Health

Health

P Passed

P HB1928

Health; vital statistics. Eliminates the prohibition against any person making a photocopy of a vital record. The prohibition against making a copy that purports to be an original or certified copy still remains. This bill will allow individuals to make copies of their vital records, for example, by faxing a copy to an insurance company or other entity without inadvertently breaking the law.

Patron - Diamonstein

P HB2004

Recapture of nursing home depreciation. Repeals the provision that requires the repayment of reimbursed depreciation upon the sale or transfer of a licensed nursing home for which depreciation has been paid under the Medicaid nursing home reimbursement methodology. The bill is effective July 1, 2000.

Patron - Diamonstein

P HB2080

Medical care facilities certificate of public need. Requires the Commissioner of Health to approve and issue a Request for Application for an increase in the nursing home bed supply for any planning district which would have met the requirements for determining need in compliance with the Board's regulations but for an increase in nursing home bed supply which was authorized by the Commissioner when such beds have not yet been licensed. The Commissioner may approve, authorize and accept applications for any certificate of public need for any project which would result in an increase in the number of nursing home or nursing facility beds in such planning district.

Patron - Baker

P HB2097

Automated external defibrillators. Requires registration of automated external defibrillators by any owner, other than an emergency medical services agency. This bill establishes that an automated external defibrillator may be used to save or attempt to save the life of a person who is in cardiac arrest upon compliance with the registration requirements. The requirements for registration must include (i) training of all users in cardiopulmonary resuscitation and the use of the automated external defibrillator; (ii) maintenance and testing of the equipment in compliance with the manufacturer's operational guidelines and any Board regulations; (iii) supervision of the program by a licensed physician; (iv) payment of a registration fee, not to exceed $25; (v) disciplinary actions for noncompliance; (vi) four-year registration period; (vii) notification of the use of the equipment on any person to the local EMS agency and physicians; and (viii) notification of the availability, location, and type of the automated external defibrillator and any changes. Persons using the defibrillators are provided immunity from liability, unless the injury was the result of gross negligence or willful or wanton misconduct. "Automated external defibrillator" is defined as a medical device which combines a heart monitor and defibrillator and (i) has been approved by the United States Food and Drug Administration, (ii) is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, (iii) is capable of determining, without intervention by an operator, whether defibrillation should be performed, and (iv) automatically charges and requests delivery of an electrical impulse to an individual's heart, upon determining that defibrillation should be performed. Technical amendments are provided to the Good Samaritan Law for more logical grouping of the various persons who are immune from liability while rendering emergency care, assistance or treatment. This bill incorporates HB 2027.

Patron - Cantor

P HB2114

Exhumations and proof of parentage. Provides a procedure for exhumation, testing, and reinterment of a dead body for the purpose of obtaining a posthumous sample to establish parentage, particularly paternity. This bill amends the exhumation statute to authorize the person attempting to prove paternity to petition for exhumation and testing of a dead body for the purpose of establishing such paternity. Present law requires substantial evidence that the person requesting the exhumation is going to prevail in his attempt to prove paternity pursuant to §§ 64.1-5.1 and 64.1-5.2. This bill renders such petitions procedural and not substantive and provides some technical amendments to the evidence statutes. The person obtaining the petition must pay for the exhumation, testing, and reinterment, unless the court determines that, for good cause shown, the estate of the decedent should pay.

Patron - Cranwell

P HB2128

Child fatality review. Allows any local or regional law-enforcement agency, fire department, department of social services, emergency medical services, Commonwealth attorney's office, or community services board to initiate a child fatality review team. Members of local or regional teams may be composed of named official positions within the localities and additional persons, not to exceed five, may be appointed by the chairperson. Each team establishes its own rules and procedures with technical assistance from the State Child Fatality Review Team. Reviews are contingent upon the completed review of any criminal investigation or consent by the attorney for the Commonwealth. All records reviewed, reports produced, and closed meetings are confidential and exempt from the Freedom of Information Act. Nonidentifying information, however, may be disclosed. Members of the teams and their agents or employees, as well as any organization, institution, or person who provided information, etc., are immune from civil liability for any act or omission unless such was the result of gross negligence or willful misconduct.

Patron - Dillard

P HB2185

Family violence. Provides localities with the authority to establish a team to examine fatal family violence incidents and to create a body of information to help prevent future family violence fatalities. The Chief Medical Examiner is required to serve as a clearinghouse of information, provide technical assistance and develop a model protocol for the development and implementation of the teams. The bill is a recommendation of the Commission on Family Violence Prevention. This bill is identical to SB 1035.

Patron - Puller

P HB2206

Health; childhood immunizations. Requires that after July 1, 2001, all children who have not received immunization against hepatitis B receive such immunizations prior to entering the sixth grade. This bill is identical to SB 1037.

Patron - Nixon

P HB2228

Health regulation; nursing homes and certified nursing aides. Requires nursing homes to fully inform patients in summary form of the findings concerning the facility in federal Health Care Financing Administration surveys and inspections, if any. The bill also requires nursing aide education programs designed to prepare nurse aides for certification to be a minimum of 120 clock hours in length. Currently, these programs are 80 hours in length. The curriculum of such programs shall include, but not be limited to, communication and interpersonal skills, safety and emergency procedures, personal care skills, appropriate clinical care of the aged and disabled, skills for basic restorative services, clients' rights, legal aspects of practice as a certified nurse aide, occupational health and safety measures, culturally sensitive care, and appropriate management of conflict. The Board of Nursing shall promulgate emergency regulations to implement the nurse aide education program provisions. The Board of Nursing must also continue to approve nurse aide programs that are in compliance with its nurse aide program regulations in effect on July 1, 1999, and to certify nurse aides who successfully complete such programs and who comply with other requirements of law or regulation, until the date on which the Board's regulations to implement the new requirements become effective. Persons who are certified by the Board as nurse aides prior to the date on which the Board's regulations to implement this act become effective shall be deemed to satisfy the new requirements for purposes of biennial renewal of their certification so long as such persons are in compliance with other requirements of law and regulation concerning continued employment or competence as a condition of renewal.

