(1) (a) There is hereby created in the state treasury the tobacco tax cash fund, which fund is referred to in this section as the "cash fund". The cash fund consists of money collected from the cigarette and tobacco taxes imposed pursuant to section 21 of article X of the state constitution and money transferred in accordance with section 24-22-118 (2). All interest and income derived from the deposit and investment of money in the cash fund shall be credited to the cash fund; except that all interest and income derived from the deposit and investment of money in the cash fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years shall be credited to the general fund. Any unexpended and unencumbered money remaining in the cash fund at the end of a fiscal year shall remain in the cash fund and shall not be credited or transferred to the general fund or any other fund, except as otherwise provided in this section. (b) Repealed. (c) For each fiscal year from the 2004-05 fiscal year through the 2007-08 fiscal year and for the 2012-13 fiscal year and each fiscal year thereafter, the general assembly shall annually appropriate three percent of the moneys estimated to be deposited in that fiscal year into the cash fund, plus three percent of the interest and income earned on the deposit and investment of moneys in the cash fund, and, for the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years, the general assembly shall annually appropriate three percent of the moneys estimated to be deposited in that fiscal year into the cash fund, for health-related purposes to provide revenue for the state's general fund and the old age pension program and for municipal and county governments to compensate proportionately for tax revenue reductions attributable to lower cigarette and tobacco sales resulting from the implementation of the tax imposed pursuant to section 21 of article X of the state constitution, as follows: (I) (A) Twenty percent of the moneys specified in this paragraph (c) to the state's general fund for health-related purposes. (B) Beginning in fiscal year 2006-07 and for fiscal year 2007-08 through fiscal year 2010-11, of the moneys specified in sub-subparagraph (A) of this subparagraph (I), fifty percent shall be appropriated for the purposes of providing immunizations performed by county or district public health agencies in areas that were served by county public health nursing services prior to July 1, 2008, and fifty percent shall be appropriated to the pediatric specialty hospital fund, created in paragraph (e) of subsection (2) of this section, for the purposes of augmenting hospital reimbursement rates for regional pediatric trauma centers as defined in section 25-3.5- 703 (4)(f), C.R.S., under the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5, C.R.S. (B.5) Beginning in fiscal year 2011-12 and for each fiscal year thereafter, of the moneys specified in sub-subparagraph (A) of this subparagraph (I), fifty percent shall be appropriated for the purposes of providing immunizations performed by county or district public health agencies in areas that were served by county public health nursing services prior to July 1, 2008, and fifty percent shall be appropriated for expenditures in the children's basic health plan created in article 8 of title 25.5, C.R.S. (C) Repealed. (II) Fifty percent of the moneys specified in this paragraph (c) to provide health-related services under the "Colorado Medical Assistance Act", articles 4 to 6 of title 25.5, C.R.S., for persons who qualify to receive old age pensions; and (III) Thirty percent of the moneys specified in this paragraph (c) to the department of revenue to be apportioned to municipal and county governments in amounts consistent with the provisions of section 39-22-623, C.R.S. (2) There are hereby created in the state treasury the following funds: (a) (I) The health care expansion fund to be administered by the department of health care policy and financing. The state treasurer and the controller shall transfer an amount equal to forty-six percent of the moneys deposited into the cash fund, plus forty-six percent of the interest and income earned on the deposit and investment of moneys in the cash fund, to the health care expansion fund; except that, for fiscal year 2004-05, the state treasurer and the state controller shall transfer an amount equal to forty-six percent of the moneys deposited into the cash fund less the amount of money sufficient to fund the reinstatement of medical assistance benefits for legal immigrants as provided for in House Bill 05-1086, enacted at the first regular session of the sixty-fifth general assembly, and except that, for the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years, the state treasurer and the controller shall transfer to the health care expansion fund only an amount equal to forty-six percent of the moneys deposited into the cash fund. All interest and income derived from the deposit and investment of moneys in the health care expansion fund shall be credited to the health care expansion fund; except that all interest and income derived from the deposit and investment of moneys in the health care expansion fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years shall be credited to the general fund. Any unexpended and unencumbered moneys