General Assembly>Division of Legislative Services>Publications>Session Summaries>2004>Health

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Health

Passed

P HB159

Vital records; filing of death certificates. Specifies that a licensed funeral director, funeral services licensee, office of the state anatomical program, or the next of kin can file the death certificate with the registrar of vital records. The bill addresses the problem encountered by the registrar of vital records under the present law when the surface transportation and removal companies that are registered with the Board of Funeral Directors and Embalmers or persons who are not licensed by the Board of Funeral Directors and Embalmers fail to file the death certificate with the registrar. This bill makes it quite clear that even the next of kin, if first to assume custody of the body, has an obligation to file the certificate of death with the registrar.
Patron - Reid

P HB224

Medical assistance services; marriage and family therapy. Mandates Medicaid reimbursement to licensed marriage and family therapists for services covered by the state plan. This bill does not mandate any new services, but merely adds marriage and family therapists to the list of mandated Medicaid providers who may be reimbursed for services that are already covered by the state plan and Medicaid regulations.
Patron - Shuler

P HB391

Certificate of public need for medical care facilities; criteria for determining need. Modifies the criteria relating to the extent to which the project will be accessible to all residents of the area proposed to be served by a medical care facility to require the Commissioner of Health to consider the effects on accessibility of any proposed relocation of an existing service or facility. The bill also requires the appropriate health planning agency to notify the local governing bodies in the planning district where the project is proposed to be located. Finally, the bill requires the health planning agency to consider comments from the relevant local governing bodies and all other public comments in making its decision, and stipulates that such comments must be part of the record provided to the Department of Health.
Patron - Amundson

P HB501

Certain certificate of public need for nursing facility or extended care services. Amends Chapter 912 of the 2000 Acts of Assembly to authorize the Commissioner of Health to accept and approve a request to amend the conditions of certain certificates of public need that were issued pursuant to an exception to the statutory moratorium on nursing home beds that was in effect until 1996. This bill revises the previously amended authority for the issuance of certificates of public need for three continuing care providers located in Loudon County, Williamsburg, and Virginia Beach. This provision authorizes the facilities to request that the Commissioner approve changes in their certificates to allow them to continue to admit private-pay patients who are not contract holders if the facility was established for the care of retired military personnel and their spouses or widows or widowers and the facility's nursing home facility has a contract holder occupancy rate less than 85 percent.
Patron - Callahan

P HB627

Ambulance permits to be consistent with certain federal requirements. Requires the Commissioner of Health to issue permits or licenses for emergency medical services agencies and vehicles as needed to ensure compliance with federal regulations relating to reimbursement of ambulance services pursuant to Medicare and Medicaid.
Patron - O'Bannon

P HB628

Health maintenance organizations; Medicaid; Family Access to Medical Insurance Security Plan (FAMIS). Removes the requirement that Medicaid HMOs include in the evidence of coverage a statement entitling any Medicaid recipient or FAMIS participants to conversion of their coverage to an individual contract. The bill conforms the requirements for the explanation of benefits for Medicaid recipients and FAMIS participants to the standards prescribed in the state plan for medical assistance services and the FAMIS Plan. Statutory requirements will not apply to the extent such requirements differ from the Department of Medical Assistance Services' standards. A second enactment clause declares that an emergency exists and this bill will become effective upon passage.
Patron - O'Bannon

P HB633

Nurse Licensure Compact; holder of multistate licensure privilege. Clarifies and reinforces the regulatory authority of the Board of Nursing and the Department of Health Professions over persons issued a multistate licensure privilege to practice nursing in Virginia. This bill renders provisions relating to discipline, practice protocols, and other scope of practice requirements applicable to any person holding a multistate licensure privilege issued under the Nurse Licensure Compact. The Compact will become effective on January 2005. The Board of Nursing is required to promulgate emergency regulations to implement the provisions of the Compact.
Patron - O'Bannon

P HB836

Children's Health Insurance Program Advisory Committee. Revises the name, purpose, membership, and responsibilities of the current Outreach Oversight Committee to Family Access to Medical Insurance Security (FAMIS) to create the Children's Health Insurance Program Advisory Committee and declares the purpose of the committee to be to assess policies, operations and outreach for FAMIS and FAMIS Plus (Medicaid for children) and to evaluate various enrollment, utilization, and outcomes of children for these programs. The committee's membership is limited to 20 members and will include the Joint Commission on Health Care, the Department of Social Services, the Department of Health, the Department of Education, the Department of Mental Health, Mental Retardation and Substance Abuse Services, the Virginia Health Care Foundation, various provider associations and children's advocacy groups, and other individuals with significant knowledge and interest in children's health insurance. The committee will make recommendations on FAMIS and FAMIS Plus to the Director of the Department of Medical Assistance Services and the Secretary of Health and Human Resources.
Patron - Brink

P HB855

Licensed nurse practitioners; forms and certificates. Provides that licensed nurse practitioners may sign various forms and certificates, and provide medical information or treatment in certain situations, including situations involving the immunization of children, examination of persons suspected of having tuberculosis, prenatal tests, nursing homes, release of certain privileged medical information, competency for driver licenses, release of certain veterinary records, and assisted living facilities. The bill also provides that whenever any law or regulation requires a signature, certification, stamp, verification, affidavit or endorsement by a physician, it will be deemed to include a signature, certification, stamp, verification, affidavit or endorsement by a nurse practitioner. Three enactment clauses provide that: (i) these provisions will take effect 60 days after the effective date of the regulations of the Boards of Medicine and Nursing; (ii) the Boards of Medicine and Nursing must promulgate emergency regulations, i.e., within 280 days of enactment, with the amendments requiring the nurse practitioners' authority for signatures, certifications, stamps, verifications, affidavits and endorsements to be included in the written protocol between the supervising physician and the nurse practitioner; and (iii) that the tanning facility signs will be updated in compliance with the new law when posted or replaced after the effective day of the act.
Patron - Jones, S.C.

