Health care access improvement grants.

2016
State of Wyoming
16LSO-0162
Introduced
1.2

HOUSE BILL

NO.

HB0116

Health care access improvement grants.

Sponsored by:
Representative(s) Wilson, Barlow and Schwartz and Senator(s) Craft, Pappas and Peterson

A BILL

for

AN ACT relating to public health; creating a process for grants to improve access to health care services and reduce the cost of uncompensated care; creating an account; authorizing grants from the account; providing for matching amounts; authorizing rulemaking; requiring reports; providing an appropriation; and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S. 9
‑
2
‑
12
8
is created to read:

9
‑
2
‑
12
8
.

Health

care access improvement
grants
; process for grants; account established; grant criteria.

(a)

There is created a process for grants
to
facilitate access to health care to persons of low income in the state
.
The process shall be administered by the Wyoming department of health.

(b)

The health

care access improvement account is created. The account shall consist of those funds appropriated to the account by the legislature and all monies received from federal grants and other contributions, grants, gifts, transfers, bequests and donations to the account. The account is specifically empowered to accept grants, gifts, transfers, bequests and donations.
Funds in the account are continuously appropriated to the department for the purpose of providing grants under this section.

(
c
)

The department shall provide grants, subject to the following:

(i)

Before submission to the department, and following public notice and a hearing, the application shall be approved by the board or boards of county commissioners
of the county
or counties in which the
service area
is located or proposed to be located
or, if the service area is located or proposed to be located on the Wind River Reservation,
the
tribal government
of either the Northern Arapaho or Eastern Shoshone tribes
;

(ii
)

Grants
may be made to
:

(
A
)

A

government
al
entity or political subdivision of the state
;

(B
)

Agencies
cooperating jointly pursuant to W.S. 16
‑
1
‑
101
through 16
‑
1
‑
109
;

(C)

A public or nonprofit organization
that
provides health care or community services to persons of low income.

(iii)

Preference for grants under this section shall be given to applicants who, in providing primary care
,
mental health
or
substance abuse services, seek input from and involvement of:

(A)

Elected officials;

(B)

Health care providers, mental health and substance abuse service providers, private health organizations and community organizations;

(C)

Persons of low income; and

(D)

Government health, social services and corrections agencies.

(iv)

Except
as otherwise provided by this paragraph, grants shall only be used
to improve access to
primary care
,
mental health and substance abuse services for
persons

of low income
in the
service area
. Grants may be used for services to other persons in the
service
area
subject to a sliding fee scale adopted pursuant to rul
e
of the department;

(v)

Grants to any one
(1)
applicant
in any two
(2)
year period
shall not exceed
five hundred thousand dollars ($500,000.00)
, multiplied by
the proportion which the population of
persons

of low income
in the service area bears to the total population of
all
persons

of low income
in the state
;

(vi)

Grant
applications shall include
, but not be limited to:

(A)

A description of the
service area
;

(B)

An estimate of the number of
persons

of low income
in the
service
area
;

(C)

E
vidence of a commitment of
monies or other forms of contributions that public or private entities will provide in matching funds. This match shall be in an amount of not less than
twenty
‑
five percent (25%)
of the grant amount.
T
he dollar amount of
any
hospital's
fractional
share of the total
cost of
uncompensated care as shown in the
federal government's
most recent Medicare cost report
in the service area
may
be
used to
satisfy
the twenty
‑
five percent (25%) threshold required
under this subparagraph
.

(
vii
)

Grants shall be awarded only if the applicant can demonstrate an operating plan that
facilitates improving
access to primary care
,
mental health
or
substance abuse services
to
persons

of low income
in the service area
and
facilitates
reduc
ing

the costs of
uncompensated care
for

any

hospital
s in the service area
.
The plan shall:

(A
)

I
nclude a review and analysis of
:

(I)

Diagnostic and demographic d
ata collected by
any
hospital

in the service area
with respect to
uncompensated care
;

(II)

T
he
ability of
persons

of low income
in the service area
to access primary care
,
mental health
and s
ubstance abuse services
, including
the
location
of services
, hours of service
, number of
providers
and the
availability of
transportation
.

(
B
)

I
dentif
y

and
describe
:

(I)

L
ocal resources
available
in the service are
a
that provide primary care
,
mental he
alth or substance abuse services.
Resources identified may include
local
hospitals, clinics, physicians and nurses, public health departments, mental health and substance abuse providers, senior centers, human service agencies, nutritionists,
emergency medical service providers
, school districts, law enforcement,
corrections
agencies
,
employers, pharmacies
and
religious and community organizations;

(II)

Opportunities for the local resources identified in subdivision (I) of this subparagraph to coordinate primary care, mental health and
substance
abuse services and provide
transportation to such services;

(I
I
I)

Existing programs
in the service area
funded by the federal, state or
a
local government or by
private
grants
,

that provide primary care
,
mental health
or
substance abuse services
;

(I
V
)

The unmet needs of
persons

of low income
in the service area;

(V)

Primary care
,
mental health or substance abuse s
ervices provided by local health care providers
in the service are
a

that receive no
compensation from the government
or other programs or insurers
.

