House Bill 1833

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    Florida House of Representatives - 1997                HB 1833

        By the Committee on Health & Human Services Appropriations
    and Representative Sanderson





  1                      A bill to be entitled

  2         An act relating to implementing the fiscal year

  3         1997-1998 General Appropriations Act in the

  4         area of health and human services; providing

  5         legislative intent; amending s. 216.292, F.S.;

  6         authorizing the Department of Children and

  7         Family Services and the Agency for Health Care

  8         Administration to transfer general revenue

  9         funds between them; providing for future

10         repeal; eliminating a provision authorizing the

11         Department of Children and Family Services to

12         transfer general revenue funds to the

13         Department of Revenue for child support

14         enforcement; eliminating a provision

15         authorizing the Agency for Health Care

16         Administration to transfer general revenue

17         funds and appropriate trust funds to the

18         Department of Elderly Affairs for

19         administrative support to implement the managed

20         long-term care waiver; amending s. 409.9115,

21         F.S.; specifying how the Agency for Health Care

22         Administration shall make payments for the

23         Medicaid disproportionate share program for

24         mental health hospitals; providing for future

25         repeal; amending s. 5, ch. 96-420, Laws of

26         Florida; requiring the Agency for Health Care

27         Administration to use a specified

28         disproportionate share formula, specified

29         audited financial data, and a specified

30         Medicaid per diem rate in fiscal year 1997-1998

31         for qualifying hospitals; providing for future

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    Florida House of Representatives - 1997                HB 1833

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  1         repeal; amending s. 409.9116, F.S.; altering

  2         the formula for rural hospital disproportionate

  3         share payments; providing for future repeal;

  4         amending s. 216.181, F.S.; authorizing the

  5         Department of Children and Family Services to

  6         advance certain moneys for certain contract

  7         services; providing for future repeal; amending

  8         s. 624.91, F.S.; authorizing appropriation of

  9         funds to the Florida Healthy Kids Corporation

10         to facilitate the provision of preventive

11         health care services to children at certain

12         sites; providing for future repeal; amending s.

13         10, ch. 96-420, Laws of Florida; directing the

14         Agency for Health Care Administration to

15         include health maintenance organization

16         recipients in the county billing for a

17         specified purpose; providing for future repeal;

18         providing severability; providing an effective

19         date.

20

21  Be It Enacted by the Legislature of the State of Florida:

22

23         Section 1.  It is the intent of the Legislature that

24  the implementing and administering provisions of this act

25  apply to the fiscal year 1997-1998 General Appropriations Act

26  in the area of health and human services.

27         Section 2.  In order to implement Specific

28  Appropriations 207 through 521 of the 1997-1998 General

29  Appropriations Act, subsection (1) of section 216.292, Florida

30  Statutes, 1996 Supplement, is amended to read:

31         216.292  Appropriations nontransferable; exceptions.--

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  1         (1)(a)  Funds provided in the General Appropriations

  2  Act or as otherwise expressly provided by law shall be

  3  expended only for the purpose for which appropriated, except

  4  that if deemed necessary such moneys may be transferred as

  5  provided in subsections (3) and (4) when it is determined to

  6  be in the best interest of the state. Appropriations for fixed

  7  capital outlay may not be expended for any other purpose, and

  8  appropriations may not be transferred between state agencies,

  9  or between a state agency and the judicial branch, unless

10  specifically authorized by law.

11         (b)  For the 1997-1998 1996-1997 fiscal year only, the

12  Department of Children and Family Health and Rehabilitative

13  Services and the Agency for Health Care Administration may

14  transfer general revenue funds as necessary to comply with any

15  provision of the General Appropriations Act that requires or

16  specifically authorizes the transfer of general revenue funds

17  between these two agencies. This paragraph is repealed on July

18  1, 1998 1997.

19         (c)  For the 1996-1997 fiscal year only, the Department

20  of Health and Rehabilitative Services may transfer general

21  revenue funds as necessary from Specific Appropriation 480 of

22  the 1996-1997 General Appropriations Act to the Department of

23  Revenue for child support enforcement. This paragraph is

24  repealed on July 1, 1997.

