First Regular Session

Sixty-first General Assembly

LLS NO. 97-0259.01D JBC SENATE BILL 97-180

STATE OF COLORADO

BY SENATORS Lacy, Blickensderfer, and Rizzuto;

also REPRESENTATIVES Grampsas, Owen, and Romero.

APPROPRIATIONS

A BILL FOR AN ACT

Concerning a supplemental appropriation to the department of health care policy and financing.

Bill Summary

(Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments which may be subsequently adopted.)

Makes 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 324, Session Laws of Colorado 1996, is amended to read:

Section 2. Appropriation.

	ITEM &SUBTOTAL $	TOTAL $	GENERAL FUND $		GENERAL FUNDEXEMPT$		CASH FUNDS $			CASH FUNDSEXEMPT $		FEDERAL FUNDS $
PART V
DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
(1) EXECUTIVE DIRECTOR'S OFFICE31
Personal Services	872,331			303,187	(M)			15,000	a			554,144
	(15.1 FTE)
Health, Life, and Dental	283,700			141,850	(M)							141,850
Short-term Disability	11,051			4,862	(M)							6,189
Salary Survey and Anniversary Increases	216,494			108,158	(M)							108,336
Workers' Compensation	119,689			59,844	(M)							59,845
Operating Expenses	133,524			96,759	(M)							36,765
Legal Services for 3,980 hours	188,838			94,419	(M)							94,419
Third Party Recovery/ Legal Services for 3,387 hours	160,702							160,702	b
Administrative Law Judge Services for 1,993 Hours	171,220			85,610	(M)							85,610
Systems Costs	330,339			132,698	(M)			32,471	c			165,170
Payment to Risk Management and Property Funds	24,748			12,374	(M)							12,374
Capitol Complex Leased Space	209,680			104,840	(M)							104,840
Department of Human Services Administration	274,734			137,367	(M)							137,367
Colorado Benefits Management System	54,070			27,035	(M)							27,035
		2,997,050
		3,051,120
a This amount shall be from the Cooperative Health Care Agreements Fund Fund.
b This amount shall be from third party recoveries.
c This amount shall be from the Old Age Pension Fund.
(2) MEDICAL PROGRAMS
(A) Administration32,33
Personal Services	6,027,610			2,824,560	(M)					6,006	a	3,197,044
				2,766,614	(M)							3,254,990
	(114.9 FTE)
Operating Expenses	575,324			277,939	(M)							297,385
Medicaid Management Information System Contract	10,713,990			2,773,407	(M)			182,012	b			7,758,571
Department of Public Health and Environment Facility Survey and Certification	3,228,600			865,944	(M)							2,362,656
Contractual Utilization Review	3,263,208			815,802	(M)							2,447,406
	3,392,221			848,055	(M)							2,544,166
Early and Periodic Screening, Diagnosis, and Treatment Program	2,688,990			1,344,495	(M)							1,344,495
Nursing Home Audits	818,834			409,417	(M)							409,417
Hospital Audits	202,700			101,350	(M)							101,350
	129,140			64,570	(M)							64,570
Nursing Home Preadmission and Resident Assessments	1,368,583			342,146	(M)							1,026,437
Nurse Aide Certification	296,138			135,225	(M)					12,844	(T)c	148,069
Nursing Home Quality Assessments	28,873			7,218	(M)							21,655
Estate Recovery	361,528			180,764	(M)							180,764
	443,200			221,600	(M)							221,600
Single Entry Point Administration	60,000			30,000	(M)							30,000
Single Entry Point Audits	63,628			31,814	(M)							31,814
Automated Medical Payments System (AMPs)	1,400,000							1,400,000	d
Phone Triage/Advice	315,000			118,125	(M)							196,875
				78,750	(M)							236,250
Automated Drug Rebate Tracking System	531			131	(M)							400
medicaid management information system transition costs	8,804,584			1,423,819	(M)							7,380,765
	31,413,537
	40,355,246
a This amount shall be from grants and donations collected pursuant to Section 26-4-519 (12), C.R.S.
b This amount shall be from the Old Age Pension Health and Medical Care Fund pursuant to Section 26-2-117, C.R.S.
c This amount shall be from the Department of Regulatory Agencies.
d This amount shall be from transaction fees paid by Medicaid providers.
(B)Medical Services7, 34, 35, 36
Services for 32,521 33,033 Old Age Pensioners (OAP-A) at an average cost of $12,357.35 $12,404.85	401,873,519
	409,769,384
Services for 4,553 4,681 Old Age Pensioners (OAP-B) at an average cost of $7,413.64 $7,941.53	33,754,310
	37,174,298
Old Age Pension State Medical Program for 3,193 3,142 clients at an average cost of $2,986.52 $3,007.93	9,535,969
