Health Passed HB861 End-of-life decisions. Revises various statutes relating to who may be authorized to make decisions for a decedent or a person who is incapable of making an informed decision. This bill (i) authorizes any person who is designated in a signed, notarized writing to make decisions concerning disposition of the decedent's body or any agent named in an advance directive to identify a body for cremation; (ii) authorizes a person designated to make decisions concerning the disposition of a person's body to direct that the body be cremated (after obtaining permission of the medical examiner or waiting 24 hours); and (iii) authorizes the person designated to make decisions concerning the disposition of a person's body to request an autopsy. There are technical amendments. Patron - Watts HB916 Virginia Hearing Impairment Identification and Monitoring System. Clarifies the requirements of the infant hearing impairment identification system. The bill requires all infants born in hospitals to be given hearing screenings by July 1, 1999. Newborns are to be tested and all infants born outside hospitals are to be offered screenings by July 1, 2000. Present law authorizes reporting of information to parents and physicians; this bill requires the Commissioner to contact the parents of children, their physicians and the local early intervention programs. Board regulations will require anyone making a determination that an infant is at risk for hearing impairment or has failed a hearing screening or has not been tested to notify the parent or guardian of the child, the primary care physician, and the Commissioner of Health. This bill also requires the appointment of an advisory committee (currently, the Commissioner of Health has the discretion to appoint this committee), adds revision of the system to its responsibilities, and requires its membership to include a representative of the health insurance industry; at least one pediatrician or family practitioner, one otolaryngologist, and one neonatologist; nurses representing newborn nurseries; audiologists; hearing aid dealers and fitters; teachers of the deaf and hard-of-hearing; parents of children who are deaf or hard-of-hearing; and adults who are deaf or hard-of-hearing. No testing will be performed if the parents of the infant object because of bona fide religious convictions. Recent studies indicate that 1.5 to 6 per 1,000 infants experience hearing loss (American Academy of Pediatrics). Young children with hearing loss who are not treated early suffer significant language development delays. Many of these children require intensive therapy and yet may never develop age-appropriate language skills. This bill is identical to SB 59 and HB 916. Patron - Darner HB990 Medical assistance services; child sexual and physical abuse and neglect assessment and treatment services. Requires the Department of Medical Assistance Services to include in its provider networks and all of its health maintenance organization contracts a provision for the payment of medical assistance on behalf of individuals up to the age of 21 who have special needs and who are Medicaid eligible, including individuals who have been victims of child abuse and neglect, for medically necessary assessment and treatment services, when such services are delivered by a provider who specializes solely in the diagnosis and treatment of child abuse and neglect, or a provider with comparable expertise, as determined by the Director. This bill is identical to SB 601. Patron - Jones, J.C. HB1021 Medical assistance services. Requires the state plan for medical assistance to include a provision for payment of medical assistance on behalf of individuals between birth and age three who are eligible for Medicaid and certified by the Department of Mental Health, Mental Retardation and Substance Abuse Services as eligible for services under Part H of the Individuals with Disabilities Education Act which provides for the Part H services to be carved-out of Medallion II when such services are covered under the state plan. This act will not become effective unless reenacted by the 1999 Session of the General Assembly. Patron - Grayson HB1074 Virginia Children's Medical Security Insurance Plan. Conforms Virginia's children's insurance plan to the new Title XXI of the federal Social Security Act by expanding Virginia Medicaid to provide coverage of children up to the age of 19 who have family incomes at or below 200 percent of the federal poverty guidelines and are otherwise eligible for this program in accordance with the federal law. The appropriation act will establish the specific level of eligibility. The Board is authorized to submit emergency regulations through language requiring the initial set of regulations within 280 days of enactment. The section prohibiting an entitlement for this program is repealed. This program was established in statute in 1997, but has not been implemented since approximately one year was necessary to generate funds and develop the program. The funding was to have been those moneys generated by an increase in the premium taxes paid by certain insurance companies. These funds and the trust into which they are deposited are preserved in this provision and may be used to fund the new Medicaid expansion. The