H. B. 2838
(By Delegates Perdue, Hatfield, Marshall, Michael,
Moore, Rodighiero and Border)
[Introduced February 26, 2009; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend and reenact §16-29H-1, §16-29H-2, §16-29H-3,
§16-29H-4 and §16-29H-5 of the Code of West Virginia, 1931, as
amended; and to amend said code by adding thereto a new
section, designated §16-29H-6, all relating generally to the
creation of the Governor's Office of Health Enhancement and
Lifestyle Planning; setting forth legislative findings;
setting forth the powers and duties of the office; creating
the position of director; setting forth the qualifications of
the director; setting forth the powers and duties of the
director; providing for staff; requiring the development of a
five year strategic plan; providing for legislative
rule-making authority; providing for coordination with various
state agencies, departments, boards, bureaus and commissions;
and requiring reporting to the Governor and the Legislature.
Be it enacted by the Legislature of West Virginia:
That §16-29H-1, §16-29H-2, §16-29H-3, §16-29H-4 and §16-29H-5 of the Code of West Virginia, 1931, as amended, be amended and
reenacted; and that said code be amended by adding thereto a new
section, designated §16-29H-6, all to read as follows:
ARTICLE 29H. GOVERNOR'S OFFICE OF HEALTH ENHANCEMENT AND
LIFESTYLE PLANNING.
§16-29H-1. Legislative findings.
The Legislature finds:
(1) Rising health care costs have a significant impact not
only on the citizens of the state but is also impacting the state's
ability to develop a competitive advantage in seeking new business.
Reducing this level of costs and developing new, more effective
options for reducing growth in health care spending is essential to
ensuring the health of West Virginia's citizens and to the
advancement of a well developed workforce.
(2) West Virginia spends thirteen percent more per person on
health care than the national average. Moreover, the growth in
spending in the state is higher than the national average. These
rising costs have contributed to fewer employers, particularly
small employers, offering health insurance as a benefit of
employment. This is an occurrence that may further drive up health
care costs throughout the state.
(3) West Virginia is among the highest in such health care
indicators as childhood and adult obesity which provides a direct
connection to higher rates of diabetes, hypertension, hyperlipidemia, heart disease, pulmonary disorders and comorbid
depression experienced in West Virginia. Nearly one third of the
rise in health care costs can be attributed to the rise in obesity
throughout the state and the nation. Additionally, high rates of
chronic illness represents a substantial reduction in worker
productivity.
(4) To address the concerns over rising costs, West Virginia
must change the way it pays for care, shifting the focus to primary
care and prevention. Seventy-five percent of health care spending
is associated with treatment of chronic diseases requiring on-going
medical management over time. Patients with chronic diseases,
however, only receive fifty-six percent of the clinically
recommended preventive services. This lack of preventive services
creates a seventy-five percent increase in health care spending.
(5) Health care delivery in West Virginia needs to be
modernized. This will require substantial changes in how health
care is delivered to the chronically ill, an increase in
information technology tools used for patient management, a
simplification of health care processing and a broad overhaul in
our perceptions of wellness and prevention.
(6) West Virginians must be challenged to engage in a more
healthy lifestyle, they must alter the focus of their perception of
health care from one of episodic care to prevention and wellness
efforts. Equally as important is that healthcare providers must be engaged with their patients and in the process of delivery of
health care and strive for continuous improvement of the quality of
care they provide.
(7) West Virginia must develop a health care system that is
sufficient to meet the needs of its citizens; equitable, fair and
sustainable but that is also accountable for quality, access, cost
containment and service delivery.
§16-29H-2. Creation of the Governor's Office of Health Enhancement
and Lifestyle Planning; duties.
(a) There is created the Governor's Office of Health
Enhancement and Lifestyle Planning. The purpose of this office is
to coordinate all state health care system reform initiatives among
executive branch agencies, departments, bureaus and offices. The
office shall be under the direct supervision of the director, who
is responsible for the exercise of the duties and powers assigned
to the office under the provisions of this article.
