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"Draft Only – Approval Pending"
Joint Labor, Health and Social Services Interim Committee
Room 302 November 27& 28, 2001
State Capitol Building Cheyenne, Wyoming
PRESENT: Senator Charles K. Scott, Cochairman;
Representative Carolyn Paseneaux, Cochairman;
Senators Tex Boggs, Cale Case and Mike Massie;
Representatives Jerry Iekel, Larry Meuli, Doug Osborn, Ann Robinson, Tony Ross and Jane Warren.
Legislative Service Office: John H. Rivera, Senior Staff Attorney.
ABSENT: Senator Delaine Roberts and Representatives George B. McMurtrey and Jane Wostenberg
OTHERS: See Appendix A.
AGENDA: See Appendix B.
* * * * * * * * * *
Tuesday
The meeting was called to order at 8:35 a.m. on Tuesday, November 27, 2001, by Chairman Scott. Chairman Scott explained that several members would be arriving late due to the weather so voting on bills may be put off until more members are present if it appears the vote may be close on a particular bill. The normal proceeding would consist of bills listed on the agenda, the proposed letter drafted by Representative Meuli and other issues related to long-term care. The following is a summary of Committee proceedings:
1. 02LSO-0058.C1, Adult acquired brain injury
Representative Meuli explained he had originally had the bill drafted to put the adult acquired brain injury program into statute so legislative review would be more thoughtful whenever a possible expansion of the program was requested. The bill would limit the adult acquired brain injury program under Medicaid for a maximum of 80 slots.
Mr. Bob Clabby, Administrator of the Developmental Disabilities Division, Department of Health, advised there are currently 90 people eligible. He stated the funding for 80 slots is adequate for this fiscal year, but may need to be increased in the future. Regardless of whether the provision is placed in statute, a waiting list may still exist. By placing a cap in the statute, the program would have less flexibility.
Chairman Scott called for a straw poll to determine whether to proceed with further consideration of the bill. As a result of a tie vote in the straw poll, the bill was set aside. Chairman Scott said the Committee needs to develop a comprehensive approach to Medicaid waiver programs.
Representative Meuli distributed his proposed letter to Management Council requesting a review of the Medicaid program (Appendix C). Chairman Scott suggested the letter should be addressed to the Management Audit Committee rather than Management Council.
Senator Massie explained that the Management Audit Committee was reluctant to proceed with a review of Medicaid at this time after hearing discussions on a similar proposal. Representative Osborn said that if the Joint Labor, Health and Social Services Interim Committee would conduct such study, it would be helpful to use the National Conference of State Legislatures since they are familiar with the programs of all 50 states.
Representative Paseneaux moved for the cochairman of the Joint Labor, Health and Social Services Interim Committee to approach Management Council with a request to consider possible ways to conduct a study of the Medicaid program. After discussion the motion carried unanimously.
2. LONG TERM CARE
Mr. Dan Stackis, Administrator, Division on Aging, Department of Health, distributed Appendix B, a white paper on "rebasing". He explained the factors involved in developing the estimate for rebasing. The costs to the state for the next biennium that would result from rebasing include $1,343,926.00. This amount would be in addition to the current budget of approximately $97,000,000.00 combined federal and state funds for nursing care costs under Medicaid.
Mr. Stackis distributed Appendix E, a white paper discussing the issue of extraordinary care. He explained that under rebasing, extraordinary care would be part of the standard reimbursement rate paid to nursing care facilities. Currently extraordinary care is paid in addition to the standard reimbursement rate. He described what type of services would be considered extraordinary care, and expansion of the current definition which only provides for ventilator care. Estimated costs would be $4,562,500.00 for the biennium for approximately 50 individuals.
Mr. Stackis distributed Appendix F containing the costs associated with a wage pass-through for certified nursing assistants (CNA's), licensed practical nurses (LPN's), and registered nurses (RN's) including benefits.
