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.