PRIOR PRINTER'S NO. 2240 PRINTER'S NO. 2379
No. 5 Session of 2008
INTRODUCED BY ERICKSON, BAKER, CORMAN, M. WHITE, RAFFERTY,
O'PAKE, ORIE, VANCE, MADIGAN, COSTA, PIPPY, EARLL,
EICHELBERGER, D. WHITE, REGOLA, WONDERLING, BROWNE, BRUBAKER,
FOLMER, GREENLEAF, GORDNER, SCARNATI, ARMSTRONG AND PILEGGI,
JUNE 24, 2008
SENATOR ERICKSON, PUBLIC HEALTH AND WELFARE, AS AMENDED,
SEPTEMBER 18, 2008
AN ACT
1 Establishing the Community-Based Health Care (CHC) Program in <--
2 the Department of Health; providing for hospital health
3 clinics and for a tax credit; and making an appropriation.
4 TABLE OF CONTENTS
5 Chapter 1. Health Care Assistance
6 Subchapter A. Preliminary Provisions
7 Section 101. Short title.
8 Section 102. Definitions.
9 Subchapter B. Community-Based Health Care (CHC)
10 Section 111. Community-Based Health Care (CHC) Program.
11 Section 112. Hospital health clinics.
12 Section 113. Community-Based Health Care (CHC) Fund.
13 Subchapter C. Tax Credit
14 Section 121. Scope of subchapter.
15 Section 122. Definitions.
16 Section 123. Establishment of program.
1 Section 124. Application.
2 Section 125. Tax credit.
3 Section 126. Limitations.
4 Section 127. Report.
5 Chapter 51. Miscellaneous Provisions
6 Section 5101. Appropriation.
7 Section 5102. Effective date.
8 ESTABLISHING THE COMMUNITY-BASED HEALTH CARE (CHC) PROGRAM IN <--
9 THE DEPARTMENT OF HEALTH; PROVIDING FOR HOSPITAL HEALTH
10 CLINICS AND FOR A TAX CREDIT; AND MAKING AN APPROPRIATION.
11 TABLE OF CONTENTS
12 CHAPTER 1. HEALTH CARE ASSISTANCE
13 SUBCHAPTER A. PRELIMINARY PROVISIONS
14 SECTION 101. SHORT TITLE.
15 SECTION 102. DEFINITIONS.
16 SUBCHAPTER B. COMMUNITY-BASED HEALTH CARE (CHC)
17 SECTION 111. COMMUNITY-BASED HEALTH CARE (CHC) PROGRAM.
18 SECTION 112. POWERS AND DUTIES OF DEPARTMENT.
19 SECTION 113. HOSPITAL HEALTH CLINICS.
20 SECTION 114. COMMUNITY-BASED HEALTH CARE (CHC) FUND.
21 SUBCHAPTER C. TAX CREDIT
22 SECTION 121. SCOPE OF SUBCHAPTER.
23 SECTION 122. DEFINITIONS.
24 SECTION 123. ESTABLISHMENT OF PROGRAM.
25 SECTION 124. APPLICATION.
26 SECTION 125. TAX CREDIT.
27 SECTION 126. LIMITATIONS.
28 SECTION 127. REPORT.
29 CHAPTER 51. MISCELLANEOUS PROVISIONS
30 SECTION 5101. APPROPRIATIONS.
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1 SECTION 5102. EFFECTIVE DATE.
2 The General Assembly of the Commonwealth of Pennsylvania
3 hereby enacts as follows:
4 CHAPTER 1 <--
5 HEALTH CARE ASSISTANCE
6 SUBCHAPTER A
7 PRELIMINARY PROVISIONS
8 Section 101. Short title.
9 This act shall be known and may be cited as the Community-
10 Based Health Care (CHC) Act.
11 Section 102. Definitions.
12 The following words and phrases when used in this chapter
13 shall have the meanings given to them in this section unless the
14 context clearly indicates otherwise:
15 "Chronic care model." A model that includes the following:
16 (1) The provision of support and information for
17 patients with chronic conditions for the purpose of effective
18 health management.
19 (2) The use of evidence-based medicine to ensure
20 appropriate treatment decisions by health care providers.
21 (3) The coordination of care and use of centralized,
22 updated patient information that encourages follow-up care as
23 a standard procedure.
24 (4) The tracking of individual patient clinical
25 information to guide treatment and effectively anticipate and
26 track health care problems.
27 "Community-based health care clinic." A nonprofit health
28 care center that provides primary health care services primarily
29 to low-income and uninsured individuals, including:
30 (1) A federally qualified health center as defined in
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1 section 1905(l)(2)(B) of the Social Security Act (49 Stat.
2 620, 42 U.S.C. § 1396d(l)(2)(B)) or a federally qualified
3 health center look-alike.
4 (2) A rural health clinic as defined in section
5 1861(aa)(2) of the Social Security Act (49 Stat. 620, 42
6 U.S.C. § 1395x(aa)(2)), certified by Medicare.
7 (3) A hospital health clinic as set forth under section
8 112.
9 (4) A free or partial-pay health clinic that provides
10 services by volunteer and nonvolunteer health care providers.
11 (5) A nurse-managed health care clinic that serves a
12 federally designated medically underserved area or medically
13 underserved population or is in a primary care health
14 professional shortage area.
15 "Department." Except as provided under section 122, the
16 Department of Health of the Commonwealth.
17 "Fund." The Community-Based Health Care (CHC) Fund.
18 "Health care provider." A health care provider licensed to
19 practice a component of the healing arts by a licensing board
20 within the Department of State who provides health care services
21 at a community-based health care clinic.
22 "Medical assistance." A State program of medical assistance
23 established under Article IV(f) of the act of June 13, 1967
24 (P.L.31, No.21), known as the Public Welfare Code.
25 "Nurse-managed health care clinic." A nurse practice
26 arrangement managed by advanced practice nurses that provides
27 primary care and is associated with a school, college or
28 department of nursing, a federally qualified health center or an
29 independent nonprofit health or social services agency.
30 "Program." The Community-Based Health Care (CHC) Program.
