Certificates of public need; creates three-phase process to sunset requirements for medical care. (HB193)

Introduced By

Del. John O'Bannon (R-Richmond) with support from co-patron Del. Dickie Bell (R-Staunton)

Progress

Introduced
Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law

Description

Certificates of public need. Creates a three-phase process to sunset certificate of public need requirements for many categories of medical care facilities and projects, with the requirement for a certificate of public need (i) for the establishment of a new imaging service or addition of new equipment for imaging services eliminated beginning July 1, 2016, for ambulatory and outpatient surgery centers eliminated beginning July 1, 2017, and (iii) for hospitals and all other categories of projects other than nursing homes and facilities and equipment for open heart surgery and organ or tissue transplant services eliminated beginning July 1, 2018. The bill also creates a new permitting process for categories of facilities and projects exempted from the certificate of public need process that requires the Commissioner of Health to issue a permit but allows the Commissioner to condition a permit(a)on the agreement of the applicant to provide a specified level of care at a reduced rate to indigents, accept patients requiring specialized care, or facilitate the development and operation of primary medical care services in designated medically underserved areas of the applicant's service area or (b) on compliance of the applicant with quality of care standards. The bill allows the Commissioner to refuse to issue a permit if he determines that the project for which the permit is sought would be detrimental to the provision of health services in underserved areas of the Commonwealth. Read the Bill »

Status

03/03/2016: Failed to Pass in Committee

History

DateAction
12/27/2015Committee
12/27/2015Prefiled and ordered printed; offered 01/13/16 16100398D
12/27/2015Referred to Committee on Health, Welfare and Institutions
01/14/2016Assigned to sub: Subcommittee Subcommittee #3
01/14/2016Assigned to sub: Subcommittee #3
01/14/2016Assigned HWI sub: Subcommittee #3
01/27/2016Subcommittee recommends reporting with amendment(s) (4-Y 1-N)
01/28/2016Committee draft substitute available 16104784D-H1
02/04/2016Reported from Health, Welfare and Institutions with substitute (12-Y 10-N) (see vote tally)
02/04/2016Committee substitute printed 16105052D-H1
02/05/2016Read first time
02/08/2016Passed by until Thursday, February 11, 2016
02/11/2016Passed by for the day
02/12/2016Read second time
02/12/2016Committee substitute agreed to 16105052D-H1
02/12/2016Engrossed by House - committee substitute (50-Y 47-N 1-A) HB193H1
02/12/2016VOTE: ENGROSSMENT (50-Y 47-N 1-A) (see vote tally)
02/15/2016Passed by temporarily
02/15/2016Read third time and passed House (52-Y 46-N 1-A)
02/15/2016VOTE: PASSAGE (52-Y 46-N 1-A) (see vote tally)
02/16/2016Constitutional reading dispensed
02/16/2016Referred to Committee on Education and Health
02/17/2016Impact statement from VDH (HB193H1)
03/03/2016Continued to 2017 in Education and Health (15-Y 0-N) (see vote tally)

Video

This bill was discussed on the floor of the General Assembly. Below is all of the video that we have of that discussion, 1 clip in all, totaling 10 minutes.

Transcript

This is a transcript of the video clips in which this bill is discussed.

THE CARVE OUT, IF YOU HAVEN'T SEEN THE MAP, COUNTIES LIKE CAMPBELL, WASHINGTON, FLOYD, FRANKLIN, ARE ALL INCLUDED IN THESE MSAs AND WOULD NOT BE PART OF THE RULE CARVE OUT THAT GENTLEMAN FROM HENRICO ELUDED TO. ECONOMICS ARE SIMPLY DIFFERENT IN SMALLER MARKETS. OTHER TWO POINTS ARE MY CONCERNS ABOUT THE PROCESS, HOW THE PROCESS NEEDS IMPROVEMENTS. AND THIRD, AND IMPORTANTLY, THERE IS CHARITY CARE AND HOW THE PROVISIONS MUST BE CHANGED WELL, TO MY SURPRISE, GENTLEMAN FROM HENRICO AGREED WITH EVERY POINT. NOW, WE KNOW THERE IS A LOT OF WORK THAT NEEDS TO BE DONE AND WE DIDN'T AGREE ON SPECIFIC LANGUAGE BUT AT LEAST SAID WE NEED TO WORK TOGETHER TO TRY TO FIGURE OUT HOW TO FIX THIS BILL AND IMPROVE IT IN THE SENATE AND SO THAT IS WHY, MR. SPEAKER, LADIES AND GENTLEMEN OF THE HOUSE I RELUCTANTLY WILL BE SUPPORTING 193.

