February 26, 2003





HOUSE BILL No. 2009

_____


DIGEST OF HB 2009 (Updated February 25, 2003 3:28 PM - DI 51)



Citations Affected: IC 4-12; IC 6-7; IC 20-12; IC 25-22.5; noncode.

Synopsis: Health program funding. Makes appropriations from the tobacco master settlement agreement fund for various health programs and commissions. Eliminates the spending caps applicable to the tobacco master settlement agreement fund. Appropriates money from the state general fund for developmentally disabled client services and the local health maintenance fund. Provides for a waiver to increase the income ceiling for eligibility for the Hoosier Rx program from 135% to 185% of the federal poverty guideline. Establishes a health professions scholarship fund.

Effective: July 1, 2003.





Crawford , Brown C




    January 23, 2003, read first time and referred to Committee on Rules and Legislative Procedures.
    February 20, 2003, reassigned to Committee on Ways and Means.
    February 25, 2003, amended, reported _ Do Pass.






February 26, 2003

First Regular Session 113th General Assembly (2003)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts between statutes enacted by the 2002 Regular or Special Session of the General Assembly.

HOUSE BILL No. 2009



    A BILL FOR AN ACT to amend the Indiana Code concerning health and to make an appropriation.

Be it enacted by the General Assembly of the State of Indiana:

    SECTION 1. IC 4-12-1-14.3, AS AMENDED BY P.L.291-2001, SECTION 52, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 14.3. (a) As used in this section, "master settlement agreement" has the meaning set forth in IC 24-3-3-6.
    (b) There is hereby created the Indiana tobacco master settlement agreement fund for the purpose of depositing and distributing money received under the master settlement agreement. The fund consists of:
        (1) all money received by the state under the master settlement agreement;
        (2) appropriations made to the fund by the general assembly; and
        (3) grants, gifts, and donations intended for deposit in the fund.
    (c) Money may be expended, transferred, or distributed from the fund during a state fiscal year only in amounts permitted by subsections (d) through (e), and only if the expenditures, transfers, or distributions are specifically authorized by another statute.
    (d) The maximum amount of expenditures, transfers, or distributions that may be made from the fund during the state fiscal year beginning

July 1, 2000, is determined under STEP THREE of the following formula:
        STEP ONE: Determine the sum of money received or to be received by the state under the master settlement agreement before July 1, 2001.
        STEP TWO: Subtract from the STEP ONE sum the amount appropriated by P.L.273-1999, SECTION 8, to the children's health insurance program from funds accruing to the state from the tobacco settlement for the state fiscal years beginning July 1, 1999, and July 1, 2000.
        STEP THREE: Multiply the STEP TWO remainder by fifty percent (50%).
    (e) The maximum amount of expenditures, transfers, or distributions that may be made from the fund during the state fiscal year beginning July 1, 2001, and each state fiscal year after that is determined under STEP THREE of the following formula:
        STEP ONE: Determine the amount of money received or to be received by the state under the master settlement agreement during that state fiscal year.
        STEP TWO: Multiply the STEP ONE amount by sixty percent (60%).
        STEP THREE: Add to the STEP TWO product any amounts that were available for expenditure, transfer, or distribution under this subsection or subsection (d) during preceding state fiscal years but that were not expended, transferred, or distributed.
    (f) The following amounts shall be retained in the fund and may not be expended, transferred, or otherwise distributed from the fund:
        (1) All of the money that is received by the state under the master settlement agreement and remains in the fund after the expenditures, transfers, or distributions permitted under subsections (c) through (e).
        (2) All interest that accrues from investment of money in the fund, unless specifically appropriated by the general assembly. Interest that is appropriated from the fund by the general assembly may not be considered in determining the maximum amount of expenditures, transfers, or distributions under subsection (e).
    (g) (c) The fund shall be administered by the budget agency. Notwithstanding IC 5-13, the treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as money is invested by the public employees retirement fund under IC 5-10.3-5. The treasurer of state may contract with investment management professionals, investment advisors, and

