Introduced By: Senators Fogarty, Roberts, Izzo, Walton, Irons, et al.
Date Introduced : January 27, 1998
It is enacted by the General Assembly as follows:
SECTION 1. Title 23 of the General Laws entitled "Health and Safety" is hereby amended by adding thereto the following chapter:
{ADD 23-17.17-1. Purpose. -- ADD} {ADD The legislature finds that: ADD}
{ADD (A) The health care service system is under transition; ADD}
{ADD (B) The growth of managed care and utilization review, the merger of facilities and regionalization of care systems, and increased competition and conversions from nonprofit to profit status, are evidence of this transition; ADD}
{ADD (C) The changes have created strong public interest in issues relating to quality of care and access to health services, and require careful monitoring of quality of care issues and new and improved public sector approaches to measuring, evaluating and improving quality; ADD}
{ADD (D) It is an important public health function to promote quality in the state's health care system by developing a health care quality performance measures and reporting program to guide quality improvement initiatives. ADD}
{ADD 23-17.17-2. Definitions. -- ADD} {ADD (1) "Clinical outcomes" means information about the results of patient care and treatment. ADD}
{ADD (2) "Director" means the director of the department of health or his or her duly authorized agent. ADD}
{ADD (3) "Health care facility" shall have the same meaning as contained in the regulations promulgated by the director of health pursuant to chapter 17 of this title. ADD}
{ADD (4) "Patient satisfaction" means the degree to which the facility or provider meets or exceeds the patients' expectations as perceived by the patient by focusing on those aspects of care that the patient can judge. ADD}
{ADD (5) "Quality of care" means the result or outcome of health care efforts. ADD}
{ADD (6) "Risk-adjusted" means the use of statistically valid techniques to account for patient variables which may include but need not to be limited to age, chronic disease history, and physiologic data. ADD}
{ADD (7) "Performance Measure" means a quantitative tool that provides an indication of an organization's performance in relation to a specified process or outcome. ADD}
{ADD (8) "Reporting Program" means an objective feedback mechanism regarding individual or facility performance that can be used internally to support performance improvement activities and externally to demonstrate accountability to the public and other purchasers, payer, and stakeholders. ADD}
{ADD 23-17.17-3. Establishment of health care quality performance measurement and reporting program. -- ADD} {ADD The director of health is authorized and directed to develop a state health care quality performance measurement and reporting program. The health care quality performance measurement and reporting program shall include quality performance measures and reporting for health care facilities licensed in Rhode Island. The program shall be phased in over a multi-year period and shall begin with the establishment of a program of quality performance measurement and reporting for hospitals. In subsequent years, quality performance measurement and reporting requirements will be established for other types of health care facilities such as nursing facilities, home nursing care providers, and other licensed facilities as determined by the director of health. Prior to developing and implementing a quality performance measurement and reporting program for hospitals or any other health care facility the director shall seek public comment regarding the type of performance measures to be used and the methods and format for collecting the data. ADD}
{ADD 23-17.17-4. Program requirements -- Adoption of rules and regulations. -- ADD} {ADD The quality performance measurement and reporting program established under this chapter shall, at a minimum, incorporate the following: (1) a standardized data set of clinical performance measures, risk-adjusted for patient variables, that shall be collected and reported periodically to the department, and (2) comparable, statistically valid patient satisfaction measures that shall be conducted periodically by facilities and reported to the department. In accordance with the provisions of section 42-35-3, the director is authorized to adopt, promulgate, and enforce rules and regulations designed to implement the provisions of this chapter including the details and format for the periodic reporting requirements. ADD}
{ADD 23-17.17-5. Annual report. -- ADD} (a) {ADD The director shall prepare and submit by January fifteenth of each year an annual report to the general assembly and governor on the status of the health care quality performance measurement and reporting program. The annual report shall include information on trends in health care quality performance measures, identify areas for quality improvement initiatives, and program plans and objectives for future years. The first annual report shall include: (1) progress to date in implementing the health care quality performance measurement and reporting program for hospitals, (2) a proposed timetable for adding additional types of licensed facilities to the health care quality performance measurement and reporting program, and (3) a study of a cost sharing mechanism for the operational costs of the health care quality performance measurement and reporting program. ADD}
{ADD (b) The director shall also prepare a statewide quality performance measurement report using the data collected from the quality performance measurement and reporting program. The report, based on risk adjusted, scientifically valid, data-driven mechanisms, shall be made available to the public to show how individual facilities compare and to help identify both exemplary performance and best practices to facilitate the provision of bench marking services to health care organizations. ADD}
{ADD 23-17.17-6. Health care quality steering committee. -- ADD} {ADD The director shall establish and serve as chairperson of a health care quality steering committee of no more than seventeen (17) members to advise in the following matters: (1) determination of the comparable performance measures to be reported on, (2) assessment of factors contributing to the provision of quality health care, (3) selection of the patient satisfaction survey measures and instrument, (4) methods and format for data collection, (5) program expansion and quality improvement initiatives, (6) format for the public quality performance measurement report, and (7) other related issues as requested by the director. The members of the health care quality performance steering committee shall include one (1) member of the house of representatives, to be appointed by the speaker; one (1) member of the senate, to be appointed by the majority leader, the director or director's designee of the department of human services, the director or the director's designee of the department of mental health, retardation and hospitals, the director or the director's designee of the department of elderly affairs, and eleven (11) members to be appointed by the director of the department of health to include persons representing Rhode Island licensed hospitals and other licensed facilities/providers, the medical and nursing professions, the business community, organized labor, consumers, and health insurers and health plans. ADD}
SECTION 2. This act shall take effect upon passage.
