House Bill 4205

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    Florida House of Representatives - 1998                HB 4205

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





  1                      A bill to be entitled

  2         An act relating to implementing the 1998-1999

  3         General Appropriations Act in the area of

  4         health and human services; providing

  5         legislative intent; amending s. 61.1812, F.S.;

  6         crediting to the Child Support Incentive Trust

  7         Fund certain distributions of the state share

  8         of Temporary Assistance to Needy Families

  9         (TANF); amending s. 216.292, F.S.; authorizing

10         the Department of Children and Family Services

11         and the Agency for Health Care Administration

12         to transfer general revenue funds between them;

13         amending s. 409.9115, F.S.; specifying how the

14         Agency for Health Care Administration shall

15         make payments for the Medicaid disproportionate

16         share program for mental health hospitals;

17         requiring the Agency for Health Care

18         Administration to use a specified

19         disproportionate share formula, specified

20         audited financial data, and a specified

21         Medicaid per diem rate in fiscal year 1998-1999

22         for qualifying hospitals; amending s. 409.9116,

23         F.S.; providing a formula for rural hospital

24         disproportionate share payments; amending s.

25         216.181, F.S.; authorizing the Department of

26         Children and Family Services and the Department

27         of Health to advance certain moneys for certain

28         contract services; directing the Agency for

29         Health Care Administration to include health

30         maintenance organization recipients in the

31         county billing for a specified purpose;

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    Florida House of Representatives - 1998                HB 4205

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  1         authorizing the Departments of Children and

  2         Family Services, Labor and Employment Security,

  3         Revenue, and Health and the Agency for Health

  4         Care Administration to transfer positions and

  5         funds to comply with the 1998-1999 General

  6         Appropriations Act or the WAGES Act; requiring

  7         the Agency for Health Care Administration to

  8         take necessary actions to ensure that

  9         expenditures for Medicaid do not exceed the

10         amount budgeted and to take certain steps if

11         that becomes impossible; providing for

12         continuation and modification of the Legal

13         Immigrant's Temporary Income Bridge Program;

14         providing for future repeal; providing for

15         providing effect of veto of specific

16         appropriation or proviso to which implementing

17         language refers; providing applicability to

18         other legislation; providing severability;

19         providing an effective 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 1998-1999 General Appropriations Act

26  in the area of health and human services.

27         Section 2.  In order to implement Specific

28  Appropriations 406, 421, 2098, 2098A, and 2098B of the

29  1998-1999 General Appropriations Act, subsection (3) is added

30  to section 61.1812, Florida Statutes, to read:

31         61.1812  Child Support Incentive Trust Fund.--

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    Florida House of Representatives - 1998                HB 4205

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  1         (3)  Notwithstanding any provision of subsection (1) to

  2  the contrary, for the 1998-1999 fiscal year only, in addition

  3  to incentive earnings and interest earnings, 29 percent of

  4  each distribution of the state share of Temporary Assistance

  5  to Needy Families (TANF) collections recovered in each fiscal

  6  year by the Title IV-D agency shall be credited to the trust

  7  fund. Once a total of $39.7 million in the state share of

  8  Temporary Assistance to Needy Families (TANF) collections has

  9  been distributed, 100 percent of any additional distributions

10  shall be credited to the trust fund. This subsection is

11  repealed on July 1, 1999.

12         Section 3.  In order to implement Specific

13  Appropriations 212 through 446A of the 1998-1999 General

14  Appropriations Act, paragraph (b) subsection (1) of section

15  216.292, Florida Statutes, is amended to read:

16         216.292  Appropriations nontransferable; exceptions.--

17         (1)

18         (b)  For the 1998-1999 1997-1998 fiscal year only, the

19  Department of Children and Family Services and the Agency for

20  Health Care Administration may transfer general revenue funds

21  as necessary to comply with any provision of the General

22  Appropriations Act that requires or specifically authorizes

23  the transfer of general revenue funds between these two

24  agencies. This paragraph is repealed on July 1, 1999 1998.

