475 (M) 9,373,475 14,508,228 7,254,114 (M) 7,254,114 18,882,145 14,641,647 (E) Mental Health and Alcohol and Drug Abuse Services - Medicaid Funding Administration 348,973 174,487 (M) 174,486 Residential Treatment for Youth (H.B. 99-1116) 119,225 35,499 (M) 24,114 (H)a 59,612 Mental Health Institutes 3,451,818 1,725,909 (M) 1,725,909 3,194,194 1,597,097 (M) 1,597,097 Alcohol and Drug Abuse Division, Administration 53,136 26,568 (M) 26,568 Alcohol and Drug Abuse Division, High Risk Pregnant Women Program 2,039,945 1,019,973 (M) 1,019,972 6,013,097 5,755,473 a This amount shall be from the Tobacco Litigation Settlement Fund created in Section 24-22-115 (1), C.R.S. (F) Services for People with Disabilities - Medicaid Funding Community Services for People with Developmental Disabilities, Administration 2,931,565 1,465,782 (M) 1,465,783 2,907,378 1,453,689 (M) 1,453,689 Community Services for People with Developmental Disabilities, Program Costs 314,100,018 156,470,124 (M) 579,887 (H)a 157,050,007 308,211,355 153,536,666 (M) 569,014 (H)a 154,105,675 Regional Centers 50,049,730 22,931,984 (M) 2,092,881 b 25,024,865 50,618,562 23,216,400 (M) 25,309,281 Regional Center Depreciation and Annual Adjustments 1,258,084 629,042 (M) 629,042 368,339,397 362,995,379 a This amount shall be from the Health Care Expansion Fund, created in Section 24-22-117 (2) (a) (I), C.R.S. b This amount shall be from service fees from regional centers for people with developmental disabilities. (G) Adult Assistance Programs, Community Services for the Elderly - Medicaid Funding 1,800 900 (M) 900 (H) Division of Youth Corrections - Medicaid Funding 1,614,799 807,400 (M) 807,399 2,026,388 1,013,195 (M) 1,013,193 (I) Other Federal Medicaid Indirect Cost Reimbursement for Department of Human Services Programs 500,000 500,000 a Transfer to the Department of Human Services for Related Administration 74,564 37,282 (M) 37,282 574,564 a This amount reflects estimated Medicaid federal indirect cost reimbursements for Department of Human Services programs. 423,355,163 414,948,145 TOTALS PART V (HEALTH CARE POLICY AND FINANCING) $4,136,596,755 $1,675,723,755 $504,000 a $407,639,249 $28,706,139 $2,024,023,612 $4,091,552,268 $1,642,487,590 $413,506,242 $28,847,030 $2,006,207,406 a This amount shall be General Fund Exempt pursuant to Section 24-22-117 (1) (c) (I) (B), C.R.S. This amount is also not subject to the statutory limitation on General Fund appropriations imposed by Section 24-75-201.1, C.R.S. FOOTNOTES -- The following statements are referenced to the numbered footnotes throughout section 2. 8 Department of Health Care Policy and Financing, Medical Services Premiums -- It is the intent of the General Assembly that expenditures for these services should be recorded only against the bill group total for Medical Services Premiums. 9 Department of Health Care Policy and Financing, Medicaid Mental Health Community Programs, Mental Health Capitation Payments -- It is the intent of the General Assembly that capitation rates for the mental health capitation program not be set above the mid-range of the actuarially sound rates in FY 2009-10. 10 Department of Health Care Policy and Financing, Medicaid Mental Health Community Programs, Mental Health Capitation Payments -- The appropriation includes $8,888,202 from the Health Care Expansion Fund. Of this amount, $960,744 is estimated for adults and $2,802,580 is estimated for children who receive Medicaid benefits due to the removal of the Medicaid asset test. The estimated fiscal impact for removal of the asset test is based on the same methodology that the Joint Budget Committee used to estimate the costs associated with removing the asset test in the Medical Services Premiums line item. It is the intent the General Assembly that this $3,763,324 appropriation from the Health Care Expansion Fund should be used in its entirety after the impact of the (H) notation before any General Fund is expended for the estimated fiscal impact of removing the asset test. 11 Department of Health Care Policy and Financing, Indigent Care Program, Children's Basic Health Plan Premium Costs -- This appropriation assumes the following: (1) A total children's caseload of 67,152 at an average per capita cost of $1,917.89 per year; and (2) a total adult prenatal caseload of 1,821 at an average per capita cost of $10,859.07 per year. In addition, the appropriation assumes savings of $900,000 total funds related to administering a new Vaccines for Children program and savings of $2,000,000 related to recoupments from reinsurance providers. 