P HB877

Health records privacy; procedure for certain patients to obtain access to their records. Revises the various laws setting out an exception to the patient's traditional access to his own health records to provide consistency with a new procedure that must be used to ensure fair appraisal of the judgment of a treating physician or clinical psychologist concerning the potential harm to the patient or others that could result from such access. This provision revises the standard by which a patient can be denied access to his records to require the treating physician or clinical psychologist to find that a review of the individual's health records would be reasonably likely to endanger the life or physical safety of the individual or another person, or that a reference in the health records to another person would be reasonably likely to cause substantial harm to the referenced person. The individual may designate a reviewing physician or clinical psychologist at his own expense, or the relevant health care provider or insurance entity denying access to the health record will designate a reviewing physician or clinical psychologist at the expense of the relevant health care provider or insurance entity. The designated physician or clinical psychologist will make a judgment as to whether the health record should be made available to the individual. The access decision of the designated reviewing physician or clinical psychologist must be followed.
Patron - O'Bannon

P HB879

Health records privacy. Revises the Virginia patient privacy provision to comply more closely with the regulations promulgated pursuant to the federal Health Insurance Portability and Accountability Act of 1996, as amended, relating to health records. Closer compliance is achieved through various syntax changes in terminology, definitions, and forms, and revisions and additions to the definitions, e.g., "health care entity," as defined in this provision, includes all health care providers, health plans or health care clearinghouses. The bill refers to an "individual" instead of a "patient"; to "health records" instead of "medical records"; and "health care providers" or "health care entities" instead of providers. This provision also revises the standard by which a patient can be denied access to his records to require the treating physician or clinical psychologist to find that a review of the individual's health records would be reasonably likely to endanger the life or physical safety of the individual or another person, or that a reference in the health records to another person would be reasonably likely to cause substantial harm to the referenced person. The individual may designate a reviewing physician or clinical psychologist at his own expense or the health care entity denying access to the health record will designate a reviewing physician or clinical psychologist at the expense of the relevant health care entity. The designated physician or clinical psychologist will make a judgment as to whether the health record should be made available to the individual.
Patron - O'Bannon

P HB891

Location of licensed nursing homes and assisted living facilities; notification to electric utilities. Requires the State Health Commissioner to notify electric utilities in Virginia on a quarterly basis as to the location of all licensed nursing homes in the State, and requires the Commissioner of the Department of Social Services to do the same for assisted living facilities. The purpose of the bill is to facilitate the restoration of electrical service and prioritization of customers during widespread power outages. The requirement of a quarterly notification can also be met by the maintenance of an accessible electronic database.
Patron - Sickles

P HB930

Validity of septic tank permits. Grandfathers certain onsite sewage systems into the Board of Health's regulatory scheme. The bill provides that whenever any onsite sewage system is failing and the Board's regulations for repairing it impose (i) a requirement for treatment beyond the level of treatment provided by the existing onsite sewage system when operating properly or (ii) a new requirement for pressure dosing, the owner may request a waiver from such requirements. The Commissioner is required to grant such request, unless he finds that the failing system was installed illegally without a permit. Such waivers must be recorded in the land records of the clerk of the circuit court. Except between a husband and a wife, such waivers are not transferable and are null and void upon transfer or sale of the property. The owner of the property is required to disclose, in writing, to any and all potential purchasers or mortgage holders that any operating permit for the onsite sewage system that has been granted a waiver shall be null and void at the time of transfer or sale of the property and that the Board's regulatory requirements for additional treatment or pressure dosing are required before an operating permit may be reinstated.
Patron - Suit

P HB952

Adult Protective Services; reporting and investigation procedures; adult fatality review teams; penalties. Revises and adds new provisions to existing adult protective services law, including reporting and investigation procedures. The bill requires local departments of social services to initiate investigations of suspected adult abuse, neglect or exploitation within 24 hours of receiving a valid report, and requires them to notify the appropriate law-enforcement agency when in receipt of reports involving sexual abuse, serious bodily injury or disease believed to be the result of abuse or neglect, or criminal activity involving abuse or neglect that places the adult in imminent danger of death or serious bodily harm. When denied access to an adult in need of protective services, local departments are given authority to seek a court order, upon a showing of good cause, permitting such access. The bill adds guardians, conservators and emergency medical services personnel to the list of persons who, acting in their official capacities, are required to report suspected cases of adult abuse, neglect or exploitation, and clarifies other mandated reporter provisions. Mandated reporters are required to report such matters to local departments or to the hotline immediately, and employers of mandated reporters must notify them of this requirement upon hiring. The bill adds employees of accounting firms to the financial personnel listed under the voluntary reporter provisions. Anyone 14 years of age or older who knowingly makes a false report of adult abuse is guilty of a Class 4 misdemeanor, and a Class 2 misdemeanor for subsequent false reports. The bill also increases the initial time period in which involuntary adult protective services may be provided through an appropriate court order from five to 15 days. Enactment clauses require (i) the Department of Social Services to develop a plan to educate newly mandated reporters on adult abuse, neglect and exploitation, and the delay of penalty provisions on newly mandated reporters until the delivery of such training; and (ii) the Secretary, in consultation with the Departments of Social Services and Health and other state and local entities, to establish procedures and cost estimates for the operation of adult fatality review teams to review suspicious deaths of vulnerable adults. This bill is identical to SB 318.
Patron - Ebbin

