SB265 H JUD AM 4-9 #1
The Committee on the Judiciary moves to amend the bill on page
three, following the enacting section, by striking out the
remainder of the bill and inserting in lieu thereof the following
language:
"ARTICLE 5. AUTHORIZATION FOR DEPARTMENT OF HEALTH AND HUMAN
RESOURCES TO PROMULGATE LEGISLATIVE RULES.
§64-5-1. Bureau for Public Health.
(a) The legislative rule filed in the State Register on August
31, 2012, authorized under the authority of section four, article
one, chapter sixteen, of this code, modified by the Department of
Health and Human Resources to meet the objections of the
Legislative Rule-Making Review Committee and refiled in the State
Register on January 10, 2013, relating to the Department of Health
and Human Resources (reportable diseases, events and conditions, 64
CSR 7), is authorized with the following amendments:
On page twenty-four, subsection 9.1., by striking out the
words "the reporting" and inserting in lieu thereof the words "the
access";
On page twenty-five, subsection 9.2., by striking out the
words "be reported" and inserting in lieu thereof the words "be
made available";
On page twenty-five, subsection 9.2., by striking out the
words "the reporting" and inserting in lieu thereof the words "the access";
On page twenty-five, subsection 9.2., after the word
"activities" by inserting the following: "consistent with the
mission of the bureau. The responsibility for communication with
healthcare facilities regarding data collection, data quality and
completeness rests with the Office of Epidemiology and Prevention
Services within the Bureau for Public Health";
And,
On page twenty-five, by striking out all of subsection 9.3.
and renumbering the remaining subsection.
(b)
The legislative rule filed in the State Register on June
29, 2012, authorized under the authority of section four, article
one, chapter sixteen, of this code, modified by the Department of
Health and Human Resources to meet the objections of the
Legislative Rule-Making Review Committee and refiled in the State
Register on November 15, 2012, relating to the Department of Health
and Human Resources (general sanitation, 64 CSR 18), is authorized
with the following amendment:
On page three, subdivision 2.13, by removing the period and
inserting the following, "Bed and Breakfast Inn."
(c) The legislative rule filed in the State Register on August
27, 2012, authorized under the authority of section five, article
seven, chapter sixteen, of this code, relating to the Department of
Health and Human Resources (Grade A pasturized milk, 64 CSR 34), is authorized with the following amendment:
On page four, subdivision 2.1.i.1, by striking everything
after the word "sold" and inserting in lieu thereof the following:
"Unpasteurized milk produced in West Virginia may be sold, provided
that said unpasteurized milk is conspicuously labeled as
'Unpasteurized Raw WV Milk'."
(d)
The legislative rule filed in the State Register on August
31, 2012, authorized under the authority of section one, article
eleven, chapter sixteen, of this code, modified by the Department
of Health and Human Resources to meet the objections of the
Legislative Rule-Making Review committee and refiled in the State
Register on January 10, 2013, relating to the Department of Health
and Human Resources (fees for services, 64 CSR 51), is authorized
with the following amendment:
On page eleven, subdivision 9.7, after the word "emergency",
by inserting a period and removing the underscored words "or as a
relevant factor associated with the provision of services and may
include but is not limited to, supply shortages, federal or other
funding restrictions of policy changes impacting the ability to
provide services".
(e)
The legislative rule filed in the State Register on
October 11, 2012, authorized under the authority of section four,
article one, chapter sixteen, of this code, relating to the
Department of Health and Human Resources (regulation of opioid treatment programs, 64 CSR 90), is repealed.
(f) The legislative rule filed in the State Register on August
27, 2012, authorized under the authority of section four, article
one, chapter sixteen, of this code, modified by the Department of
Health and Human Resources to meet the objections of the
Legislative Rule-Making Review Committee and refiled in the State
Register on January 10, 2013, relating to the Department of Health
and Human Resources (pulse oximetry newborn testing, 64 CSR 100),
is authorized with the following amendment:
On page two, subdivision 5.3, by striking out the words "the
closest" and inserting in lieu thereof the word "an".
§64-5-2. Department of Health and Human Resources.
(a)
The legislative rule filed in the State Register on August
31, 2012, authorized under the authority of section one, article
eleven, chapter sixteen, of this code, modified by the Department
of Health and Human Resources to meet the objections of the
Legislative Rule-Making Review Committee and refiled in the State
Register on February 5, 2013, relating to the Department of Health
and Human Resources (regulation of opioid treatment programs, 69
CSR 7), is authorized with the following amendment:
On page fourteen by striking section 7.3 and inserting a new
section 7.3 to read as follows:
"7.3. License Fees and Inspection Costs.