Department of Medical Assistance Services is directed in a second enactment to apply for a waiver to provide for premiums and copayments on a sliding fee scale for children having families with incomes above 150 percent of the federal poverty guidelines. If the waiver is not granted, the Title XXI plan must include Medicaid benefits and income methodologies but charge premiums and copayments on a sliding fee scale for children in families above 150 percent of the federal poverty level. This bill is identical to SB 433. Patron - Melvin HB1084 Medical assistance services. Requires reimbursement for prostheses following medically necessary complete or partial removal of a breast for any medical reason. This bill primarily relates to Medicaid coverage of prostheses after the performance of a mastectomy because of breast cancer. Patron - Bryant HB1085 Medical assistance services. Requires Virginia Medicaid to include in the state plan for medical assistance services a requirement that certificates of medical necessity (CMN) for durable medical equipment and any supporting verifiable documentation shall be signed, dated, and returned by the physician and in the durable medical equipment provider's possession within 60 days from the time the ordered durable medical equipment and supplies are first furnished by the provider. Presently, Medicaid regulations require the CMN to be completed and returned within 21 days. Allegedly, many physicians accomplish this task much later than 21 days. Patron - Bryant HB1391 Information available on inspections. Clarifies that the Department of Health's right of entry to inspect regulated entities does not apply to information identified as privileged communications under the Malpractice Act. Patron - Clement SB378 Postmortem examinations. Requires the State Health Commissioner to have adequate medical investigative personnel for each office and facility established to perform medicolegal investigations and postmortem examinations. Patron - Howell SB433 Virginia Children's Medical Security Insurance Plan. Conforms Virginia's children's insurance plan to the new Title XXI of the federal Social Security Act by expanding Virginia Medicaid to provide coverage of children up to the age of 19 who have family incomes at or below 200 percent of the federal poverty guidelines and are otherwise eligible for this program in accordance with the federal law. The appropriation act will establish the specific level of eligibility. The Board is authorized to submit emergency regulations through language requiring the initial set of regulations within 280 days of enactment. The section prohibiting an entitlement for this program is repealed. This program was established in statute in 1997, but has not been implemented since approximately one year was necessary to generate funds and develop the program. The funding was to have been those moneys generated by an increase in the premium taxes paid by certain insurance companies. These funds and the trust into which they are deposited are preserved in this provision and may be used to fund the new Medicaid expansion. The Department of Medical Assistance Services is directed in a second enactment to apply for a waiver to provide for premiums and copayments on a sliding fee scale for children having families with incomes above 150 percent of the federal poverty guidelines. If the waiver is not granted, the Title XXI plan must include Medicaid benefits and income methodologies but charge premiums and copayments on a sliding fee scale for children in families above 150 percent of the federal poverty level. This bill is identical to HB 1074. Patron - Walker SB466 Certificates of public need; nursing home beds. Establishes the following conditions for the continuing care retirement community (CCRC) exception from the Request For Applications (RFA) process for certificates of public need for an increase in the number of nursing home beds: (i) the CCRC will be required to be registered with the State Corporation Commission as a continuing care provider, (ii) any initial application cannot exceed the lesser of 20 percent of the continuing care retirement community's total number of beds that are not nursing home beds or 60 beds, (iii) any subsequent application cannot cause the continuing care retirement community's total number of nursing home beds to exceed 20 percent of its total number of beds that are not nursing home beds, and (iv) the CCRC has established a qualified resident assistance policy. The Commissioner of Health may authorize a one-time, three-year open admission period. In addition to the certificate for nursing home beds requested for the initial one-time, three-year open admission period, the Commissioner may approve a certificate if (i) the number of new nursing home beds requested in any subsequent application does not cause the continuing care retirement community's total number of nursing home beds to exceed 20 percent of its total number of beds that are not nursing beds, (ii) the number of licensed nursing home beds within the CCRC does not and will not exceed 20 percent of the number of occupied beds that are not nursing beds, and (iii) no open-admission period is allowed for these additional nursing home beds. After the expiration of the one-time, three-year