COMMITTEE SUBSTITUTE
FOR
H. B. 2400
(By Delegates Mezzatesta and Compton)
(Originating in the Committee on Health and Human Resources)
[February 22, 1995]
A BILL to amend and reenact sections four and five, article
twenty-nine-c, chapter sixteen of the code of West Virginia,
one thousand nine hundred thirty-one, as amended; and to
further amend said chapter by adding thereto a new article,
designated article twenty-nine-e, all relating to the
creation of a legislative oversight commission on health and
human resources accountability; declaring findings, purposes
and legislative intent; defining terms; terminating the
uncompensated health care and medicaid expenditures task
force and transferring its duties to the legislative
oversight commission on health and human resources
accountability; establishing the powers and duties of the
commission; requiring annual reports to the Legislature; and
requiring submission of health-related legislative rules to
the commission for review and recommendations.
Be it enacted by the Legislature of West Virginia:
That sections four and five, article twenty-nine-c, chapter sixteen of the code of West Virginia, one thousand nine hundred
thirty-one, as amended, be amended and reenacted; and that said
chapter be further amended by adding thereto a new article,
designated article twenty-nine-e, all to read as follows:
CHAPTER 16. PUBLIC HEALTH.
ARTICLE 29C. INDIGENT CARE.
§16-29C-4. Legislative study; appointment of members; expenses;
reports; termination.
(a) Not later than the first day of June, one thousand nine
hundred eighty-five, the president of the Senate and speaker of
the House of Delegates of the West Virginia Legislature shall
appoint a legislative task force on uncompensated health care
and medicaid expenditures which shall meet, study and make
recommendations as herein provided.
(b) The task force shall be composed of three members of
the Senate appointed by the president from the membership of the
Senate standing committee on health and human resources, three
members of the House of Delegates appointed by the speaker from
the membership of the House of Delegates standing committee on
health and human resources, and a number of citizens appointed
jointly by the president and speaker which, in their discretion,
adequately provides for the appropriate representation of the
interests of the providers of health care services, the providers
of health care insurance, state departments involved in the
administration of health care and health care related programs
and the citizens of this state. Of the members of the Senate appointed by the president, not more than two shall be from the
same political party. Of the members of the House of Delegates
appointed by the speaker, not more than two shall be from the
same political party.
(c) Members originally appointed to the task force shall
serve for terms beginning on the date of appointment and ending
on the thirtieth day of June, one thousand nine hundred ninety-
six ninety-five, unless sooner replaced by the president or the
speaker as applicable, or, in the discretion of the president and
the speaker, unless the work of the task force is completed or
the need for the task force no longer exists prior to that date.
The task force shall cease to exist on the thirtieth day of June,
one thousand nine hundred ninety-six ninety-five. The duties of
the task force, as defined in this section, shall be assumed by
the legislative oversight commission on health and human
resources accountability created pursuant to the provisions of
article twenty-nine-e of this chapter.
(d) The task force shall meet on such dates as may be
approved by the joint committee on government and finance for the
regular meetings of its subcommittees unless approval is first
obtained from the joint committee on government and finance for
additional meetings. The task force shall conduct studies on the
amount of funds expended by hospitals and other health care
providers of this state for services to persons who are unable to
pay for those services and for which they receive no other form
of reimbursement, the extent to which persons in this state forego needed medical services because of insufficient income and
assets to pay for those services, the extent to which the state
is maximizing available federal programs and moneys in providing
health care services to the citizens of this state, the operation
of the programs and funds created by this article and the roles
of the public, private and private nonprofit sectors in providing
health care services to the citizens of this state. The task
force shall also study the state medicaid program in order to
determine if the state medicaid agency, as the payor of last
resort, is expending maximum effort to identify alternate private
insurance resources for medicaid beneficiaries and shall study
the feasibility and financial impact upon the state of assuring
increased access to medicaid beneficiaries to primary health care
in the nonhospital setting by requiring enrollment in a primary
care clinic program, if available, and of the establishment of
different and lesser schedules of payment for primary health
services delivered by a hospital emergency room as compared to
the schedule of payments for emergency room services of a true
medical emergency nature.
(e) The task force shall file an interim report with the
joint committee on government and finance and the Legislature on
the date of the last meeting of the joint committee on
government and finance prior to commencement of the regular
session of the Legislature in each year before the final report
of the task force is filed with the joint committee on government
and finance and the Legislature on or before the thirtieth day of June, one thousand nine hundred ninety-six ninety-five.