25         Section 4.  In order to implement Specific

26  Appropriation 271 of the 1998-1999 General Appropriations Act,

27  subsection (3) of section 409.9115, Florida Statutes, is

28  amended to read:

29         409.9115  Disproportionate share program for mental

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

31  shall design and implement a system of making mental health

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    Florida House of Representatives - 1998                HB 4205

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  1  disproportionate share payments to hospitals that qualify for

  2  disproportionate share payments under s. 409.911. This system

  3  of payments shall conform with federal requirements and shall

  4  distribute funds in each fiscal year for which an

  5  appropriation is made by making quarterly Medicaid payments.

  6  Notwithstanding s. 409.915, counties are exempt from

  7  contributing toward the cost of this special reimbursement for

  8  patients.

  9         (3)  For the 1998-1999 1997-1998 fiscal year only, the

10  Agency for Health Care Administration shall make payments for

11  the Medicaid disproportionate share program for mental health

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

13  the Medicaid disproportionate share program for mental health

14  hospitals are increased or decreased during the fiscal year

15  pursuant to the requirements of chapter 216, the required

16  adjustment shall be prorated over the remaining payment

17  periods. This subsection is repealed on July 1, 1999 1998.

18         Section 5.  During the 1998-1999 fiscal year, the

19  Agency for Health Care Administration shall use the 1992-1993

20  disproportionate share formula, the 1989 audited financial

21  data, and the Medicaid per diem rate as of January 1, 1992,

22  for those hospitals that qualify for the hospital

23  disproportionate share program funded in Specific

24  Appropriation 247 of the 1998-1999 General Appropriations Act.

25  This section is repealed on July 1, 1999.

26         Section 6.  In order to implement Specific

27  Appropriation 240 of the 1998-1999 General Appropriations Act,

28  subsection (6) of section 409.9116, Florida Statutes, is

29  amended to read:

30         409.9116  Disproportionate share/financial assistance

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

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

  2  shall administer a federally matched disproportionate share

  3  program and a state-funded financial assistance program for

  4  statutory rural hospitals. The agency shall make

  5  disproportionate share payments to statutory rural hospitals

  6  that qualify for such payments and financial assistance

  7  payments to statutory rural hospitals that do not qualify for

  8  disproportionate share payments. The disproportionate share

  9  program payments shall be limited by and conform with federal

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

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

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

13  funds shall be distributed quarterly in each fiscal year for

14  which an appropriation is made. Notwithstanding the provisions

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

16  the cost of this special reimbursement for hospitals serving a

17  disproportionate share of low-income patients.

18         (6)  For the 1998-1999 1997-1998 fiscal year only, the

19  Agency for Health Care Administration shall use the following

20  formula for distribution of the funds in Specific

21  Appropriation 240 226 of the 1998-1999 1997-1998 General

22  Appropriations Act for the disproportionate share/financial

23  assistance program for rural hospitals.

24         (a)  The agency shall first determine a preliminary

25  payment amount for each rural hospital by allocating all

26  available state funds using the following formula:

27

28                  PDAER = (TAERH x TARH)/STAERH

29

30  Where:

31

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    Florida House of Representatives - 1998                HB 4205

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  1         PDAER = preliminary distribution amount for each rural

  2  hospital.

  3         TAERH = total amount earned by each rural hospital.

  4         TARH = total amount appropriated or distributed under

  5  this section.

  6         STAERH = sum of total amount earned by each rural

  7  hospital.

  8         (b)  Federal matching funds for the disproportionate

  9  share program shall then be calculated for those hospitals

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

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

12  calculated for each hospital using the formula:

13

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

15

16  Where:

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

18  hospital.

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

20  4 percent of TARH.

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

22  disproportionate share program shall then be calculated using

23  the following formula:

24

25                     ATARH = (TARH - SSFOER)

26

27  Where:

28         ATARH = adjusted total amount appropriated or

29  distributed under this section.

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

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

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  1         (e)  The determination of the amount of rural

  2  disproportionate share hospital funds is calculated by the

  3  following formula:

  4

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

  6

  7  Where:

  8         TDAERH = total distribution amount for each rural

  9  hospital.