(b) All state agencies that have responsibility for the
development, improvement and implementation of any aspect of West
Virginia's health care system, including, but not limited to, the
Public Employees Insurance Agency, the Bureau for Senior Services,
the Children's Health Insurance Program, Office of the
Pharmaceutical Advocate, the Health Care Authority, the Insurance
Commission, the Department of Health and Human Resources, state
colleges and universities, public hospitals, state or local institutions such as nursing homes, veteran's homes, the Division
of Rehabilitation, public health departments, shall cooperate with
the Governor's Office of Health Enhancement and Lifestyle Planning
established pursuant for the purpose of coordinating the health
care delivery system in West Virginia for any program over which
they have authority:
Provided, That no action of Governor's Office
of Health Enhancement and Lifestyle Planning shall encumber greater
than five percent of the state share of the annual funds
appropriated to any one agency or board without prior approval of
the secretary with authority over that office.
§16-29H-3. Director of the Governor's Office of Health Enhancement
and Lifestyle Planning appointment; qualifications;
oath; salary.
(a) The office is under the supervision of the director. The
director is the executive and administrative head of the office and
shall be appointed by the Governor with advice and consent of the
Senate. The director shall be qualified by training and experience
to direct the operations of the Governor's Office of Health
Enhancement and Lifestyle, and serves at the will and pleasure of
the Governor. The duties of the director include, but are not
limited to, the management and administration of the Governor's
Office of Health Enhancement and Lifestyle.
(b) The director:
(1) Serves on a full-time basis and may not be engaged in any other profession or occupation;
(2) May not hold political office in the government of the
state either by election or appointment while serving as the
director;
(3) Shall be a citizen of the United States and become a
resident of the state within ninety days of appointment;
(4) Is entitled to receive an annual salary as provided by the
Governor; and
(5) Is ineligible for civil service coverage as provided in
section four, article six, chapter twenty-nine of this code. Any
other employee hired by the director is also ineligible for civil
service coverage.
(c) Before entering upon the discharge of the duties as
director, the director shall take and subscribe to the oath of
office prescribed in section five, article IV of the Constitution
of West Virginia. The executed oath shall be filed in the Office
of the Secretary of State.
§16-29H-4. Director of the Governor's Office of Health Enhancement
and Lifestyle; powers and duties, hiring of staff.
(a) The director has the power and authority to:
(1) Purchase or enter into contracts or agreements as
necessary to achieve the purposes of this article;
(2) File suit;
(3) Evaluate and renegotiate existing contracts for state purchase necessary for health care delivery services. In
renegotiating existing contracts, the director shall include the
secretary, or his or her designee, of the department which is the
subject of the contract in all negotiations;
(4) Make recommendations to the Governor and the Legislature
regarding strategies that could more effectively make the health
care delivery system in West Virginia more timely, more
patient-centered, provide greater patient access and quality of
service and control health care costs;
(5) Develop and implement other programs, projects and
initiatives to achieve the purposes of this article, including
initiating, evaluating and promoting other strategies that result
in greater access to health care, assure greater quality of care
and result in reduced costs for health care delivery services to
the citizens of West Virginia, and
(6) Develop a five-year strategic plan as set forth in section
five of this article for implementation of West Virginia's health
care system reform initiatives together with recommendations for
administration, policy, legislative rules or legislation. This
plan shall be reported to the Joint Committee on Government and
Finance, the Legislative Oversight Commission on Health and Human
Resources Accountability and the Governor on or before December 31,
2009.
(b) The director shall employ such professional, clerical, technical and administrative personnel as may be necessary to carry
out the provisions of this article.
(c) The director shall prepare and submit to the Governor and
the Legislature annual proposed appropriations for the next fiscal
year which shall include sums necessary to support the activities
of the Governor's Office of Health Enhancement and Lifestyle.
(d) Submit an annual report separate from the strategic plan
by January 1 of each year to the Governor and the Legislative
Oversight Commission on Health and Human Resources Accountability
on the condition, operation and functioning of the Governor's
Office of Health Enhancement and Lifestyle Planning.
(e) Supervise the fiscal management and responsibilities of
the Office of Health System Improvement.
(f) Keep an accurate and complete record of all the Governor's
Office of Health Enhancement and Lifestyle proceedings, records and
file all bonds and contracts and assume responsibility for the
custody and preservation of all papers and records of the office.
(g) Convene a series of focus groups, polls and any other
available research tool to determine issues of importance to all
stakeholders. The development of these survey tools shall be done
in conjunction with employers, health care providers and consumers.
