HOUSE CONCURRENT RESOLUTION NO. 29

(By Mr. Speaker, Mr. Kiss, and Delegate Ashley)




Creating a Small and Rural Hospital Study Commission to examine the economic preservation of and regulatory relief for small and rural hospitals for a period of time not to exceed the term of the seventy-third Legislature.

Whereas, The financial condition of some small and rural hospitals in this state over the past several years has, at best, been marginal and consistently deteriorating; and
Whereas, These hospitals provide the economic backbone of rural health care and lead other health care providers in uncompensated and charity care; and
Whereas, The value of these health care providers is significant by providing community access to a range of primary, obstetric, emergency and other health care services as well as employment of over six thousand West Virginia citizens frequently in the most economically deprived areas of the State; and
Whereas, Present state medicaid and managed care reimbursement policies provide substantial financial disincentives to certain not-for-profit small and rural hospitals, discouraging them from continuing to offer obstetric and other needed health care services in rural communities; and
Whereas, Recent independent studies indicate that some small and rural not- for- profit hospitals are operating with financially severe losses, are in a position of probable financial default, and face an increasing risk of closure within the next several years, and the seriousness of this matter is such that even minor changes in reimbursement could quickly wipe out existing cash balances; and
Whereas, Projected changes in reimbursement due to enactment of the federal Balanced Budget Act of 1997, will inevitably result in decreasing availability of federal health care dollars; and
Whereas, Additional projected changes in financing and delivery of health care services by state government may act to disproportionately exacerbate the financial instability of these hospitals, increasing the possibility of closure or reduction of services and employees, hindering future economic development; and
Whereas, An immediate need exists to develop consistent public fiscal and regulatory policy which fosters access to rural health care services for the direct benefit of the citizens of West Virginia; and
Whereas, Access to critically needed health care services in rural areas will be enhanced by development of public policy by this Sstate which:
(1) Encourages stability and adequacy of payments to not - for- profit small and rural hospitals;
(2) Maintains access to essential services in rural communities including emergency and obstetric services;
(3) Recognizes that medicaid disproportionate share payments are vital to the financial survival of not- for- profit small and rural hospitals;
(4) Recognizes the potentially severe net effect that medicare, medicaid and other payor reductions have on these hospitals; and
(5) Identifies and eliminates competing or conflicting policy decisions made by various state agencies affecting small and rural hospitals; therefore, be it
Resolved by the Legislature of West Virginia:
That there is hereby created a Small and Rural Hospital Study Commission dedicated to the preservation of and regulatory relief for small and rural hospitals. The Commission shall be composed of six members of the Senate appointed by the President of the Senate and six members of the House of Delegates appointed by the Speaker of the House of Delegates. No more than four members appointed by the President of the Senate and Speaker of the House of Delegates, respectively, may be members of the same political party. Additionally, the President of the Senate and the Speaker of the House of Delegates shall be ex officio nonvoting members of the Commission. At least three of the members appointed by the President of the Senate and Speaker of the House of Delegates, respectively, shall be current or former members of the Legislative Commission on Health and Human Resources Accountability created by article twenty-nine-e, of chapter sixteen of the code of West Virginia; and, be it
Further Resolved, That due to the present or projected dire financial condition of certain small and rural hospitals, the Commission shall meet at any time both during sessions of the Legislature and in the interim as often as necessary; and, be it
Further Resolved, That the powers and duties of the Commission shall be to:
(1) Make an expedited investigation, study and review of the practices, policies and procedures the state medicaid agency and public employees insurance agency relating to the payment policies and methodologies affecting small and rural hospitals and the financial effect of such policies and methodologies;
(2) Make an expedited investigation, study and review of statutory and regulatory requirements of state agencies including, but not limited to, the department of health and human resources and the health care authority which unnecessarily add to the cost of or impede access to rural health care within this state and those statutory and regulatory requirements which foster and encourage the provision of rural health services;
(3) Recommend action to encourage and provide regulatory and other incentives to locally reconfigure the manner of delivering rural health care services. In instances in which acute care capacity is reduced, develop proposed statutory or other authority which allows hospitals to utilize excess capacity in a timely manner, omitting bureaucratic overkill, to deliver new or modified health care services which meet community needs while preserving local employment; and
(4) Develop other specific legislative initiatives to create public policy which preserves access to needed health services in rural areas, prevents closure and encourages preservation of not- for- profit small and rural hospitals and maintains an employment base for local communities; and, be it
Further Resolved, That members of the Commission shall receive such compensation and expenses as provided in article two-a, chapter four of this code. Such expenses and all other expenses including those incurred in the employment of legal, technical, investigative, clerical, stenographic, advisory, and other personnel shall be paid from an appropriation to be made expressly for this Commission: Provided, That if no such appropriation be made, such expenses shall be paid from the appropriation under "Fund No. 0175 for Joint Expenses" created pursuant to the provisions of said chapter: Provided, however, That no expense of any kind payable under the account for joint expenses shall be incurred unless first approved by the Joint Committee on Government and Finance; and, be it
Further Resolved, That the Commission shall report its findings and recommendations, if any, to the Legislature on the first day of the next Regular Session.