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Health

P Passed

P HB326

Certificate of public need. Authorizes, notwithstanding the provisions of subdivision 6 of § 32.1-102.3:2 as in effect on June 30, 1996, the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of public need issued to a continuing care provider registered with the State Corporation Commission pursuant to Chapter 49 of Title 38.2 for an increase in beds in[SC37] which nursing facility or extended care services are provided to allow such continuing care provider to continue, until the continuing contract holders constitute ninety percent of the occupancy for such facility or until July 1, 2004, whichever occurs first, to admit patients, other than continuing care contract holders, with whom the facility has an agreement with the individual responsible for the patient for private payment of the costs upon the following conditions being met: (i) the continuing care community is established for the care of retired military personnel and their families and (ii) the facility's bond requires that the nursing home unit maintain a 90 percent occupancy rate.

Patron - Black

P HB542

Phenylketonuria; Board of Health's responsibility for treatment. Requires the Board of Health, out of such funds as may be appropriated, to include both the medical formulas and low protein modified foods (foods which are not naturally low in protein) in the food program for children with phenylketonuria and any pregnant woman who is diagnosed as requiring treatment for phenylketonuria. Currently, Virginia's program only supplies parents with the medical formulas, at a cost of no more than two percent of their annual income; however, no low protein modified foods are provided. The bill will provide reinbursement from the Department for low protein modified foods in an amount not to exceed $2,000 per diagnosed person per year. Phenylketonuria is an inborn error of metabolism in which the body is unable to process an amino acid (phenylalanine) that, unless treated early by restricting phenylalanine intake, results in brain damage and mental retardation. In Virginia, all infants are tested for this disease at birth. The bill will not become effective unless an appropriation effectuating the purpose of the bill is included in the 2000 appropriation act and signed into law by the Governor.

Patron - McDonnell

P HB603

Statewide cancer registry. Requires the Commissioner of the Department of Health to implement a system for notifying, within 30 days of receipt of the case records, all cancer patients whose records have been reported to the statewide cancer registry of the purpose, objectives, reporting requirements, confidentiality policies and procedures of the statewide cancer registry, including, but not limited to, continued surveillance and investigation procedures, and to inform such patients of their rights under the Privacy Protection Act.

Patron - McQuigg

P HB613

Medical care facilities certificate of public need. Provides that nuclear cardiac imaging services and equipment will not require a certificate of public need.

Patron - Nixon

P HB689

Health; qualifications for Commissioner. Expands the pool of persons eligible for the position of State Health Commissioner by adding, in addition to being certified by the American Board of Preventive Medicine, that the candidate may, instead, be certified by a recognized board in a primary care specialty as approved by the American Board of Medical Specialties. Any candidate will still be expected to have public health experience as currently provided in statute. Current qualifications severely narrow the field of candidates because so few individuals are certified by the American Board of Preventive Medicine.

Patron - Hamilton

P HB714

Certified nursing facility education initiative. Authorizes the Board of Medical Assistance Services (Board), assisted by the Department of Medical Assistance Services (DMAS), to administer education initiatives for certified nursing facilities. The Director of DMAS shall contract with a nonprofit organization for early on-site training and assistance to promote quality of care in such facilities. Competitive procurement shall not apply. Such nonprofit organization shall be governed by a board of directors composed of the Director of DMAS, or his designee, a representative from the Virginia Department of Health, a representative from the Department of Social Services' Adult Protective Services Unit, a representative from the Office of the State Long-Term Care Ombudsman, and representatives from the consumer, long-term care provider, and business communities. The board of directors shall report on accomplishments, priorities, and activities of the nonprofit organization and submit a strategic plan to the Board, the Governor and the General Assembly. Funding to initially implement the nonprofit organization shall be from civil money penalty funds, and thereafter such organization shall be self-sustaining. Funding for services shall come from charges to nursing facilities, from general appropriations, and from civil money penalty funds. Civil money penalty funds are those funds collected by the DMAS for enforcement of nursing facility remedies pursuant to Title XIX of the Social Security Act.

Patron - McQuigg

P HB739

Certificate of public need. Authorizes, notwithstanding the provisions of the moratorium on nursing home bed construction/additions which was in effect until July 1, 1996, the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of public need issued for an increase in beds in which nursing facility or extended care services are provided to allow such facility to continue, for three years from the issuance of a certificate of public need for the second mid-rise residential unit building associated with such facility or until June 30, 2003, whichever occurs first, to admit persons, other than residents of the cooperative units, to its nursing facility beds when such facility (i) is operated by an association described in § 55-458; (ii) was created in connection with a real estate cooperative; (iii) offers its residents a level of nursing services consistent with the definition of continuing care in chapter 49 (§ 38.2-4900) of Title 38.2; and (iv) was issued a certificate of public need prior to October 3, 1995.

Patron - Suit

P HB741

Health; duties of DMAS Director. Adds specific duties to the general responsibilities of the Director of the Department of Medical Assistance Services, including the responsibilities to monitor health care financing programs, to advise the Governor and the General Assembly on matters related to health care financing, to consult with the General Assembly in developing policies and procedures on health care financing, and to communicate and work cooperatively with stakeholder organizations about issues and policies related to the Department's health care financing. The Director must also make a formal report each year by November 1 to the Governor and General Assembly on the status of the Department's operations and progress towards meeting health care financing problems.

Patron - Rhodes

P HB889

Health; Medicaid forecasting. Requires the Department of Planning and Budget, in cooperation with the Department of Medical Assistance Services, to prepare and submit an estimate of Medicaid expenditures for the current year and a forecast for the next two years. Currently, the Department of Planning and Budget assists in this forecast. The bill provides that the Joint Legislative Audit and Review Commission will receive such forecast. The bill also repeals the sunset clause of July 1, 2004. This bill is identical to SB 515.

Patron - Rollison

P HB892

Medical assistance services; appeals. Provides that, to the extent not prohibited by federal statute or regulation, the findings of the Commissioner of Health, with respect to periodic surveys, i.e., inspections of nursing homes conducted pursuant to federal regulations relating to certification for reimbursement through Medicare and Medicaid, will be case decisions under the Administrative Process Act and will be subject to administrative appeal. Further, not withstanding the current limitations concerning court review of inspection findings, the Commissioner's nursing home survey findings will be subject to court review. This bill also provides for an initial determination in cases of appeal as to whether an overpayment has been made by the Virginia Medicaid program to a provider of medical assistance services to be made within 180 days of receipt of the appeal request. If such initial determination is not made within 180 days, the decision is presumed to be in favor of the provider. A hearing officer is to make a ruling within 120 days, and the Director of the Department of Medical Assistance Services then has 60 days to adopt the recommendation of the hearing officer unless to do so would be in error of law or department policy. Rejection of the ruling by the hearing officer must be explained. No recovery can be made prior to the final decision, and interest will accrue on any amounts from the date of the final determination. The burden of proof is on the provider who shall receive reasonable attorney's fees on a one-time basis if he substantially prevails. The Board of Medical Assistance Services is required to promulgate emergency regulations. The Commissioner of Health must report to the Joint Commission on Health Care on the effects of the inspection findings being subject to administrative appeal, such as the kinds of survey deficiencies appealed, the reasons for the Department of Health's findings of deficiency, any federal actions taken as a result of the deficiencies, any effects on patient care, and the costs to the Commonwealth of the appeals.

Patron - Woodrum

P HB982

HIV premium assistance program. Increases the eligibility income from 200 percent of federal poverty level to 250 percent of federal poverty level.

Patron - Van Landingham

P HB1008

Return of bodies donated for scientific study. Requires institutions and individuals who receive lawfully donated bodies for scientific study and health training to return any cremated remains after such study or training has been completed to the decedent's next of kin or relatives, if (i) the decedent has stipulated in writing before his death that his cremated remains should be returned to his next of kin, or (ii) the decedent's next of kin, who donated the body, requests the return of the cremated remains in writing at the time of donation. The bill provides that the institution or individual that received the decedent's body is not obligated to return the cremated remains, if the name, current address and telephone number of the decedent's next of kin or relatives are not provided in the written request. The institution or individual receiving the body must bear the costs of transporting and delivering the cremated remains.

Patron - Shuler

P HB1011

Health; medically underserved areas. Defines "underserved area," for purposes of certain primary health care scholarships and loan repayment programs, to include medically underserved areas designated by the Board of Health and health professional shortage areas designed pursuant to federal regulations.

Patron - Morgan

P HB1012

Statewide asthma management. Requires the Commissioner of the Department of Health, with such funds as may be appropriated, to develop a statewide comprehensive asthma management strategy which includes disease surveillance, public and professional education, identification and replication of best practices for public health and clinical interventions, public and private partnerships with health care providers, third-party payors, local school divisions, community coalitions, and identification of sources of grant funding. In addition, the Commissioner shall implement programs to meet the objectives of the statewide asthma management plan and report periodically to the Board of Health on such implementation. This bill is a recommendation of the Joint Commission on Health Care. This bill is identical to SB 490.