7.3.a. All applications for an initial or renewed license shall be accompanied by a non-refundable license fee in the amount
required by this rule. The annual renewal fee is based upon the
average daily total census of the program. In addition to the set
fee, the annual renewal fee shall be adjusted on the first day of
June of each year to correspond with increases in the consumer
price index. The base amounts for initial and renewal fees are as
follows:
7.3.a.1. Initial license fee - $250;
7.3.a.2. Renewal fee - fewer than 500 patients - $500
plus adjustment;
7.3.a.3. Renewal fee - 500 to 1,000 patients - $1,000
plus adjustment;
7.3.a.4. Renewal fee - more than 1,000 patients - $1,500 plus
adjustment.
7.3.b. An opioid treatment program shall pay for the cost of
the initial inspection made by the secretary prior to issuing a
license. The cost of the initial inspection is $400, and shall be
billed to the applicant by the secretary within five business days
after the inspection. The cost of the initial inspection must be
paid in full by the applicant before a license may be issued.
7.3c. The Office of Health Facility Licensure and
Certification shall use the fee for increased oversight on opioid
treatment programs.";
On page thirty-two by inserting a new subdivision 18.3.j. to read as follows:
"18.3.j. There shall be one (1) counselor for every forty (40)
clients in the program.";
On page fifty-three by striking section 30.8 and inserting a
new section 30.8 to read as follows:
"30.8. Each opioid treatment program must provide counseling
on preventing exposure to, and the transmission of, human
immunodeficiency virus (HIV) disease and Hepatitis C disease for
each patient admitted or re-admitted to maintenance or
detoxification treatment. Services rendered to patients with HIV
disease shall comply with the requirements of section 44 of this
rule.";
On page fifty-four by striking subdivision 31.4.a and
inserting a new subdivision 31.4.a to read as follows:
"31.4.a. Preventing exposure to, and the transmission of, HIV
disease and Hepatitis C disease for each patient admitted or
readmitted to maintenance or detoxification treatment; and";
On page fifty-six by striking subdivision 32.2.a and inserting
a new subdivision 32.2.a to read as follows:
"32.2.a. The initial post-admission assessment shall consist
of a comprehensive medical evaluation, which shall include, but not
be limited to:
32.2.a.1. A comprehensive physical evaluation;
32.2.a.2. A comprehensive psychiatric evaluation, including mental status examination and psychiatric history;
32.2.a.3. A personal and family medical history;
32.2.a.4. A comprehensive history of substance abuse,
both personal and family;
32.2.a.5. A tuberculosis skin test and chest X-ray, if
skin test is positive;
32.2.a.6. A screening test for syphilis;
32.2.a.7. A Hepatitis C test;
32.2.a.8. An HIV test; and
32.2.a.9. Other tests as necessary or appropriate (e.g.,
CBC, EKG, chest X-ray, pap smear, hepatitis B surface antigen and
hepatitis B antibody testing).";
On page seventy by striking section 37.14 and inserting a new
section 37.14 to read as follows:
"37.14 The state authority may approve exceptional
unsupervised-medication dosages, including alternative medications,
on a case-by-case basis upon application for an exemption by the
program physician. Any authorization for exceptions shall be
consistent with guidelines and protocols of approved authorities,
provided that the authority may not grant any exceptions during a
calendar month which exceed three (3) exceptions or ten (10)
percent of the number of patients enrolled in the program on the
last day of the previous month, whichever is greater.";
On page seventy-three by inserting a new subdivision 38.14 to
read as follows:
"38.14 Maintenance treatment shall be discontinued within two
(2) continuous years after the treatment is begun unless, based
upon the clinical judgement of the medical director or program
physician and staff which shall be recorded in the client's record
by the medical director or program physician, the client's status
indicates that the treatment should be continued for a longer
period of time because discontinuance from treatment would lead to
a return to illicit opiate abuse or dependence.";
On page seventy-five by striking subdivision 41.2.d.3 and
inserting a new subdivision 41.2.d.3 to read as follows:
"41.2.d.3. When using urine as a screening mechanism, all
patient drug testing shall be observed to minimize the chance of
adulterating or substituting another individual's urine.";
And,
On page eighty-one by striking subdivision 44.5.d.1. and
inserting a new subdivision 44.5.d.1. to read as follows:
"44.5.d.1.