12 Department of Health Care Policy and Financing, Indigent Care Program, Children's Basic Health Plan Dental Costs -- This appropriation assumes an average cost of $163.04 per child per year. 13 Department of Health Care Policy and Financing, Department of Human Services - Medicaid-Funded Programs, Executive Director's Office Medicaid Funding -- The appropriation in this Health Care Policy and Financing line item corresponds to the Medicaid funding in the Department of Human Services, Executive Director's Office, General Administration. As such, the appropriation contains amounts that correspond to centralized appropriation amounts in the Department of Human Services. Consistent with the head notes to the Long Bill, the Department of Human Services is authorized to transfer the centralized appropriations to other line item appropriations to the Department of Human Services. In order to aid budget reconciliation between the Department of Health Care Policy and Financing and the Department of Human Services, the Department of Health Care Policy and Financing is hereby authorized to make line item transfers out of this appropriation to other Department of Human Services Medicaid-funded programs appropriations in this section (5) in amounts equal to the centralized appropriation transfers made by the Department of Human Services for Medicaid-funded programs in the Department of Human Services. SECTION 2. Part V (1) (B), (1) (C), (4), (5), (6) (B), and the affected totals of section 2 of chapter 474, Session Laws of Colorado 2008, as the said Part V (1) (C), (5), and the affected totals are amended by section 5 of chapter 224, as Part V and the affected totals are amended by section 1 of chapter 446, as Part V (1) (B), (1) (C), (4), (5), and the affected totals are further amended by section 13 of chapter 464, as Part V (4) and the affected totals are further amended by section 7 of chapter 124 and section 8 of chapter 204, and as the affected totals are further amended by section 2 of chapter 201 and section 4 of chapter 203, Session Laws of Colorado 2009, are amended to read: Section 2. Appropriation. PART V DEPARTMENT OF HEALTH CARE POLICY AND FINANCING (1) EXECUTIVE DIRECTOR'S OFFICE (B) Transfers to Other Departments Transfer to Department of Public Health and Environment Facility for Survey and Certification 4,923,759 1,356,814 (M) 3,566,945 5,236,795 1,669,850 (M) Transfer to Department of Regulatory Agencies for Nurse Aide Certification 325,343 148,020 (M) 14,652 a 162,671 Transfer to Department of Regulatory Agencies for Review 9,000 3,000 (M) 6,000 Transfer to Department of Education for Public School Health Services Administration 407,747 407,747 5,665,849 5,978,885 a This amount shall be transferred from the Department of Regulatory Agencies. (C) Information Technology Contracts and Projects Information Technology Contracts 22,307,943 5,424,454 (M) 513,768 a 100,328 b 16,269,393 Fraud Detection Software Contract 778,403 127,764 (M) 650,639 Colorado Benefits Management System Medical Assistance Project 1,561,000 746,993 (M) 814,007 98,825 42,122 (M) 56,703 Centralized Eligibility Vendor Contract Project8a 153,600 73,503 (M) 80,097 24,800,946 23,338,771 a Of this amount, $284,899 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I); $226,984 shall be from the Children's Basic Health Plan Trust Fund created in Section 25.5-8-105 (1), C.R.S.; and $1,885 shall be from the Autism Treatment Fund created in Section 25.5-6-805, C.R.S. b Of this amount, $97,981 shall be from Old Age Pension Fund moneys appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution; and $2,347 shall be a transfer from the Department of Public Health and Environment pursuant to Section 24-22-117 (2) (d) (II), C.R.S. 98,925,890 97,776,751 (4) INDIGENT CARE PROGRAM Safety Net Provider Payments 304,357,286 13,090,782 (M) 139,087,861 a 152,178,643 Colorado Health Care Services Fund 12,918,750 12,918,750 