legal counsel to assist in the investment of the fund and may pay the state expenses incurred under those contracts from the fund. Interest that accrues from these investments shall be deposited in the fund. Money in the fund at the end of the state fiscal year does not revert to the state general fund.
    (h) (d) The state general fund is not liable for payment of a shortfall in expenditures, transfers, or distributions from the Indiana tobacco master settlement agreement fund or any other fund due to a delay, reduction, or cancellation of payments scheduled to be received by the state under the master settlement agreement or for any other reason. Unless otherwise provided by statute, if such a shortfall occurs in any state fiscal year, the budget agency shall make the full transfer to the regional health facilities construction account and then reduce all remaining expenditures, transfers, and distributions affected by the shortfall shall be reduced proportionately.
    SECTION 2. IC 4-12-8.5-3, AS ADDED BY P.L.291-2001, SECTION 72, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 3. (a) The regional health care construction account is established for the purpose of providing funding for state psychiatric hospitals and developmental centers, regional health centers, or other health facilities designed to provide crisis treatment, rehabilitation, or intervention for adults or children with mental illness, developmental disabilities, addictions, or other medical or rehabilitative needs. The account consists of:
        (1) amounts, if any, that any statute requires to be distributed to the account from the Indiana tobacco master settlement agreement fund;
        (2) appropriations to the account from other sources; and
        (3) grants, gifts, and donations intended for deposit in the account.
    (b) Fourteen million dollars ($14,000,000) shall be transferred during state fiscal years 2001-2002 and 2002-2003 from the Indiana tobacco master settlement fund to the account.
    (c) (b) The budget agency shall administer the account. Money in the account at the end of a state fiscal year does not revert to the state general fund but remains available for expenditure.
    (d) (c) Money in the account may be used for:
        (1) the construction, equipping, renovation, demolition, refurbishing, or alteration of existing or new state hospitals, regional health centers, or other health facilities; or
        (2) lease rentals to the state office building commission or other public or private providers of such facilities.


