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S.B. 75


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House Floor Amendments 3-12-2014 le/sj
This document includes Senate 2nd and 3rd Reading Floor Amendments incorporated into the bill on Fri, Mar 7, 2014 at 2:59 PM by bhansen. --> This document includes House Floor Amendments incorporated into the bill on Wed, Mar 12, 2014 at 8:21 PM by lerror. -->              1
    
PRIMARY CARE GRANTS AMENDMENTS

             2     
2014 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Allen M. Christensen

             5     
House Sponsor: Michael S. Kennedy

             6     

             7      LONG TITLE
             8      General Description:
             9          This bill amends provisions of the Utah Health Code related to primary care grants.
             10      Highlighted Provisions:
             11          This bill:
             12          .    creates the Primary Care Grant Committee;
             13          .    directs the committee to evaluate applications for primary care grants and make
             14      recommendations to the department;
             15          .    directs the department to review and rank applications for primary care grants;
             16          .    allows the department to use up to 5% of funds appropriated by the Legislature for
             17      primary care grants to pay the department's costs to administer the primary care
             18      grant program;
             19          .    recodifies provisions related to community outreach and education contracts;
             20          .    adds the primary care grant program to the list of programs with nonlapsing funds;
             21      and
             22          .    makes technical and conforming amendments.
             23      Money Appropriated in this Bill:
             24          This bill appropriates in fiscal year 2014-15:
             25          .    to the Department of Health - Primary Care Grants as H. [ an ongoing ] a one-time .H
             25a      appropriation:
             26              .    from General Fund, $2,000,000.
             27      Other Special Clauses:



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             28
         None
             29      Utah Code Sections Affected:
             30      AMENDS:
             31          26-1-7, as last amended by Laws of Utah 2003, Chapter 246
             32          26-10b-101, as renumbered and amended by Laws of Utah 2010, Chapter 340
             33          26-10b-102, as last amended by Laws of Utah 2012, Chapter 347
             34          26-10b-103, as renumbered and amended by Laws of Utah 2010, Chapter 340
             35          26-10b-104, as renumbered and amended by Laws of Utah 2010, Chapter 340
             36          63J-1-602.1, as last amended by Laws of Utah 2013, Chapter 394
             37      ENACTS:
             38          26-10b-106, Utah Code Annotated 1953
             39          26-10b-107, Utah Code Annotated 1953
             40     

             41      Be it enacted by the Legislature of the state of Utah:
             42          Section 1. Section 26-1-7 is amended to read:
             43           26-1-7. Committees within department.
             44          (1) There are created within the department the following committees:
             45          (a) Health Facility Committee;
             46          (b) State Emergency Medical Services Committee;
             47          (c) Health Data Committee; [and]
             48          (d) Utah Health Care Workforce Financial Assistance Program Advisory Committee[.];
             49      and
             50          (e) Primary Care Grant Committee.
             51          (2) The department shall:
             52          (a) review all committees and advisory groups in existence before July 1, 2003 that are
             53      not listed in Subsection (1) or Section 26-1-7.5 , and not required by state or federal law; and
             54          (b) beginning no later than July 1, 2003:
             55          (i) consolidate those advisory groups and committees with other committees or
             56      advisory groups as appropriate to create greater efficiencies and budgetary savings for the
             57      department; and
             58          (ii) create in writing, time-limited and subject-limited duties for the advisory groups or