Patron - Hamilton

P HB2230

Virginia Children's Medical Security Insurance Plan. Amends the existing law authorizing a children's health insurance plan to be consistent with Virginia's Title XXI plan for the State Children's Health Insurance Program as submitted to and approved by the federal Health Care Financing Administration. The amendments, which are essentially technical, cite Title XXI of the Social Security Act, strike outmoded language, and require compliance with the federal law, the Code of Virginia, and any conditions set forth in the appropriation act.

Patron - Melvin

P HB2242

Water Supply Assistance Grant Fund. Establishes the Water Supply Assistance Grant Fund to allow the State Board of Health to provide grants to assist in the provision of safe drinking water. The Board is to develop guidelines establishing criteria, conditions and priorities for grants that are to include consideration of the financial need where the grant is requested. Funds raised through certain existing penalty provisions are directed to the Fund. All funds appropriated as matching funds for moneys available through the federal Safe Drinking Water Act are to deposited in the Fund, and used as matching funds for that purpose.

Patron - Phillips

P HB2295

Health; childhood immunizations. Requires that all children born on or after January 1, 1997, shall be required to receive immunization against varicella zoster (chicken pox) not earlier than the age of twelve months. Children who have evidence of immunity as demonstrated by laboratory confirmation of immunity or a reliable medical history of disease are exempt from such requirement.

Patron - Moran

P HB2314

Health; certificate of public need. Eliminates a certificate of public need for the replacement of certain diagnostic imaging equipment, including computed tomography, positron emission tomography, and magnetic source imaging. This is a recommendation of the Joint Commission on Health Care.

Patron - Baker

P HB2337

Health; permits. Extends from July 1, 1996, to July 1, 2001, the "grandfather" date for certified professional soil scientists to be deemed onsite soil evaluators for the purposes of adoption of regulations for the program. The Board, Commissioner, and Department of Health are required to accept evaluations from such onsite soil evaluators for the purposes of certifying the appropriateness of onsite sewage site conditions for the issuance of letters which are in lieu of permits. This bill also requires the Department to issue such letters (in lieu of permits) within 20 working days of the application filing date when such evaluation by onsite soil evaluations are submitted as supporting documentation. The Board of Health is required, by a second enactment, to promulgate emergency regulations to implement this provision.

Patron - Dickinson

P HB2369

Medical care facilities certificate of public need. Eliminates the requirement for a certificate of public need for the replacement of any equipment; requires registration with the Commissioner of Health and the appropriate health systems agency, within 30 days of becoming contractually obligated, of purchases of any medical equipment for the provision of cardiac catheterization, computed tomographic scanning, gamma knife surgery, lithotripsy, magnetic resonance imaging, magnetic source imaging, open heart surgery, positron emission tomographic scanning, radiation therapy, or other specialized service designated by the Board regulation; and revises the administrative process for obtaining a certificate. The administrative procedures for review of applications for certificate of public need are revised to require (i) concise procedures for prompt review of applications; (ii) fees of one percent of the proposed expenditure for the project, with a minimum of $1,000 and a maximum of $20,000; (iii) transmission of the application by certified mail or a delivery service, return receipt requested, or delivery of the document by hand, with signed receipt to be provided; (iv) the 120-calendar-day review period must begin on the date upon which the application is determined to be complete within the batching process or, if the application is not determined to be complete within 40 calendar days from submission, the application must be refiled in the next batch for like projects; (v) the application review by the health systems agencies will be limited to 60 calendar days; (vi) the health systems agency must submit its recommendations on each application and its reasons within 10 calendar days after the completion of its 60-calendar-day review or such other period the applicant has requested; (vii) if the health systems agency does not complete its review within the 60-calendar-day period or the period requested by the applicant and submit its recommendations within the 10 calendar days after the completion of its review, the Department of Health must, on the 11th calendar day after the expiration of the health systems agency's review period, proceed as though the health systems agency has recommended project approval without conditions or revision; (viii) the Department and the Commissioner must begin the review of the application upon receipt of the completed application and simultaneously with the review conducted by the health systems agency. The Administrative Process Act will only apply to the COPN process in those instances for which timelines and specifications are not delineated in the COPN law, e.g., a formal hearing procedure. Upon accepting an application as complete, (i) the Department must establish a date for every application between the 80th and 90th days within the 120-calendar-day review period for holding an informal fact-finding conference, if necessary; (ii) the Department must review every application at or before the 75th day within the 120-calendar-day period to determine whether an informal fact-finding conference is necessary; (iii) any informal fact-finding conference will be to consider the record and not a de novo review; (iv) in any case in which an informal fact-finding conference is held, a date must be established for the closing of the record in not more than 45 calendar days after the date of the conference; (v) in any case in which an informal fact-finding conference is not held, the record will be closed on the earlier of the date established for holding the conference or the date that the Department determines no conference is necessary; (vi) if the Commissioner's determination is not made within 15 calendar days of the closing of the record, he must notify the Attorney General and copy the parties and persons petitioning for good cause standing, in writing, that the application must be deemed approved unless the determination is made within 40 calendar days of the closing of the record; (vii) in any case in which the determination is not made within 40 calendar days after the closing of the record, the Department must refund 50 percent of the fee, the application will be deemed approved, and the certificate must be granted; (viii) if a determination is not made within 15 calendar days of the closing of the record, any applicant who is competing in the relevant batch or who has filed an application in response to the relevant Request For Applications may, prior to the application being deemed approved, institute a proceeding for mandamus against the Commissioner; (ix) if the writ of mandamus is granted, the Department will be liable for the costs and reasonable attorney's fees; and (x) upon the filing of a petition for mandamus, the relevant application will not be deemed approved, regardless of the time between the closing of the record and the final decision. Deemed approvals will be construed as the Commissioner's case decision on the application pursuant to the Administrative Process Act and will be subject to judicial review on appeal as provided in the APA. The Commissioner's annual report on COPN must include an analysis of the effectiveness of the application review procedures used by the health systems agencies and the Department which details the review time required during the past year for various project categories, the number of contested or opposed applications and the project categories of these contested or opposed projects, the number of applications upon which the health systems agencies have failed to act within the timelines, the number of deemed approvals from the Department because of their failure to comply with the timelines, any other data determined by the Commissioner to be relevant to the efficient operation of the program, and an analysis of the equipment registrations, including the type of equipment replaced and purchased and the equipment costs. This bill is identical to SB 1282.