Data received from this research should be easily available to the
public and utilized in the development and design of health benefit
programs. The data should also be accessible to providers to allow them to meet the needs of the health care market.
(h) The director may propose rules for legislative approval in
accordance with the provisions of article three, chapter
twenty-nine-a of this code to accomplish the goals and purposes of
this article.
§16-29H-5. Development of a strategic plan.
The director shall develop a five-year strategic plan for
implementation of any and all health care system reform
initiatives. These initiatives shall be included, but are not
limited to:
(1) Development of pilot projects for patient-centered medical
homes as set forth in article two-l of this chapter;
(2) Prioritization of chronic conditions to be targeted for
purposes of resource allocation and for greater chronic care
management. This should include pilot projects for community based
health teams for the development of care plans for healthy children
and adults to maintain good health and for at-risk populations to
prevent development of preventable chronic diseases;
(3) Development of a single private entity, or no more than
three regional entities, in the state to provide centralized
practitioner credentialing as set forth in article one-a, chapter
sixteen of this code;
(4) Development of standardized prior authorization
requirements and processes from insurers;
(5) Implementation of nutrition labeling in restaurants as
required by section six, article one-e, chapter five of this code;
(6) Coordination with the State Board of Education as set
forth in article two, chapter eighteen of this code to provide for:
(i) The preservation and allocation of recess time away from
instruction and separate from physical education classes in the
state schools;
(ii) Continuing education for school food personnel and a
career hierarchy for food personnel that offers rewards for
continuing education hours and credits;
(iii) School based physical education coordinators; and
(iv) Placement of a dietician in each regional education
service area throughout the state.
(7) Implementation of school based initiatives to achieve
greater dietary consistency in West Virginia's school system and to
gain greater physical fitness from students;
(8) Development of community based projects designed for the
construction, development and maintenance of bicycle and pedestrian
trails and sidewalks;
(9) Development and implementation of universal wellness and
health promotion benefits;
(10) Continued promotion and support for efforts to decrease
the number of West Virginians using tobacco products;
(11) Any necessary changes that will increase small businesses who offer available health insurance as a benefit of employment;
(12) Development of goals to further improve health care
delivery in West Virginia. This should include a means to evaluate
progress toward achieving these goals in a simple and timely
manner;
(13) Measurement of progress of health care provider and
physicians to the adoption and use of electronic medical records in
their offices;
(14) Coordination of the health information technology in
coordination with the West Virginia Health Information Network
which shall include:
(i) Working through the West Virginia Health Information
Network, as set forth in article twenty nine-g, of this chapter, to
develop a single common path for health information exchange;
(ii) Facilitation and encouragement of ongoing projects such
as electronic medical record resources in community health clinics;
(iii) Encourage continued development of hospital systems and
deployment of hospital-supported electronic medical records when
available for hospital-based, hospital-employed and
nonhospital-employed physicians;
(iv) Development of strategies to implement tax incentives,
vendor discounts, enhanced reimbursement and other means to
individual physician offices and clinics to encourage greater
adoption and use of electronic medical records;
(v) Develop recommended electronic medical record best
practices utilizing the Certification Commission for Healthcare
Information Technology as the minimum standard; and
(vi) Develop funding mechanisms that provide initial start-up
funds and a mechanism for sustainability of electronic medical
records that shall be managed by the West Virginia Health
Information Network.
§16-29H-6. Coordination with higher education.
The director shall consult with all the colleges and
universities in the state, both public and private, with the
state's three medical schools and with community and technical
colleges. The purpose of this collaboration would be:
(1) The development of curricula focused on a chronic care
model to reflect the multidisciplinary team approach to the
delivery of health care services in West Virginia as contemplated
by the development of a patient centered medical home as that term
is defined in section two, article two-j of this chapter; and
(2) The development of technology centered jobs that would
further the state's efforts in moving toward the broader use of
electronic health records.
NOTE: The purpose of this bill is to create the Governor's
Office of Health Enhancement and Lifestyle Planning to oversee
coordination of state departments, agencies, bureaus and
commissions for the purpose of redesigning health system delivery
services in West Virginia. This bill was recommended for passage
during the 2009 Regular Session by Select Committee D on Health.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.