ARIZONA STATE SENATE
Phoenix, Arizona
REVISED
tobacco tax allocation;
detoxification services
Purpose
Makes several 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 forty 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.
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 community health centers. Additionally, several other programs are
funded with medically needy account monies pursuant to the health omnibus
budget reconciliation act. These
programs include the AHCCCS offset loss of federal match, the AHCCCS phase-out
of quick payment discount, the AHCCCS $10 million discount hospital
reimbursement, the AHCCCS maternity length of stay and the Arizona drug
assistance program.
H.B. 2238 makes several
changes to the medically needy account allocations. First, the bill reauthorizes funding for the detoxification
program by appropriating $375,000 for detoxification services in rural
areas. This legislation also repeals
the mental health grant program and reduces the community health center grant
program by $250,000 beginning in FY 2002-2003.
Lastly, this bill appropriates $250,000 annually from the medically
needy account 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.
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.
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. Eliminates the pilot status of the detoxification program.
4. Appropriates $250,000 annually from the medically needy account for health care services in an area of Tucson that was contaminated by TCE.
5. 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.
6. Repeals the medically needy account mental health grant program.
7. Reduces the community health center grant program by $250,000 beginning FY 2002-2003.
8. 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 a 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 from the medically needy account 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.
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
Prepared by Senate Staff
April 20, 2001