2013 -- S 0832

=======

LC01655

=======

STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

____________

A N A C T

RELATING TO HEALTH AND SAFETY - HEALTH ANALYTICS, POLICY AND

PLANNING COMMISSION ACT

     Introduced By: Senators Goldin, Cool Rumsey, Satchell, Miller, and Ottiano

     Date Introduced: April 04, 2013

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

1-1

     WHEREAS, Rhode Island’s health care system is an integral part of the state, meeting

1-2

the critical need of health services for its residents but also serving as a major economic engine

1-3

supporting research, technology development, education and service sector employment; and

1-4

     WHEREAS, The implementation of the Patient Protection and Affordable Care Act is the

1-5

first in a series of steps necessary to reform the state’s health care system in a manner that

1-6

improves health outcomes, improves the patient experience and lowers the overall cost of care;

1-7

and

1-8

     WHEREAS, Agencies and departments with influence over the state’s health care system

1-9

have different areas of focus, responsibility, authority and expertise in the system, while none

1-10

have a holistic, system-wide focus; and

1-11

     WHEREAS, Systematic collection and analysis of health data has not been fully utilized

1-12

to address policy and regulatory activities in the state; and

1-13

     WHEREAS, The development of a comprehensive, coordinated state health plan is a

1-14

critical need in addressing the challenges facing the state’s health system;

1-15

     THEREFORE, The General Assembly finds it necessary and proper to enact the

1-16

following amendments to the General Laws.

1-17

     SECTION 1. Chapter 23-81 of the General Laws entitled "RHODE ISLAND

1-18

COORDINATED HEALTH PLANNING ACT OF 2006" is hereby amended to read as follows:

2-19

     CHAPTER 23-81

2-20

Rhode Island Coordinated Health Planning Act of 2006

2-21

     CHAPTER 81

2-22

HEALTH ANALYTICS, POLICY AND PLANNING COMMISSION ACT

2-23

     23-81-1. Short title. -- This chapter shall be known as the "Rhode Island Coordinated

2-24

Health Planning Act of 2006." "Health Analytics, Policy and Planning Commission Act."

2-25

     23-81-2. Legislative findings. -- It is hereby found and declared:

2-26

      (a) The vast majority of Rhode Islanders believe that quality, affordable health care

2-27

should be available to all in our state;

2-28

      (b) Our current health care crisis affects all facets of Rhode Island's economy, with a

2-29

particular burden on small business owners, young people, and those approaching retirement;

2-30

      (c) A majority of Rhode Islanders believe that the state government has a significant role

2-31

to play in solving this health care crisis;

2-32

      (d) The current state health care infrastructure is fragmented with an array of state

2-33

departments and offices carrying out health care planning, along with a myriad of private efforts,

2-34

all with a lack of coordination;

2-35

      (e) Because an essential component of health planning is resource allocation, there is a

2-36

need to professionalize the health services council and revitalize the certificate of need process;

2-37

      (f) Recognizing that many departments of state government are involved in the

2-38

collection of data and information related to health care, health care outcomes, health care

2-39

insurance, consumer behavior and trends, and that accurate and accessible, collection and housing

2-40

of this information is necessary for the general assembly to enact useful health care policy;

2-41

      (g) Rhode Island's small size makes us the perfect laboratory to create a unified health

2-42

care system, planned and coordinated with a functioning public/private partnership, with broad

2-43

representation of all of the health care stakeholders;

2-44

      (h) The general assembly finds that the people of this state have a fundamental interest in

2-45

the establishment of a comprehensive strategic health care planning process and the preparation,

2-46

maintenance, and implementation of plans to improve the quality, accessibility, portability, and

2-47

affordability of health care in Rhode Island; that the continued growth, viability and development

2-48

of the health care infrastructure by the private and public sectors requires effective planning by

2-49

the state; and that state and local plans and programs must be properly coordinated with the

2-50

planning requirements and programs of the federal government; and

2-51

      (i) The coordinated health planning process should create usable and dynamic guidance

2-52

that helps design a health care system and improves the health of Rhode Islanders. ; and

3-53

     (j) Systematic collection and analysis of health data has not been fully utilized to address

3-54

policy and regulatory activities in the state.