P HB1133

Screening tests for infants. Directs that the physician or certified nurse midwife charged with an infant's care after delivery perform the screening test for inborn errors of metabolism rather than the physician, nurse or midwife in charge of the delivery of the baby.
Patron - McDonnell

P HB1178

Vaccines in certified nursing facilities and nursing homes. Requires, unless the vaccination is medically contraindicated or the resident declines the offer of the vaccination, that each nursing home and certified nursing facility provide or arrange for the administration to its residents of (i) an annual vaccination against influenza and (ii) a pneumococcal vaccination, in accordance with the most recent recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
Patron - Bryant

P HB1198

Emergency plans for the safe handling of community public water supplies during any extended power outage. Authorizes the Board of Health to promulgate requirements and criteria for the development and maintenance of an emergency management plan for each community public water supply for the provision of pure water during any extended power outage.
Patron - Jones, D.C.

P HB1202

Promotion of pharmaceutical assistance programs and pharmaceutical discount purchasing cards. Requires the Commissioner of Health and the Commissioner of the Department for the Aging to develop a strategy, in coordination with the Virginia Area Agencies on Aging and other private and nonprofit organizations, for disseminating information to the public concerning the availability of pharmaceutical assistance programs and for training senior citizen volunteers to assist in completing applications for such programs and discount purchasing cards. The bill also requires the Commissioners to disseminate, with such funds as may be made available, information to the public relating to recent congressional actions concerning pharmaceutical benefits to be provided under the Medicare program and how such benefits may help senior citizens with the costs of pharmaceutical benefits. In addition, the two Commissioners will encourage pharmaceutical manufacturers to include application forms for pharmaceutical discount purchasing card programs on their respective websites in a format capable of being downloaded and printed by consumers. The Department for the Aging will include direct links to the forms on its website, when practicable. The bill also requires the Commissioners to report to the Governor and the General Assembly on the feasibility of developing a single application form for Virginians to use to seek eligibility for the nearly 50 pharmaceutical assistance programs and pharmaceutical discount purchasing cards. In determining the feasibility, the Commissioners must obtain copies of the application forms used by such pharmaceutical assistance programs and pharmaceutical discount purchasing cards in Virginia, compile a list of the various information required to complete such application forms, identify common elements, and analyze the forms for readability and simplicity. In order to perform the duties provided in the new subsection, the Commissioners may appoint an advisory task force of stakeholders to assist them.
Patron - Cline

P HB1483

Communicable diseases of public health threat; quarantine and isolation. Sets out a procedure for the State Health Commissioner to issue orders of quarantine when a person or persons or an affected area in Virginia have been known to be exposed to or infected with or may reasonably be suspected to be exposed to or infected with a communicable disease of public health threat. The bill also sets out a procedure for the State Health Commissioner to prepare orders of isolation when he determines that a person or persons or an affected area have been infected or reasonably may be suspected to be infected with a communicable disease of public health threat and that exceptional circumstances exist rendering the isolation procedures that apply to communicable diseases of public health significance insufficient control measures to contain the communicable disease of public health threat. Amendments are provided to exempt the State Health Commissioner's records of findings for an order of quarantine or order of isolation from the Freedom of Information Act, to authorize disclosure of patient's health records to the State Health Commissioner or his designee, to coordinate any quarantine or isolation of an affected area with a declaration of a state of emergency by the Governor and to make certain cross-related sections consistent. The Board of Health is required to promulgate emergency regulations to implement this provision. An enactment clause states there is an emergency thus rendering the bill effective upon passing. Technical amendments to list definitions in alphabetical order and correct archaic syntax are also included.
Patron - O'Bannon

P SB86

Certificate of public need for medical care facilities; criteria for determining need. Modifies the criteria relating to the extent to which the project will be accessible to all residents of the area to be served to add consideration of the effects on accessibility of any proposed relocation of an existing service or facility. The bill also modifies the administrative procedures law to require the health planning agency (i) to notify local governing bodies in the planning district of the required public hearing on relevant applications and (ii) to consider the comments of governing bodies and all other public comments in making its decision. The comments will be part of the record provided to the Department of Health.
Patron - Puller

P SB125

Private well construction; local standards. Adds Goochland County to those localities that may by ordinance establish their own standards, consistent with State Board of Health regulations, pertaining to location and testing of water from private wells, and more stringent than those adopted by the Board pertaining to construction and abandonment of such wells.
Patron - Watkins

P SB158

Dissemination of Medicare pharmaceutical benefits information; certain training of senior citizen volunteers. Requires the Commissioners of Health and the Department for the Aging to disseminate, with such funds as may be made available, information to the public relating to recent congressional actions relating to pharmaceutical benefits to be provided under the Medicare program and how such benefits may help senior citizens with the costs of pharmaceutical benefits. This bill also requires the Commissioner of Health and the Commissioner of the Department for the Aging to develop a strategy, in coordination with the Virginia Area Agencies on Aging, for disseminating information to the public concerning the availability of pharmaceutical assistance programs and for training senior citizen volunteers to assist in completing applications for pharmaceutical assistance programs and pharmaceutical discount purchasing cards.
Patron - Potts