Patron - Morgan

P HB1049

Registration of automated external defibrillators; immunity. Clarifies that immunity from liability relating to registered automated external defibrillators includes, when in compliance with the applicable law, registrants of the equipment, trainers of individuals who operate the registered automated external defibrillators, individuals who order the equipment (which is classified as a Schedule VI device in Virginia and requires a controlled device order under federal law and regulation), and the properly trained operators of the registered automated external defibrillators. In addition, physicians who supervise registered automated external defibrillators are provided some limited immunity when performing these responsibilities without compensation. This bill also clarifies that "compensation," as used in the Good Samaritan law, does not include the salary of any person who registers an automated external defibrillator, trains the individuals who operate the registered automated external defibrillators, orders the automated external defibrillators which will subsequently be registered, or operates a registered automated external defibrillator at the scene of an emergency. Other syntax changes reinforce the concept of and requirements for registration and fees of the machines. Automated external defibrillators are technological medical wonders combining heart monitors and defibrillators which are being stocked on airplanes and in many places where the public gathers. These computerized machines are capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia; determining, without intervention by an operator, whether defibrillation should be performed; and, if defibrillation is determined to be necessary, automatically charging the machine and delivering the proper electrical impulse to an individual's heart. In other words, these machines are used to prevent deaths during heart attacks. Training is required to operate this equipment; however, complex medical knowledge is not necessary to use this life-saving device.

Patron - Cantor

P HB1075

Health; Dentist Loan Repayment Program. Establishes a loan repayment program for dental school graduates identical to the existing program for physicians. Preference is given to graduates of Virginia Commonwealth University's School of Dentistry, and recipients must agree to a period of service in an underserved area or health professional shortage area. The Program is limited to funds appropriated. This bill is identical to SB 576.

Patron - Melvin

P HB1076

Health; health workforce recruitment and retention. Requires the State Health Commissioner to direct activities and programs for recruitment and retention of health care providers for underserved populations, underserved areas, and health professional shortage areas (HPSAs). To assist in this, a Health Workforce Advisory Committee is established within the Department and includes representatives of various organizations and types of health care. The Commissioner is required to report to the Governor and the General Assembly by October 1 of each year.

Patron - Melvin

P HB1077

Statewide cancer registry; civil penalties. Permits the Commissioner of the Department of Health, with such funds as may be appropriated, to implement a system for ensuring all cancer cases are completely and accurately reported to the statewide cancer registry by hospitals, clinics, independent pathology laboratories and physician offices so long as consent to on-site inspection is obtained. The bill clarifies that registry information shall be confidential, yet the Commissioner may divulge the identity of patients and practitioners if pertinent to an investigation, research or study. Anonymity is to be preserved by those to whom the information is divulged. Finally, the bill clarifies that the unauthorized use, disclosure or release of data shall be subject, in addition to the existing remedies, to a civil penalty of up to $25,000 for each violation. This bill is a recommendation of the Joint Commission on Health Care. This bill is identical to SB 575.

Patron - Melvin

P HB1090

Organ donations. Requires each hospital in Virginia to establish a protocol for organ donation, in compliance with the Health Care Financing Administration's (HCFA) regulations, that includes (i) an agreement with an organ procurement organization designated in HCFA regulations for routine contact; (ii) the notification of organ procurement organizations in a timely manner of all deaths and imminent deaths in the hospital; (iii) the authorization of an organ procurement organization to determine the suitability of the decedent or patient for organ donation, and, in absence of an arrangement with any eye bank or tissue bank, the suitability for tissue and eye donation; (iv) an agreement with at least one tissue bank and at least one eye bank for retrieval, processing, preservation, storage, and distribution of tissues and eyes; (v) a process for collaboration with the designated organ procurement organization to inform the family of each potential donor of the option to donate organs, tissues, or eyes or to decline to donate; (vi) the requirement that an individual making contact with the family must have completed a course in the methodology for approaching potential donor families and requesting organ or tissue donation offered or approved by the organ procurement organization and designed in conjunction with the tissue and eye bank community, which such course encouraging discretion and sensitivity according to the specific circumstances, views, and beliefs of the relevant family; and (vii) the coordination of the hospital with the organ procurement organization in educating the staff responsible for contacting the organ procurement organization's personnel on donation issues, concerning the proper review of death records for identification of potential donors and the proper procedures for maintaining potential donors while necessary testing and placement of potential donated organs, tissues, or eyes take place. This procedure must be followed, without exception, unless the relevant decedent or patient has expressed opposition to organ donation, the hospital administrator or his designee knows of this opposition, and no donor card or other relevant document can be found. This bill also (i) clarifies when the decedent's or patient's medical records may be disclosed; (ii) removes or revises some archaic language; (iii) clarifies various definitions; (iv) affirms that a donor document that is not revoked by the donor before death is irrevocable and does not require the consent or concurrence of any person after the donor's death; and (vi) notes, in several places, that no family member, guardian, agent named pursuant to an advance directive or person responsible for the decedent's estate can refuse to honor the donor designation, seek to revoke the donor's wishes, or seek to avoid honoring the donor designation.

Patron - Bryant

P HB1176

Standardized prescription benefits cards. Requires the state employee's health insurance plan, the Virginia Medicaid program, and each health insurer, corporation providing individual or group accident and sickness subscription contracts, and health maintenance organization providing coverage for prescription drugs, to issue a standardized prescription benefits card. The standardized prescription benefits identification card must comply with the National Council for Prescription Drug Programs (NCPDP) standards as set forth in the NCPDP Pharmacy ID Card Implementation Guide. The standardized prescription benefits identification card must be capable of accommodating the mandatory and situational data elements included in the NCPDP Pharmacy ID Card Implementation Guide and must be issued to each new covered person and reissued upon changes in coverage that affect the data elements on the card. Contracts, policies or plans delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 2002, must comply with this requirement. The bill will become effective if reenacted by the 2001 Session of the General Assembly.

Patron - Reid

P HB1202

Health; Statewide AHEC Program. Requires the Statewide Area Health Education Program to include, in its annual report, a detailed summary of how state general funds were expended on the state and local level for the most recent fiscal year.

Patron - DeBoer

P HB1203

Health care data reporting. Expands the patient-level data reported to the Board of Health and analyzed by the nonprofit health data organization to include all outpatient surgery performed under general anesthesia in hospitals, ambulatory surgery centers, and doctors' offices, when performed by physicians of medicine or osteopathy. This provision becomes effective on July 1, 2001, except for an enactment which requires the nonprofit health data organization to review the impact of requiring the submission of outpatient surgical data by physicians and the impact of current inpatient reporting requirements on hospitals. The review will be conducted in consultation with the various affected parties and will include such items as an estimate of the number and type of oupatient surgical records to be submitted, plans for processing the outpatient surgical data, and estimates of resources needed to process and anlyze the data and publish any appropriate reports. This information will be included in the organization's annual report and also a report to the Joint Commission on Health Care by October 1, 2000, and to the General Assembly prior to the 2001 Session.

Patron - DeBoer

P HB1257

Health; organ and tissue donor registry. Establishes an Organ and Tissue Donor Registry to be administered by the Department of Health. The registry will contain information about persons who have indicated a willingness to donate in accordance with law. Such information shall be available only to the Department and qualified organ procurement organizations, eye banks, and tissue banks operating in or serving Virginia. The Board will promulgate regulations to implement the provisions of this act.

Patron - Brink

P HB1270

Health; certificate of public need. Changes various timelines and procedures for issuance or denial of a certificate of public need including: (i) changing the references to health systems agency to health planning agency; (ii) extending the review period from 120 days by referencing the "appropriate batch period" established by the Board by regulation not to exceed 190 days; (iii) extending the time period for the Commissioner to make a determination from 15 days to 45 days after which time the Commissioner must notify the applicant or applicants that the application shall be deemed approved 25 calendar days after the expiration of the 45-day period unless information from the hearing officer permits the Commissioner to make his decision within that 25-day period; (iv) providing that, if the Commissioner does not make a determination within 70 calendar days after the closing of the record, the application shall be deemed approved; (v) deleting the provision for the refund of 50 percent of the fee paid if the application is not deemed approved; and (vi) providing that, if the Commissioner does not make a determination within 45 days, any applicant may institute a proceeding for mandamus against the Commissioner in the circuit court. In any appeal of the case decision granting a certificate of public need, the court may require the appellant to file a bond for protection of all parties interested in the case decision, conditioned on the payment of all damages and costs incurred in consequence of such appeal. If the applicants consent to extending any time period, the Commissioner, with the concurrence of the applicants, must establish a new schedule for the remaining time periods.

Patron - Rust

P HB1368

Long-term care nursing scholarship and loan repayment program. Establishes a scholarship and loan repayment program for registered nurses, licensed practical nurses, and certified nurse aides who agree to work in a Commonwealth long-term care facility for a given period of time. This bill is a recommendation of the Joint Commission on Health Care. This bill is identical to SB 564.

Patron - Brink

P HB1405

Medical assistance services; coverage. Requires Medicaid coverage for high-dose chemotherapy and bone marrow transplants for persons over 21 who have been diagnosed with myeloma or leukemia. These persons must be determined to have a performance status sufficient to proceed with such procedures. Current law already requires coverage of these procedures for those persons over 21 with lymphoma or breast cancer. The bill will not become effective unless an appropriation effectuating its purposes are included in the 2000 appropriation act, passed during the 2000 Session of the General Assembly, and signed into law by the Governor.

Patron - Christian

P HB1487

Health; inspections. Requires the Board of Health to make scheduled and unannounced inspections of facilities and physicians' offices that perform mammography services to ensure compliance with the laws, regulations or conditions specified by the Board. The Board currently inspects X-ray machines on a regular basis and has the general power to enter any property housing an entity which is permitted, licensed or certified by the Board.

