HD29 - Alternatives for a Long-Term State Indigent Health Care Policy

  • Published: 1986
  • Author: General Assembly. Joint Subcommittee
  • Enabling Authority: House Joint Resolution 129 (Regular Session, 1984)

Executive Summary:
SUMMARY OF RECOMMENDATIONS

• A Governor's Task Force representing the public and private sectors should be established to provide a focal point for broad consideration of indigent health are issues.

• The Code of Virginia should be modified to specify that the Health Services Cost Review Council shall develop, in consultation with the Auditor of Public Accounts, standard accounting definitions to be used by hospitals in reporting uncompensated balances as contractual allowances, bad debt or charity care.

• The teaching hospitals should be required to adopt the Auditor's proposed cost report format in data submissions to the legislative money committees.

• The Bureau of Insurance of the State Corporation Commission should conduct a comprehensive analysis of the degree of health insurance coverage of the general population.

• The Secretary of Human Resources should designate staff within the secretariat to conduct an on-going review and analysis of other states' actions in response to indigent health care issues.

• Administration of the SLH Program should be transferred from the Department of Social Services to the Department of Medical Assistance on July 1, 1987.

• An amount of $525,000 in general funds should be transferred from the SLH Program to the Department of Mental Health and Mental Retardation for the provision of inpatient mental health services. An additional $105,000 in general funds per year should be appropriated to DMHMR to compensate for the difference in local match rates for the SLH and Community Services Board programs.

• The Department of Medical Assistance should submit a report to the General Assembly by October 1986 which identifies a strategy for setting uniform eligibility criteria under the SLH Program, offers recommendations concerning the SLH hospital reimbursement structure, and the value of applying Medicaid cost-containment features to the SLH Program. Concurrent with implementation of these recommendations, the State match for the SLH program should be increased from 75% to 80% in the second year of the 1986-88 biennium.

• The Joint Legislative Audit and Review Commission should be asked to conduct a study of formulas used in the SLH Program and the State/Local Cooperative Health Department Program, and make recommendations to improve both formulas.

• The State should appropriate $1.0 million in general funds for four model projects in FY 1988 in order to encourage localities to employ innovative techniques when addressing the health care needs of their low-income population.

• The Study Committee should support by resolution the Virginia Hospital Association's efforts to overcome market barriers that exist for small firms in the purchase of reasonably priced health insurance.