open admission period, the CCRC can admit (i) standard contract holders who have been bona fide residents of the non-nursing home portions of the CCRC for at least 30 days, (ii) a person who is a standard contract holder who has lived in the non-nursing home portion of the continuing care retirement community for less than 30 days but who requires nursing home care due to change in health status since admission to the facility or (iii) a person who is a family member of a standard contract holder residing in a non-nursing home portion of the continuing care retirement community. A CCRC applicant must authorize the State Corporation Commission to disclose information to the Commissioner of Health; the SCC must provide the requested information. Definitions are set forth for "family member," "one-time, three-year open admission period," and "qualified resident assistance policy." The CCRC must have a qualified resident assistance policy to aid residents who suffer financial exigencies. A CCRC is not prohibited or prevented from discharging a resident for breach of nonfinancial contract provisions or if medically appropriate care can no longer be provided to the resident or if the resident is a danger to himself or others while in the facility. The Commissioner of Health is empowered to monitor compliance with and enforce the conditions of CCRC certificates obtained under the exception to the RFA process. A certificate may be revoked for failure to honor the conditions of a certificate granted pursuant to the special provisions. Patron - Woods SB483 Oil release report and notification. Requires the Department of Environmental Quality to compile a list of the locations of oil releases which are serious enough to have a site characterization analysis performed. This list is to be sent monthly to the State Department of Health, which is to disseminate the list to all of its local offices. A person who has a well located in an area affected by an oil release may request the Department of Health to test his well's water for oil contamination. If the test indicates that the water supply is a potential risk to public health, the state will assume the costs of the test. The Department of Health is also directed to keep a list of private laboratories which perform such tests and furnish the list to any person who might request information on companies that test well water. In addition, the bill requires that residential property disclosure statements contain a notice to prospective purchasers and owners that the Department of Environmental Quality maintains information which identifies the location of oil releases that may affect the property. Patron - Couric SB484 License reinstatement fee; Neurotrauma Fund; funding. Authorizes DMV to collect an additional fee of $30 in order to have an operator's license reinstated. The additional fee will be charged only to persons whose operators licenses were suspended or revoked upon conviction of specified dangerous driving offenses (e.g., DUI related offenses; hit and run; reckless driving; failure to comply with conditions imposed upon license probation for driving offenses, etc.). Of the additional money, $25 will fund the Commonwealth Neurotrauma Initiative Fund. The balance of $5 will go to DMV; however, if the driving offense was DUI-related, the $5 will go to the VASAP Commission. Patron - Couric SB548 Statewide cancer registry. Changes the nature of the reports to be made to the Commissioner of Health for inclusion in the statewide cancer registry. The bill requires a physician to make reports, but only if he determines that another entity has not already done so. Reports of basal or squamous cell carcinoma of the skin are excepted. The authority of the Board of Health to establish fees to be charged when nonparticipating hospitals and clinics request data from the Virginia Tumor Registry is repealed. Patron - Woods SB551 Statewide prehospital and interhospital trauma triage plan. Requires the Board of Health to develop and maintain a statewide prehospital and interhospital Trauma Triage Plan as a component of the Statewide Emergency Medical Services Plan to provide rapid access to appropriate trauma care for pediatric and adult trauma patients to appropriate trauma care. The criteria for prehospital and interhospital triage and transport will be revised by the Emergency Medical Services Advisory Board to incorporate accepted changes in medical practice or to respond to needs indicated by analyses of data on patient outcomes. The criteria will be used as guides and resources for health care providers and are not intended to establish, in and of themselves, standards of care or to abrogate the requirements of the standard of care established in the Medical Malpractice Act. Patron - Woods SB585 Virginia Hearing Impairment Identification and Monitoring System. Clarifies the requirements of the infant hearing impairment identification system. The bill requires all infants born in hospitals to be given hearing screenings by July 1, 1999. Newborns are to be tested and all infants born outside hospitals are to be offered screenings by July 1, 2000. Present law authorizes reporting of information to parents and physicians; this bill requires the Commissioner to contact the parents of children, their physicians