Mr. Tom Jones, Wyoming Health Care Association, stated the extraordinary care proposal and the rebasing proposal are complimentary not competing issues. In response to a question from the Committee, Mr. Jones indicated he will inquire as to what is happening to people who currently do not qualify for extraordinary care, but who would qualify under the proposed expansion.
Mr. Dan Lex, Quality Health Care Foundation of Wyoming, advised some nursing care facility boards of directors have consciously held the private pay rates down which have limited their Medicaid reimbursement rate. Those boards may have been able to hold down their private pay costs because they have other funds available to offset lower reimbursement rates. He agreed with the statements made by Mr. Jones and advised that the wage path through proposal needs to look at all related costs and not just direct care staff wages. Senator Massie advised that the "footnote 9" Committee will be looking at other staff increases at nursing care facilities.
Ms. Iris Oleske, Office of Medicaid, explained that under the current definition of "extraordinary care" if an individual is not qualified for "ventilator dependent" then cost shifting occurs. The cost may be later recognized when the new reimbursement rate is established unless a facility is already at its maximum reimbursement rate. To her knowledge, patients are not being transferred out of state to receive extraordinary care.
Ms. Ruth Sommers, Regional Service Providers, expressed her support for a comprehensive look at the Medicaid program. She has gone to the Joint Appropriations Committee asking to look at wages and salaries for all providers under Medicaid not limited to nursing homes. The "footnote 9" committee will be issuing its report within the next few days.
Chairman Scott asked how these issues mesh with the Department of Health's budget request. Dr. Garry McKee, Director, Department of Health, explained the extraordinary care issue, rebasing and wage pass-through are not in the Department's budget request due to requested increases in other areas.
Chairman Scott stated that he did not want to do an end run of the Joint Appropriations Committee. He would rather have the cochairs of the Joint Labor, Health and Social Services Interim Committee communicate with the cochairs of the Joint Appropriations Committee to discuss possible incorporation of these costly issues into the budget bill. In the alternative, the Joint Labor, Health and Social Services Interim Committee could submit amendments to the budget bill or propose a Committee bill for introduction to address these issues.
Representative Ross suggested the Joint Labor, Health and Social Services Committee should have a bill drafted as backup if those issues are not included in the budget bill. Chairman Scott recommended a budget amendment would also be worthwhile. Senator Massie added that this would avoid the need for introductory vote on a bill by this Committee.
Chairman Scott called for a straw vote on the issues. After the straw vote, he directed Representative Ross and Senator Massie to draft proposed legislation for consideration on the second day of the meeting providing appropriations for extraordinary care, rebasing and wage pass-through.
3. 02LSO-0183.W3, Nursing education
Senator Boggs explained each component of the proposed draft legislation, consisting of a nursing loan program, a LPN mobile education program and authorizing additional teaching positions at community colleges and the University of Wyoming. He recommended changes to the bill to delete CNA training and related expenses from the proposed nursing loan program.
Senator Boggs moved to amend the bill on page 2-line 21 by deleting references to "nurse aid training for"; and on page 3-lines 11 through 21 by deleting entirely and renumbering as necessary. The motion carried unanimously on a voice vote.
Senator Boggs moved to amend the bill on page 6-line 1 after (f), insert "except for a salary replacement grant under subsection (e) of this section,". The motion carried unanimously on a voice vote.
Senator Boggs moved to amend page 6-line 4 after ".", delete language through line 10. The motion carried unanimously on a voice vote.
Senator Boggs moved to amend page 7-after line 14, insert a new subsection to read: "Notwithstanding subsection (h) of this section, qualified work for a recipient of both a WYIN loan and a salary replacement grant shall be credited so that the student's loan balance is reduced on the basis of two (2) years of full-time employment repaying the loan balance for one (1) academic year. Qualified work shall be credited on a proportional basis." After discussion and direction to staff to ensure that repayment work requirements are performed in-state, the motion carried unanimously.
