FISCAL
NOTE
WEST virginia Legislature
2017 regular session
By
[
to the Committee on Health and Human Resources then Finance.
A BILL to amend the Code
of West Virginia, 1931, as amended, by adding thereto two new sections,
designated §16-1-16 and §16-1-16a, all
relating to social determinants of health; establishing the Minority Health
Advisory Team including its composition and duties; authorizing a Community
Health Equity Initiative Demonstration Project; authorizing the Commissioner of
the Bureau for Public Health to establish a Community Health Equity Initiative
Demonstration Project; establishing eligibility requirements; providing for the
administration of the demonstration project; establishing requirements for a
demonstration project plan and the selection of communities for participation;
establishing reporting requirements; and establishing the date on which the
demonstration project terminates.
Be it enacted by the
Legislature of West Virginia:
That the Code of West
Virginia, 1931, as amended, be amended by adding thereto two new sections,
designated §16-1-16 and §16-1-16a, all to read as follows:
ARTICLE 1. STATE PUBLIC
HEALTH SYSTEM.
§16-1-16. Minority
Health Advisory Team.
(a) Advisory Team.-- The Minority Health Advisory Team (MYHAT) is
hereby created as an advisory body to the commissioner for the purpose of
advising the commissioner as to the provision of adequate public health
services for the state’s minority population.
(1) The advisory team
shall be composed of twenty members, appointed by the commissioner, and
comprised as follows:
(A) The Dean of the West
Virginia University School of Public Health or his or her designee;
(B) The Director of the
Marshall University Graduate Program in Public Health or his or her designee;
(C) The Dean of the West
Virginia University School of Medicine or his or her designee;
(D) The Dean of the
Marshall University School of Medicine or his or her designee;
(E) The Dean of the West
Virginia School of Osteopathic Medicine or his or her designee;
(F) The Commissioner of
the Bureau for Behavioral Health and Health Facilities or his or her designee;
(G) The Commissioner of
the Bureau for Medical Services or his or her designee;
(H) The Commissioner of
the Bureau for Children and Families or his or her designee;
(I) The State
Superintendent of Schools or his or her designee;
(J) A representative of
a local health department;
(K) A representative of
a free health care clinic;
(L) A representative of
a health insurance provider;
(M) A representative of
a hospital;
(N) A representative of
the Minority Health Advisory Group;
(O) An individual to
represent community and technical colleges;
(P) A representative of
a health care provider recruiting entity;
(Q) A representative of
a federally qualified health center;
(R) Two persons to
represent the general public; and
(S) The coordinator of
the Office of Minority Health within the Bureau for Public Health who shall
serve as the chairperson.
(2) Pursuant to the
provisions of this section, the commissioner shall appoint an advisory team on
or before August 1, 2017.
(3) The advisory team
shall meet at the call of the commissioner at least twice a year.
(b) Advisory team's powers and duties.-- The advisory team may:
(1) Provide technical
assistance to communities, including assistance with research and information
on grant opportunities and other potential funding sources;
(2) Provide letters of
support and recommendations for grant applications;
(3) By a majority vote,
select communities to participate in the demonstration project authorized by
section sixteen-a of this article;
(4) Review, evaluate,
make recommendations and approve or reject, by a majority vote, a written plan
or amendments to a written plan submitted by a community participating in the
demonstration project authorized by section sixteen-a of this article;
(5) Work with state
executive departments and agencies to ensure that appropriate consideration is
given by such departments and agencies to the potential impact of their actions
on minority public health;
(6) Work to ensure that
state government assets are targeted to the state vulnerable populations and
are effectively utilized on the highest impact programs; and
(7) Engage in outreach
and work closely with state and local officials, with nonprofit organizations,
and with the private sector, both in seeking input regarding the development of
a comprehensive minority public health policy and in ensuring that the
implementation of state programs advances the objectives of that policy.
(8) Consult with any
state executive department or agency affected by the written plans or the
amendments to the written plans;
(9) Establish by
guidelines criteria to evaluate the progress and results of implemented plans;
(10) Require participating communities to submit
such data and other information related to the demonstration project authorized
by section sixteen-a of this article;
(11) Coordinate with
established or ad hoc committees, task forces, and interagency groups; and
(12) Perform any other
powers or duties necessary to effectuate the provisions of this section.
§16-1-16a. Community
Health Equity Initiative Demonstration Project.
(a) Legislative Findings.-- The Legislature makes the following
findings:
(1) In West Virginia,
statewide, babies in African American families are born with lower birth
weights and higher rates of infant mortality than for babies born in white
families; and further, black children under the age of five years live in
poverty at higher rates than for children under five years in white families;
and African American families have household income and home ownership rates
much lower than for similarly situated white families;
(2) The unemployment
rate of African Americans recently has been almost twice the unemployment rate
for Caucasians and significantly higher in some counties with a greater
concentration of African American population;
(3) Statistics provided
by the state Equal Employment Opportunity Office indicate that the percentage
of minority employees among the full-time state government employees under the
control of the Department of Administration is approximately the same as the
percentage of African Americans in the state's population as a whole;
(4) The West Virginia Advisory
Committee to the United States Commission on Civil Rights has found continuing
reports of racial discrimination in hiring, tension between law-enforcement
officers and African American citizens and hate crimes and violence against
minorities, including reported incidents of harassment of racial and ethnic
minorities in schools;
(5) West Virginia enjoys
both a low juvenile crime rate and one of the nation's lowest juvenile
detention rates, yet the percentage of minority youth in the West Virginia juvenile
justice system exceeds the national rate of minority youths in the juvenile
justice system;
(6) In West Virginia,
African Americans make up only 3.6 percent of the general population, but
account for one third of the adult prison population, one fifth of the
juveniles placed in detention and admitted to correctional facilities, and over
one half of the juveniles transferred to adult jurisdiction for major felonies;
and
(7) There is a great and
immediate need for comprehensive data collection and analysis on a multiyear
basis and for continuing examination and review of solutions with regard to
racial disparities in the areas of civil rights, health, education, housing,
social issues, employment, economic development and criminal and juvenile justice
systems.