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             59
     committees as necessary to carry out the responsibilities of the department.
             60          Section 2. Section 26-10b-101 is amended to read:
             61           26-10b-101. Definitions.
             62          As used in this [part] chapter:
             63          (1) "Committee" means the Primary Care Grant Committee created in Section 26-1-7
             64      and described in Section 26-10b-105 .
             65          [(1)] (2) "Community based organization":
             66          (a) means a private entity; and
             67          (b) includes for profit and not for profit entities.
             68          [(2)] (3) "Cultural competence" means a set of congruent behaviors, attitudes, and
             69      policies that come together in a system, agency, or profession and enables that system, agency,
             70      or profession to work effectively in cross-cultural situations.
             71          (4) "Executive director" means the executive director of the department.
             72          [(3)] (5) "Health literacy" means the degree to which an individual has the capacity to
             73      obtain, process, and understand health information and services needed to make appropriate
             74      health decisions.
             75          [(4)] (6) "Institutional capacity" means the ability of a community based organization
             76      to implement public and private contracts.
             77          [(5)] (7) "Medically underserved population" means the population of an urban or rural
             78      area or a population group [designated by the department as having] that the committee
             79      determines has a shortage of primary health care [services].
             80          (8) "Primary care grant" means a grant awarded by the department under Subsection
             81      26-10b-102 (1).
             82          [(6)] (9) (a) "Primary health care" means:
             83          [(a)] (i) basic and general health care services given when a person seeks assistance to
             84      screen for or to prevent illness and disease, or for simple and common illnesses and injuries;
             85      and
             86          [(b)] (ii) care given for the management of chronic diseases.
             87          [(7)] (b) "Primary health care" [services" include] includes:
             88          [(a)] (i) services of physicians, nurses, physician's assistants, and dentists licensed to
             89      practice in this state under Title 58, Occupations and Professions;



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             90
         [(b)] (ii) diagnostic and radiologic services;
             91          [(c)] (iii) preventive health services including perinatal services, well-child services,
             92      and other services that seek to prevent disease or its consequences;
             93          [(d)] (iv) emergency medical services;
             94          [(e)] (v) preventive dental services; and
             95          [(f)] (vi) pharmaceutical services.
             96          (10) "Program" means the primary care grant program created under this chapter.
             97          Section 3. Section 26-10b-102 is amended to read:
             98           26-10b-102. Department to award grants -- Applications.
             99          (1) [(a)] Within appropriations specified by the Legislature for this purpose, the
             100      department may [make grants to public and nonprofit entities for the cost of operation of
             101      providing], in accordance with the recommendation of the committee, award a grant to a public
             102      or nonprofit entity to provide primary health care [services] to a medically underserved
             103      [populations] population.
             104          [(b) The department may, as funding permits, contract with community based
             105      organizations for the purpose of developing culturally and linguistically appropriate programs
             106      and services for low income and medically underserved populations through a pilot program to
             107      accomplish one or more of the following:]
             108          [(i) to educate individuals:]
             109          [(A) to use private and public health care coverage programs, products, services, and
             110      resources in a timely, effective, and responsible manner;]
             111          [(B) to make prudent use of private and public health care resources;]
             112          [(C) to pursue preventive health care, health screenings, and disease management; and]
             113          [(D) to locate health care programs and services;]
             114          [(ii) to assist individuals to develop:]
             115          [(A) personal health management;]
             116          [(B) self-sufficiency in daily care; and]
             117          [(C) life and disease management skills;]
             118          [(iii) to support translation of health materials and information;]
             119          [(iv) to facilitate an individual's access to primary care services and providers,
             120      including mental health services; and]



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             121
         [(v) to measure and report empirical results of the pilot project.]
             122          [(2) (a) Grants by the department shall be awarded based on:]
             123          (2) When awarding a grant under Subsection (1), the department shall, in accordance
             124      with the committee's recommendation, consider:
             125          [(i) applications] (a) the content of a grant application submitted to the department;
             126          (b) whether an application is submitted in the manner and form prescribed by the
             127      department; and
             128          [(ii)] (c) the criteria established in Section 26-10b-103 .
             129          [(b)] (3) The application for a grant under Subsection (2)(a) shall contain:
             130          [(i)] (a) a requested award amount;
             131          [(ii)] (b) a budget; and
             132          [(iii)] (c) a narrative plan of the manner in which the applicant intends to provide the
             133      primary health care [services] described in Subsection [ 26-10b-101 (7)] (1).
             134          [(c) A contract bid for a service under Subsection (1)(b):]
             135          [(i) shall be awarded in accordance with Title 63G, Chapter 6a, Utah Procurement
             136      Code;]
             137          [(ii) shall include the information described in Section 26-10b-103 ; and]
             138          [(iii) is subject to Subsection (3).]
             139          [(3) (a) An applicant under this chapter shall demonstrate to the department that the
             140      applicant will not deny services to a person because of the person's inability to pay for the
             141      services.]
             142          [(b) Subsection (3)(a) does not preclude an applicant from seeking payment from the
             143      person receiving services, a third party, or a government agency if:]
             144          [(i) the applicant is authorized to charge for the services; and]
             145          [(ii) the person, third party, or government agency is under legal obligation to pay the
             146      charges.]
             147          [(4) The department shall maximize the use of federal matching funds received for
             148      services under Subsection (1)(b) to fund additional contracts under Subsection (1)(b).]
             149          Section 4. Section 26-10b-103 is amended to read:
             150           26-10b-103. Content of grant applications.
             151          [Applications for grants] An applicant for a grant under this chapter shall include, in an