25         (d)  For the 1996-1997 fiscal year only, the Agency for

26  Health Care Administration may transfer general revenue funds

27  and appropriate trust funds from Specific Appropriation 250 of

28  the 1996-1997 General Appropriations Act to the Department of

29  Elderly Affairs for administrative support to implement the

30  managed long-term care waiver. This paragraph is repealed on

31  July 1, 1997.

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  1         Section 3.  In order to implement Specific

  2  Appropriation 257 of the 1997-1998 General Appropriations Act,

  3  section 409.9115, Florida Statutes, 1996 Supplement, is

  4  amended to read:

  5         409.9115  Disproportionate share program for mental

  6  health hospitals.--The Agency for Health Care Administration

  7  Department of Health and Rehabilitative Services shall design

  8  and implement a system of making mental health

  9  disproportionate share payments to hospitals that qualify for

10  disproportionate share payments under s. 409.911. This system

11  of payments shall conform with federal requirements and shall

12  distribute funds in each fiscal year for which an

13  appropriation is made by making quarterly Medicaid payments.

14  Notwithstanding s. 409.915, counties are exempt from

15  contributing toward the cost of this special reimbursement for

16  patients.

17         (1)  The following formula shall be used by the agency

18  department to calculate the total amount earned for hospitals

19  that participate in the mental health disproportionate share

20  program:

21

22                               DSH

23                      TAP = (........)  x TA

24                              TDSH

25

26  Where:

27         TAP = total additional payment for a mental health

28  hospital.

29         DSH = total amount earned by a mental health hospital

30  under s. 409.911.

31

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  1         TDSH = sum of total amount earned by each hospital that

  2  participates in the mental health hospital disproportionate

  3  share program.

  4         TA = total appropriation for the mental health hospital

  5  disproportionate share program.

  6

  7         (2)  In order to receive payments under this section, a

  8  hospital must participate in the Florida Title XIX program and

  9  must:

10         (a)  Agree to serve all individuals referred by the

11  agency department who require inpatient psychiatric services,

12  regardless of ability to pay.

13         (b)  Be certified or certifiable to be a provider of

14  Title XVIII services.

15         (c)  Receive all of its inpatient clients from

16  admissions governed by the Baker Act as specified in chapter

17  394.

18         (3)  For the 1997-1998 1996-1997 fiscal year only, the

19  Agency for Health Care Administration shall make payments for

20  the Medicaid disproportionate share program for mental health

21  hospitals on a monthly basis. If the amounts appropriated for

22  the Medicaid disproportionate share program for mental health

23  hospitals are increased or decreased during the fiscal year

24  pursuant to the requirements of chapter 216, the required

25  adjustment shall be prorated over the remaining payment

26  periods. This subsection is repealed on July 1, 1998 1997.

27         Section 4.  Section 5 of chapter 96-420, Laws of

28  Florida, is amended to read:

29         Section 5.  During the 1997-1998 1996-1997 fiscal year,

30  the Agency for Health Care Administration shall use the

31  1992-1993 disproportionate share formula, the 1989 audited

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    Florida House of Representatives - 1997                HB 1833

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  1  financial data, and the Medicaid per diem rate as of January

  2  1, 1992, for those hospitals that qualify for the hospital

  3  disproportionate share program funded in Specific

  4  Appropriation 233 240 of the 1997-1998 1996-1997 General

  5  Appropriations Act. This section is repealed on July 1, 1998

  6  1997.

  7         Section 5.  In order to implement Specific

  8  Appropriation 226 of the 1997-1998 General Appropriations Act,

  9  subsection (6) of section 409.9116, Florida Statutes, 1996

10  Supplement, is amended to read:

11         409.9116  Disproportionate share/financial assistance

12  program for rural hospitals.--In addition to the payments made

13  under s. 409.911, the Agency for Health Care Administration

14  shall administer a federally matched disproportionate share

15  program and a state-funded financial assistance program for

16  statutory rural hospitals. The agency shall make

17  disproportionate share payments to statutory rural hospitals

18  that qualify for such payments and financial assistance

19  payments to statutory rural hospitals that do not qualify for

20  disproportionate share payments. The disproportionate share

21  program payments shall be limited by and conform with federal

22  requirements. In fiscal year 1993-1994, available funds shall

23  be distributed in one payment, as soon as practicable after

24  the effective date of this act. In subsequent fiscal years,

25  funds shall be distributed quarterly in each fiscal year for

26  which an appropriation is made. Notwithstanding the provisions

27  of s. 409.915, counties are exempt from contributing toward

28  the cost of this special reimbursement for hospitals serving a

29  disproportionate share of low-income patients.