    (e) (d) Money in the account shall be used to pay any outstanding lease rentals before making any other payments from the account.
    (f) (e) Money in the account is annually appropriated for the purposes described in this chapter.
    SECTION 3. IC 6-7-1-30.5 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 30.5. (a) There is annually appropriated to the local health maintenance fund established by IC 16-46-10 two million three hundred seventy thousand dollars ($2,370,000) two million four hundred thirty thousand dollars ($2,430,000) from the state general fund to provide funds for annual distribution to local boards of health in accordance with IC 16-46-10-2 to enable local boards of health to provide basic health services.
    (b) The state department of health may retain annually a maximum of fifty thousand dollars ($50,000) of the total appropriation to the local health maintenance fund under subsection (a) to pay administrative expenses incurred by the state department of health in distributing the funds to local health departments.
    SECTION 4. IC 20-12-21.9-5 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 5. (a) The commission shall administer the fund.
    (b) The expenses of administering the fund shall be paid from money in the fund.
    (c) The treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as other public funds. Interest that accrues from those investments shall be deposited in the fund.
    (d) Money in the fund at the end of a fiscal year does not revert to the state general fund or the Indiana tobacco master settlement agreement fund.
    SECTION 5. IC 20-12-22.2 IS ADDED TO THE INDIANA CODE AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]:
     Chapter 22.2. Health Professions Scholarship Fund
    Sec. 1. As used in this chapter, "approved institution of higher learning" has the meaning set forth in IC 20-12-21-3.
    Sec. 2. As used in this chapter, "commission" refers to the state student assistance commission established by IC 20-12-21-4.
    Sec. 3. As used in this chapter, "fund" refers to the health professions scholarship fund.
    Sec. 4. (a) The health professions scholarship fund is established to encourage and promote qualified individuals to pursue careers in health professions in Indiana.
    (b) The fund consists of the following:
        (1) Appropriations by the general assembly.
        (2) Gifts to the fund.
    Sec. 5. (a) The commission shall administer the fund.
    (b) The expenses of administering the fund shall be paid from money in the fund.
    (c) The treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as other public funds may be invested. Interest that accrues from those investments shall be deposited in the fund.
    (d) Money in the fund at the end of a fiscal year does not revert to the state general fund or the Indiana tobacco master settlement agreement fund.
    Sec. 6. (a) The money in the fund shall be used to provide annual scholarships to:
        (1) students in programs leading to degrees that will enable the students to qualify for licensing in health professions governed by the:
            (A) board of environmental health specialists (IC 25-32);
            (B) speech-language pathology and audiology board (IC 25-35.6-2);
            (C) Indiana physical therapy committee (IC 25-27);
            (D) respiratory care committee (IC 25-34.5);
            (E) occupational therapy committee (IC 25-23.5);
            (F) physician assistant committee (IC 25-27.5); and
            (G) Indiana dietitians certification board (IC 25-14.5-2-1); and
        (2) students in training programs identified by the medical licensing board by rule adopted under IC 25-22.5-2-7 as training programs for nonlicensed allied health care professions.
    (b) Scholarships shall be awarded under this section to students who qualify by demonstrating a financial need and meeting the requirements listed under section 8 of this chapter in an amount that is equal to the lesser of the following amounts:
        (1) The balance of the student's total cost of tuition or fees in attending the eligible institution for the academic year.
        (2) Five thousand dollars ($5,000).
    (c) A scholarship awarded under this section may be used only for the payment of tuition or fees that are:
        (1) approved by the approved institution of higher learning that awards the scholarship; and
        (2) not otherwise payable under any other scholarship or form of financial assistance specifically designated for tuition or fees.
    (d) Subject to section 7(c) of this chapter, each scholarship awarded under this section is renewable under section 8(b) of this chapter for a total number of terms that does not exceed eight (8) full-time (or part-time equivalent) semesters or twelve (12) full-time (or part-time equivalent) quarters.
    Sec. 7. (a) The commission for higher education shall provide the commission with the most recent information concerning the number of students enrolled in programs described in section 6 of this chapter at each eligible institution.
    (b) The commission shall allocate the available money from the fund to each approved institution of higher learning that has a program for persons training for health professions designated in section 6 of this chapter in proportion to the number of students enrolled in courses for health professions designated in section 6 of this chapter at each eligible institution based upon the information received by the commission under subsection (a).
    (c) Each approved institution of higher learning shall determine the scholarship recipients under this chapter based upon the criteria set forth in section 8 of this chapter and the rules adopted by the commission under section 10 of this chapter. In addition, the approved institution of higher learning shall consider the need of the applicant when awarding scholarships under this chapter.
    (d) The approved institution of higher learning may not grant a scholarship renewal to a student for an academic year that ends later than six (6) years after the date the student received the initial scholarship under this chapter.
    (e) Any funds that:
        (1) are allocated to an approved institution of higher learning; and
        (2) are not used for scholarships under this chapter;
shall be returned to the commission for reallocation by the commission to any other eligible institution in need of additional funds.
    Sec. 8. (a) To qualify initially for a scholarship from the fund, a student must:
        (1) be admitted to an approved institution of higher learning as a full-time or part-time student in one (1) of the areas designated in section 6(a) of this chapter;
        (2) agree, in writing, to work in a health profession described

in section 6(a) of this chapter in any type of health care setting in Indiana for at least two (2) years following graduation;
        (3) meet any other minimum criteria established by the commission; and
        (4) demonstrate a financial need for the scholarship.
    (b) To qualify for a scholarship renewal from the fund, a health professions student must:
        (1) comply with the criteria set forth in subsection (a);
        (2) maintain at least the cumulative grade point average:
            (A) that is required by an approved institution of higher learning for admission to the approved institution of higher learning; or
            (B) equivalent to 2.0 on a 4.0 grading scale, as established by the approved institution of higher learning, if the institution's program for health professions described in section 6 of this chapter does not require a certain minimum cumulative grade point average; and
        (3) demonstrate a continuing financial need for the scholarship.
    Sec. 9. (a) The commission shall maintain complete and accurate records in implementing the program, including the following:
        (1) Scholarships awarded under this chapter.
        (2) The number of individuals who fulfilled the agreement described under section 8(a)(2) of this chapter.
        (3) The number of individuals who did not fulfill the agreement described under section 8(a)(2) of this chapter.
    (b) Each eligible institution shall provide the commission with information concerning the following:
        (1) The awarding of scholarships under this chapter.
        (2) The academic progress made by each recipient of a scholarship under this chapter.
        (3) Other pertinent information requested by the commission.
    Sec. 10. The commission shall adopt rules under IC 4-22-2 necessary to carry out this chapter, including rules governing the enforcement of the agreements under section 8(a)(2) of this chapter.

