HOUSE CONCURRENT RESOLUTION NO. 59
(By Delegates Leach, Compton, Hutchins, Beach,
Capito, Caputo, Given, Henderson, Hubbard,
Kelley, Louisos, Mahan, Manuel, Miller,
Osborne, Rowe, Smith, Stemple and Thomas)
Directing the Speaker of the House of Delegates and the President
of the Senate to appoint an ad hoc six-member joint
committee, consisting of three members from each house of
the Legislature, to make a study of the role of certain
advanced nurse practitioners (ANP) in the delivery of high- quality, costs-effective health care for the citizens of
West Virginia.
Whereas, Approximately fifty-five percent of West Virginians
live in rural areas that are considered medically underserved and
in need of more primary health care providers; and
Whereas, ANPs have historically functioned in primary care
provider roles in West Virginia, particularly in the rural areas
of the State, and ANPs have been recognized by this Legislature
for the valuable role they play in today's health care delivery
system as evidenced by the codification of their scope of
practice in section three, article three, chapter eighteen-e of
the code of West Virginia, and ANPs have been declared eligible
by this Legislature for the scholarship program designed to
attract more primary care providers to rural areas of West
Virginia; and
Whereas, The health maintenance organization (HMO) act of
West Virginia, codified in article twenty-five-a, chapter thirty-three of said code, mandates that primary care physicians serve
as the exclusive "gate-keepers" of the HMO systems operating in
this state and thereby eliminated ANPs as primary care providers;
and
Whereas, The West Virginia Nurses Association cites research
regarding patient satisfaction with the care rendered by ANPs,
the interpersonal skills of ANP, the technical quality of ANP
services, the outcomes of patients serviced by ANPs and the use
of ANPs to improve the access to health care in rural areas as
well as in a variety of nongeographic settings and for
populations traditionally medically underserved; and
Whereas, The American Nurses Association maintains that ANPs
can provide sixty to eighty percent of the primary and preventative
care traditionally performed by physicians; and
Whereas, The goals of managed care in West Virginia include containing health care costs by focusing upon the prevention of
illnesses, health maintenance strategies and controlling access
to specialty services; and
Whereas, The Legislature of West Virginia of 1998, expects the
implementation of high-quality managed care systems in West
Virginia to be challenging and perceives the need to explore
options associated with the use of ANPs to provide consumers with
choices in their primary health care provider; therefore, be it
Resolved by the Legislature of West Virginia:
That the Speaker of the House of Delegates and the President
of the Senate appoint an ad hoc six-member committee, with three
members appointed by each the Speaker of the House of Delegates
and three members appointed by thethe President of the Senate, and
the ad hoc joint committee appointed by the Speaker of the House
of Delegates and the President of the Senate is hereby directed
to review, examine and study the role of advanced nurse
practitioners in the delivery of health care in this sState and
whether there is a need to develop alternatives to physician
centered health systems in West Virginia and the kinds of options
that may be feasible and advisable in West Virginia and to make recommendations to the Legislature regarding the same; and, be it
Further Resolved, That the committee should explore roles
for ANPs not only in urban areas but also in rural, poor or
underserved areas of West Virginia: Provided, That the study
should explore the qualifications of these certain ANPs as
primary care providers: Provided, however, That the study should
include a review of community health care needs, how identified
community health care needs may best be fulfilled, what payment
sources are available to meet identified community health care
needs and the effects of managed care on the delivery of health
care by ANPs: Provided further, That the rights of the citizens
of West Virginia to choose their primary health care providers
should be kept in mind by the ad hoc committee conducting the
study; and, be it
Further Resolved, That the ad hoc joint committee report to
the regular session of the Legislature, 1999, on its findings,
conclusions and recommendations, together with drafts of any
legislation necessary to effectuate its recommendations; and, be
it
Further Resolved, That the expenses necessary to conduct this study, to prepare a report and to draft necessary
legislation be paid from legislative appropriations to the Joint
Committee on Government and Finance.