10         (f)  Federal matching funds for the disproportionate

11  share program shall then be calculated for those hospitals

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

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

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

15  to determine the total distribution amount for each rural

16  hospital.

17         (h)  This subsection is repealed on July 1, 1999 1998.

18         Section 7.  In order to implement Specific

19  Appropriations 293 through 446A and 466 through 555 of the

20  1998-1999 General Appropriations Act, paragraph (c) of

21  subsection (15) of section 216.181, Florida Statutes, is

22  amended to read:

23         216.181  Approved budgets for operations and fixed

24  capital outlay.--

25         (15)

26         (c)  For the 1998-1999 1997-1998 fiscal year only,

27  funds appropriated to the Department of Children and Family

28  Services in Specific Appropriations 293 272 through 446A 403

29  and the Department of Health in Specific Appropriations 466

30  426 through 555 511A of the 1998-1999 1997-1998 General

31  Appropriations Act may be advanced, unless specifically

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  1  prohibited in such General Appropriations Act, for those

  2  contracted services that were approved for advancement by the

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

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

  5  paragraph is repealed on July 1, 1999 1998.

  6         Section 8.  In order to implement Specific

  7  Appropriation 247 of the 1998-1999 General Appropriations Act,

  8  and for the 1998-1999 fiscal year only, the Agency for Health

  9  Care Administration shall include health maintenance

10  organization recipients in the county billing for inpatient

11  hospital stays for the purpose of shared costs with counties

12  in accordance with the Florida Statutes. This section is

13  repealed on July 1, 1999.

14         Section 9.  For the 1998-1999 fiscal year only, the

15  Departments of Children and Family Services, Revenue, Labor

16  and Employment Security, and Health and the Agency for Health

17  Care Administration may transfer positions and general revenue

18  funds as necessary to comply with any provision of the

19  1998-1999 General Appropriations Act or WAGES Act which

20  requires or specifically authorizes the transfer of positions

21  and general revenue funds between these agencies. This section

22  expires July 1, 1999.

23         Section 10.  In order to implement Specific

24  Appropriation 258 of the 1998-1999 General Appropriations Act,

25  the Agency for Health Care Administration shall take any

26  necessary lawfully authorized action to ensure that total

27  expenditures for Medicaid transportation remain within the

28  amount budgeted in the 1998-1999 General Appropriations Act.

29  In the event that the agency finds that it is impossible to

30  constrain Medicaid transportation expenditures to within the

31  budgeted amount, it shall notify the Legislature of this and

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  1  provide suggestions for statutory revisions necessary to

  2  alleviate future deficits as well as a description of all

  3  action taken under its current authority. This section expires

  4  July 1, 1999.

  5         Section 11.  In order to implement section 8 of the

  6  1998-1999 General Appropriations Act, the Legal Immigrant's

  7  Temporary Income Bridge Program, established in fiscal year

  8  1997-1998, is continued as set out in this section. The

  9  program shall be administered by the Department of Children

10  and Family Services to provide temporary assistance to legal

11  immigrants who have lost their eligibility for benefits while

12  they are awaiting completion of the citizenship process or an

13  exemption thereto. All relevant state agencies are instructed

14  to cooperate with the Department of Children and Family

15  Services to implement this program.

16         (1)  The program shall be designed to provide temporary

17  assistance to any legal immigrant who lost his or her

18  eligibility for federal benefits and meets one or more of the

19  following criteria:

20         (a)  Was 65 years of age or older at the time his or

21  her eligibility for federal benefits ceased; or

22         (b)  Met the definition of a child under federal Food

23  Stamp Act of 1997 at the time his or her eligibility for

24  federal benefits ceased, continues to meet that definition,

25  and is now less than 8 years of age.

