11-292

11-292. Medical care; definition

A. The board of supervisors, subject to the applicable provisions of title 42,
chapter 17, articles 2 and 3, shall include in its annual budget an amount equal to fifty
per cent of the amount budgeted by the county board of supervisors or the amount
expended, whichever is less, for the hospitalization and medical care of the indigent
sick pursuant to this article for fiscal year 1980-1981, except for Yuma and La Paz
counties. The contribution amounts of those counties shall be equal to the amount Yuma
county would have made pursuant to this subsection if a division had not occurred
apportioned between the counties. The office of the auditor general shall determine the
amount Yuma county would otherwise have included if a division had not occurred and shall
then determine the contribution amounts of Yuma and La Paz counties based on the
proportionate share of the estimated population in these counties as of July 1, 1982.

B. For fiscal year 1994-1995, and for each fiscal year thereafter, the state
treasurer shall withhold an amount sufficient to meet the county portion of the
nonfederal costs of providing long-term care system services, pursuant to title 36,
chapter 29, article 2, excluding services to the developmentally disabled, from monies
otherwise payable to the county under section 42-5029, subsection D, paragraph 2. This
amount and the state portion of the nonfederal costs shall be specified in the annual
appropriation for the maintenance and operation of the Arizona health care cost
containment system. For fiscal years 1994-1995, 1995-1996 and 1996-1997, monies shall be
withheld from each county based on the following percentages derived from a state auditor
general's certified audit of fiscal year 1987-1988 county long-term care and home health
care expenditures, except that amounts withheld shall be adjusted to reflect amounts paid
by counties pursuant to section 36-2952:


 1.  Apache: 0.22%
 2.  Cochise: 2.49%
 3.  Coconino: 0.66%
 4.  Gila: 2.56%
 5.  Graham: 0.64%
 6.  Greenlee: 0.34%
 7.  La Paz: 0.34%
 8.  Maricopa: 56.55%
 9.  Mohave: 2.73%
 10.  Navajo: 0.91%
 11.  Pima: 20.55%
 12.  Pinal: 5.09%
 13.  Santa Cruz: 1.05%
 14.  Yavapai: 3.12%
 15.  Yuma: 2.75%

C. In each fiscal year, of the total amount that is specified in the annual
appropriation as the nonfederal portion of the cost of providing long-term care services
and that portion of the phased-down medicare prescription drug state contribution
attributable to the Arizona long-term care system, excluding services and phased-down
medicare prescription drug state contribution costs associated with the developmentally
disabled, and that represents an increase from the amount that was specified in the
annual appropriation for the prior fiscal year, the state shall pay fifty per cent of the
increase. The remaining nonfederal portion of the costs shall be apportioned among the
counties according to the proportion that each county's net nonfederal expenditures for
long-term care services, excluding services to the developmentally disabled, bears to the
total nonfederal expenditure for all counties two fiscal years earlier, with the
following adjustments in the following order:

1. If the resulting net county contribution when expressed as an imputed property
tax rate per one hundred dollars of net assessed value exceeds ninety cents, the county's
contribution shall be reduced so that the imputed property tax rate equals ninety cents
and the difference shall be paid by the state.

2. Any county with a native American population that represents at least twenty per
cent of the county's total population according to the most recent United States
decennial census shall contribute an amount equal to the prior fiscal year's contribution
plus fifty per cent of the difference between the prior year's contribution were it
calculated using the percentage in subsection B of this section and the current year's
contribution as if its share of the total nonfederal portion of the long-term care costs
had been calculated using the percentage prescribed in subsection B of this section and
the state shall pay any difference from the amount otherwise required by this subsection.

3. If, after making the adjustments in this subsection, a county would contribute
more than if its contribution were calculated using the percentage prescribed in
subsection B of this section multiplied by the total nonfederal costs of long-term care
services, excluding services to the developmentally disabled, the county's contribution
shall be reduced to the sum of its prior year's contribution plus fifty per cent of the
difference between the prior year's contribution were it calculated using the percentage
in subsection B of this section and the current year's contribution as if its share of
the total nonfederal portion of long-term care costs had been calculated using the
percentage prescribed in subsection B of this section and the state shall pay any
difference from the amount otherwise required by this subsection.