Patron - Devolites

P HB1488

Health; mammograms. Requires the Board of Health to establish guidelines to require that licensed facilities or physicians' offices that perform mammography services offer to the patient, prior to departure, to develop the film to ensure quality and integrity of the film. When film developing is not available or the patient chooses not to wait, the patient must be notified within two business days if another mammogram is necessary. This requirement does not imply or require that a diagnostic opinion be made at the time of the mammogram. The interpreting physician may require that the mammogram be retaken if, in the opinion of the physician, the study is of inadequate quality.

Patron - Devolites

P HB1489

Health insurance for children. Revises and renames the Virginia Children's Medical Security Insurance Plan (CMSIP) as the Family Access to Medical Insurance Security (FAMIS) Plan. The FAMIS Plan coverage will be for individuals up to the age of 19, when such individuals (i) have family incomes at or below 200 percent of the federal poverty level; (ii) are not eligible for medical assistance services pursuant to Title XIX of the Social Security Act, as amended; (iii) are not covered under a group health plan or under health insurance coverage, as defined in § 2791 of the Public Health Service Act; (iv) have been without health insurance for at least six months or meet the exceptions as set forth in the Virginia Plan for Title XXI of the Social Security Act, as amended; and (v) meet both the requirements of Title XXI of the Social Security Act, as amended, and the FAMIS Plan. Those individuals who were enrolled on the date of federal approval of the FAMIS Plan in CMSIP will continue to be enrolled in FAMIS for so long as they continue to meet the eligibility requirements of CMSIP. Participants whose incomes are between 100 and 150 percent of the federal poverty level will participate in cost sharing only nominally, with the annual aggregate cost-sharing not exceeding two and one-half percent of the family's gross income. The annual aggregate cost-sharing for all eligible children in families at or above 150 percent of the federal poverty level will not exceed five percent of the family's gross income or as allowed by federal law and regulations. No cost sharing will be required for well-child and preventive services. In the event an application is denied, the applicant must be notified of any services available in the locality that can be accessed by contacting the local department of social services. The FAMIS Plan will provide comprehensive health care benefits, including medical, dental, vision, mental health, and substance abuse services and physical therapy, occupational therapy, speech language pathology, and skilled nursing services for special education students. FAMIS participants who have access to employer-sponsored health insurance coverage may, but will not be required to, enroll in an employer's health plan, with payments being made on their behalf if enrollment in the employer's plan is cost effective. Supplemental insurance equivalent to the comprehensive health care benefits provided to other participants will be provided for the benefits not included in the employer-sponsored health insurance benefit plan. Existing DMAS contracts and future contracts will be used to provide the benefits through health maintenance organizations and other providers and employer insurance plans. FAMIS will provide that, in addition to any centralized processing site for administration of the program, DMAS may contract with third-party administrators to provide additional administrative services, including providing and assisting with applications. Local social services agencies must provide and accept applications for the program and assist families in completing applications. Any centralized processing site will determine eligibility for either FAMIS or Medicaid and enroll the children accordingly. FAMIS must provide for coordinated implementation of publicity, enrollment, and service delivery with existing local programs. Employer-sponsored health insurance is defined as comprehensive health insurance offered by the employer when the employer contributes at least 50 percent towards the cost of dependent or family coverage, or as otherwise approved by Health Care Financing Administration (HCFA). The regulations for this program will include a comprehensive, statewide community-based outreach plan to enroll children in FAMIS or in Medicaid, as appropriate. The Outreach Plan must include specific strategies for improving outreach and enrollment in localities having less than the statewide average enrollment and enrolling uninsured children of former Temporary Assistance to Needy Families recipients. The Department will also maintain an Outreach Oversight Committee, composed of various interested parties and consumers, to make recommendations on state-level outreach activities, the coordination of regional and local outreach activities, and procedures for streamlining and simplifying the application process, brochures, other printed materials, forms, and applicant correspondence. DMAS will enroll applicants to the extent funds are available or as directed in the appropriation act. FAMIS is specifically noted as not being assistance or public assistance. The Medicaid fraud provisions will apply to FAMIS. The Board, or the Director, may adopt, promulgate and enforce regulations as may be necessary to implement and administer the FAMIS Plan. The provisions of the bill will not become effective until approved by HCFA; however, the Department is directed, as soon as possible after the enactment of this provision, to develop, submit, and seek approval of the FAMIS Plan. The Board is directed to promulgate emergency regulations. Certain outreach provisions of HB366 and eligibility provisions of HB1253 were incorporated into HB1489.

Patron - Devolites

P HB1525

Emergency medical services vehicles. Defines the term "ambulance" as a vehicle, vessel or aircraft, holding a valid permit from the State Emergency Medical Services Office, that is specially constructed, equipped, maintained, and operated, and is intended to be used for emergency medical care and the transportation of patients who are sick, injured, wounded, or otherwise incapacitated or helpless. This bill provides that any vehicle, vessel or aircraft must hold a valid emergency medical services vehicle permit issued by the Office of Emergency Medical Services to be licensed to operate and be considered an ambulance in the Commonwealth. The word "ambulance" is prohibited on any vehicle, vessel or aircraft that does not hold a valid permit. This bill also repeals the archaic law which authorizes counties to require any ambulance, when responding to emergency calls, to be staffed, in addition to other personnel, with a medical doctor or a graduate nurse or an attendant holding a valid first aid card or certificate of the advanced type issued by the American Red Cross or the United States Bureau of Mines. Current requirements for staffing are established at the state level and are uniform throughout the Commonwealth.

Patron - Orrock

P SB25

Medical care facilities certificate of public need. Strikes the requirement for obtaining a certificate of public need before introducing into an existing medical facility any new nuclear cardiac imaging service or equipment.

Patron - Stosch

P SB337

Regulation of health care facilities; certificate of public need. Requires a transition for elimination of the requirements for determination of need to begin on July 1, 2001, and to be completed by July 1, 2004. This deregulation will be accomplished in accordance with a plan to be developed by the Joint Commission on Health Care, in consultation with groups and organizations representing public and private health care providers and consumers and appropriate state agencies. The plan must be submitted for review and approval by the 2001 General Assembly. The plan for deregulation must include, but will not be limited to, provisions for (i) meeting the health care needs of the indigent and uninsured citizens of the Commonwealth, with all health care providers sharing the burden of such care; (ii) providing adequate oversight of the various deregulated services to protect the public health and safety and promote the quality of services provided by deregulated medical facilities and projects; (iii) monitoring the effects of deregulation on the number and location of medical facilities and projects throughout the Commonwealth; (iv) recommending appropriate regulation of nursing homes, certified nursing facilities, intermediate care facilities, extended care facilities, long-term care facilities, and new hospitals with respect to requirements for determination of need; (v) recommending a schedule for necessary statutory changes to implement the plan and for requiring, subject to approval of the General Assembly, that the appropriate regulatory boards promulgate regulations implementing the Commission's plan prior to any deregulation recommended in the plan; and (vi) determining the effect of deregulation on the unique mission of academic medical centers. In developing the plan, the Commission must also consider the impact of deregulation on state-funded health care financing programs and must include an examination of the fiscal impact of such deregulation on the market rates paid by such financing programs for health care and long-term care services.

Patron - Martin

P SB338

Medical assistance services; transplantation services for adults. Requires the state plan for medical assistance services to include a provision for payment of medical assistance services for liver, heart, and lung transplantation procedures for individuals over the age of 21 years when (i) there is no effective alternative medical or surgical therapy available with outcomes that are at least comparable; (ii) the transplant procedure and application of the procedure in treatment of the specific condition have been clearly demonstrated to be medically effective and not experimental or investigational; (iii) prior authorization by the Department of Medical Assistance Services has been obtained; (iv) the patient-selection criteria of the specific transplant center where the surgery is proposed to be performed has been used by the transplant team or program to determine the appropriateness of the patient for the procedure; (v) current medical therapy has failed, and the patient has failed to respond to appropriate therapeutic management; (vi) the patient is not in an irreversible terminal state; and (vii) the transplant is likely to prolong the patient's life and restore a range of physical and social functioning in the activities of daily living. Presently, the Virginia Medicaid program covers such services for individuals under the age of 21 years. The provisions of the bill will not become effective unless an appropriation is included in the 2000 appropriation act, passed by the General Assembly, and signed into law by the Governor.

Patron - Potts

P SB489

Health; health workforce recruitment and retention. Directs the State Health Commissioner to implement programs of recruitment and retention of health care providers for underserved populations, underserved areas, and health professional shortage areas (HPSAs). To assist in this, a Health Workforce Advisory Committee is established within the Department and includes representatives of various organizations and types of health care. The Commissioner is required to report on the Department's activities to the Governor and the General Assembly by October 1 of each year.

Patron - Lambert

P SB490

Statewide asthma management. Requires the Commissioner of the Department of Health, with such funds as may be appropriated, to develop a statewide comprehensive asthma management strategy which includes disease surveillance, public and professional education, identification and replication of best practices for public health and clinical interventions, public and private partnerships with health care providers, third-party payors, local school divisions, and community coalitions, and identification of sources of grant funding. In addition, the Commissioner shall implement programs to meet the objectives of the statewide asthma management plan and report periodically to the Board of Health on such implementation. This bill is a recommendation of the Joint Commission on Health Care. Identical to HB 1012.

Patron - Lambert

P SB515

Health; Medicaid forecasting. Requires the Department of Planning and Budget, with the assistance of the Department of Medical Assistance Services, to prepare and submit an estimate of Medicaid expenditures for the current year and a forecast for the next two years to the General Assembly, including the Joint Legislative Audit and Review Commission. The bill also repeals the sunset clause of July 1, 2004. Identical to HB 889.

