Source: http://dls.virginia.gov/pubs/summary/2003/03sum32.htm
Timestamp: 2017-11-23 14:50:00
Document Index: 181054926

Matched Legal Cases: ['§ 55', '§ 38', '§ 1115', '§ 32', '§ 8', '§ 32', '§ 54', '§ 2', '§ 54', '§ 54', '§ 32', '§ 32', '§ 32']

General Assembly>Division of Legislative Services>Publications>Session Summaries>2003>Health
Health; Certificate of Birth Resulting in Stillbirth. Requires, upon the request of either individual listed as the mother or father on a report of fetal death in the Commonwealth, the issuance of a Certificate of Birth Resulting in Stillbirth for unintended, intrauterine fetal deaths occurring after a gestational period of 20 weeks or more. The requesting mother or father may provide a name for the stillborn child on the Certificate. The Board of Health is required to prescribe a reasonable fee to cover the administrative costs and preparation of the Certificate. This provision will apply retroactively to any circumstances that would have resulted in the issuance of a Certificate of Birth Resulting in Stillbirth, as prescribed by the Board. This bill is identical to SB 1267.
Reporting radioactive materials. Requires immediate reporting to the State Departments of Health and Police when radioactive materials, including sources of ionizing radiation approved by the Federal Food and Drug Administration for the treatment of foods pursuant to the Federal Food, Drug and Cosmetic Act (21 U.S.C. 301 et seq.), cannot be accounted for within 24 hours. Authorizes the Department to share this information with the Department of Emergency Management, United States Nuclear Regulatory Commission, United States Food and Drug Administration, and state, local and federal law-enforcement agencies, as appropriate.
State Emergency Medical Services Advisory Board. Clarifies the membership of the State Emergency Medical Services Advisory Board, provides that any person appointed to the Advisory Board must be a member of the organization or group that he represents, changes the name of the State Fire Chiefs Association to the Virginia Fire Chief's Association, and makes technical corrections. In addition, provisions pertaining to the compensation and reimbursement of members and staff support for the Advisory Board have been added, pursuant to the new legislative guidelines adopted by the Joint Rules Committee.
Certificate of public need; regulations authorizing a single application for all proposed cancer care center services. Requires the Board of Health to include in the radiation therapy batch, applications, either combined or separate, for computed tomographic (CT) scanning, magnetic resonance imaging (MRI), positron emission tomographic (PET) scanning, radiation therapy or nuclear imaging. A single application for a combination of radiation therapy and any or all of the other named services may be filed. This bill is identical to SB 1226.
Medicaid; preadmission screening. Allows a team of licensed physicians, nurses, and social workers to provide preadmission screening for clients of the Woodrow Wilson Rehabilitation Center for determination of need for nursing facility services. Currently, only the Departments of Health or Social Services or hospitals may perform this assessment. Woodrow Wilson Rehabilitation Center performed this function when it was designated as a hospital; however, it is licensed currently as a comprehensive outpatient rehabilitation facility and is, therefore, not recognized under law to do the assessment.
Health; local health partnership authorities. Extends the sunset provision from July 1, 2003, to July 1, 2006, for local health partnership authorities. The bill also would require any local health partnership authority to report on an annual basis any programmatic initiatives to the Joint Commission on Health Care. This bill is identical to SB 1068.
P HB1697
Certified nursing facility education initiative. Repeals the expiration date of July 1, 2003, that would have sunsetted this program; makes some technical or clarifying amendments; and declares the records, reports, and communications of any staff member, employee, consultant, or other person, acting on behalf of the nonprofit organization that is contracted to conduct the nursing facility education initiative, to be privileged and not to be disclosed or obtained by legal discovery proceedings unless a circuit court, after a hearing and a showing of good cause arising from extraordinary circumstances, orders the disclosure. This declaration will not, however, provide any privilege for the records of the facilities with respect to any patient or any facts or information contained in the records or preclude or affect discovery of or production of evidence relating to the treatment of any patient by a health care provider. Technical amendments are also included.
P HB1718
Date and time of death. Provides that, when the date of death is unknown, it must be determined by approximation, taking into consideration all relevant information, including, but not limited to, information provided by the immediate family regarding the date and time that the deceased was last seen alive if the individual died in his home.
Notification of cancer patients of reports to the statewide cancer registry. Revises the requirements for notification of cancer patients of reports to the statewide cancer registry that must currently be implemented by the Commissioner of Health to require the physician diagnosing a malignant tumor or cancer, at such time and in such manner as considered appropriate by the physician, to notify each patient whose name and record abstract is required to be reported to the cancer registry that personal identifying information about him has been included in the registry as required by law. This provision authorizes the physician to notify, when the notice would be, in the opinion of the physician, injurious to the patient's health or well being, the patient's authorized representative or next of kin in lieu of notifying the patient. In addition, upon request to the statewide cancer registry, the patient whose personal identifying information has been submitted to such registry has a right to know the identity of the reporter of his information to such registry. This bill is identical to SB 1010.
Certificate of public need; authorization of certain amendment. Authorizes, notwithstanding the provisions of the moratorium on nursing home bed construction/additions that was in effect until July 1, 1996, or the provisions of a previous authorization for amendments to the relevant certificate, the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of public need issued as an exception to the former restriction on filing applications for nursing home bed projects. Many of the facilities provided exceptions to the moratorium, including the one that is the subject of this bill, and had strict conditions imposed by the law concerning acceptance of private pay patients directly into their nursing homes. This bill will authorize the facility to ask the Commissioner of Health for an amendment to its previous certificate of public need to continue, for three years from the issuance of an occupancy permit for the third-midrise residential unit building associated with such facility or until June 30, 2006, whichever occurs first, to admit persons, other than residents of the cooperative units, to its nursing facility beds. The facility must be (i) operated by an association described in § 55-458 (an association for the management of real estate cooperatives); (ii) created in connection with a real estate cooperative; and (iii) providing its residents a level of nursing services consistent with the definition of continuing care in Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2 (a continuing care facility). This bill applies to one facility to which the original certificate of public need was issued prior to October 3, 1995.
Health; emergency services. Expands the State Emergency Medical Services Advisory Board by one member and adds a Virginia professional firefighter.
Health; protection of complainants. Applies to hospitals the same confidentiality and protection already available in nursing facilities regarding complainants who in good faith complain or provide information to any entity having responsibility for protecting the rights of patients of hospitals.
Medicaid-Buy-In. Requires the Board of Medical Assistance Services to prepare and seek a § 1115 waiver to implement one of the options for a Medicaid Buy-In program for up to 200 working families with disabilities. Such option must be designed to provide working persons with disabilities, who, because of their higher earnings, were not eligible for medical assistance services in Virginia, with access to coverage under the Virginia medical assistance services program. The provision for a Medicaid Buy-In must provide such working persons with disabilities access to this comprehensive health care when they meet the Board's established income and resource or other eligibility criteria. Any Medicaid Buy-In Program for which a waiver is granted shall not become effective until an appropriation of moneys effectuating such benefits is included in a general appropriation and passed during a regular session of the General Assembly.
P HB1823
Prescriptions for therapeutically equivalent drugs; Virginia Voluntary Formulary repealed. Repeals the Virginia Voluntary Formulary---the Commonwealth's generic drug statutes---and replaces these archaic requirements with Drug Control Act provisions relating to the prescribing and dispensing of "therapeutically equivalent" (generic) drug products. This bill updates the law relating to prescribing and dispensing generic drugs, but provides few changes in prescribing and dispensing requirements.
Automated external defibrillators; public-access defibrillation. Eliminates the requirement for registration of automated external defibrillators by repealing § 32.1-111.14:1 and amends existing immunity provisions to be consistent with this deregulation of ownership and use of automated external defibrillators. The last subsection of the Good Samaritan statute (§ 8.01-225) is also amended to require that the public be urged to receive training on how to use cardiopulmonary resuscitation (CPR) and automated external defibrillators (AED) in order to acquire the skills and confidence to respond to emergencies using both CPR and an AED.