The Children's Hospital, Clinic Based Indigent Care 27,029,760 3,059,880 (M) 9,004,369 b 14,965,511 Health Care Services Fund Programs 9,090,000 3,914,381 b 5,175,619 Pediatric Speciality Hospital 12,829,721 5,483,000 (M) 68,000 e 317,000 c 427,000 d 6,534,721 H.B. 05-1262 Appropriation from General Fund to Pediatric Speciality Hospital Fund 427,000 427,000 e H.B. 05-1262 Appropriation from Tobacco Tax Cash Fund to the General Fund 495,000 495,000 f Primary Care Fund Program 31,294,657 31,294,657 g H.B. 97-1304 Children's Basic Health Plan Trust 1,570 1,570 Children's Basic Health Plan Administration 6,351,590 2,785,441 j 3,566,149 Children's Basic Health Plan Premium Costs14 117,867,119 41,450,332 k 76,416,787 Children's Basic Health Plan Dental Benefit Costs15 10,076,035 3,526,612 6,549,423 Comprehensive Primary and Preventive Care Grants Program15a 3,082,680 3,082,680 m Comprehensive Primary and Preventative Care Rural and Public Hospitals Payment 5,000,000 2,153,125 m 2,846,875 540,819,598 540,821,168 a This amount represents public funds certified as representing expenditures incurred by hospitals that are eligible for federal financial participation under the Medicaid Major Teaching Hospital Program, Medicaid, and the Medicaid Disproportionate Share Payments to Hospitals Program. b These amounts shall be from the Health Care Services Fund created in Section 25.5-3-112 (1) (a), C.R.S. c This amount shall be from the Supplemental Tobacco Litigation Settlement Moneys Account in the Pediatric Specialty Hospital Fund created in Section 24-22-117 (2) (e) (II), C.R.S. d This amount shall be from the Pediatric Specialty Hospital Fund created in Section 24-22-117 (2) (e), C.R.S. e This amount is not subject to the limitation on state fiscal year spending imposed by Article X, Section 20 of the State Constitution. This amount is also not subject to the statutory limitation on General Fund appropriation growth or any other spending limitation existing in law pursuant to Article X, Section 21 (8) of the State Constitution. f This amount shall be from the Tobacco Tax Cash Fund created in Section 24-22-117 (l) (a), C.R.S. This appropriation partially meets the requirement to appropriate a portion of the revenues collected from imposition of additional state cigarette and tobacco taxes to the General Fund pursuant to Section 21 of Article X of the State Constitution. g This amount shall be from the Primary Care Fund created in Section 24-22-117 (2) (b) (I), C.R.S. j Of this amount, $2,245,441shall be from the Children's Basic Health Plan Trust Fund created in Section 25.5-8-105 (1), C.R.S., and $540,000 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. k Of this amount, $16,372,968 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S.; $23,064,654 shall be from the Children's Basic Health Plan Trust Fund created in Section 25.5-8-105 (1), C.R.S.; $1,841,459 shall be from the Children's Basic Health Plan Trust and Supplemental Tobacco Litigation Settlement Moneys Account created in Section 25.5-8-105 (1), C.R.S.; and $171,251 shall be from the Colorado Immunization Fund created in Section 25-4-2301, C.R.S. l Of this amount, $2,478,974 shall be from the Children's Basic Health Plan Trust Fund created in Section 25.5-8-105 (1), C.R.S.; $1,047,638 shall be from the Health Care Expansion Fund created in Section 24-22-117 (2) (a) (I), C.R.S. m This amount shall be from the Comprehensive Primary and Preventive Care Fund created in Section 25.5-3-207 (1), C.R.S. (5) OTHER MEDICAL SERVICES Services for 5,389 Old Age Pension State Medical Program clients 15,311,715 12,836,715 a 2,475,000 b Transfer of Tobacco Tax Cash Fund into the Supplemental Old Age Pension State Medical Fund 2,475,000 2,475,000 c Commission on Family Medicine Residency Training Programs 2,173,558 1,086,779 (M) 1,086,779 Enhanced Prenatal Care Training and Technical Assistance 117,411 58,706 (M) 58,705 Nurse Home Visitor Program 3,010,000 1,505,000 d 1,505,000 2,394,708 d 615,292 Medicare Modernization Act of 2003 State Contribution Payment 74,208,834 74,208,834 73,895,798 73,895,798 Public School Health Services 20,242,120 10,472,200 e 9,769,920 117,538,638 117,225,602 a Of this amount, $9,998,483 shall be from the Old Age Pension