AN
ACT Relating to human services; authorizing supplemental payments for nursing
facilities operated by public hospital districts; amending 1999 c ... (ESSB
5180) s 210 (uncodified); and adding a new section to chapter 74.46 RCW.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. A
new section is added to chapter 74.46 RCW and codified under part F to read as
follows:
To
the extent the federal government approves such payments under the state's plan
for medical assistance, and only to the extent that funds are specifically
appropriated for this purpose in the biennial appropriations act, the
department shall make supplemental payments to nursing facilities operated by
public hospital districts. The payments shall be calculated and distributed in
accordance with the terms and conditions specified in the biennial
appropriations act. The payments shall be supplemental to the component rate
allocations calculated in accordance with part E of this chapter, and neither
the provisions of part E of this chapter nor the provisions of part C of this
chapter apply to these supplemental payments.
*Sec.
2. 1999
c ... (ESSB 5180) s 210 (uncodified) is amended to read as follows:
FOR
THE DEPARTMENT OF SOCIAL AND HEALTH SERVICES‑-MEDICAL
ASSISTANCE PROGRAM
General
Fund‑-State Appropriation (FY 2000).... $ 722,863,000
General
Fund‑-State Appropriation (FY 2001).... $ 784,657,000
General
Fund‑-Federal Appropriation............. $.................................. ((2,345,803,000))
2,401,804,000
General
Fund‑-Private/Local Appropriation...... $ 261,534,000
Emergency
Medical Services and Trauma Care Systems
Trust
Account‑-State Appropriation......... $ 9,200,000
Health
Services Account‑-State Appropriation... $ ((339,535,000))
391,582,000
TOTAL
APPROPRIATION................. $ ((4,463,592,000))
4,571,641,000
The
appropriations in this section are subject to the following conditions and
limitations:
(1) The
department shall continue to make use of the special eligibility category
created for children through age 18 and in households with incomes below 200
percent of the federal poverty level made eligible for medicaid as of July 1,
1994.
(2) It
is the intent of the legislature that Harborview medical center continue to be
an economically viable component of the health care system and that the state's
financial interest in Harborview medical center be recognized.
(3)
Funding is provided in this section for the adult dental program for Title XIX
categorically eligible and medically needy persons and to provide foot care
services by podiatric physicians and surgeons.
(4)
$1,647,000 of the general fund‑-state appropriation for fiscal year 2000
and $1,672,000 of the general fund‑-state appropriation for fiscal year
2001 are provided for treatment of low-income kidney dialysis patients.
(5)
$80,000 of the general fund‑-state appropriation for fiscal year 2000,
$80,000 of the general fund‑-state appropriation for fiscal year 2001,
and $160,000 of the general fund‑-federal appropriation are provided
solely for the prenatal triage clearinghouse to provide access and outreach to
reduce infant mortality.
(6) The
department shall adopt a new formula for distributing funds under the
low-income disproportionate share hospital (LI-DSH) program. Under this new
formula, (a) the state's Level 1 trauma center shall continue to receive the
same amount of LI-DSH payments as in fiscal year 1999; and (b) ((in addition
to other factors, the amount of a hospital's LI-DSH payment shall be inversely
related to its net operating income as a percentage of total expenditures, such
that more profitable hospitals receive a relatively smaller payment under the
program)) a net profitability factor shall be included with other
factors to determine LI-DSH payments. The net profitability factor shall
inversely relate hospital percent net operating income to payment under the
program.
(7) The
department shall report to the fiscal committees of the legislature by
September 15, 1999, and again by December 15, 1999, on (a) actions it has taken
and proposes to take to increase the share of medicare part B premium payments
upon which it is collecting medicaid matching funds; (b) the percentage of such
premium payments for each month of service subsequent to June 1998 which have
been paid with unmatched, state-only funds; and (c) why matching funds could
not be collected on those payments.
(8) The
department shall report to the fiscal committees of the legislature by December
1, 1999, and again by October 1, 2000, on the amount which has been recovered
from third-party payers as a result of its efforts to improve coordination of
benefits on behalf of "basic health plan-plus" enrollees.
(9) The
department shall report to the health care and fiscal committees of the
legislature by December 1, 1999, on options for controlling the growth in
medicaid prescription drug expenditures through strategies such as but not
limited to volume purchasing, selective contracting, supplemental drug
discounts, and improved care coordination for high utilizers.
(10)
$3,992,000 of the health services account appropriation and $7,651,000 of the
general fund‑-federal appropriation are provided solely for health
insurance coverage for children with family incomes between 200 percent and 250
percent of the federal poverty level, as provided in Substitute Senate Bill No.
5416 (children's health insurance program). If the bill is not enacted by June
30, 1999, these amounts shall lapse.
(11)
$191,000 of the general fund‑-state appropriation for fiscal year 2000
and $391,000 of the general fund‑-state appropriation for fiscal year
2001 are provided solely for implementation of Substitute Senate Bill No. 5587 (patient
bill of rights). If the bill is not enacted by June 30, 1999, these amounts
shall lapse.
(12)
Upon approval from the federal health care financing administration, the
department shall implement the section 1115 family planning waiver to provide family
planning services to persons with family incomes at or below two hundred
percent of the federal poverty level.
(13)
Except in the case of rural hospitals and Harborview medical center, weighted
average payments ((rates)) under the ratio-of-cost-to-charges
hospital payment system shall increase by no more than ((4.7)) 175
percent ((per year)) of the DRI HCFA hospital reimbursement market
basket index.
(14)
From the funds appropriated in this section, the department shall provide
chiropractic services for persons qualifying for medical assistance services
under chapter 74.09 RCW.
(15)
In accordance with Substitute Senate Bill No. 5968, $25,978,000 of the health
services account appropriation for fiscal year 2000, $26,069,000 of the health
services account appropriation for fiscal year 2001, and $56,002,000 of the
general fund--federal appropriation, or so much thereof as may be expended
without exceeding the medicare upper payment limit, are provided solely for
supplemental payments to nursing homes operated by rural public hospital
districts. Such payments shall be distributed among the participating rural
public hospital districts proportional to the number of days of medicaid-funded
nursing home care provided by each district during the preceding calendar year,
relative to the total number of such days of care provided by all participating
rural public hospital districts. Prior to making any supplemental payments,
the department shall first obtain federal approval for such payments under the
medicaid state plan. The payments shall further be conditioned upon (a) a
contractual commitment by the association of public hospital districts and
participating rural public hospital districts to make an intergovernmental
transfer to the state treasurer, for deposit into the health services account,
equal to at least 82 percent of the supplemental payment amount; and (b) a
contractual commitment by the participating districts to not allow expenditures
covered by the supplemental payments to be used for medicaid nursing home
rate-setting.
*Sec. 2 was partially vetoed. See message at end of
chapter.