Patron - Rust

P HB2427

Patient health records. Clarifies that no person receiving patient records from the patient or a provider can redisclose or otherwise reveal the records of the patient, beyond the purpose for which the disclosure was made, without first obtaining the patient's specific consent to the redisclosure. This redisclosure prohibition does not prevent (i) any provider who receives records from another provider from making subsequent disclosures as permitted by the law or (ii) any provider from furnishing records and aggregate or other data, from which patient-identifying information has been removed, encoded, or encrypted, to qualified researchers, including, but not limited to, pharmaceutical manufacturers, and their agents or contractors, for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or other health services research. "Patient-identifying prescription information" includes all prescriptions, drug orders or any other prescription information that specifically identifies an individual patient. This bill also modifies the subdivision relating to disclosure to third-party payors and their agents to note that such disclosure may be made with respect to services rendered to patients covered by such third-party payors for purposes of reimbursement for such services or in compliance with the third-party payor's contract. This bill is identical to SB 1010.

Patron - Jones, S.C.

P HB2543

Medical care facilities certificate of public need. Amends various sections relating to medical care facilities certificate of public need to require the establishment of specific criteria for determining need in rural areas. The rural area criteria must include due consideration to distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to care in such areas and providing for weighted calculations of need based on the barriers to health care access in such rural areas in lieu of the determinations of need used for the particular proposed project within the relevant health systems area as a whole.

Patron - Ruff

P HB2452

Patient's health records. Revises the standard for limiting a patient's ability to obtain his own record by reason of his treating physician placing a written statement in his record to require that the physician's opinion be based on a belief that the furnishing to or review by the patient of such records would cause actual harm to the patient's physical or mental health or cause the patient to be an imminent danger to himself or others. Present law requires that the written statement be based on the physician's opinion that the furnishing to or review by the patient of his records would be injurious to the subject person's physical or mental health or well-being.

Patron - Williams

P HB2567

Medical assistance services. Requires Virginia Medicaid to cover high-dose chemotherapy and bone marrow transplant when this treatment is the appropriate treatment for individuals over the age of 21 who have been diagnosed with 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. This bill also provides for an appeal of the initial determination concerning provider reimbursement by the Director of the Department of Medical Assistance Services directly to court in lieu of an administrative process review. The appellant will be entitled to recover from the Department (a) reasonable costs and attorney fees, up to $25,000, if he substantially prevails on the merits of the case and the agency's position is not substantially justified, unless special circumstances would make an award unjust, and (b) interest at the legal rate on any claim against the Department from the date the court finds payment by the Department was justly due. Emergency regulations to implement this bill are required by the second enactment. Technical amendments are made to improve the organization of this long statute and to provide accurate cross references in related statutes.

Patron - Christian

P HB2596

Emergency medical services. Clarifies that the Richmond Ambulance Authority must comply with state EMS law and other state laws and regulations.

Patron - Jones, D.C.

P HB2617

Medical assistance services; early intervention services. Requires the Department of Medical Assistance Services to amend the Medallion II waiver and its implementing regulations to develop and implement an exception, with procedural requirements, to mandatory enrollment for certain children between birth and age three certified by the Department of Mental Health, Mental Retardation and Substance Abuse Services as eligible for services pursuant to Part C of the Individuals with Disabilities Education Act. Emergency regulations are required.

Patron - Grayson

P HB2655

Health; radioactive materials. Empowers the Board of Health to establish fee schedules, not to exceed comparable federal Nuclear Regulatory Commission fees, for the licensure and inspection of radioactive materials facilities and to adopt regulations for the imposition of civil penalties for violations of law, regulation or licensure conditions by persons licensed for the use or possession or radioactive materials. These fees will be deposited into a special fund to support the licensure and inspection activities. The Special Trust Fund for Radioactive Materials Facility Licensure and Inspection is created as a revolving, nonreverting fund on the books of the Comptroller. The Fund will only be used to support the Department of Health's program for licensure and inspection of radioactive materials facilities. In addition, the bill modifies the Governor's current authority to enter into agreements with the federal government for the state to assume responsibilities for regulating sources of ionizing radiation by making such agreements subject to funds being appropriated. This bill also includes several technical amendments.

Patron - Katzen

P HB2717

Medicaid; family planning. Requires the state plan for medical assistance services to include a provision for payment for family planning services on behalf of women who were eligible for prenatal and delivery services under Medicaid at the time of delivery. Family planning services will not cover payment for abortion services. These services would continue for 24 months after delivery. The bill also directs the Department of Medical Assistance Services to apply for a waiver as soon as possible, but not later than December 31, 1999. Technical reorganizing and cross-reference amendments are also included.

Patron - Baskerville

P HB2751

Health; data reporting. Extends the sunset provision for the health care data reporting requirements from July 1, 1999, to July 1, 2003. This is a recommendation of the Joint Commission on Health Care.

Patron - DeBoer

P SB942

Health; cancer registry. Requires the Joint Commission on Health Care to include, in its study of the cancer registry, an analysis of the exchange of patient-identifying information pursuant to reciprocal data-sharing agreements with other cancer registries and confidentiality protections for patient data. The Commission is directed to examine the potential for inappropriate disclosure of patient data as a result of such data exchange, whether the patient should be required to consent to disclosure or authorized to bar such disclosure and any appropriate penalties for breach of confidentiality.