(b) Policy.-- Researchers have established that the social and physical
environment, not just genetic makeup and individual behavior, influences health
and well being outcomes. Structural determinants of health such as
socioeconomic status have serious health consequences. Discrimination is a
known risk factor for unhealthy behavior, psychological distress, and high
blood pressure. More proximate social determinants of health, such as living
conditions in the home and neighborhood, can affect exposure to both
environmental and social risk factors for poor health. There are compelling and
timely reasons for government, nonprofits, and their partners in the private
sector to address social determinants of health through smarter investments in
community development by establishing and embedding systems of innovation and
establishing a state and local policy advocacy team. It is important that any
system of innovation developed to address social determinates of health:
(1) Identify community
strengths and areas for improvement;
(2) Identify and
understand the status of community health needs;
(3) Define improvement
areas to guide the community toward implementing and sustaining policy,
systems, and environmental changes around healthy living strategies (e.g.,
increased physical activity, improved nutrition, reduced tobacco use and
exposure, and chronic disease management);
(4) Assist with
prioritizing community needs and consider appropriate allocation of available
resources;
(5) Allows local
stakeholders to work together in a collaborative process to survey their
community;
(6) Offers suggestions
and examples of policy, systems, and environmental change strategies; and
(7) Provides feedback to
communities as they institute local-level change for healthy living.
(c) Authorizing
participation.-- Effective July 1, 2017, the Commissioner of the Bureau for
Public Health shall establish a Community Health Equity Initiative
Demonstration Project, to be continued for a period of four years, to develop a
model government program to promote public health and general welfare through
comprehensive community development for communities across West Virginia.
(1) Purpose. The purpose
of the demonstration project is the development of model community programs
which will focus and use existing resources of government agencies and
community organizations, whose state or local missions include services for
health and human resources, public education and arts, higher education, mental
health care, social and economic diversity, housing development, economic and
community development, urban renewal, workforce development, and small business
development, all intended generally to improve community and individual public
health and welfare, in and for communities identified as needing special
coordination and delivery of services from those agencies.
(2) Objective. The
objective of the demonstration project is to improve public health by
addressing child and family poverty, educational limitations and other social
determinants of health and welfare through a comprehensive community
development plan. The plan should serve as a model to improve public health and
education through comprehensive community development across the state.
(3) Eligibility.
Communities are eligible to participate in a demonstration project which have
an area of approximately one square mile, and a population of at least three
thousand persons, of whom: (A) Twenty-five percent are minorities; (B) at least
fifty-five percent live in rental housing; and (C) at least fifty percent have
an income under $27,000.
(4) Administration. The
demonstration project shall be developed and administered by the Commissioner
of the Bureau for Public Health’s Minority Health Advisory Team established
pursuant to section sixteen of this article, and it shall encourage state and
local agencies and community groups to work together to coordinate government
and community activities for improvement of community and individual public
health and welfare, and shall identify new and existing funds, personnel and
other existing resources available for the demonstration project.
(5) Resources. A
demonstration project may receive funding and other committed resources from
government, nonprofit, private sector, and community organizations. The demonstration
project shall focus and leverage existing resources, including, but not limited
to, education services, planning and development services, social services,
housing and urban development services, youth and family services and other
public and private resources intended to benefit the quality of life for the
community and people living and working in the target community.
(c) Plan.-- Any community desiring to participate in the demonstration
project shall submit a plan to the advisory team that provides for the
following elements:
(1) Community and
government participation identifying the agencies of state and local government
and nonprofit and private sector organizations to participate in the activities
of the project whose resources would be focused and directed to best produce
anticipated outcomes for the project and community;
(2) Health impact
assessment by local participants in collaboration with state and federal health
officials and organizations;
(3) Review of health
impact assessment results;
(4) Development of a
community action plan with measurable, achievable, realistic, time-phased steps
to achieving project objectives;
(5) Implementation of
the community action plan; and
(6) Evaluation of
measured outcomes.
(d) Selection.-- By a majority vote, the advisory team may select one
or more eligible communities from those which submit plans for a demonstration
project.
(e) Reporting requirements.--
Commencing November 1, 2017, and each year thereafter, each
participating community shall give a progress report to the advisory team and
commencing January 1, 2018, and each year thereafter, the advisory team shall
give a summary report of all the participating communities to the Legislative
Oversight Commission of Health and Human Resources Accountability as
established in article twenty-nine-e of this chapter on progress made by a
pilot demonstration project including any suggested legislation or needed
changes to a demonstration project and any suggested expansion of a
demonstration project.
(f) This section is not
intended to, and does not, create any right or benefit, substantive or
procedural, enforceable at law or in equity by any party against the state, its
departments, agencies, or entities, its officers, employees, or agents, or any other
person.
(g) Termination of the demonstration project.-- The demonstration
project terminates on July 1, 2022.
NOTE: The purpose of this bill is
to authorize model Community Health Equity Initiative Demonstration Projects
which use existing state and local resources to promote community health and
well being. The bill authorizes the Commissioner of the Bureau for Public
Health to establish projects with eligibility requirements; and provides for
the administration of projects. Additionally, the bill establishes the Minority
Health Advisory Team including its composition and duties.
Strike-throughs indicate language
that would be stricken from a heading or the present law and underscoring
indicates new language that would be added.