and the local school divisions. Board regulations will require anyone making a determination that an infant is at risk for hearing impairment or has failed a hearing screening or has not been tested to notify the parent or guardian of the child, the primary care physician, and the Commissioner of Health. This bill also requires the appointment of an advisory committee (currently, the Commissioner of Health has the discretion to appoint this committee), adds revision of the system to its responsibilities, and requires its membership to include a representative of the health insurance industry; at least one pediatrician or family practitioner, one otolaryngologist, and one neonatologist; nurses representing newborn nurseries; audiologists; hearing aid dealers and fitters; teachers of the deaf and hard-of-hearing; parents of children who are deaf or hard-of-hearing; and adults who are deaf or hard-of-hearing. No testing will be performed if the parents of the infant object because of bona fide religious convictions. Recent studies indicate that 1.5 to 6 per 1,000 infants experience hearing loss (American Academy of Pediatrics). Young children with hearing loss who are not treated early suffer significant language development delays. Many of these children require intensive therapy and yet may never develop age-appropriate language skills. This bill is identical to Senate Bill 591 and House Bill 916. Patron - Forbes SB591 Virginia Hearing Impairment Identification and Monitoring System. Clarifies the requirements of the infant hearing impairment identification system. The bill requires all infants born in hospitals to be given hearing screenings by July 1, 1999. Newborns are to be tested and all infants born outside hospitals are to be offered screenings by July 1, 2000. Present law authorizes reporting of information to parents and physicians; this bill requires the Commissioner to contact the parents of children, their physicians and the local school divisions. Board regulations will require anyone making a determination that an infant is at risk for hearing impairment or has failed a hearing screening or has not been tested to notify the parent or guardian of the child, the primary care physician, and the Commissioner of Health. This bill also requires the appointment of an advisory committee (currently, the Commissioner of Health has the discretion to appoint this committee), adds revision of the system to its responsibilities, and requires its membership to include a representative of the health insurance industry; at least one pediatrician or family practitioner, one otolaryngologist, and one neonatologist; nurses representing newborn nurseries; audiologists; hearing aid dealers and fitters; teachers of the deaf and hard-of-hearing; parents of children who are deaf or hard-of-hearing; and adults who are deaf or hard-of-hearing. No testing will be performed if the parents of the infant object because of bona fide religious convictions. Recent studies indicate that 1.5 to 6 per 1,000 infants experience hearing loss (American Academy of Pediatrics). Young children with hearing loss who are not treated early suffer significant language development delays. Many of these children require intensive therapy and yet may never develop age-appropriate language skills. This bill is identical to Senate Bill 585 and House Bill 916. Patron - Ticer SB601 Medical assistance services; child sexual and physical abuse and neglect assessment and treatment services. Requires the Department of Medical Assistance Services to include in its provider networks and all of its health maintenance organization contracts a provision for the payment of medical assistance on behalf of individuals up to the age of 21 who have special needs and who are Medicaid eligible, including individuals who have been victims of child abuse and neglect, for medically necessary assessment and treatment services, when such services are delivered by a provider who specializes solely in the diagnosis and treatment of child abuse and neglect, or a provider with comparable expertise, as determined by the Director. This bill is identical to HB 990. Patron - Walker SB603 Certificate of Public Need. Eliminates the requirement that an operator obtain a COPN for a replacement magnetic resonance imaging (MRI). Patron - Hawkins SB660 Practitioner information. Requires the collection, compilation and disclosure or availability of various information on licensed practicing physicians and health maintenance organizations in Virginia. This bill amends the various collection and reporting statutes (i) to require the Commissioner of Health to collect data relating to the quality and performance of medical services in health maintenance organizations, to prepare an annual summary of complaints filed against health maintenance organizations, and to disseminate such information to consumers, and may report a summary of data so collected to the patient level data system; (ii) to authorize the Department of Health Professions to include in its reports and summaries information specially required by the Board of Medicine, and to allow disclosure of such information to the public; (iii) to require reporting of disciplinary actions and malpractice judgments and multiple malpractice settlements from