Senate Bill No. 399
(By Senators Tomblin (Mr. President) and Boley
By Request of the Executive)
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[Introduced February 14, 1996; referred to the
Committee on Health and Human Resources; and then to the
Committee on Finance.]
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A BILL to amend chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article one-b, relating to
enacting the West Virginia transitional rural health systems
act; helping rural communities establish and maintain health
care systems; setting forth the powers and duties of the
advisory board; providing for preliminary designation and
certification; allowing withdrawal of designation; and
developing reimbursement and other financial incentives for
providers.
Be it enacted by the Legislature of West Virginia:
That chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article one-b, to read
as follows:
ARTICLE 1B. TRANSITIONAL RURAL HEALTH SYSTEMS ACT.
§16-1B-1. Short title.
This article may be known and cited as the "West Virginia
Transitional Rural Health Systems Act."
§16-1B-2. Legislative findings; purpose.
(a) The West Virginia Legislature finds:
(1) That many West Virginia rural health care providers of
critical importance to their region are financially vulnerable
due to health care cost containment strategies by private and
public sector payors, a decreasing and aging population, excess
capacity, and increased numbers of uninsured patients;
(2) That people in rural areas need local access to health
care providers which offer an integrated system of essential
local health care services and referral to more specialized
services; and
(3) That the state has a compelling interest in encouraging
rural health care providers to develop integrated rural health
care systems that provide well-coordinated local access to a
continuum of high quality and cost-effective essential local
health care and referral services.
(b) It is the purpose of this article to help rural
communities establish and maintain integrated health care systems
that provide access to a continuum of high quality and cost-
effective essential local health care and referral services.
§16-1B-3. Definitions.
(1) "Advisory board" means the advisory board described in section five of this article.
(2) "Authority" means the West Virginia health care cost
review authority.
(3) "Essential local health care services" are defined as
those health services that are delivered on the local level in
rural areas, including at a minimum appropriate levels of
emergency medical services, primary care services, preventive
care services, routine health maintenance, short term inpatient
services, basic primary diagnostic services, routine obstetrics
services, certain public health services, and certain long term
care services;
(4) "Office" means the office of community and rural health
services within the bureau of public health; and
(5) "Provider" means a person or entity which provides
health care services.
§16-1B-4. General powers and duties of the authority and the
office.
In addition to the powers granted to the authority and the
office elsewhere in this code, the authority and the office, in
consultation with the advisory board, shall have the powers as
set forth in by this section:
(1) To promulgate emergency rules within sixty days
implementing the provisions of this article;
(2) To provide technical and temporary financial assistance,
including grants and loans, in furthering the purpose of this article;
(3) To support transitional rural health systems by
coordinating activities with other state agencies, including the
office of medical services, the public employees insurance
agency, workers' compensation, the division of insurance, the
office of health facility licensure and certification; and
(4) Notwithstanding the provisions of articles two-d and
twenty-nine-b of this chapter, the authority may exempt from or
expedite the rate review and certificate of need processes and
reduce or waive the annual assessment required by section eight,
article twenty-nine-b, chapter sixteen of the code for providers
certified as participating in transitional rural health systems.
§16-1B-5. Advisory board.
The authority and the office shall convene an advisory board
consisting of providers, consumers and state agency
representatives familiar with rural health issues which shall
assist in the implementation and policy development of the
transitional rural health care systems program. Providers will
be appointed to the advisory board from a list of names submitted
by statewide associations representing hospitals, primary care
clinics, family practice physicians, and other associations
representing rural providers and the advisory board shall be
representative of the provider demographics within rural
communities.
§16-1B-6. Transitional health care systems program; preliminary designation.
(a) There is hereby created the transitional rural health
care systems program jointly administered by the authority and
the office. Any rural health care provider certified by the
authority and the office as participating in a transitional rural
health care system may qualify for the benefits specified in
subsection (b), section seven of this article.
(b) In order to be preliminarily designated as participating
in a transitional rural health care system, rural health care
providers must be determined by the authority and the office to:
(1) Be participating in a consortia of providers that offer
or is able to offer essential health care services within their
service area;
(2) Be at risk financially; and
(3) Be committed, as evidenced in a memorandum of
understanding, to collaborating with existing providers in the
service area to:
(i) Substantially reduce excess capacity for health care
services in the region;
(ii) Eliminate or reduce the duplication of administrative
costs and health services;
(iii) Reconfigure health care facilities and services to
emphasize the delivery of essential local health care services;
(iv) Provide the optimal use of the existing rural health
infrastructure and resources;
(v) Link health care services in rural areas to specialized
care providers in order that rural citizens can access a full
continuum of health services;
(vi) Improve the health status of residents;
(vii) Develop community based health promotion/disease
prevention programs; and
(viii) Prepare to operate in a managed care environment.
(c) Upon determination of the items specified in subsections
(a) and (b) of this section, the authority and the office may
preliminarily designate applicant providers as participating in
a transitional rural health care system.
(d) Upon preliminary designation by the authority and the
office, the transitional rural health system will be assigned a
technical team to provide assistance in achieving the goals of
the memorandum of understanding through the development of a
business and operational plan that includes projections of the
working capital needed to implement the plan.
(e) Upon designation by the authority and the office,
providers participating in a transitional rural health system may
apply for grants to support efforts to achieve the objectives of
their memorandum of understanding.
§16-1B-7. Certification.
(a) Upon completion of the business and operational plan
specified in section six-d of this article, participating
providers may seek certification from the authority and the office as a transitional rural health system. Certification will
be awarded based upon criteria to be developed by rule.
(b) Providers certified in accordance with subsection (a) of
this section as participating in a transitional rural health
system shall be eligible for:
(1) Exemptions from and/or expedited rate review and
certificate of need processing;
(2) Reductions or waivers from the annual assessment
required pursuant to section eight, article twenty-nine-b,
chapter sixteen of the code; and
(3) Working capital loans.
§16-1B-8. Withdrawal of designation; certification.
The authority and the office, following consultation with
the advisory board, may withdraw from a provider preliminary
designation or certification as participating in a transitional
rural health system if that provider does not demonstrate
progress towards achieving the objectives of this article.
§16-1B-9. Reimbursement and financial incentives.
The office of medical services, public employees insurance
agency, and division of workers' compensation shall develop
reimbursement and other financial incentives to support providers
certified as participating in a transitional rural health care
system.
§16-1B-10. Termination date.
The provisions of this article shall terminate and have no further force and effect on and after the first day of July,
one thousand nine hundred ninety-nine: Provided, That the
termination of this article's provisions shall not be construed
as effecting any other applicable provision of this code or rule.
NOTE: The purpose of this bill is to create the West
Virginia Rural Health Systems Act to help rural communities
establish and maintain health care systems.
This article is new; therefore, strike-throughs and
underscoring have been omitted.