In October 2002, the New England Journal of Medicine published a study of the use of automated external defibrillators by users with no prior training or duty to act in emergency situations. This study found that the untrained public can effectively use the automated external defibrillators. An automated external defibrillator is a medical device combining a heart monitor and a defibrillator that is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia and of determining, without intervention by an operator, whether defibrillation should be performed and, upon determining that defibrillation should be performed, automatically charging and requesting delivery of an electrical impulse to an individual's heart. These instruments have become so sophisticated and user-friendly that even young children have been reported as using them to successfully save lives.
Medicaid; prohibited acts. Clarifies that exceptions provided in the federal anti-kickback law, i.e., the Medicare and Medicaid Patient Protection Act of 1987, as amended, and in the implementing regulations promulgated by the Secretary of Health and Human Services are also exceptions to Virginia's Medicaid self-referral statute. The federal law and regulations relate to Medicare and Medicaid reimbursable services and provide for criminal penalties for violations of its anti-kickback provisions. Numerous and complex exceptions, known as "safe harbors," are provided.
P HB1961
Health; practice of midwifery. Repeals Article 4 (§ 32.1-145 et seq.) of Chapter 5 of Title 32.1 and amends § 54.1-2901 to eliminate the registration and permitting to practice midwifery of individuals who are not registered nurses and were registered and permitted to practice midwifery in compliance with this law prior to January 1, 1977.
Health; water quality analysis. Adds Warren and Goochland Counties to the list of localities that may, by ordinance, establish testing requirements for compliance with existing federal or state drinking water quality standards for building permit applicants that propose to use private ground water wells. This bill also authorizes any local governing body allowed to have such an ordinance that also has well abandonment ordinance to require property owners to close and cap abandoned or inactive wells pursuant to such ordinance.
The University of Virginia Medical Center; deemed licensure. Deems the University of Virginia Medical Center to be a licensed hospital for purposes of other law relating to the operation of hospitals licensed by the Board of Health, for so long as the Medical Center maintains its accreditation by the Joint Commission on Accreditation of Health Care Organizations or any successor in interest thereof. The Medical Center will not be deemed to be a licensed hospital to the extent any law relating to licensure of hospitals specifically excludes the Commonwealth or its agencies. As an agency of the Commonwealth, the Medical Center will remain exempt from licensure by the Board of Health and subject to the provisions of the Virginia Tort Claims Act. The bill states that deemed licensure must not be construed as a waiver of the Commonwealth's sovereign immunity.
Health; vital statistics. Deletes any statement as to racial designation from marriage and adoption records. Similar designations were removed from divorce records in the 2002 Session.
P HB2225
Prescription assistance mechanisms. Creates a special, nonreverting fund to be known as the Healthy Lives Prescription Fund, under the auspices of the Secretary of Health and Human Resources, to accept appropriations, donations, grants, and in-kind contributions to develop and implement programs that will enhance current prescription programs for citizens of the Commonwealth who are without insurance or the ability to pay for prescription drugs and to develop innovative programs to make such prescription drugs more available. The Commissioner of Health must create links from the Department of Health's website to the Department for the Aging's website and its affiliated sites pertaining to pharmaceutical assistance programs and pharmaceutical discount purchasing cards. The Commissioner of the Department for the Aging must cooperate with the Commissioner of Health by ensuring that such information is available on the Department for the Aging's website. The Commissioner of Health must also ensure that all clinical sites administered by local health Departments are provided with adequate information concerning the services of the Virginia Department for the Aging, including, but not limited to, the toll-free telephone number and website information on pharmaceutical assistance programs and pharmaceutical discount purchasing cards. Both commissioners must coordinate the dissemination of information to the public regarding any pharmaceutical discount purchasing card programs while maintaining a neutral posture regarding such programs. The Commissioner of Health must establish a toll-free number to be administered by the Department of Health that will provide recorded information concerning services provided by the Department for the Aging, the Virginia Area Agencies on Aging, and other appropriate organizations for senior citizens. A second enactment clause requires the Joint Commission on Health Care or any successor in interest thereof to prepare a plan to establish the Health Lives Prescription Assistance Program to provide prescription drug benefits for low-income senior citizens and persons with disabilities, which must include consideration of the resources of both the public and private sectors. The plan will be prepared in cooperation with the Secretary of Health and Human Resources, the Virginia Health Care Foundation, pharmaceutical manufacturers, health care provider organizations, advocacy groups, and other interested parties. In preparing the plan, the Joint Commission on Health Care must review and incorporate, to the maximum extent possible, the conclusions of the Joint Commission on Prescription Drug Assistance. The plan must coordinate state, federal and private programs providing prescription assistance, including any programs the federal government may implement. The plan will be reported to the Governor and the Chairmen of the House Committee on Appropriations, the Senate Committee on Finance, the House Committee on Health, Welfare and Institutions, and the Senate Committee on Education and Health by October 15, 2003. This bill is identical to SB 1341.
Children's health insurance. Establishes a program incorporating both Medicaid and the Family Access to Medical Insurance Security (FAMIS) Plan in order to provide coordinated services to individuals defined as children in these programs. The Medicaid portion is named FAMIS Plus. The bill codifies practice by requiring the use of a single application to determine eligibility for both Medicaid coverage for children and FAMIS. Coverage for the mental health services currently provided for children enrolled in Medicaid is extended to individuals eligible for FAMIS. The bill reduces the waiting period from six to four months between the time that a child was covered by private health insurance and when eligibility for FAMIS can be established. [The cost-sharing requirements are amended to clarify that the annual aggregate cost-sharing for all eligible children in a family between 100 percent and at or below 150 percent of the federal poverty level will be limited to nominal copayments and the annual aggregate cost-sharing will not exceed 2.5 percent of the family's gross income. The nominal copayments for all eligible children in a family will not be less than those in effect on January 1, 2003.] This bill is identical to SB 1218.
P HB2297
Children's health insurance through employer-sponsored health insurance programs. Changes the provision in FAMIS on minimum employer contribution from 50 percent towards the cost of dependent or family coverage for an employer's comprehensive health insurance program to be considered employer-sponsored health insurance (ESHI) to a percentage defined in the Virginia Plan for Title XXI of the Social Security Act. Under the current Family Access to Medical Insurance Security Plan, if a family chooses to participate in ESHI and ESHI is deemed cost-effective, the Department of Medical Assistance Services must contribute to the cost of ESHI for eligible dependent children for those program participants that have access to ESHI.
P HB2300
Health; State Emergency Medical Services Advisory Board. Revises and clarifies the required and discretionary representation on the State Emergency Medical Services Advisory Board. The members of the Advisory Board are appointed by the Governor in accordance with this statute. Technical amendments are also provided.
Administration of controlled substances by nurses. Provides that prescribers may authorize registered nurses or licensed practical nurses under the immediate and direct supervision of a registered nurse to possess and administer tuberculin purified protein derivative (PPD) in accordance with policies and guidelines established by the Department of Health. The bill also provides that the State Health Commissioner or his designee may authorize registered nurses, acting as agents of the Department, at the nurse's discretion, to possess and administer PPD to those persons in whom tuberculin skin testing is indicated based on protocols and policies established by the Department.
Health; perinatal depression. Requires each licensed nurse midwife and hospital providing maternity care to make available to each patient and relevant family members information on postpartum blues and perinatal depression (formerly called postpartum depression) prior to discharge. This information will be discussed with the maternity patient.