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1 SUBCHAPTER B
2 COMMUNITY-BASED HEALTH CARE (CHC)
3 Section 111. Community-Based Health Care (CHC) Program.
4 (a) Establishment.--The Community-Based Health Care (CHC)
5 Program is established within the department to provide grants
6 to community-based health care clinics to:
7 (1) Improve and expand access to quality primary care in
8 medically underserved areas or to medically underserved
9 populations in this Commonwealth.
10 (2) Assist in covering the reasonable costs of providing
11 health care services through community-based health care
12 clinics.
13 (3) Improve access to preventive, curative and
14 palliative physical, dental and behavioral health care
15 services offered by and through community-based health care
16 clinics, while reducing unnecessary or duplicative services.
17 (4) Reduce the unnecessary utilization of hospital
18 emergency services by supporting the development and
19 provision of effective alternatives offered by or through
20 community-based health care clinics.
21 (5) Improve the availability of quality health care
22 services offered by or through community-based health care
23 clinics for women who are pregnant or who have recently given
24 birth.
25 (6) Promote the use of chronic care and disease
26 management protocols offered by or through community-based
27 health care clinics.
28 (7) Encourage collaborative relationships among
29 community-based health care clinics, hospitals and other
30 health care providers.
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1 (b) Administration.--The program shall be administered by
2 the department and shall be funded by annual transfers as
3 provided under this subchapter.
4 (c) Department responsibilities.--The department shall:
5 (1) Administer the program.
6 (2) Within 90 days of the effective date of this
7 section, develop and provide an application form consistent
8 with this subchapter. The department shall provide
9 applications for grants under this section to all known
10 community-based health care clinics. A grant under this
11 section may be extended over two State fiscal years at the
12 request of the community-based health care clinic.
13 (3) Establish a process to allocate funding based on all
14 of the following:
15 (i) Number of patient visits to the community-based
16 health care clinic.
17 (ii) Evidence of increased operating capacity.
18 (iii) Addition or expansion of ancillary health care
19 services, such as dental, behavioral health and pharmacy.
20 (iv) The development or enhancement of preventative
21 and chronic disease health care management techniques and
22 community outreach.
23 (v) The establishment of collaborative relationships
24 among community-based health care clinics, hospitals and
25 other health care providers.
26 (4) Calculate and make grants to qualified community-
27 based health care clinics.
28 (5) The department shall provide an annual report to the
29 chair and minority chair of the Public Health and Welfare
30 Committee of the Senate and the chair and minority chair of
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1 the Health and Human Services Committee of the House of
2 Representatives. The report shall be due November 30. The
3 report shall include a list of the total dollar amount for
4 each grant awarded by grantee, a summary of the use of the
5 grant by grantee, the impact of the grant on improving the
6 delivery and quality of health care in the community and the
7 total amount of funds spent. The report shall be made
8 available for public inspection and posted on the
9 department's publicly accessible Internet website.
10 (6) Audit grants awarded under this subchapter to ensure
11 that funds have been used in accordance with this subchapter
12 and the terms and standards adopted by the department.
13 (7) Provide assessment of the benefits and costs of the
14 assistance provided under this subchapter.
15 (d) Grants for resources.--Grants shall be available to
16 community-based health care clinics to increase access and
17 improve health care services which will enhance the delivery and
18 quality of health care by developing and expanding necessary
19 community-based health care resources. A grant under this
20 subsection shall not exceed $500,000, which can be in the form
21 of cash or equivalent in-kind services, and shall require a
22 matching commitment of 25% of the grant.
23 (e) Federal matching funds.--The department shall seek any
24 available Federal matching funds under medical assistance, as
25 well as any available grants and funding from other sources, to
26 supplement amounts made available under this subchapter to the
27 extent permitted by law.
28 (f) Limitations on payments by department.--Payments to
29 community-based health care clinics for assistance under this
30 subchapter shall not exceed the amount of funds available in the
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1 fund for the program and any payment under this subchapter shall
2 not constitute an entitlement from the Commonwealth or a claim
3 on any other funds of the Commonwealth.
4 (g) Report.--A community-based health care clinic that
5 receives a grant under this subchapter shall report at least
6 annually to the department. The report shall include a
7 description of:
8 (1) The community-based health care clinic's efforts to
9 improve access to and the delivery and management of health
10 care services.
11 (2) The reduction of unnecessary and duplicative health
12 care services.
13 (3) Changes in overall health indicators and in
14 utilization of health care services among the communities and
15 individuals served by the community-based health care
16 clinics, with particular emphasis on indicators including:
17 (i) The creation and maintenance of relationships
18 among community-based health care clinics, health care
19 providers and individuals, which are directed at
20 establishing a point of service for the individuals and
21 the provision of preventive and chronic care management
22 services.
23 (ii) Prenatal and postpartum care.
24 (iii) The care of newborns and infants.
25 (iv) Any other matters as may be specified by the
26 department.
27 (4) An accounting of the expenditure of funds from the
28 grant and all funds received from other sources.
29 Section 112. Hospital health clinics.
30 (a) Funding.--
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1 (1) For fiscal year 2008-2009 and each year thereafter,
2 upon Federal approval of an amendment to the Medicaid State
3 plan, the Department of Public Welfare shall distribute
4 annually from funds appropriated for this purpose
5 disproportionate share payments to hospitals in this
6 Commonwealth to provide financial assistance to assure
7 readily available and coordinated primary health care of the
8 highest quality to the citizens of this Commonwealth.
9 (2) For July 1, 2008, and annually thereafter, the
10 Secretary of Public Welfare may evaluate the funds available
11 and may make appropriate adjustments based on the number of
12 qualifying hospitals.
13 (b) Maximization.--The Department of Public Welfare shall
14 seek to maximize any Federal funds, including funds obtained
15 under Title XIX of the Social Security Act (49 Stat. 620, 42
16 U.S.C. § 1396 et seq.), available for burn care stabilization.
17 (c) Eligibility.--An entity located in this Commonwealth
18 that is licensed as a hospital under the act of July 19, 1979
19 (P.L.130, No.48), known as the Health Care Facilities Act, and
20 which operates a nonprofit hospital clinic that serves a
21 medically underserved area, serves a medically underserved
22 population or is in a federally designated health professional
23 shortage area shall be eligible to receive funds under this
24 section.