P SB197

Certificate of public need for medical care facilities; intermediate care facilities for the mentally retarded. Removes the requirement to obtain a certificate of public need (COPN) for intermediate care facilities for the mentally retarded that will have no more than 12 beds and are in an area identified as in need of residential services for people with mental retardation in any plan of the Department of Mental Health, Mental Retardation and Substance Abuse Services. Other intermediate care facilities will continue to be covered by COPN.
Patron - Reynolds

P SB223

Health statistics and vital records. Deletes the requirement that any statement indicating racial designation be omitted from reports of divorces and annulments required to be filed by the clerk of court with the State Registrar regarding a final decree of divorce or annulment, and in marriage and adoption records. Information pertaining to racial designation is essential in establishing health histories, and in conducting anthropological, sociological, and genealogical research, particularly among racial and ethnic minority persons.
Patron - Marsh

P SB278

Reporting of telemedicine initiatives. Repeals the statute that requires the Commissioner of Health to annually report by October 1 to the Governor and the General Assembly on the status of telemedicine initiatives by agencies of the Commonwealth.
Patron - Wampler

P SB318

P SB337

Health records privacy; access to health records; compliance with federal Health Insurance Portability and Accountability Act regulations. Makes statutes relating to the Freedom of Information Act, civil procedure, denial of access to health records, juvenile and domestic court proceedings, health records privacy, involuntary commitment, court-appointed guardians and conservators, release of mental health information, and health insurance information consistent with federal regulations concerning disclosure and electronic transmission of protected health information promulgated pursuant to the Health Insurance Portability and Accountability Act. The bill provides a modified procedure for a patient to pursue obtaining his own records when a treating physician or clinical psychologist has placed a statement in his record denying such access. The standard for such statements is changed to reasonably likely to endanger the life or physical safety of the individual or another person, or that a reference in the health records to another person, who is not a health care provider, would be reasonably likely to cause substantial harm to the referenced person. The individual may, at his own expense, designate a reviewing physician or clinical psychologist with equivalent credentials to those of the physician or clinical psychologist denying him access to his records to determine whether he can have access to the information. In the alternative, the relevant health care entity is obligated to designate a physician or clinical psychologist, at its expense, to determine whether the individual will obtain access to his information. The decision of the designated physician or clinical psychologist must be followed. The bill also includes technical amendments to laws relating to disclosure of mental health information. The bill addresses access to health records and information for guardians ad litem and attorneys representing minors in juvenile and domestic court proceedings, proceedings to authorize treatment for patients incapable of providing consent to treatment, persons who are subject to petitions for involuntary commitment, and respondents who are the subjects of petitions to appoint guardians or conservators or both.
Patron - Stolle

P SB388

Certain certificate of public need for nursing facility or extended care services. Amends Chapter 912 of 2000 Acts of Assembly to authorize the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of public need that was issued during the moratorium on nursing home beds that was in effect until 1996. This bill adjusts the previously amended certificate of public need authorization for three continuing care facilities that are established for the care of retired military personnel and their families to extend the deadline for discontinuing the admission of private-pay patients who are not contract holders from July 1, 2004, to July 1, 2008, if the facility's contract holder occupancy rate is less than 85 percent.
Patron - Norment

P SB685

Communicable diseases of public health threat; quarantine and isolation. Sets out a procedure for the State Health Commissioner to issue orders of quarantine when a person or persons or an affected area in Virginia have been known to be exposed to or infected with or may reasonably be suspected to be exposed to or infected with a communicable disease of public health threat. The bill also sets out a procedure for the State Health Commissioner to prepare orders of isolation when he determines that a person or persons or an affected area have been infected or reasonable may be suspected to be infected with a communicable disease of public health threat and that exceptional circumstances exist rendering the isolation procedures that apply to communicable diseases of public health significance insufficient control measures to contain the communicable disease of public health threat. Amendments are provided to exempt the State Health Commissioner's records of findings for an order of quarantine or order of isolation from the Freedom of Information Act, to authorize disclosure of patient's health records to the State Health Commissioner or his designee, to coordinate any quarantine or isolation of an affected area with a declaration of a state of emergency by the Governor and to make certain cross-related sections consistent. The Board of Health is required to promulgate emergency regulations to implement this provision. Technical amendments to list definitions in alphabetical order and correct archaic syntax are also included.
Patron - Howell

P SJ122

Medicaid reimbursement for translation and interpretation services. Requests the Department of Medical Assistance Services to seek reimbursement for translation and interpretation services for Medicaid-eligible persons with limited English proficiency. The resolution notes that in August 2000 the Office of Civil Rights of the United States Department of Health and Human Services issued "Policy Guidance on the Title VI Prohibition Against National Origin Discrimination as It Affects Persons with Limited English Proficiency," requiring all health care providers and entities that receive federal Medicaid or State Children's Health Insurance Program funds to provide oral and written translation or interpretation services to persons with limited English proficiency to enable them apply for and obtain services. Under the guidelines, federal matching funds are available to states for expenditures related to "oral and written translation administrative activities and services provided persons with limited English proficiency, whether provided by staff or contract interpreters, or through a telephone service." However, many states, including Virginia, have not applied to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to receive federal funds to cover translation and interpretation services for eligible Medicaid patients. In 2003, the Joint Legislative Audit and Review Commission recommended in its report, The Acclimation of Virginia's Foreign-Born Population, that the Department of Medical Assistance Services request Medicaid reimbursement for interpretation and translation services. The Department must submit an executive summary indicating its progress in meeting the objectives of this resolution in the 2005 Session of the General Assembly.
Patron - Lucas