remaining in the health care expansion fund at the end of a fiscal year shall remain in the fund and shall not be credited or transferred to the general fund or any other fund. (II) Except as provided in subparagraph (III) of this paragraph (a), for fiscal year 2005- 06 and each fiscal year thereafter, moneys in the health care expansion fund shall be annually appropriated by the general assembly to the department of health care policy and financing for the following purposes: (A) To increase eligibility in the children's basic health plan, article 8 of title 25.5, C.R.S., for children and pregnant women from one hundred eighty-five percent to two hundred percent of the federal poverty line; (B) To remove the asset test under the medical assistance program, articles 4, 5, and 6 of title 25.5, C.R.S., for children and families; (C) To expand the number of children that can be enrolled in the children's home- and community-based service waiver program, section 25.5-6-901, C.R.S., and the children's extensive support waiver program; (D) To increase eligibility in the medical assistance program, articles 4, 5, and 6 of title 25.5, C.R.S., to at least sixty percent of the federal poverty line for a parent of a child who is eligible for the medical assistance program or the children's basic health plan, article 8 of title 25.5, C.R.S.; (E) To fund medical assistance to legal immigrants pursuant to section 25.5-5-201, C.R.S.; (F) To pay for enrollment increases above the average enrollment for state fiscal year 2003-04 in the children's basic health plan, article 8 of title 25.5, C.R.S., or, for state fiscal year 2011-12 and for each fiscal year thereafter, to pay for costs associated with children enrolled in the medical assistance program, articles 4, 5, and 6 of title 25.5, C.R.S., whose family income is more than one hundred percent but does not exceed one hundred thirty-three percent of the federal poverty line and who would have been eligible for enrollment in the children's basic health plan prior to September 1, 2011; (G) To provide up to five hundred forty thousand dollars for cost-effective marketing to increase the enrollment of eligible children and pregnant women in the children's basic health plan, article 8 of title 25.5, C.R.S.; (H) To provide presumptive eligibility to pregnant women under the medical assistance program, articles 4, 5, and 6 of title 25.5, C.R.S.; and (I) To provide funding for extending medicaid eligibility for persons who are in the foster care system immediately prior to emancipation, as set forth in section 25.5-5-101 (1)(e), C.R.S. (III) Moneys transferred to the health care expansion fund in fiscal year 2004-05, less the amount necessary for the administrative costs of the department of health care policy and financing to facilitate the program expansions specified in subparagraph (II) of this paragraph (a), shall remain in the health care expansion fund as a reserve. Beginning in fiscal year 2005-06 and for each fiscal year thereafter, ten percent of the moneys transferred in each fiscal year to the health care expansion fund and any unexpended and unencumbered moneys remaining in the health care expansion fund at the end of a fiscal year shall remain in the fund and be added to the reserve until the first time the reserve balance is equal to the amount annually transferred to the health care expansion fund. Moneys in the health care expansion fund that are designated as reserve moneys, up to one-half of the amount annually transferred to the health care expansion fund, may be expended only if the appropriations necessary to sustain the populations specified in subparagraph (II) of this paragraph (a) exceed the annual transfer of moneys to the health care expansion fund. (IV) and (V) Repealed. (b) (I) The primary care fund to be administered by the department of health care policy and financing. The state treasurer and the controller shall transfer an amount equal to nineteen percent of the moneys deposited into the cash fund, plus nineteen percent of the interest and income earned on the deposit and investment of those moneys, to the primary care fund; except that, for the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years, the state treasurer and the controller shall transfer to the primary care fund only an amount equal to nineteen percent of the moneys deposited into the cash fund. All interest and income derived from the deposit and investment of moneys in the primary care fund shall be credited to the primary care fund; except that all interest and income derived from the deposit and investment of moneys in the primary care fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years shall be credited to the general fund. Any unexpended and unencumbered moneys remaining in the primary care fund at the end of a fiscal year shall remain in the fund and shall not be credited or transferred to the general fund or any other fund. (II) For fiscal year 2005-06 and each fiscal year thereafter, moneys in the primary care fund shall be annually appropriated by the general assembly to the department of health care policy and financing for comprehensive primary care as specified in part 3 of article 3 of title 25.5, C.R.S. (III) to (V) Repealed. (c) (I) The tobacco education programs fund is to be administered by the department of