Patron - Barry

P SB529

Certain health professional credentials. Requires the medical director who is the employee of a utilization review organization to be licensed to practice medicine in the Commonwealth. Also clarifies that a "peer of a health care provider" and a "physician advisor" be licensed in the Commonwealth or in another state with comparable licensing requirements to Virginia.

Patron - Williams

P SB533

Health care data reporting. Requires health maintenance organizations (HMOs) to submit Health Employer Data and Information Set (HEDIS) information or other quality of care or performance information sets approved by the Board of Health to the Commissioner of Health. A nonprofit organization under contract with the Department of Health will be authorized to compile, store, analyze, and evaluate such data. The Commissioner may grant a waiver of the HEDIS or other information set if he determines that the HMO has met Board-approved exemption criteria. The Board will establish a tiered-fee structure based on the number of enrollees of the HMO to cover the costs of collecting, etc., of the data. The fees cannot exceed $3,000 for each HMO. This program is currently set to expire on July 1, 2003.

Patron - Watkins

P SB550

Health insurance for children. Revises and renames the Virginia Children's Medical Security Insurance Plan (CMSIP) as the Family Access to Medical Insurance Security (FAMIS) Plan. The FAMIS Plan coverage will be for individuals up to the age of 19, when such individuals (i) have family incomes at or below 200 percent of the federal poverty level; (ii) are not eligible for medical assistance services pursuant to Title XIX of the Social Security Act, as amended; (iii) are not covered under a group health plan or under health insurance coverage, as defined in § 2791 of the Public Health Service Act; (iv) have been without health insurance for at least six months or meet the exceptions as set forth in the Virginia Plan for Title XXI of the Social Security Act, as amended; and (v) meet both the requirements of Title XXI of the Social Security Act, as amended, and the FAMIS Plan. Those individuals who were enrolled on the date of federal approval of the FAMIS Plan in CMSIP will continue to be enrolled in FAMIS for so long as they continue to meet the eligibility requirements of CMSIP. Participants whose incomes are between 100 and 150 percent of the federal poverty level will participate in cost sharing only nominally, with the annual aggregate cost-sharing not exceeding two and one-half percent of the family's gross income. The annual aggregate cost-sharing for all eligible children in families at or above 150 percent of the federal poverty level will not exceed five percent of the family's gross income or as allowed by federal law and regulations. No cost sharing will be required for well-child and preventive services. In the event an application is denied, the applicant must be notified of any services available in the locality that can be accessed by contacting the local department of social services. The FAMIS Plan will provide comprehensive health care benefits, including medical, dental, vision, mental health, and substance abuse services and physical therapy, occupational therapy, speech language pathology, and skilled nursing services for special education students. FAMIS participants who have access to employer-sponsored health insurance coverage may, but will not be required to, enroll in an employer's health plan, with payments being made on their behalf if enrollment in the employer's plan is cost effective. Supplemental insurance equivalent to the comprehensive health care benefits provided to other participants will be provided for the benefits not included in the employer-sponsored health insurance benefit plan. Existing DMAS contracts and future contracts will be used to provide the benefits through health maintenance organizations and other providers and employer insurance plans. FAMIS will provide that, in addition to any centralized processing site for administration of the program, DMAS may contract with third-party administrators to provide additional administrative services, including providing and assisting with applications. Local social services agencies must provide and accept applications for the program and assist families in completing applications. Any centralized processing site will determine eligibility for either FAMIS or Medicaid and enroll the children accordingly. FAMIS must provide for coordinated implementation of publicity, enrollment, and service delivery with existing local programs. Employer-sponsored health insurance is defined as comprehensive health insurance offered by the employer when the employer contributes at least 50 percent towards the cost of dependent or family coverage, or as otherwise approved by Health Care Financing Administration (HCFA). The regulations for this program will include a comprehensive, statewide community-based outreach plan to enroll children in FAMIS or in Medicaid, as appropriate. The Outreach Plan must include specific strategies for improving outreach and enrollment in localities having less than the statewide average enrollment and enrolling uninsured children of former Temporary Assistance to Needy Families recipients. The Department will also maintain an Outreach Oversight Committee, composed of various interested parties and consumers, to make recommendations on state-level outreach activities, the coordination of regional and local outreach activities, and procedures for streamlining and simplifying the application process, brochures, other printed materials, forms, and applicant correspondence. DMAS will enroll applicants to the extent funds are available or as directed in the appropriation act. FAMIS is specifically noted as not being assistance or public assistance. The Medicaid fraud provisions will apply to FAMIS. The Board, or the Director, may adopt, promulgate and enforce regulations as may be necessary to implement and administer the FAMIS Plan. The provisions of the bill will not become effective until approved by HCFA; however, the Department is directed, as soon as possible after the enactment of this provision, to develop, submit, and seek approval of the FAMIS Plan. The Board is directed to promulgate emergency regulations.

Patron - Bolling

P SB551

Health; organ and tissue donor registry. Establishes an Organ and Tissue Donor Registry to be administered by the Department of Health. The registry will contain information about persons who have indicated a willingness to donate in accordance with law. Such information will be available only to the Department and qualified organ procurement organizations, eye banks, and tissue banks operating in or serving Virginia. The Board will promulgate regulations to implement the provisions of this act.

Patron - Bolling

P SB564

Long-term care nursing scholarship and loan repayment program. Establishes a scholarship and loan repayment program for registered nurses, licensed practical nurses and certified nurse aides who agree to work in a Commonwealth long-term care facility for a given period of time. This bill is a recommendation of the Joint Commission on Health Care. Identical to HB 1368.

Patron - Martin

P SB575

Statewide cancer registry; civil penalties. Permits the Commissioner of the Department of Health, with such funds as may be appropriated, to implement a system for ensuring all cancer cases are completely and accurately reported to the statewide cancer registry by hospitals, clinics, independent pathology laboratories and physician offices so long as consent to on-site inspection is obtained. The bill clarifies that registry information shall be confidential, yet the Commissioner may divulge the identity of patients and practitioners if pertinent to an investigation, research or study. Anonymity is to be preserved by those to whom the information is divulged. Finally, the bill clarifies that the unauthorized use, disclosure or release of data shall be subject, in addition to the existing remedies, to a civil penalty of up to $25,000 for each violation. This bill is a recommendation of the Joint Commission on Health Care. Identical to HB 1077.

Patron - Schrock

P SB576

Health; Dentist Loan Repayment Program. Establishes a loan repayment program for dental school graduates identical to the existing program for physicians. Preference is given to graduates of VCU's School of Dentistry, and recipients must agree to a period of service in an underserved area or health professional shortage area. The Program is limited to funds appropriated. Identical to HB 1075.

Patron - Schrock

P SB581

Virginia Tobacco Settlement Foundation. Applies the standards of the State and Local Government Conflict of Interests Act to (i) members of the Board of Trustees and employees of the Virginia Tobacco Settlement Foundation and (ii) the members of the Tobacco Indemnification and Community Revitalization Commission. The bill also requires the director appointed by the Governor to be subject to confirmation by the General Assembly and provides for the Foundation to appoint a chairman and vice-chairman from its membership. Under current law, the Governor appoints these officers.

Patron - Hawkins

P SB596

Certificate of public need. Authorizes, notwithstanding the provisions of the moratorium on nursing home bed construction/additions which was in effect until July 1, 1996, the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of public need issued for an increase in beds in which nursing facility or extended care services are provided to allow such facility to continue, for three years after the date of issuance of a certificate of occupancy for the second mid-rise residential-unit building associated with the facility or until June 30, 2003, whichever occurs earlier, to admit persons, other than residents of the cooperative units, to its nursing facility beds when such facility (i) is operated by an association described in § 55-458; (ii) was created in connection with a real estate cooperative; (iii) offers its residents a level of nursing services consistent with the definition of continuing care in chapter 49 (§ 38.2-4900) of Title 38.2; and (iv) was issued a certificate of public need prior to October 3, 1995. The bill also creates a COPN exception to the request for applications (RFAs) procedure and requires the Commissioner to accept and authorizes him to approve an application for an increase of 60 beds in a described nursing facility in Giles County which will be dedicated to the provision of skilled nursing, hospice services, and care of persons with Alzheimer's and related diseases.

Patron - Stolle

P SB665

Rural health. Requires the Commissioner of Health to submit to the Health Care Financing Administration (HCFA) an application to establish a Medicare Rural Hospital Flexibility Program in Virginia. The Commissioner is also required to develop a rural health care plan for the Commonwealth. The rural health care plan must be developed and revised as necessary as may be required by the Balanced Budget Act of 1997and amendments to its provisions. The plan has to be developed in cooperation and consultation with the Virginia Hospital and Health Care Association, the Medical Society of Virginia representatives of rural hospitals, and experts within the Department of Health on rural health programs. The Commissioner may seek the assistance of the Virginia Health Planning Board and the regional health planning agencies in developing the plan. The plan must verify that Virginia will be designating critical access hospitals and certifying some facilities as "necessary providers" of health care in any rural area, including the process, methodology, and eligibility criteria for such designations or certifications. The plan must reflect local needs and resources and must include (as required by federal law) a mechanism for creating one or more rural health networks, ways to encourage rural health service regionalization, and initiatives to improve access to health services for rural Virginians. In addition and notwithstanding other law or regulations to the contrary, the plan must use, as minimum standards for critical access hospitals, the certification regulations for critical access hospitals promulgated by the Health Care Financing Administration pursuant to Title XVIII of the Social Security Act, and authorize critical access hospitals to utilize a maximum of ten beds as swing beds. Critical access hospitals are not prohibited from leasing unused portions of their facilities or reorganizing their corporate structures to facilitate the continuation of the nursing home beds that were licensed to such hospital prior to the designation as a critical access hospital.

