FISCAL
NOTE
2017 regular session
By
[
to the Committee on Political Subdivisions then Health and Human Resources.
A BILL to amend and
reenact §16-1-6 of the Code of West Virginia, 1931, as amended; and to amend
and reenact §16-2-5 and §16-2-11 of said code, all relating to powers and
duties of the Commissioner of Public Health; modifying administration of local
boards of health; providing for regionalization of administration and services
of local health departments; requiring local health departments to bill health
insurance plans for services that are provided; mandating development of needle
exchange programs in local health departments; and providing for rule-making
authority.
Be it enacted by the Legislature
of West Virginia:
That §16-1-6 of the
Code of West Virginia, 1931, as amended, be amended and reenacted; and that
§16-2-5 and §16-2-11 of said code be amended and reenacted, all to read as
follows:
article 1. State Public
Health System.
§16-1-6. Powers and
duties of the commissioner.
The commissioner is the
chief executive, administrative and fiscal officer of the Bureau for Public
Health and has the following powers and duties:
(a) To supervise and direct
the fiscal and administrative matters of the bureau, and in that regard and in
accordance with law, employ, fix the compensation of and discharge all persons
necessary for the proper execution of the public health laws of this state and
the efficient and proper discharge of the duties imposed upon, and execution of
powers vested in the commissioner by law and as directed by the secretary;
(b) To enforce all laws of
this state concerning public health; to that end, the commissioner shall make,
or cause to be made, investigations and inquiries respecting the cause of
disease, especially of epidemics and endemic conditions, and the means of
prevention, suppression or control of those conditions; the source of sickness
and mortality, and the effects of environment, employment, habits and
circumstances of life on the public health.
The commissioner shall
further make, or cause to be made, inspections and examinations of food, drink
and drugs offered for sale or public consumption in the manner the commissioner
considers necessary to protect the public health and shall report all
violations of laws and rules relating to the law to the prosecuting attorney of
the county in which the violations occur;
(c) To make complaint or
cause proceedings to be instituted against any person, corporation or other
entity for the violation of any public health law before any court or agency,
without being required to give security for costs; the action may be taken
without the sanction of the prosecuting attorney of the county in which the
proceedings are instituted or to which the proceedings relate;
(d) To promote the
provision of essential public health services to citizens of this state;
(e) To monitor the administration, operation and
coordination of the local boards of health and local health officers. This may include, but is not limited to, requiring two or
more local county boards of health or any county or counties and one or more
municipalities within or partially within the county or counties to combine
their service delivery and administrative duties. If the commissioner feels
that health care services offered through local boards of health could be
better provided to the citizens of the state through the combining of services,
he or she may require that local boards of health combine their administration
for the purpose of streamlined delivery of services. The commissioner shall
have the authority to require that two or more local county boards of health or
any county or counties and one or more municipalities within or partially
within the county or counties enter into then necessary agreements to combine
administrative duties and the operation of their services for better health
care delivery. The Secretary of the Department of Health and Human Resources
shall propose rules for legislative approval to provide for the combining of
administrative functions and service delivery of two or more local boards of
health in accordance with the provisions of article three, chapter
twenty-nine-a of this code if the commissioner recommends a combining of
service delivery and administration of two or more local boards of health.
(f) Any existing agreements
between two or more local boards of health in place at the time of the
reenactment of this section in the 2017 regular session of the Legislature shall
not be required to alter or modify any agreement or operation which does not
meet the requirements set forth in any legislative rule promulgated pursuant to
the provisions of this subsection.
(g) Nothing in this section
should be construed to permit the commissioner to require that two local boards
of health be combined beyond combining of administrative functions and services
delivery.