Senator Boggs moved to amend page 7-line 23 after "employment", delete balance of line and insert "in the targeted occupation for which the person received the education"; and to delete page 7-line 24 and page 8-lines 1 through 3. The motion carried unanimously on a voice vote.
Senator Boggs moved to amend page 9-line 9 after "terms", insert "which shall be established so as to encourage students to repay loans by engaging in qualified work under subsection (g) of this section". After discussion the motion failed on a hand vote with 4 ayes 7 noes.
Senator Boggs moved to amend page 9-after line 18, by inserting a new subsection to read "funding of the targeted loan program established under this section shall be by appropriation of the legislature. The authority shall transfer approved loan amounts to the University of Wyoming and to Wyoming community colleges at which loan recipients are enrolled. In consultation with the university and effective community colleges, the authority shall establish procedures for transferring loan amounts and for reporting requirements on the expenditure of transferred loan amounts." After discussion the motion carried on a voice vote.
Senator Boggs moved to amend page - after line 21, by inserting a new subsection to read "The authority shall annually review the targeted loan program established under this section and report to the governor and legislature in accordance with W.S. 9‑2‑1014, regarding program results, funds received and loans issued during the preceding academic year, together with the status of all outstanding loan commitments and repayments under the program." The motion carried unanimously on a voice vote.
Ms. Toni Decklever, Wyoming Nursing Association, stated the solutions to the nursing shortage are very complex but this bill is a step in the right direction. She believes the focus should be on training and is opposed to the mobile LPN program portion of the bill.
Mr. Lex explained that he had conducted a survey of nursing facilities which showed a shortage of CNA's, LPN's and RN's. He stated that nursing care facilities do use LPN's to administer medications, so contrary to what Ms. Decklever says LPN's are necessary at nursing care facilities.
Mr. Dan Purdue, Wyoming Hospital Association, expressed the bill specifically addresses issues faced by hospitals in the state and encourages support for the bill.
Representative Meuli moved to amend the bill by deleting language beginning on page 11-line 23 through page 12-line 19 with respect to a mobile licensed practical nurse education program. The motion failed for lack of a second.
Senator Boggs moved, seconded by Senator Massie, for Committee introduction of 02LSO-0183.W3, as amended. The motion carried on a roll call vote with 10 ayes, 1 no and 3 excused. Senators Boggs, Massie and Scott and Representatives Iekel, Meuli, Osborn, Paseneaux, Robertson, Ross and Warren voted aye. Senator Case voted no. Senator Roberts and Representatives McMurtrey and Wostenberg were excused.
4. 02LSO-0085.W3, Workers' Compensation-amendments
Senator Case explained the bill had previously been approved by the Committee except for the burial benefits provision.
After discussion of burial benefits provisions, Senator Case moved to amend page 6 line 19 by deleting "and 27‑14‑403(e)(ii) are" and inserting "is". The motion carried on a voice vote.
Representative Robinson moved to amend the bill on page 3-line 20 by deleting "such" and inserting "the"; on page 5-line 18 delete "an" and insert "a". The motion carried unanimously on a voice vote.
Senator Massie moved to amend page 5 by deleting new language on lines 9 through 21 and to insert W.S. 27‑14‑403(e)(ii), which should be amended to increase the burial and the related expenses provisions from $2,500.00 each to $5,000.00 each and to conform the bill title to reflect the changes caused by this amendment. The motion carried on a voice vote.
Senator Case moved, seconded by Representative Ross, for the Committee introduction of 02LSO-0085.W3, as amended. The motion carried on a unanimous roll call vote of those members in attendance. Senators Boggs, Case, Massie and Scott and Representatives Iekel, Meuli, Osborn, Paseneaux, Robinson, Ross and Warren voted aye. Senator Roberts and Representatives McMurtrey and Wostenberg were excused.