Patron - Reynolds

P SB699

Examination of certain testing. Requires the Commissioner of Health to examine the efficacy of requiring testing of infants for congenital adrenal hyperplasia (CAH), a developmental condition that is difficult to diagnose, with slowly developing symptoms, resulting in sudden death among affected infants early in life. This bill is an uncodified act. The Commissioner would be required to seek expertise from pediatricians and others and the parents of affected children and to report to the 2001 General Assembly.

Patron - Ticer

P SB725

Testing for elevated blood lead levels. Requires the Board of Health to promulgate emergency regulations establishing a protocol for the identification of children at risk for elevated blood-lead levels. Effective July 1, 2001, the Commonwealth will require testing of children for elevated blood-lead levels or determinations that the children are at low risk for lead poisioning pursuant to Board regulations. These requirements will not apply to any child whose parent, guardian other person having control or charge of such child objects to such testing on the grounds that the procedure conflicts with his religious tenets or practices. This bill is a recommendation of the Joint Subcommittee Studying Lead Poison Prevention.

Patron - Lambert

P SB778

Department of Mental Health, Mental Retardation and Substance Abuse Services; rights-of-way. Authorizes the conveyance of a 50-foot right-of-way and a one 100-foot right-of-way on property held by the Department of Mental Health, Mental Retardation and Substance Abuse Services in Amherst County, to Amherst County, with the approval of the Governor and in a form approved by the Attorney General.

Patron - Newman

F Failed

F HB366

Virginia Children's Medical Security Insurance Plan (CMSIP); outreach. Requires certain outreach activities, including: (i) Virginia's Title XXI Plan to provide for coordinated implementation of publicity, enrollment, and service delivery with existing local programs throughout the Commonwealth that provide medical services, educational services, and case management services to children and (ii) the Board of Medical Assistance Services' regulations to include a comprehensive, statewide community-based outreach plan to enroll eligible children in CMSIP. The outreach plan must be developed and implemented in cooperation with the Department of Social Services and local social services agencies and other private and public outreach programs. The outreach plan must include, but need not be limited to, (i) a requirement that each regional social services agency hire an outreach coordinator; (ii) a blueprint, developed with the Department of Education and the local school division superintendents, for conducting outreach through the public schools of the Commonwealth which takes into consideration all requirements for delivery of health services by local school divisions; (iii) a procedure for directly contacting families who have received Temporary Assistance to Needy Families (TANF) at any time since June 1997, whose children are not enrolled in Medicaid or CMSIP, to provide such families with information and applications for CMSIP; (iv) a requirement that, in any locality in which 1,000 or more children are estimated to be eligible for CMSIP and enrollment is less than the statewide average enrollment, at least one caseworker shall be identified as the Children's Health Insurance Eligibility Specialist; and (v) such other strategies for informing the parents of eligible children as may be appropriate, such as educational activities, public service announcements, targeted mailings, and local community activities. This provision also requires the establishment, by the Department of Medical Assistance Services, of an Outreach Oversight Committee composed of representatives from community-based organizations engaged in outreach activities, social services eligibility workers, the provider community, and consumers. Quarterly meetings will be for the purpose of discussing strategies to improve outreach activities and to make recommendations regarding outreach, coordination, and procedures for streamlining and simplifying the application process, brochures, other printed materials, forms, and applicant correspondence. Certain outreach provisions of the bill were incorporated into HB1489.

Patron - Brink

F HB661

Virginia Prescription Drug Payment Assistance Program. Establishes a program to be administered by the Department of Medical Assistance Services, modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes below 200 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of his or her annual income. They must also be age 65 or older or eligible for federal Old Age, Survivors and Disability Insurance Benefits, and be ineligible for Medicaid prescription benefits and/or not receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payer prescription benefit. Eligible persons enrolled in the program are eligible for an annual benefit of up to $2,500. Eligible enrollees will receive an identification card to be presented to pharmacists and will start receiving the benefit the month after their eligibility is determined. Benefits will be paid to pharmacies under a point-of-service claims procedure to be established by DMAS. Participants are required to make a co-payment for each prescription, which in general will not exceed 25 percent of the cost but not less than five dollars. Money to pay the claims will come from the newly established Prescription Assistance Fund, which is to be financed by 20 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement. To the extent available, administrative costs are to be paid from the pharmaceutical manufacturer rebates. This bill is identical to HB 1403 and SB 470.

Patron - Deeds

F HB730

Medical care facilities certificate of public need. Provides an exemption from the applicability of the certificate of public need law for a facility having an application pending as of January 1, 1999, for a COPN to construct an ambulatory surgery center in a city of 14 square miles having a population of more than 22,000 and less than 24,000, which was withdrawn on or before June 30, 1999. This provision amends the law providing for certain exemptions from coverage by the COPN law. The exempted facility must file a completed application for an exemption by October 1, 2000; the Commissioner must make forms for the application available by August 1, 2000; and the Commissioner may deny the exemption if the application is not complete on October 1, 2000.

Patron - Griffith

F HB816

Cancer care centers; certificate of public need. Removes any cancer care center, defined as any specialized center or clinic or that portion of a physician's office developed for the provision of outpatient cancer treatment, regardless of whether providing services covered by certificate of need, from the requirement to obtain a certificate prior to initiating the service or purchasing covered equipment. The administration of general anesthesia will not be allowed in these exempted situations. Registration of equipment purchases continues to be required. Such cancer centers shall not take into consideration the ability to pay in the provision of services and shall report annually to DMAS the amount of indigent care provided.

Patron - Hamilton

F HB839

Medicaid reimbursement of nursing facilities. Requires the Department of Medical Assistance Services to develop a revised nursing home reimbursement procedure, effective July 1, 2001, consisting of two distinct cost centers: direct care costs and indirect costs; and to develop a price-based methodology for indirect costs using a Resource Utilization Group (RUG) methodology, by July 1, 2001. The RUG methodology will be differentiated for the specialized care program (heavy-care patients). The Department is required to publicize the regulations and provide a searchable electronic format. The Department must develop a plan for implementing the provisions of the bill and report to the Governor and General Assembly by January 1, 2001.

Patron - Hamilton

F HB878

Medical assistance services' audits and investigations. Permits the attorney for the Commonwealth to audit and investigate providers of services furnished under the State Medical Plan within their jurisdictions, if the Office of the Attorney General declines to do so.

Patron - Phillips

F HB885

Medical assistance services. Provides that the spouse of a nursing home resident who remains in the community shall have a protected resource minimum of $74,820.

Patron - Phillips

F HB969

Medical care facilities certificate of public need. Exempts projects for the renovation of existing nursing facilities or nursing homes or an increase in the number of nursing facility or nursing home beds, whether through the construction of a new facility or additions to an existing nursing facility or nursing home, when such proposed project is affiliated with the Virginia Veterans Care Centers and will be dedicated solely to the care of aged or disabled veterans meeting the admissions requirements in effect for such facilities on January 1, 2000.

Patron - Louderback

F HB1055

Reporting of certain complications to the Board of Health. Requires any physician, regardless of whether he performed the surgical procedure, who treats a patient experiencing complications from an outpatient and inpatient surgical procedure which occurs within 60 days of the performance of the procedure to report to the Board on such complications in accordance with the Board's regulations. The Board's regulations must address, among other complications, any infections, perforations and psychological problems which have resulted from such surgical procedures.

Patron - Marshall

F HB1215

Medical assistance services. Requires the Board of Medical Assistance Services to include in the state plan a provision for coverage of aged, blind and disabled individuals, in compliance with federal law, whose income does not exceed 80 percent of the federal poverty level as authorized by Title XIX of the Social Security Act, as amended.

Patron - Tate

F HB1253

Virginia Children's Medical Security Insurance Plan. Requires the Board of Medical Assistance Services to promulgate regulations addressing eligibility which include, but need not be limited to: (i) a waiting period for previously insured children of not more than six months when such individuals have family incomes above 150 percent of the federal poverty level; (ii) a two-month waiting period for previously insured children when such individuals have family incomes at or below 150 percent of the federal poverty level; and (iii) a request for assignment of third-party payments and medical support rights to the state and for cooperation with the state in securing such payments, as well as child support payments; however, the granting of such assignment and cooperation shall not be a condition of eligibility. In a second enactment clause, the Board of Medical Assistance Services is required to promulgate emergency regulations for these provisions (within 280 days of its enactment), and the Department of Medical Assistance Services is required to develop and submit to the federal Secretary of Health and Human Services the revisions to Virginia's Title XXI plan to implement the provisions of this act within 90 days of its enactment. Certain eligibillity provisions of HB1253 were incorporated in HB1489.