Failed

F HB116

F HB197

Department of Medical Assistance Services; Virginia Insurance Plan for Seniors (VIPS); prescription drug assistance. Establishes the VIPS to provide assistance in the purchase of prescription drugs for those persons who are dually eligible for Medicaid and Medicare but who do not qualify for prescription coverage under Medicaid. Payment assistance is limited to $80 per month per eligible person, but unused amounts may be rolled over and credited to that person for future use. However, no direct cash payment will be made to any eligible person. Participants must pay a $10 copayment for each prescription. They are also required to use generic drugs unless they are willing to pay the difference between the generic and brand-name drug. Approved drugs in the Plan are those manufactured by pharmaceutical companies that agree to provide manufacturer rebates equal to the rebate required by the Medicaid program and to make the drug product available to the Plan for the best price that the manufacturer makes the drug available in the Medicaid program. Any licensed pharmacist may participate according to the rules adopted for the program and will be paid a reasonable reimbursement to cover the cost of the drug and costs for dispensing; payments to pharmacists will not vary based on the size of the entity dispensing the prescription. Beneficiary cost-sharing amounts will not vary based on the source of dispensing or method of distribution of the prescription. Three enactment clauses require the Board of Medical Assistance Services to promulgate emergency regulations; the Department of Medical Assistance Services to seek a waiver for VIPS from the Centers for Medicare and Medicaid Services, if necessary; and set the effective date of the act as July 1, 2005, with implementation to occur on the earlier of 90 days following the adoption of emergency regulations or July 1, 2006.
Patron - Purkey

F HB310

Information on nosocomial infections. Requires the Board of Health to develop a procedure whereby aggregate information on each hospital's incidence of nosocomial infections, without patient identifiers, may be released to the public, upon request; filed in the hospital's licensure records within the Department of Health; and transmitted to the Division of Consumer Counsel and the Administrator of Consumer Affairs for use in determining any necessary actions to protect the interests of Virginia's consumers. Nosocomial infections are acquired in a hospital or other health care setting. The Board of Health is required to promulgate emergency regulations to implement this provision.
Patron - Purkey

F HB312

Board of Health; interest rates for nonprofit hospitals' unpaid bills. Requires the Board of Health to establish, in their licensure regulations, a standard interest rate to be charged for bills of nonprofit hospitals that remain unpaid for 30 or more days that shall not exceed the then current rate for the one-year treasury bill.
Patron - Purkey

F HB327

Health; Virginia Health Security Act. Provides generally that the Commonwealth must fund state-funded health care services and programs in a manner that minimizes the need for subsidization of providers by those citizens who are privately insured, self-insured or uninsured; to do otherwise burdens all citizens of the Commonwealth and threatens the viability and availability of health care providers. The bill sets out the policy of the Commonwealth in funding such programs.
Patron - Griffith

F HB359

Preventive pharmaceutical services for certain low-income patients. Requires the Commissioner of Health to establish, by January 1, 2005, a mechanism whereby any public health clinic operated by a local or district health department that maintains pharmacy services shall continue to provide free or low-cost prescription drugs (on a sliding fee scale) to any low-income patients who do not have any prescription drug benefit and whose primary and specialty health care services have been transferred to a community health clinic delivering free or reduced price services to such patients at the recommendation of the public health clinic. However, any such patients shall be required to obtain prescription drugs from pharmaceutical companies' free or reduced price programs in so far as possible.
Patron - BaCote

F HB413

Certificate of Public Need; exemption of certain facilities performing outpatient or ambulatory ophthalmic surgery. Exempts from the requirements for obtaining a certificate of public need prior to building, obtaining licensure, and opening a covered medical care facility, any specialized centers or clinics or portions of physicians' offices developed for the provision of outpatient or ambulatory ophthalmic surgery upon meeting the following conditions: (i) providing annual charity care to the extent that, if charges had been levied for such charity care, the funds generated would have equaled two percent of the net profit for the relevant year or, in the event the specialized center or clinic or that portion of a physician's office developed for the provision of outpatient or ambulatory ophthalmic surgery has failed to deliver such charity care in any year, contributing an amount to the Virginia Indigent Health Care Trust Fund that would equal two percent of the net profit for the relevant year after subtracting the charity care that was delivered, if any; and (ii) submitting documentation of accreditation by the Joint Commission on Accreditation of Health Care Organizations, the Accreditation Association of Ambulatory Health Care, Inc., or the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. The Boards of Health and Medical Assistance Services are required to promulgate emergency regulations in a second enactment clause.
Patron - Purkey

F HB479

Systematic reporting of abortion. Requires physicians performing abortions or treating the complications of induced abortions to report detailed information on forms prepared and distributed by the Board of Health. The information will be collected for the purpose of ensuring compliance with statutory requirements for obtaining an abortion. In addition, the Board must issue a public report annually providing the same detailed information for the most recent year and all previous calendar years, adjusted to reflect any additional information from late or corrected reports. Filing fees to defray the costs of collecting, analyzing, and storage of the data will be charged by the Board. Physicians failing to report in a timely manner will be subject to a late fee of $500 for each additional 30 days that the forms are overdue and the Board may pursue the penalties or other relief provided in § 32.1-27 in any case in which a physician has failed to file the required forms within one year or has filed incomplete forms.
Patron - Black

F HB521

Reporting of medical errors. Requires, as a condition of licensure, that each licensed hospital report medical errors committed by physicians, medical and nursing students, nurses, and other health care providers who are granted privileges to practice at the hospital. Each hospital must establish a procedure to identify, classify, and report medical errors. Also, hospitals are required to report this information under the patient level data system reporting requirements.
Patron - Jones, D.C.