25 (d) Payment calculation.--
26 (1) Fifteen percent of the total amount available shall
27 be allocated to rural hospitals located in this Commonwealth
28 as follows:
29 (i) Twenty-five percent of the total amount
30 available for rural hospitals shall be allocated equally
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1 among each rural hospital.
2 (ii) Seventy-five percent of the total amount
3 available for rural hospitals shall be allocated on the
4 basis of each hospital's percentage of medical assistance
5 hospital outpatient clinic visits compared to the
6 Statewide total number of medical assistance hospital
7 outpatient clinic visits for all rural hospitals.
8 (2) Eighty-five percent of the total amount available
9 shall be allocated to qualified nonrural hospitals located in
10 this Commonwealth as follows:
11 (i) Twenty-five percent of the total amount
12 available for nonrural hospitals shall be allocated
13 equally among each nonrural hospital.
14 (ii) Seventy-five percent of the total amount
15 available for nonrural hospitals shall be allocated on
16 the basis of each hospital's percentage of medical
17 assistance hospital outpatient clinic visits compared to
18 the Statewide total number of medical assistance hospital
19 outpatient clinic visits for all nonrural hospitals.
20 (3) Any hospital that has reached its disproportionate
21 share limit under Title XIX of the Social Security Act shall
22 receive its share of the State funds available under this
23 act.
24 (e) Definitions.--For the purpose of this section, a "rural
25 hospital" is a hospital that is located in a geographic area not
26 located in a Core-Based Statistical Area (CBSAs) established by
27 the United States Office of Management and Budget.
28 Section 113. Community-Based Health Care (CHC) Fund.
29 (a) Establishment.--The Community-Based Health Care (CHC)
30 Fund is established in the State Treasury.
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1 (b) Funding sources.--The fund shall be funded by:
2 (1) Transfers or appropriations to the fund.
3 (2) Money received from the Federal Government or other
4 sources.
5 (3) Money required to be deposited in the fund pursuant
6 to other provisions under this act or any other law.
7 (4) Investment earnings from the fund, net of investment
8 costs.
9 (c) Use.--The department shall utilize the fund to carry out
10 the program.
11 (d) Nonlapse.--The money in the fund is appropriated on a
12 continuing basis to the department and shall not lapse at the
13 end of any fiscal year.
14 SUBCHAPTER C
15 TAX CREDIT
16 Section 121. Scope of subchapter.
17 This subchapter deals with the community-based health care
18 clinic tax credit.
19 Section 122. Definitions.
20 The following words and phrases when used in this subchapter
21 shall have the meanings given to them in this section unless the
22 context clearly indicates otherwise:
23 "Business firm." An entity authorized to do business in this
24 Commonwealth and subject to taxes imposed under Article IV, VI,
25 VII, VII-A, VIII, VIII-A, IX or XV of the act of March 4, 1971
26 (P.L.6, No.2), known as the Tax Reform Code of 1971.
27 "Contribution." A donation of cash or personal property by
28 the business firm to the Commonwealth.
29 "Department." Notwithstanding section 102, the Department of
30 Community and Economic Development of the Commonwealth.
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1 Section 123. Establishment of program.
2 A community-based health care clinic tax credit program is
3 hereby established in order to fund the Community-Based Health
4 Care (CHC) Program.
5 Section 124. Application.
6 (a) Application.--A business firm shall apply to the
7 department in a form and manner determined by the department for
8 a tax credit under section 125.
9 (b) Availability of tax credits.--Tax credits under this
10 subchapter shall be made available by the department on a first-
11 come, first-served basis within the limitations established
12 under section 126.
13 (c) Contributions.--A contribution shall be made no later
14 than 60 days following the approval of an application under
15 subsection (a).
16 Section 125. Tax credit.
17 (a) Grant.--The Department of Revenue shall grant a tax
18 credit against any tax due under Article IV, VI, VII, VII-A,
19 VIII, VIII-A, IX or XV of the act of March 4, 1971 (P.L.6,
20 No.2), known as the Tax Reform Code of 1971, to a business firm
21 that has applied for, been approved for and made a contribution.
22 In the taxable year in which the contribution is made, the
23 credit shall not exceed 75% of the total amount contributed by
24 the business firm. The credit shall not exceed $100,000 annually
25 per business firm.
26 (b) Expense.--All money received from business firms in
27 accordance with this subchapter shall be expended solely for
28 community-based health care clinics pursuant to Subchapter A.
29 Section 126. Limitations.
30 (a) Amount.--The total aggregate amount of all tax credits
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1 approved under this subchapter shall not exceed $5,000,000 in a
2 fiscal year.
3 (b) Activities.--No tax credit shall be approved for
4 activities that are a part of a business firm's normal course of
5 business.
6 (c) Tax liability.--A tax credit granted for any one taxable
7 year may not exceed the tax liability of a business firm.
8 (d) Use.--A tax credit not used in the taxable year the
9 contribution was made may not be carried forward or carried back
10 and is not refundable or transferable.
11 Section 127. Report.
12 (a) Delivery.--The department shall provide a report to the
13 chair and minority chair of the Appropriations Committee of the
14 Senate, the chair and minority chair of the Public Health and
15 Welfare Committee of the Senate, the chair and minority chair of
16 the Appropriations Committee of the House of Representatives and
17 the chair and minority chair of the Health and Human Services
18 Committee of the House of Representatives.
19 (b) Substance.--The report shall include:
20 (1) The total amount of the tax credits awarded.
21 (2) The total amount of the contributions from all
22 business firms.
23 (3) The total number of additional persons served
24 through the program due to contributions from business firms,
25 by county.
26 CHAPTER 51
27 MISCELLANEOUS PROVISIONS
28 Section 5101. Appropriation.
29 The sum of $45,000,000 is hereby appropriated to the
30 Department of Health for deposit into the Community-Based Health
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1 Care (CHC) Fund for the fiscal year July 1, 2008, to June 30,
2 2009, to carry out the provisions of Ch. 1 Subch. B. This
3 appropriation is subject to section 113(d).