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             152
     application:
             153          (1) a statement of specific, measurable objectives, and the methods [to be used] the
             154      applicant will use to assess the achievement of those objectives;
             155          (2) the precise boundaries of the area [to be served by the entity making the
             156      application] the applicant will serve, including a description of the medically underserved
             157      population [to be served by] the applicant will serve using the grant;
             158          (3) the results of [an assessment of need demonstrating] a need assessment that
             159      demonstrates that the population [to be served] the applicant will serve has a need for the
             160      services provided by the applicant;
             161          (4) a description of the personnel responsible for carrying out the activities of the grant
             162      along with a statement justifying the use of any grant funds for the personnel;
             163          [(5) letters and other forms of evidence showing that efforts have been made to secure
             164      financial and professional assistance and support for the services to be provided under the
             165      grant;]
             166          (5) evidence that demonstrates the applicant's existing financial and professional
             167      assistance and any attempts by the applicant to obtain financial and professional assistance;
             168          (6) a list of services [to be provided by] the applicant will provide;
             169          (7) the schedule of fees [to be charged by], if any, the applicant will charge;
             170          (8) the estimated number of [medically underserved persons to be served] individuals
             171      the applicant will serve with the grant award; and
             172          (9) [other provisions as determined] any other information required by the department
             173      in consultation with the committee.
             174          Section 5. Section 26-10b-104 is amended to read:
             175           26-10b-104. Process and criteria for awarding primary care grants.
             176          (1) The department shall review and rank applications based on the criteria in this
             177      section and transmit the applications to the committee for review.
             178          (2) The committee shall, after reviewing the applications transferred to the committee
             179      under Subsection (1), make recommendations to the executive director.
             180          (3) The executive director shall, in accordance with the committee's recommendations,
             181      decide which applications to award grants under Subsection 26-10b-102 (1).
             182          [(1)] (4) The department shall establish rules in accordance with Title 63G, Chapter 3,



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             183
     Utah Administrative Rulemaking Act, governing the application form, the process, and the
             184      criteria [it] the department will use in [awarding] reviewing, ranking, and awarding grants and
             185      contracts under this chapter.
             186          [(2)] (5) When reviewing, ranking, and awarding a primary care grant under Subsection
             187      26-10b-102 (1)[(a)], the department shall consider the extent to which [the] an applicant:
             188          (a) demonstrates that the area or a population group [to be served] the applicant will
             189      serve under the application has a shortage of primary health care and that the [services] primary
             190      health care will be located so that [they will provide] it provides assistance to the greatest
             191      number of [persons residing in the area or included] individuals in the population group;
             192          (b) utilizes other sources of funding, including private funding, to provide primary
             193      health care;
             194          (c) demonstrates the ability and expertise to serve [traditionally] a medically
             195      underserved [populations] population; [including persons of limited English-speaking ability,
             196      single heads of households, the elderly, persons with low incomes, and persons with chronic
             197      diseases;]
             198          [(d) demonstrates that it will assume financial risk for a specified number of medically
             199      underserved persons within its catchment area for a predetermined level of care on a prepaid
             200      capitation basis; and]
             201          (d) agrees to submit a report to the committee annually; and
             202          (e) meets other criteria determined by the department in consultation with the
             203      committee.
             204          [(3) When awarding a contract for community based services under Subsection
             205      26-10b-102 (1)(b), the department shall:]
             206          [(a) consider the extent to which the applicant:]
             207          [(i) demonstrates that the area or a population group to be served under the application
             208      is a medically underserved area or population and that the services will be located so that they
             209      will provide assistance to the greatest number of persons residing in the area or included in the
             210      population group;]
             211          [(ii) utilizes other sources of funding, including private funding, to provide the services
             212      described in Subsection 26-10b-102 (1)(b);]
             213          [(iii) demonstrates the ability and expertise to serve traditionally medically underserved