Health; radon testing. Requires that radon professionals conducting or offering radon screening, testing or mitigation must comply with the radon mitigation and testing standards outlined in the Environmental Protection Agency's publication, EPA 402-R-93-078, as revised, or the American Society for Testing and Materials (ASTM International) Standard, E-2121-02, or any other radon testing and mitigation standards accepted by the Environmental Protection Agency and the Board of Health. The Environmental Protection Agency recognizes the ASTM Standard as equal to or exceeding its standards for radon testing or mitigation.
P HB2402
Nursing home, home care organization and hospice program criminal records checks. Expands the list of crimes that are barriers to employment in home care organizations and hospice programs to be consistent with the barrier crimes currently provided for employment in nursing homes and assisted living facilities.
Patient health records privacy; subpoenas duces tecum; emergency. Revises the subpoena provisions in the patient records law to provide consistency between the existing Virginia provisions and federal regulations promulgated pursuant to the Health Insurance Portability and Accountability Act (HIPAA) of 1996 relating to standards for security and privacy of protected health information. This bill requires that the return date for a subpoena duces tecum will be 15 days unless a court or administrative agency directs an earlier day and that a motion to quash must be filed within 15 days of the notice to the patient or the provider. The language of the notice that must be given to providers acknowledges that the patient or the patient's counsel has received a copy of the subpoena; that either the patient or the provider has the right to file a motion to quash; and as HIPAA requires, that the provider must not respond to the subpoena until he has received written certification from the party on whose behalf the subpoena was issued that the time for filing a motion to quash has elapsed and that no motion was filed or any filed motion has been resolved and the disclosures are consistent with this resolution. As provided in present law, upon receiving a notice that the patient has filed a motion to quash or if the provider files such motion, the provider must send the records to the court or administrative agency in a sealed envelope with a cover letter stating that confidential health records are enclosed and are to be held pending the court's ruling on the motion to quash. The sealed envelope and the cover letter must be placed in an outer envelope or package for transmittal. Explicit instructions are provided for the resolutions of motions to quash in terms of the disposition of the records and the certification that must be given to the provider, as follows: full disclosure and no records submitted under seal to the court or administrative agency to be returned or, if the provider has not responded to the subpoena, that he must respond with the records within 15 days of the subpoena or five days of the certification, whichever is later; no disclosure and return of all records submitted under seal to the court or, if the provider has not submitted records to the court or agency, that the provider must not respond to the subpoena; or limited disclosure and return of a portion of the records submitted under seal to the court or administrative agency or if the provider has not responded to the subpoena, that he must respond with the portion of the records that have been authorized to be disclosed within 15 days of the subpoena date or the five days of the certification. "Certification" is defined as "a written representation that is delivered by hand, by first-class mail, by overnight delivery service, or by facsimile if the sender obtains a facsimile-machine-generated confirmation reflecting that all facsimile pages were successfully transmitted." This bill contains an emergency clause providing that the act will be in force from its passage, i.e., on such date as may be consistent with the constitutional requirements for passage of legislation that does not become effective in due course.
P HB2594
Health; Family Access to Medical Insurance Security Plan eligibility. Provides 12 continuous months of coverage for eligible children residing in Virginia whose family income does not exceed 200 percent of the federal poverty level during the enrollment period as permitted by Title XXI of the Social Security Act.
Construction and operation of treatment works. Gives the State Water Control Board (SWCB) and the Department of Environmental Quality sole authority to regulate the construction and operation of sewage treatment plants, including the review and approval of the plans and specifications for such facilities. This means that the SWCB will issue the certificates to construct and operate the facility. Currently, this is the joint responsibility of the Board of Health and the SWCB.
Licensure of hospice programs and facilities. Provides that any entity licensed as a hospice may concurrently hold a license as an assisted living facility and may provide hospice care to such residents. An entity licensed as an assisted living facility may concurrently hold a license as a hospice and provide hospice care.
Department of Health; regulation of bedding and upholstered furniture. Provides that the Health Department is authorized to inspect the premises of the holder of a license or permit who deals in the sale of bedding and upholstered furniture only upon a complaint. In addition to the penalties provided for a violation under the Health Department, it shall also be a prohibited practice under the Consumer Protection Act.
P HR42
Medical Equipment Recovery of Clean Inventory (MERCI) program. Encourages all hospitals in Virginia to adopt the MERCI program to eliminate the disposal of usable medical supplies and provide such supplies to missions and programs in need.
P SB763
Home Care Services Advisory Committee. Abolishes the Home Care Services Advisory Committee. The Committee advises and makes recommendations to the State Board of Health regarding the regulations of home care organizations. The Committee has been inactive and has not met since 1994. An advisory committee convened by the State Department of Health carries out the functions of the Home Care Services Advisory Committee, including the provision for public participation. This bill is a recommendation of the Joint Subcommittee Studying the Operations, Practices, Duties, and Funding of the Commonwealth's Agencies, Boards, Commissions, Councils, and Other Governmental Entities pursuant to HJR 159 (2002).
P SB805
AIDS Advisory Committee. Abolishes an advisory committee to the State Board of Health known as the AIDS Services and Education Grants Program Advisory Committee. The Committee was established in 1989 to assist the Board in awarding acquired immunodeficiency syndrome services and education grants. The Committee is constituted on an ad hoc basis when there are new grants to award. The State Department of Health would continue to seek the advice of experts knowledgeable in HIV issues to assist with the administration of the grants process. This bill is a recommendation of the Joint Subcommittee Studying the Operations, Practices, Duties, and Funding of the Commonwealth's Agencies, Boards, Commissions, Councils, and Other Governmental Entities pursuant to HJR 159 (2002).
Suspicious deaths. Provides that reports and autopsies of the medical examiner performed for suspicious deaths must be given to the appropriate law-enforcement agency investigating the death. Currently, copies of these documents must be delivered to the appropriate attorney for the Commonwealth and are often supplied to law-enforcement officials, upon request.
P SB966
Certain private waterworks; appointment of receiver. Grants the Commissioner of Health the authority, in addition to the other civil and criminal penalties and injunctive or other relief, to petition the circuit court for the jurisdiction in which any private waterworks is located for the appointment of a receiver. The Commissioner must find that the waterworks is unable or unwilling to provide adequate and safe service for any of the following reasons: (i) the waterworks can no longer be depended upon to furnish pure water; (ii) the waterworks has inadequate capacity to furnish pure water to its customers; (iii) the owner has failed to comply with an order issued by the Commissioner; (iv) the owner has abandoned the waterworks and has discontinued supplying pure water to his customers; (v) the owner is subject to a forfeiture order on his bond; or (vi) the Commissioner has issued an emergency order because there is an imminent danger to the public health and welfare resulting from the operation of the waterworks or the source of the water supply. Upon the filing of a petition for appointment of a receiver for a private waterworks, the court must hold a hearing within 10 days, at which time the Commissioner and the owner of the waterworks may present evidence. The court may grant the petition if it finds any one or more of the named conditions and the court further finds that the conditions will not be remedied and that the health and welfare of the owner's customers will not be protected unless the petition is granted. Upon appointment, the receiver will take possession of the assets of the waterworks and operate the waterworks in the best interests of the customers. The receiver will have such powers and duties to operate and manage the waterworks as the court may grant and direct, including the filing of such reports as the court may direct and the power to receive, conserve, protect, and disburse funds. The court may grant injunctive relief as it deems appropriate to the Commissioner or the receiver either in conjunction with or subsequent to the granting of a petition for appointment of a receiver under this section. Control of and responsibility for the waterworks will remain in the receiver until the waterworks can, in the best interest of the customers, be returned to the owner, transferred to a new owner, or otherwise configured as the court may determine to be in the best interests of the public and the customers. The court may terminate the receivership on the motion of the Commissioner, the receiver, or the owner, upon finding, after a hearing, that the conditions initiating the petition for the appointment of a receiver have been eliminated or resolved. Within 30 days after such termination, the receiver shall file a complete report of his activities with the court, including an accounting for all property of which he took possession and all funds collected. A receiver appointed pursuant to this provision will be an officer of the court, will not be liable for the conditions of the waterworks that existed prior to his receivership, and will not be personally liable, except for his own gross negligence or intentional acts, to injuries or damage to property relating to the waterworks, during his receivership. This immunity provision cannot, however, be construed to relieve any owner of any duty imposed by law or of any civil or criminal liability incurred by reasons of any act or omission of such owner.