Del. Bill Howell (R-Fredericksburg): GENTLEMAN FROM COLONIAL HEIGHTS MR. COX.

Del. Kirk Cox (R-Colonial Heights): THANK YOU, MR. SPEAKER, I'D LIKE TO SPEAK TO THE BILL.

Del. Bill Howell (R-Fredericksburg): GENTLEMAN HAS THE FLOOR.

Del. Kirk Cox (R-Colonial Heights): I RISE IN SUPPORT OF HB 193. I WANT TO THANK THE LEADERSHIP ON THIS ISSUE. WE CONSIDER A LOT OF LEGISLATION TEAR, EVERYTHING FROM BILLS AND TRAFFIC LAWS, IMPORTANT BILLS LIKE ON GRASS CUTTING, AND THOSE ON LOCAL GOVERNMENT, BILLS ON ENERGY POLICY AND BANKING. THEY'RE ALL IMPORTANT TO SOME DEGREE BUT EVERY NOW AND THEN WE HAVE A CHANCE TO VOTE ON SOMETHING CONSIDERING MEANINGFUL. DELEGATE O'BANNONTALKED ABOUT THE FAITH REFORMS AND RURAL PROVIDERS AND KEY SERVICES AND DELEGATE BYRON SHARED WITH YOU INTERESTING FACTS THAT ADD TO THIS DISCUSSION. OF COURSE THIS HAS BEEN A VERY, VERY HEATED DEBATE. AS A MATTER OF FACT, A COMMERCIAL IS PROBABLY ONE OF THE WORST I HAVE SEEN IN 26 YEARS SINCE I'VE BEEN THERE. DOWN HERE, BUT TODAY I WANT TO CASE FOR MEANINGFUL ACTIONS. THE MEDICAL SOCIETY OF VIRGINIA, THE THOMAS JEFFERSON INSTITUTE, VIRGINIA FOREST FOUNDATION, AND DISCUSS WHY WE'RE MAKING THE WE BELIEVE LEADS TO BETTER SERVICES AND LOWER COSTS. AND PEOPLE SAY HEALTH CARE IS NOT A FREE MARKET. YOU KNOW, THAT MAY BE TRUE. IT DOES NOT MEAN WE SHOULD NOT TRY TO MAKE IT A FREE MARKET. VERY HEARD PEOPLE SAY REPUBLICANS DO NOT OFFER SOLUTIONS ON HEALTH CARE. HERE, WE STAND WITH A SOLUTION ON HEALTH CARE. WE CAN PROVIDE PATIENTS WITH ACCESS TO SERVICES, KEEPING COSTS LOWER WITH MORE COMPETITION. IF WE DON'T ACT TODAY, THEN, IT'S GOING TO END NOW. THIS HAS A LEADING VOICE AND IF YOU LOOK AT MAJOR REFORMS, THEY STARTED IN THIS HOUSE. IF WE DO NOT MOVE FORWARD, NO ONE ELSE WILL. DELEGATE O'BANNONIS READY TO MOVE FORWARD. LET ME CONCLUDE WITH THIS, A GOOD BILL WILL IMPROVE ACCESS, INCREASE COMPETITION AND LOWER COSTS. IT'S TRUE AND MEANINGFUL REFORM, I HOPE YOU'LL SUPPORT THE BILL.

Del. Bill Howell (R-Fredericksburg): GENTLEMAN FROM CHESAPEAKE, MR. SPRUILL.