4 Section 5102. Effective date.
5 This act shall take effect in 90 days.
6 CHAPTER 1 <--
7 HEALTH CARE ASSISTANCE
8 SUBCHAPTER A
9 PRELIMINARY PROVISIONS
10 SECTION 101. SHORT TITLE.
11 THIS ACT SHALL BE KNOWN AND MAY BE CITED AS THE COMMUNITY-
12 BASED HEALTH CARE (CHC) ACT.
13 SECTION 102. DEFINITIONS.
14 THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS CHAPTER
15 SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
16 CONTEXT CLEARLY INDICATES OTHERWISE:
17 "CHRONIC CARE AND DISEASE MANAGEMENT." A MODEL OF CARE THAT
18 INCLUDES THE FOLLOWING:
19 (1) THE PROVISION OF EFFECTIVE HEALTH MANAGEMENT THROUGH
20 SUPPORT AND INFORMATION THAT ALSO PROMOTES PATIENT SELF-CARE
21 FOR PATIENTS WITH CHRONIC CONDITIONS.
22 (2) THE USE OF EVIDENCE-BASED MEDICINE TO ENSURE
23 APPROPRIATE TREATMENT DECISIONS BY HEALTH CARE PROVIDERS.
24 (3) THE COORDINATION OF CARE AND USE OF REASONABLY
25 ACCESSIBLE AND UPDATED PATIENT INFORMATION THAT ENCOURAGES
26 FOLLOW-UP CARE AS A STANDARD PROCEDURE.
27 (4) THE TRACKING OF CLINICAL INFORMATION FOR INDIVIDUAL
28 AND GENERAL PATIENT POPULATIONS TO GUIDE TREATMENT AND
29 EFFECTIVELY ANTICIPATE COMMUNITY HEALTH CARE PROBLEMS.
30 "COMMUNITY-BASED HEALTH CARE CLINIC." A NONPROFIT HEALTH
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1 CARE CENTER LOCATED IN THIS COMMONWEALTH THAT PROVIDES
2 COMPREHENSIVE PRIMARY CARE SERVICES WITHOUT REGARD FOR A
3 PATIENT'S ABILITY TO PAY AND THAT:
4 (1) MEETS EITHER OF THE FOLLOWING CRITERIA:
5 (I) SERVES A FEDERALLY DESIGNATED MEDICALLY
6 UNDERSERVED AREA, A MEDICALLY UNDERSERVED POPULATION OR A
7 HEALTH PROFESSIONAL SHORTAGE AREA; OR
8 (II) SERVES A PATIENT POPULATION WITH A MAJORITY OF
9 THAT POPULATION HAVING AN INCOME LESS THAN 200% OF THE
10 FEDERAL POVERTY INCOME GUIDELINES; AND
11 (2) INCLUDES ANY OF THE FOLLOWING:
12 (I) A FEDERALLY QUALIFIED HEALTH CENTER AS DEFINED
13 IN SECTION 1905(L)(2)(B) OF THE SOCIAL SECURITY ACT (49
14 STAT. 620, 42 U.S.C. § 1396D(L)(2)(B)) OR A FEDERALLY
15 QUALIFIED HEALTH CENTER LOOK-ALIKE.
16 (II) A RURAL HEALTH CLINIC AS DEFINED IN SECTION
17 1861(AA)(2) OF THE SOCIAL SECURITY ACT (49 STAT. 620, 42
18 U.S.C. § 1395X(AA)(2)), CERTIFIED BY MEDICARE.
19 (III) A HOSPITAL HEALTH CLINIC.
20 (IV) A FREE OR PARTIAL-PAY HEALTH CLINIC THAT
21 PROVIDES SERVICES BY VOLUNTEER AND NONVOLUNTEER HEALTH
22 CARE PROVIDERS.
23 (V) A NURSE-MANAGED HEALTH CARE CLINIC THAT IS
24 MANAGED BY ADVANCED PRACTICE NURSES AND IS ASSOCIATED
25 WITH A NURSING EDUCATION PROGRAM, A FEDERALLY QUALIFIED
26 HEALTH CENTER OR AN INDEPENDENT NONPROFIT HEALTH OR
27 SOCIAL SERVICES AGENCY.
28 "DEPARTMENT." EXCEPT AS PROVIDED UNDER SECTION 122, THE
29 DEPARTMENT OF HEALTH OF THE COMMONWEALTH.
30 "FUND." THE COMMUNITY-BASED HEALTH CARE (CHC) FUND.
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1 "HEALTH CARE PROVIDER." A HEALTH CARE PROVIDER LICENSED TO
2 PRACTICE A COMPONENT OF THE HEALING ARTS BY A LICENSING BOARD
3 WITHIN THE DEPARTMENT OF STATE WHO PROVIDES HEALTH CARE SERVICES
4 AT A COMMUNITY-BASED HEALTH CARE CLINIC.
5 "HOSPITAL." AN ENTITY LOCATED IN THIS COMMONWEALTH THAT IS
6 LICENSED AS A HOSPITAL UNDER THE ACT OF JULY 19, 1979 (P.L.130,
7 NO.48), KNOWN AS THE HEALTH CARE FACILITIES ACT.
8 "MEDICAL ASSISTANCE." A STATE PROGRAM OF MEDICAL ASSISTANCE
9 ESTABLISHED UNDER ARTICLE IV(F) OF THE ACT OF JUNE 13, 1967
10 (P.L.31, NO.21), KNOWN AS THE PUBLIC WELFARE CODE.
11 "PATIENT." A NATURAL PERSON RECEIVING HEALTH CARE FROM A
12 HEALTH CARE PROVIDER AT A COMMUNITY-BASED HEALTH CARE CLINIC.
13 "PROGRAM." THE COMMUNITY-BASED HEALTH CARE (CHC) PROGRAM.
