Click here for Fiscal Note

Second Regular Session

Sixty-first General Assembly

LLS NO. 98­0511.01 JGG HOUSE BILL 98­1175

STATE OF COLORADO

BY REPRESENTATIVES Veiga, Clarke, Kreutz, and Leyba;

HEWI

A BILL FOR AN ACT

CONCERNING THE EXPANSION OF TREATMENT PROGRAMS FOR HIGH­RISK PREGNANT WOMEN TO INCLUDE THOSE PREGNANT WOMEN WHO USE TOBACCO.

Bill Summary

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

Directs the executive director of the department of health care policy and financing to apply to the federal health care financing administration for approval of a state plan amendment or waiver allowing for federal financial participation in the provision of services to high­risk pregnant women who use tobacco. Conditions the implementation of such provisions on the written approval by the federal health care financing administration.

Subject to federal approval of such state plan amendment or waiver, adds the use of tobacco to those conditions contributing to a high­risk pregnancy for which treatment programs are required to be made available by entities that qualify to provide medicaid services.

Be it enacted by the General Assembly of the State of Colorado:

SECTION 1.  25­1­212 (1), Colorado Revised Statutes, is amended to read:

25­1­212.  Legislative declaration ­ treatment program for high­risk pregnant women ­ creation. (1)  The general assembly hereby finds and declares that the health and well­being of the women of Colorado is at risk; that such women are at risk of poor birth outcomes or physical and other disabilities due to substance abuse, which is the abuse of alcohol and drugs, AND THE USE OF TOBACCO during the prenatal period; that early identification of such high­risk pregnant women and substance abuse treatment greatly reduce the occurrence of poor birth outcomes; and that the citizens of Colorado will greatly benefit from a program to reduce poor birth outcomes and subsequent problems resulting from such poor birth outcomes in cases involving high­risk pregnant women through the cost savings envisioned by the prevention and early treatment of such problems.

SECTION 2.  25­1­213, Colorado Revised Statutes, is amended to read:

25­1­213.  Alcohol and drug counseling and treatment ­ necessary components. Any entity which THAT qualifies to provide services pursuant to section 26­4­302 (1) (s), C.R.S., in regards to the treatment program for high­risk pregnant women, shall make available, in addition to alcohol and drug counseling and treatment AND TOBACCO COUNSELING AND TREATMENT, IF A STATE PLAN AMENDMENT OR WAIVER IS APPROVED BY THE FEDERAL HEALTH CARE FINANCING ADMINISTRATION PURSUANT TO SECTION 26­4­302 (1) (s.5): Risk assessment services; care coordination; nutrition assessment; psychosocial counseling; intensive health education, including but not limited to parenting education and education on risk factors and appropriate health behaviors; home visits; transportation services; and other services deemed necessary by the division of alcohol and drug abuse of the department of human services, the department of public health and environment, and the department of health care policy and financing.

SECTION 3.  The introductory portion to 26­4­302 (1), Colorado Revised Statutes, is amended, and the said 26­4­302 (1) is further amended BY THE ADDITION OF A NEW PARAGRAPH, to read:

26­4­302.  Basic services for the categorically needy ­ optional services ­ repeal. (1)  The following are services for which federal financial participation is available and which Colorado has selected to provide as optional services under the medical assistance program OR FOR WHICH COLORADO HAS SOUGHT APPROVAL OF A WAIVER OR STATE PLAN AMENDMENT BY THE FEDERAL HEALTH CARE FINANCING ADMINISTRATION:

(s.5) (I)  SUBJECT TO APPROVAL OF A STATE PLAN AMENDMENT BY THE FEDERAL HEALTH CARE FINANCING ADMINISTRATION, FOR ANY PREGNANT WOMAN WHO IS ENROLLED FOR SERVICES PURSUANT TO SECTION 26­4­508, OR WHO WOULD BE ELIGIBLE FOR AID TO FAMILIES WITH DEPENDENT CHILDREN PURSUANT TO RULES IN EFFECT ON JULY 16, 1996, TOBACCO COUNSELING AND TREATMENT, INCLUDING OUTPATIENT AND RESIDENTIAL CARE BUT NOT INCLUDING ROOM AND BOARD WHILE RECEIVING RESIDENTIAL CARE.

