RD6 - Annual Report of the Joint Commission on Health Care

Executive Summary:

The Joint Commission on Health Care (JCHC), a standing Commission of the General Assembly, was established in 1992 to continue the work of the Commission on Health Care for All Virginians. The statutory authority for JCHC in Code of Virginia, Title 30, Chapter 18, states in part: “The purpose of the Joint Commission on Health Care is to study, report, and make recommendations on all areas of health care provision, regulation, insurance, liability, licensing, and delivery of services." As of July 1, 2003, JCHC assumed the responsibilities of the Joint Commission on Behavioral Health Care.

2003 Activities of the Joint Commission on Health Care

JCHC met four times between May and December 2003, and the findings of the following staff reports were considered:

• Authorization for Electronic Monitoring in Nursing Facilities (SB 922 – 2003)

• Review of Medicaid Reimbursement of Physicians (SJR 38/HJR 42 – 2002)

• Review of Prescriptive Authority for Nurse Practitioners (HB 818 – 2000)

• Healthy Lives Prescription Plan (SB 1341/HB2225 – 2003)

JCHC members also considered issues presented during the following presentations:

• Plan for Developing the Preferred Drug List Program for Medicaid by Patrick W. Finnerty of the Department of Medical Assistance Services

• Collaborative Public/Private Programs to Improve Health Care Access in Rural Virginia by Rene Cabral-Daniels of the Department of Health and Rebecca J. Davis, Ph.D. of the Virginia Rural Health Association

• Making Prostate Cancer History in Virginia by Carol Noggle of the Virginia Prostate Cancer Coalition

• Update on Family Access to Medical Insurance Security by Linda L. Nablo of the Department of Medical Assistance Services

• Discussion of Preferred Drug List Implementation by Sam Musynski of the American Psychiatric Association

• Prescription Drug Access Partnership Initiative by Deborah D. Oswalt of the Virginia Health Care Foundation

• Update on Medicaid Transportation by Patrick W. Finnerty of the Department of Medical Assistance Services and John Shermyen of LogistiCare

• Community-Based Health Improvement Initiatives by Randolph L. Gordon, M.D., of the Virginia Center for Healthy Communities

• Olmstead Plan for Virginia by Jerry Deans of the Department of Mental Health, Mental Retardation and Substance Abuse Services

• Annual Report of Virginia Health Information by Richardson Grinnan, M.D., of the Virginia Health Information Board

JCHC Subcommittees. The Joint Commission on Health Care has established two ongoing, standing subcommittees – the Long-Term Care Subcommittee and the Behavioral Health Care Subcommittee. During 2003, the Long-Term Care Subcommittee considered such issues as providing incentives to purchase long-term care insurance, designing Virginia’s Olmstead Plan, addressing the nursing shortage, and financing long-term care. The Behavioral Health Care Subcommittee monitored the development of the preferred drug list for Medicaid, reviewed the reinvestment and restructuring initiatives being undertaken in the mental health arena, and finalized a three-year study of mental health and substance abuse services for adult and juvenile offenders.

Legislation Proposed for the 2004 General Assembly Session

The JCHC legislative package, as determined during its meeting in November, included two bills, a resolution, and ten budget amendments (both House and Senate amendments will be submitted). (Three additional resolutions, requested by a JCHC member to address proposed budget amendments, will be considered during a meeting on January 13, 2004.)

Bills and Joint Resolution. The legislative package includes a bill to convert the tax deduction for purchase of a long-term care insurance policy to be a tax credit of ten percent of the premium paid, a bill to add language to the statutory provisions for JCHC to state explicitly the responsibility of state entities to provide assistance to the Commission, and a resolution to request the Board of Nursing and the Board of Medicine to collect information on nurse practitioner prescriptive authority.

Budget Amendments. Six budget amendments request funding for the following health care services: to support the Rx Partnership, to increase Medicaid physician reimbursement, to increase Medicaid personal care reimbursement, to develop a methodology for setting reimbursement rates for personal care providers, to increase the personal maintenance allowance for home and community-based service waivers for Medicaid, and to establish a public education/awareness campaign regarding the benefits of long-term care insurance coverage. Four budget amendments include language-only provisions that address mental health and substance abuse services provided for offenders.