H. B. 4149


(By Mr. Speaker, Mr. Kiss, and Delegates Givens,
Thompson, Michael, Martin, Yeager and Linch)
[Introduced January 25, 2000; referred to the
Committee on Veterans Affairs then Finance.]



A BILL to amend and reenact section four, article six, chapter five of the code of West Virginia, one thousand nine hundred thirty-one, as amended; to amend chapter nine-a of said code by adding thereto a new article, designated article two-a; and to amend and reenact section four, article two-d, chapter sixteen of said code, all relating to the establishment of state veterans' nursing homes; authorizing the state building commission to acquire or construct facilities necessary for the establishment of one or more state veterans' nursing homes; granting the division of veterans affairs jurisdiction over the state veterans' nursing homes; providing for the promulgation of rules; authorizing the division of veterans' affairs to seek necessary state or federal funding; authorizing the issuance of revenue bonds and other financial arrangements; exempting veterans' nursing homes from certificate of need requirements and coordination with nursing home licensing and regulation requirements.

Be it enacted by the Legislature of West Virginia:
That section four, article six, chapter five of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended and reenacted; that chapter nine-a of said code be amended by adding thereto a new article, designated article two-a; and that section four, article two-d, chapter sixteen of said code be amended and reenacted, all to read as follows:
CHAPTER 5. GENERAL POWERS AND AUTHORITY OF THE GOVERNOR,

SECRETARY OF STATE AND ATTORNEY GENERAL; BOARD

OF PUBLIC WORKS; MISCELLANEOUS AGENCIES, COMMISSIONS,

OFFICES, PROGRAMS, ETC.

ARTICLE 6. STATE BUILDING COMMISSION.
§5-6-4. Powers of commission.

The commission has the power:
(1) To sue and be sued, plead and be impleaded;
(2) To have a seal and alter the same at pleasure;
(3) To contract to acquire and to acquire, in the name of the commission or of the state, by purchase, lease, lease-purchase or otherwise, real property or rights or easements necessary or convenient for its corporate purposes and to exercise the power of eminent domain to accomplish those purposes;
(4) To acquire, hold and dispose of personal property for its corporate purposes;
(5) To make bylaws for the management and regulation of its affairs;
(6) With the consent of the attorney general of the state of West Virginia, to use the facilities of his or her office, assistants and employees in all legal matters relating to or pertaining to the commission;
(7) To appoint officers, agents and employees, and fix their compensation;
(8) To make contracts, and to execute all instruments necessary or convenient to effectuate the intent of, and to exercise the powers granted to it by this article;
(9) To renegotiate all contracts entered into by it whenever, due to a change in situation, it appears to the commission that its interests will be best served;
(10) To construct a building or buildings on real property, which it may acquire, or which may be owned by the state of West Virginia, in the city of Charleston, as convenient as may be to the capitol building, together with incidental approaches, structures and facilities, subject to the consent and approval of the city of Charleston in any case as may be necessary; and, in addition, to acquire or construct a warehouse, including office space in the warehouse, in Kanawha County for the West Virginia alcohol beverage control commissioner, and equip and furnish the office space; and to acquire or construct, through lease, purchase, lease-purchase or bond financing, hospitals or other facilities, buildings, or additions or renovations to buildings as may be necessary for the safety and care of patients, inmates and guests at facilities under the jurisdiction of and supervision of the division of health and at institutions under the jurisdiction of the division of corrections or the regional jail and correctional facilities authority; and to formulate and program plans for the orderly and timely capital improvement of all of the hospitals and institutions and the state capitol buildings; and to construct a building or buildings in Kanawha County to be used as a general headquarters by the division of public safety West Virginia state police to accommodate that division's the state police's executive staff, clerical offices, technical services, supply facilities and dormitory accommodations; and to develop, improve and expand state parks and recreational facilities to be operated by the division of natural resources; and to acquire or construct, through lease, purchase, lease-purchase or bond financing, buildings, or additions or renovations to buildings as may be necessary for the establishment of state veterans' nursing homes under the jurisdiction of the division of veterans' affairs; and to establish one or more systems or complexes of buildings and projects under control of the commission; and, subject to prior agreements with holders of bonds previously issued, to change the systems, complexes of buildings and projects from time to time, in order to facilitate the issuance and sale of bonds of different series on a parity with each other or having such priorities between series as the commission may determine; and to acquire by purchase, eminent domain or otherwise all real property or interests in the real property necessary or convenient to accomplish the purposes of this subdivision. The rights and powers set forth in this subdivision shall not be construed as in derogation of any rights and powers now vested in the West Virginia alcohol beverage control commissioner, the department of health and human resources, the division of corrections or the division of natural resources;
(11) To maintain, construct and operate a project authorized under this article;
(12) To charge rentals for the use of all or any part of a project or buildings at any time financed, constructed, acquired or improved, in whole or in part, with the proceeds of sale of bonds issued pursuant to this article, subject to and in accordance with such agreements with bondholders as may be made as provided in this article: Provided, That on and after the effective date of the amendments to this section, to charge rentals for the use of all or any part of a project or buildings at any time financed, constructed, acquired, maintained or improved, in whole or in part, with the proceeds of sale of bonds issued pursuant to this article, subject to and in accordance with such agreements with bondholders as may be made as in this section provided, or with any funds available to the state building commission, including, but not limited to, all buildings and property owned by the state of West Virginia or by the state building commission, but no rentals shall be charged to the governor, attorney general, secretary of state, state auditor, state treasurer, the Legislature and the members of the Legislature, the supreme court of appeals, nor for their offices, agencies, official functions and duties;
(13) To issue negotiable bonds and to provide for the rights of the holders of the negotiable bonds;
(14) To accept and expend any gift, grant or contribution of money to, or for the benefit of, the commission, from the state of West Virginia or any other source for any or all of the purposes specified in this article or for any one or more of such purposes as may be specified in connection with the gift, grant or contribution;
(15) To enter on any lands and premises for the purpose of making surveys, soundings and examinations;
(16) To invest in United States government obligations, on a short-term basis, any surplus funds which the commission may have on hand pending the completion of any project or projects;
(17) To issue revenue bonds in accordance with the applicable provisions of this article for the purposes set forth in section eleven-a of this article; and
(18) To do all things necessary or convenient to carry out the powers given in this article.
CHAPTER 9A. VETERANS' AFFAIRS.