3-55

     23-81-3.1. Establishment of health care planning and accountability advisory

3-56

council. -- Contingent upon funding:

3-57

      (a) The health care planning and accountability advisory council shall be appointed by

3-58

the secretary of the executive office of health and human services and the health insurance

3-59

commissioner, no later than September 30, 2011, to develop and promote recommendations on

3-60

the health care system in the form of health planning documents described in subsection 23-81-

3-61

4(a).

3-62

      (b) The secretary of the executive office of health and human services and the health

3-63

insurance commissioner shall serve as co-chairs of the health care planning council.

3-64

      (c) The department of health, in coordination with the executive office of health and

3-65

human services and the office of the health insurance commissioner, shall be the principal staff

3-66

agency of the council to develop analysis of the health care system for use by the council,

3-67

including, but not limited to, health planning studies and health plan documents; making

3-68

recommendations for the council to consider for adoption, modification and promotion; and

3-69

ensuring the continuous and efficient functioning of the health care planning council.

3-70

      (d) The health care planning council shall consist of, but not be limited to, the following:

3-71

      (1) Five (5) consumer representatives. A consumer is defined as someone who does not

3-72

directly or through a spouse or partner receive any of his/her livelihood from the health care

3-73

system. Consumers may be nominated from the labor unions in Rhode Island; the health care

3-74

consumer advocacy organizations in Rhode Island, the business community; and organizations

3-75

representing the minority community who have an understanding of the linguistic and cultural

3-76

barriers to accessing health care in Rhode Island;

3-77

      (2) One hospital CEO nominated from among the hospitals in Rhode Island;

3-78

      (3) One physician nominated from among the primary care specialty societies in Rhode

3-79

Island;

3-80

      (4) One physician nominated from among the specialty physician organizations in Rhode

3-81

Island;

3-82

      (5) One nurse or allied health professional nominated from among their state trade

3-83

organizations in Rhode Island;

3-84

      (6) One practicing nursing home administrator, nominated by a long-term care provider

3-85

organization in Rhode Island;

3-86

      (7) One provider from among the community mental health centers in Rhode Island;

4-87

      (8) One representative from among the community health centers of Rhode Island;

4-88

      (9) One person from a health professional learning institution located in Rhode Island;

4-89

      (10) Director of the Department of Health;

4-90

      (11) Director of the department of human services or designee;

4-91

      (12) CEOs of each health insurance company that administers the health insurance of ten

4-92

percent (10%) or more of insured Rhode Islanders;

4-93

      (13) The speaker of the house or designee;

4-94

      (14) The house minority leader or designee;

4-95

      (15) The president of the senate or designee;

4-96

      (16) The senate minority leader or designee; and

4-97

      (17) The health care advocate of the department of the attorney general.

4-98

     23-81-3.2. Commission established. – (a) In order to create a state entity responsible for

4-99

a holistic approach to the development of policy and planning for the state’s healthcare system,

4-100

including the analysis of relevant data to guide the planning and policy development, there is

4-101

hereby established within the executive branch of state government a health analytics, policy and

4-102

planning commission to serve as the principal statewide health policy development and planning

4-103

entity consisting of eleven (11) members:

4-104

     (1) The secretary of health and human services;

4-105

     (2) The health insurance commissioner;

4-106

     (3) The director of the department of health;

4-107

     (4) The director of the department of administration or his or her designee whose

4-108

principle duties relate to health and/or health insurance;

4-109

     (5) The health care advocate of the department of the attorney general; and

4-110

     (6) Six (6) members of the public with expertise in the health care system, appointed by

4-111

the governor with the advice and consent of the senate, and in accordance with chapter 28-5.1,

4-112

two (2) of whom shall serve an initial term of three (3) years, two (2) of whom shall serve an

4-113

initial term of two (2) years and one of whom shall serve an initial term of one year, and until his

4-114

or her successor is appointed and qualified. Thereafter, the members appointed pursuant to this

4-115

subsection shall serve for a term of three (3) years and until his or her successor is appointed and

4-116

qualified.

4-117

     (b) The governor shall select the chair of the commission from the appointed public

4-118

members.

4-119

     (c) The governor shall consider the expertise of the other members of the commission and

4-120

attempt to make appointments so that the commission’s composition reflects a range and diversity

4-121

of skills, backgrounds, and geographic and stakeholder perspectives.