Medical assistance services; consumer-directed care. Requires the Department of Medical Assistance Services to prepare, and authorizes the Department to seek approval of, an application for (i) a revision of the consumer-directed personal care services waiver to allow spouses, parents, adult children, and guardians to direct care on behalf of the waiver recipient, when such recipient is incapable of directing such care on his own behalf and (ii) a new waiver for home- and community-based services, as soon as such waiver template becomes available. Any such waiver revision or new waiver must be cost-neutral and must expand consumer-directed care in so far as practicable. Any such waiver application must protect the health and safety of recipients as well as the fiscal integrity of the Commonwealth. Such waiver will provide for a fiscal agent to handle tax issues and payment of personal attendants on the part of recipients. In addition, any such waiver application will (a) provide recipients with flexible choices and personal independence in so far as possible and (b) include provisions for family members to deliver the covered services when consistent with and not prohibited by federal law and regulation. This provision or any new or revised project that may be, but is not required to be, implemented must not be construed as creating any legally enforceable right or entitlement to consumer-directed care, the Virginia Plan for Medical Assistance Services, or Title XIX of the Social Security Act, as amended, on the part of any person or to create any legally enforceable right or entitlement to participation in any consumer-directed care by any person. A second enactment clause authorizes the Board of Medical Assistance Services to promulgate emergency regulations, upon the approval by the Centers for Medicare and Medicaid Services of any application for revision of the consumer-directed personal care services waiver or for any new waiver that may be submitted by the Department of Medical Assistance Services pursuant to this act. Further, a third enactment clause authorizes the Board of Medical Assistance Services to use, when in compliance with the Administrative Process Act (§ 2.2-4000 et seq.), electronic media as much as possible during the promulgation of the regulations, including, but not limited to, posting documents to and receiving comments via the Department's website, by e-mail and fax. The Board must, however, continue to provide public notice and participation to those persons who do not have access to the Internet or other forms of electronic media. This bill incorporates SB 1216.
Notification of cancer patients of reports to the statewide cancer registry. Revises the requirements for notification of cancer patients of reports to the statewide cancer registry that must currently be implemented by the Commissioner of Health to require the physician diagnosing a malignant tumor or cancer, at such time and in such manner as considered appropriate by the physician, to notify each patient whose name and record abstract is required to be reported to the cancer registry that personal identifying information about him has been included in the registry as required by law. This provision authorizes the physician to notify, when the notice would be, in the opinion of the physician, injurious to the patient's health or well being, the patient's authorized representative or next of kin in lieu of notifying the patient. In addition, upon request to the statewide cancer registry, the patient whose personal identifying information has been submitted to such registry has a right to know the identity of the reporter of his information to such registry. This bill is identical to HB 1743.
Health; local health partnership authorities. Extends the sunset provision from July 1, 2003, to July 1, 2006, for local health partnership authorities. The bill also would require any local health partnership authority to report on an annual basis any programmatic initiatives to the Joint Commission on Health Care. The bill is identical to HB 1695.
P SB1082
Protocol for testing children for elevated blood-lead levels. Mandates that the Board of Health require, in its protocol for testing children for elevated blood-lead levels, testing at appropriate ages and frequencies, when indicated. The present protocol provides criteria to determine that a child is not at risk of lead poisoning and testing is not required. Currently, the protocol also notes that testing "should" be conducted at certain intervals. Lead poisoning causes permanent neurological injury, particularly to young children, which can result in mental retardation and even death. During the past year, controversy concerning the effectiveness of merely recommending the testing has arisen. This bill is a recommendation of the Joint Subcommittee Studying Lead Poisoning Prevention.
Sharing of protected health information between state agencies. Expands the authority to share protected health information to include the Department of Rehabilitative Services and the Departments for the Aging, the Blind and Vision Impaired, and the Deaf and Hard-of-Hearing or any successors in interest thereof. Present law, enacted in 2002, was intended to clarify the authority of various state departments to obtain and the discretion of health care providers to disclose protected health information in compliance with the regulations promulgated by the federal Department of Health and Human Services pursuant to the Health Insurance Portability and Accountability Act of 1996, as amended. The present statute covers the Departments of Health, Medical Assistance Services, Mental Health, Mental Retardation and Substance Abuse Services, and Social Services. This provision extends this protection and authority to the other agencies within the purview of Virginia's Secretary of Health and Human Resources. The implementation of the 2002 provision has been estimated by the relevant auditors within the presently covered agencies to have saved the Commonwealth more than $1 million since July 1, 2002. This provision is a recommendation of the Joint Subcommittee Studying Lead Poisoning Prevention.
Land application of sewage sludge; requirements and regulations; study; report. Amends current biosolids land application law by establishing standard complaint and investigation procedures, including the maintenance of a searchable electronic database of complaints by the Virginia Department of Health (VDH). The bill requires nutrient management plans (NMPs) prepared by persons certified by the Virginia Department of Conservation and Recreation (DCR) for all land application sites, regardless of the frequency of application. Under current VDH regulations, only sites where biosolids are applied more than once every three years are required to prepare NMPs prior to permit issuance. The bill also requires DCR approval of all NMPs for sites where the permit authorizes land application more than once every three years at greater than 50 percent of agronomic rates, and certain sites operated by the owner or lessee of a Confined Animal Feeding Operation or Confined Poultry Feeding Operation. The bill allows VDH to incorporate into the permit reasonable site-specific special conditions to protect the environment or the health, safety and welfare of persons residing in the vicinity of the proposed application site. VDH must also include in its notice of special conditions such site-specific conditions recommended by the locality. The permit applicant will have at least 14 days to respond to the proposed conditions and any objections shall be heard by the Health Commissioner. The bill requires permit holders to provide VDH with evidence of financial responsibility, to be established regulation, which shall be available to pay claims for cleanup costs, personal injury and property damage. The bill creates a land application certification program to be established by VDH pursuant to which all future land application sites must have a certified land applicator on location at all times during the application process. The bill grants localities that have adopted a biosolids testing and monitoring ordinance the authority to order the abatement of land application activity for violations of relevant laws and regulations. Finally, the bill requests that VDH review certain reports of the National Research Council and the United States Environmental Protection Agency, report its findings to the Virginia Board of Health by June 30, 2004, and if requested by the Board, initiate rulemaking proceedings by September 1, 2004.
P SB1091
Health care data reporting. Requires licensed dentists who are registered as oral and maxillofacial surgeons and certified to perform certain procedures by the Board of Dentistry pursuant to § 54.1-2709.1, to submit required outpatient surgery data relating to several procedures. Only those procedures requiring certification under § 54.1-2709.1 will be reported.
Children's health insurance. Establishes a program incorporating both Medicaid and the Family Access to Medical Insurance Security (FAMIS) Plan in order to provide coordinated services to individuals defined as children in these programs. The Medicaid portion is named FAMIS Plus. The bill codifies current practice of requiring the use of a single application to determine eligibility for both Medicaid coverage for children and FAMIS. Coverage for the mental health services currently provided for children enrolled in Medicaid is extended to individuals eligible for FAMIS. The bill reduces the waiting period from six to four months between the time that a child was covered by private health insurance and when eligibility for FAMIS can be established. [The cost-sharing requirements are amended to clarify that the annual aggregate cost-sharing for all eligible children in a family between 100 percent and at or below 150 percent of the federal poverty level will be limited to nominal copayments and the annual aggregate cost-sharing will not exceed 2.5 percent of the family's gross income. The nominal copayments for all eligible children in a family will not be less than those in effect on January 1, 2003.] This bill is identical to HB 2287.
