ARIZONA STATE SENATE
Phoenix, Arizona
FINAL
REVISED
tobacco tax allocation;
detoxification services
Purpose
Makes numerous changes to
allocations under the tobacco tax and health care fund medically needy account.
Background
In 1994, Arizona voters
passed Proposition 200, establishing the tobacco tax and health care fund and
increasing the state’s tax on packages of cigarettes by 40 cents, as well as on
other smoking tobacco products. The
ballot initiative allocates 70 percent of the fund’s revenue to the medically
needy account for the provision of health care services to medically needy or
medically indigent persons. Statute
authorizes the Arizona Health Care Cost Containment System (AHCCCS)
administration to utilize monies from the medically needy account, subject to
the availability of funds, for programs in the following order of priority (ARS
§36-2921):
1. An unspecified amount necessary to cover
transplants for certain AHCCCS members.
2. $16 million annually to the Department of
Health Services (DHS) for:
(a) the
mental health grants program - $5 million.
(b) grants
for primary care services - $6 million.
(c) grants for community health centers - $5 million.
3. $250,000 annually to DHS for contracts with
nonprofit organizations for prescription medications that supplement treatment
for end stage renal disease.
4. $1 million annually to the health crisis
fund.
5. $500,000 annually to the Aging and Adult
Administration in the Department of Economic Security for nonmedical home and
community based services.
6. $200,000 annually to DHS for contracts with
hospitals that perform nonrenal organ transplant operations.
7. $111,200 annually to DHS to implement the
rural private primary care provider loan repayment program.
The
Legislature has also appropriated funds from the medically needy account to
support other programs such as telemedicine pilot programs, detoxification
programs and rural capital projects for health care centers. Additionally, several other programs are
funded with medically needy account monies pursuant to the health omnibus
budget reconciliation act, including the AHCCCS offset loss of federal matching
monies, the AHCCCS phase-out of the quick payment discount, the AHCCCS $10
million discount of hospital reimbursement, the AHCCCS maternity length of stay
and the Arizona drug assistance program.
H.B. 2238 makes numerous
changes to the medically needy account allocations. Among the changes, the bill re-authorizes funding for the
detoxification program by appropriating $375,000 for detoxification services in
rural areas. This legislation also
appropriates $7 million in FY 2001-2002 to AHCCCS to offset losses associated
with Healthcare Group and continues the telemedicine program for the next two
fiscal years. In addition, the bill
appropriates $200,000 in each year of the biennium to DHS to distribute to
specific counties for public health services, and appropriates $3 million over
the biennium for non-Title XIX children’s behavioral health services. This legislation also reduces the community
health center grant program by $250,000 beginning in FY 2002-2003.
H.B. 2238 also appropriates
$250,000 annually to DHS for primary health care services in areas contaminated
by trichloroethylene (TCE). TCE is a
colorless and poisonous liquid that is primarily used as a degreasing agent and
solvent. The National Institute for
Occupational Safety and Health classifies TCE as a carcinogen and the
Occupational Safety and Health Administration notes high levels of TCE exposure
results in nausea, vomiting, fatigue, unconsciousness and even death in some
cases. Currently, an area in South
Tucson has a TCE contaminated water supply.
Since FY 1994-1995, the El Pueblo Clinic, which serves this area of
South Tucson, has received $250,000 each year to provide primary health care
services to low income patients. In
1999, Joint Legislative Budget Committee staff recommended eliminating the use
of state general fund monies for TCE contaminated areas since the El Pueblo
Clinic is eligible for the tobacco tax primary care services grant
program. Although the Legislature
approved funding for the TCE contamination special line item for FY 1999-2000, funding
was discontinued for FY 2000-2001.
In her veto message, the Governor said she
was restoring the mental health grant program because this funding was
“inexplicably eliminated by the Legislature.”
She further stated that “meeting the needs of this population is one of
my top priorities and I continue to pursue all options to increase resources.”
Provisions
1. Appropriates, subject to the availability of monies, $375,000 annually from the medically needy account for detoxification services in counties with a population under 500,000. Eliminates the pilot status of the program.
2. Specifies $250,000 is to be distributed to a program that provides long-term social model detoxification services and $125,000 to a short-term detoxification treatment program that is part of a continuum of care.
3. Appropriates $250,000 annually from the medically needy account for health care services in an area of Tucson that was contaminated by TCE.
4. Requires the Governor to submit a copy of executive orders to JLBC when monies in the health crisis fund are set aside for a health crisis or potential health crisis in this state.