14 SUBCHAPTER B
15 COMMUNITY-BASED HEALTH CARE (CHC)
16 SECTION 111. COMMUNITY-BASED HEALTH CARE (CHC) PROGRAM.
17 (A) ESTABLISHMENT.--THE COMMUNITY-BASED HEALTH CARE (CHC)
18 PROGRAM IS ESTABLISHED WITHIN THE DEPARTMENT TO PROVIDE GRANTS
19 TO COMMUNITY-BASED HEALTH CARE CLINICS TO:
20 (1) EXPAND AND IMPROVE HEALTH CARE ACCESS AND SERVICES,
21 SUCH AS PREVENTIVE CARE, CHRONIC CARE AND DISEASE MANAGEMENT,
22 PRENATAL, OBSTETRIC, POSTPARTUM AND NEWBORN CARE, DENTAL
23 TREATMENT, BEHAVIORAL HEALTH AND PHARMACY SERVICES.
24 (2) REDUCE UNNECESSARY UTILIZATION OF HOSPITAL EMERGENCY
25 SERVICES BY PROVIDING AN EFFECTIVE ALTERNATIVE HEALTH CARE
26 DELIVERY SYSTEM.
27 (3) ENCOURAGE COLLABORATIVE RELATIONSHIPS AMONG
28 COMMUNITY-BASED HEALTH CARE CLINICS, HOSPITALS AND OTHER
29 HEALTH CARE PROVIDERS.
30 (B) GRANT AWARD METHODOLOGY.--A METHODOLOGY FOR THE
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1 ALLOCATION OF GRANT AWARDS SHALL BE DEVELOPED BY THE DEPARTMENT
2 BASED ON THE FOLLOWING DISTRIBUTION:
3 (1) FIFTY PERCENT FOR THE EXPANSION OF AN EXISTING OR
4 THE DEVELOPMENT OF A NEW COMMUNITY-BASED HEALTH CARE CLINIC
5 USING CRITERIA THAT INCLUDE:
6 (I) THE ACTUAL AND PROJECTED NUMBER OF TOTAL
7 PATIENTS, NEW PATIENTS AND PATIENT VISITS FOR ALL
8 PATIENTS SERVED OR TO BE SERVED, SPECIFICALLY DELINEATING
9 THE NUMBER OF LOW-INCOME AND UNINSURED PATIENTS, WHO FALL
10 BELOW 200% OF THE FEDERAL POVERTY INCOME GUIDELINES.
11 (II) THE ADDITION OR EXPANSION OF ANCILLARY HEALTH
12 CARE SERVICES, SUCH AS DENTAL, BEHAVIORAL HEALTH AND
13 PHARMACY.
14 (III) THE DEVELOPMENT OR ENHANCEMENT OF PREVENTIVE
15 AND CHRONIC CARE AND DISEASE MANAGEMENT TECHNIQUES.
16 (2) TWENTY-FIVE PERCENT FOR IMPROVEMENTS IN PRENATAL,
17 OBSTETRIC, POSTPARTUM AND NEWBORN CARE.
18 (3) TWENTY PERCENT FOR IMPROVED ACCESS AND SERVICES
19 INTENDED TO REDUCE UNNECESSARY EMERGENCY ROOM UTILIZATION.
20 (4) FIVE PERCENT FOR THE ESTABLISHMENT OF COLLABORATIVE
21 RELATIONSHIPS AMONG COMMUNITY-BASED HEALTH CARE CLINICS,
22 HOSPITALS AND OTHER HEALTH CARE PROVIDERS.
23 (C) LIMITATION.--NO MORE THAN 15% OF THE GRANTS AWARDED
24 UNDER SUBSECTION (B) SHALL GO TO FEDERALLY QUALIFIED HEALTH
25 CENTERS OR FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKES.
26 (D) DISTRIBUTION.--FUNDS SHALL BE DISTRIBUTED IN A MANNER
27 THAT IMPROVES ACCESS AND EXPANDS SERVICES IN ALL GEOGRAPHIC
28 AREAS OF THIS COMMONWEALTH.
29 (E) REALLOCATION.--THE DEPARTMENT SHALL REALLOCATE FUNDS
30 AMONG THE CATEGORIES DESCRIBED IN SUBSECTION (B) IF SUFFICIENT
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1 GRANT REQUESTS ARE NOT RECEIVED TO USE ALL THE FUNDS AVAILABLE
2 IN A SPECIFIC CATEGORY.
3 (F) AMOUNT OF GRANTS.--A GRANT UNDER THIS SUBSECTION SHALL
4 NOT EXCEED $500,000, AND SHALL REQUIRE A MATCHING COMMITMENT OF
5 25% OF THE GRANT, WHICH CAN BE IN THE FORM OF CASH OR EQUIVALENT
6 IN-KIND SERVICES.
7 (G) FEDERAL FUNDS.--THE DEPARTMENT SHALL SEEK ANY AVAILABLE
8 FEDERAL FUNDS, AS WELL AS ANY AVAILABLE GRANTS AND FUNDING FROM
9 OTHER SOURCES, TO SUPPLEMENT AMOUNTS MADE AVAILABLE UNDER THIS
10 SUBCHAPTER TO THE EXTENT PERMITTED BY LAW.
11 SECTION 112. POWERS AND DUTIES OF DEPARTMENT.
12 THE DEPARTMENT SHALL HAVE THE FOLLOWING POWERS AND DUTIES:
13 (1) TO ADMINISTER THE PROGRAM.
14 (2) TO DEVELOP AN ALLOCATION METHODOLOGY PURSUANT TO
15 SECTION 111(B).
16 (3) WITHIN 90 DAYS OF THE EFFECTIVE DATE OF THIS
17 SECTION, TO DEVELOP AND PROVIDE A GRANT APPLICATION FORM
18 CONSISTENT WITH THIS ACT. THE DEPARTMENT SHALL PROVIDE
19 APPLICATIONS FOR GRANTS UNDER THIS SECTION TO ALL KNOWN
20 COMMUNITY-BASED HEALTH CARE CLINICS. A GRANT UNDER THIS
21 SECTION MAY BE EXTENDED OVER TWO STATE FISCAL YEARS AT THE
22 REQUEST OF THE COMMUNITY-BASED HEALTH CARE CLINIC.
23 (4) TO CALCULATE AND MAKE GRANTS TO QUALIFIED COMMUNITY-
24 BASED HEALTH CARE CLINICS.
25 (5) TO PROVIDE AN ANNUAL REPORT NO LATER THAN NOVEMBER
26 30 TO THE CHAIR AND MINORITY CHAIR OF THE PUBLIC HEALTH AND
27 WELFARE COMMITTEE OF THE SENATE AND THE CHAIR AND MINORITY
28 CHAIR OF THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE HOUSE
29 OF REPRESENTATIVES. THE REPORT SHALL INCLUDE ALL OF THE
30 FOLLOWING:
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1 (I) THE TOTAL DOLLAR AMOUNT FOR EACH GRANT AWARDED,
2 LISTING THE TYPE OF COMMUNITY-BASED HEALTH CARE CLINIC
3 AND THE NAME OF THE GRANTEE.
4 (II) A SUMMARY OF THE USE OF THE GRANT BY EACH
5 GRANTEE.
6 (III) A SUMMARY OF HOW EACH GRANT EXPANDED ACCESS
7 AND SERVICES IN ACCORDANCE WITH THE CRITERIA SET FORTH IN
8 SECTION 111(A) AND (B) AND THE TOTAL AMOUNT OF FUNDS
9 ALLOCATED IN EACH DISTRIBUTION CATEGORY UNDER SECTION
10 111(B).