(f) The members of the task force shall be entitled to
compensation at the rate authorized for members of the
Legislature participating in legislative interim meetings and to
reimbursement for reasonable and necessary expenses actually
incurred in attending meetings of the task force, except that any
employee of the state appointed to the task force is not entitled
to such compensation. Funds necessary for the work of the task
force shall be paid from joint appropriations to the Senate and
House of Delegates but no such funds shall be spent or
obligations incurred in the conduct of such work without prior
approval of the joint committee on government and finance.
§16-29C-5. Effective date and termination date.
This article shall be effective from passage, and,
notwithstanding the provisions of section four of this article,
shall terminate on the thirtieth day of June, one thousand nine
hundred ninety-six ninety-five.
ARTICLE 29E. LEGISLATIVE OVERSIGHT COMMISSION ON HEALTH AND
HUMAN RESOURCES ACCOUNTABILITY.
§16-29E-1. Findings and purpose.
The Legislature hereby finds and declares that:
(1) A crisis exists in the funding of health and social
programs of this state;
(2) These programs exist to provide federal and state
supported services to citizens in need;
(3) The health and well-being of these citizens is jeopardized when uncontrolled growth in various programs uses a
disproportionate share of the available funding;
(4) State programs are often developed and implemented with
limited private or federal grant moneys, which require future
funding from the limited state resources; and
(5) The problem is exacerbated when various state agencies
make competing or conflicting policy decisions.
§16-29E-2. Legislative intent.
It is the intent of the Legislature that all actions taken
pursuant to the provisions of this article by the Legislature and
the various agencies within the department of health and human
resources serve the following core set of principles:
(1) That all health and social programs offered under state
authority be coordinated to maximize efficiencies and minimize
competition within the various agencies thereby addressing the
needs of the citizens more effectively;
(2) That communication be facilitated among the various
agencies within the department of health and human resources and
between the department and the Legislature;
(3) That policy changes, not made by legislative rule, be
discussed with the commission for purposes of coordinating those
policies with existing programs and stated goals;
(4) That programs or policies implemented in accordance with
federal mandates be communicated to the commission;
(5) That in developing and implementing programs with
private or federal grant moneys, the various agencies communicate their efforts to the commission to ensure and facilitate future
state funding; and
(6) That agencies previously exempted from rule-making
review by federal or state statutes advise the commission of
program changes which may affect the health and well-being of the
citizens of West Virginia.
§16-29E-3. Definitions.
As used in this article:
(a) "Agency" means those various agencies, authorities,
boards, committees, commissions or departments of the department
of health and human resources with authority to promulgate
legislative rules pursuant to this chapter that regulate health
care providers, practitioners or consumers; or those offering
social services programs.
(b) "Commission" means the legislative oversight commission on
health and human resources accountability; and
(c) "Department" means the department of health and human
resources.
§16-29E-4. Creation of a legislative oversight commission on
health and human resources accountability.
(a) There is hereby created a joint commission of the
Legislature known as the legislative oversight commission on
health and human resources accountability. 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 five of the six members appointed by the president of the Senate
and the speaker of the House of Delegates, respectively, may be
members of the same political party. In addition, the president
of the Senate and speaker of the House of Delegates shall be ex
officio nonvoting members of the commission and shall designate
the cochairpersons. At least one of the Senate appointees and
one of the House of Delegates appointees shall be the chairperson
of the committee on health and human resources of the Senate and
House of Delegates, respectively, and at least one of the Senate
appointees and at least one of the House of Delegates appointees
shall be a member of the committee on finance of the Senate and
House of Delegates, respectively. The members shall serve until
their successors shall have been appointed as heretofore
provided.
(b) 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 the legislative oversight commission on health and
human resources accountability: Provided, That if no such
appropriation be made, such expenses shall be paid from the
appropriation under "Account No. 1030 for Joint Expenses":
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.
(c) The commission shall meet at any time both during
sessions of the Legislature and in the interim or as often as may
be necessary.
§16-29E-5. Powers and duties of commission.
(a) The powers, duties and responsibilities of the
commission shall include the following:
(1) Make a continuing investigation, study and review of
the practices, policies and procedures of the health care and
social services agencies in this state;
(2) Make a continuing investigation, study and review of
all matters related to health and social policy in the state;
(3) Review all legislative rules of the several health care
agencies, unless exempt from rule-making review by federal law;
(4) Review such other rules as the commission deems
appropriate;
(5) Review program development by the various agencies of
the department of health and human resources if those programs
impact the physical, emotional or social well-being of the
citizens of West Virginia.