ARTICLE 2A. ESTABLISHMENT OF A STATE VETERANS' HOME.
§9A-2A-1. Purpose.
The Legislature has determined that the establishment of one or more state veterans' nursing homes is in the best interest of the veterans of West Virginia and necessary to the well-being of our elderly and disabled veterans. Therefore, it is the purpose of this article to authorize the establishment of state veterans' nursing homes, to promote the construction or renovation of such homes, and to assign administrative responsibility for the planning and operation of such homes.
§9A-2A-2. Veterans' nursing homes authorized under jurisdiction of division of veterans' affairs; rules; funding.
(a) Subject to the acquisition of funds as provided by this article, there may be established and maintained in West Virginia one or more state veterans' nursing homes to provide long-term care to veterans who are residents of West Virginia.
(b) The West Virginia division of veterans' affairs shall have jurisdiction over any state veterans' nursing homes established in this state.
(c) The division of veterans' affairs may propose administrative rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code to operate state veterans' nursing homes in compliance with applicable state and federal statutes and rules.
(d) The division of veterans' affairs may seek federal and private funding for the construction or renovation, and operation of the state veterans' nursing homes.
§9A-2A-3. Authorization to apply for issuance of revenue bonds; other financial arrangements.

In order to finance the cost of the construction or renovation of any state veterans' nursing home and all proper costs necessary or incidental thereto, the division of veterans' affairs is hereby authorized to apply to the state building commission for the issuance of revenue bonds, and enter into any leases or other financing agreements with respect to state veterans' nursing homes which are necessary to provide revenues to amortize and secure the revenue bonds.
§9A-2A-4. Exemption from certificate of need; coordination with regulatory requirements.

(a) Any state veterans' nursing home established pursuant to this article is not required to obtain a certificate of need pursuant to the requirements of article two-d, chapter sixteen of this code.
(b) Any state veterans' nursing home established pursuant to this article shall be subject to the provisions of article five-c, chapter sixteen of this code: Provided, That any requirement of said article regarding certificate of need approval shall not apply to any state veterans' nursing home.
CHAPTER 16. PUBLIC HEALTH

ARTICLE 2D. CERTIFICATE OF NEED
§16-2D-4. Exemptions from certificate of need program.