F HB542

Emergency medical services vehicles; local agency consolidation; vehicle markings. Allows any locality that has granted authority or approval for the operation of emergency medical services vehicles to governmental agencies or agencies operating independent volunteer fire and rescue companies to combine such agencies under one consolidated agency for permitting purposes. Unless directed otherwise by the consolidated permitting agency, the bill provides for such independently operated fire and rescue companies to continue operating under their own name, which shall serve as the emergency medical services agency name required by regulation to appear on both sides of the vehicle body in reflective lettering.
Patron - May

F HB684

Certain certificate of public need for nursing facility or extended care services. Amends Chapter 912 of the 2000 Acts of Assembly to authorize the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of public need that was issued during the moratorium on nursing home beds that was in effect until 1996. This bill adjusts the previously amended certificate of public need authorization for a continuing care facility that is established for the care of retired military personnel and their families and is located in Loudoun County to extend the deadline for discontinuing the admission of private-pay patients who are not contract holders from July 1, 2004, to July 1, 2008. This bill is incorporated into HB 501.
Patron - Rapp

F HB789

Health; nursing home standards. Requires the Board of Health to establish staffing standards for nursing homes that will provide an average of three and one-half hours of direct care services per resident per 24-hour period. The Board must also adopt regulations defining direct care services and procedures for quarterly reporting.
Patron - Watts

F HB1290

Licensure of abortion clinics. Requires all abortion clinics, defined as any facility, other than a hospital or an ambulatory surgery center, in which 25 or more first trimester abortions are performed in any 12-month period, to be licensed and to comply with the requirements currently in place for ambulatory surgery centers effective January 1, 2005. The bill also places proposed and existing abortion clinics under the certificate of public need (COPN) law after January 1, 2005. Existing abortion clinics will be required to apply annually to the Board of Health to obtain an exemption by providing a rationale for being excluded. The Commissioner of Health will determine whether existing abortion clinics have demonstrated sufficient cause to be excluded from the COPN requirements according to certain criteria. The Commissioner is also empowered to deny, suspend or revoke the license upon finding the clinic is in violation of state or federal law or regulations.
Patron - Reid

F HB1477

Support services activities; regional AIDS resource and consultation centers. Requires, to the greatest extent practicable, that each regional AIDS resource and consultation center include in its support services for persons with human immunodeficiency virus (HIV) infection, activities designed to educate health care practitioners, students, and the community at large about the comorbidity of HIV with hepatitis C and mechanisms to prevent the transmission of infection with hepatitis C.
Patron - Sickles

F HJ156

Adopting the American Academy of Pediatrics recommendations concerning the use of Synagis (palivizumab) for the treatment of respiratory syncytial virus (RSV). Requests the State Health Department and the Virginia Academy of Pediatrics to adopt the recommendations issued by the American Academy of Pediatrics concerning the use of Synagis (palivizumab) for the treatment of respiratory syncytial virus (RSV). The State Health Department and the Virginia Academy of Pediatrics must submit an executive summary and report of its progress in meeting the request of this resolution by the first day of the 2005 Regular Session of the General Assembly.
Patron - Baskerville

F SB146

Definition of hospitals; certain facilities to be regulated as hospitals. Defines "hospital," for the purposes of the Board of Health's regulatory requirements, to include "any clinic or other facility performing 25 or more abortions per year."
Patron - Cuccinelli

F SB220

Equal Education Opportunity Plan. Requires the Secretary of Education to develop and implement a statewide plan to provide for equal education opportunity for all students in the Commonwealth. The Plan must include, but not be limited to, (i) an annual report of the number and percentage of minority students enrolled in the public schools by grade, and in undergraduate, graduate, professional, and postdoctoral degree programs by discipline; (ii) strategies to increase college admissions, retention, and graduation rates of minority students at the undergraduate and graduate degree levels; (iii) an analysis of the preparation of minority students for college-level work; (iv) an evaluation of the impact of financial assistance and tuition rates as inducements and obstacles to college education; (v) a summary of existing programs in Virginia and nationally that have proven effective in providing equal education opportunity; and (vi) an evaluation of the effectiveness of the Plan. The Secretary shall modify the Plan as necessary and recommend appropriate and feasible strategies and alternatives, including the projected costs of implementing the Plan, to address issues and policies identified by the Secretary as essential to the furtherance of the objectives of the Plan. Effective on December 1, 2005, and biennially thereafter, the Secretary must submit to the Governor and the General Assembly an executive summary of the Equal Education Opportunity Plan no later than the first day of each regular session of the General Assembly. The Equal Education Opportunity Plan, although never implemented, was required initially as a result of Adams v. Richardson, 480 F2d 1159 (DC Cir. 1973) and Adams v. Califano, 430 F. Supp. 118 (DC 1977), concerning the desegregation of Virginia colleges and universities, and, in 1973, the Plan was incorporated in the Virginia Plan for Equal Opportunity in State-Supported Institutions of Higher Education, Item 131.10 of the 2001 Budget communicated by the Governor. However, the Virginia plan for Equal Opportunity in State-Supported Institutions of Higher Education was removed from the budget during the 2003 Session. Nevertheless, the agreement entered into by Governor Gilmore on behalf of the Commonwealth with the United States Department of Education Office for Civil Rights on November 7, 2001, requires evidence of Virginia's good faith effort to comply with the Accord. The Plan would demonstrate the Commonwealth's good faith effort during the five-year monitoring and reporting phase of the United States. Office for Civil Rights federal compliance review precipitated by the United States Supreme Court's decision in Ayers v. Fordice (505 US 717, 112 S.Ct. 2727, 1992).
Patron - Marsh

