Prop 202 History

April 9, 2012
As part of the recent CMS approval of the SNCP program in the AHCCCS 2012 Waiver Amendment, over $13 million in new federal funds will be added to the Prop 202 fund. Specifically, funds will be directed primarily to rural hospitals and other hospitals with Emergency Department and trauma centers across the State. More information is provided below:

2012 Waiver Amendment Fact Sheet [PDF]
CMS Approved Authorities [PDF]

March 28, 2012
CMS has not finalized their position on this proposal, but has indicated that if a proposal were to be approved, the maximum the State would receive is approximately $13.3 million in additional federal funds. Given this position, AHCCCS has updated the modeling options to reflect a proposal that would meet the general consensus of the previous options. The updated models:

  • Ensure that Trauma facilities are maintained at a level of funding at least equal to current levels.
  • Target the majority of new resources towards rural facilities.

AHCCCS will continue to keep stakeholders informed as the process moves forward. AHCCCS continues to seek stakeholder comments with regards to the proposed allocation should CMS approve federal funding.

DRAFT Option under SNCP 3/29/12 * [PDF]

* Note: Based on preliminary information and is subject to change. 


Prop 202 Options

January 27, 2012
AHCCCS has been working with CMS to determine if there is an opportunity to obtain Title XIX match for the proposition 202 gaming funds. Historically these state-only funds have provided approximately $20 million with 90% of the funds paid to 6 trauma facilities and the remaining 10% spread among dozens of hospitals for uncompensated emergency department costs.

Current Allocation vs. Options 1-3 Modeled * [PDF] (as of 1/27/12)

* Note: Based on preliminary information and is subject to change.

AHCCCS has all of the existing statutory authority to implement this change and is already proceeding and has included these funds as part of the Safety Net Care Pool (SNCP) proposal currently pending before CMS. This would be a time limited proposal to leverage these monies. Currently, it is envisioned that the SNCP Pool will be terminated on January 1, 2014.

Should CMS approve this proposal, AHCCCS will use its existing exempt rule making authority to reflect the new allocation and the SNCP methodology. Upon receiving stakeholder input from hospitals and CMS approval, AHCCCS will move forward in promulgating the rule. AHCCCS has developed the following 3 options based on the SNCP methodology and is seeking hospital input**  regarding the best option to pursue and why.

Option 1- Split the funds in half with 50% of the monies to go to Trauma facilities and 50% of the monies to fund Emergency Department costs.

Option 2 - Split the funds so 1/3 of the monies go to Trauma facilities and 2/3 toward Emergency Department costs.

Option 3 - Take 10% of the funds to provide a supplemental payment to rural hospitals; 60% of the monies to fund Emergency Department costs (including rural hospitals); and 30% of the monies would go to Trauma facilities.

**Hospital Meeting Agenda 2/22/12 [PDF]

The AHCCCS Administration is accepting comments on the Prop 202 Options at


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