HD9 - 1995 Annual Report of the Joint Commission on Health Care

Executive Summary:

Authority for Study

The Joint Commission on Health Care was created b the 1992 Session of the Virginia General Assembly, pursuant to Senate Bill 501 and House Bill 1032. This sixteen-member legislative commission, with a separately staffed agency, continues the work of the Commission on Health Care for All Virginians (Senate Joint Resolution 118, 1990).

1995 Commission Activities

The Joint Commission held eight meetings in 1995, as well as one additional meeting in January, 1996, prior to the 1996 Session of the General Assembly. All meetings were held at the General Assembly Building in Richmond. In addition to the agenda items identified below, monthly staff reports were presented at each meeting.

At the March 27th meeting, the final status of the Joint Commission's 1995 legislation, as well as the current status of Joint Commission on Health Care initiatives were reviewed. Additionally, the workplan for 1995 was presented and reviewed.

The April 24th meeting included a presentation by Steven T. Foster, Commissioner of Insurance, on the status of a settlement between the State Corporation Commission and Trigon BlueCross BlueShield to resolve allegations that Trigon had violated state insurance law.

Also at the April 24th meeting, a workplan for the Joint Commission's study on the value and utility of Virginia's cost and quality data initiatives was presented. A panel of experts reacted to the work plan and provided testimony regarding health care data initiatives. The panelists were Robert E. Hurley, Ph.D., Associate Professor, Department of Health Administration, Virginia Commonwealth University (VCU); Louis F. Rossiter, Ph.D., Director, Medical College of Virginia (MCV) Office of Health Care Policy and Research; Ramesh K. Shukla, Ph.D., Director, MCV's Williamson Institute for Health Studies; and Wally R. Smith, M.D., Assistant Professor and Health Administrator, MCV Division of General Medicine.

During the May 22nd meeting, a staff report on telemedicine was presented. In addition, Karen S. Rheuban, M.D., Associate Dean for Continuing Medical Education and Associate Professor of Pediatric Cardiology at the University of Virginia (UVA), presented an example of a telemedicine consultation. Laura Adams, Director of Operations, Telemedicine Center Medical College of Georgia, gave an overview of Georgia's telemedicine program. Following these presentations, a panel of experts provided testimony and answered questions regarding telemedicine. The panelists were Laura Adams, Hudnall R. Croasdale, Director, Council on Information Management, Charles C. Livingston, Director, Department of Information Technology, and Karen S. Rheuban, M.D.

The May 22nd meeting also included a staff report on organizing and funding poison control services in the Commonwealth. The meeting concluded with a presentation by Toby Litovitz, M.D., Director, National Capital Poison Center.

The July 24th meeting included presentations on the organization and effectiveness of health workforce iniatives and the value and utility of current health care cost and quality data iniatives. A summary of the public comments received on the two studies presented at the May 22nd meeting was provided.

During the August 28th meeting, Jack O. Lanier, DR.P.H., FACHE, Chairman and Professor, Department of Preventive Medicine, Medical College of Virginia/VCU, gave an overview of Virginia's Area Health Education Centers Program. The August 28th meeting also included reports on obstetrical care in rural areas and long-term care pharmacy operations. Lastly, a summary of public comments received on the reports presented at the previous meeting was provided.

The October 2nd meeting was attended by members of the Health and Human Resources Subcommittee of Senate Finance and House Appropriations and the Joint Subcommittee on Deinstitutionalization. A status report was presented by Robert C. Metcalf, Director, Department of Medical Assistance Services on Federal Medicaid Block Grant Proposals and the Department's proposed Medicaid Managed Care Implementation Plan. Timothy A. Kelly, Ph.D., Commissioner, Department of Mental Health, Mental Retardation and Substance Abuse Services, presented an update on the mental health component of the Medallion II project. The executive directors of the Virginia Association of Community Services Boars and the Virginia Alliance for the Mentally III commented on his report.

Staff reports on: (i) the impact of third party reimbursement on pharmacies; and (ii) pharmaceutical care delivery programs also were presented at the October 2nd meeting.

The November 20th meeting included a presentation by Katharine M. Webb, Senior Vice President of the Virginia Hospital and Health care Association (VHHA) and Richard G. Steele, Executive Vice President of Southeastern Institute of Research, Inc., on a study commissioned by the VHHA regarding Virginia's consumer and business interests in cost and quality information. A brief follow-up on the cost and quality study also was presented.

Commission of Insurance, Steven T. Foster, reported on the Bureau of Insurance's study of individual insurance market reforms and other related insurance issues. Additionally, a staff report was presented on the pre-hospital and inter-hospital triage of trauma patients in Virginia. Lastly, summaries of public comments on the obstetrical care and long-term care pharmacy operations studies were provided.

Secretary Kay Coles James presented a report on her proposal for a Medicaid block grant planning process at the December 4th meeting. A decision matrix which summarized each issue studied by the Joint Commission during 1995, along with a recap of the options presented for addressing each issue, was presented and discussed.

Recommendations regarding each of the various issues studied by the Joint Commission throughout 1995, as well as potential legislation to be introduced during the 1996 Session of the General Assembly were presented at the meeting on January 11, 1996. Final decisions regarding potential 1996 legislation were made.