5-1

     (d) A member of the commission shall not be employed by, a consultant to, a member of

5-2

the board of directors of, affiliated with, or otherwise a representative of, an insurer, a health

5-3

insurance agent or broker, a health care provider, or a health care facility or health clinic while

5-4

serving on the commission. A member of the commission shall not be a member, a board

5-5

member, or an employee of a trade association of insurers, health facilities, health clinics, or

5-6

health care providers while serving on the board or on the staff of the exchange. A member of the

5-7

commission shall not be a health care provider unless he or she receives no compensation for

5-8

rendering services as a health care provider and does not have an ownership interest in a

5-9

professional health care practice.

5-10

     (e) Six (6) members shall constitute a quorum of the health analytics, policy and planning

5-11

commission.

5-12

     (f) The commission shall not abridge the powers, duties and authorities of any other state

5-13

entity in the administration, operations or management of duly authorized programs.

5-14

     23-81-3.3. Authority of commission. -- The commission is authorized and empowered

5-15

to hold public and private hearings, to enter into contracts, within the limit of funds available for

5-16

these contracts, with individuals, organizations, and institutions for services furthering the

5-17

objectives of the commission's programs; to enter into contracts, within the limit of funds

5-18

available for these contracts, with local and regional associations for co-operative endeavors

5-19

furthering the objectives of the commission's programs; to accept gifts, contributions, and

5-20

bequests of unrestricted funds from individuals, foundations, corporations, and other

5-21

organizations or institutions which shall be deposited as general revenues; to make and sign any

5-22

agreements and to do and perform any acts that may be necessary to carry out the purposes of this

5-23

chapter. The commission may request and shall receive from any department, division, board,

5-24

bureau, commission, or agency of the state any assistance and data that will enable it properly to

5-25

carry out its powers and duties. The commission may empanel any advisors that it deems

5-26

necessary.

5-27

     23-81-4. Powers of the health care planning and accountability advisory council.

5-28

Powers of the health analytics, policy and planning commission. -- Powers of the council

5-29

commission shall include, but not be limited to the following:

5-30

      (a) The authority to develop and promote studies, advisory opinions and to recommend a

5-31

unified health plan on the state's health care delivery and financing system, including but not

5-32

limited to:

5-33

      (1) Ongoing assessments of the state's health care needs and health care system capacity

5-34

that are used to determine the most appropriate capacity of and allocation of health care

6-1

providers, services, including transportation services, and equipment and other resources, to meet

6-2

Rhode Island's health care needs efficiently and affordably. These assessments shall be used to

6-3

advise the "determination of need for new health care equipment and new institutional health

6-4

services" or "certificate of need" process through the health services council;

6-5

      (2) The establishment of Rhode Island's long range health care goals and values, and the

6-6

recommendation of innovative models of health care delivery, that should be encouraged in

6-7

Rhode Island;

6-8

      (3) Health care payment models that reward improved health outcomes;

6-9

      (4) Measurements of quality and appropriate use of health care services that are designed

6-10

to evaluate the impact of the health planning process;

6-11

      (5) Plans for promoting the appropriate role of technology in improving the availability

6-12

of health information across the health care system, while promoting practices that ensure the

6-13

confidentiality and security of health records; and

6-14

      (6) Recommendations of legislation and other actions that achieve accountability and

6-15

adherence in the health care community to the council's commission's plans and

6-16

recommendations.

6-17

      (b) Convene meetings of the council commission no less than every sixty (60) days,

6-18

which shall be subject to the open meetings laws and public records laws of the state, and shall

6-19

include a process for the public to place items on the council's commission's agenda.

6-20

      (c) Appoint advisory committees as needed for technical assistance throughout the

6-21

process.

6-22

      (d) Modify recommendations and plans in order to reflect changing health care systems

6-23

needs.

6-24

      (e) Promote responsiveness to recommendations among all state agencies that provide

6-25

health service programs, not limited to the five (5) four (4) state agencies coordinated by the

6-26

executive office of health and human services, the office of health insurance commissioner, and

6-27

the department of administration.

6-28

      (f) Coordinate the review of existing data sources from state agencies and the private

6-29

sector that are useful to developing a unified health plan.

