2013 -- H 5750

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LC01745

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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A N A C T

RELATING TO HEALTH AND SAFETY - RHODE ISLAND COORDINATED HEALTH

PLANNING ACT OF 2006

     Introduced By: Representatives Ferri, Tanzi, McNamara, Cimini, and Bennett

     Date Introduced: February 28, 2013

     Referred To: House Finance

It is enacted by the General Assembly as follows:

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     SECTION 1. The title of Chapter 23-81 of the General Laws entitled "Rhode Island

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Coordinated Health Planning Act of 2006" is hereby amended to read as follows:

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     CHAPTER 23-81

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Rhode Island Coordinated Health Planning Act of 2006

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     CHAPTER 23-81

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RHODE ISLAND HEALTH IMPROVEMENT PLANNING ACT OF 2013

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     SECTION 2. Sections 23-81-1, 23-81-2, 23-81-3.1, 23-81-4, 23-81-5 and 23-81-6 of the

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General Laws in Chapter 23-81 entitled "Rhode Island Coordinated Health Planning Act of 2006"

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are hereby amended to read as follows:

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

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Health Planning Act of 2006 Health Improvement Planning Act of 2013."

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

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

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care should be available to all in our state;

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

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

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

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to play in solving this health care crisis;

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

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

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all with a lack of coordination;

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

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

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An essential component of health planning is the rational allocation of resources to balance the

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supply and demand of healthcare services. Thus there is a need to revitalize the certificate of need

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process so that it is based on a unified state healthcare plan that carefully considers the healthcare

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needs of all Rhode Islanders, and drives the decisions that healthcare regulatory structures make

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about the availability, affordability and accessibility of quality healthcare;

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

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collection of data and information related to health status, health risks, health care, health care

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outcomes, health care insurance, consumer behavior and trends, and that accurate and accessible,

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collection and housing analysis of this information is necessary for the general assembly to enact

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useful health care policy population health improvement and healthcare policies;

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

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

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representation of all of the health care stakeholders;

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

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

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

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

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

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

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planning requirements and programs of the federal government; and

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

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

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      (j) Recognizing the broad input and effort from government, industry and consumer

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participants in the creation of the 2007 department of health report "Coordinated Health Planning

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in Rhode Island," the general assembly further adopts the following findings of the report:

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     (1) The healthcare system has not and will not transform optimally or effectively without

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a robust health planning process that features collaboration and coordination across all public and

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private sector participants.

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     (2) Additional authorities are needed for a fully effective health planning process.

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     (3) The state does not currently have sufficient capacity to conduct a fully effective health

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planning process. Existing capacity is limited to conducting isolated health planning studies that

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are single-issue and not coordinated with a comprehensive plan.

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

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council. -- Establishment of the Rhode Island health planning authority. -- Contingent upon

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funding:

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

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

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

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

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4(a).

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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barriers to accessing health care in Rhode Island;

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

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

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Island;

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

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Island;

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

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organizations in Rhode Island;

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

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organization in Rhode Island;

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

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

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

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      (10) Director of the Department of Health;

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

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

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

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      (13) The speaker of the house or designee;

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      (14) The house minority leader or designee;

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      (15) The president of the senate or designee;

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      (16) The senate minority leader or designee; and

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

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     (a) There is hereby established a Rhode Island health planning authority.

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     (b) The authority shall be composed of members with expertise, experience and

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knowledge in health planning and the implementation of a broad range of evidence-based

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interventions supporting and promoting population health at the state and community levels.

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     (c) The members of the authority shall be appointed by the governor and shall represent

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Rhode Island's demographic diversity and government and private sectors.

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     (d) The Rhode Island health planning authority shall consist of, but not be limited to:

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

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directly or through a spouse/partner, receive any of his/her livelihood from the healthcare system.

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Consumers may be nominated from among the labor unions in Rhode Island; the healthcare

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

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

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barriers to accessing healthcare in Rhode Island;

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

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

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Island;

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

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Island;

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     (5) One nurse or allied professional nominated from among nursing organizations in

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Rhode Island;

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     (6) One practicing long-term care administrator, nominated from among the long-term

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care provider organizations in Rhode Island;

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

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

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     (9) One person form a school or program for health professionals in Rhode Island;

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     (10) The health insurance commissioner, serving ex officio;

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     (11) The executive secretary of health and human services, serving ex officio; and

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     (12) The CEO of each health insurance company that administers the health insurance of

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ten percent (10%) or more of insured lives in Rhode Island, serving ex officio.

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     (e) The authority shall elect a non-governmental chairperson from its members;

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     (f) The members of the authority shall serve staggered terms with one-third (?) of the

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members appointed for an initial term of one year, one-third (?) of the members appointed for an

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initial term of two (2) years, and one-third (?) of the members appointed for an initial term of

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three (3) years. After these initial appointments all appointments shall be for a term of three (3)

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years.