(f) (h) To develop and maintain a state plan of
operation that sets forth the needs of the state in the areas of public health;
goals and objectives for meeting those needs; methods for achieving the stated
goals and objectives; and needed personnel, funds and authority for achieving
the goals and objectives;
(g) (i) To collect data as may be required to
foster knowledge on the citizenry's health status, the health system and costs
of health care;
(h) (j) To delegate to any appointee, assistant or
employee any and all powers and duties vested in the commissioner, including,
but not limited to, the power to execute contracts and agreements in the name
of the bureau: Provided, That the commissioner is responsible for the
acts of his or her appointees, assistants and employees;
(i) (k) To transfer at the direction of the
secretary, notwithstanding other provisions of this code, any patient or
resident between hospitals and facilities under the control of the commissioner
and, by agreement with the state Commissioner of Corrections and otherwise in
accord with law, accept a transfer of a resident of a facility under the
jurisdiction of the state Commissioner of Corrections;
(j) (l) To make periodic reports to the Governor
and to the Legislature relative to specific subject areas of public health, the
state facilities under the supervision of the commissioner, or other matters
affecting the public health of the people of the state, at the direction of the
secretary;
(k) (m) At the direction of the secretary, to
accept and use for the benefit of the health of the people of this state, any
gift or devise of any property or thing which is lawfully given: Provided,
That if any gift is for a specific purpose or for a particular state hospital
or facility it shall be used as specified. Any profit which may arise from any
gift or devise of any property or thing shall be deposited in a special revenue
fund with the State Treasurer and shall be used only as specified by the donor
or donors;
(l) (n) To acquire by condemnation or otherwise
any interest, right, privilege, land or improvement and hold title to the land
or improvement, for the use or benefit of the state or a state hospital or
facility, and, by and with the consent of the Governor, and at the direction of
the secretary, to sell, exchange or otherwise convey any interest, right,
privilege, land or improvement acquired or held by the state, state hospital or
state facility and deposit the proceeds from the sale, exchange or other
conveyance into the hospital services revenue account. Any condemnation
proceedings shall be conducted pursuant to chapter fifty-four of this code;
(m) (o) To inspect and enforce rules to control
the sanitary conditions of and license all institutions and health care
facilities as set forth in this chapter, including, but not limited to,
schools, whether public or private, public conveyances, dairies,
slaughterhouses, workshops, factories, labor camps, places of entertainment,
hotels, motels, tourist camps, all other places open to the general public and
inviting public patronage or public assembly, or tendering to the public any
item for human consumption and places where trades or industries are conducted;
(n) (p) To make inspections, conduct hearings, and
to enforce the legislative rules concerning occupational and industrial health
hazards, the sanitary condition of streams, sources of water supply, sewerage
facilities, and plumbing systems, and the qualifications of personnel connected
with the supplies, facilities or systems without regard to whether they are
publicly or privately owned; and to make inspections, conduct hearings and
enforce the legislative rules concerning the design of chlorination and
filtration facilities and swimming pools;
(o) (q) To provide in accordance with this
subdivision and the definitions and other provisions of article one-a, chapter
twenty-seven of this code, and as directed by the secretary, for a
comprehensive program for the care, treatment and rehabilitation of alcoholics
and drug abusers; for research into the cause and prevention of alcoholism and
drug abuse; for the training and employment of personnel to provide the
requisite rehabilitation of alcoholics and drug abusers; and for the education
of the public concerning alcoholism and drug abuse. That the commissioner, as directed by the secretary, shall
propose rules for legislative approval in accordance with the provisions of
article three, chapter twenty-nine-a of this code that would require each local
board of health as defined in article two, section three of this chapter to develop
and operate a needle exchange program;
(p) (r) To provide in accordance with this
subdivision for a program for the care, treatment and rehabilitation of the
parents of sudden infant death syndrome victims; for the training and
employment of personnel to provide the requisite rehabilitation of parents of
sudden infant death syndrome victims; for the education of the public
concerning sudden infant death syndrome; for the responsibility of reporting to
the Legislature on a quarterly basis the incidence of sudden infant death
syndrome cases occurring in West Virginia; for the education of police,
employees and volunteers of all emergency services concerning sudden infant
death syndrome; for the state sudden infant death syndrome advisory council to
develop regional family support groups to provide peer support to families of
sudden infant death syndrome victims; and for requesting appropriation of funds
in both federal and state budgets to fund the sudden infant death syndrome
program;
(q) (s) To establish and maintain a state hygienic
laboratory as an aid in performing the duties imposed upon the commissioner,
and to employ chemists, bacteriologists, and other employees that may be
necessary to properly operate the laboratory. The commissioner may establish
branches of the state laboratory at any points within the state that are
necessary in the interest of the public health;
(r) (t) To establish and fund a uniform health
professionals data system to collect and maintain uniform data on all health
professionals in the state. This data shall include, but not be limited to, the
following information about each health professional: His or her name,
profession, the area of the state where he or she is practicing, his or her
educational background, his or her employer's name, and number of years
practicing within the profession. The boards provided for in articles three,
four, four-a, five, seven, seven-a, fourteen, fourteen-a, fifteen, sixteen,
twenty, twenty-one, twenty-three, twenty-eight, thirty-one, thirty-two,
thirty-four, thirty-five, thirty-six and thirty-seven, chapter thirty of this
code shall annually collect the data on health professionals under their
jurisdiction in the format prescribed by the commissioner. Each board shall pay
to the bureau annually, an amount determined by the commissioner to be a pro
rata portion, for anticipated expenses to establish and operate the uniform
health professionals data system required by this section. The commissioner may
standardize data collection methods if necessary to implement the provisions of
this section. The commissioner shall publish annually and make available, upon
request, a report setting forth the data which was collected the previous year;
areas of the state which the collected data indicates have a shortage of health
professionals; and projections, based upon the collected data, as to the need
for more health professionals in certain areas;
(s) (u) To expend, for the purpose of performing
the public health duties imposed on the bureau, or authorized by law, any sums
appropriated by the Legislature. The commissioner may make advance payments to
public and nonprofit health services providers when the commissioner determines
it is necessary for the initiation or continuation of public health services. The
advance payments, being in derogation of the principle of payment only after
receipt of goods or services, shall be authorized only after serious
consideration by the commissioner of the necessity of the advance payments and
shall be for a period no greater than ninety days in advance of rendition of
service or receipt of goods and continuation of health services; and
(t) (v) To exercise all other powers delegated to
the commissioner by the secretary or by this chapter or otherwise in this code,
to enforce all health laws, and to pursue all other activities necessary and
incident to the authority and area of concern entrusted to the bureau or the
commissioner.