Senator Case explained that he had worked with LSO to draft a joint resolution to amend the Wyoming Constitution Article 6, Section 10 to allow payment of death benefits to the estate of a deceased worker injured on the job rather than restricting payment to dependent family members. After discussion, Chairman Scott called for a straw vote on whether to proceed on the proposed resolution to amend the Constitution. As a result of the straw vote the proposed resolution was laid back.
5. PROPOSED DRAFT LEGISLATION-SUBSTANCE ABUSE/MENTAL HEALTH IN CORRECTIONS SUBCOMMITTEE
a) 02LSO-0167.W6, Substance abuse control plan.
Chairman Paseneaux indicated she would chair the discussion with respect to proposed draft legislation proposed by the Subcommittee.
Director McKee explained the bill had been patterned after the tobacco prevention initiative. He urged the Committee to look at the bill as a whole, not just at the individual parts of the bill.
Ms. Diane Galloway, Administrator, Substance Abuse Division, Department of Health, added the effort to develop the substance abuse control plan was a multiparty effort to develop a comprehensive approach to dealing with substance abuse in the state. She reiterated that the whole is greater than the sum of its parts with respect to consideration of this bill.
Mr. Rodger McDaniel, advised that many states have complimented the comprehensive approach this bill proposes for consideration. Most states use a piecemeal approach that proves unsuccessful. He distributed proposed amendments based on concerns expressed at the October meeting of the Committee (Appendix G). He explained a drafting error in amendment placed proposed language on pages 3 and 4 of the bill but the language would actually go on page 8 of the bill. A revised version would be provided. He explained that the amendment would propose removing misdemeanants from the bill because the inclusion of those provisions would be too costly. He proceeded to explain the amendments that were being proposed in Appendix G.
Senator Scott suggested dividing the instruction for page 6-line 15 from the rest of the amendment.
Mr. Tom Pagel, Division of Criminal Investigation, advised that 47% of the arrestees in the state have drug problems and 89-90% of them have involvement with alcohol abuse.
Mr. Steve Lindly, Department of Corrections, stated that approximately 60-65% of the male felons have a problem, not just involvement with alcohol. The same is true for approximately 70% of female felons in the custody of the Department of Corrections.
Representative Osborn asked for a provision requiring an annual report on the progress of studies under W.S. 9‑2‑2605. Mr. McDaniel stated he would prepare an amendment to require such report. Senator Massie advised that the proposed amendment should include an instruction on page 20-line 18 of the bill to insert before "use" the word "illegal". It was recommended that, in the proposed amendment to W.S. 27‑14‑201(o)(v), after "drug free approved workplace" delete "and" and insert "which may include".
Chairman Paseneaux also asked Mr. Samulski to call Director Galeotos at the Department of Administration and Information to learn how a workers' compensation discount rate of 10% was arrived at in W.S. 27‑14‑201(o).
Representative Iekel suggested the bill should be amended on page 21-lines 12 and 13 with respect to psychologist and psychiatrists. Senator Scott asked Representative Iekel to consider preparing an amendment for consideration of the bill on the next day of the meeting.
With no further business before the Committee, Chairman Paseneaux adjourned the meeting at 5:20 p.m., Tuesday, November 27, 2001.
* * * * *
Wednesday
November 28, 2001
Chairman Paseneaux reconvened the meeting at 8:40 a.m., on Wednesday, November 28, 2001. Chairman Paseneaux called for public comment on 02LSO-0167.W6.
Mr. Mike Mosher, Wyoming Liquor Dealers Association (WLDA), provided the Committee with an update on the voluntary posters being distributed to dealers throughout the state in cooperation with the Department of Health. He stated there has been welcome cooperation among the WLDA, Department of Health and the Liquor Division of the Department of Revenue that has had some positive results already.
Senator Scott provided a general explanation of the intent of his proposed amendment (Appendix H) which would provide an alternative secure treatment facility to treat substance abuse offenders.
