ENROLLED
COMMITTEE SUBSTITUTE
FOR
SENATE BILL No. 161
(By Senators Tomblin, Mr. President, and Boley,
By Request of the Executive)
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[Passed March 9, 1995; in effect ninety days from passage.]
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AN ACT to amend and reenact sections two, three, four, six and
nine, article sixteen, chapter eighteen-b of the code of
West Virginia, one thousand nine hundred thirty-one, as
amended, all relating to creating the West Virginia rural
health advisory panel; legislative findings; definitions;
continuing the rural health initiative; reports and audit
required; and termination date.
Be it enacted by the Legislature of West Virginia:
That sections two, three, four, six and nine, article
sixteen, chapter eighteen-b of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended and
reenacted, all to read as follows:
ARTICLE 16. HEALTH CARE EDUCATION.
§18B-16-2. Legislative findings and declarations.
(a) The Legislature hereby finds and declares that the health of the citizens of West Virginia is of paramount
importance; that the education of health care professionals
must be reshaped; that the delivery of health care services
must be improved; that refocusing health sciences education
will aid in the recruitment of health care professionals and
their retention in the state; that the educational process
should incorporate clinical experience in rural areas and
provide improved availability of health care services
throughout the state, especially in rural areas; and that the
state investment in such education and services must be
contained within reasonable limits.
(b) The Legislature further hereby finds and declares that
the vice chancellor for health sciences shall provide an
integral link among the advisory panel created in section six
of this article, the health sciences programs at the state
institutions of higher education, the governing boards of the
state's institutions of higher education and the joint
commission for vocational-technical-occupational education to
assure cooperation and the coordination of efforts to
effectuate the goals set forth in section four of this article.
(c) It is the further finding of the Legislature that the
appropriations pursuant to section eight of this article are
made with the understanding that the educational and clinical
programs existing at the schools of medicine on the effective
date of this section, as well as the goals of this article, will be met without requests for increases in the annual
appropriations through the fiscal year beginning on the first
day of July, one thousand nine hundred ninety-five, with the
exception of requested increases in appropriations for the
purpose of meeting any increases in the salaries of personnel
as may be given to other employees at state institutions of
higher education under the board of trustees.
(d) The Legislature further finds that there is a serious
need throughout the state for a greater number of primary care
physicians and allied health care professionals and a serious
need for improved accessibility to adequate health care
throughout the state, especially in rural areas; that the
state's medical schools are finding it difficult to satisfy the
ever increasing demand for qualified persons to deliver these
health care services; and that the state's institutions of
higher education and rural health care facilities existing
throughout the state are a major educational resource for
training students in these health care services, as well as a
major resource for providing health care to underserved
citizens of this state.
(e) The Legislature further finds that in order to provide
adequate health care in rural communities there must be a
cooperative initiative among educators, physicians, mid-level
providers, allied health care providers and the rural
communities.
(f) The Legislature further finds that the rural health
initiative and the Kellogg program have together implemented a
nationally acclaimed, highly successful effort to enable the
health professions schools to serve the rural and primary care
health needs of the state and should be continued as a single
program within the office of the vice chancellor for health
sciences.
§18B-16-3. Definitions.
For purposes of this article, and in addition to the
definitions set forth in section two, article one of this
chapter, the terms used in this article have the following
definitions ascribed to them:
(a) "Advisory panel" or "panel" means the West Virginia
rural health advisory panel created under section six of this
article.
(b) "Allied health care" means health care other than that
provided by physicians, nurses, dentists and mid-level
providers and includes, but is not limited to, care provided by
clinical laboratory personnel, physical therapists,
occupational therapists, respiratory therapists, medical
records personnel, dietetic personnel, radiologic personnel,
speech-language-hearing personnel and dental hygienists.
(c) "Mid-level provider" includes, but is not limited to,
advanced nurse practitioners, nurse-midwives and physician
assistants.
(d) "Office of community and rural health services" means
that agency, staff or office within the department of health
and human resources which has as its primary focus the delivery
of rural health care.
(e) "Primary care" means basic or general health care
which emphasizes the point when the patient first seeks
assistance from the medical care system and the care of the
simpler and more common illnesses. This type of care is
generally rendered by family practice physicians, general
practice physicians, general internists, obstetricians,
pediatricians, psychiatrists and mid-level providers.