6-30

      (g) Formulating, testing, and selecting policies and standards that will achieve desired

6-31

objectives.

6-32

     (h) Managing the analysis and reporting of health data and information.

6-33

      (h) (i) Provide an annual report each July, after the convening of the council

6-34

commission, to the governor and general assembly on implementation of the plan adopted by the

7-1

council commission. This annual report shall:

7-2

      (1) Present the strategic recommendations, updated annually;

7-3

      (2) Assess the implementation of strategic recommendations in the health care market;

7-4

      (3) Compare and analyze the difference between the guidance and the reality;

7-5

      (4) Recommend to the governor and general assembly legislative or regulatory revisions

7-6

necessary to achieve the long-term goals and values adopted by the council commission as part of

7-7

its strategic recommendations, and assess the powers needed by the council or governmental

7-8

entities of the state deemed necessary and appropriate to carry out the responsibilities of the

7-9

council commission. The initial priority of the council shall be an assessment of the needs of the

7-10

state with regard to hospital services and to present recommendations, if any, for modifications to

7-11

the Hospital Conversion Act and the Certificate of Need Program to execute the strategic

7-12

recommendations of the council. The council shall provide an initial report and recommendations

7-13

to the governor and general assembly on or before March 1, 2013.

7-14

      (5) Include the request for a hearing before the appropriate committees of the general

7-15

assembly.

7-16

      (6) Include a response letter from each state agency that is affected by the state health

7-17

plan describing the actions taken and planned to implement the plans plan's recommendations.

7-18

     23-81-5. Implementation of the council recommendations. Implementation of the

7-19

commission plans and policies. -- In order to promote effective implementation of the unified

7-20

health plan, the council commission shall recommend to the governor, the general assembly, and

7-21

other state agencies actions that may be taken to promote and ensure implementation of the

7-22

council's policy and program guidance. The secretary of the executive office of health and human

7-23

services, and the health insurance commissioner, and the director of administration, as members

7-24

of the commission, as co-chairs, of the council, shall use the powers of their offices to implement

7-25

the recommendations adopted by the council commission, as deemed appropriate, or as required

7-26

by the governor or general assembly. The secretary shall coordinate the implementation of the

7-27

recommended actions by the state agencies within the executive office of health and human

7-28

services.

7-29

     23-81-6. Funding Appropriations. -- The executive office of health and human services

7-30

may provide funding to carry out the requirements of this chapter. The general assembly shall

7-31

annually appropriate such sums as it may deem necessary to enable the commission to carry out

7-32

its assigned purposes; and the state controller is hereby authorized and directed to draw his or her

7-33

orders upon the general treasurer for the payment of such sums appropriated or so much thereof

7-34

as may be from time to time required, upon receipt by him or her of proper vouchers approved by

8-1

the chairperson, or the executive director as delegated by section 23-81-7.

8-2

     23-81-7. Executive director - Employees. -- The health analytics, policy and planning

8-3

commission shall appoint an executive director, who shall not be subject to the provisions of

8-4

chapter 4 of title 36; and shall set his or her compensation and terms of employment. The

8-5

executive director, through a vote of the commission, may be delegated to act as authorized agent

8-6

for the approval of all fiscal and personnel documents requiring an authorized signature. The

8-7

commission shall also cause to be employed such staff, and technical and professional

8-8

consultants, as may be required to carry out the powers and duties set forth in this chapter.

8-9

     23-81-8. Health data and information analysis and reporting. – No later than January

8-10

1, 2014, the commission shall report to the general assembly and the governor of the general

8-11

status of analyses and reports relating to follow subject areas:

8-12

     (1) Financial and quality reports for licensed health care providers;

8-13

     (2) Health outcomes; and

8-14

     (3) Health expenditures.

8-15

     The report shall provide recommendations for the transfer of the analytical and reporting

8-16

process to the commission, including the transfer of any employees, funding and/or authorities to

8-17

the commission.

8-18

     SECTION 2. This act shall take effect upon passage.

=======

LC01655

========

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO HEALTH AND SAFETY - HEALTH ANALYTICS, POLICY AND

PLANNING COMMISSION ACT

***

9-1

     This act would replace the health care planning and accountability advisory council with

9-2

the health analytics, policy and planning commission.

9-3

     This act would take effect upon passage.

=======

LC01655

=======