5. Reduces the community health center grant program by $250,000 beginning FY 2002-2003.
6. Requires DHS to distribute $500,000 in FY 2001-2002 and FY 2002-2003 from the primary care services program for urgent care and primary care services during evening and weekend hours.
7. Appropriates $7 million in FY 2001-2002 from the medically needy account to AHCCCS to offset losses associated with Healthcare Group.
8. Continues the telemedicine program in FY 2001-2002 and FY 2002-2003.
9. Reduces the nonrenal disease management program from $200,000 to $70,000 beginning in FY 2001-2002.
10. Allocates monies from the medically needy account beginning in FY 2003-2004 to continuing programs based on the percentage of the total expenditures each program received during FY 2002-2003.
11. Appropriates $500,000 in FY 2000-2001 from the medically needy account to DHS for emergency vaccines.
12. Appropriates $200,000 in FY 2001-2002 and FY 2002-2003 from the medically needy account to DHS to distribute to specified counties for public health services.
13. Appropriates $125,000 in FY 2001-2002 to the University of Arizona to expand the Arizona telemedicine program.
14. Appropriates $100,000 in FY 2001-2002 to the University of Arizona to determine the efficacy of school-based telemedicine services.
15. Appropriates $1.5 million in each of FY 2001-2002 and FY 2002-2003 to DHS for non-Title XIX children’s behavioral health services.
16. Allows DHS to use $2 million of the $8 million annual medically needy account appropriation to DHS for psychotropic medications for non-Title XIX behavioral health services.
17. Provides for a general effective date.
Amendments Adopted by Health Committee
1. Decreases the appropriation for the detoxification services program from $500,000 to $375,000.
2.
Removes
the requirement of the AHCCCS administration to divide the detoxification
monies equally between programs, and requires $250,000 be distributed to a
program that provides long-term social
model detoxification services and $125,000 to a short-term detoxification
treatment program that is part of a continuum of care.
3.
Adds
a $250,000 annual appropriation for health care services in an area of Tucson
that was contaminated by TCE.
4.
Makes
a technical change.
Amendments Adopted by Appropriations Committee
1.
Includes
the Health Committee amendment.
2.
Requires
the Governor to submit copies of executive orders to the JLBC regarding health
crisis fund expenditures.
3.
Repeals
the medically needy account mental health grant program.
4.
Reduces
the annual appropriation for the community health center grant program by
$250,000 beginning in FY 2002-2003.
Amendments Adopted by Committee of the Whole
1.
The
Health Committee amendment was withdrawn.
2.
Requires
DHS to distribute $500,000 in each year of the biennium from the primary care
services program for urgent care and primary care services during evening and
weekend hours.
3.
Appropriates
$7 million in FY 2001-2002 to offset losses associated with Healthcare Group.
4.
Continues
the telemedicine program for each year in the biennium.
5.
Reduces
the tobacco tax nonrenal disease management from $200,000 to $70,000.
6.
Allocates
monies from the medically needy account beginning in FY 2003-2004 to continuing
programs based on the percentage of the total expenditures each program
received during FY 2002-2003.
7.
Appropriates
$500,000 from the medically needy account in FY 2000-2001 for emergency
vaccines.
8.
Appropriates
$200,000 from the medically needy account in FY 2001-2002 and FY 2002-2003 to
DHS to distribute to specified counties for public health services.
9.
Appropriates
$225,000 in FY 2001-2002 to the University of Arizona to expand the Arizona
telemedicine program and to determine the efficacy of school-based telemedicine
services.
10.
Appropriates
$1.5 million in each year of the biennium to DHS for non-Title XIX children’s
behavioral health services.
11.
Allows
DHS to use $2 million of the $8 million annual appropriation of medically needy
account monies to DHS for psychotropic medications for non-Title XIX behavioral
health services.
Items vetoed by the Governor
Eliminates the elimination of the mental health
grant program.
House Action Senate
Action
HEA 1/29/01 DPA 9-0-1-0 HEA 3/20/01 DPA 5-0-3-0
APPROP 2/27/01 DP 13-0-0-3 APPROP 4/03/01 DPA 11-0-1-0
3rd Read 3/12/01 40-11-9-0 3rd Read 4/30/01 24-5-1-0
Final Read 5/2/01 44-11-5-0
Signed by the Governor 5/7/01 (LIV)
Chapter 374
Prepared by Senate Staff
May 24, 2001