Patron - Brink

F HB1272

Regulation of medical care facilities. Removes specialized services, major medical equipment, and operating rooms from the requirement to obtain a certificate of public need and authorizes the Board of Health to issue a license certifying accredited specialized centers and clinics and physician's offices developed for the provision of outpatient or ambulatory surgery, cardiac catheterization, or radiation therapy to be medical care facilities pursuant to § 32.1-137. The Board may revoke or suspend a license for failure to maintain accreditation with the Joint Commission on Accreditation of Health Care Organizations, the Accreditation Association of Ambulatory Health Care, or the American Association for Accreditation of Ambulatory Surgery Facilities and may reissue the license upon reinstatement of the accreditation. The Board is also authorized to issue provisional licenses for two years to facilities that have applied for accreditation and to certify such facilities as medical care facilities pursuant to its agreement with the federal government, i.e., the Secretary of Health and Human Services. A provisional license may be extended for a third year if the relevant accreditation organization provides the Board with a written statement confirming (i) a facility site visit within the six months prior to the date of the application for the third-year extension of the provisional license and (ii) sufficient progress of the facility toward accreditation.

Patron - Rust

F HB1320

Maternal and Child Health Fund. Establishes the Maternal and Child Health Fund, which is to be financed by 10 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement, in addition to federal funds. The Fund shall be used by the Commissioner of the Department of Health to administer the state plan prepared by the Board of Health for maternal and child health services and children's specialty services pursuant to Title V of the United States Social Security Act.

Patron - Van Landingham

F HB1333

Board of Health; exemption. Exempts Planning Districts One and Two from the regulations pending on sewage handling and disposal.

Patron - Phillips

F HB1336

Regulation of certain health care facilities. Defines "hospital" as including any clinic performing 25 or more abortions per year. Any such clinic will be subjected to all of the requirements for outpatient surgical hospitals and the regulations of the Board in the same manner as any other hospital, including any standards, inspections, staffing and laboratory requirements, equipment mandates, or other criteria. Such facilities will be exempted from the certificate of public need requirements unless the facility expresses its intention to be licensed as an ambulatory surgery center.

Patron - Marshall

F HB1354

Master Settlement Agreement. Provides for the appropriation of the remaining 40 percent of the state's share of the Master Settlement Agreement dollars in the following manner.

Patron - Van Yahres

F HB1363

Medicaid adverse determinations. Stipulates that, in any instance in which the Director of Medical Assistance Service's final decision on an appeal of the initial determination of provider reimbursement has not been received within 180 days of the closing of the record of the appeal, the provider may appeal the final decision in accordance with the Administrative Process Act or a de novo action may be filed in the appropriate circuit court. In any de novo civil action in which any person contests any action of the Department of Medical Assistance Services, the court must receive the records of the administrative proceedings, if any; must hear additional evidence at the request of either party; must base its decision on the preponderance of the evidence; and must grant such relief as the court determines appropriate.

Patron - Griffith

F HB1364

Medical care facilities certificate of public need. Excludes from the requirement to obtain a certificate of public need a specialized center or clinic developed for the provisions of outpatient or ambulatory surgery when such specialized center or clinic consists of no more than two operating rooms and is dedicated exclusively to the provision of ophthalmic surgical services.

Patron - Griffith

F HB1365

Medical care facilities certificate of public need. Excludes from the requirement to obtain a certificate of public need a proposed project for a specialized center or clinic developed for the provision of outpatient or ambulatory surgery when such specialized center or clinic is owned and operated solely by a single group practice dedicated to the practice of ophthalmic surgery and used exclusively for the provision of ophthalmic surgical services by such group practice. The use of such specialized center or clinic for the provision of services by practitioners other than those practitioners who are partners or owners in the single group practice would be prohibited.

Patron - Griffith

F HB1403

Virginia Prescription Drug Payment Assistance Program. Establishes a program to be administered by the Department of Medical Assistance Services, modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes below 200 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of his or her annual income. They must also be age 65 or older or eligible for federal Old Age, Survivors and Disability Insurance Benefits, and be ineligible for Medicaid prescription benefits and/or not receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payer prescription benefit. Eligible persons enrolled in the program are eligible for an annual benefit of up to $2,500. Eligible enrollees will receive an identification card to be presented to pharmacists and will start receiving the benefit the month after their eligibility is determined. Benefits will be paid to pharmacies under a point-of-service claims procedure to be established by DMAS. Participants are required to make a co-payment for each prescription, which in general will not exceed 25 percent of the cost but not less than five dollars. Money to pay the claims will come from the newly established Prescription Assistance Fund, which is to be financed by 20 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement. To the extent available, administrative costs are to be paid from the pharmaceutical manufacturer rebates. This bill is identical to HB 661 and SB 470.

Patron - Christian

F HB1551

Virginia Health Care Trust Fund. Establishes the Virginia Health Care Trust Fund into which ten percent of the amount received by the Commonwealth pursuant to the Master Tobacco Settlement Agreement shall be deposited annually. The fund shall be used for health care purposes as specified in the general appropriations act.

Patron - Hamilton

F SB302

Medicaid and the Virginia Program for Displaced Workers. Requires the Board of Medical Assistance Services to include, in Virginia's Medicaid program, the federal option to provide Medicaid eligibility to qualified COBRA continuation beneficiaries, i.e., individuals who are entitled to elect COBRA continuation coverage, whose incomes do not exceed 100 percent of the federal poverty level, and whose resources do not exceed twice the maximum amount of resources that an individual may have under Virginia's regular Medicaid program. In addition, this bill establishes a state-only program for displaced Virginia workers which is similar to the federal option for qualified COBRA continuation beneficiaries, with 24-month eligibility for individuals having incomes of 200 percent of the federal poverty level (or a higher income, at the discretion of the Board), allowable resources of twice the amount an individual may have to obtain Virginia Medicaid eligibility, and disallowance of the costs of incurred medical care or any other type of remedial care when determining income. The services must not exceed the amount, duration or scope of those available to Medicaid recipients. The Board is required to establish an aggressive outreach mechanism for recently displaced workers in Virginia in order to link them to essential services and ameliorate, to the extent possible, the effects of loss of income and benefits.

Patron - Reynolds

F SB320

Rural health. Requires the Commissioner of Health to submit to the Health Care Financing Administration (HCFA) an application to establish a Medicare Rural Hospital Flexibility Program in Virginia. The Commissioner is also required to develop a rural health care plan for the Commonwealth. The rural health care plan must be developed and revised as necessary as may be required by the Balanced Budget Act of 1997 and amendments to its provisions. The plan has to be developed in cooperation and consultation with the Virginia Hospital and Health Care Association, representatives of rural hospitals, and experts within the Department of Health on rural health programs. The Commissioner may seek the assistance of the Virginia Health Planning Board and the regional health planning agencies in developing the plan. The plan must describe Virginia's commitment to designating critical access hospitals and whether Virginia wants to certify some facilities as "necessary providers" of health care in any rural area, including the process, methodology, and eligibility criteria for such designations or certifications. The plan must reflect local needs and resources and must include (as required by federal law) a mechanism for creating one or more rural health networks, ways to encourage rural health service regionalization, and initiatives to improve access to health services for rural Virginians.

Patron - Reynolds

F SB503

Medical assistance services; medically needy. Requires the state plan for medical assistance services to include a provision for payment of medical assistance for aged and disabled individuals with incomes up to 100 percent of the federal poverty guideline as permitted by federal law.

Patron - Reynolds

F SB507

Medical assistance services. Requires the Director of the Department of Medical Assistance Services to develop and apply for a waiver, pursuant to § 1115 of the federal Social Security Act, for a demonstration project to offer services to Virginia's working poor and other uninsured citizens through managed care organizations. The waiver must be designed, in so far as allowed by federal law and regulations, to provide services to families having children with chronic illnesses. The waiver must be financed by pooling various federal, state, and, if available for indigent care, local funds, such as the funds appropriated for the State/Local Hospitalization Program. A second enactment clause provides that the waiver must be developed and submitted to the Health Care Financing Administration by October 1, 2000, and must provide services to children with such chronic illnesses as diabetes whose families have incomes at or below 200 percent of the federal poverty level.

Patron - Reynolds

F SB560

Health; duties of DMAS Director. Adds specific duties to the general responsibilities of the Director of the Department of Medical Assistance Services, including the responsibilities to ensure that health care financing programs are run efficiently and effectively, to advise and consult on a regular basis with the Governor, the General Assembly, and stakeholder organizations on matters related to health care financing, and to ensure the efficient enrollment of eligible children into any health insurance plan approved by the General Assembly. The Director shall also make a formal report each year by November 1 to the Governor and General Assembly on the status of the Department's operations and progress toward meeting health care financing problems.

Patron - Quayle

F SB604

Health; Medical assistance services. Changes the name of the Board and Department of Medical Assistance Services to the Board and Department of Health Care Financing. All duties and powers of the Board and Department shall remain the same. Current appointments to the Board shall expire on June 30, 2000, and shall be replaced by a board of 11 members with experience and expertise in health care delivery and health care financing to be comprised in the following manner and on staggered terms: six members shall be appointed by the Governor; three members shall be appointed by the Speaker of the House of Delegates; and two members shall be appointed by the Senate Committee on Privileges and Elections. The Board will be required to submit an annual report to the Governor and General Assembly rather than biennially as now provided. The bill includes technical amendments. This provision will become effective on June 30, 2002, at which time the current appointments to the Board of Medical Assistance Services will expire. The regulations of the Board of Medical Assistance Services will continue in effect unless and until revised or repealed by the new entity.

Patron - Saslaw

F SB609

Health; licensure of ambulatory surgery centers. Defines ambulatory surgery centers to meet federal standards and definitions and requires licensure of such facilities.

Patron - Saslaw

F SB687

Emergency medical services. Revises various sections relating to emergency medical services to modify the authority of local governments to prohibit ambulances from outside their jurisdictions from providing nonemergency transport within their jurisdictions. The Richmond Ambulance Authority is also amended in this regard.