health maintenance organizations to the Board of Medicine; and (iv) to require the Board of Medicine to compile and release, upon request, specific information on physicians relating to education, practice demographics, disciplinary actions and malpractice suits or settlements. Patron - Watkins SB712 Managed care health insurance plans; penalties. Provides a framework for statutory and regulatory oversight of managed care health insurance plans. Managed care health insurance plans ("MCHIPs") are defined as arrangements by which a health carrier undertakes to provide, arrange for, pay for, or reimburse any of the cost of health care services for a covered person on a prepaid or insured basis which (i) contain one or more incentive arrangements, including any credentialing requirements intended to influence the cost or level of health care services between the health carrier and one or more providers with respect to the delivery of health care services, and (ii) requires or creates benefit payment differential incentive for covered persons to use providers that are directly or indirectly managed, owned, under contract with or employed by the health carrier. For purposes of this bill, the prohibition of balance billing by a provider is not considered a benefit payment differential. All MCHIPs must, at the time of initial application for licensure by the Bureau of Insurance, simultaneously apply to the Department of Health for quality assurance certification. All MCHIPs presently licensed must receive quality assurance certification by July 1, 2000, and no plan may be operated in a manner that is materially different from the information submitted during the licensure process. No certificate of quality assurance will be issued by the Department of Health until the Health Commissioner has examined and is satisfied that the MCHIP has in place procedures for guaranteeing the quality of care provided by MCHIPs, including measures addressing (i) complaint resolution and consumer satisfaction; (ii) access, availability, and continuity of care; (iii) preventive care; (iv) credentialing; (v) consumer and provider education and awareness; (vi) utilization review; and (vii) improvement of community health status. Additionally, the Department may establish criteria for review of an MCHIP licensee's administration and internal organization with regard to the quality of care provided and policies concerning patient information, consent and confidentiality. Those MCHIPs receiving certificates of quality assurance may be reviewed periodically for complaint investigation and compliance with the quality of care certification standards. Failure of an MCHIP to fulfill its obligation to furnish quality health care services as per the quality of care certification standards will subject such MCHIP to civil penalties imposed by the State Health Commissioner. Such penalties will not exceed $1,000 per incident of noncompliance or $10,000 for a series of related incidents of noncompliance. Fines payable under this bill are paid into the Literary Fund. The bill also establishes, within the Department of Health, a system of utilization review standards and appeals for MCHIPs. All MCHIP utilization review programs must establish reasonable and prudent standards and criteria, with established procedures for adverse decisions and an appeal process. Persons covered under an MCHIP must receive, at the time of enrollment, (i) a list of the names and locations of all affiliated providers, (ii) a description of the service area within which the MCHIP will provide health care services, (iii) a description of the complaint procedures, and (iv) notice that the MCHIP is subject to regulation by both the Bureau of Insurance and the Virginia Department of Health. Under current law, such utilization review is conducted by the Bureau of Insurance. This bill requires MCHIPs to establish and maintain a complaint system to provide reasonable procedures for the resolution of written complaints. Complaint systems will be examined by the Health Commissioner to determine compliance with respect to quality of care and may require necessary corrections or modifications. The bill also creates, in Title 38.2, a new chapter addressing the establishment and licensing requirements of MCHIPs. MCHIPs must provide, at enrollment or at the time of issuance of coverage, (i) a list of names and locations of all affiliated providers, (ii) a description of the service areas within which the MCHIP will provide health care services, (iii) a description of the method for resolving complaints, and (iv) notice that the MCHIP is subject to regulation by both the SCC and the Department of Health. Included in this new chapter are requirements for MCHIP provider contracts, including termination notice, liability provisions, and essential language that must be included in any "hold harmless" clause. Finally, the bill establishes criteria for coordinated examinations by the Department of Health and the SCC, and the criteria by which the SCC may suspend or revoke a license issued to a health carrier. The Commissioner of the Department of Health will report annually to the Joint Commission on Health Care the status of the ongoing requirements of this bill, including, but not limited to (i) the criteria developed by