	9,450,916
Services for 55,623 52,797 Recipients of Aid to the Needy Disabled - Social Supplemental Security Income at an average cost of $6,096.49 $5,601.76	339,104,911
	295,756,028
Services for 168 162 Recipients of Aid to the Blind at an average cost of $2,975.34 $3,453.15	499,857
	559,410
Services for 41,709 38,013 Adult Recipients of Aid to Families with Dependent Children at an average cost of $2,348.61 $2,480.16	97,958,182
	94,278,318
Services for 108,531 109,521 Child Recipients of Aid to Families with Dependent Children at an average cost of $961.17 $1,122.93	104,316,879
	122,984,499
Services for 9,304 9,543 Foster Children at an average cost of $2,680.66 $2,951.36	24,940,850
	28,164,793
Services for 8,678 6,831 Baby Care Program Adults (BC-A) at an average cost of $5,705.67 $5,594.48	49,513,829
	38,215,893
Services for 17,019 10,900 Baby Care Program Children (BC-C) at an average cost of $1,373.11 $1,359.62	23,368,955
	14,819,858
Services for 4,541 4,276 Qualified Medicare Beneficiaries (QMBs) at an average cost of $1,907.32 $1,433.38	8,661,129
	6,129,125
Services for 6,331 5,557 Undocumented Aliens at an Average Cost of $2,383.79 $2,571.00	15,091,772
	14,287,047
H.B. 95-1081 Payments to the Department of Corrections	29,432
Enhanced Prenatal Care Services	2,025,000
	1,110,674,594			525,684,525	(M)			9,817,988	a			575,172,081
	1,073,644,001			508,428,083	(M)							555,397,930
a This amount shall be from the Old Age Pension Health and Medical Care Fund pursuant to Section 26-2-117, C.R.S.
(C) Indigent Care Program37
Program Administration	252,758			252,758
				(3.0 FTE)
Denver Indigent Care	9,682,775			4,616,747	(M)							5,066,028
Specialty and Outstate Programs	15,382,304			8,409,691	(M)							6,972,613
	17,879,584			10,698,121	(M)							7,181,463
University Hospital	10,727,750			5,114,991	(M)							5,612,759
	36,045,587
	38,542,867
(D) Other Medical Services
Home Care Allowance for 6,729 6,006 Recipients at an average monthly cost of $217.847,38	17,590,144			16,895,617						694,527	(L)
	15,700,164			15,007,207						692,957	(L)
Adult Foster Care for 393 359 Recipients at an average monthly cost of $192.837	909,386			863,696						45,690	(L)
	830,712			787,254						43,458	(L)
Physician Incentive Pool	5,431,236			2,577,121	(M)							2,854,115
	4,431,236			2,100,521	(M)							2,330,715
Disproportionate Share Payments to Providers	122,733,322			61,238,950	(M)							61,494,372
	121,745,322			59,277,015	(M)							62,468,307
High Risk Pregnant Women Program	205,324			97,857	(M)							107,467
H.B. 92-1208 Immunizations	848,630			404,457	(M)							444,173
	20,586			10,188	(M)							10,398
Poison Control	1,148,034			1,148,034
University of Colorado Family Medicine Residency Training Programs	1,918,755			914,479	(M)							1,004,276
Enhanced Prenatal Care Training and Technical Assistance	60,000			30,000	(M)							30,000
	150,844,831
	146,060,133
(E) Department of Human Services
Transfer to the Department of Human Services	258,067,020			122,528,875	(M)a							135,538,145
	276,130,996			131,138,166	(M)a							144,992,830
a Of this amount, $2,856,098 $3,593,078 is appropriated pursuant to final court orders, including $2,763,704 $3,500,684 for a final court order for the Child Welfare lawsuit, Case #94-M-1417, and $92,394 for Goebel vs. Colorado Department of Institutions, Case #81 MH 270 and Case #81 CV 6961 (Consolidated). These amounts are exempt from the statutory limit on state General Fund appropriations pursuant to Section 24-75-201.1(1)(a)(III)(B), C.R.S.
		1,587,045,569
		1,574,733,243
TOTALS PART V
(HEALTH CARE POLICY AND FINANCING)2,3		$1,590,042,619		$762,318,103				$11,608,173	a	$759,067	b	$815,357,276
		$1,577,784,363		$752,551,568						$755,265	b	$812,869,357
a Of this amount, $10,000,000 is included as information for purposes of complying with the limitation on state fiscal year spending imposed by Article X, Section 20 of the State Constitution. As this amount is continuously appropriated by a constitutional provision, it is not subject to the limitation of General Fund appropriations as set forth in Section 24-75-201.1, C.R.S.
b Of this amount, $740,217 $736,415 contains an (L) notation, and $12,844 contains a (T) notation.