Health and Medical Care Fund, pursuant to Section 7 (C) of Article 24 of the State Constitution, and $2,838,232 shall be from the Supplemental Old Age Pension Health and Medical Care Fund created in Section 25.5-2-101 (2), C.R.S. Of the amount from the Supplemental Old Age Pension Health and Medical Care Fund, $750,000 is the statutorily required transfer into the fund pursuant to the provisions of Section 39-26-123 (3), C.R.S., and $2,088,232 is unexpended fund balance in the Supplemental Old Age Pension Health Medical Care Fund. b This amount shall be a transfer of funds from the Tobacco Tax Cash Fund created in Section 24-22-117 (1) (a), C.R.S., into the Supplemental Old Age Pension Health and Medical Care Fund and shall be in addition to the amount appropriated from this fund as cash funds. c This amount shall be from the Tobacco Tax Cash Fund created in Section 24-22-117 (1) (a), C.R.S. This appropriation meets the requirement to appropriate a portion of the revenues collected from the imposition of additional state cigarette and tobacco taxes to the Old Age Pension program for health related purposes pursuant to Section 21 of Article X of the State Constitution. d This amount shall be transferred from the Department of Public Health and Environment. e This amount represents funds certified as expenditures incurred by school districts that are eligible for federal financial participation under Medicaid. (6) DEPARTMENT OF HUMAN SERVICES MEDICAID-FUNDED PROGRAMS (B) Office of Information Technology Services - Medicaid Funding Colorado Benefits Management System 9,713,067 3,716,692 (M) 1,115,501 c 31,086 a 4,849,788 CBMS SAS-70 Audit 57,075 24,228 (M) 1,319 c 3,030 a 28,498 CBMS Federal Reallocation 974,393 974,393 CBMS Client Service Improvement Project 621,098 306,415 (M) 3,781 b 310,902 Other Office of Information Technology Services line items 442,191 221,095 (M) 221,096 11,186,726 11,807,824 a These amounts shall be from moneys in the Old Age Pension Fund appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution. b Of this amount, $2,211 shall be from moneys in the Old Age Pension Fund appropriated to the Department of Human Services, pursuant to Article 24 of the State Constitution and $1,570 shall be from the Children's Basic Health Plan Trust Fund created in Section 25.5-8-105 (1), C.R.S. c Of these amounts, $1,099,496 shall be from the Health Care Supplemental Appropriations and Overexpenditures Account in the Tobacco Litigation Settlement Cash Fund established pursuant to Section 24-22-115 (4) (a), C.R.S., and $17,324 shall be from the Children's Basic Health Trust Fund created in Section 25.5-8-105 (1), C.R.S. 401,705,574 402,326,672 TOTALS PART V (HEALTH CARE POLICY AND FINANCING) $3,823,393,636 $1,527,447,395 $39,746,792 a $363,220,770 b $20,770,129 $1,872,208,550 $3,822,554,129 $1,527,050,509 $21,663,618 $1,870,872,440 a Of this amount, $39,251,792 shall be from the General Fund Exempt Account created in Section 24-77-103.6 (2), C.R.S., and $495,000 shall be General Fund Exempt pursuant to Section 24-22-117 (1) (c) (I) (B), C.R.S. Further, said $495,000 is also not subject to the statutory limitation on General Fund appropriations imposed by Section 24-75-201.1, C.R.S. b This amount includes $884,946 from the Colorado Autism Treatment Fund created in Section 25.5-6-805, C.R.S., and represents the total amount that the State Treasurer shall transfer from the Tobacco Litigation Settlement Cash Fund created in Section 24-22-115 (1) (a), C.R.S., to the Colorado Autism Treatment Fund pursuant to Section 24-22-115 (1) (a), C.R.S. SECTION 3. Section 12 (1) (b), (1) (c), and (1) (d) of chapter 152, Session Laws of Colorado 2009, are amended to read: Section 12. Appropriation - adjustments to the 2009 long bill. (1) For the implementation of this act, appropriations made in the annual general appropriation act for the fiscal year beginning July 1, 2009, to the department of health care policy and financing shall be adjusted as follows: (b) The appropriation to the medical services premiums division is increased by three hundred twenty-seven million one hundred seventy-one thousand four hundred sixty dollars ($327,171,460) three hundred fifteen million five hundred seventy-six thousand six