30         (6)  For the 1997-1998 1996-1997 fiscal year only, the

31  Agency for Health Care Administration shall use the following

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  1  formula for distribution of the funds in Specific

  2  Appropriation 226 231 of the 1997-1998 1996-1997 General

  3  Appropriations Act for the disproportionate share/financial

  4  assistance program for rural hospitals.

  5         (a)  The agency shall first determine a preliminary

  6  payment amount for each rural hospital by allocating all

  7  available state funds using the following formula:

  8

  9                  PDAER = (TAERH x TARH)/STAERH

10

11  Where:

12         PDAER = preliminary distribution amount for each rural

13  hospital.

14         TAERH = total amount earned by each rural hospital.

15         TARH = total amount appropriated or distributed under

16  this section.

17         STAERH = sum of total amount earned by each rural

18  hospital.

19         (b)  Federal matching funds for the disproportionate

20  share program shall then be calculated for those hospitals

21  that qualify for disproportionate share in paragraph (a).

22         (c)  The state-funds-only payment amount is then

23  calculated for each hospital using the formula:

24

25         SFOER = Maximum value of (1) SFOL - PDAER or (2) 0

26

27  Where:

28         SFOER = state-funds-only payment amount for each rural

29  hospital.

30         SFOL = state-funds-only payment level, which is set at

31  4 percent of TARH.

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  1         (d)  The adjusted total amount allocated to the rural

  2  disproportionate share program shall then be calculated using

  3  the following formula:

  4

  5                     ATARH = (TARH - SSFOER)

  6

  7  Where:

  8         ATARH = adjusted total amount appropriated or

  9  distributed under this section.

10         SSFOER = sum of the state-funds-only payment amount

11  calculated under paragraph (c) for all rural hospitals.

12         (e)  The determination of the amount of rural

13  disproportionate share hospital funds is calculated by the

14  following formula:

15

16                TDAERH = [(TAERH x ATARH)/STAERH]

17

18  Where:

19         TDAERH = total distribution amount for each rural

20  hospital.

21         (f)  Federal matching funds for the disproportionate

22  share program shall then be calculated for those hospitals

23  that qualify for disproportionate share in paragraph (e).

24         (g)  State-funds-only payment amounts calculated under

25  paragraph (c) are then added to the results of paragraph (f)

26  to determine the total distribution amount for each rural

27  hospital.

28         (h)  This subsection is repealed on July 1, 1998 1997.

29         Section 6.  In order to implement Specific

30  Appropriations 272 through 403 of the 1997-1998 General

31  Appropriations Act, paragraph (c) of subsection (14) of

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  1  section 216.181, Florida Statutes, 1996 Supplement, is amended

  2  to read:

  3         216.181  Approved budgets for operations and fixed

  4  capital outlay.--

  5         (14)

  6         (c)  For the 1997-1998 1996-1997 fiscal year only,

  7  funds appropriated to the Department of Children and Family

  8  Health and Rehabilitative Services in Specific Appropriations

  9  272 304 through 403 519 of the 1997-1998 1996-1997 General

10  Appropriations Act may be advanced, unless specifically

11  prohibited in such General Appropriations Act, for those

12  contracted services that were approved for advancement by the

13  Comptroller in fiscal year 1993-1994, including those services

14  contracted on a fixed-price or unit cost basis. This paragraph

15  is repealed on July 1, 1998 1997.

16         Section 7.  In order to implement Specific

17  Appropriation 211 of the 1997-1998 General Appropriations Act,

18  paragraph (b) of subsection (3) of section 624.91, Florida

19  Statutes, 1996 Supplement, is amended to read:

20         624.91  The Florida Healthy Kids Corporation Act.--

21         (3)  CORPORATION AUTHORIZATION, DUTIES, POWERS.--

22         (b)  The Florida Healthy Kids Corporation shall phase

23  in a program to:

24         1.  Organize school children groups to facilitate the

25  provision of preventive health care services to children and

26  to provide comprehensive health insurance coverage to

27  children;

28         2.  Arrange for the collection of any family or

29  employer payment or premium, in an amount to be determined by

30  the board of directors, from all participant families or

31  employers to provide for payment for preventive health care

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    Florida House of Representatives - 1997                HB 1833

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  1  services or premiums for comprehensive insurance coverage and

  2  for the actual or estimated administrative expenses incurred

  3  during the period for which family or employer payments are

  4  made;

  5         3.  Establish the administrative and accounting

  6  procedures for the operation of the corporation;