11 (IV) THE IMPACT OF THE GRANT ON IMPROVING THE
12 DELIVERY AND QUALITY OF HEALTH CARE IN THE COMMUNITY.
13 (V) AN ACCOUNTABILITY ASSESSMENT OF THE BENEFITS OF
14 THE ASSISTANCE PROVIDED UNDER THIS SUBCHAPTER AND ANY
15 RECOMMENDATIONS FOR CHANGES TO THE PROGRAM.
16 THE REPORT SHALL BE MADE AVAILABLE FOR PUBLIC INSPECTION AND
17 POSTED ON THE DEPARTMENT'S PUBLICLY ACCESSIBLE INTERNET
18 WEBSITE.
19 (6) TO AUDIT GRANTS AWARDED UNDER THIS SUBCHAPTER TO
20 ENSURE THAT FUNDS HAVE BEEN USED IN ACCORDANCE WITH THIS
21 SUBCHAPTER AND THE TERMS AND STANDARDS ADOPTED BY THE
22 DEPARTMENT.
23 (7) TO ESTABLISH AND MAINTAIN AN ONLINE DATABASE OF
24 COMMUNITY-BASED HEALTH CARE CLINICS.
25 (8) TO ESTABLISH A TOLL-FREE TELEPHONE NUMBER FOR
26 INDIVIDUALS TO OBTAIN INFORMATION ABOUT COMMUNITY-BASED
27 HEALTH CARE CLINICS.
28 SECTION 113. HOSPITAL HEALTH CLINICS.
29 (A) PROGRAM.--THE DEPARTMENT OF PUBLIC WELFARE SHALL BE
30 RESPONSIBLE FOR ADMINISTERING THE PROGRAM AS IT RELATES TO
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1 HOSPITAL HEALTH CLINICS IN ACCORDANCE WITH THE REQUIREMENTS OF
2 THIS ACT AND SHALL HAVE THE FOLLOWING ADDITIONAL DUTIES:
3 (1) TO DEVELOP AN APPLICATION AND COLLECT SUCH DATA AND
4 INFORMATION AS MAY BE NECESSARY TO DETERMINE THE ELIGIBILITY
5 OF HOSPITAL HEALTH CLINICS FOR PAYMENTS UNDER THIS SECTION
6 USING THE CRITERIA SET FORTH IN SECTION 111(A) AND (B).
7 (2) TO REVIEW AN APPLICATION AND MAKE A FINAL
8 DETERMINATION REGARDING A HOSPITAL HEALTH CLINIC'S
9 ELIGIBILITY FOR FUNDING WITHIN 90 DAYS OF RECEIPT.
10 (3) TO MAKE PAYMENTS TO HOSPITAL HEALTH CLINICS IN
11 ACCORDANCE WITH THE PAYMENT CALCULATION SET FORTH IN
12 SUBSECTION (E).
13 (B) SUBMISSION OF APPLICATION.--IN ORDER TO QUALIFY FOR
14 FUNDING PURSUANT TO THIS SECTION, A HOSPITAL HEALTH CLINIC SHALL
15 SUBMIT THE REQUIRED APPLICATION TO THE DEPARTMENT OF PUBLIC
16 WELFARE NO LATER THAN 90 DAYS AFTER THE EFFECTIVE DATE OF THIS
17 ACT.
18 (C) FUNDING.--
19 (1) FOR FISCAL YEAR 2009-2010 AND EACH YEAR THEREAFTER,
20 UPON FEDERAL APPROVAL OF AN AMENDMENT TO THE MEDICAID STATE
21 PLAN, THE DEPARTMENT OF PUBLIC WELFARE SHALL ANNUALLY
22 DISTRIBUTE ANY AVAILABLE FUNDS OBTAINED UNDER THIS ACT FOR
23 HOSPITAL HEALTH CLINICS THROUGH DISPROPORTIONATE SHARE
24 PAYMENTS TO HOSPITALS TO PROVIDE FINANCIAL ASSISTANCE THAT
25 WILL ASSURE READILY AVAILABLE AND COORDINATED COMPREHENSIVE
26 PRIMARY HEALTH CARE TO THE CITIZENS OF THIS COMMONWEALTH.
27 (2) THE SECRETARY OF PUBLIC WELFARE SHALL DETERMINE THE
28 FUNDS AVAILABLE AND MAKE APPROPRIATE ADJUSTMENTS BASED ON THE
29 NUMBER OF QUALIFYING HOSPITALS WITH HOSPITAL HEALTH CLINICS.
30 (D) MAXIMIZATION.--THE DEPARTMENT OF PUBLIC WELFARE SHALL
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1 SEEK TO MAXIMIZE ANY FEDERAL FUNDS, INCLUDING FUNDS OBTAINED
2 UNDER TITLE XIX OF THE SOCIAL SECURITY ACT (49 STAT. 620, 42
3 U.S.C. § 1396 ET SEQ.).
4 (E) PAYMENT CALCULATION.--
5 (1) THIRTY PERCENT OF THE TOTAL AMOUNT AVAILABLE SHALL