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             214
     populations including persons of limited English-speaking ability, single heads of households,
             215      the elderly, persons with low incomes, and persons with chronic diseases;]
             216          [(iv) meets other criteria determined by the department; and]
             217          [(v) demonstrates the ability to empirically measure and report the results of all
             218      contract supported activities;]
             219          [(b) consider the extent to which the contract increases the applicant's institutional
             220      capacity;]
             221          [(c) consult with the state's:]
             222          [(i) Medicaid program;]
             223          [(ii) Children's Health Insurance Program; and]
             224          [(iii) other assistance programs within the Department of Workforce Services and the
             225      Department of Human Services; and]
             226          [(d) as funding permits, implement the community based service contract as a pilot
             227      program for which the department shall enter into contracts for services as follows:]
             228          [(i) two contracts in the amount of $50,000 each to be awarded to experienced and
             229      established applicants; and]
             230          [(ii) three contracts in the amount of $30,000 each to be awarded to applicants that:]
             231          [(A) are not as established or experienced as the applicants under Subsection (3)(d)(i);
             232      or]
             233          [(B) represent smaller community based approaches than the applicants described in
             234      Subsection (3)(d)(i).]
             235          [(4) Once a contract has been awarded under Subsection (3), the department shall
             236      provide technical assistance to the contractee to familiarize the contractee with public and
             237      private resources available to support wellness, health promotion, and disease management.]
             238          (6) The department may use up to 5% of the funds appropriated by the Legislature to
             239      the primary care grant program under this chapter to pay the costs of administering the
             240      program.
             241          Section 6. Section 26-10b-106 is enacted to read:
             242          26-10b-106. Primary Care Grant Committee.
             243          (1) The Primary Care Grant Committee created in Section 26-1-7 shall:
             244          (a) review grant applications forwarded to the committee by the department under



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Senate 2nd & 3rd Reading Amendments 3-7-2014 bh/sj
             245
     Subsection 26-10b-104 (1);
             246          (b) recommend, to the S. executive .S director, grant applications to award under
             246a      Subsection
             247      26-10b-102 (1);
             248          (c) evaluate:
             249          (i) the need for primary health care in different areas of the state;
             250          (ii) how the program is addressing those needs; and
             251          (iii) the overall effectiveness and efficiency of the program;
             252          (d) review annual reports from primary care grant recipients;
             253          (e) meet as necessary to carry out its duties, or upon a call by the committee chair or by
             254      a majority of committee members; and
             255          (f) make rules, in accordance with Title 63G, Chapter 3, Utah Administrative
             256      Rulemaking Act, that govern the committee, including the committee's grant selection criteria.
             257          (2) The committee shall consist of:
             258          (a) as chair, the S. executive .S director or an individual designated by the S.
             258a      executive .S director; and
             259          (b) six members appointed by the governor to serve up to two consecutive, two-year
             260      terms of office, including:
             261          (i) four licensed health care professionals; and
             262          (ii) two community advocates who are familiar with a medically underserved
             263      population and with health care systems, where at least one is familiar with a rural medically
             264      underserved population.
             265          (3) The S. executive .S director may remove a committee member:
             266          (a) if the member is unable or unwilling to carry out the member's assigned
             267      responsibilities; or
             268          (b) for a rational reason.
             269          (4) A committee member may not be compensated for the member's service, except a
             270      committee member may be reimbursed for reasonable travel expenses related to the member's
             271      committee responsibilities.
             272          Section 7. Section 26-10b-107 is enacted to read:
             273          26-10b-107. Community education and outreach contracts.
             274          (1) The department may, as funding permits, contract with community based
             275      organizations for the purpose of developing culturally and linguistically appropriate programs