ARTICLE 2. Local Boards
of Health.
§16-2-5. Authority to
create, establish and maintain combined local boards of health; service area.
Any two or more counties or
any county or counties and one or more municipalities within or partially
within the county or counties may voluntarily combine to create,
establish and maintain a combined local board of health organized pursuant to
and with the powers and duties prescribed by this article. The plan of
combination must be approved by the commissioner. The service area of any
combined local board of health is the combined territorial limits of the
participating municipality or municipalities and county or counties: Provided,
That if all or a portion of a participating municipality is located in a
nonparticipating county, the service area of the combined local board of health
is limited to the territorial limits of the municipality and does not extend to
or include any area of the nonparticipating county outside of the municipal
limits: Provided, however, That the service area of a combined local
board does not extend to or include any area within the service area of a
municipal board of health maintaining a separate full-time municipal health
department under the supervision of a municipal local health officer.
§16-2-11. Local board of
health; powers and duties.
(a) Each local board of
health created, established and operated pursuant to the provisions of this
article shall:
(1) Provide the following
basic public health services and programs in accordance with state public
health performance-based standards:
(i) Community health
promotion including assessing and reporting community health needs to improve
health status, facilitating community partnerships including identifying the
community's priority health needs,
mobilization of a community around identified priorities and monitoring the
progress of community health education services;
(ii) Environmental health
protection including the promoting and maintaining of clean and safe air,
water, food and facilities and the administering of public health laws as
specified by the commissioner as to general sanitation, the sanitation of
public drinking water, sewage and wastewater, food and milk, and the sanitation
of housing, institutions, and recreation; and
(iii) Communicable or
reportable disease prevention and control including disease surveillance, case
investigation and follow-up, outbreak investigation, response to epidemics, and
prevention and control of rabies, sexually transmitted diseases, vaccine
preventable diseases, HIV/AIDS, tuberculosis and other communicable and
reportable diseases;
(2) Appoint a local health
officer to serve at the will and pleasure of the local board of health with
approval of the commissioner;
(3) Submit a general plan
of operation to the commissioner for approval, if it receives any state or
federal money for health purposes. This program plan shall be submitted
annually and comply with provisions of the local board of health standards
administrative rule;
(4) Provide equipment and
facilities for the local health department that are in compliance with federal
and state law;
(5) Permit the commissioner
to act by and through it, as needed. The commissioner may enforce all public
health laws of this state, the rules and orders of the secretary, any county
commission orders or municipal ordinances of the board's service area relating to public health, and the
rules and orders of the local board within the service area of a local board.
The commissioner may enforce these laws, rules and orders when, in the opinion
of the commissioner, a public health emergency exists or when the local board
fails or refuses to enforce public health laws and rules necessary to prevent
and control the spread of a communicable or reportable disease dangerous to the
public health. The expenses incurred shall be charged against the counties or
municipalities concerned;
(6) Deposit all moneys and
collected fees into an account designated for local board of health purposes.
The moneys for a municipal board of health shall be deposited with the
municipal treasury in the service area. The moneys for a county board of health
shall be deposited with the county treasury in the service area. The moneys for
a combined local board of health shall be deposited in an account as designated
in the plan of combination: Provided, That nothing contained in this
subsection is intended to conflict with the provisions of article one, chapter
sixteen of this code;
(7) Submit vouchers or
other instruments approved by the board and signed by the local health officer
or designated representative to the county or municipal treasurer for payment
of necessary and reasonable expenditures from the county or municipal public
health funds: Provided, That a combined local board of health shall draw
upon its public health funds account in the manner designated in the plan of
combination;
(8) Participate in audits,
be in compliance with tax procedures required by the state and annually develop
a budget for the next fiscal year;
(9) Perform public health
duties assigned by order of a county commission or by municipal ordinance
consistent with state public health laws; and
(10) Enforce the public
health laws of this state and any other laws of this state applicable to the
local board.