public health and environment. The state treasurer and the controller shall transfer an amount equal to sixteen percent of the money deposited into the cash fund, plus sixteen percent of the interest and income earned on the deposit and investment of such money and the amounts specified in section 24-22-118 (2), to the tobacco education programs fund; except that, for the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years, the state treasurer and the controller shall transfer to the tobacco education programs fund only an amount equal to sixteen percent of the money deposited into the cash fund. All interest and income derived from the deposit and investment of money in the tobacco education programs fund shall be credited to the tobacco education programs fund; except that all interest and income derived from the deposit and investment of money in the tobacco education programs fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years shall be credited to the general fund. Any unexpended and unencumbered money remaining in the tobacco education programs fund at the end of a fiscal year shall remain in the fund and shall not be credited or transferred to the general fund or any other fund. (II) The interest and income derived from the deposit and investment of moneys in the tobacco education programs fund and credited to the tobacco education programs fund may be used to give credit to a wholesaler or distributor for taxes paid on cigarettes or other tobacco products that are bad debts pursuant to sections 39-28-104 and 39-28.5-107, C.R.S.; except that the interest earned on the tobacco education programs fund shall be used only for that portion of the bad debt attributable to the taxes imposed pursuant to section 21 of article X of the state constitution. (III) For fiscal year 2005-06 and each fiscal year thereafter, moneys in the tobacco education programs fund shall be annually appropriated by the general assembly as follows: (A) To the prevention services division of the department of public health and environment for the tobacco education, prevention, and cessation programs specified in part 8 of article 3.5 of title 25, C.R.S.; and (B) Up to three hundred fifty thousand dollars to the division of liquor enforcement in the department of revenue for the purpose of enforcing laws relating to the sale of tobacco to minors. (III.5) For fiscal year 2011-12 and for each fiscal year thereafter, the general assembly may annually appropriate moneys in the tobacco education programs fund to the department of health care policy and financing in order to allow the department to obtain federal matching funds for the Colorado quitline program. (IV) Repealed. (d) (I) The prevention, early detection, and treatment fund to be administered by the department of public health and environment. The state treasurer and the controller shall transfer an amount equal to sixteen percent of the moneys deposited into the cash fund, plus sixteen percent of the interest and income earned on the deposit and investment of those moneys, to the prevention, early detection, and treatment fund; except that, for the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years, the state treasurer and the controller shall transfer to the prevention, early detection, and treatment fund only an amount equal to sixteen percent of the moneys deposited into the cash fund. All interest and income derived from the deposit and investment of moneys in the prevention, early detection, and treatment fund shall be credited to the prevention, early detection, and treatment fund; except that all interest and income derived from the deposit and investment of moneys in the prevention, early detection, and treatment fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years shall be credited to the general fund. Any unexpended and unencumbered moneys remaining in the prevention, early detection, and treatment fund at the end of a fiscal year shall remain in the fund and shall not be credited or transferred to the general fund or any other fund. The moneys in the prevention, early detection, and treatment fund shall be annually appropriated by the general assembly to the department of public health and environment for allocation by the department consistent with the provisions of this paragraph (d). (II) Of the moneys appropriated annually by the general assembly to the department of public health and environment pursuant to subparagraph (I) of this paragraph (d), moneys shall be annually allocated by the department of public health and environment for breast and cervical cancer screenings pursuant to section 25-4-1505, C.R.S., in the following amounts not to exceed five million dollars in any fiscal year: (A) For the 2005-06 fiscal year, fourteen percent of the amount appropriated pursuant to subparagraph (I) of this paragraph (d); (B) For the 2006-07 fiscal year, sixteen percent of the amount appropriated pursuant to subparagraph (I) of this paragraph (d); (C) For the 2007-08 fiscal year, eighteen percent of the amount appropriated pursuant to subparagraph (I) of this paragraph (d); and (D) For the 2008-09 fiscal year and each fiscal year thereafter, twenty percent of the amount appropriated pursuant to subparagraph (I) of this paragraph (d). (III) For fiscal year 2005-06, and each fiscal year