Emergency medical services technician (EMTs) authorization to possess and administer epinephrine. Requires the Board of Health's regulations on certification of emergency medical services technicians to authorize certain levels of EMTs to possess and administer epinephrine in emergency cases of anaphylactic shock. Clarifying amendments are added to the Good Samaritan law and to the Drug Control Act to reinforce this authorization.
P SB1226
Certificate of public need; regulations authorizing a single application for all proposed cancer care center services. Clarifies that, in any structured batching process established by the Board of Health for certificate of public need, applications, combined or separate, for computed tomographic (CT) scanning, magnetic resonance imaging (MRI), positron emission tomographic (PET) scanning, radiation therapy or nuclear imaging will be considered in the radiation therapy batch. A single application may be filed for a combination of (i) radiation therapy and (ii) any or all of the CT scanning, MRI, PET scanning, and nuclear medicine imaging. This bill is identical to HB 1621.
Prehospital patient care reports; disclosure. Authorizes licensed emergency medical services agencies to disclose prehospital patient care reports to law-enforcement officials upon request (i) when the patient is the victim of a crime or (ii) when the patient is in the custody of the law-enforcement officials and has received emergency medical services or has refused emergency medical services. This bill also includes technical amendments.
P SB1264
Health care data reporting. Revises the fee structure for processing, verification, and dissemination of reported health care data. The limitation on the Board's authority to prescribe a reasonable fee that does not exceed one dollar per discharge is removed. The Board continues to be authorized to prescribe a reasonable fee for each affected health care provider to cover the costs of the reasonable expenses of establishing and administering the data processing methodology and to establish a tiered-fee structure. The nonprofit organization's authorization to charge and collect fees prescribed by the Board and to charge a fee of up to one dollar for records that it determines are not processed, verified data is removed. A specific prohibition against the nonprofit organization assessing any fee against any health care provider that submits processed, verified, and timely data is stated. The Board of Health is required to establish penalties for submission of data in a manner that is inconsistent with its standards. The requirement for the Board to maintain records of its activities; collect and account for all fees and deposit the moneys in a special fund; and enforce all regulations is moved to a new subsection.
Health; Certificate of Birth Resulting in Stillbirth. Requires, upon the request of either individual listed as the mother or father on a report of fetal death in the Commonwealth, the issuance of a Certificate of Birth Resulting in Stillbirth for unintended, intrauterine fetal deaths occurring after a gestational period of 20 weeks or more. The requesting mother or father may provide a name for the stillborn child on the Certificate. The Board of Health is required to prescribe a reasonable fee to cover the administrative costs and preparation of the Certificate. This provision will apply retroactively to any circumstances that would have resulted in the issuance of a Certificate of Birth Resulting in Stillbirth, as prescribed by the Board. This bill is identical to HB 1450.
Prescription assistance mechanisms. Creates a special, nonreverting fund to be known as the Healthy Lives Prescription Fund, under the auspices of the Secretary of Health and Human Resources, to accept appropriations, donations, grants, and in-kind contributions to develop and implement programs that will enhance current prescription programs for citizens of the Commonwealth who are without insurance or the ability to pay for prescription drugs and to develop innovative programs to make such prescription drugs more available. The Commissioner of Health must create links from the Department of Health's website to the Department for the Aging's website and its affiliated sites pertaining to pharmaceutical assistance programs and pharmaceutical discount purchasing cards. The Commisioner of the Department for the Aging must cooperate with the Commissioner of Health by ensuring that such information is available on the Department for the Aging's website. The Commissioner of Health must also ensure that all clinical sites administered by local health Departments are provided with adequate information concerning the services of the Virginia Department for the Aging, including, but notlimited to, the toll-free telephone number and website information on pharmaceutical assistance programs and pharmaceutical discount purchasing cards. Both commissioners must coordinate the dissemination of information to the public regarding any pharmaceutical discount purchasing card programs while maintaining a neutral posture regarding such programs. The Commissioner of Health must establish a toll-free number to be administered by the Department of Health that will provide recorded information concerning services provided by the Department for the Aging, the Virginia Area Agencies on Aging, and other appropriate organizations for senior citizens. A second enactment clause requires the Joint Commission on Health Care or any successor in interest thereof to prepare a plan to establish the Health Lives Prescription Assistance Program to provide prescription drug benefits for low-income senior citizens and persons with disabilities, which must include consideration of the resources of both the public and private sectors. The plan will be prepared in cooperation with the Secretary of Health and Human Resources, the Virginia Health Care Foundation, pharmaceutical manufacturers, health care provider organizations, advocacy groups, and other interested parties. In preparing the plan, the Joint Commission on Health Care must review and incorporate, to the maximum extent possible, the conclusions of the Joint Commission on Prescription Drug Assistance. The plan must coordinate state, federal and private programs providing prescription assistance, including any programs the federal government may implement. The plan will be reported to the Governor and the Chairmen of the House Committee on Appropriations, the Senate Committee on Finance, the House Committee on Health, Welfare and Institutions, and the Senate Committee on Education and Health by October 15, 2003. This bill is identical to HB 2225.
P SJ325
Long-term care. Recognizes the problems affecting the provision of long-term care services to Virginia citizens. Some of these problems include increasing long-term care costs, decreased Medicaid reimbursement, lack of nursing personnel, increasing liability costs, and the low incidence of long-term care insurance purchase. The Clerk of the Senate is directed to forward a copy of this resolution to the Joint Commission on Health Care for consideration during its deliberations.
Department of Medical Assistance Services; Virginia Insurance Plan for Seniors (VIPS). Establishes the VIPS to provide assistance in the purchase of prescription drugs for those persons who are dually eligible for Medicaid and Medicare but who do not qualify for prescription assistance. Payment assistance is limited to $80 per month per eligible person, but unused amounts may be rolled over and credited to that person for future use. However, no direct cash payment will be made to any eligible person. Participants must pay a $10 co-payment for each prescription. They are also required to use generic drugs unless they are willing to pay the difference between the generic and name-brand drug. Approved drugs in the Plan are those manufactured by pharmaceutical companies that agree to provide manufacturer rebates equal to the rebate required by the Medicaid program and to make the drug product available to the Plan for the best price that the manufacturer makes the drug available in the Medicaid program. Any licensed pharmacist may participate according to the rules adopted for the program and shall be paid a reasonable reimbursement to cover the cost of the drug and costs for dispensing; payments to pharmacists shall not vary based on the size of the entity dispensing the prescription. Beneficiary cost-sharing amounts shall not vary based on the source of dispensing or method of distribution of the prescription.
Health; reports by hospitals. Requires the Board to collect and hospitals licensed by the Board to report on infections contracted by patients while in the hospital. Information, while ensuring the anonymity of the patients, shall be shared with the Division of Consumer Counsel and the Administrator of Consumer Affairs for appropriate action.
Onsite sewage evaluations and septic system permits. Provides that, when a field analysis is necessary to protect the public health and integrity of the Commonwealth's environment, the Department of Health must conduct the field analysis prior to issuing a letter, permit or approval. If a field analysis is conducted, for any reason, after initiation of construction and the system design or site evaluation is found to be out of compliance with the Board's regulations, the permit shall remain valid and shall not be revoked. For the purposes of the Onsite Sewage Indemnification Fund, no negligence shall be impugned to the Department of Health if a system having a negative field analysis after initiation of construction fails within three years of construction.
Medical assistance services; circumcision. Provides that infant circumcision shall be covered under the Commonwealth's Medicaid program only if it is medically necessary.
