Senate Bill No. 563
(By Senator Walker)
____________
[Originating in the Committee on Health and Human Resources;
reported 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 state health care
and human services programs generally, including, but not
limited to, terminating the uncompensated health care and
medicaid expenditures task force and transferring their duties
to the legislative oversight commission on health and human
resources accountability; creating a legislative oversight
commission on health and human resources accountability;
appointments; compensation and expenses; powers and duties;
studies; and annual reports to the Legislature.
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:
ARTICLE 29C. INDIGENT CARE.
§16-29C-4. Legislative study; appointment of members; expenses;
reports; termination.
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.
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.
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-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-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.
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.
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-five.
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-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 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
reported to 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. 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,
but 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, but no expense
of any kind whatever payable under said account for joint expenses
shall be incurred unless first approved by the joint committee on
government and finance. The commission shall meet at any time both
during sessions of the Legislature and in the interim.
§16-29E-4. 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 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;
(4) 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 article
twenty-nine-c of this chapter; and
(E) The roles of the public, private and private nonprofit
sectors in providing health care services to the citizens of this
state;
(5) 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;
(6) 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;
(7) 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
(8) 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. These reports shall include:
(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.
Further, these reports may specify in what manner said
practices, policies and procedures 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.
(c) The commission may meet as often as may be necessary and
employ such professional, clerical and technical personnel as it
considers necessary to perform effectively the duties herein
prescribed.