F SB292

Emergency electrical systems. Directs the Virginia Board of Health and State Board of Social Services to promulgate emergency regulations to require emergency electrical systems in hospitals, nursing homes, certified nursing facilities and assisted living facilities. This bill is incorporated into SB 181.
Patron - O'Brien

F SB671

Medical assistance services; consumer-directed care; cash and counseling project waiver. Revises the provision relating to the Department of Medical Assistance Services and an application for a revision of or a new waiver for consumer-directed personal care services. The bill modifies the mandate for submission of the waiver to allow the Department to prepare the application "when appropriate and practicable" in order to provide time and opportunity for flexibility and consideration of various alternatives. In addition, the bill requires the Department of Medical Assistance Services, contingent on receiving (i) approval by the Robert Wood Johnson Foundation of a Cash and Counseling Demonstration and Evaluation grant or (ii) a state appropriation for the contracting or hiring of a fiscal agent and appropriate staff to implement such project to develop and submit an application for a research and demonstration project pursuant to § 1115 of the Social Security Act, 42 U.S.C. § 1315, for a Cash and Counseling Demonstration and Evaluation project to be implemented in two demonstration areas, i.e., Lynchburg and Winchester.
Patron - Newman

F SB672

Board of Health regulations; guidelines for staffing of nursing homes. Requires the Board of Health, in its licensure regulations for nursing homes, to establish staffing standards in nursing homes that provide a minimum of three and one-half hours of direct care services per resident per 24-hour period. The Board must adopt regulations defining direct care services and procedures for quarterly reporting.
Patron - Edwards

Carried Over

C HB305

Assisted reproductive technology program; disclosure of gamete donors. Provides that a person conceived by assisted reproductive technology as a result of a donation of gametes may, if 18 years of age or older, request access to the records of the donor in the possession of an assisted reproductive technology program in order to acquire identifying information from the donor file, including any medical, psychological or genetic history and the name of the donor. Should the person receive identifying information on the donor, the assisted reproductive technology program shall, as soon as possible, inform the donor that the identifying information has been provided. The Board of Health must promulgate regulations to implement the provisions of the bill, including, but not limited to, the procedures for retaining donor files, requesting access to donor files, and notifying donors when identifying information has been provided.
Patron - Marshall, R.G.

C HB740

Certificate of Public Need. Provides authorization and acceptance of certain certificate of public need applications for pediatric specialized care nursing beds in Planning District 15.
Patron - O'Bannon

C HB747

Adequacy of local sewage systems and public water supplies. Directs the State Department of Health to undertake a comprehensive assessment process to determine the adequacy of local sewage systems and public water supplies provided to its citizens by each locality in the Commonwealth. If the Department determines that a locality's sewage systems or public water supplies are not adequate to serve its current population, or will be inadequate within the next five years, and the locality fails to develop a program to cure this situation, then Department shall establish and apply a local sewage system and public water supply residential development impact fee in such locality. The fee, collected from builders of new residential units, shall be based upon the Department's determination of the following (i) the pro-rata impact of each additional residential unit on existing sewage systems and public water supplies, and (ii) the pro-rata impact of each additional residential unit on the costs of improving or developing new sewage systems and public water supplies in order to adequately meet the needs of such new residential development. The Department shall make disbursements to the locality for the acquisition, improvement or development of new or existing sewage systems and public water supplies, until such time as the Department determines that the local sewage systems and public water supplies are adequate.
Patron - Marshall, R.G.

C HB1215

Medical assistance services; asset transfer limit waiver. Directs the Department of Medical Assistance Services to seek a waiver pursuant to § 1115 of the Social Security Act (42 U.S.C. § 1315) from the Centers for Medicare and Medicaid Services to establish asset transfer limits that are more restrictive than those currently permitted under federal Medicaid law or regulations. This waiver application may provide, insofar as it is not already included in the state plan for medical assistance services pursuant to § 32.1-325, that (i) transfer prohibitions would affect the transfer of all assets, including certain excluded assets set forth in § 1613 of the Social Security Act (42 U.S.C. § 1382b), such as vehicles and valuable jewelry; (ii) eligibility for all medical assistance services shall be subject to penalty periods for a calculated period for transfers of assets for less than fair market value; (iii) all transfers of assets for less than fair market value be subject to a 72-month look-back period; (iv) the transfer penalty period for applicants shall commence at the beginning of the month in which a person applies for medical assistance services or is otherwise eligible, or when the Department of Medical Assistance Services becomes aware of the transfer, whichever is later; (v) the transfer penalty period for recipients shall commence at the beginning of the month in which the Department of Medical Assistance Services becomes aware of the transfer and can give proper notice or the month following a period of ineligibility existing when the transfer was made; (vi) the divisor used to calculate a penalty period shall be the statewide average nursing facility payment made by the Department of Medical Assistance Service in effect at the time the penalty is determined and the penalty period begins, a figure that takes into consideration the income that would otherwise be applied to cost of care in the post-eligibility process; (vii) the transfer of the institutionalized person's interest in a homestead even to specified relatives be prohibited, except that the homestead may retain excluded status as long as the specified relatives continue to reside in the household; (viii) transfers to spouses for less than fair market value after eligibility for medical assistance services is established will be permitted only to an amount allowed under spousal impoverishment asset provisions so that assets acquired by or made available to the institutionalized spouse after medical assistance services are obtained would first be spent on the institutionalized spouse's medical costs; (ix) permissible transfers of assets to a disabled child would be limited to transfers into a trust for the child's sole benefit that reverts to the Commonwealth after the death of the disabled child, to recover medical assistance services payments made on behalf of either the grantor or the beneficiary of the trust, or both; (x) transfers to trusts for people with a disability who are under age 65 and who are not the children, adopted children, or legal wards of the transferor would no longer be permitted without penalty; and (xi) the Commonwealth would have discretion to designate some trust purposes as invalid under § 1917 (c) or (d) of the Social Security Act , such as care for a pet. The bill requires the Director of the Department of Medical Assistance Services to develop, in collaboration with the Office of the Attorney General, Department of Social Services, Office of Executive Secretary to the Supreme Court, the Trusts and Estates Section of the Virginia State Bar, local governments and other key stakeholders, an aggressive estate recovery program and a program to thoroughly pursue resources that become available to recipients subsequent to their enrollment in Medicaid. The Director shall report on the status of the programs, including recommendations for any legislation necessary to address the proposed waiver limitations on asset transfers, and an analysis of the amount of resources that would be required to implement such programs, to the Governor and to the Chairmen of the House Appropriations and Senate Finance Committees on or before September 30, 2004.
Patron - Landes