Health; location and testing of water. Adds Warren County to the list of those localities that may, by local ordinance, adopt standards consistent with the Board of Health for location and testing of water from private wells and that are more stringent than those adopted by the Board for construction and abandonment.
Medicaid; buy-in. Requires the Department of Medical Assistance Services to apply for a Section 1115 waiver from the federal Center for Medicare and Medicaid Services to implement a Medicaid buy-in for those working persons with disabilities whose earnings are too high to qualify for traditional Medicaid comprehensive health care services. Eligible individuals would include those who have (i) income not in excess of 175 percent of the federal poverty level, (ii) minimum gross monthly earnings of at least $400; and (iii) maximum unearned income per month not exceeding 80 percent of the federal poverty level. This bill is a recommendation of the Disability Commission.
Health; Virginia Prescription Drug Payment Assistance Plan. Establishes a program to be administered by the Department of Medical Assistance Services (DMAS), modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. DMAS may contract with third-party administrators to provide administrative services that include enrollment, outreach, eligibility determination, data collection, financial oversight, and reporting. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes at or below 150 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of their annual income, as set forth in the appropriation act. They must also be age 65 or older or eligible for Federal Old-Age Survivors and Disability Insurance Benefits, not be receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payor prescription benefit as of July 1, 2003, and be ineligible for Medicaid prescription benefits. However, nothing shall prohibit the enrollment of a person in the program during the period in which his Medicaid eligibility is determined. Eligible enrollees will receive an identification card to be presented to pharmacists and will start receiving the benefit the month after their eligibility is determined. Benefits will be paid to pharmacies under a point-of-service claims procedure to be established by DMAS. Participants are required to make a copayment for each prescription, which in general will not exceed 25 percent of the cost, but not less than five dollars. Money to pay the claims will come from the newly established Prescription Assistance Fund, which is to be financed by an increase to 50 cents per pack of cigarettes sold in the state and any federal funds available for this purpose. Administrative costs are to be paid from the pharmaceutical manufacturer rebates to the extent available and the $20 annual enrollment fees. The Board shall develop a comprehensive statewide community-based outreach plan to enroll eligible persons and DMAS shall report annually on the program's implementation. No entitlement to prescription drug coverage on the part of any eligible person or any right or entitlement to participation is created and such coverage shall only be available to the extent that funds are appropriated therefor.
Regulation and licensure of abortion clinics. Requires abortion clinics, defined as any facility other than a hospital in which 25 or more first trimester abortions are performed in any calendar year, to be licensed. Abortion is defined as "an act of using or prescribing RU 486 or its equivalents, or any instrument, machine or device with the intent to terminate a woman's pregnancy for reasons other than to increase the probability of a live birth, to preserve the life or health of a child, after a live birth, to treat an ectopic pregnancy or to remove a dead fetus." The Board is required to regulate minimum standards for abortion clinics including, among other matters, structural requirements, supplies and equipment standards, requirements for abortion personnel, standards for medical screening and evaluation of patients, requirements for abortion procedures, minimum recovery room standards, follow-up visit requirements, and incident reporting. Violations of the provisions on licensure of abortion clinics may result in denial, suspension, or revocation of a license or the civil or criminal penalties already set out in the Board's statutes, including injunction, mandamus, civil penalties and criminal fines, and a Class 1 misdemeanor. Each day of violation will constitute a separate offense for the purposes of civil penalties and criminal fines and various factors concerning the violation must be considered in assessing the penalty. This provision is modeled after Louisiana legislation.
F HB2366
Human Embryo Research Act. Prohibits "destructive research," which is defined as "medical procedures, scientific or laboratory research, or other kinds of investigation that kill or injure the embryo subject of such research." Certain procedures are not included in this definition, i.e., (i) in vitro fertilization and accompanying embryo transfer to a woman's uterus or (ii) any diagnostic procedure that may benefit the human embryo that is the subject of such tests. This bill prohibits (a) intentional or knowing conduct of destructive research on a human embryo; (b) buying, selling, receiving, or otherwise transferring a human embryo with the knowledge that such embryo will be subjected to destructive research; or (c) buying, selling, receiving, or otherwise transferring gametes with the knowledge that human embryos will be produced from such gametes to be used in destructive research. Violations are punishable as Class 1 misdemeanors under the present general penalty statute in Title 32.1.
Regulation and licensure of abortion clinics. Requires abortion clinics, defined as any facility other than a hospital or ambulatory surgery center, in which 25 or more first trimester abortions are performed in any 12-month period, to be licensed. Each clinic will be assigned a unique licensure number that must be noted in any advertisement, with a listing in any directory as well as more traditional forms of advertisement, defined as "abortion advertisements." The Board is required to regulate minimum standards to protect the health and safety of patients, including, among other matters, a requirement that only physicians may perform an abortion in an abortion clinic, and standards for personnel, supervision, medical treatment and medical services, coordination of treatment and services, sanitary and hygienic conditions, essential equipment, clinical records, and the management, ownership, and control of the facility. Each abortion clinic is required to annually report to the Board on each abortion performed in the clinic, including the patient's birth date, race, marital status, and state or country of residence, the date on which the abortion was performed, whether the patient survived, and if not, the cause of death; the period of gestation at the time of the procedure; the date, if known, of the patient's last menstrual cycle; the number of previous live births; and the number of previous induced abortions. The Board must also include patient privacy protections in its regulations that comply with state and federal laws and regulations relating to protected health information. The Department of Health is required to maintain a toll-free hot line to provide the public information on abortion clinics. Each clinic must provide the number for the hot line to a patient upon her initial visit and must inform her in writing of the availability of information on abortion clinics at the number, that her identity will remain anonymous, and the call will verify the licensure status, any citations for violations of state law or regulations or inspection citations. Violations of the provisions on licensure of abortion clinics may result in denial, suspension, or revocation of a license of the civil or criminal penalties already set out in the Board's statutes, including a possible Class 1 misdemeanor. Licensure fees will be used to support the licensure and inspection program. This provision is modeled after Texas law.
Regulation and licensure of abortion clinics. Requires abortion clinics, defined as any facility other than a hospital, in which first trimester abortions are performed, to be licensed and to comply with specific requirements that the Board of Health must include in its regulations. The Board's regulations must include standards for the facilities, supplies and equipment, personnel, medical screening and evaluation, medical procedures, recovery rooms, follow-up visits, and incident reporting. The Board must also promulgate regulations to protect the privacy of patients and provide for disclosure of protected health information in compliance with state and federal laws and regulations. The regulations will not limit the ability of a physician or other health professional to advise a patient on any health issue. This provision is modeled after Arizona law.
Licensure and regulation of certain facilities. Requires the Board and Department of Health to license as abortion clinics any facility, other than a hospital as defined in the law, in which any second trimester or five or more first trimester abortions per month are performed. Each facility so licensed will be required to comply with requirements relating to facility safety and patient protection, including cleanliness, sterilization, fire protection, evacuation, staff credentials, equipment, maintenance of facilities and equipment, allowable procedures, and facility procedures and policies. This provision is modeled after South Carolina law.
Systematic reporting of abortion. Requires physicians performing abortions or treating the complications of induced abortions to report detailed information on forms prepared and distributed by the Board of Health. In addition, the Board must issue a public report annually providing the same detailed information for the most recent year and all previous calendar years, adjusted to reflect any additional information from late or corrected reports. Physicians failing to report in a timely manner will be subject to a late fee of $500 for each additional 30 days that the forms are overdue and the Board may pursue the penalties or other relief provided in § 32.1-27 in any case in which a physician has failed to file the required forms within one year or has filed incomplete forms.
Board of Health; regulations; waterworks. Provides for the regulations of the Board of Health pertaining to waterworks to require new water meters up to two inches installed after January 1, 2005, to conform to American National Standards Institute/National Sanitation Foundation (ANSI/NSF) Standard 61, Drinking Water System Components. This ANSI/NSF standard provides for the certification of devices as lead-free.
