As Introduced

130th General Assembly
Regular Session
2013-2014
S. B. No. 280


Senators Jones, Tavares 


A BILL
To enact sections 3701.68, 5162.135, and 5167.15 of 1
the Revised Code to require that case management 2
services for postpartum care be included in the 3
Medicaid managed care system, to require the 4
Director of Health to award grants for 5
community-based services that are not covered by 6
Medicaid and are intended to reduce infant 7
mortality rates among at-risk populations, and to 8
make an appropriation.9


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1. That sections 3701.68, 5162.135, and 5167.15 of 10
the Revised Code be enacted to read as follows:11

       Sec. 3701.68. (A) There is hereby created in the state 12
treasury the infant vitality grant fund. The fund shall consist of 13
money appropriated to the fund by the general assembly and be used 14
to award grants under this section.15

       (B) In accordance with the process the director of health 16
specifies under division (C) of this section, the director shall 17
award grants to private, nonprofit entities that provide 18
community-based services meeting both of the following criteria: 19

       (1) Are intended to reduce infant mortality rates among 20
populations, identified by the director, that have historically 21
experienced high infant mortality rates or are at risk of 22
experiencing them;23

       (2) Are not covered by the medicaid program. 24

       (C) The director shall create a grant application and develop 25
a process for receiving and evaluating completed grant 26
applications on a competitive basis. In the grant application, the 27
director shall specify that a grant applicant must demonstrate how 28
it will use grant money only to supplement, and not supplant, 29
public and private funds that the applicant has procured in the 30
years recently preceding submission of the application to pay for 31
expenses associated with the provision of community-based services 32
meeting the criteria in division (B) of this section. In 33
evaluating completed grant applications, the director shall 34
consider the applicant's efforts to date to procure public and 35
private funds to pay for such expenses. 36

       (D) The director's decision on a submitted grant application 37
is final. 38

       Sec. 5162.135. Not less than once each year, the medicaid 39
director shall complete a report about the optimal pregnancy 40
spacing counseling that medicaid managed care organizations are to 41
include in case management services for postpartum care under 42
section 5167.15 of the Revised Code. The report shall include 43
information about the counseling's effectiveness in promoting 44
healthy pregnancies, reducing the risk of infant mortality, and 45
achieving other positive health outcomes. The director shall 46
provide a copy of the report to the governor, general assembly, 47
and joint medicaid oversight committee. The copy to the general 48
assembly shall be provided in accordance with section 101.68 of 49
the Revised Code. The director also shall make the report 50
available to the public.51

       Sec. 5167.15.  Each contract the department of medicaid 52
enters into under section 5167.10 of the Revised Code with a 53
managed care organization that is a health insuring corporation 54
shall provide for the payment the organization receives under the 55
contract to be reduced if the organization fails to provide, or 56
arrange for the provision of, case management services for the 57
postpartum care available to each medicaid recipient who is 58
enrolled in the organization, is covered by the medicaid program 59
under division (B) of section 5163.06 of the Revised Code on the 60
basis of the recipient's pregnancy, and has a high risk of 61
suffering poor health outcomes related to the pregnancy as 62
determined in accordance with rules the medicaid director shall 63
adopt under section 5167.02 of the Revised Code. The director 64
shall determine the amount of the payment reduction. The case 65
management services for the postpartum care shall include 66
counseling regarding the optimal intervals at which an 67
individual's pregnancies may be spaced in order to promote healthy 68
pregnancies, reduce the risk of infant mortality, and achieve 69
other positive health outcomes.70

       Section 2. Of the unexpended and unencumbered portion of the 71
state share appropriation made to GRF appropriation item 651525, 72
Medicaid/Health Care Services, in Am. Sub. H.B. 59 of the 130th 73
General Assembly, at the end of fiscal year 2014, $25,000,000 is 74
hereby reappropriated for fiscal year 2015 to the credit of the 75
Infant Vitality Grant Fund created under section 3701.68 of the 76
Revised Code. 77