Patron - Mims

P SB963

Health; onsite sewage evaluations. Requires, for purposes of subdivision review, permit approval, and issuance of letters for residential development, the Board, Commissioner and Department of Health to accept private site evaluations and designs in compliance with the Board's regulations for septic systems and other onsite sewage systems, designed and certified by licensed professional engineers or certified professional soil scientists. Although the Department is not required to perform a field check of the private evaluations and designs prior to issuing a letter, permit or approval, the Department may conduct review of the work and field analysis to protect the public health and integrity of the Commonwealth's environment. The Department must make a decision within 15 days of a request for a single lot evaluation and design approval and within 60 days of a request for multiple lot evaluation and design or subdivision review approval. If the Department fails to take action within these time lines, the designs, evaluations or subdivision review will be deemed approved and the letter, permit or approval issued.

Patron - Norment

P SB1010

Patient health records. Clarifies that no person receiving patient records from the patient or a provider can redisclose or otherwise reveal the records of the patient, beyond the purpose for which the disclosure was made, without first obtaining the patient's specific consent to the redisclosure. This redisclosure prohibition does not prevent (i) any provider who receives records from another provider from making subsequent disclosures as permitted by the law or (ii) any provider from furnishing records and aggregate or other data, from which patient-identifying information has been removed, encoded, or encrypted, to qualified researchers, including, but not limited to, pharmaceutical manufacturers, and their agents or contractors, for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or other health services research. "Patient-identifying prescription information" includes all prescriptions, drug orders or any other prescription information that specifically identifies an individual patient. This bill also modifies the subdivision relating to disclosure to third-party payors and their agents to note that such disclosure may be made with respect to services rendered to patients covered by such third-party payors for purposes of reimbursement for such services or in compliance with the third-party payor's contract. This bill is identical to HB 2427.

Patron - Gartlan

P SB1035

Patron - Howell

P SB1037

Health; childhood immunizations. Requires, after July 1, 2001, that all children who have not received immunization against hepatitis B receive such immunization prior to entering the sixth grade. There is a technical amendment. This bill is identical to HB 2206.

Patron - Walker

P SB1062

Health; private wells. Adds Powhatan County to the list of those localities who may, by ordinance, establish standards, consistent with state standards, for the location and testing of water from private wells and standards more stringent than the state for construction and abandonment of such wells.

Patron - Watkins

P SB1131

Health statistics for minority populations. Requires the Virginia Health Department to publish statistics and analyses regarding the health status of minority populations in the Commonwealth as a part of the Department's annual report. This is a recommendation of the Joint Subcommittee Studying the Status and Needs of African-American Males.

Patron - Maxwell

P SB1158

Patient records. Authorizes health care providers to disclose patient records for the purpose of conducting record reviews of inpatient hospital deaths to promote identification of all potential organ, eye, and tissue donors in conformance with the requirements of applicable federal law and regulations, including 42 C. F.R. § 482.45, (i) to the provider's designated organ procurement organization certified by the United States Health Care Financing Administration and (ii) to any eye bank or tissue bank certified by the Eye Bank Association of America or the American Association of Tissue Banks.

Patron - Gartlan

P SB1172

Nursing homes. Directs the Joint Commission on Health Care, with the assistance of the Department of Health, to study, (i) the adequacy of current Virginia regulations for licensure of nursing homes and the advisability of utilizing "deemed status" for nationally accredited nursing homes and (ii) the concept of centers of excellence in long-term care in cooperation with the Secretary of Health and Human Resources. In its study, the Joint Commission will examine the Commonwealth's nursing home licensure regulations to determine (i) means for making such regulations more outcome-oriented and focused on continuous quality improvement, (ii) opportunities for gathering additional resident and family input as part of the licensure process for nursing homes, (iii) the advisability of accepting national accreditation as evidence of compliance with state licensure standards, and (iv) other states' laws regarding deemed status for state licensure of nursing homes. The Joint Commission shall examine the concept of centers of excellence with regard to long-term care reimbursement, specialized care programs, and best management practices. The Joint Commission will report to the Senate Committee on Education and Health and the House Committee on Health, Welfare, and Institutions prior to October 1, 1999.

Patron - Woods

P SB1186

Medicaid provider communication. Requires the Director of the Department of Medical Assistance Services, consistent with federal law, to establish work groups consisting of key providers and constituency groups, and separate work groups for physicians, hospitals, long-term care providers, dentists, behavioral health providers, pharmacists, school division participating as Medicaid providers, and managed care plans to facilitate communication between the Department and providers of health care regarding program and payment system policies and procedures, performance improvement goals, and such other matters as the Director may deem appropriate. The work groups are required to meet quarterly, unless the Director and the work group participants agree to another schedule. The Board is required to render final decisions regarding the payment systems and other policies in accordance with the Administrative Process Act. Further, the Department must disseminate information on data schedules, policy memoranda, and other information routinely developed by the Department or frequently requested by providers, on the Department's web site or through other efficient means.

Patron - Chichester

P SB1214

Health; telemedicine. Requires the Commissioner of Health to report to the Governor and General Assembly by October 1 of each year on the status of telemedicine initiatives by state agencies. The report will include the current status, cost-effectiveness and efficacy, and recommendations for improvements and expansion. This is a recommendation of the Joint Commission on Health Care.

Patron - Martin

P SB1275

Medical assistance services; burial expenses disregard. Increases the disregard from countable resources when calculating Medicaid eligibility from $2,500 to $3,500.

Patron - Quayle

P SB1280

Health; dissemination of information on birth defects. Requires the Commissioner of Health to develop a publication regarding birth defects and the role of folic acid in preventing birth defects for distribution to physicians, hospitals and other medical facilities, and local health departments for use with patients. Such information must also be provided to the clerks of county and city circuit courts for inclusion in health information required to be given to applicants for marriage licenses.