thereafter, fifteen percent of the money transferred to the prevention, early detection, and treatment fund shall be transferred to the health disparities grant program fund created in subsection (2)(f) of this section for the health disparities and community grant program in part 22 of article 4 of title 25. (IV) and (IV.5) Repealed. (V) (A) For fiscal year 2008-09 and each fiscal year thereafter, after the allocations made pursuant to subparagraphs (II) and (III) of this paragraph (d), moneys in the prevention, early detection, and treatment fund shall be annually appropriated by the general assembly to the prevention services division of the department of public health and environment for the cancer, cardiovascular disease, and chronic pulmonary disease prevention, early detection, and treatment program established in part 3 of article 20.5 of title 25, C.R.S. (B) and (C) Repealed. (VI) Pursuant to the declaration of a state fiscal emergency as described in subparagraph (III) of paragraph (b) of subsection (6) of this section, notwithstanding any provisions of subparagraphs (II), (III), (IV.5), and (V) of this paragraph (d) to the contrary, for fiscal year 2011-12, the general assembly shall appropriate moneys in the prevention, early detection, and treatment fund for the purposes described in subparagraphs (II), (III), (IV.5), and (V) of this paragraph (d), as well as any other health-related purpose and to serve populations enrolled in the children's basic health plan and the Colorado medical assistance program at the programs' respective levels of enrollment as of January 1, 2005. (e) Repealed. (f) (I) The health disparities grant program fund to be administered by the department of public health and environment. Money must be transferred to the health disparities grant program fund as described in subsection (2)(d)(III) of this section. The health disparities grant program fund also consists of any other money appropriated to the health disparities grant program fund by the general assembly. All interest and income derived from the deposit and investment of money in the health disparities grant program fund must be credited to the health disparities grant program fund. Any unexpended or unencumbered money remaining in the health disparities grant program fund at the end of the fiscal year must remain in the fund and shall not be credited to the general fund or any other fund. The money in the health disparities grant program fund must be annually appropriated by the general assembly to the department of public health and environment for allocation by the department of public health and environment consistent with the provisions of subsection (2)(d) of this section. (II) to (IV) Repealed. (3) For purposes of section 20 of article X of the state constitution and article 77 of this title, any moneys collected or expended from the imposition of the cigarette and tobacco tax imposed pursuant to section 21 of article X of the state constitution are not included in fiscal year spending, as defined in section 20 of article X of the state constitution, and are excluded from the spending limit contained in section 24-75-201.1 and any corresponding spending limits on local governments receiving such revenues. (4) Moneys appropriated to the health care expansion fund, the primary care fund, and the prevention, early detection, and treatment fund shall be used to supplement revenues that are appropriated by the general assembly for health-related purposes as of January 1, 2005, and shall not be used to supplant those appropriations. (5) The moneys generated by the implementation of the tax pursuant to section 21 of article X of the state constitution shall be appropriated by the general assembly and utilized by the recipients of the moneys only for such purposes as are specified in section 21 of article X of the state constitution. The moneys shall not be utilized: (a) For the purposes of lobbying as defined in section 24-6-301 (3.5)(a); or (b) To support or oppose any ballot issue or ballot question. (6) (a) Notwithstanding any other provision of law, the general assembly may use revenue generated by the implementation of the cigarette and tobacco taxes pursuant to sections 39-28-103.5 and 39-28.5-102.5, C.R.S., and section 21 of article X of the state constitution for any health-related purpose and to serve populations enrolled in the children's basic health plan and the Colorado medical assistance program at the respective program levels of enrollment as of January 1, 2005. Such use of revenue shall be preceded by a declaration of a state fiscal emergency, which shall be adopted by a joint resolution, approved by a two-thirds majority vote of the members of the senate and of the house of representatives, and signed by the governor. The declaration shall apply only to a single fiscal year. (b) to (d) Repealed. (7) The general assembly hereby finds and declares that for purposes of this section and section 21 (5) of article X of the state constitution, interest or income credited to the general fund pursuant to paragraph (a) of subsection (1) of this section and paragraphs (a) to (d) and (f) of subsection (2) of this section are not revenues generated by operation of section 21 (2) of article X of the state constitution.
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