  7         4.  Establish, with consultation from appropriate

  8  professional organizations, standards for preventive health

  9  services and providers and comprehensive insurance benefits

10  appropriate to children;

11         5.  Establish eligibility criteria which children must

12  meet in order to participate in the program;

13         6.  Establish procedures under which applicants to and

14  participants in the program may have grievances reviewed by an

15  impartial body and reported to the board of directors of the

16  corporation;

17         7.  Establish participation criteria and, if

18  appropriate, contract with an authorized insurer, health

19  maintenance organization, or insurance administrator to

20  provide administrative services to the corporation;

21         8.  Contract with authorized insurers or any provider

22  of health care services, meeting standards established by the

23  corporation, for the provision of comprehensive insurance

24  coverage and preventive health care services to participants;

25         9.  Develop and implement a plan to publicize the

26  Florida Healthy Kids Corporation, the eligibility requirements

27  of the program, and the procedures for enrollment in the

28  program and to maintain public awareness of the corporation

29  and the program;

30         10.  Secure staff necessary to properly administer the

31  corporation. Staff costs shall be funded from state and local

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  1  matching funds and such other private or public funds as

  2  become available.  The board of directors shall determine the

  3  number of staff members necessary to administer the

  4  corporation;

  5         11.  As appropriate, enter into contracts with local

  6  school boards or other agencies to provide onsite information,

  7  enrollment, and other services necessary to the operation of

  8  the corporation; and

  9         12.  Provide a report on an annual basis to the

10  Governor, Insurance Commissioner, Commissioner of Education,

11  Senate President, Speaker of the House of Representatives, and

12  Minority Leaders of the Senate and the House of

13  Representatives.

14         13.  For the 1997-1998 1996-1997 fiscal year only,

15  funds may be appropriated to the Florida Healthy Kids

16  Corporation to organize school children groups to facilitate

17  the provision of preventive health care services to children

18  at sites in addition to those allowed in subparagraph 1. This

19  subparagraph is repealed on July 1, 1998 1997.

20         Section 8.  Section 10 of chapter 96-420, Laws of

21  Florida, is amended to read:

22         Section 10.  For the purpose of implementing Specific

23  Appropriation 233 240 of the 1997-1998 1996-1997 General

24  Appropriations Act, and for the 1997-1998 1996-1997 fiscal

25  year only, the Agency for Health Care Administration shall

26  include health maintenance organization recipients in the

27  county billing for inpatient hospital stays for the purpose of

28  shared costs with counties in accordance with the Florida

29  Statutes. This section is repealed on July 1, 1998 1997.

30         Section 9.  If any provision of this act or the

31  application thereof to any person or circumstance is held

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  1  invalid, the invalidity shall not affect other provisions or

  2  applications of the act which can be given effect without the

  3  invalid provision or application, and to this end the

  4  provisions of this act are declared severable.

  5         Section 10.  This act shall take effect July 1, 1997,

  6  or in the event this act fails to become a law until after

  7  that date, it shall operate retroactively thereto.

  8

  9            *****************************************

10                          HOUSE SUMMARY

11
      For the purpose of implementing the fiscal year 1997-1998
12    General Appropriations Act in the area of health and
      human services: authorizes the Department of Children and
13    Family Services and the Agency for Health Care
      Administration to transfer general revenue funds between
14    them; eliminates a provision authorizing the Department
      of Children and Family Services to transfer general
15    revenue funds to the Department of Revenue for child
      support enforcement; eliminates a provision authorizing
16    the Agency for Health Care Administration to transfer
      general revenue funds and appropriate trust funds to the
17    Department of Elderly Affairs for administrative support
      to implement the managed long-term care waiver; specifies
18    how the Agency for Health Care Administration shall make
      payments for the Medicaid disproportionate share program
19    for mental health hospitals; requires the Agency for
      Health Care Administration to use a specified
20    disproportionate share formula, specified audited
      financial data, and a specified Medicaid per diem rate in
21    fiscal year 1997-1998 for qualifying hospitals; alters
      the formula for rural hospital disproportionate share
22    payments; authorizes the Department of Children and
      Family Services to advance certain moneys for certain
23    contract services; authorizes appropriation of funds to
      the Florida Healthy Kids Corporation to facilitate the
24    provision of preventive health care services to children
      at certain sites; and directs the Agency for Health Care
25    Administration to include health maintenance organization
      recipients in the county billing for a specified purpose.
26

27

28

29

30

31

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