COMMITTEE SUBSTITUTE
FOR
H. B. 4579
(By Delegates Compton and Leach)
(Originating in the Committee on Finance)
[March 1, 2000]
A BILL to amend article five, chapter nine of the code of West
Virginia, one thousand nine hundred thirty-one, as amended,
by adding thereto a new section, designated section
nineteen, relating to behavioral health services; exempting
from certificate of need review any service authorized by a
summary review; requiring the secretary to direct the
revision of the state mental health plan, appoint an
advisory committee, designating certain appointments,
requiring reporting of the revisions; authorizing the
secretary to initiate a summary review for behavioral health
services, requiring notice; requiring certain findings;
providing the right of appeal; and including an expiration
date for the provisions of this section.
Be it enacted by the Legislature of West Virginia:
That article five, chapter nine of the code of West
Virginia, one thousand nine hundred thirty-one, as amended, be
amended by adding thereto a new section, designated section nineteen, to read as follows:
ARTICLE 5. MISCELLANEOUS PROVISIONS.
§9-5-19. Summary review for certain behavioral health
facilities and services.
(a) A certificate of need as provided for in article two-d,
chapter sixteen of this code is not required by an entity
proposing behavioral health care services if a summary review is
performed in accordance with the provisions of this section.
(b) Prior to initiating any summary review, the secretary
shall direct the revision of the state mental health plan as
required by the provisions of 42 U.S.C. 300x and section 4,
article one-a, chapter twenty-seven of this code. In developing
those revisions, the secretary is to appoint an advisory
committee composed of representatives of the associations
representing providers, child care providers, physicians and
advocates. The secretary shall appoint the appropriate
department employees representing regulatory agencies,
reimbursement agencies and oversight agencies of the behavioral
health system. The members shall submit the revisions to the
secretary for final approval and the report is to be submitted to
the Legislature and governor on the first day of January, two
thousand one.
(c) If the secretary of the department of health and human
resources determines that specific services are needed but
unavailable, he or she shall provide notice of the department's
intent to develop those services. Notice may be provided through publication in the state register, publication in newspapers, or
a modified request for proposal as developed by the secretary.
(d) The secretary may initiate a summary review of
behavioral health care services by recommending exemption from
the provisions of article two-d, chapter sixteen of this code to
the health care authority. The recommendation is to include the
following findings:
(1) That the proposed service is consistent with the state
health plan and the state mental health plan;
(2) That the proposed service is consistent with the
department's programmatic and fiscal plan for behavioral health
services;
(3) That the proposed service contributes to providing
services that prevent admission to restrictive environments or
enables an individual to remain in a non-restrictive environment;
(4) That the proposed service contributes to reducing the
number of individuals admitted to inpatient or residential
treatment programs or services;
(5) If applicable, that the proposed service will be
community-based, locally accessible, provided in an appropriate
setting consistent with the unique needs and potential of each
client and his or her family, and located in an area that is
unserved or underserved or does not allow consumers a choice of
providers; and
(6) That the secretary is making additional funds available
for the proposed service. The secretary may from time to time transfer funds pursuant to the general provisions of the budget
bill.
(e) The secretary's findings required by this section shall
be filed with the secretary's recommendation and appropriate
documentation. If the secretary's findings are supported by the
accompanying documentation, the proposal shall not require a
certificate of need.
(f) Any entity that does not qualify for summary review
shall be subject to a certificate of need review.
(g) Any provider of the proposed services denied
authorization to provide those services pursuant to the summary
review, has the right to appeal that decision to the state agency
in accordance with the provisions of section ten, article two-d,
chapter sixteen of this code.
(h) The provisions of this section shall expire on the
thirtieth day of June, two thousand three.