Patron - Trumbo

F SB702

Medical records. Ensures that the patient's consent is required for obtaining medical records in many situations; establishes that the medical records belong to the provider maintaining them and the patient; prohibits the charging of fees to the patient for his medical record; strikes the sentence rendering confidential communications with a practitioner and information otherwise acquired by the provider in the delivery of care a part of the patient's record; and modifies the list of persons who may receive the patient's records to place the patient first instead of twentieth. Technical renumbering is also included.

Patron - Ticer

F SB723

Health Insurance; review of prescription drug plans. Creates the Consumer Advisory Council for the Review of Prescription Drug Plans to develop a ratings system for health benefit plans providing coverage for prescription drugs. The rating system will be developed no later than July 1, 2001, and carriers and employers must display the plan's rating on the first page of any materials communicating information about the plan.

Patron - Couric

F SB763

Textile Workers Relief Act of 2000. Provides a state Medicaid program and additional unemployment benefits for displaced Virginia workers in high-unemployment areas. The Board of Medical Assistance Services is directed to develop the State Program for Displaced Virginia Workers to provide at least 24 months coverage for individuals and their families who are eligible for NAFTA transitional adjustment assistance. For displaced workers whose residence or last place of employment is in a locality with an unemployment rate of two times the statewide unemployment rate or greater as of December 1999, the weekly unemployment benefit amount is increased by 43 percent, with a maximum weekly benefit amount of $332. The current maximum is $232. Displaced employees in high-unemployment localities do not have to serve a statutory waiting week for benefits, and those former employees in industries requiring shift work shall not be deemed unavailable for work if enrolled in higher education, provided that such enrollment only limits the employee's availability for work in one shift and the employee is otherwise available to work any other shifts. The bill has an emergency clause, and the bill is retroactive to January 1, 2000, except the increased unemployment benefits are retroactive to December 1, 1999. The bill will sunset on July 1, 2003.

Patron - Reynolds

F SB768

Provision of fire protection or emergency medical services by a for profit entity. Provides that any county, city or town that, as of June 30, 2000, provided fire protection or emergency medical services for its citizens through the utilization of a fire department and fire protection personnel, may not thereafter provide fire protection or emergency medical services by utilizing an entity that provides fire protection for the county, city or town for profit under contract or other agreement and that is not a county, city or town, or a department of a county, city or town, or a state or federal agency, unless first approved by a majority of voters at a referendum called for that purpose.

Patron - Lucas

C Carried Over

C HB327

Sale of body parts. Makes it a Class 6 felony to buy or sell the body parts of an aborted child.

Patron - Black

C HB604

Confidentiality of health records. Requires the State Health Commissioner or his designee to obtain (i) the written consent of a patient with a noncommunicable disease or his agent or guardian or (ii) a court order in order to divulge the patient's identity in the course of investigations, research or studies of diseases or deaths of public health importance.

Patron - McQuigg

C HB840

Health; medical assistance services. Changes the name of the Board and Department of Medical Assistance Services to the Board and Department of Health Care Financing. All duties and powers of the Board and Department shall remain the same. Current appointments to the Board shall expire on June 30, 2000, and shall be replaced by a board of eleven members with experience and expertise in health care delivery and health care financing to be comprised in the following manner and on staggered terms: six members shall be appointed by the Governor; three members shall be appointed by the Speaker of the House of Delegates; and two members shall be appointed by the Senate Committee on Privileges and Elections. The Board will be required to submit an annual report to the Governor and General Assembly rather than biennially as now provided. The bill includes technical amendments. In addition, the Director assumes new responsibilities to ensure that programs are being administered efficiently and effectively, to advise the Governor and General Assembly on pertinent matters, to consult regularly with the appropriate staff and committees of the General Assembly, and to work with other agencies and stakeholders to ensure efficient enrollment of children in any appropriate health insurance program.

Patron - Hamilton

C HB934

Health; pre-assessment screening teams. For those individuals over the age of 18 and under 65 who have no indicators of cognitive impairment and have no legal guardian, the pre-assessment screening team must include a person employed by a Center for Independent Living, or someone named by them, who has personal experience with consumer-directed personal assistance and has knowledge of the assessment instrument. For persons over 65, the team may include such a representative at the discretion of the individual. Screening teams currently are composed of a nurse, social worker, and physician who are employees of the Department of Health or the local department of social services.

Patron - Almand

C HB1006

Health; nursing homes. Requires the Board of Health to develop staffing standards for nursing homes that will provide an average of five hours of direct care services per resident per 24-hour period. The Board shall develop a definition of direct care services by regulation.

Patron - Watts

C HB1072

Health; medical assistance services. Changes the name of the Board and Department of Medical Assistance Services to the Board and Department of Health Care Financing. All duties and powers of the Board and Department shall remain the same. Current appointments to the Board shall expire on June 30, 2000, and shall be replaced by a board of 11 members with experience and expertise in health care delivery and health care financing to be comprised in the following manner and on staggered terms: six members shall be appointed by the Governor; three members shall be appointed by the Speaker of the House of Delegates; and two members shall be appointed by the Senate Committee on Privileges and Elections. The Board will be required to submit an annual report to the Governor and General Assembly rather than biennially as now provided. The bill includes technical amendments.

Patron - Melvin

C HB1113

Virginia Pharmaceutical Assistance Program. Establishes, within the Department of Health, the Virginia Pharmaceutical Assistance Program for the purpose of assuring that individuals who are 65 years old or older and whose incomes do not exceed 200 percent of the federal poverty level have access to medically necessary prescription drugs. The Board of Health is required to (i) use the Medicaid methodology for calculating income eligibility, (ii) establish a methodology for allowing participation of individuals who are eligible and whose prescription drug costs are covered, in part, by a health benefits plan or health insurance; (iii) give priority to individuals who do not have prescription drug coverage from any health benefits plan or health insurance; (iv) establish a formulary of covered drugs; and (v) appoint an advisory committee of no more than 20 citizens with expertise in prescription drug formularies or experience with the issues related to prescription drug coverage and senior citizens. The Board's regulations will also include a sliding fee scale of copayments, establish supply limits, and establish criteria for contracting for the procurement of drugs. This program will not be an entitlement and would only be available to the extent that funds are appropriated. The Board of Health is provided an exception from the procurement act for this program. Emergency regulations are required in a second enactment clause, and a third enactment clause authorizes the Board of Health to implement the program as a pilot to serve a predetermined number of clients on a first-come, first-served basis in the 2000-2002 biennium.

Patron - Tate

C HB1243

Virginia Medivac Authority. Directs the Board of Health, with input from the State Emergency Services Advisory Board, to organize the Virginia Medivac Authority to ensure that all regions of the state have access to medivac services. The Board must hold at least two public hearings before organizing the Authority. The Authority will be governed by a 15-member organization that consists predominantly of participants, i.e., public or private entities currently operating medivac services in Virginia. The Authority is given broad powers, including contracting, hiring, suing and being sued, and charging fees, etc., for its services. The revenues raised by the Authority must be geared to cover the expenses of its operation. The Board must promulgate emergency regulations.

Patron - Orrock

C HB1478

Health Care Decisions Act. Defines the health care decisions that an "agent" may make for a declarant under an advance directive to include visitation directives.

Patron - Robinson

C HB1531

State Board of Health; onsite soil evaluators. Provides that the State Board of Health's program to qualify individuals as authorized onsite soil evaluators require each evaluator to hold a current certificate as a Virginia certified professional soil scientist.

Patron - Dickinson

C SB142

Local septic system databases. Requires, with such funds as may be appropriated for this purpose, the Board of Health to develop and establish a uniform electronic system for the storage, retrieval, application, and approval of local septic system and other onsite sewage system applications and permits. The local septic system database must be phased-in across the Commonwealth as funding becomes available, beginning with those jurisdictions with large volumes of applications due to growth and development. In order to provide for immediate implementation and planning for the statewide implementation of the database, the Board must, by January 1, 2002, implement a pilot project for two rural counties in which a large recreational lake is located as such pilot project is established in the appropriation act.

Patron - Reynolds

C SB321

Medical care facilities certificate of public need. Removes the purchase of computed tomographic (CT) scanners and the introduction, regardless of the site, of new computed tomographic scanning services from the requirement to obtain a certificate of public need. In recent years, improvements in computed tomographic scanning technology have made it possible for physicians to view various organs and organ systems in great detail, thus providing a more efficient diagnostic tool and eliminating the need for other more invasive techniques or those procedures requiring exposure to radiation or injection of tracers.

Patron - Stosch

C SB469

Health; nursing homes. Requires the Board of Health to develop staffing ratios in nursing homes sufficient to meet the needs of the residents therein. The term "staffing ratios" means the quotient of the number of personnel in a particular category of direct care givers regularly on duty for a particular time period in a nursing home divided by the number of residents of the nursing home at that time. The Board shall also promulgate regulations to (i) define direct care givers, (ii) establish higher staffing ratios to respond to particular circumstances, including care of residents with lower acuity levels and who require rehabilitation, and (iii) require public disclosure of staffing ratios.