Mr. Lindly, advised that the Department of Corrections supports the amendment. The current cost for out-of-state placements could allow for treatment for up to 100 inmates returning to Wyoming for treatment in a secured treatment facility instate.
Senator Scott moved for adoption of his proposed amendment. Mr. McDaniel added the amendment is consistent with the blueprint for the substance abuse control plan. Up to $330,000.00 may be needed for a monitor from the Department of Corrections for the facility which would include projected medical costs for inmates also. The proposed cost of $1 million dollars could be absorbed in the next fiscal year by returning inmates from out-of-state placements. Mr. Lindly added that the Department of Corrections intensive care program at the Wexford Facility in Rawlins is doing a good job but doesn't currently have the capacity needed to treat all inmates with alcohol or substance abuse problems.
Representative Robinson moved to amend Appendix H on page 1-line 40, delete "in"; page 2-line 12, delete "any such"; page 2-line 25, delete the second "for"; page 3-line 33, delete "any such" insert "a"; page 3-line 3, delete "intended to"; page 3-lines 4 and 5, delete entirely; and page 3-line 6 delete the line through "development," and insert "which will", delete "preparing" insert "prepare". The motion carried unanimously on a voice vote.
Representative Ross moved to amend page 2 of the amendment, after line 2, by adding a new subparagraph to read "(B) Breach of contract; or" and renumber as necessary. The motion carried on a voice vote.
Representative Ross moved to amend the amendment on page 2-lines 26 and 27 by replacing the last sentence with "the facility may not contract with other governmental jurisdictions to provide additional beds without the consent of the department of corrections." The motion carried unanimously on a voice vote.
Returning to the motion by Senator Scott to incorporate Appendix H, as amended, into the bill carried on a voice vote with one no.
The Committee then returned to consideration of the revised Appendix G previously presented by Mr. McDaniel.
Senator Scott moved to give LSO the discretion to add introductory language in the bill title for W.S. 9‑2‑2601(a), as proposed by the amendment. The motion carried unanimously.
Senator Massie moved to delete the provisions of W.S. 9‑2‑2018 from the bill and from the proposed amendment in Appendix G. The motion carried on a hand vote with 7 ayes and 4 noes.
Ms. Merit Thomas, Department of Family Services, expressed concern with language in the bill on page 20-lines 18 and 19 and on page 21-lines 1 and 2. She stated it is difficult to define "excessive use" which could result in an increase in child abuse referrals to DFS by approximately 1,000 referrals per year. This would require 9 additional full-time equivalent employees to investigate those referrals and another 15 full-time equivalent employees to provide case management if the referrals are substantiated. She stated current rules can address the situation this bill attempts to address and asked for a deletion from the bill of the amendments to W.S. 14‑3‑202. Mr. McDaniel added that he does not object to deleting the section and related amendments from the bill.
Senator Case moved to remove the amendments to W.S. 14‑3‑202 and the proposed amendment in Appendix G.
Senator Case moved to divide that portion of Appendix G that would amend W.S. 27‑14‑201. The motion failed on a hand vote with 1 aye.
Chairman Paseneaux advised that she would propose an amendment to W.S. 33‑1‑115(g) in Appendix H to include a state employee's assistance program.
Representative Robinson moved to amend Appendix G on page 40-line 1 by deleting "such" and inserting "the" and on page 3-line 4 deleting "however". The motion carried unanimously.
Senator Scott moved to adopt Appendix G, as amended, for inclusion in 02LSO-0167.W6. The motion carried on a voice vote.
Representative Robinson moved for adoption of a proposed amendment contained in Appendix I. Senator Scott moved to divide the amendment to consider the instruction on page 6-line 11 separately. The motion carried unanimously. The Committee then voted on the proposed amendment with respect to the instructions for page 1-line 12 through page 6-line 8. The motion carried unanimously on a voice vote. The Committee then voted on the instruction contained for page 6-line 11. That portion of the proposed amendment in Appendix I failed.
