Senate Bill No. 399
(By Senators Tomblin (Mr. President) and Boley
By Request of the Executive)
[Originating in the Committee on Health and Human
Resources; reported on February 26, 1996.]
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; authorizing rural communities to establish and maintain
a transitional rural health care system; setting forth the
powers and duties of the advisory board; providing for
preliminary designation and certification; allowing
withdrawal of designation; and authorizing the development
of reimbursement and other financial incentives for
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
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
(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.
As used in this article, unless otherwise indicated by the
(1)(a) "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)(b) "Essential local health care services" are defined as
means 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
(4)(c) "Office" means the office of community and rural
health services within the bureau of public health; and
(5)(d) "Provider" means a person or entity which provides
health care services; and
(e) "State agency" means the West Virginia health care cost
review authority created pursuant to article twenty-nine-b of
§16-1B-4. General powers and duties of the state agency and the
In addition to the powers granted to the
agency and the office elsewhere in this code, the authority state
agency and the office, in consultation with the advisory board,
shall have the powers as set forth in by this section:
(1)(a) To promulgate emergency rules, in accordance with the
provisions of article three, chapter twenty-nine-a of this code,
within sixty days implementing to implement the provisions of
(2)(b) To provide technical and temporary financial
assistance, including grants and loans, in furthering the purpose of this article;
(3)(c) 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)(d) Notwithstanding the provisions of articles two-d and
twenty-nine-b of this chapter, the authority state agency may (1)
exempt from or expedite the rate review and certificate of need
processes, and (2) 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.
authority state agency 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 serving rural areas. and the The
advisory board shall be representative of the provider
demographics within serving rural communities.
§16-1B-6. Transitional health care systems program; preliminary
(a) There is hereby created the transitional rural health care systems program jointly administered by the
agency and the office. Any rural health care provider certified
by the authority state agency 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
(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 state agency and
the office to be located in rural underserved areas and to:
(1) Be participating in a consortia of providers that offer,
or is able to offer, essential health care services within their
at risk financially in financial jeopardy; 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 state agency and the
office may preliminarily designate applicant providers as
participating in a transitional rural health care system.
(d) Upon preliminary designation by the
agency 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 state agency 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.
(a) Upon completion of the business and operational plan
specified in section
six-d six of this article, participating
providers may seek certification from the authority state agency
and the office as a transitional rural health system.
Certification will be awarded based upon criteria to be developed
by legislative rule, in accordance with the provisions of article
three, chapter twenty-nine-a of this code.
(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.
authority state agency and the office, following
consultation with the advisory board, may withdraw from a
provider the 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
§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.