6 BE ALLOCATED TO ELIGIBLE HOSPITAL HEALTH CLINICS OF HOSPITALS
7 LOCATED IN COUNTIES OF THE FIRST AND SECOND CLASS. THE TOTAL
8 AMOUNT AVAILABLE FOR EACH HOSPITAL HEALTH CLINIC AT A
9 HOSPITAL IN THESE COUNTIES SHALL BE ALLOCATED ON THE BASIS OF
10 EACH HOSPITAL'S PERCENTAGE OF MEDICAL ASSISTANCE AND LOW-
11 INCOME HOSPITAL HEALTH CLINIC VISITS COMPARED TO THE TOTAL
12 NUMBER OF MEDICAL ASSISTANCE AND LOW-INCOME HOSPITAL HEALTH
13 CLINIC VISITS FOR ALL HOSPITALS IN THESE COUNTIES.
14 (2) FIFTY PERCENT OF THE TOTAL AMOUNT AVAILABLE SHALL BE
15 ALLOCATED TO ELIGIBLE HOSPITAL HEALTH CLINICS OF HOSPITALS
16 LOCATED IN COUNTIES OF THE THIRD, FOURTH AND FIFTH CLASS. THE
17 TOTAL AMOUNT AVAILABLE FOR EACH HOSPITAL HEALTH CLINIC AT A
18 HOSPITAL IN THESE COUNTIES SHALL BE ALLOCATED ON THE BASIS OF
19 EACH HOSPITAL'S PERCENTAGE OF MEDICAL ASSISTANCE AND LOW-
20 INCOME HOSPITAL HEALTH CLINIC VISITS COMPARED TO THE TOTAL
21 NUMBER OF MEDICAL ASSISTANCE AND LOW-INCOME HOSPITAL HEALTH
22 CLINIC VISITS FOR ALL HOSPITALS IN THESE COUNTIES.
23 (3) TWENTY PERCENT OF THE TOTAL AMOUNT AVAILABLE SHALL
24 BE ALLOCATED TO ELIGIBLE HOSPITAL HEALTH CLINICS OF HOSPITALS
25 LOCATED IN COUNTIES OF THE SIXTH, SEVENTH AND EIGHTH CLASS.
26 THE TOTAL AMOUNT AVAILABLE FOR EACH HOSPITAL HEALTH CLINIC AT
27 A HOSPITAL IN THESE COUNTIES SHALL BE ALLOCATED ON THE BASIS
28 OF EACH HOSPITAL'S PERCENTAGE OF MEDICAL ASSISTANCE AND LOW-
29 INCOME HOSPITAL HEALTH CLINIC VISITS COMPARED TO THE TOTAL
30 NUMBER OF MEDICAL ASSISTANCE AND LOW-INCOME HOSPITAL HEALTH
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1 CLINIC VISITS FOR ALL HOSPITALS IN THESE COUNTIES.
2 (4) ANY HOSPITAL THAT HAS REACHED ITS DISPROPORTIONATE
3 SHARE LIMIT UNDER TITLE XIX OF THE SOCIAL SECURITY ACT SHALL
4 RECEIVE ITS SHARE OF THE STATE FUNDS AVAILABLE UNDER THIS
5 ACT.
6 (F) DEFINITION.--AS USED IN THIS SECTION, THE TERM "LOW-
7 INCOME" MEANS UNDER 200% OF THE FEDERAL POVERTY INCOME
8 GUIDELINES.
9 SECTION 114. COMMUNITY-BASED HEALTH CARE (CHC) FUND.
10 (A) ESTABLISHMENT.--THE COMMUNITY-BASED HEALTH CARE (CHC)
11 FUND IS ESTABLISHED IN THE STATE TREASURY.
12 (B) FUNDING SOURCES.--FUNDING SOURCES FOR THE FUND SHALL
13 INCLUDE ALL OF THE FOLLOWING:
14 (1) TRANSFERS OR APPROPRIATIONS TO THE FUND.
15 (2) MONEY RECEIVED FROM THE FEDERAL GOVERNMENT OR OTHER
16 SOURCES.
17 (3) MONEY REQUIRED TO BE DEPOSITED IN THE FUND PURSUANT
18 TO OTHER PROVISIONS UNDER THIS ACT OR ANY OTHER LAW.
19 (4) INVESTMENT EARNINGS FROM THE FUND, NET OF INVESTMENT
20 COSTS.
21 (C) USE.--THE DEPARTMENT SHALL UTILIZE THE FUND TO CARRY OUT
22 THE PROGRAM.
23 SUBCHAPTER C
24 TAX CREDIT
25 SECTION 121. SCOPE OF SUBCHAPTER.
26 THIS SUBCHAPTER DEALS WITH THE COMMUNITY-BASED HEALTH CARE
27 CLINIC TAX CREDIT.
28 SECTION 122. DEFINITIONS.
29 THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS SUBCHAPTER
30 SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
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1 CONTEXT CLEARLY INDICATES OTHERWISE:
2 "BUSINESS FIRM." AN ENTITY AUTHORIZED TO DO BUSINESS IN THIS
3 COMMONWEALTH AND SUBJECT TO TAXES IMPOSED UNDER ARTICLE IV, VI,
4 VII, VIII, IX OR XV OF THE ACT OF MARCH 4, 1971 (P.L.6, NO.2),
5 KNOWN AS THE TAX REFORM CODE OF 1971.
6 "CONTRIBUTION." A DONATION OF CASH OR PERSONAL PROPERTY BY
7 THE BUSINESS FIRM TO THE COMMONWEALTH.
8 "DEPARTMENT." NOTWITHSTANDING SECTION 102, THE DEPARTMENT OF
9 COMMUNITY AND ECONOMIC DEVELOPMENT OF THE COMMONWEALTH.
10 SECTION 123. ESTABLISHMENT OF PROGRAM.
11 A COMMUNITY-BASED HEALTH CARE CLINIC TAX CREDIT PROGRAM IS
12 HEREBY ESTABLISHED IN ORDER TO FUND THE COMMUNITY-BASED HEALTH
13 CARE (CHC) PROGRAM.
14 SECTION 124. APPLICATION.
15 (A) APPLICATION.--A BUSINESS FIRM SHALL APPLY TO THE
16 DEPARTMENT IN A FORM AND MANNER DETERMINED BY THE DEPARTMENT FOR
17 A TAX CREDIT UNDER SECTION 125.
18 (B) AVAILABILITY OF TAX CREDITS.--TAX CREDITS UNDER THIS
19 SUBCHAPTER SHALL BE MADE AVAILABLE BY THE DEPARTMENT ON A FIRST-
20 COME, FIRST-SERVED BASIS WITHIN THE LIMITATIONS ESTABLISHED
21 UNDER SECTION 126.
22 (C) CONTRIBUTIONS.--A CONTRIBUTION SHALL BE MADE NO LATER
23 THAN 60 DAYS FOLLOWING THE APPROVAL OF AN APPLICATION UNDER
24 SUBSECTION (A).
25 SECTION 125. TAX CREDIT.
26 (A) GRANT.--THE DEPARTMENT OF REVENUE SHALL GRANT A TAX
27 CREDIT AGAINST ANY TAX DUE UNDER ARTICLE IV, VI, VII, VIII, IX
28 OR XV OF THE ACT OF MARCH 4, 1971 (P.L.6, NO.2), KNOWN AS THE
29 TAX REFORM CODE OF 1971, TO A BUSINESS FIRM THAT HAS APPLIED
30 FOR, BEEN APPROVED FOR AND MADE A CONTRIBUTION. IN THE TAXABLE
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1 YEAR IN WHICH THE CONTRIBUTION IS MADE, THE CREDIT SHALL NOT
2 EXCEED 75% OF THE TOTAL AMOUNT CONTRIBUTED BY THE BUSINESS FIRM.
3 THE CREDIT SHALL NOT EXCEED $100,000 ANNUALLY PER BUSINESS FIRM.
4 (B) EXPENSE.--ALL MONEY RECEIVED FROM BUSINESS FIRMS IN
5 ACCORDANCE WITH THIS SUBCHAPTER SHALL BE EXPENDED SOLELY FOR
6 COMMUNITY-BASED HEALTH CARE CLINICS PURSUANT TO SUBCHAPTER A.
7 SECTION 126. LIMITATIONS.
8 (A) AMOUNT.--THE TOTAL AGGREGATE AMOUNT OF ALL TAX CREDITS
9 APPROVED UNDER THIS SUBCHAPTER SHALL NOT EXCEED $5,000,000 IN A
10 FISCAL YEAR.
11 (B) ACTIVITIES.--NO TAX CREDIT SHALL BE APPROVED FOR
12 ACTIVITIES THAT ARE A PART OF A BUSINESS FIRM'S NORMAL COURSE OF
13 BUSINESS.
14 (C) TAX LIABILITY.--A TAX CREDIT GRANTED FOR ANY ONE TAXABLE
15 YEAR MAY NOT EXCEED THE TAX LIABILITY OF A BUSINESS FIRM.
16 (D) USE.--A TAX CREDIT NOT USED IN THE TAXABLE YEAR THE
17 CONTRIBUTION WAS MADE MAY NOT BE CARRIED FORWARD OR CARRIED BACK
18 AND IS NOT REFUNDABLE OR TRANSFERABLE.
19 SECTION 127. REPORT.
20 (A) DELIVERY.--THE DEPARTMENT SHALL PROVIDE A REPORT TO THE
21 CHAIR AND MINORITY CHAIR OF THE APPROPRIATIONS COMMITTEE OF THE
22 SENATE, THE CHAIR AND MINORITY CHAIR OF THE PUBLIC HEALTH AND
23 WELFARE COMMITTEE OF THE SENATE, THE CHAIR AND MINORITY CHAIR OF
24 THE APPROPRIATIONS COMMITTEE OF THE HOUSE OF REPRESENTATIVES AND
25 THE CHAIR AND MINORITY CHAIR OF THE HEALTH AND HUMAN SERVICES
26 COMMITTEE OF THE HOUSE OF REPRESENTATIVES.
27 (B) SUBSTANCE.--THE REPORT SHALL INCLUDE:
28 (1) THE TOTAL AMOUNT OF THE TAX CREDITS AWARDED.
29 (2) THE TOTAL AMOUNT OF THE CONTRIBUTIONS FROM ALL
30 BUSINESS FIRMS.
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1 (3) THE TOTAL NUMBER OF ADDITIONAL PERSONS SERVED
2 THROUGH THE PROGRAM DUE TO CONTRIBUTIONS FROM BUSINESS FIRMS,
3 BY COUNTY.
4 CHAPTER 51
5 MISCELLANEOUS PROVISIONS
6 SECTION 5101. APPROPRIATIONS.
7 (A) DEPARTMENT OF HEALTH.--THE SUM OF $35,000,000 FROM THE
8 COMMUNITY-BASED HEALTH CARE (CHC) FUND IS HEREBY APPROPRIATED TO
9 THE DEPARTMENT OF HEALTH FOR THE FISCAL YEAR JULY 1, 2009, TO
10 JUNE 30, 2010, TO CARRY OUT THE PROVISIONS OF CH. 1 SUBCH. B,
11 WITH THE EXCEPTION OF FUNDING UNDER SECTION 113.
12 (B) DEPARTMENT OF PUBLIC WELFARE.--THE SUM OF $10,000,000
13 FROM THE COMMUNITY-BASED HEALTH CARE (CHC) FUND IS HEREBY
14 APPROPRIATED TO THE DEPARTMENT OF PUBLIC WELFARE FOR THE FISCAL
15 YEAR JULY 1, 2009, TO JUNE 30, 2010, TO CARRY OUT THE PROVISIONS
16 OF CH. 1 SUBCH. B AND THE FUNDING OF HOSPITAL HEALTH CLINICS
17 UNDER SECTION 113.
18 (C) LIMITATIONS ON PAYMENTS.--PAYMENTS TO COMMUNITY-BASED
19 HEALTH CARE CLINICS FOR ASSISTANCE UNDER THIS ACT SHALL NOT
20 EXCEED THE AMOUNT OF FUNDS AVAILABLE FOR THE PROGRAM, AND ANY
21 PAYMENT UNDER THIS ACT SHALL NOT CONSTITUTE AN ENTITLEMENT FROM
22 THE COMMONWEALTH OR A CLAIM ON ANY OTHER FUNDS OF THE
23 COMMONWEALTH.
24 SECTION 5102. EFFECTIVE DATE.
25 THIS ACT SHALL TAKE EFFECT IN 90 DAYS.
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