Representative Warren moved to amend the bill on page 6-line 6 after "." delete balance of line and on line 7 delete the line through "," and in the Robinson amendment instruction to page 1-line 15, delete "a pregnant" insert "an". The motion failed on a voice vote.
Senator Scott moved to amend the bill on page 10-after line 8 by inserting a new subsection to read "the department of health may allow exceptions to the requirements of rules adopted pursuant to subsection (b) of this section relating to the use of best practices to permit bona fide research to develop new effective treatment, intervention and prevention.". The motion carried unanimously on a voice vote.
Representative Ross moved to amend the bill to delete language on page 13-beginning on line 22 through page 18-line 16. The motion failed on a hand vote.
Senator Case moved to amend the bill on page 15-line 16 after "." through page 16-line 4 to delete the language entirely with respect to the use of minors. The motion failed on a hand vote.
Senator Scott moved, seconded by Representative Osborn, for Committee introduction of 02LSO-0167.W6, as amended. The motion carried on a roll call vote of 10 ayes, 1 no and 3 excused. Senators Boggs, Massie and Scott and Representatives Iekel, Meuli, Osborn, Paseneaux, Robinson, Ross and Warren voted aye. Senator Case voted no. Senator Roberts and Representatives McMurtrey and Wostenberg were excused. Dr. Galloway distributed Appendix J containing a fiscal summary of 02LSO‑0167.W6.
Mr. Les Pozsgi, Department of Family Services, presented the DFS budget request. Mr. Lindly explained the Department of Corrections fiscal impact. Senator Scott added that the bill would need to address the $330,000.00 that would be required as a result of his amendment (Appendix H).
Senator Scott moved to include the presented fiscal information as an appropriation within the bill. The motion carried unanimously on a voice vote.
b) 02LSO-0237.W1, Substance abuse-professions and occupations.
Mr. McDaniel explained this bill would be unnecessary in light of the proposed amendment to W.S. 33‑1‑115 which was incorporated into the previous bill. With that information, Chairman Paseneaux laid back 02LSO-0237.W1 indefinitely.
Senator Scott distributed Appendix K, relating to the Management Audit Committee's review of the Medicaid topic identification background, dated July, 2001. The information was provided to give the Joint Labor, Health and Social Services Interim Committee the same information that had been considered by the Management Audit Committee.
6. DEPARTMENT OF WORKFORCE SERVICES
Ms. Lisa Skiles, Director, Department of Workforce Services, explained the bill. She asked for additional language on page 5-line 17 with respect to the general authority for memoranda of understanding.
Mr. Rivera explained that the provision beginning on page 7-line 14 through page 8-line 12 would transfer a program that is no longer in effect. Therefore he suggested that language should be deleted.
Senator Scott moved to delete the language beginning page 7-line 14 through page 8-line 12 and to renumber as necessary. The motion carried unanimously.
Representative Ross moved to make the section title to W.S. 9‑2‑2603 more descriptive of the section as it currently reads. The motion carried unanimously.
Senator Boggs moved to amend page 15-line 18 by deleting "existing". After discussion the motion was withdrawn.
Senator Case moved to adopt the proposed amendment drafted by Mr. Rivera and Director Skiles (Appendix L). Director Nelson suggested the provision would be more complete if language contained in W.S. 27‑3‑607(c) and (d)(ii) were added to the amendment. The motion was amended to include the suggestion by Director Nelson. The motion carried unanimously on a voice vote.
Senator Scott moved to give LSO the authority to correct any grammatical or citation errors. The motion carried unanimously.
Representative Ross moved to amend the bill on page 23-line 13 by striking "free". The motion carried on a voice vote.
Director Nelson asked that the amendment to W.S. 27‑3‑307 be removed from the bill. After discussion, the Committee voted against removing W.S. 27‑3‑307 from the bill.