FOOTNOTES -- The following statements are referenced to the numbered footnotes throughout section 2.

2(Governor lined through this provision. See L. 96, p. 2258.)

3All Departments, Totals -- The General Assembly requests that copies of all reports requested in other footnotes contained in this act be delivered to the Joint Budget Committee and the majority and minority leadership in each house of the General Assembly.

7(Governor lined through this provision. See L. 96, p. 2258.)

31 (Governor lined through this provision. See L. 96, p. 2258.)

32Department of Health Care Policy and Financing, Medical Programs, Administration -- The Department is requested to report to the Joint Budget Committee on the delineation of FY 1994-95 program expenditures by cost components for each of the following programs: home care allowance, adult foster care, home and community based services for the elderly, blind, and disabled (HCBS-EBD), home and community based services for persons living with AIDS (HCBS-PLWA), home health, and the Katie Beckett/model 200 waiver. For purposes of this report, the cost components are defined as: personal services, operating, lab/medical, food, and other. The Joint Budget Committee requests that this information be provided no later than December 1, 1996.

33Department of Health Care Policy and Financing, Medical Programs, Administration -- The Department is requested to report to the Joint Budget Committee on the effectiveness of the primary care rate indexing initiated by the Department in FY 1994-95. The report shall include: the change in the reimbursement for physicians, dentists, and emergency and county transportation for FY 1993-94 through FY 1996-97; the change in the number of Medicaid participating providers for the same time period relative to the need of the Medicaid eligible population; and recommendations for reimbursement methodologies for FY 1997-98. The Joint Budget Committee requests that this information be provided no later than October 15, 1996.

34Department of Health Care Policy and Financing, Medical Programs, Medical Services; and Department of Public Health and Environment, Family and Community Health Services Division, Family Planning, Purchase of Services -- The Departments are requested to provide a preliminary report to the Joint Budget Committee by November 1, 1996, and a final report by February 1, 1997, outlining the progress made in reducing the rate of low birth-weight babies as a result of the enhanced prenatal program appropriation. The final report shall delineate, by fiscal year, the total, General Fund, and federal fund savingsachieved as a result of the FY 1995-96 and FY 1996-97 program appropriation and recommendations for further programmatic and funding changes based on the findings.

35Department of Health Care Policy and Financing, Medical Programs, Medical Services -- It is the intent of the General Assembly that expenditures for these services shall be recorded only against the Long Bill group total for Medical Services.

