Bill Text: WV HB3155 | 2014 | Regular Session | Introduced
Bill Title: Establishing a definition of "no significant additional fiscal burden" in the minimum criteria for certificate of need reviews
Spectrum: Partisan Bill (Republican 10-0)
Status: (Introduced - Dead) 2014-01-09 - To House Health and Human Resources [HB3155 Detail]
Download: West_Virginia-2014-HB3155-Introduced.html
(By Delegates Sobonya, Westfall, Border,
Rowan and Householder)
[Introduced March 25, 2013 ; referred to the
Committee on Health and Human Resources then the Judiciary.]
A BILL to amend and reenact §16-2D-6 of the Code of West Virginia, 1931, as amended, relating to certificate of need; and establishing a definition of "no significant additional fiscal burden" in the minimum criteria for certificate of need reviews when an application is made by a hospital, nursing home or other health care facility to provide ventilator services which have not previously been provided for a nursing facility bed.
Be it enacted by the Legislature of West Virginia:
That §16-2D-6 of the Code of West Virginia, 1931, as amended, be amended and reenacted to read as follows:
ARTICLE 2D. CERTIFICATE OF NEED.
§16-2D-6. Minimum criteria for certificate of need reviews.
(a) Except as provided in subsection (f), section nine of this article, in making its determination as to whether a certificate of need shall be issued, the state agency shall, at a minimum, consider all of the following criteria that are applicable: Provided, That the criteria set forth in subsection (f) of this section apply to all hospitals, nursing homes and health care facilities when ventilator services are to be provided for any nursing facility bed:
(1) The relationship of the health services being reviewed to the state health plan;
(2) The relationship of services reviewed to the long-range development plan of the person providing or proposing the services;
(3) The need that the population served or to be served by the services has for the services proposed to be offered or expanded, and the extent to which all residents of the area, and in particular low income persons, racial and ethnic minorities, women, handicapped persons other medically underserved population and the elderly, are likely to have access to those services;
(4) The availability of less costly or more effective alternative methods of providing the services to be offered, expanded, reduced, relocated or eliminated;
(5) The immediate and long-term financial feasibility of the proposal as well as the probable impact of the proposal on the costs of and charges for providing health services by the person proposing the new institutional health service;
(6) The relationship of the services proposed to the existing health care system of the area in which the services are proposed to be provided;
(7)
(8) The appropriate and nondiscriminatory utilization of existing and available health care providers;
(9) The relationship, including the organizational relationship, of the health services proposed to be provided to ancillary or support services;
(10) Special needs and circumstances of those entities which provide a substantial portion of their services or resources, or both, to individuals not residing in the health service areas in which the entities are located or in adjacent health service areas. The entities may include medical and other health professional schools, multidisciplinary clinics and specialty centers;
(11)
(12)
(13)
(14)
(15)
(16) In accordance with section five of this article, the factors influencing the effect of competition on the supply of the health services being reviewed;
(17) Improvements or innovations in the financing and delivery of health services which foster competition, in accordance with section five of this article, and serve to promote quality assurance and cost effectiveness;
(18)
(19)
(20)
(21) The special circumstances of health care facilities with respect to the need for conserving energy;
(22) The contribution of the proposed service in meeting the health-related needs of members of medically underserved populations which have traditionally experienced difficulties in obtaining equal access to health services, particularly those needs identified in the state health plan as deserving of priority. For the purpose of determining the extent to which the proposed service will be accessible, the state agency shall consider:
(A) The extent to which medically underserved populations currently use the applicant's services in comparison to the percentage of the population in the applicant's service area which is medically underserved, and the extent to which medically underserved populations are expected to use the proposed services if approved;
(B) The performance of the applicant in meeting its obligation, if any, under any applicable federal regulations requiring provision of uncompensated care, community service or access by minorities and handicapped persons to programs receiving federal financial assistance, including the existence of any civil rights access complaints against the applicant;
(C) The extent to which Medicare, Medicaid and medically indigent patients are served by the applicant; and
(D) The extent to which the applicant offers a range of means by which a person will have access to its services, including, but not limited to, outpatient services, admission by a house staff and admission by personal physician;
(23) The existence of a mechanism for soliciting consumer input into the health care facility's decision-making process.
(b) The state agency may include additional criteria which it prescribes by rules adopted pursuant to section eight of this article.
(c) Criteria for reviews may vary according to the purpose for which a particular review is being conducted or the types of health services being reviewed.
(d) An application for a certificate of need may not be made subject to any criterion not contained in this article, in rules adopted pursuant to section eight of this article or in the certificate of need standards approved pursuant to section five of this article.
(e)
(f)
(g)
(h) For purposes of subsection (f), "no significant additional fiscal burden" means cost increase above normal annual increases in trend for utilization or cost for the state as well as any projected increase in need due to the aging of the state's population. In determining significant fiscal burden the bureau shall consider cost reductions by virtue of avoiding institutional care. The Bureau of Medical Services may not include administrative or monitoring expenses when determining significant additional fiscal burden to the state. If the Bureau for Medical Services believes the applicant's project will result in a significant additional fiscal burden to the state, then the Bureau for Medical Services shall submit the findings in writing within thirty days of the filing of the Certificate of Need applicant and the findings shall be considered by the agency. If the Bureau for Medical Services submits findings that the applicant's application will result in a significant additional fiscal burden, then the Bureau for Medical Services shall develop and submit the findings without respect to the type of entity submitting the application. Notwithstanding any statute, rule or regulation to the contrary, the agency shall make the determination of need without respect to the type of entity making such application and shall make the final of whether the project places no significant additional fiscal burden on the state based on the evidence presented in the applicant's filing and other findings presented by the Bureau of Medical Services and other interested parties and the evidence gathered during the certificate of need process within the time frames established by this code.
NOTE: The purpose of this bill is to establish a definition of "no significant additional fiscal burden" in the minimum criteria for certificate of need reviews when an application is made by a hospital, nursing home or other health care facility to provide ventilator services which have not previously been provided for a nursing facility bed.
Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.