4. After making all of the adjustments in this subsection, a statewide per capita
county contribution shall be calculated by summing the contributions for all counties and
then dividing the resulting total by the total state population. If an individual
county's contribution when expressed as a per capita contribution exceeds the statewide
per capita county contribution, the county's contribution shall be reduced so that the
county's contribution equals the statewide per capita contribution and the difference
shall be paid by the state. For the purposes of this paragraph, "population" means the
population estimate approved by the director of the department of economic security for
the most recent fiscal year.

D. The director of the Arizona health care cost containment system administration
shall notify each county of the amount determined pursuant to subsection A of this
section to be included in its annual budget no later than May 1 of each year.

E. If a county does not provide funding as specified in subsection A of this
section, the state treasurer shall subtract the amount owed to the Arizona health care
cost containment system fund by the county from any payments required to be made by the
state treasurer to that county pursuant to section 42-5029, subsection D, paragraph 2,
plus interest on that amount pursuant to section 44-1201 retroactive to the first day the
funding was due. If the monies the state treasurer withholds are insufficient to meet
that county's funding requirement as specified in subsection A of this section, the state
treasurer shall withhold from any other monies payable to that county from whatever state
funding source is available an amount necessary to fulfill that county's requirement.
The state treasurer shall not withhold distributions from the highway user revenue fund
pursuant to title 28, chapter 18, article 2.

F. Each month payment of an amount equal to one-twelfth of the total amount
determined pursuant to subsection A of this section shall be made to the state treasurer.
Payment of this amount shall be made to the state treasurer on or before the fifth day of
each month. Upon request from the director of the Arizona health care cost containment
system administration, the state treasurer shall require that up to three months'
payments be made in advance, if necessary.

G. The state treasurer shall deposit the amounts paid pursuant to subsection F of
this section and amounts withheld pursuant to subsection E of this section in the Arizona
health care cost containment system fund established by section 36-2913.

H. If payments made pursuant to subsection F of this section exceed the amount
required to meet the costs incurred by the Arizona health care cost containment system
for the hospitalization and medical care of a person who is defined as an eligible person
pursuant to section 36-2901, paragraph 6, subdivision (a), the director of the Arizona
health care cost containment system administration may instruct the state treasurer
either to reduce remaining payments to be paid pursuant to this section by a specified
amount or to provide to the counties specified amounts from the Arizona health care cost
containment system fund.

I. The amount of the county contribution to the Arizona health care cost
containment system fund established by section 36-2913 shall not exceed thirty-three per
cent of the amount that the system administration expended in the county for fiscal year
1983-1984. For the purposes of this subsection, system administration expenditures in a
county for fiscal year 1983-1984 are the total capitation and fee for service amounts
paid by the system administration to providers in a county before February 1, 1986 for
services rendered during fiscal year 1983-1984 to persons eligible for the system.

J. The state treasurer shall deposit the monies withheld from the counties and
contributed by the state pursuant to subsection B of this section in the long-term care
system fund established by section 36-2913, in twelve equal monthly installments. The
monthly installments shall be deposited in the fund by the state treasurer by the fourth
working day of each month.

K. By July 1 or within sixty days after enactment of the annual appropriation for
the maintenance and operation of the Arizona health care cost containment system,
whichever is later, and after consulting with the joint legislative budget committee and
the governor's office of strategic planning and budgeting, the state treasurer shall
notify each county of the amount to be withheld pursuant to subsection B of this section.

L. If the monies deposited in the long-term care system fund pursuant to subsection
J of this section are insufficient to meet the funding requirement as specified in the
annual appropriation for the maintenance and operation of the Arizona health care cost
containment system pursuant to subsection B of this section, the state treasurer shall
withhold from any other monies payable to that county from any available state funding
source, other than the highway user revenue fund, the amount required to fulfill fifty
per cent of the funding requirement and shall deposit the monies in the long-term care
system fund. The state shall pay the remaining fifty per cent of the funding requirement.