(f) "Primary health care education sites" or "sites",
whether the term is used in the plural or singular, means those
rural health care facilities established for the provision of
educational and clinical experiences pursuant to section seven
of this article.
(g) "Rural health care facilities" or "facilities",
whether the term is used in the plural or singular, means
nonprofit, free-standing primary care clinics in medically
underserved or health professional shortage areas and nonprofit
rural hospitals with one hundred or less licensed acute care
beds located in a nonstandard metropolitan statistical area.
(h) "Schools of medicine" means the West Virginia
university school of medicine, which is the school of health
sciences; the Marshall school of medicine, which is the Marshall medical school; and the West Virginia school of
osteopathic medicine.
(i) "Vice chancellor" means the vice chancellor for health
sciences provided for under section six, article two of this
chapter.
§18B-16-4.
Establishment of rural health initiative; goals of
rural health initiative.
There is hereby established a rural health initiative
under the auspices of the board of trustees and under the
direction and administration of the vice chancellor. This
initiative shall combine the efforts of the rural health
initiative as created by this article in the year one thousand
nine hundred ninety-one, and the Kellogg program as
administered by the vice chancellor before the effective date
of this section. The goals of the rural health initiative
include, but are not limited to:
(a) The development of at least six primary health care
education sites;
(b) The establishment of satellite programs from the
primary health care education sites to provide additional
opportunities for students and medical residents to serve under
role models in rural areas;
(c) The provision of training to all medical students
under the direction of primary care physicians practicing in
rural areas;
(d) The provision of admission preferences for qualified
students entering primary care in needed specialties in
underserved areas;
(e) The creation of medical residency rotations in
hospitals and clinics in rural areas and the provision of
incentives to medical residents to accept the residencies at
these hospitals and clinics;
(f) The placement of mid-level providers in rural
communities and the provision of support to the mid-level
providers;
(g) The extension of rural hospital physician respite loan
programs to rural primary health care clinics;
(h) The development of innovative programs which enhance
student interest in rural health care opportunities;
(i) The increased placement of primary care physicians in
underserved areas;
(j) The increased retention of obstetrical providers and
the availability of prenatal care;
(k) The increased use of underserved areas of the state in
the educational process;
(l) An increase in the number of support services provided
to rural practitioners;
(m) An increase in the retention rate of graduates from
West Virginia medical schools, nursing schools and allied
health care education programs;
(n) The development of effective health promotion and
disease prevention programs to enhance wellness; and
(o) The establishment of primary health care education
sites which complement existing community health care resources
and which do not relocate the fundamental responsibility for
health care from the community to the board of trustees.
§18B-16-6. Creation of the West Virginia rural health advisory
panel.
(a) The West Virginia rural health advisory panel is
hereby created and the rural health initiative advisory panel
is hereby terminated as of the first day of July, one thousand
nine hundred ninety-five. The advisory panel, which shall be
appointed by the governor after consulting with the vice
chancellor, shall consist of one community representative from
each of the consortia of primary health care education sites;
five members shall be rural health care providers, two of whom
shall be representatives of rural health care facilities
selected from such lists as may be submitted by associations
interested or involved in the provision of rural health care,
two of whom shall be physicians engaged in the private practice
of rural medicine, and one of whom shall be an advanced nurse
practitioner or a nurse midwife with experience in rural health
care delivery; the dean or designee from each of the
participating health sciences schools, ex officio; one
representative from private colleges; one representative from the state college system; one site coordinator; the
commissioner of public health, ex officio; and the director of
the office of community and rural health services, ex officio.
Except for the ex officio members, members of the panel shall
serve for staggered three-year terms:
Provided, That one third
of the initial appointments shall be designated by the governor
for one-year terms and one third of the initial appointments
shall be designated by the governor for two-year terms.
Members of the advisory panel shall be reimbursed for the
cost of reasonable and necessary expenses actually incurred in
the performance of their duties:
Provided, That members of the
panel who are employed by the state of West Virginia shall not
be reimbursed for their expenses under the provisions of this
section.
(b) The functions and duties of the panel are to recommend
policies and procedures to the vice chancellor related to the
rural health initiative and to oversee and coordinate
implementation of those policies and procedures.