(a) Except as provided in subsection (b), subdivision (9), section three of this article, nothing in this article or the rules adopted pursuant to the provisions of this article may be construed to authorize the licensure, supervision, regulation or control in any manner of the following:
(1) Private office practice of any one or more health professionals licensed to practice in this state pursuant to the provisions of chapter thirty of this code: Provided, That such exemption from review of private office practice shall not be construed to include such practices where major medical equipment otherwise subject to review under the provisions of this article is acquired, offered or developed: Provided, however, That such exemption from review of private office practice shall not be construed to include the acquisition, offering or development of one or more health services, including ambulatory surgical facilities or centers, lithotripsy, magnetic resonance imaging and radiation therapy by one or more health professionals. The state agency shall adopt rules pursuant to section eight of this article which specify the health services acquired, offered or developed by health professionals which are subject to certificate of need review;
(2) Dispensaries and first-aid stations located within business or industrial establishments maintained solely for the use of employees: Provided, That such facility does not contain inpatient or resident beds for patients or employees who generally remain in the facility for more than twenty-four hours;
(3) Establishments, such as motels, hotels and boardinghouses, which provide medical, nursing personnel and health related services;
(4) The remedial care or treatment of residents or patients in any home or institution conducted only for those who rely solely upon treatment by prayer or spiritual means in accordance with the creed or tenets of any recognized church or religious denomination;
(5) The creation of new primary care services located in communities that are underserved with respect to primary care services: Provided, That to qualify for this exemption, an applicant must be a community-based nonprofit organization with a community board that provides or will provide primary care services to people without regard to ability to pay: Provided, however, That the exemption from certificate of need review of new primary care services provided by this subdivision shall not include the acquisition, offering or development of major medical equipment otherwise subject to review under the provisions of this article or to include the acquisition, offering or development of ambulatory surgical facilities, lithotripsy, magnetic resonance imaging or radiation therapy. The office of community and rural health services shall define which services constitute primary care services for purposes of this subdivision, and shall, to prevent duplication of primary care services, determine whether a community is underserved with respect to certain primary care services within the meaning of this subdivision. Any organization planning to qualify for an exemption pursuant to this subdivision shall submit to the state agency a letter of intent describing the proposed new services and area of service; and
(6) The creation of birthing centers by nonprofit primary care centers that have a community board and provide primary care services to people in their community without regard to ability to pay, or by nonprofit hospitals with less than one hundred licensed acute care beds: Provided, That to qualify for this exemption, an applicant shall be located in an area that is underserved with respect to low-risk obstetrical services: Provided, however, That if a primary care center attempting to qualify for this exemption is located in the same county as a hospital that is also eligible for this exemption, or if a hospital attempting to qualify for this exemption is located in the same county as a primary care center that is also eligible for this exemption, then at least one primary care center and at least one hospital from said county shall collaborate for the provision of services at a birthing center in order to qualify for this exemption: Provided further, That for purposes of this subsection, a "birthing center" is a short-stay ambulatory health care facility designed for low-risk births following normal uncomplicated pregnancy. Any primary care center or hospital planning to qualify for an exemption pursuant to this subdivision shall submit to the state agency a letter of intent describing the proposed birthing center and area of service.
(b) (1) A health care facility is not required to obtain a certificate of need for the acquisition of major medical equipment to be used solely for research, the addition of health services to be offered solely for research, or the obligation of a capital expenditure to be made solely for research if the health care facility provides the notice required in subdivision (2) of this subsection, and the state agency does not find, within sixty days after it receives such notice, that the acquisition, offering or obligation will, or will have the effect to:
(A) Affect the charges of the facility for the provision of medical or other patient care services other than the services which are included in the research;
(B) Result in a substantial change to the bed capacity of the facility; or
(C) Result in a substantial change to the health services of the facility.
(2) Before a health care facility acquires major medical equipment to be used solely for research, offers a health service solely for research or obligates a capital expenditure solely for research, such health care facility shall notify in writing the state agency of such facility's intent and the use to be made of such medical equipment, health service or capital expenditure.
(3) If major medical equipment is acquired, a health service is offered or a capital expenditure is obligated and a certificate of need is not required for such acquisition, offering or obligation as provided in subdivision (1) of this subsection, such equipment or service or equipment or facilities acquired through the obligation of such capital expenditure may not be used in such a manner as to have the effect or to make a change described in paragraphs (A), (B) and (C) of said subdivision unless the state agency issues a certificate of need approving such use.
(4) For purposes of this subsection, the term "solely for research" includes patient care provided on an occasional and irregular basis and not as part of a research program.
(c) (1) The state agency may adopt rules pursuant to section eight of this article to specify the circumstances under which a certificate of need may not be required for the obligation of a capital expenditure to acquire, either by purchase or under lease or comparable arrangement, an existing health care facility: Provided, That a certificate of need is required for the obligation of a capital expenditure to acquire, either by purchase or under lease or comparable arrangement, an existing health care facility if:
(A) The notice required by subdivision (2) of this subsection is not filed in accordance with that subdivision with respect to such acquisition; or
(B) The state agency finds, within thirty days after the date it receives a notice in accordance with subdivision (2) of this subsection, with respect to such acquisition, that the services or bed capacity of the facility will be changed by reason of said acquisition.
(2) Before any person enters into a contractual arrangement to acquire an existing health care facility, such person shall notify the state agency of his or her intent to acquire the facility and of the services to be offered in the facility and its bed capacity. Such notice shall be made in writing and shall be made at least thirty days before contractual arrangements are entered into to acquire the facility with respect to which the notice is given. The notice shall contain all information the state agency requires.
(d) The state agency shall adopt rules pursuant to section eight of this article to specify the circumstances under which and the procedures by which a certificate of need may not be required for shared services between two or more acute care facilities providing services made available through existing technology that can reasonably be mobile. The state agency shall specify the types of items in the rules and under what circumstances mobile MRI and mobile lithotripsy may be so exempted from review. In no case, however, will mobile cardiac catheterization be exempted from certificate of need review. In addition, if the shared services mobile unit proves less cost effective than a fixed unit, the acute care facility will not be exempted from certificate of need review.
On a yearly basis, the state agency shall review existing technologies to determine if other shared services should be included under this exemption.
(e) A certificate of need is not required for the construction, renovation, maintenance or operation of a state veterans' nursing home established pursuant to the provisions of article two-a, chapter nine-a of this code.




NOTE: The purpose of this bill is to authorize and promote the establishment of one or more state veterans' nursing homes.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.

§9A-2A is new; therefore, strike-throughs and underscoring have been omitted.