[Unknown]: THANK YOU, MR. SPEAKER, LET'S TALK ABOUT THE BILLS AS FA R AS ALL THREE. THE BILLS FIRST CAME BEFORE US, WE HAD SEVERAL MEETINGS IN MY OFFICE, HESTER AND DR. O'BANNONCAME. THE BILLS WERE VOTED 21 AND 1, 1 MEMBER ON OUR SIDE VOTED NO. AND THAT IS THE BILL IS TO ALLOW THIS WOULD HURT. THE VIEWERS TO TAKE IT OUT OF IT AND TO MY SURPRISE, AS YOU HEARD A COUPLE YEARS AGO, I TALK ABOUT MY GRAND DAUGHTER, BORN WITH NO BOTTOM FACE, THAT HOSPITAL WAS RESPONSIBLE FOR HER LIVING TODAY. THAT HOSPITAL WE HAVE 14 KIDS WHO HAVE HAD THE SAME PHYSICIAN AS MY GRANDDAUGHTER, THEY ALL DIED AND SHE'S THE LAST ONE STANDING F I HAD TO PICK A HOUSE BILL UP, IT WOULD BE. NOW GETTING BACK POT POINT IS THIS. MY FRIEND SAYS WE'VE GOT TO DO IT NOW. IF DR. O'BANNON'S BILL WAS SO GOOD, LET'S SEND THE BILL OVER TO THE SENATE. THEY CAN PART OF HIS BILL AND PUT IT IN. WE DON'T HAVE TO DO IT HERE, IF WE HAVE TO DO IT HERE, WHY THE WORLD ARE WE ALLOWING THE SENATE TO FIX OUR BILL? WHY ARE WE SENDING THIS BILL DOWN TO THE HOUSE OF LAWS TO DO OUR JOB? TELL ME THAT? BECAUSE WE DO NOT HAVE ENOUGH VOTES ON THAT SIDE OR THIS SIDE TO PASS, OR KILL THAT BILL F THAT BILL WAS SO GREAT, HOW COME VOTE SAID GET IT OUT OF HERE? WHY? BECAUSE WE ALL VOTED FOR THE BILL. SO, WHAT ARE THE PROBLEMS? WHY CAN'T WE FIX IT HERE? WHY CAN'T WE? WHY CAN'T YOU SAY WE DON'T NEED YOU AND WE'RE GOING TO FIX IT. WHY? BECAUSE THERE ARE PROBLEMS WITH THE BILL. SO REMEMBER, WE'RE NOT GOING TO DO FOR IT. WE'RE GOING TO SUPPORT THE BILL. I HOPE THEY'RE GOING TO THE SENATE IF THERE ARE GOOD PARTS THEY CAN PUT IT DOWN IN THAT SIDE. DON'T VOTE FOR THE BILL. THANK YOU, MR. SPEAKER. SPEAKING TO THE BILL.

Del. Bill Howell (R-Fredericksburg): GENTLEMAN HAS THE FLOOR.

[Unknown]: MR. SPEAKER IT'S BEEN A LONG TIME SINCE I HAD A PERFECT BILL. BUT WE HAVE TWO HOUSES. SO WITH ALL DUE RESPECT I ASK YOU TO VOTE YES TODAY AND ADVANCE THE PROCESS. WE HAVE AMPLE OPPORTUNITY IN THE BILL TO MAKE THE RURAL PROTECTIONS BETTER AND OPPORTUNITY TO TAKE PROVISIONS AND FINE TUNE THEM. WITHOUT THIS BILL, WE DON'T HAVE THE OPPORTUNITY TO ACTUALLY ENGAGE IN A MEANINGFUL REFORM TO THIS PROCESS WHICH WE, WHATEVER SIDE OF IT YOU'RE ON, YOU REALIZE IT IS A IT IS A MONOPOLY. THEY CAN GET CARE THAT IS MEANINGFUL AND LESS EXPENSIVE AND PROTECT OUR HOSPITALS. I HOPE YOU WILL VOTE FOR THIS BILL.

Del. Bill Howell (R-Fredericksburg): GENTLEMAN FROM HANOVER, MR. PEACE.

Del. Chris Peace (R-Mechanicsville): MR. SPEAKER, I MOVE HOUSE BILL 193 BE TAKEN BY TEMPORARILY.

Del. Bill Howell (R-Fredericksburg): GENTLEMAN FROM HENRICO, MR. O'BANNON.