which managed health insurance plans are reviewed and evaluated; (ii) the number of quality assurance certificates issued by the Department; (iii) the number of quality assurance certificates denied by the Department and the reasons for the denial; (iv) the status of the periodic reviews for complaint investigations and compliance with the quality of care certificate standards established by this bill; and (v) the number and amount of civil penalties which were imposed during that year for noncompliance. Patron - Martin Failed HB441 Emergency Medical Services Do Not Resuscitate Orders (EMS-DNR Orders). Clarifies that the EMS-DNR Orders do not require any emergency services personnel to attempt to resuscitate an individual after the death of such individual has been pronounced or determined in accordance with § 54.1-2972. Patron - Orrock HB503 Sewage sludge land application. Prohibits the land application of sewage sludge containing any untreated human waste. Prohibits the issuance of permits for the land application of sewage sludge unless all holders of property interests in the land designated for the application have provided written consent. Patron - Guest HB1059 Treatment for phenylketonuria. Requires the Board of Health to include both formulas and solid kinds of low protein (low phenylalanine) foods in its program. Parents are currently supplied all of the formulas needed, at a cost of no more than two percent of their annual income; however, no solid foods are provided. Phenylketonuria is an inborn error of metabolism in which the body does not oxidize phenylalanine. Early treatment, i.e., restricting phenylalanine intake, prevents children born with this disorder from becoming brain damaged and thus mentally retarded. Patron - McDonnell HB1259 Medicaid; family planning. Adds to the state plan for medical assistance services coverage for a period of 24 months for family planning services for those women who were Medicaid-eligible for prenatal care and delivery at the time of delivery. The 24 months begins with delivery. The bill also contains technical amendments. Patron - Baskerville HB1290 Medical assistance services; state plan. Adds to the state plan for medical assistance services the payment of medical assistance for high-dose chemotherapy and bone marrow transplants on behalf of individuals over the age of 21 who have been diagnosed with myeloma or leukemia. The bill also contains technical amendments. Patron - Christian HB1429 Children's Health Insurance Law in the Dominion (CHILD) Program. Conforms Virginia's children's insurance plan to the new Title XXI of the federal Social Security Act by establishing an insurance program which will provide health care benefits equivalent to the state employees plan, such as Key Advantage. The Department of Medical Assistance Services will administer this program which will be available for children up to the age of 18 with family incomes up to 175 percent of the federal poverty level who are not eligible for medical assistance services in Virginia and who otherwise meet the requirements of the new federal law. The plan must include a mechanism to discourage termination of other health insurance coverage. Medicaid is authorized to use its managed care contracts, without further procurement efforts, to deliver services in areas in which such contracts provide services to Medicaid recipients. Technical amendments to correct cross references and archaic language are also included. This bill is identical to SB 714. Patron - Harris SB547 Medical care facilities certificates of public need. Clarifies that the Requests for Applications process relates to increases in nursing home beds in the planning district. Patron - Woods SB575 Medical assistance services. Requires Virginia Medicaid to cover a condition for which high dose chemotherapy and bone marrow transplant is the appropriate treatment for individuals over the age of 21 who have been diagnosed with various diseases for which such treatment is appropriate and medically necessary, e.g., myeloma and leukemia. Present law requires payment for this treatment for only lymphoma and breast cancer. The patient must have a performance status sufficient to proceed with the high-dose chemotherapy and bone marrow transplant. Emergency regulations to implement this bill are required by the second enactment. Patron - Saslaw SB623 Medicaid; state plan. Requires the Department of Medical Assistance Services to reimburse licensed clinical social workers and licensed professional counselors employed by and providing services to community services boards for mental health services provided to Medicaid-eligible clients. Currently these professionals are reimbursed by Medicaid if they work in the private sector. Patron - Schrock SB714 Children's Health Insurance Law in the Dominion (CHILD) Program. Conforms Virginia's children's insurance plan to the new Title XXI of the federal Social Security Act by establishing an insurance program which will provide health care benefits equivalent to the state employees plan, such as Key Advantage. The Department of Medical Assistance Services will administer this program which will be available for children up to the age of 18 with family incomes up to 175 percent of the federal poverty level who are not eligible