26         (2)  In addition to the criteria set forth in

27  subsection (1), eligibility for assistance requires that each

28  individual demonstrate that he or she:

29         (a)  Was a resident of the State of Florida prior to

30  February 1, 1997;

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  1         (b)  Became ineligible for food stamp benefits after

  2  August 1, 1997, under the Federal Personal Responsibility and

  3  Work Opportunity Reconciliation Act of 1996;

  4         (c)  Will be screened to verify that there exists no

  5  other sustainable means of support or assistance to make up

  6  for those lost benefits; and

  7         (d)  Is engaged in the process of becoming a United

  8  States citizen or is seeking an exemption thereto.

  9         (3)  The total amount of temporary assistance provided

10  to an adult individual shall not exceed the food stamps

11  benefits for which such individual has become ineligible. The

12  department shall use the maximum federal food stamp benefit

13  allowable for a family of four to determine the per-person

14  benefit amount to be used for children.

15         (4)  The total administrative charges of the Department

16  of Children and Family Services, including administrative

17  costs for contract service providers, as a percentage of total

18  costs for this program may not exceed the current costs to

19  administer the federal food stamp program as a percentage of

20  total costs for that program.

21         (5)  If the United States Congress acts to reinstate

22  benefit eligibility to those noncitizens who lost eligibility

23  under the Federal Personal Responsibility and Work Opportunity

24  Reconciliation Act of 1996, only those direct assistance and

25  administrative dollars which were spent prior to reinstatement

26  becoming effective are provided in this specific

27  appropriation.

28         (6)  This section is repealed on July 1, 1999.

29         Section 12.  A section of this act that implements a

30  specific appropriation or specifically identified proviso

31  language in the 1998-1999 General Appropriations Act is void

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  1  if the specific appropriation or specifically identified

  2  proviso language is vetoed. A section of this act that

  3  implements more than one specific appropriation or more than

  4  one portion of specifically identified proviso language in the

  5  1998-1999 General Appropriations Act is void if all the

  6  specific appropriations or portions of specifically identified

  7  proviso language are vetoed.

  8         Section 13.  If any other act passed during the 1998

  9  Regular Session of the Legislature or any extension thereof

10  contains a provision which is substantively the same as a

11  provision in this act, but which removes or is otherwise not

12  subject to the future repeal applied to such provision by this

13  act, the Legislature intends that the provision in the other

14  act shall take precedence and shall continue to operate,

15  notwithstanding the future repeal provided by this act.

16         Section 14.  If any provision of this act or the

17  application thereof to any person or circumstance is held

18  invalid, the invalidity shall not affect other provisions or

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

20  invalid provision or application, and to this end the

21  provisions of this act are declared severable.

22         Section 15.  This act shall take effect July 1, 1998;

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

24  that date, it shall operate retroactively thereto.

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  1            *****************************************

  2                          HOUSE SUMMARY

  3
      For the purpose of implementing the 1998-1999 General
  4    Appropriations Act in the area of health and human
      services, credits to the Child Support Incentive Trust
  5    Fund certain distributions of the state share of
      Temporary Assistance to Needy Families (TANF), authorizes
  6    the Department of Children and Family Services and the
      Agency for Health Care Administration to transfer general
  7    revenue funds between them, specifies how the Agency for
      Health Care Administration shall make payments for the
  8    Medicaid disproportionate share program for mental health
      hospitals, requires the Agency for Health Care
  9    Administration to use a specified disproportionate share
      formula, specified audited financial data, and a
10    specified Medicaid per diem rate in fiscal year 1998-1999
      for qualifying hospitals, provides a formula for rural
11    hospital disproportionate share payments, authorizes the
      Department of Children and Family Services and the
12    Department of Health to advance certain moneys for
      certain contract services, directs the Agency for Health
13    Care Administration to include health maintenance
      organization recipients in the county billing for a
14    specified purpose, authorizes the Departments of Children
      and Family Services, Labor and Employment Security,
15    Revenue, and Health and the Agency for Health Care
      Administration to transfer positions and funds to comply
16    with the 1998-1999 General Appropriations Act or the
      WAGES Act, requires the Agency for Health Care
17    Administration to take necessary actions to ensure that
      expenditures for Medicaid do not exceed the amount
18    budgeted and to take certain steps if that becomes
      impossible, and provides for continuation and
19    modification of the Legal Immigrant's Temporary Income
      Bridge Program.
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