(II)  THE EXECUTIVE DIRECTOR OF THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING IS DIRECTED TO APPLY FOR AND SECURE FROM THE FEDERAL HEALTH CARE FINANCING ADMINISTRATION ANY FEDERAL WAIVERS OR STATE PLAN AMENDMENTS THAT MAY BE NECESSARY TO IMPLEMENT THIS PARAGRAPH (s.5) AND ALLOW FOR THE PROVISION OF THE SERVICES DESCRIBED IN SUBPARAGRAPH (I) OF THIS PARAGRAPH (s.5).

(III)  THE IMPLEMENTATION OF THIS PARAGRAPH (s.5) IS CONDITIONED UPON WRITTEN APPROVAL OF A WAIVER OR STATE MEDICAID PLAN AMENDMENT BY THE FEDERAL HEALTH CARE FINANCING ADMINISTRATION, AND, IF SUCH WRITTEN APPROVAL IS NOT RECEIVED BY THE STATE DEPARTMENT ON OR BEFORE JUNE 30, 1999, THIS PARAGRAPH (s.5) IS REPEALED AS OF JULY 1, 1999. THIS PARAGRAPH (s.5) SHALL REMAIN IN EFFECT ONLY FOR SO LONG AS FEDERAL FINANCIAL PARTICIPATION IS AVAILABLE FOR REIMBURSEMENTS TO SERVICE PROVIDERS PROVIDING THE SERVICES DESCRIBED IN SUBPARAGRAPH (I) OF THIS PARAGRAPH (s.5). IN THE EVENT, AS SPECIFIED IN WRITING BY THE ATTORNEY GENERAL TO THE GOVERNOR, THAT FEDERAL LAW DOES NOT ALLOW OR IS AMENDED TO DISALLOW REIMBURSEMENTS TO SUCH SERVICE PROVIDERS OR OTHERWISE PREVENT THE IMPLEMENTATION OF THIS PARAGRAPH (s.5), THIS PARAGRAPH (s.5) IS REPEALED, EFFECTIVE ON THE DATE OF THE ATTORNEY GENERAL'S OPINION.

SECTION 4.  26­4­508.2 (1), Colorado Revised Statutes, is amended to read:

26­4­508.2.  Pregnant women ­ needs assessment ­ referral to treatment program. (1) (a)  The health care practitioner for each pregnant woman who is enrolled for services pursuant to section 26­4­508 or who would be eligible for aid to families with dependent children pursuant to rules in effect on July 16, 1996, shall be encouraged to identify as soon as possible after such woman is determined to be pregnant whether such woman is at risk of a poor birth outcome due to substance abuse during the prenatal period and in need of special assistance in order to reduce such risk. SUBJECT TO THE APPROVAL OF A STATE PLAN AMENDMENT OR WAIVER BY THE FEDERAL HEALTH CARE FINANCING ADMINISTRATION PURSUANT TO SECTION 26­4­302 (1) (s.5), A HEALTH CARE PRACTITIONER FOR A PREGNANT WOMAN SHALL ALSO BE ENCOURAGED TO IDENTIFY AS SOON AS POSSIBLE AFTER SUCH WOMAN IS DETERMINED TO BE PREGNANT WHETHER SUCH WOMAN IS AT RISK OF A POOR BIRTH OUTCOME DUE TO THE USE OF TOBACCO DURING THE PRENATAL PERIOD AND IS IN NEED OF SPECIAL ASSISTANCE IN ORDER TO REDUCE SUCH RISK.

(b)  If the health care practitioner makes such a determination DESCRIBED IN PARAGRAPH (a) OF THIS SUBSECTION (1) regarding any pregnant woman, the health care practitioner shall be encouraged to refer such woman to any entity approved and certified by the department of health for the performance of a needs assessment. Any pregnant woman who is eligible for services pursuant to section 26­4­508 or who would be eligible for aid to families with dependent children pursuant to rules in effect on July 16, 1996, may refer herself for such needs assessment.

SECTION 5.  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.