    SECTION 6. IC 25-22.5-2-7 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 7. The board shall do the following:
        (1) Adopt rules and forms necessary to implement this article that concern, but are not limited to, the following areas:
            (A) Qualification by education, residence, citizenship,

training, and character for admission to an examination for licensure or by endorsement for licensure.
            (B) The examination for licensure.
            (C) The license or permit.
            (D) Fees for examination, permit, licensure, and registration.
            (E) Reinstatement of licenses and permits.
            (F) Payment of costs in disciplinary proceedings conducted by the board.
        (2) Administer oaths in matters relating to the discharge of its official duties.
        (3) Enforce this article and assign service bureau personnel duties as may be necessary in the discharge of the board's duty.
        (4) Maintain, through the service bureau, full and complete records of all applicants for licensure or permit and of all licenses and permits issued.
        (5) Make available, upon request, the complete schedule of minimum requirements for licensure or permit.
        (6) Issue, at the board's discretion, a temporary permit to an applicant for the interim from the date of application until the next regular meeting of the board.
        (7) Issue an unlimited license, a limited license, or a temporary medical permit, depending upon the qualifications of the applicant, to any applicant who successfully fulfills all of the requirements of this article.
        (8) Adopt rules establishing standards for the competent practice of medicine, osteopathic medicine, or any other form of practice regulated by a limited license or permit issued under this article.
        (9) Adopt rules regarding the appropriate prescribing of Schedule III or Schedule IV controlled substances for the purpose of weight reduction or to control obesity.
         (10) Adopt rules identifying training programs for nonlicensed allied health care professions that qualify for annual scholarships under IC 20-12-22.2.
    SECTION 7. [EFFECTIVE JULY 1, 2003] (a) The definitions set forth in HEA 1001-2003, SECTION 1, apply throughout this SECTION.
    (b) The following sums are appropriated for the periods designated from the Indiana tobacco master settlement agreement fund (IC 4-12-1-14.3):
                            FY 2003-FY 2004    2004-2005
    FOR THE INDIANA HEALTH CARE ADVISORY BOARD
        Children's Health Insurance Program


        Total Operating
        Expense    23,800,000    26,200,000
    FOR THE TOBACCO USE PREVENTION AND
    CESSATION BOARD
        TOBACCO USE PREVENTION AND CESSATION
        PROGRAM
        Total Operating
        Expense    32,000,000    32,000,000
    FOR THE STATE BUDGET AGENCY
        INDIANA PRESCRIPTION DRUG PROGRAM
        Total Operating
        Expense    8,000,000    8,000,000
        With the approval of the governor and the budget agency, the above appropriations for the Indiana prescription drug program may be augmented for each fiscal year from the Indiana tobacco master settlement agreement fund to an amount not to exceed in total, together with the above specific amounts, $20,000,000.
    FOR THE STATE DEPARTMENT OF HEALTH
        COMMUNITY HEALTH CENTERS
        Total Operating
        Expense    15,000,000    15,000,000
        LOCAL HEALTH MAINTENANCE FUND
        Total Operating
        Expense    1,400,000    1,400,000
        The above appropriations for the local health maintenance fund are in addition to and not in lieu of the appropriation provided for this purpose in IC 6-7-1-30.5 or any other law.
        LOCAL HEALTH DEPARTMENT ACCOUNT
        Total Operating
        Expense    3,000,000    3,000,000
        The foregoing appropriations for the local health department account are statutory distributions pursuant to IC 4-12-7.
    FOR THE FAMILY AND SOCIAL SERVICES
    ADMINISTRATION
        DIVISION OF DISABILITY, AGING, AND
        REHABILITATIVE SERVICES ADMINISTRATION
        Total Operating
        Expense    3,000,000    3,000,000
        The foregoing appropriations for the division of disability, aging, and rehabilitative services are appropriated for the home health providers to increase the salaries of direct care