Maintenance treatment dosage levels of pregnant
clients shall be maintained at the lowest possible dosage level."
(b) The legislative rule filed in the State Register on
January 7, 2013, authorized under the authority of section nine,
article five-h, chapter sixteen, of this code, relating to the
Department of Health and Human Resources (chronic pain management clinic licensure, 69 CSR 8), is authorized with the following
amendments:
On page one, subsection 1.4, line eleven, following the number
"2013.", by inserting the following words:
"This rule is effective upon the date specified in an
emergency rule promulgated by the Department of Health and Human
Resources as being the date funding for implementation of Chronic
Pain Management Clinic Licensure will become available pursuant to
a duly enacted appropriation bill authorizing the expenditure of
funds for that purpose.";
On page four, subsection 3.1., by striking out all of
subdivisions 3.1.a., 3.1.b., 3.1.c. and 3.1.d. and inserting in
lieu thereof the following:
3.1.a. The primary component of the medical practice of the
clinic, facility or office is treatment of chronic pain for non-
malignant conditions;
3.1.b. More than fifty percent of patients in any one month of
the prescribers are provided treatment for chronic pain for
nonmalignant conditions and are prescribed, administered or
dispensed tramadol, carisoprodol, opioid drug products or other
Schedule II or Schedule III controlled substances for such
diagnosis;
3.1.c. The calculation of more than fifty percent of patients
will be calculated by dividing the number of unique patient encounters at the clinic, facility or office during any one month
for a diagnosis of chronic nonmalignant pain and pursuant to such
diagnosis of chronic nonmalignant pain were prescribed,
administered or dispensed tramadol, carisoprodol, opioid drugs or
other Scheduled II or Scheduled III controlled substances by the
total number of all patient encounters at the clinic, facility or
office during any month; and
3.1.d. Patients receiving tramadol, carisoprodol, opioid drug
products or other Schedule II or Schedule III controlled substances
for treatment of an injury or illness that lasts or is expected to
last thirty days or less shall not be included in the calculation
of more than fifty percent of all patients." and renumbering the
remaining subdivisions;
On page five, by inserting a new paragraph, 3.2.i.2., to read
as follows:
"3.2.i.2. Medical practices, clinics or offices in which a
physician treats an average of 20 or fewer patients a day during
any month and with any diagnosis and, in which the physician holds
a Competency Certification in Controlled Substances Management.";
And,
On page thirteen, subparagraph 6.5.b.2.B., after the words
"Osteopathic Specialist;" by inserting the words "hold Competency
Certification in Controlled Substances Management;".
(c)
The legislative rule filed in the State Register on August
30, 2012, authorized under the authority of section four, article
two-b, chapter forty-nine, of this code, modified by the Department
of Health and Human Resources to meet the objections of the
Legislative Rule-Making Review Committee and refiled in the State
Register on January 15, 2013, relating to the Department of Health
and Human Resources (minimum licensing requirements for residential
child care and treatment facilities for children and transitioning
adults in West Virginia, 78 CSR 3), is authorized, with the
following amendment:
On page fifty-two, paragraph 11.2.a.3., line five, by striking
out the word
"Training" and inserting the word "Certification".
§64-5-3. Health Care Authority.
The legislative rule filed in the State Register on May 14,
2012, authorized under the authority of section seven, article
twenty-nine-g, chapter sixteen, of this code, modified by the
Health Care Authority to meet the objections of the Legislative
Rule-Making Review Committee and refiled in the State Register on
July 19, 2012, relating to the Health Care Authority to promulgate
a legislative rule relating to (West Virginia Health Information
Network, 65 CSR 28), is authorized.
§64-5-4. Bureau of Senior Services.
The legislative rule filed in the State Register on August 31,
2012, authorized under the authority of section fifteen, article five-p, chapter sixteen, of this code, modified by the Bureau of
Senior Services to meet the objections of the Legislative Rule-
making Review Committee and refiled in the State Register on
January 17, 2013, relating to the Bureau of Senior Services (in-
home care worker registry, 76 CSR 2), is authorized with the
following amendment:
On page two, subdivision 4.1(i), by striking the word
"training" and inserting the word "certification".