36Department of Health Care Policy and Financing, Medical Programs, Medical Services -- The General Assembly has determined that the average appropriated rates provide sufficient funds to pay reasonable and adequate compensation to efficient and economical providers. The Department should take actions to ensure that the average appropriated rates are not exceeded.

37(Governor lined through this provision. See L. 96, p. 2260.)

38Department of Health Care Policy and Financing, Medical Programs, Other Medical Services, Home Care Allowance for 6,729 Recipients at an average monthly cost of $217.84 -- The Department is requested to report to the Joint Budget Committee by November 1, 1996, on the causes for the caseload increase in the home care allowance program, the program criteria that recipients currently meet, and specific recommendations for program containment.

SECTION 2. Part VI (2) (B) and (2) (E) and the affected totals of Part VI of section 2 of chapter 283, Session Laws of Colorado 1995, as amended by section 1 of chapter 308, Session Laws of Colorado 1996, as further amended by section 7 of chapter 324, Session Laws of Colorado 1996, are amended to read:

Section 2. Appropriation.

PART VI
DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
(2) MEDICAL PROGRAMS 32
(B)Medical Services15, 33, 34, 35
Services for 32,099 Old Age Pensioners (OAP-A) at an average cost of $11,171.51	358,594,374
Services for 4,387 Old Age Pensioners (OAP-B) at an average cost of $6,975.50	30,601,507
Old Age Pension State Medical Program for 3,142 clients at an average cost of $2,926.46	9,194,929
Services for 51,295 Recipients of Aid to the Needy Disabled - Social Security Income at an average cost of $5,703.00	292,535,348
	289,752,818
Services for 169 Recipients of Aid to the Blind at an average cost of $3,122.08	527,632
Services for 42,412 Adult Recipients of Aid to Families with Dependent Children at an average cost of $2,231.91	94,659,949
Services for 109,749 Child Recipients of Aid to Families with Dependent Children at an average cost of $944.03	103,606,286
Services for 8,592 Foster Children at an average cost of $2,741.49	23,554,869
Services for 8,701 Baby Care Program Adults (BC-A) at an average cost of $5,319.30	46,283,195
Services for 16,966 Baby Care Program Children (BC-C) at an average cost of $1,396.19	23,687,768
Services for 3,976 Qualified Medicare Beneficiaries (QMBs) at an average cost of $1,697.74	6,750,195
Services for 5,225 Undocumented Aliens at an Average Cost of $2,457.55	12,840,687
Enhanced Prenatal Care Services	2,025,000
	1,004,861,739			474,367,755	(M)			9,194,929	a			521,299,055
	1,002,079,209			471,585,225	(M)
a This amount shall be from the Old Age Pension Health and Medical Care Fund pursuant to Section 26-2-117, C.R.S.
(E) Department of Human Services
Transfer to the Department of Human Services	237,209,576	a		112,101,802	(M)b							125,107,774
a This amount does not include any disproportionate share payments appropriated to the Department of Human Services Mental Health Institutes.
b Of this amount, $5,899,261 $4,922,357 is appropriated pursuant to a final court order, including $5,464,900 $4,487,996 for a final court order for the Child Welfare lawsuit, Case #94-M-1417, and $434,361 for Goebel vs. Colorado Department of Institutions, Case #81 MH 270 and Case #81 CV 6961 (Consolidated). This amount is exempt from the statutory limit on state General Fund appropriations pursuant to Section 24-75-201.1(1)(a)(III)(B), C.R.S.
		1,438,737,241
		1,435,954,711
TOTALS PART VI
(HEALTH CARE POLICY AND FINANCING)10, 11, 11a		$1,441,849,135		$688,167,127				$11,048,310	a	$710,974	b	$741,922,724
		$1,439,066,605		$685,384,597
a Of this amount, $9,353,324 is included as information for purposes of complying with the limitation on state fiscal year spending imposed by Article X, Section 20 of the State Constitution. As this amount is continuously appropriated by a constitutional provision, it is not subject to the limitation of General Fund appropriations as set forth in Section 24-75-201.1, C.R.S.
b Of this amount, $704,968 contains an (L) notation.

SECTION 3. 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.