Patron - Woods

P SB1282

Medical care facilities certificate of public need. Eliminates the requirement for a certificate of public need for the replacement of any equipment; requires registration with the Commissioner of Health and the appropriate health systems agency, within 30 days of becoming contractually obligated, of purchases of any medical equipment for the provision of cardiac catheterization, computed tomographic scanning, gamma knife surgery, lithotripsy, magnetic resonance imaging, magnetic source imaging, open heart surgery, positron emission tomographic scanning, radiation therapy, or other specialized service designated by the Board regulation; and revises the administrative process for obtaining a certificate. The administrative procedures for review of applications for certificate of public need are revised to require (i) concise procedures for prompt review of applications; (ii) fees of one percent of the proposed expenditure for the project, with a minimum of $1,000 and a maximum of $20,000; (iii) transmission of the application by certified mail or a delivery service, return receipt requested, or delivery of the document by hand, with signed receipt to be provided; (iv) the 120-calendar-day review period must begin on the date upon which the application is determined to be complete within the batching process or, if the application is not determined to be complete within 40 calendar days from submission, the application must be refiled in the next batch for like projects; (v) the application review by the health systems agencies will be limited to 60 calendar days; (vi) the health systems agency must submit its recommendations on each application and its reasons within 10 calendar days after the completion of its 60-calendar-day review or such other period the applicant has requested; (vii) if the health systems agency does not complete its review within the 60-calendar-day period or the period requested by the applicant and submit its recommendations within the 10 calendar days after the completion of its review, the Department of Health must, on the 11th calendar day after the expiration of the health systems agency's review period, proceed as though the health systems agency has recommended project approval without conditions or revision; (viii) the Department and the Commissioner must begin the review of the application upon receipt of the completed application and simultaneously with the review conducted by the health systems agency. The Administrative Process Act will only apply to the COPN process in those instances for which timelines and specifications are not delineated in the COPN law, e.g., a formal hearing procedure. Upon accepting an application as complete, (i) the Department must establish a date for every application between the 80th and 90th day within the 120-calendar-day review period for holding an informal fact-finding conference, if necessary; (ii) the Department must review every application at or before the 75th day within the 120-calendar-day period to determine whether an informal fact-finding conference is necessary; (iii) any informal fact-finding conference will be to consider the record and not a de novo review; (iv) in any case in which an informal fact-finding conference is held, a date must be established for the closing of the record in not more than 45 calendar days after the date of the conference; (v) in any case in which an informal fact-finding conference is not held, the record will be closed on the earlier of the date established for holding the conference or the date that the Department determines no conference is necessary; (vi) if the Commissioner's determination is not made within 15 calendar days of the closing of the record, he must notify the Attorney General and copy the parties and persons petitioning for good cause standing, in writing, that the application must be deemed approved unless the determination is made within 40 calendar days of the closing of the record; (vii) in any case in which the determination is not made within 40 calendar days after the closing of the record, the Department must refund 50 percent of the fee, the application will be deemed approved, and the certificate must be granted; (viii) if a determination is not made within 15 calendar days of the closing of the record, any applicant who is competing in the relevant batch or who has filed an application in response to the relevant Request For Applications may, prior to the application being deemed approved, institute a proceeding for mandamus against the Commissioner; (ix) if the writ of mandamus is granted, the Department will be liable for the costs and reasonable attorney's fees; and (x) upon the filing of a petition for mandamus, the relevant application will not be deemed approved, regardless of the time between the closing of the record and the final decision. Deemed approvals will be construed as the Commissioner's case decision on the application pursuant to the Administrative Process Act and will be subject to judicial review on appeal as provided in the APA. The Commissioner's annual report on COPN must include an analysis of the effectiveness of the application review procedures used by the health systems agencies and the Department which details the review time required during the past year for various project categories, the number of contested or opposed applications and the project categories of these contested or opposed projects, the number of applications upon which the health systems agencies have failed to act within the timelines, the number of deemed approvals from the Department because of their failure to comply with the timelines, any other data determined by the Commissioner to be relevant to the efficient operation of the program, and an analysis of the equipment registrations, including the type of equipment replaced and purchased and the equipment costs. This bill is identical to HB 2369.

Patron - Woods

F Failed

F HB749

Licensure of certain health care facilities. Defines "hospital" as including any clinic performing 25 or more of certain procedures per year, including abortions or any procedures that involve the use of anesthesia or the risk of organ perforation or damage or the risk of internal infection. 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

F HB1845

Premium assistance program for HIV-positive individuals. Revises the criteria for eligibility for the premium assistance program for HIV-positive individuals to include a period of at least six months during which the person was unable to work for medical reasons or, as currently required, that the individual be unable to continue working, and increases the maximum income level from 200 percent of the federal poverty level to 300 percent of the federal poverty level or approximately $24,150 for one person. This program has been estimated to save the Commonwealth well over a million dollars in Medicaid costs because it assists individuals living with AIDS to maintain independence. At this time, more and more HIV patients are on the triple or quadruple therapy which, although enormously expensive, improves the quality of life and enables many to return to work. Although many do not qualify for Medicaid, few, if any, of these individuals can afford the costs of individual health insurance; in most instances, the costs of prescription drugs are large (even with prescription coverage) because of the high costs or quantity of the medications. Therefore, this bill may save Medicaid costs for the Commonwealth by enabling more individuals to qualify for this program while also allowing them to return to work.

Patron - Darner

F HB2025

Health; water works. Provides that no owner shall establish a water works system in the state without providing sufficient standby power to treat and distribute the water in the event of power failures.

Patron - Grayson

F HB2027

Automatic external defibrillators. Requires registration of automatic external defibrillators by any owner, other than an emergency medical services agency. This bill establishes that an automatic external defibrillator may be used to save or attempt to save the life of a person who is in cardiac arrest upon compliance with the registration requirements. The requirements for registration must include (i) training of all users in cardiopulmonary resuscitation and the use of the automatic external defibrillator; (ii) maintenance and testing of the equipment in compliance with the manufacturer's operational guidelines and any Board regulations; (iii) supervision of the program by a licensed physician; (iv) payment of a registration fee, not to exceed $25; (v) disciplinary actions for noncompliance; and (vi) four-year registration period. Persons using the defibrillators are provided immunity from liability, unless the injury was the result of gross negligence or willful or wanton misconduct. "Automatic external defibrillator" is defined as a medical device which combines a heart monitor and defibrillator and (i) has been approved by the United States Food and Drug Administration, (ii) is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, (iii) is capable of determining, without intervention by an operator, whether defibrillation should be performed, and (iv) automatically charges and requests delivery of an electrical impulse to an individual's heart, upon determining that defibrillation should be performed. Technical amendments are provided to the Good Samaritan Law for more logical grouping of the various persons who are immune from liability while rendering emergency care, assistance or treatment. This bill has been incorporated into HB 2097.