(
C
)

Consider
methods
for
:

(I)

C
oordinat
ing

primary
care
,
mental health and substance abuse
services to
persons

of low income
in the service area
;

(II)

Measuring the desired outcomes of improved access to primary care
,
mental health and substance abuse services and reduced
costs of
uncompensated care
for
hospitals
in the service area;

(I
II
)

R
eceiv
ing
other grants or funding
from federal, state or local government or private sources to provide
improved access to primary care
,
mental health
and
substance abuse services
to
persons

of low income
in the service area
.

(D)

Explain how any grant awarded under this section will improve access to primary care
,
mental health and substance abuse services and reduce
the costs of
uncompensated care
for
hospitals
in the service area
.

(
d
)

A grant recipient under this section shall agree to provide primary care
,
mental health and substance abuse services
to

persons

of low income
in the service area for a period of two (2) years. The grant recipient shall, prior to the end of the grant period, report to the department
the following information
applicable to the entire
grant period:

(i
)

The type and amount of
uncompensated
service
s
provided to
persons
in the service area;

(ii)

The cost, as calculated by the federal government's most recent Medicare cost report, to any hospital
in
the service area
to provide the services
reported pursuant to
paragraph (
i
) of this
subsection
;

(i
ii
)

The outcomes of the grant award, including the effect on access to primary care
,
mental health and substance abuse services
to
persons

of low income
in the service area
and
any
reduction
in
the costs of uncompensated care
for
hospitals in the service area.

(e)

A grant recipient under this section may, after the initial grant period, reapply for a grant provided that the grant recipient
can demonstrate
an improvement in access to primary care
,
mental health
or
substance abuse services to
persons

of low income
in the service area and a
reduction in costs of uncompensated care
for
hospitals in the service area. A grant recipient unable to show the improvement and reduction required under this subsection may reapply for a grant provided that the grant recipient submit to the department a revised operating plan
containing provisions designed to improve
the results of the prior grant award. Applications under this subsection shall include evidence of a commitment of
monies or other forms of contributions that public or private entities will provide in matching funds. This match shall be in an amount of not less than twenty
‑
five percent (25%) of the grant amount
and may be
reduced

by
the amount
of any reduction in
the costs of uncompensated care
to
any hospitals in the service
in
the initial grant period. Application
procedures
under this subsection may be revised by the department as necessary.

(
f
)

The department shall
:

(i)

Establish by rule an application procedure and calendar for grants awarded under this section and adopt other rules as necessary to implement this section;

(i
i)

Define in rule the term "uncompensated care" as it applies to this section. The department shall use the definition of uncompensated care used by the federal government in preparing the Medicare cost report;

(iii)

Establish criteria for matching funds as required under this section;

(
iv
)

C
ollect
and maintain appropriate data regarding the
effect of the department's process under this section to:

(A)

Improve

access to
primary care
,
mental health and substance abuse services
for
persons

of low income
;
and

(B)

R
educ
e

the costs of
uncompensated care

for
hospitals in the state
.

(
v
)

On or before
October 31 of each year, r
eport to the
joint labor, health and social services interim
committee
and the
joint appropriations interim committee
. The report shall include a list of all grant requests made in the previous
twelve

(
12
)
months, the grants awarded and the progress of
improving access to primary care
,
mental health and substance abuse services
to
persons

of low income
in
each
service area
and reducing
the costs of
uncompensated care

for
hospitals
in the state
as of the date of the report.

(g)

As used in this section
:

(i)

"Hospital" means a hospital licensed in Wyoming pursuant to W.S. 35
‑
2
‑
901 through 35
‑
2
‑
911;

(ii)

"Persons of low income" means
persons whose income is less than one hundred percent (100%) of the federal poverty level;

(iii)

"
S
ervice area" means the geographic area to be serviced using the grant funds awarded under this section, which may include all or a portion of a county or may cover several counties.

Section
2
.

There is appropriated five hundred thousand dollars ($500,000.00) from the general fund to the
health

care access improvement account
created by this act
.

This appropriation shall be for the period beginning with the effective date of this act and ending June 30, 2018.
This appropriation shall only be expended for the purpose of
making grant awards pursuant to this act
.

Notwithstanding any other provision of law, this appropriation shall not be transferred or expended for any other purpose. Any unexpended monies in the account shall revert
as provided by law on June 30, 2018. This appropriation shall be included in the department's 201
9
‑
20
20
standard biennial budget request.

Section
3
.

This
act is effective
immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

1
HB0116