Health; vital statistics. Requires the Department of Health to utilize one uniform form of birth certificate that has a space for the names of both the father and the mother. If the father is unknown, the space shall be left blank. Currently, the state uses two birth certificates, one for a birth where the parents are married, and one for births to unmarried persons. The bill also allows a father who voluntarily acknowledges paternity to have his name placed on the birth certificate without the consent of the mother. The bill also provides that a person who voluntarily acknowledges paternity and is paying child support shall have his name on the birth certificate.
Health; Virginia Prescription Drug Payment Assistance Plan. Establishes a program to be administered by the Department of Medical Assistance Services (DMAS), modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. DMAS may contract with third-party administrators to provide administrative services that include enrollment, outreach, eligibility determination, data collection, financial oversight, and reporting. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes at or below 150 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of their annual income, as set forth in the appropriation act. They must also be age 65 or older or eligible for federal Old-Age, Survivors and Disability Insurance Benefits, not be receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payor prescription benefit as of July 1, 2003, and be ineligible for Medicaid prescription benefits. However, nothing shall prohibit the enrollment of a person in the program during the period in which his Medicaid eligibility is determined. Eligible enrollees will receive an identification card to be presented to pharmacists and will start receiving the benefit the month after their eligibility is determined. Benefits will be paid to pharmacies under a point-of-service claims procedure to be established by DMAS. Participants are required to make a co-payment for each prescription, which in general will not exceed 25 percent of the cost, but not less than five dollars. Money to pay the claims will come from the newly established Prescription Assistance Fund, which is to be financed by 10 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement and any federal funds available for this purpose. Administrative costs are to be paid from the pharmaceutical manufacturer rebates to the extent available and the $20 annual enrollment fees. The Board shall develop a comprehensive statewide community-based outreach plan to enroll eligible persons and DMAS shall report annually on the program's implementation. No entitlement to prescription drug coverage on the part of any eligible person or any right or entitlement to participation is created and such coverage shall only be available to the extent that funds are appropriated therefor.
Medical assistance coverage for certain preventive and rehabilitative services. Provides Medicaid coverage for membership in wellness clubs prescribed by a licensed physician as a part of the treatment plan for physically disabled persons, who are Medicaid eligible, to assist such persons in maintaining mobility and health.
F HB2595
Medicaid; eligibility for medically indigent children. Provides for 12-month continuous eligibility for children enrolled in the medically indigent category as permitted by Title XIX of the Social Security Act.
Medicaid; presumptive eligibility. Provides for presumptive eligibility of children applying in the medically indigent category for Medicaid and the Family Access to Medical Insurance Security Plan, as permitted by Titles XIX and XXI of the Social Security Act, through qualified entities, including hospitals, health departments and federally qualified health centers.
Virginia Medevac Authority. Directs the Board of Health, with input from the State Emergency Services Advisory Board, to organize the Virginia Medevac Authority to ensure that all regions of the Commonwealth have access to medevac services. The Board must hold at least two public hearings and receive input of the Advisory Board before organizing the Authority. The Authority will be governed by a 15-member organization that consists predominantly of participants, i.e., public or private entities currently operating medevac services in Virginia. The Authority is given broad powers, including contracting, hiring, suing and being sued, and charging fees, etc., for its services. The revenues raised by the Authority must be geared to cover the expenses of its operation. The Board of Health is required to promulgate emergency regulations by a second enactment clause.
Health; certificate of public need. Amends Chapter 912 of the 2000 Acts of Assembly that was issued to a continuing care provider that operates a facility operated for the care of retired military personnel and their families. The bill allows the facility to extend nursing or extended care services to persons other than contract holders until the continuing care contract holders constitute 85 percent of the occupancy or until July 1, 2008, whichever comes first, to comply with changes in the facility's bond and to utilize those beds until contract holders need them.
Wastewater and drinking water programs. Transfers the Sewage Disposal program, the State Health Department Sewage Handling and Disposal Appeal Review Board, the Public Water Supplies program, the Private Well Construction program, and the gray water program from the Department of Health to the Department of Environmental Quality.
Diabetes on death certificates. Requires death certificates for any person who dies in the Commonwealth to indicate whether diabetes was the immediate or underlying cause of death. Diabetes mellitus, a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both, is associated with serious complications and premature death. With proper medical care, the disease can be controlled, and associated complications and other adverse health consequences can be lowered. The inclusion of this information on the death certificate will allow the State Health Department to better understand and more accurately report the prevalence of diabetes and its impact on diverse populations in the Commonwealth, and to effectively and efficiently target health interventions to high risk populations.
F HJ611
Contraceptives. Urges hospitals, health care facilities, health care providers, pharmacists, and pharmacies in the Commonwealth to provide patients and the public with complete, accurate, and objective information about the full range of contraceptives, including emergency contraception, to enable women to make responsible and informed health care decisions.
Registered nurses performing infusion services; medical assistance services. Requires the Board of Medical Assistance Services to provide for reimbursement for infusion care rendered by registered nurses to patients in long-term care facilities, hospitals or home- and community-based care, including, but not limited to, peripheral IV catheters, Advanced Vascular Access Devices, such as Hickman, Mediport, Peripherally Inserted Central Catheters, and midlines, and IV access care and maintenance of peripheral and central catheters, when such registered nurses have met the requirements of the Board of Nursing for experience and training in such care. This bill provides an exception to the medical practice act for such registered nurses and requires the Board of Nursing to develop, in coordination with the Board of Medicine, guidelines for experiential and training requirements for registered nurses to render infusion care.
Medical efficacy of health care services. Removes the determination of the medical efficacy of health care services.
F SB772
Medicaid; buy-in. Requires the Department of Medical Assistance Services to apply for a Section 1115 waiver from the federal Center for Medicare and Medicaid Services to implement a Medicaid buy-in for those working persons with disabilities whose earnings are too high to qualify for traditional Medicaid comprehensive health care services. Eligible individuals would include those who have (i) income not in excess of 175 percent of the federal poverty level; (ii) minimum gross monthly earnings of at least $400; and (iii) maximum unearned income per month not exceeding 80 percent of the federal poverty level. This bill is a recommendation of the Disability Commission.
Requirements for nursing home licensure; Medicaid reimbursement. Establishes, as a condition of licensure, staffing standards for all nursing homes as follows: (i) each nursing home must have a full-time director of nursing who must be a professional registered nurse; (ii) each nursing home must have designated nursing supervisors on duty at all times who must be professional registered nurses; (iii) each nursing home with 100 beds or more must employ a full-time assistant director of nursing who must be a professional registered nurse; (iv) each nursing home with fewer than 100 beds must employ a part-time professional registered nurse as assistant director of nursing; (v) each nursing home with 100 beds or more must employ a full-time director of in-service education; and (vi) each nursing home with fewer than 100 beds must employ a part-time director of in-service education. In addition, each nursing home must maintain a minimum staffing ratio of registered nurses or licensed practical nurses to residents of at least one to 15 during the day shift, at least one to 20 during the evening shift, and at least one to 30 during the night shift. A nursing home must maintain a minimum staffing ratio of certified nurse aides to residents of at least one to five during the day shift, at least one to five during the evening shift, and at least one to 10 during the night shift. Further, in order to meet the individual needs of residents with extensive nursing care requirements or higher acuity levels, each nursing home must decrease the established caregiver to resident ratios. On a form provided by the Board, each nursing home must post, in a manner easily visible and readily accessible to residents, families, caregivers, and others on each wing and floor of its facility, the actual staffing ratios, according to the most recently completed cost reporting period, grouped by categories of employees and shifts and a list, in at least 48-point type, of the names of the nursing staff on duty at the beginning of each shift on each such wing or floor. This information must be expressed in actual numbers and as staffing ratios, and must include the actual numbers of additional staff employed to meet the additional needs of residents with extensive nursing care requirements or higher acuity levels. The Commissioner of Health is required to ensure that the nursing home staffing requirements are enforced and, in the case of any violations, the Commissioner may evoke various penalties and remedies and must report compliance and survey citations to the Department of Medical Assistance Services. The Board of Medical Assistance Services must develop a state plan provision for increasing payment for medical assistance services when such facilities are found in compliance with the staffing ratios set forth in subdivision B 12 of § 32.1-127 and for reducing payment of medical assistance for long-term care facilities when such facilities receive citations for violations of the staffing ratios set forth in subdivision B 12 of § 32.1-127. Such provision must provide for 20 percent increases in reimbursement for complying facilities and 20 percent reductions in such reimbursement for facilities receiving survey citations for noncompliance with such staffing ratios. Reimbursement to complying facilities shall be increased by 20 percent for so long as the relevant facility remains in compliance with the staffing ratios. Reimbursement to any facility receiving a citation for staffing ratio violations shall be reduced by 20 percent until the next succeeding survey finds the facility in compliance with the staffing ratio requirements.
