HOUSE CONCURRENT RESOLUTION NO. 63
(By Delegates Boggs, Amores, Anderson, Angotti, Ashley, Azinger,
Beach, Beane, Border, Brown, Browning, Butcher, Campbell, Cann,
Canterbury, Caputo, Carmichael, Coleman, Compton, Craig, DeLong,
Dempsey, Douglas, Doyle, Ellem, Ennis, Evans, Fahey, Faircloth,
Ferrell, Flanigan, Fleischauer, Fletcher, Fox, Fragale,
Frederick, Givens, Hall, Hatfield, Hrutkay, Hubbard, Keener,
Kominar, Kuhn, Leach, Leggett, Louisos, Mahan, Manchin, Manuel,
Marshall, Martin, Mathews, McGraw, Mezzatesta, Michael, Morgan,
Overington, Paxton, Perdue, Perry, Pethtel, Pino, Poling,
Proudfoot, Prunty, Riggs, Romine, Schadler, Shaver, Shelton,
Smirl, J. Smith, L. Smith, Spencer, Stalnaker, Staton, Stemple,
Stephens, Susman, Swartzmiller, R. Thompson, R. M. Thompson,
Trump, Tucker, Varner, Walters, Warner, Webb, Webster, C. White,
G. White, H. White, Williams, Wills, Wright and Yeager)
[Introduced February 28, 2002; referred to the
Committee on Rules.]
Creating a Small and Rural Hospital Study Commission to examine the
economic preservation of and regulatory relief for small and
rural hospitals and to report findings and recommendations to
the Legislature by the first day of the 2003 regular session.
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 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 quickly wipe out 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 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 State 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
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 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 of 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 2003 Regular Session.