hundred forty-two dollars ($315,576,642). Of said sum, one hundred sixty-three million five hundred eighty-five thousand seven hundred thirty dollars ($163,585,730) one hundred twenty-six million two hundred eighty-three thousand six hundred seventy-four dollars ($126,283,674) shall be from the hospital provider fee cash fund created in section 25.5-4-402.3 (4), Colorado Revised Statutes, and one hundred sixty-three million five hundred eighty-five thousand seven hundred thirty dollars ($163,585,730) one hundred eighty-nine million two hundred ninety-two thousand nine hundred sixty-eight dollars ($189,292,968) shall be from federal funds. (c) The appropriation to the medicaid mental health community programs division is increased by three million three hundred forty-five thousand one hundred ten dollars ($3,345,110) six hundred fourteen thousand three hundred six dollars ($614,306). Of said sum, one million six hundred seventy-two thousand five hundred fifty-five dollars ($1,672,555) three hundred seven thousand one hundred fifty-three dollars ($307,153) shall be from the hospital provider fee cash fund created in section 25.5-4-402.3 (4), Colorado Revised Statutes and one million six hundred seventy-two thousand five hundred fifty-five dollars ($1,672,555) three hundred seven thousand one hundred fifty-three dollars ($307,153) shall be from federal funds. (d) The appropriation to the indigent care program for safety net provider payments is increased by three hundred twenty-two million two hundred thousand dollars ($322,200,000) two hundred seventy-three million two hundred fourteen thousand four hundred seven dollars ($273,214,407). Of said sum, one hundred sixty-one million one hundred thousand dollars ($161,100,000) one hundred twenty-two million five hundred fifty-five thousand three hundred seventy-six dollars ($122,555,376) shall be from the hospital provider fee cash fund created in section 25.5-4-402.3 (4), Colorado Revised Statutes and one hundred sixty-one million one hundred thousand dollars ($161,100,000) one hundred fifty million six hundred fifty-nine thousand thirty-one dollars ($150,659,031) shall be federal funds. SECTION 4. Section 9 (1) (f), (1) (g) and (1) (h) of chapter 204, Session Laws of Colorado 2009, are amended to read: Section 9. Appropriations - adjustments in 2009 long bill. (1) For the implementation of this act, appropriations made in the annual general appropriation act for the department of health care policy and financing, for the indigent care division, the fiscal year beginning July 1, 2009, shall be adjusted as follows: (f) The appropriation to the pediatric speciality hospital is increased by two hundred seventy-seven thousand eight hundred two dollars ($277,802) three hundred sixteen thousand twenty-six dollars ($316,026). Of said sum, one hundred three thousand ($103,000) one hundred sixteen thousand eight hundred twenty-seven dollars ($116,827) shall be general fund exempt, and one hundred seventy-four thousand eight hundred two dollars ($174,802) one hundred ninety-nine thousand one hundred ninety-nine dollars ($199,199) shall be from federal funds. (g) The appropriation to the pediatric speciality hospital is decreased by two hundred seventy-eight thousand three hundred fifty-nine dollars ($278,359) three hundred sixteen thousand twenty-six dollars ($316,026). Of said sum, one hundred three thousand dollars ($103,000) one hundred sixteen thousand eight hundred twenty-seven dollars ($116,827) shall be from the general fund, seventy-two thousand three hundred fifty-nine dollars ($72,359) eighty-two thousand three hundred seventy-two dollars ($82,372) shall be from the supplemental tobacco litigation settlement moneys account in the pediatric speciality hospital fund created in section 24-22-117 (2) (e) (II), Colorado Revised Statutes, and one hundred three thousand dollars ($103,000) one hundred sixteen thousand eight hundred twenty-seven dollars ($116,827) shall be reappropriated funds from the pediatric speciality hospital fund created in section 24-22-117 (2) (e) (II), Colorado Revised Statutes. (h) The general fund appropriation to the House Bill 05-1262 appropriation from the general fund to pediatric speciality hospital fund is decreased by one