C HB1333

Hospice licensure. Provides that a person may establish and operate an inpatient hospice under a hospice license within a facility that has a preexisting license to operate a hospital or nursing home. A certificate of public need will not be required for the person to establish and operate an inpatient hospice within a preexisting licensed hospital or nursing home. Upon closure of that inpatient hospice, a certificate of public need will not be required for the reinstatement of the preexisting licensed hospital or nursing home's licensed bed capacity.
Patron - Hogan

C HB1422

Health insurance; mandated coverage for ovarian cancer and screening; mammograms. Requires the state health plan, Medicaid, health insurers, health maintenance organizations, and corporations providing health care coverage subscription contracts to provide coverage for annual mammograms for persons age 40 and older and screening for ovarian cancer using the CA125 blood test, for individuals who are at risk for such cancer or who exhibit persistent undiagnosed symptoms that may be attributed to ovarian cancer.
Patron - Stump

C SB195

Income eligibility for medical assistance services of aged and disabled individuals. Requires the Virginia Medicaid program to increase the income eligibility of aged and disabled individuals to 100 percent of the federal poverty lines as allowed by federal law.
Patron - Reynolds

C SB196

Virginia Health Access Plan. Establishes the Virginia Health Access Plan (Plan) to be administered by the Department of Medical Assistance Services (DMAS), modeled on Vermont's Health Access Plan, to provide uninsured and underinsured adults in the Commonwealth with health benefits coverage. Uninsured or underinsured adults (i) with children with income at or below 185 percent of the federal poverty level or (ii) without children with income up to 150 percent of the federal poverty level are eligible under the plan. DMAS may contract with third-party administrators to provide administrative services that include enrollment, outreach, eligibility determination, data collection, financial oversight, and reporting. The Board of Medical Assistance Services shall implement emergency regulations to implement the Plan. No entitlement to health benefits coverage on the part of any eligible person or any right or entitlement to participation is created and such coverage shall only be available to the extent that funds are appropriated therefor. Enactment clauses require DMAS to seek a waiver for the Plan from the Centers for Medicare and Medicaid Services and set the effective date of the act as July 1, 2005, with implementation to occur on the earlier of 90 days following the adoption of emergency regulations or July 1, 2006.
Patron - Reynolds

C SB377

Health; Virginia Prescription Drug Payment Assistance Plan. Establishes a program to be administered by the Department of Medical Assistance Services (DMAS), modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. DMAS may contract with third-party administrators to provide administrative services that include enrollment, outreach, eligibility determination, data collection, financial oversight, and reporting. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes at or below 150 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of their annual income, as set forth in the appropriation act. They must also be age 65 or older or eligible for federal Old-Age, Survivors and Disability Insurance Benefits, not be receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payor prescription benefit as of July 1, 2004, and be ineligible for Medicaid prescription benefits. However, nothing shall prohibit the enrollment of a person in the program during the period in which his Medicaid eligibility is determined. 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 $5. Money to pay the claims will come from the newly established Prescription Assistance Fund, which is to be financed by 10 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement and any federal funds available for this purpose. Administrative costs are to be paid from the pharmaceutical manufacturer rebates to the extent available and the $20 annual enrollment fees. The Board shall develop a comprehensive statewide community-based outreach plan to enroll eligible persons and DMAS shall report annually on the program's implementation. No entitlement to prescription drug coverage on the part of any eligible person or any right or entitlement to participation is created and such coverage shall only be available to the extent that funds are appropriated therefor.
Patron - Deeds

C SB611

Medical care facilities certificate of public need; parties to the case. Revises the designation of the parties to the case to provide that the staff or board members of the relevant health planning agency are parties if the health planning agency's recommendation is to approve the application in whole or in part and such recommendation is not consistent with the Department staff's report on the application. In present law, the health planning agency is only a party to the case if its recommendation was to deny the application.
Patron - Stolle

C SB625

C SB641

Insurance; mandated coverage for hearing aids for minors. Requires the state health plan, health insurers, health maintenance organizations, corporations providing health care coverage subscription contracts, and Medicaid to provide coverage for hearing aids and related services for children from birth to age five when a licensed audiologist prescribes such hearing aids and related services. Such coverage shall include one hearing aid per hearing-impaired ear, up to a cost of $1,400, every 36 months. The insured may choose a higher priced hearing aid and pay the difference in cost above $1,400. No copayment will apply. Hearing aids are not to be considered durable medical equipment.
Patron - Ticer

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