HOUSE CONCURRENT RESOLUTION NO. 84

(By Delegates Boggs, Poling, Azinger, Beach, Campbell, Canterbury, Carmichael, Compton, DeLong, Dempsey, Doyle, Ellem, Ennis, Evans, Fahey, Faircloth, Flanigan, Fletcher, Frederick, Givens, Hrutkay, Kominar, Leggett, Manchin, Martin, McGraw, Perry, Pino, Prunty, Riggs, Romine, Schadler, L. Smith, Stalnaker, Staton, R. Thompson, Trump, Varner, Walters, C. White, G. White and Yeager)


[Introduced March 8, 2002; referred to the

Committee on Rules.]


Requesting the Joint Committee on Government and Finance to create a Healthcare Delivery Study Commission to examine our citizens? access to health care, including the viability of our rural healthcare providers and the availability of physicians and to report findings and recommendations to the Legislature by the first day of the 2003 regular session.

Whereas, The healthcare delivery system, especially in our rural areas, is extremely fragile which jeopardizes the essential services needed by our citizens; and
Whereas, The financial condition of the health providers in this State over the past several years has, at best, been marginal and consistently deteriorating; and
Whereas, Our rural hospitals provide the economic backbone of rural health care in
our rural communities; and
Whereas, The value of the 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, The State has the oldest median age in the nation and as the population continues to age, the prevalence of chronic disease and demand for health care services increases; and
Whereas, Present State Medicaid and managed care reimbursement policies provide substantial financial disincentives to discourage the continuation of obstetric and other needed health care services in communities; and
Whereas, Recent independent studies indicate that some small and rural not-for-profit hospitals are operating with severe financial 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 extinguish existing cash balances; and
Whereas, Projected changes in reimbursement due to enactment of the Federal Balanced Budget Act of 1997, may 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 the hospital and other health providers 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 health care services for the direct benefit of the citizens of West Virginia; and
Whereas, The critical concern facing our communities is the quest to secure adequate, affordable, high quality healthcare; and
Whereas, Access to critically needed health care services, especially in rural areas, will be enhanced by development of public policy by this State which:
(1) Encourages stability and adequacy of payments to healthcare providers;
(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 the providers; and
(5) Identifies and eliminates competing or conflicting policy decisions made by various state agencies affecting all healthcare providers; therefore, be it
Resolved by the Legislature of West Virginia:
That the Joint Committee on Government and Finance is hereby requested to create a Healthcare Delivery Study Commission dedicated to the preservation of and regulatory relief for healthcare providers. The Commission shall be composed of twelve members of the House and Senate, with 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. An additional two members will be the Chairs of the House and Senate Committees on Health and Human Resources. 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; and, be it
Further Resolved, That due to the present or projected dire financial condition of certain healthcare providers, 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) Develop a strategic approach to addressing healthcare access and provide measurable outcomes that support ongoing refinement of a comprehensive health care strategy;
(2) Make an expedited investigation, study and review of the practices, policies and procedures of the state Medicaid agency and public employees insurance agency relating to the payment policies and methodologies affecting healthcare providers and the financial effect of such policies and methodologies;
(3) 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 health care within this State and those statutory and regulatory requirements which foster and encourage the provision of rural health services and other safety net services;
(4) Recommend action to encourage and provide regulatory and other incentives to locally reconfigure the manner of delivering health care services. In instances in which acute care capacity is reduced, develop proposed statutory or other authority which will allow 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;
(5) To explore the development of financial incentives to encourage providers to form viable links to improve access to health care service delivery; and
(6) 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 rural providers and maintains an employment base for local communities; and, be it
Further Resolved, That members of the Commission shall receive compensation and expenses as provided in article two-a, chapter four of the code of West Virginia. These 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 is made under "Fund No. 0175 for Joint Expenses" created pursuant to the provisions of article two-a, chapter four of the code of West Virginia, then no expenses 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 2003 Regular Session.