for medical assistance services in Virginia and who otherwise meet the requirements of the new federal law. The plan must include a mechanism to discourage termination of other health insurance coverage. Medicaid is authorized to use its managed care contracts, without further procurement efforts, to deliver services in areas in which such contracts provide services to Medicaid recipients. Technical amendments to correct cross references and archaic language are also included. This bill is identical to HB 1429. Patron - Bolling Carried Over HB749 Licensure of certain health care facilities. Defines "hospital" as including any clinic, which is not a private physician's office, 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. Patron - Marshall HB752 Human cloning. Makes it unlawful to clone humans and punishes the violator by a civil penalty of up to $50,000. Patron - Grayson HB778 Health; nursing homes. Mandates that the Board of Health require, in its regulations, all nursing homes to establish protocols to provide access to the facility for professionals performing mental health evaluations of patients. Patron - Deeds HB869 Medical facilities certificates of public need. Modifies the provision exempting certain nursing home projects from the requirement to obtain a certificate of public need when such facilities meet all of certain strict criteria. This bill removes the requirement that the facility meet all of the conditions, allowing the exempted facility to meet only one of the criteria and authorizes a freestanding nursing home facility which is not associated with a hospital or part of a long-term care community having multiple levels of care to be exempted, if (i) such nursing home has a licensed bed capacity of less than 60 beds on July 1, 1998, (ii) all of the beds in such nursing home are certified to receive individuals eligible for medical assistance services, (iii) the nursing facility project is planned to increase the licensed bed capacity of the facility to not more than 60 such beds, (iv) all of the new nursing home beds will seek certification for reimbursement from Medicare and Medicaid, and (v) the projected allocation of licensed nursing home beds provided in the State Medical Facilities Plan will not be reduced through the expansion of the number of nursing home beds in the exempted facility. Any project for which a certificate is issued pursuant to this exemption will not be considered an incomplete project by the Commissioner when determining future allocations of beds within the planning district of the project. Patron - Griffith HB870 Medical care facilities certificates of public need. Exempts a facility located in the City of Salem in planning district 5 from the requirements of the Requests for Applications process for obtaining a certificate of public need for nursing home projects. This bill allows a facility with 45 beds to apply for an additional 15 beds if the facility maintains a 97.6 percent occupancy rate and the increase in the beds will not reduce the planning district's allocation of nursing home beds in the State Medical Facilities Plan. Patron - Griffith HB975 Sale or conversion of nonprofit hospitals. Requires that all acquisitions of nonprofit hospitals by for-profit entities be approved by the Attorney General. The Department of Health is required to hold a public hearing and report to the Attorney General on the effect the acquisition will have on the community's continued access to health care, including indigent care and access to elderly and emergency care. The entity acquiring the nonprofit hospital must disclose financial details about the transaction to the Attorney General. The Attorney General will approve the application if appropriate steps are taken to safeguard the value of the charitable assets and the underlying details of the transaction reveal no conflict of interest. The proceeds from the sale of the nonprofit hospital are to be placed in the Commonwealth Health Research Fund. Failure to obtain approval prior to acquiring a nonprofit hospital will prevent the issuance or renewal of an operating license. Patron - Purkey HB1068 Certificate of need. Adds home care organizations to the list of medical care facilities and projects for which a certificate of need is required. Patron - Stump HB1215 Emergency medical services. Amends Chapter 431 of the 1991 Acts of Assembly, which created the Richmond Ambulance Authority to prohibit the city from limiting nonemergency transportation, whether the service originates within or outside the locality. Patron - Ingram HB1384 Health care; consumer bill of rights. Establishes a Consumer Bill of Rights and Responsibilities for Health Care. Patron - Brink SB528 Inspections of licensed facilities. Requires, that in the course of entering a facility for an inspection, whenever the Commissioner or his designee finds violations serious enough to justify concerns about protection of the environment or the life, safety and health of the patients, the Commissioner or his designee must either (i) meet with two or more members of the governing board of the facility to disclose the violations and discuss redediation or (ii) notify the board by mail, return receipt requested, of such violations. 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