hundred three thousand dollars ($103,000) one hundred sixteen thousand eight hundred twenty-seven dollars ($116,827). SECTION 5. Appropriation. In addition to any other appropriation, there is hereby appropriated, out of any moneys in the general fund not otherwise appropriated, to the department of health care policy and financing, for the fiscal year beginning July 1, 2008, the sum of one hundred forty-seven thousand six hundred five dollars ($147,605), or so much thereof as may be necessary for the payment of overexpenditures in the personal services line item appropriation contained in Part V (1) (A) of section 2 of chapter 474, Session Laws of Colorado 2008, as amended by section 5 of chapter 224, section 1 of chapter 446, and section 13 of chapter 464, Session Laws of Colorado 2009. In accordance with section 24-75-109 (4) (a) Colorado Revised Statutes, all restrictions on funds for the executive director's office, general administration, personal services, department of health care policy and financing, for the 2008-09 fiscal year, shall be released. SECTION 6. Appropriation. In addition to any other appropriation, there is hereby appropriated, out of any moneys in the general fund not otherwise appropriated, to the department of health care policy and financing, for the fiscal year beginning July 1, 2008, the sum of eleven million one hundred seventy thousand two hundred sixty-four dollars ($11,170,264), or so much thereof as may be necessary for the payment of overexpenditures of line item appropriations contained in Part V (2) of section 2 of chapter 474, Session Laws of Colorado 2008, as amended by section 2 of chapter 201, section 4 of chapter 203, section 1 of chapter 446, and section 13 of chapter 464, Session Laws of Colorado 2009. In accordance with section 24-75-109 (4) (a), Colorado Revised Statutes, all restrictions on funds for medical services premiums, department of health care policy and financing, for the 2008-09 fiscal year, shall be released. SECTION 7. Appropriation. In addition to any other appropriation, there is hereby appropriated, out of any moneys in the general fund not otherwise appropriated, to the department of health care policy and financing, for the fiscal year beginning July 1, 2008, the sum of seven hundred nine thousand two hundred fifteen dollars ($709,215), or so much thereof as may be necessary for the payment of overexpenditures of line item appropriations contained in Part V (3) (A) of section 2 of chapter 474, Session Laws of Colorado 2008, as amended by section 1 of chapter 446 and by section 13 of chapter 464, Session Laws of Colorado 2009. In accordance with section 24-75-109 (4) (a), Colorado Revised Statutes, all restrictions on funds for medicaid mental health community programs, department of health care policy and financing, for the 2008-09 fiscal year, shall be released. SECTION 8. Appropriation. In addition to any other appropriation, there is hereby appropriated, out of any moneys in the general fund not otherwise appropriated, to the department of health care policy and financing, for the fiscal year beginning July 1, 2008, the sum of one hundred nine thousand five hundred fifty-one dollars ($109,551), or so much thereof as may be necessary for the payment of overexpenditures of line item appropriations contained in Part V (3) (B) of section 2 of chapter 474, Session Laws of Colorado 2008, as amended by section 1 of chapter 446 and by section 13 of chapter 464, Session Laws of Colorado 2009. In accordance with section 24-75-109 (4) (a) Colorado Revised Statutes, all restrictions on funds for other medicaid mental health payments, department of health care policy and financing, for the 2008-09 fiscal year, shall be released. SECTION 9. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety. ________________________________________________________ Terrance D. Carroll Brandon C. Shaffer SPEAKER OF THE HOUSE PRESIDENT OF OF REPRESENTATIVES THE SENATE ____________________________ ____________________________ Marilyn Eddins Karen Goldman CHIEF CLERK OF THE HOUSE SECRETARY OF OF REPRESENTATIVES THE SENATE APPROVED________________________________________ _________________________________________ Bill Ritter, Jr. GOVERNOR OF THE STATE OF COLORADO