(b) Each local board of
health created, established and operated pursuant to the provisions of this
article may:
(1) Provide primary care
services, clinical and categorical programs, and enhanced public health
services;
(2) Employ or contract with
any technical, administrative, clerical or other persons, to serve as needed
and at the will and pleasure of the local board of health. Staff and any
contractors providing services to the board shall comply with applicable West
Virginia certification and licensure requirements. Eligible staff employed by
the board shall be covered by the rules of the Division of Personnel under
section six, article ten, chapter twenty-nine of this code. However, any local
board of health may, in the alternative and with the consent and approval of
the appointing authority, establish and adopt a merit system for its eligible
employees. The merit system may be similar to the state merit system and may be
established by the local board by its order, subject to the approval of the
appointing authority, adopting and making applicable to the local health
department all, or any portion of any order, rule, standard, or compensation
rate in effect in the state merit system as may be desired and as is properly
applicable;
(3) Adopt and promulgate
and from time to time amend rules consistent with state public health laws and
the rules of the West Virginia State Department of Health and Human Resources
that are necessary and proper for the protection of the general health of the
service area and the prevention of the introduction, propagation and spread of
disease. All rules shall be filed with the clerk of the county commission or
the clerk or the recorder of the municipality or both and shall be kept by the
clerk or recording officer in a separate book as public records;
(4) Accept, receive and
receipt for money or property from any federal, state or local governmental
agency, from any other public source or from any private source, to be used for
public health purposes or for the establishment or construction of public
health facilities;
(5) Assess, charge and collect fees for
permits and licenses for the provision of public health services: Provided,
That permits and licenses required for agricultural activities may not be
assessed, charged or collected: Provided, however, That a local board of
health may assess, charge and collect all of the expenses of inspection of the
physical plant and facilities of any distributor, producer or pasteurizer of
milk whose milk distribution, production or pasteurization facilities are
located outside this state but who sells or distributes in the state, or
transports, causes or permits to be transported into this state, milk or milk
products for resale, use or consumption in the state and in the service area of
the local board of health. A local board of health may not assess, charge and
collect the expenses of inspection if the physical plant and facilities are
regularly inspected by another agency of this state or its governmental
subdivisions or by an agency of another state or its governmental subdivisions
certified as an approved inspection agency by the commissioner. No more than
one local board of health may act as the regular inspection agency of the
physical plant and facilities; when two or more include an inspection of the
physical plant and facilities in a regular schedule, the commissioner shall
designate one as the regular inspection agency;
(6) Assess, charge and
collect fees for services provided by the local health department: Provided,
That fees for services shall be submitted to and approved by the commissioner: Provided, however, That
local boards of health are required to bill health insurance plans, including
Medicaid, for delivery of any health care services if an individual is treated
in a local health department and has health insurance or is a participant in
Medicaid;
(7) Contract for payment
with any municipality, county or Board of Education for the provision of local
health services or for the use of public health facilities. Any contract shall
be in writing and permit provision of services or use of facilities for a
period not to exceed one fiscal year. The written contract may include
provisions for annual renewal by agreement of the parties; and
(8) Retain and make
available child safety car seats, collect rental and security deposit fees for
the expenses of retaining and making available child safety car seats, and
conduct public education activities concerning the use and preventing the
misuse of child safety car seats: Provided, That this subsection is not
intended to conflict with the provisions of section forty-six, article fifteen,
chapter seventeen-c of this code: Provided, however, That any local
board of health offering a child safety car seat program or employee or agent
of a local board of health is immune from civil or criminal liability in any
action relating to the improper use, malfunction or inadequate maintenance of
the child safety car seat and in any action relating to the improper placement,
maintenance or securing of a child in a child safety car seat.
(c) The local boards of
health are charged with protecting the health and safety, as well as promoting
the interests of the citizens of West Virginia. All state funds appropriated by
the Legislature for the benefit of local boards of health shall be used for
provision of basic public health services.
NOTE: The purpose of this bill is
to modify administration of local boards of health; provide for regionalization
of administration and services of local health departments; require local
health departments to bill health insurance plans for services that are
provided; mandate development of needle exchange programs in local health
departments; and provide for rule-making authority.
Strike-throughs indicate language
that would be stricken from a heading or the present law, and underscoring
indicates new language that would be added.