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             276
     and services for low income and medically underserved populations to accomplish one or more
             277      of the following:
             278          (a) to educate individuals:
             279          (i) to use private and public health care coverage programs, products, services, and
             280      resources in a timely, effective, and responsible manner;
             281          (ii) to pursue preventive health care, health screenings, and disease management; and
             282          (iii) to locate health care programs and services;
             283          (b) to assist individuals to develop:
             284          (i) personal health management;
             285          (ii) self-sufficiency in daily care; and
             286          (iii) life and disease management skills;
             287          (c) to support translation of health materials and information;
             288          (d) to facilitate an individual's access to primary care and providers, including mental
             289      health services; and
             290          (e) to measure and report empirical results of the pilot project.
             291          (2) When awarding a contract for community based services under Subsection (1), the
             292      department shall consider the extent to which the applicant:
             293          (a) demonstrates that the area or a population group to be served under the application
             294      is a medically underserved population and that the services will be located to provide
             295      assistance to the greatest number of individuals residing in the area or included in the
             296      population group;
             297          (b) utilizes other sources of funding, including private funding, to provide the services
             298      described in Subsection (1);
             299          (c) demonstrates the ability and expertise to serve medically underserved populations,
             300      including individuals with limited English-speaking ability, single heads of households, the
             301      elderly, individuals with low income, and individuals with a chronic disease;
             302          (d) meets other criteria determined by the department; and
             303          (e) demonstrates the ability to empirically measure and report the results of all contract
             304      supported activities.
             305          (3) The department may only award a contract under Subsection (1):
             306          (a) in accordance with Title 63G, Chapter 6a, Utah Procurement Code;



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             307
         (b) that contains the information described in Section 26-10b-103 , relating to grants;
             308      and
             309          (c) that complies with Subsections (4) and (5).
             310          (4) An applicant under this chapter shall demonstrate to the department that the
             311      applicant will not deny services to a person because of the person's inability to pay for the
             312      services.
             313          (5) Subsection (4) does not preclude an applicant from seeking payment from the
             314      person receiving services, a third party, or a government agency if:
             315          (a) the applicant is authorized to charge for the services; and
             316          (b) the person, third party, or government agency is under legal obligation to pay for
             317      the services.
             318          (6) The department shall maximize the use of federal matching funds received for
             319      services under Subsection (1) to fund additional contracts under Subsection (1).
             320          Section 8. Section 63J-1-602.1 is amended to read:
             321           63J-1-602.1. List of nonlapsing accounts and funds -- General authority and Title
             322      1 through Title 30.
             323          (1) Appropriations made to the Legislature and its committees.
             324          (2) The Percent-for-Art Program created in Section 9-6-404 .
             325          (3) The Martin Luther King, Jr. Civil Rights Support Restricted Account created in
             326      Section 9-18-102 .
             327          (4) The LeRay McAllister Critical Land Conservation Program created in Section
             328      11-38-301 .
             329          (5) An appropriation made to the Division of Wildlife Resources for the appraisal and
             330      purchase of lands under the Pelican Management Act, as provided in Section 23-21a-6 .
             331          (6) Award money under the State Asset Forfeiture Grant Program, as provided under
             332      Section 24-4-117 .
             333          (7) Funds collected from the emergency medical services grant program, as provided in
             334      Section 26-8a-207 .
             335          (8) The Prostate Cancer Support Restricted Account created in Section 26-21a-303 .
             336          (9) State funds appropriated for matching federal funds in the Children's Health
             337      Insurance Program as provided in Section 26-40-108 .



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House Floor Amendments 3-12-2014 le/sj
             338
         (10) The Utah Health Care Workforce Financial Assistance Program created in Section
             339      26-46-102 .
             340          (11) The primary care grant program created in Section 26-10b-102 .
             341          Section 9. Appropriation.
             342          Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, for
             343      the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following sums of money
             344      are appropriated from resources not otherwise appropriated, or reduced from amounts
             345      previously appropriated, out of the funds or accounts indicated. These sums of money are in
             346      addition to any amounts previously appropriated for fiscal year 2015.
             347          To Department of Health - Primary Care Grants
             348              From General Fund H. , One-time .H
$2,000,000

             349              Schedule of Programs:
             350                  Primary Care Grants                $2,000,000





Legislative Review Note
    as of 2-21-14 5:46 PM


Office of Legislative Research and General Counsel


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