Senator Scott moved to amend page 29-line 13 by striking "department of employment". The motion carried unanimously on a voice vote.
Senator Scott moved to amend page 30-line 20 by reinserting stricken "family" and adding ", department of workforce services". The motion carried unanimously on a voice vote.
Representative Ross moved to amend page 33-line 1 by deleting "April 1, 2002" and inserting "immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution". The motion carried unanimously on a voice vote.
Senator Massie moved to amend page 5-line 9 by deleting ":" and inserting "."; page 5-line 17 after "districts" insert "and any other entities"; and page 5-line 22 before "and" insert "(A) through (C)". The motion carried unanimously on a voice vote.
Representative Robinson moved to amend page 26 by deleting lines 4 through 16. The motion failed on a voice vote.
Representative Robinson moved to amend page 9-lines 6 and 10, and page 12-line 3, by deleting "this" and inserting "the"; page 13-line 4, delete "he"; page 13-line 12, by deleting "such" and inserting "the"; page 13-line 21, by deleting "this" and inserting "the"; page 14- line 7, by deleting "such"; deleting "as the" and inserting "directed by"; on page 14-line 8, by deleting "directs"; and to amend page 20-lines 21 and 22 to read similar to the amendments on page 14-lines 7 and 8. The motion carried unanimously on a voice vote.
Director Skiles distributed Appendix M containing the fiscal information which led to the appropriation in 02LSO-0275.W2. Senator Scott recommended not considering a separate appropriation bill, but rather consolidating the appropriation contained in 02LSO-0275.W2 into 02LSO-0235.W1.
Representative Ross moved to incorporate the appropriation of $2,330,844.00 from 02LSO-0275.W2 into 02LSO-01235.W1. The motion carried on a voice vote.
Senator Scott moved, seconded by Representative Osborn, for Committee introduction of 02LSO-0235.W1, as amended. The motion carried on a unanimous roll call vote. Senators Boggs, Case, Massie and Scott and Representatives Iekel, Meuli, Osborn, Robinson, Ross and Warren voted aye. Senator Roberts and Representatives McMurtrey and Wostenberg were excused.
7. OTHER BUSINESS
Representative Ross explained 02LSO-0286.W2 which was drafted in response to the request to consider appropriations for extraordinary care in nursing care facilities, wage pass-throughs for direct patient care staff and rebasing of the Medicaid reimbursement rate for nursing care facilities.
Representative Meuli moved to amend section 5 of the bill to make the effective date of the bill July 1, 2003. The motion carried unanimously.
Senator Massie moved to amend W.S. 42‑4‑104(c) to read: "The department shall, not less than every five (5) years, establish a new base period to be used in calculating all skilled nursing homes' Medicaid assistance per diem base rate reimbursable under this chapter, using the most recent cost report information provided to the department.". The motion carried unanimously on a voice vote.
Representative Ross moved, seconded by Senator Massie, for Committee introduction of 02LSO-0286.W2 as amended. The motion carried unanimously on a roll call vote. Senators Boggs, Massie and Scott and Representatives Iekel, Meuli, Osborn, Paseneaux, Robinson, Ross and Warren voted aye. Senators Case and Roberts and Representatives McMurtrey and Wostenberg were excused.
Representative Ross advised the Committee that he had been contacted by the Department of Family Services with respect to compliance mandates for child support enforcement. He would be introducing the bills to deal with medical support payments, notice to payors and a single distribution unit provision.
ADJOURNMENT
With no further business before the Committee, Chairman Scott adjourned the meeting at 4:20 p.m., Wednesday, November 28, 2001.
Respectfully submitted,
________________________ ___________________________
Senator Charles K. Scott Representative Carolyn Paseneaux
Cochairman Cochairman
Please Note: Due to the length and complexity of the appendices, the appendices are not being distributed with the summary of proceedings. A copy of the appendices is on file at the Legislative Service Office for anyone wishing to view them.