Patron - Grayson

F HB2078

Medical assistance services; reimbursement. Provides for an appeal of the initial determination concerning provider reimbursement by the Director of the Department of Medical Assistance Services directly to court in lieu of an administrative process review. The appellant shall be entitled to recover from the Department (a) reasonable costs and attorney fees if he substantially prevails on the merits of the case and the agency's position is not substantially justified, unless special circumstances would make an award unjust, and (b) interest at the legal rate on any claim against the Department from the date the court finds payment by the Department was justly due.

Patron - Woodrum

F HB2090

Medical care facilities certificate of public need. Revises the administrative procedure for review of applications for certificate of public need by providing that in any case in which a determination whether a public need exists for a project is not made by the Commissioner within 120 days of the receipt of a completed application, the application will be deemed to be approved and the certificate must be granted.

Patron - Clement

F HB2183

Referendum in certain localities; nonprofit hospitals. Allows the governing body of Prince William County (described by population) and the governing bodies of the Cities of Manassas and Manassas Park to provide by ordinance that in any proposed sale of a nonprofit hospital located within the boundaries of such county which will result in the conversion of such hospital to a for-profit hospital, any required state or local governmental approvals shall be conditioned upon approval by voters of such localities in a referendum on the question of the proposed hospital conversion.

Patron - Marshall

F HB2187

Treatment for phenylketonuria. Requires the Board of Health to include both formulas and solids 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

F HB2285

Interfering with local medical examiner; penalty. Punishes as a Class 1 misdemeanor the willful interference with the authority of a local medical examiner.

Patron - Marshall

F HB2309

Condition on issuance of certain articles of incorporation. Prohibits the State Corporation Commission from making a finding of compliance with the law and issuing a certificate of incorporation when a corporation which is a hospital organized as a not-for-profit institution files amended or new articles of incorporation for the purpose of converting such hospital structure to a for-profit organization, unless the governing board of the not-for-profit institution provides the Commission with documentation of an agreement with the governing body of the locality in which the hospital is located that provides (i) an accounting of the charitable funds received by such institution, including any Hill-Burton moneys, and (ii) restitution of part or all of such charity funds to the people of the jurisdiction in the form of a trust fund dedicated to providing health care for uninsured and underinsured persons.

Patron - Marshall

F HB2310

Medical care facilities certificate of public need. Requires the purchaser or the governing board of a facility that has been sold or restructured from nonprofit status to for-profit status to obtain a certificate of public need prior to assuming ownership or beginning operation as a for-profit institution. Present law requires notice to the Commissioner and the health systems agency of a sale of a facility for $600,000 or more and authorizes the Commissioner to require a certificate of public need for such purchase.

Patron - Marshall

F HB2390

Local health ordinances. Clarifies local government authority to adopt local ordinances for the protection of public health and establishes civil penalties and injunctive relief for certain violations of local ordinances. The bill provides authority for local government to adopt a uniform schedule of civil penalties for violations of local ordinances regulating the sale, preparation and handling of food and of local ordinances regulating swimming pools, saunas and similar facilities. The bill also grants the local director of health or his designee the authority to issue a civil summons for a violation. Any person so summoned may pay the civil penalty or proceed to trial in the general district court. The locality shall have the burden to show the liability of the violator by a preponderance of the evidence.

Patron - Brink

F HB2418

Health; cloning. Prohibits the use of cloning techniques to reproduce humans. The bill provides exceptions for biomedical research and gene therapy which do not create human animals. Civil penalties are provided.

Patron - Grayson

F HB2444

State Health Commissioner; qualifications. Provides that the State Health Commissioner may be certified by a recognized board in a primary care specialty as approved by the American Board of Medical Specialties, as well as by the American Board of Preventive Medicine. The requirements for experience in public health duties, sanitary science and environmental health, etc., are continued. Currently, the Commissioner must be certified by the American Board of Preventive Medicine and have the public health, etc., experience.

Patron - Hamilton

F HB2492

Prescription drugs for Medicare beneficiaries. Authorizes participating licensed pharmacies under agreements with the Board of Pharmacy to issue prescriptions to Medicare beneficiaries at a reduced price. The bill permits such pharmacies to purchase drugs under the same conditions as local health departments and dispense drugs to Medicare beneficiaries pursuant to Board of Pharmacy regulations. The bill also permits hospice programs to enter into agreements with participating licensed pharmacies to procure for and deliver discounted prescription drugs to Medicare beneficiaries.