workers.
        DEVELOPMENTALLY DISABLED CLIENT SERVICES
        Total Operating
        Expense    21,300,000    21,300,000
        The foregoing appropriations for developmentally disabled client services are in addition to and not in lieu of any other appropriations for developmentally disabled client services.
    FOR THE STATE STUDENT ASSISTANCE COMMISSION
        NURSING SCHOLARSHIP PROGRAM
        Total Operating
        Expense    1,000,000    1,000,000
        The above appropriations for the nursing scholarship program are in addition to and not in lieu of any other appropriations for the program. The state student assistance commission shall use twenty-five percent (25%) of the above appropriations for the nursing scholarship program to encourage and promote qualified minority individuals to pursue a career in nursing in accredited schools in Indiana.
        HEALTH PROFESSIONS SCHOLARSHIP PROGRAM
        Total Operating
        Expense    1,000,000    1,000,000
        The state student assistance commission shall use twenty-five percent (25%) of the above appropriations for the health professions scholarship program to encourage and promote qualified minority individuals to pursue a career in health professions in accredited schools in Indiana.
    FOR THE COMMISSION ON HISPANIC/LATINO AFFAIRS
        Total Operating
        Expense    125,000    125,000
        The above appropriations are in addition to any funding for the commission derived from funds appropriated to the department of workforce development.
    (c) There is appropriated to the budget agency two million nine hundred thousand dollars ($2,900,000) from the Indiana tobacco master settlement agreement fund for its use in carrying out the purposes of the regional health facilities construction account (IC 4-12-8.5) during the period beginning July 1, 2004, and ending June 30, 2005.
    (d) The following provisions apply if the Indiana tobacco master settlement agreement fund contains insufficient money to make the appropriations made by subsections (b) and (c) for any state fiscal year:


        (1) The appropriations made for the TOBACCO USE PREVENTION AND CESSATION PROGRAM and the LOCAL HEALTH DEPARTMENT ACCOUNT are not subject to any reduction.
        (2) Each of the other appropriations made by this act is subject to a pro rata reduction. The amount of each appropriation is determined under STEP FOUR of the following formula:
            STEP ONE: Subtract the sum of the appropriations described in subdivision (1) for that state fiscal year from the amount available in the Indiana tobacco master settlement agreement fund for that state fiscal year.
            STEP TWO: Determine the sum of the appropriations made by this act for that state fiscal year, other than the appropriations described in subdivision (1).
            STEP THREE: Divide the amount of the particular appropriation by the STEP TWO sum.
            STEP FOUR: Multiply the STEP ONE remainder by the STEP THREE quotient.

     (e) The following sums are appropriated for the state fiscal years designated from the state general fund:
                            FY 2003-FY 2004    2004-2005
    FOR THE FAMILY AND SOCIAL SERVICES
    ADMINISTRATION
        DIVISION OF DISABILITY, AGING, AND
        REHABILITATIVE SERVICES ADMINISTRATION
        DEVELOPMENTALLY DISABLED CLIENT SERVICES
        Total Operating
        Expense    9,000,000    9,000,000
        The foregoing appropriations for developmentally disabled client services are in addition to and not in lieu of any other appropriations for developmentally disabled client services.
    (f) The additional money appropriated by the amendment made to IC 6-7-1-30.5 by this act is intended to provide additional funding to adjust funding through the formula in IC 16-46-10 to reflect population increases in various counties.

    SECTION 8. [EFFECTIVE JULY 1, 2003] (a) As used in this SECTION, "office" refers to the office of Medicaid policy and planning established by IC 12-8-6-1.
    (b) With the approval of the governor and the budget agency after review by the budget committee, the office may apply to the United States Department of Health and Human Services for an amendment to the Pharmacy Plus Section 115 Demonstration

waiver for Phase II of the Indiana prescription drug program established under IC 12-10-16 that would amend the waiver to allow the program to provide services to an individual whose family income does not exceed one hundred eighty-five percent (185%) of the federal income poverty level for the same size family.
    (c) The office may not implement the amendment to the waiver until the office files an affidavit with the governor attesting that the amendment to the federal waiver applied for under this SECTION is in effect. The office shall file the affidavit under this subsection not later than five (5) days after the office is notified that the amendment to the waiver is approved.
    (d) If the office receives approval to amend the waiver as set forth in subsection (b) of this SECTION from the United States Department of Health and Human Services and the governor receives the affidavit filed under subsection (c), the office shall implement the amendment to the waiver not more than thirty (30) days after the governor receives the affidavit.
    (e) The office may adopt rules under IC 4-22-2 necessary to implement this SECTION.
    (f) This SECTION expires December 31, 2008.