Electronic monitoring in nursing homes to detect abuse and neglect of the elderly and disabled residents. Requires the Board of Health to include, in its regulations to license nursing homes, provisions to authorize the use of electronic monitoring devices in the room of a resident of a nursing home or certified nursing facility for the purpose of detecting abuse or neglect of elderly or disabled persons that take into consideration Virginia law relating to nonconsensual interception of wire or electronic communications, privacy rights, notice requirements, covert and noncovert placements of such devices, and potential violations of existing civil and criminal law. Such regulations must include, but need not be limited to, (i) a description of appropriate electronic monitoring devices that may be used; (ii) a consent form recognizing the sole right of a resident who is capable of making an informed decision to make such request and, in the case of a resident who is not capable of making an informed decision, the resident's legally authorized representative; (iii) a form releasing the nursing home or nursing facility from civil liability for violation of the privacy rights of the resident who is the subject of the request as well as any other residents in the same room; (iv) a form to provide other residents in the same room the opportunity to consent to such electronic monitoring devices or to be provided privacy protections from the electronic monitoring devices or to be moved to another room, in so far as possible; (v) a procedure to cease any electronic monitoring upon another resident being moved into the room with the subject resident; (vi) the size and location outside the subject resident's room of conspicuous signs to notify the staff, other residents, and the public of the presence of electronic monitoring devices; (vii) timelines for all procedures that include adequate notice of the commencing of electronic monitoring to the subject resident, all residents, the public and the staff; (viii) the responsibility for reporting abuse and neglect detected via electronic monitoring to adult protective services; (ix) instructions to protect the safety of all residents, staff and the public in the placement, size, and stability of the electronic monitoring devices; (x) protections for the privacy of residents who do not wish to be the subjects of or who object to electronic monitoring; and (xi) penalties for nursing home or certified nursing facility failure to comply with the electronic monitoring requirements. Amendments are provided to the law on Rights and Responsibilities of Patients in Nursing Homes to ensure that residents are notified of the right to request electronic monitoring and to prohibit the transfer or discharge of a patient who requests or indicates that he will request electronic monitoring. A second enactment clause requires the Office of the Attorney General to advise and assist the Board of Health in the development and implementation of the regulations relating to the use of electronic monitoring devices in nursing homes and certified nursing facilities for the purpose of detecting abuse and neglect of the elderly or disabled residents.
State plan for medical assistance services; administrative hold days of nursing facility beds during inpatient hospitalization of recipient. Requires the Board of Medical Assistance Services to include, in the state plan that is submitted to the United States Secretary of Health and Human Services, a provision for payment of medical assistance for reserving beds for up to 12 administrative hold days per year in long-term care facilities for recipients during inpatient hospital admissions at reduced rates when such provision is in compliance with federal law and regulation and approved by the Centers for Medicare and Medicaid Services and agreed to by the participating provider; such provision shall be in addition to and not in lieu of the present regulatory provision for reserving beds in long-term care facilities for recipients during their temporary absences for up to 18 days per year for any reason other than inpatient hospital admissions.
Sale of liquid mercury fever thermometers prohibited. Requires a ban on the sale of liquid mercury fever thermometers in Virginia. Any person violating the prohibition against the sale of liquid mercury fever thermometers will be subject to the general penalties for violations of Title 32.1 statutes and Board of Health regulations, for example, Class 1 misdemeanor and fines of up to $10,000 per violation. A second enactment clause requires the Department of Health, in cooperation with the Department of Environmental Quality, to provide information on the proper disposal of liquid mercury fever thermometers to local governments and other landfill operators for the purpose of informing the public about the proper disposal of liquid mercury fever thermometers.
Medical assistance services; consumer-directed care. Requires the Department of Medical Assistance Services to prepare and submit to the Centers for Medicare and Medicaid Services, as soon as such waiver template shall become available, an application for a new waiver for home- and community-based services that is cost effective and expands consumer-directed care to the maximum extent allowable under federal law and regulation while protecting the health and safety of recipients. Such waiver shall provide for a fiscal agent to handle tax issues and payment of personal attendants on the part of recipients. The waiver application shall provide recipients with flexible choices and personal independence in so far as possible and shall include provisions for family members to deliver the covered services when consistent with and not prohibited by federal law and regulation. This bill is incorporated into SB 1008.
Diseases to be reported to the Board of Health; sepsis and septicemia-related diseases. Requires the Board of Health to include in its list of reportable diseases, sepsis and septicemia-related diseases. In recent years, the incidence of sepsis appears to have increased; however, reliable statistics on this disease may not be readily available. Sepsis is a pathologic condition that results from the presence of microorganisms or their byproducts in the bloodstream. Severe sepsis is commonly known to the layperson as "blood poisoning" and to medical personnel as bacteriemia and septicemia and related diseases, including multiple organ dysfunction syndrome. Physicians and laboratories are required to report the Board's listed diseases. This system of disease reporting is well developed and of long standing in Virginia. Various technical amendments are made to several related statutes to ensure the reporting of the frequently severe illnesses caused by sepsis and septicemia-related diseases and to provide immunity from liability for the reporting of sepsis and septicemia-related diseases and from liability for failure to identify these illnesses when exercising judgement consistent with the competence of a reasonable person practicing the same profession.
Certificate of Public Need. Authorizes the application for and the issuance of a certificate of public need for the conversion of 34 assisted living facility beds to nursing facility or extended care services beds in an existing facility when (i) the application is filed by an existing 134-bed nursing facility located in Orange County within Planning District 9; (ii) the 34 assisted living beds in the existing facility were built to nursing home standards; (iii) the existing facility is operated by a health center commission; and (iv) the existing facility has plans to build a new, more home-like, assisted living facility on adjacent property to replace the current medical model assisted living facility beds.
Hospital-acquired infections. Recognizes the need to ensure the continued quality of the Commonwealth's hospital care and prevent needless hospital-acquired infections among patients. This resolution notes that hospitals are an essential component of health care, providing life-saving inpatient care and important testing and imaging for outpatient care. Further, warm hospital environments, with sick people, contaminated biological materials, and the constant going and coming of the public, encourage the growth of germs. The rates of hospital-acquired infections, commonly referred to as nosocomial infections, have reportedly increased significantly in recent years. The reasons for this increase are many, including the development of antibiotic-resistant bacteria, the nursing shortage and its attendant increased workloads and delegation, budget cuts that postpone needed building maintenance relating to air and water quality, and the failure of many doctors and nurses to scrupulously wash their hands, to only wear scrubs in the hospital, and to always wear clean scrubs. The Clerk of the Senate is directed to forward a copy of this resolution to the Joint Commission on Health Care for consideration during its deliberations.