Patron - Deeds

F HB2540

Health care decisions; study. Revises various provisions relating to health care decision-makers to prohibit the withdrawing or withholding of artificially administered nutrition and hydration if such removal or withholding would be the direct cause of death; prohibits judicial decisions to withdraw or withhold artificially administered nutrition and hydration for incompetent persons for whom there is no legally authorized person available to give consent; and defines "minimally conscious state." The bill provides that "terminal condition" does not include a "minimally conscious state"; no physician is authorized to withhold or withdraw a particular treatment on the authorization of a guardian or committee for the patient if any members of any prioritized class objects; any person in any priority class may obtain, upon request, the medical records of the patient for whom treatment is proposed to be provided, withheld or withdrawn; in any case where a petition is filed to prevent the removal of artificially administered nutrition and hydration for a patient who may be in a persistent vegetative state or a minimally conscious state, the petitioner may call experts to testify to the condition of the patient; and no judge can assess attorney's fees against any person who is a member of any priority class, regardless of order of priority, who has filed a petition for a finding that the action being contemplated is not lawfully authorized by law upon denying such petition for an injunction. Under this bill, the Secretary of Health and Human Resources must appoint and convene a task force to study the operation of the Health Care Decisions Act. The task force will consist of physicians, medical experts having experience with the management of coma patients and patients in persistent vegetative state, nurses, clergymen, family members, and other relevant parties. The task force will be charged with collecting data on the number of persons diagnosed as in a persistent vegetative state in Virginia; collecting data on the circumstances and ability to make an informed consent of the various patients having advance directives in Virginia's institutions; developing, with the assistance of any other experts, guidelines for identification of a diagnosis as being in a persistent vegetative state, including criteria relating to attempts to communicate, whether traditional or unique; developing, with the assistance of any other experts, guidelines for defining and identifying a diagnosis of being in a minimally conscious state, including criteria relating to attempts to communicate, whether traditional or unique; developing procedures to ensure that decisions to withdraw or withhold artificially administered nutrition and hydration are made in the best interests of the patient and will not be the direct cause of death; assessing the issues relating to decision-makers under this act and other laws of the Commonwealth relating to persons incapable of making informed consent, including the provisions in this article concerning the appointment of agents and whether the guardian of an estate should also serve as the guardian of the person; examining and recommending rehabilitation and prevention guidelines and protocols for utilization of alternative therapies; and studying such other matters as the Secretary shall determine to be necessary to protect vulnerable patients. The task force will report annually to the Governor and the General Assembly on the issues before it.

Patron - Marshall

F HB2541

Health Care Decisions Act. Deletes the authority to discontinue artificially administered nutrition and hydration as part of the health care decisions process, i.e., in an advance directive or by an agent named in an advance directive or by a person authorized to make a health care decision for a person incapable of informed consent in the absence of an advance directive. This provision adds a new section setting forth the "LOVING WILL," a document expressing an individual's intent for his body to be maintained regardless of prognosis and for artificially administered nutrition and hydration to be continued indefinitely.

Patron - Marshall

F HB2542

Sale or conversion of nonprofit hospitals. Requires that all acquisitions of nonprofit hospitals which are located in a city having a land area of eight square miles with a population of more than 24,461 and less than 30,707 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. The entity acquiring the nonprofit hospital must disclose financial details about the transaction to the Attorney General. The Attorney General shall 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. Failure to obtain approval prior to acquiring such a nonprofit hospital will prevent the issuance or renewal of an operating license.

Patron - Marshall

F HB2549

Certain Board of Health guidelines. Requires the Board of Health to develop, in cooperation with the Board of Medicine and the Medical Society of Virginia, guidelines for the prevention, diagnosis, and treatment of lead poisoning, with particular emphasis on childhood lead poisoning. The Board's guidelines will not be regulations pursuant to the Administrative Process Act (§ 9-6.14:1 et seq.) and will not be construed as requirements for the practice of medicine or osteopathy.

Patron - Crittenden

F HB2576

Medicaid; state plan. Directs the Department of Medical Assistance Services to include in its state plan a provision for the payment of mandated nutritional counseling for those Medicaid-eligible persons who are diagnosed with Type I or II diabetes and who it is determined would benefit from such counseling. Since other programs for some persons who are Medicaid-eligible already mandate nutritional counseling, such as WIC, those persons would continue to receive nutritional counseling from that program until eligibility expires. There is also a technical amendment.

Patron - Baskerville

F HB2587

Review of adverse utilization review decisions; review of claims appeal by an independent external panel. Establishes a process of independent external review for individuals denied a course of treatment by their managed care health plan. If the person seeking review is determined by the Health Commissioner or his designee (i) to have coverage by the health plan, (ii) to be seeking a treatment that appears to be covered by the plan, (iii) to have exhausted all available utilization review complaint and appeals procedures and (iv) to have provided all information necessary to begin review, an impartial health entity which is not related to or associated with the health plan being reviewed shall review the case. The Health Commissioner will, after reviewing the decision, issue a binding order affirming, modifying or reversing the decision of the health plan, based on a majority decision of the impartial health entity performing the review. The Board of Health will also promulgate regulations establishing (i) expedited appeals procedures for emergency situations, (ii) criteria and standards for eligible impartial health entities, and (iii) a schedule of fees to be paid by health plans upon conclusion of review. The bill also creates the Health Care Regulatory Fund, comprised of sums (i) appropriated from the General Assembly, (ii) health care regulatory assessments, (iii) income from the investment of moneys held by the Fund, and (iv) any other sums designated for deposit to the fund. The Health Commissioner will impose and collect from each managed care health insurance plan an assessment designed to fund the implementation of the review process created by this bill. This bill has been incorporated into 2594.