Patron - Byrne

C SB470

Virginia Prescription Drug Payment Assistance Program. Establishes a program to be administered by the Department of Medical Assistance Services, modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes below 200 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of his or her annual income. They must also be age 65 or older or eligible for federal Old Age, Survivors and Disability Insurance Benefits, and be ineligible for Medicaid prescription benefits and/or not receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payer prescription benefit. Eligible persons enrolled in the program are eligible for an annual benefit of up to $2,500. Eligible enrollees will receive an identification card to be presented to pharmacists and will start receiving the benefit the month after their eligibility is determined. Benefits will be paid to pharmacies under a point-of-service claims procedure to be established by DMAS. Participants are required to make a co-payment for each prescription, which in general will not exceed 25 percent of the cost but not less than five dollars. Money to pay the claims will come from the newly established Prescription Assistance Fund, which is to be financed by 20 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement. To the extent available, administrative costs are to be paid from the pharmaceutical manufacturer rebates. Identical to HB 661 and HB 1403.

Patron - Reynolds

C SB473

Health; pre-assessment screening teams. For those individuals over the age of 18 and under 65 who have no indicators of cognitive impairment and have no legal guardian, the pre-assessment screening team must include a person employed by a Center for Independent Living, or someone named by them, who has personal experience with consumer-directed personal assistance and has knowledge of the assessment instrument. For persons over 65, the team may include such a representative at the discretion of the individual. Screening teams currently are composed of a nurse, social worker, and physician who are employees of the Department of Health or the local department of social services.

Patron - Puller

C SB477

Medical care facilities certificate of public need. Strikes the requirement for obtaining a certificate of public need before introducing into an existing medical facility any new positron emission tomographic (PET) scanning service or purchasing new PET equipment.

Patron - Martin

C SB513

Managed care health insurance plans. Excludes preferred provider policies or contracts from the definition of a managed care health insurance plan (MCHIP). MCHIPs are required, among other things, to (i) apply to the Department of Health for quality assurance certification; (ii) establish procedures addressing complaint resolution and consumer satisfaction, access, availability, and continuity of care; and (iii) use a system of utilization review standards and an appeal process.

Patron - Barry

C SB539

Virginia Pharmaceutical Assistance Program. Establishes, within the Department of Health, the Virginia Pharmaceutical Assistance Program for the purpose of assuring that individuals who are 65 years old or older and whose incomes do not exceed 200 percent of the federal poverty level have access to medically necessary prescription drugs. The Board of Health is required to (i) use the Medicaid methodology for calculating income eligibility; (ii) establish a methodology for allowing participation of individuals who are eligible and whose prescription drug costs are covered, in part, by a health benefits plan or health insurance; (iii) give priority to individuals who do not have prescription drug coverage from any health benefits plan or health insurance; (iv) establish a formulary of covered drugs; and (v) appoint an advisory committee of no more than 20 citizens with expertise in prescription drug formularies or experience with the issues related to prescription drug coverage and senior citizens. The Board's regulations will also include a sliding fee scale of copayments, establish supply limits, and establish criteria for contracting for the procurement of drugs. This program will not be an entitlement and would only be available to the extent that funds are appropriated. The Board of Health is provided an exception from the procurement act for this program. Emergency regulations are required in a second enactment clause, and a third enactment clause authorizes the Board of Health to implement the program as a pilot to serve a predetermined number of clients on a first-come, first-served basis in the 2000-2002 biennium.

Patron - Marye

C SB540

Medical assistance services. Requires the Board of Medical Assistance Services to include in the state plan a provision for coverage of aged, blind and disabled individuals, in compliance with federal law, whose income does not exceed 100 percent of the federal poverty level as authorized by Title XIX of the Social Security Act, as amended.

Patron - Marye

C SB557

Drug-testing policies in certain health care settings. Requires every health care provider regulated by the Board of Health to initiate drug-free workplace initiatives by July 1, 2001. The Board of Health is required to promulgate regulations establishing the components of these programs, including: (i) differentiated requirements for various categories of health care providers in compliance with the federal Drug-Free Workplace Act; (ii) allowable drug-testing policies, in compliance with the federal Drug-Free Workplace Act and any applicable federal court decisions, including appropriate policies relating to proper notice and disclosure of the drug-testing policy, privacy assurances during and after testing, confidentiality protections for test results, the consequences of refusing to take any drug test, appropriate disciplinary actions and consequences, the employees' right to contest or explain the test results, the types of testing that may be required, and the appropriate bases and situations for drug testing, including the circumstances which may be presumed to give rise to reasonable suspicion of substance abuse; and (iii) recommendations for substance abuse education and assistance programs. A second enactment requires emergency regulations.

Patron - Potts

C SB613

Virginia Resources Authority. Provides that the Environmental Protection Agency approves the bill's provisions as they pertain to the Commonwealth's qualifications for full funding from the federal government, allows the Virginia Resources Authority, with the prior approval of the Board of Health and the state treasurer, to pledge funds in the Water Supply Assistance Grant Fund as security for bonds of the Authority. The bill also gives the Department of Housing and Community Development the responsibility for making grants from the fund, if Senate Bill 616 is enacted into law by the Governor. Under current law, the Board of Health is charged with awarding grants from the fund.

Patron - Wampler

C SB632

Health; cancer registry. Prohibits the disclosure of any patient-identifying information for any patient who has requested in writing that such information be kept confidential. Penalties include a Class 1 misdemeanor and/or civil fines.

Patron - Mims

C SB633

Regulation of medical care facilities. Removes specialized services, major medical equipment, and operating rooms from the requirement to obtain a certificate of public need and authorizes the Board of Health to issue a license certifying accredited specialized centers and clinics and physician's offices developed for the provision of outpatient or ambulatory surgery, cardiac catheterization, or radiation therapy to be medical care facilities pursuant to § 32.1-137. The Board may revoke or suspend a license for failure to maintain accreditation with the Joint Commission on Accreditation of Health Care Organizations, the Accreditation Association of Ambulatory Health Care, or the American Association for Accreditation of Ambulatory Surgery Facilities and may reissue the license upon reinstatement of the accreditation. The Board is also authorized to issue provisional licenses for two years to facilities that have applied for accreditation and to certify such facilities as medical care facilities pursuant to its agreement with the federal government, i.e., the Secretary of Health and Human Services. A provisional license may be extended for a third year if the relevant accreditation organization provides the Board with a written statement confirming (i) a facility site visit within the six months prior to the date of the application for the third-year extension of the provisional license and (ii) sufficient progress of the facility toward accreditation.

Patron - Mims

C SB635

Medical care facilities certificate of public need. Exempts projects for the renovation of existing nursing facilities or nursing homes or an increase in the number of nursing facility or nursing home beds, whether through the construction of a new facility or additions to an existing nursing facility or nursing home, when such proposed project is affiliated with the Virginia Veterans Care Centers and will be dedicated solely to the care of aged or disabled veterans meeting the admissions requirements in effect for such facilities on January 1, 2000.

Patron - Miller, K.G.

C SB690

Medical care facilities certificate of public need. Removes any specialized center or clinic or that portion of a physician's office developed for the provision of outpatient cancer treatment, regardless of whether providing services covered by certificate of need, from the requirement to obtain a certificate prior to initiating the service or purchasing covered equipment. The administration of general anesthesia will not be allowed in these exempted situations. Registration of equipment purchases continues to be required.

Patron - Schrock

C SB724

Virginia Children's Medical Security Insurance Plan. Requires the Board of Medical Assistance Services to promulgate regulations addressing eligibility which include, but need not be limited to: (i) a waiting period for previously insured children of not more than six months when such individuals have family incomes above 150 percent of the federal poverty level; (ii) a two-month waiting period for previously insured children when such individuals have family incomes at or below 150 percent of the federal poverty level; and (iii) a request for assignment of third-party payments and medical support rights to the state and for cooperation with the state in securing such payments, as well as child support payments; however, the granting of such assignment and cooperation shall not be a condition of eligibility. In a second enactment clause, the Board of Medical Assistance Services is required to promulgate emergency regulations for these provisions (within 280 days of its enactment), and the Department of Medical Assistance Services is required to develop and submit to the federal Secretary of Health and Human Services the revisions to Virginia's Title XXI plan to implement the provisions of this act within 90 days of its enactment.

Patron - Lambert

C SB726

Lead-poisoning prevention; memorandum of agreement between the Departments of Health and Medical Assistance Services. Requires the Commissioner of Health and the Director of the Department of Medical Assistance Services to develop and execute a memorandum of agreement relating to the prevention of lead poisoning, particularly among children. The memorandum of agreement must be revised on a periodic basis as necessary. The agreement must include, but need not be limited to, (i) requirements for regular and consistent communications and consultations between the two departments and other relevant state and local personnel and officials; (ii) a specific and concise description of the regulations of the Board of Health and the standards and guidelines of the Centers for Disease Control and prevention for elevated blood-level testing and lead-poisoning prevention; (iii) data sharing for the more efficient and effective delivery of services; and (iv) assignment of the specific responsibilities of the two state departments for reaching the goal of eliminating lead poisoning by 2010, including provisions addressing environmental investigations to determine the source of lead, required testing by medical providers on a recommended schedule, education of Medicaid providers in the proper follow-up testing, and care coordination of patients with lead poisoning. This bill is a recommendation of the Joint Subcommittee Studying Lead-Poisoning Prevention.

Patron - Lambert

C SB727

Medical assistance services and the children's health insurance program. Requires the Board of Medical Assistance Services to ensure that all contracts for implementation of the children's health insurance program and all contracts for implementation of managed care include testing of children for elevated blood lead levels in accordance with the regulations of the Board of Health. This bill is a recommendation of the Joint Subcommittee Studying Lead Poisoning Prevention.

Patron - Lambert