(c) Pursuant to the provisions of article ten, chapter
four of this code, the West Virginia rural health advisory
panel shall continue to exist until the first day of July, two
thousand one, to allow for the completion of a preliminary
performance review by the joint committee on government
operations.
(d) The advisory panel has the power and the duty to recommend rural health care facilities to be established as
primary health care education sites. Such recommendation shall
be made to the vice chancellor in accordance with the criteria
set forth in section seven of this article. After review of
the proposals submitted to the vice chancellor by the schools
of medicine pursuant to section eight of this article, the
panel's recommendation shall include an estimation of the costs
to be allocated per site from available funds in the university
of West Virginia health sciences account in the line item
designated for rural health initiative site support.
(e) The advisory panel shall adopt guidelines regarding
the application by rural health care facilities for selection
as primary health care education sites and shall approve an
application form which provides the panel with sufficient
information to consider the criteria set forth in section eight
of this article. The guidelines and application shall be sent
by registered mail to each rural health care facility in the
state as soon as practicable after the effective date of this
section.
(f) The advisory panel shall provide an ongoing evaluation
of the rural health initiative and shall make the reports
required under this article.
§18B-16-9. Accountability; reports and audit required.
(a) The vice chancellor, with the assistance of the
advisory panel, shall report in detail to the board of trustees on the expenditure and planned expenditure of public funds to
the schools of medicine under section eight of this article.
The board of trustees shall report to the governor, the
president of the Senate and the speaker of the House of
Delegates annually prior to the first day of December as a part
of the higher education report cards required by section
eight-a, article one of this chapter.
(b) The vice chancellor, with the guidance and
recommendations of the advisory panel, shall develop additional
performance indicators, including, but not limited to: (1) An
analysis of the health care needs of the targeted areas; (2)
the number of persons served and the nature of the services
provided; (3) the number of full-time and part-time faculty,
students, interns and residents, by discipline, participating
in the health science and allied health care education
programs; (4) the number of health providers in each community
served by primary health care education sites; (5) the
financial, social and health status changes in each community
served by primary health care education sites; and (6) the
extent to which the plans and policies of the office of rural
health and the health care planning commission are being
effectuated. The vice chancellor shall provide information on
the performance indicators to the board of trustees for
inclusion in the higher education accountability report card
for health sciences provided for in section eight-a, article one of this chapter.
(c) The advisory panel shall report at least annually to
the joint legislative oversight commission on education
accountability created under section eleven, article three-a,
chapter twenty-nine-a of this code and to the area health
education centers subcommittee of the joint committee on
government and finance regarding the status of the rural health
care initiative, paying particular attention to the role of the
communities.
(d) The vice chancellor shall report at least annually to
the joint legislative oversight commission on education
accountability created under section eleven, article three-a,
chapter twenty-nine-a of this code and to the area health
education centers subcommittee of the joint committee on
government and finance regarding the status of the rural health
care initiative, paying particular attention to the role of the
schools of medicine.
(e) The board of trustees shall facilitate a meeting at
least quarterly for the chief administrators of each primary
health care education site established pursuant to this article
and each chief administrator at other rural health care
facilities providing educational and clinical experiences to
students, interns and residents at the state's schools of
medicine. The meetings shall commence no later than the first
day of July, one thousand nine hundred ninety-two, and shall be for the purpose of discussing the status, efficiency and
effectiveness of the various programs and their operation and
recommending any changes to the board of trustees, which may
include statutory recommendations to be made to the
Legislature.
In addition to the reports otherwise required and
commencing with a report for the fiscal year beginning on the
first day of July, one thousand nine hundred ninety-one, the
chief administrators shall submit to the board of trustees an
annual evaluation of the extent to which the goals set forth in
section four of this article and other goals relating to
collaborative efforts between the schools of medicine and rural
health care facilities are being attained. Such report shall
be forwarded annually in its entirety to the governor, the
president of the Senate and the speaker of the House of
Delegates no later than the fifteenth day of January.
(f) The legislative auditor, at the direction of the joint
committee on government and finance, shall perform on an
ongoing basis a fiscal audit of the medical education
components within the university of West Virginia system, the
state college system and the rural health initiative for
periodic review by the Legislature.