Patron - Rust

F HB2593

Certain hospital conversions. Charges, in accordance with the doctrine of parens patriae, the Attorney General with the oversight of any conversion of a not-for-profit hospital to a for-profit hospital, regardless of how such conversion is accomplished; the oversight of any ensuing charitable assets and surplus revenues; and the assurance that the assets of the nonprofit hospital are protected and inured to the community benefit. This bill requires notice to the Attorney General at least six months prior to the execution of a contract for sale or the filing of the articles of incorporation as a for-profit corporation; an outside, independent expert's appraisal of the assets, fair market value and charitable assets of the not-for-profit hospital and amount of any offers for purchase; and a community impact statement. A review process for approval or disapproval of hospital conversion transactions will be established which must require public disclosure of the negotiations and terms of the transactions as follows: (i) at least one year prior to any such conversion, the public shall be notified of the contemplated purchase or restructuring, in accordance with the Attorney General's procedures, in a newspaper of general distribution and through radio and television announcements in the jurisdiction in which the hospital is located; (ii) within one month of disclosure of the contract for purchase or the filing of the articles of incorporation, and bimonthly thereafter until the conversion is approved or disapproved by the Attorney General or withdrawn by the relevant hospital board, public meetings and/or hearings shall be conducted by the Attorney General's Office, in accordance with the Attorney General's procedures; (iii) the community impact statement shall be published in a newspaper of general distribution in the jurisdiction in which the hospital is located; and (iv) all documents submitted to the Attorney General regarding any such conversion shall be available for inspection by the public at reasonable times and places in the jurisdiction. The Attorney General's process for approval or disapproval of hospital conversions must include (i) assessment of the independent expert's evaluation of assets and whether the seller is receiving fair market value for the assets; (ii) criteria to review the valuation and bidding process, transaction terms, documents, the process for the determination of fair market value, the names and activities of the parties to the transaction, management contracts, and all other collateral agreements relevant to the conversion; (iii) conditions to ensure the avoidance of conflicts of interest on the part of hospital board members and administrators; (iv) stipulations to ensure that the transaction terms are fair and in the community interest; (v) conditions and restrictions on the terms of such conversions which relate to the circumstances of the particular hospital and community; (vi) review of the seller's decisions and actions to ensure that such seller is acting with due diligence and without conflicts of interest and that the use of outside experts was appropriate; (vii) conflict of interest provisions which shall apply to all board members, hospital executives and staff and be designed to avoid conflicts of interest on the part of such hospital board members, hospital executives, and staff; (viii) accounting procedures to ensure that all charitable contributions, federal Hill-Burton moneys, and tax-free revenues are identified; (ix) safeguards to ensure continued assess to care for uninsured and underinsured populations within the jurisdiction, as well as those services traditionally provided to the public by the hospital, such as, but not limited to, emergency services; and (x) criteria to determine the appropriateness of any board or foundation established to oversee the use of any trust or endowment fund set up as a condition of such conversion. In developing and conducting the reviews of hospital conversions, the Attorney General may request, and shall receive upon request, full cooperation from the Commonwealth's agencies. The Attorney General will also determine and establish remedies and penalties for violations of this section to be included in his review and approval/disapproval procedures.

Patron - Purkey

F HB2620

Patient health records. Clarifies that permitted disclosures of patient records include disclosures by providers made pursuant to mandatory reporting requirements. Providers may also disclose records (i) to third-party payors and their agents whenever the patient or a person acting on a patient's behalf has so requested for payment under a contract or insurance policy, (ii) pursuant to a medical temporary detention order, (iii) to both custodial and noncustodial parents of a minor as permitted by law, and (iv) by exchange when a person committed to jail is transferred to another facility. The bill also permits providers to charge a reasonable fee for requests for copies of medical records. There are technical amendments.

Patron - Jones, S.C.

F HB2631

Use of tobacco settlement agreement funds. Requires any public or private entity utilizing any moneys received by the Commonwealth pursuant to the settlement agreement with tobacco product manufacturers, as a condition to receiving such funds, to establish and maintain policies to support the reduction of tobacco use and reduce exposure to secondhand smoke. The Board of Health shall (i) establish criteria for determining whether an entity's policies support the reduction of tobacco use and reduce exposure to secondhand smoke and (ii) monitor the distribution of such moneys to ensure that the recipients of such funds are in compliance with the provisions of this section.

Patron - Darner

F HB2637

Health; certified copies. Provides that when a single request is made for five or more certified copies of vital records, no more than eight dollars shall be charged for the first four copies and no more than four dollars shall be charged for each of the subsequent copies. Currently, each certified copy or search for vital information carries a charge not to exceed eight dollars.

Patron - Devolites

F HB2642

Application for certain certificate of public need. Provides an exception to the certificate of need requirements for a medical care facility which had an application pending as of January 1, 1999, for a certificate to construct an ambulatory surgery center in a city of 14 square miles having a population of more than 22,000 and less than 24,000, which was withdrawn on or before June 30, 1999.

Patron - Griffith

F HB2760

Pharmacy benefits managers; registration. Defines "pharmacy benefits manager" and requires such persons, whether located in Virginia or in another state, territory or possession, to register such information as the Board of Pharmacy prescribes by regulation. The Board must promulgate regulations to identify and monitor the implementation of pharmacy benefits management in Virginia and to ensure the confidentiality of patient records. Pharmacy benefits managers will only be authorized to disclose prescription dispensing information and patient record information in accordance with the Board's regulations. This provision specifically states that pharmacy benefits managers are not health care providers and are not the owners of the medical records. Any pharmacy benefits manager practicing a profession or business which is regulated by any health regulatory board must continue to hold a valid license, permit, certificate or registration. The registration fee will be the same as that charged for pharmacy permitting in Virginia and the registration must be renewed annually.

Patron - Morgan

F SB946

Patron - Howell

F SB1058

Patron - Hawkins

F SB1211

Certificate of public need. Repeals the need for all medical care facilities to obtain a certificate of public need, yet retains the existing requirement for a certificate for nursing homes. Nursing homes alone will continue to be required to obtain a certificate from the Commissioner of Health prior to commencing any project as provided under current law. Such projects include the establishment, increase or relocation of nursing home beds. Current exemptions for nonprofits and adult care residences remain. Also, existing provisions for continuing care retirement communities are incorporated.

Patron - Martin

F SB1266

Practice of midwifery. Requires the Board to register and permit direct-entry midwifes, after July 1, 1999, in accordance with the regulations promulgated prior to January 1, 1977, and provides an exception to the medical practice provisions for such direct-entry midwifes.

Patron - Reynolds

F SB1319

Ambulatory surgery centers. Defines ambulatory surgery center as a medical entity which provides surgical or diagnostic procedures for patients who are not required to be hospitalized for 24 hours. The bill also provides that an ambulatory center may be a part of a hospital or a separate and distinct entity.

Patron - Houck

F SB1331

Health care data reporting. Adds hospitals operated by the Department of Mental Health, Mental Retardation and Substance Abuse Services for the care and treatment of the mentally ill to the list of health care providers who are required to submit patient level data to a centralized health information system. This bill also extends the sunset provision for the health care data reporting requirements from July 1, 1999 to July 1, 2003.

Patron - Martin

F SB1332

State Health Commissioner; qualifications. Provides that the State Health Commissioner may be certified by a recognized board in a primary care specialty, as well as by the American Board of Preventive Medicine, as is currently the case.

Patron - Martin

F SB1333

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

Patron - Maxwell

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P Passed

F Failed