(6) Conduct studies on:
(A) The amount of funds expended by hospitals and other
health care providers of this state for services to persons who
are unable to pay for those services and for which they receive
no other form of reimbursement;
(B) The extent to which persons in this state forego needed medical services because of insufficient income and assets to pay
for those services;
(C) The extent to which the state is maximizing available
federal programs and moneys in providing health care services to
the citizens of this state;
(D) The operation of the programs and funds created by this
article; and
(E) The roles of the public, private and private nonprofit
sectors in providing health care services to the citizens of this
state;
(7) Review and study the state medicaid program in order
to determine if the state medicaid agency, as the payor of last
resort, is expending maximum effort to identify alternate private
insurance resources for medicaid beneficiaries;
(8) Review and study the feasibility and financial impact
upon the state of assuring increased access to medicaid
beneficiaries to primary health care in the nonhospital setting
by requiring enrollment in a primary care clinic program, if
available;
(9) Review and study the feasibility and financial impact
upon the state of the establishment of different and lesser
schedules of payment for primary health services delivered by a
hospital emergency room as compared to the schedule of payments
for emergency room services of a true medical emergency nature;
and
(10) Conduct a study to determine whether the bureaucracies of the state department of health and human resources effectively
and efficiently deliver services to the citizens of this state.
The commission may request assistance from the legislative
auditor to conduct this study.
(b) The commission shall make annual reports to the
Legislature regarding the results of all investigations, studies
and reviews pursuant to the provisions of section seven of this
article.
§16-29E-6. Examination and subpoena powers; contempt
proceedings.
(a) For purposes of carrying out its duties, the commission
is hereby empowered and authorized to examine witnesses and to
subpoena such persons and books, records, documents, papers or
any other tangible things as it believes should be examined to
make a complete investigation.
(b) All witnesses appearing before the commission under
subpoena shall testify under oath or affirmation. Any member of
the commission may administer oaths or affirmations to such
witnesses.
(c) To compel the attendance of witnesses at such hearings
or the production of any books, records, documents, papers or any
other tangible thing, the commission is hereby empowered and
authorized to issue subpoenas, signed by one of the
cochairpersons, in accordance with section five, article one,
chapter four of this code. Such subpoenas shall be served by any
person authorized by law to serve and execute legal process and service shall be made without charge. Witnesses subpoenaed to
attend hearings shall be allowed the same mileage and per diem as
is allowed witnesses before any petit jury in this state.
(d) If any person subpoenaed to appear at any hearing shall
refuse to appear or to answer inquiries there propounded, or
shall fail or refuse to produce books, records, documents, papers
or any other tangible thing within his control when the same are
demanded, the commission shall report the facts to the circuit
court of Kanawha County or any other court of competent
jurisdiction and such court may compel obedience to the subpoena
as though such subpoena had been issued by such court in the
first instance.
§16-29E-7. Legislative reports.
(a) The commission shall submit annual reports to the
Legislature, as required by the provisions of section five of
this article, which such reports shall describe and evaluate in
a concise manner:
(1) The major activities of the several health and human
resources agencies for the fiscal year immediately past,
including important policy decisions reached on initiatives
undertaken during that year, especially as such activities,
decisions and initiatives relate to:
(A) The implementation of health care or social services
programs;
(B) Improving the accessibility of appropriate health care
in all areas of this state;
(C) Improving the health status of the citizens of this
state; and
(D) Coordinating social services programs to reflect a
cohesive delivery of transitional services.
(2) Other information considered by the commission to be
important, including recommendations for statutory, fiscal or
policy reforms and reasons for such recommendations.
(b) The reports may specify in what manner any practice,
policy or procedure may or should be modified to satisfy the goal
of efficient and effective delivery of health and social services
programs and to improve the quality of health and social services
available in this state.
§16-29E-8. Submission of legislative rules to the commission;
review and recommendations.
(a) When an agency approves a proposed health-related
legislative rule for submission to the Legislature, the agency
shall submit to the legislative oversight commission on health
and human resources accountability at its offices or at a regular
meeting of such commission fifteen copies of:
(1) The full text of the legislative rule as finally
approved by the agency, with new language underlined and with
language to be deleted from any existing rule stricken through
but clearly legible;
(2) A brief summary of the content of the legislative rule
and a description and a copy of any existing rule which the
agency proposes to amend or repeal;
(3) A statement of the circumstances which require the
rule;
(4) A fiscal note containing all information included in a
fiscal note for either house of the Legislature and a statement
of the economic impact of the rule on the state or its residents;
and
(5) Any other information which the commission may request
or which may be required by law.
(b) The commission shall review each proposed legislative
rule and, in its discretion, make recommendations regarding such
rules to the Legislature pursuant to the rulemaking procedures
provided in article three, chapter twenty-nine-a of this code.