HOUSE CONCURRENT RESOLUTION NO. 48
(By Delegates Spencer, Rowe, Seacrist, Hunt,
Staton, Amores and Beane)
Requesting the Joint Committee on Government and Finance to make
a study of the economic impact of measures intended to
promote economic preservation and provide regulatory relief
for small and rural hospitals.
Whereas, The financial condition of some small and rural
hospitals in this State over the past several years has, at best,
been marginal and consistently deteriorating; and
Whereas, These hospitals provide the economic backbone of
rural health care and lead other health care providers in
uncompensated and charity care; and
Whereas, The value of these health care providers is
significant by providing community access to a range of primary,
obstetric, emergency and other health care services as well as
employment of over six thousand West Virginia citizens frequently
in the most economically deprived areas of the State; and
Whereas, Present state medicaid and managed care
reimbursement policies provide substantial financial
disincentives to certain not-for-profit small and rural
hospitals, discouraging them from continuing to offer obstetric and other needed health care services in rural communities; and
Whereas, Recent independent studies indicate that some small
and rural not-for-profit hospitals are operating with financially
severe losses, are in a position of probable financial default,
and face an increasing risk of closure within the next several
years, and the seriousness of this matter is such that even minor
changes in reimbursement could quickly wipe out existing cash
balances; and
Whereas, Projected changes in reimbursement due to enactment
of the federal Balanced Budget Act of 1997, will inevitably
result in decreasing availability of federal health care dollars;
and
Whereas, Additional projected changes in financing and
delivery of health care services by state government may act to
disproportionately exacerbate the financial instability of these
hospitals, increasing the possibility of closure or reduction of
services and employees, hindering future economic development; and
Whereas, An immediate need exists to develop consistent
public fiscal and regulatory policy which fosters access to rural
health care services for the direct benefit of the citizens of
West Virginia; and
Whereas, Access to critically needed health care services in
rural areas will be enhanced by development of public policy by
this State which:
(1) Encourages stability and adequacy of payments to
not-for-profit small and rural hospitals;
(2) Maintains access to essential services in rural
communities including emergency and obstetric services;
(3) Recognizes that Mmedicaid disproportionate share payments
are vital to the financial survival of not-for-profit small and
rural hospitals;
(4) Recognizes the potentially severe net effect that
Mmedicare, Mmedicaid and other payor reductions have on these
hospitals; and
(5) Identifies and eliminates competing or conflicting
policy decisions made by various state agencies affecting small and rural hospitals; therefore, be it
Resolved by the Legislature of West Virginia:
That the Joint Committee on Government and Finance is hereby
requested to review, examine and study the preservation of and
regulatory relief for small and rural hospitals; and, be it
Further Resolved, That due to the present or projected dire
financial condition of certain small and rural hospitals, the
Joint Committee on Government and Finance shall meet for the
purpose of this study at any time both during sessions of the
Legislature and in the interim as often as necessary; and, be it
Further Resolved, That the study mission of the Joint
Committee on Government and Finance shall be to:
(1) Make an expedited investigation, study and review of the
practices, policies and procedures the state Mmedicaid agency and
public employees insurance agency relating to the payment
policies and methodologies affecting small and rural hospitals
and the financial effect of such policies and methodologies;
(2) Make an expedited investigation, study and review of
statutory and regulatory requirements of state agencies
including, but not limited to, the Department of Health and Human Resources and the Health Care Authority which unnecessarily add
to the cost of or impede access to rural health care within this
state and those statutory and regulatory requirements which
foster and encourage the provision of rural health services;
(3) Recommend action to encourage and provide regulatory and
other incentives to locally reconfigure the manner of delivering
rural health care services. In instances in which acute care
capacity is reduced, develop proposed statutory or other
authority which allows hospitals to utilize excess capacity in a
timely manner, omitting bureaucratic overkill, to deliver new or
modified health care services which meet community needs while
preserving local employment; and
(4) Develop other specific legislative initiatives to create
public policy which preserves access to needed health services in
rural areas, prevents closure and encourages preservation of
not-for-profit small and rural hospitals and maintains an
employment base for local communities; and, be it
Further Resolved, That the Joint Committee on Government and
Finance report to the regular session of the Legislature, 1999,
on its findings, conclusions and recommendations, together with drafts of any legislation necessary to effectuate its
recommendations; and, be it
Further Resolved, That the expenses necessary to conduct
this study, to prepare a report and to draft necessary
legislation be paid from legislative appropriations to the Joint
Committee on Government and Finance.