M. If any monies in the funds for the purpose of title 36, chapter 29, article 2
remain unexpended at the end of the fiscal year, the director of the Arizona health care
cost containment system administration shall specify to the state treasurer the amount to
be withdrawn from the long-term care system fund. Of the amount specified, the state
treasurer shall distribute fifty per cent to the counties pursuant to subsection B or C
of this section. The remaining fifty per cent shall be distributed to the state.

N. The board of supervisors of a county that is a program contractor pursuant to
section 36-2940 shall include in its annual budget, subject to title 42, chapter 17,
articles 2 and 3, monies received from the Arizona health care cost containment system
fund and long-term care system fund for the purposes of title 36, chapter 29, article 2.

O. Notwithstanding any law to the contrary, beginning in fiscal year 2005-2006 and
in each fiscal year thereafter, the state treasurer shall withhold a total of two million
three hundred ninety-five thousand four hundred dollars for the county contribution for
the administrative costs of implementing sections 36-2901.01 and 36-2901.04 beginning
with the second monthly distribution of transaction privilege tax revenues otherwise
distributable after subtracting any amounts withheld for the county long-term care
contribution. Beginning in fiscal year 2006-2007, the state treasurer shall adjust the
amount withheld according to the annual changes in the GDP price deflator and as
calculated by the joint legislative budget committee staff. Beginning in fiscal year
2006-2007, the joint legislative budget committee shall calculate an additional
adjustment of the allocation required by this subsection based on changes in the
population as reported by the department of economic security. For the purposes of this
subsection, "GDP price deflator" has the same meaning prescribed in section 41-563. Each
county's annual contribution is as follows:

1. Apache, 3.296 per cent.

2. Cochise, 6.148 per cent.

3. Coconino, 6.065 per cent.

4. Gila, 2.491 per cent.

5. Graham, 1.7710 per cent.

6. Greenlee, 0.455 per cent.

7. La Paz, 0.9430 per cent.

8. Mohave, 7.079 per cent.

9. Navajo, 4.640 per cent.

10. Pima, 42.168 per cent.

11. Pinal, 8.251 per cent.

12. Santa Cruz, 1.950 per cent.

13. Yavapai, 7.794 per cent.

14. Yuma, 6.949 per cent.

P. The state treasurer shall deposit the amounts paid pursuant to subsection O of
this section in the budget neutrality compliance fund established by section 36-2928.

Q. Beginning in fiscal year 2006-2007 for a county that is subject to section
12-269, the county's contributions pursuant to this section shall be reduced by the
amount of state aid for probation services that the county would have received in the
first fiscal year in which the county does not receive state aid for probation services.
Any increase in the county's contributions in subsequent years shall be reduced according
to its proportionate share of the base contribution. County contributions shall be
reduced in the following priority:

1. First as applied to the contribution provided for in subsection O of this
section.

2. Second as applied to the contribution provided for in subsection A of this
section or any other contribution for acute care or for the provision of hospitalization
and medical care that would otherwise be required.

3. Third as applied to the contribution provided for in subsection C of this
section.

R. Beginning in fiscal year 2007-2008 for a county that is subject to section
22-117, subsection D, the county's contributions pursuant to this section shall be
reduced by the amount of the state reimbursement that the county would have received in
fiscal year 2007-2008 for the salaries of justices of the peace pursuant to section
22-217, subsection B. Any increase in the county's contributions in subsequent years
shall be reduced according to its proportionate share of the base contribution. County
contributions shall be reduced in the following priority:

1. First as applied to the contribution provided for in subsection O of this
section.

S. For the purposes of this section, "net assessed value" includes the values used
to determine voluntary contributions collected pursuant to title 9, chapter 4, article 3
and title 48, chapter 1, article 8.