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     (g) The members of the authority shall serve no more than two (2) consecutive terms of

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three (3) years each.

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

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Powers of the Rhode Island health planning authority. -- Powers of the council authority

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shall include, but not be limited to the following:

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      (a) The authority to provide leadership, direction and oversight for the development and

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implementation of the Rhode Island population health improvement plan. The goal of the plan is

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to drive excellence in population health management and serve as the foundation for a healthcare

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system that is affordable, accessible, and delivers high quality outcomes and health promotion

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services in order to pursue the complete physical, mental and social well-being of Rhode

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Islanders.

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

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recommend a unified health plan on the state's health care delivery and financing system,

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including but not limited to:

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

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

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

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

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

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

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

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

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Rhode Island;

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

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

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to evaluate the impact of the health planning process;

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

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

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confidentiality and security of health records; and

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

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adherence in the health care community and in the state agencies of state government to the

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council's authority's plans and recommendations findings.

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

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

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

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

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process.

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     (d) Appoint such permanent or ad hoc advisory committees, technical task forces and

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statewide stakeholder coalitions, as the authority considers necessary to aid and advise in the

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performance of its functions and as needed for technical assistance throughout the planning

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process.

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     (d)(e) Modify recommendations in order to reflect changing health care systems needs.

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

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

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office of the health and human services.

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

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sector that are useful to developing a unified health plan.

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

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objectives.

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

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the governor and general assembly on implementation of the plan adopted by the council

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authority. This annual report shall:

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      (1) Present the strategic recommendations, updated annually Present the strategic

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recommendations, which shall be updated annually and shall be known as the Rhode Island

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strategic plan for population health improvement and healthcare reform;

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

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

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

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

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strategic recommendations, and assess the powers needed by the council authority or

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

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responsibilities of the council authority. The initial priority of the council shall be an assessment

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of the needs of the state with regard to hospital services and to present recommendations, if any,

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for modifications to the Hospital Conversion Act and the Certificate of Need Program to execute

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

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

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

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assembly.

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

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plan describing the actions taken and planned in order to implement the plans plan's

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recommendations.

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     (j) Collaborate with the staff of the office of health planning to perform the functions of

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the health planning process;

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     (k) Provide oversight of the permanent or ad hoc advisory and technical task forces and

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stakeholder coalition created pursuant to this chapter;

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     (l) Monitor the progress of the milestones set forth in the Rhode Island strategic plan for

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population health improvement and healthcare reform;

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     (m) Evaluate the outcomes and efforts of the operating departments, other agencies of the

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executive branch, and political subdivision of the state in the implementation of the Rhode Island

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strategic plan for population health improvement and healthcare reform in achieving the

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established goals and objectives;

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     (n) Develop new goals and objectives or refine the established goals and objectives of the

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Rhode Island strategic plan for population health improvement and healthcare reform in

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accordance with the changing and emerging population health and community needs;

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     (o) Develop new strategies or refine strategies to achieve the long-term goals and values

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of the Rhode Island strategic plan for population health improvement and healthcare reform.

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

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office of health planning. -- In order to promote effective implementation of the unified health

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plan, the council shall recommend to the governor, the general assembly, and other state agencies

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actions that may be taken to promote and ensure implementation of the council's policy and

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program guidance. The secretary of the executive office of health and human services and the

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health insurance commissioner, as co-chairs, of the council, shall use the powers of their offices

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to implement the recommendations adopted by the council, as deemed appropriate, or as required

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

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

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services.

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     (a) There is hereby established within the department of health the office of health

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planning. The office of health planning shall serve the staff functions necessary to support to the

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work of the Rhode Island health planning authority's development of the population health

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improvement plan and the strategic plan for population health improvement and healthcare

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reform.

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     (b) The office of health planning shall be the principal staff agency of the authority to

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develop analysis of the population health and healthcare information for use by the authority,

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

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

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ensuring the continuous and efficient functioning of the health planning authority.

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     (c) The office of health planning shall have a sufficient number of qualified professional

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staff to perform the staff functions of the health planning authority.

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     (d) The office of health planning shall maintain records (which shall consist of files of

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complete copies) of all plans, recommendations, rules, and modifications or amendments thereto

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adopted or issued by the health planning authority.

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

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funding to carry out the requirements of this chapter. As recommended by the 2007 department of

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health report on coordinated health planning, the general assembly shall appropriate a minimum

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of one million two hundred fifty thousand dollars ($1,250,000) per year to fund the office of

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health planning for the sole purpose of conducting and supporting statewide health improvement

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planning with the Rhode Island health planning authority.

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     SECTION 3. Chapter 23-81 of the General Laws entitled "Rhode Island Coordinated

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Health Planning Act of 2006" is hereby amended by adding thereto the following section:

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     23-81-7. Definitions. -- (a) "High quality, affordable healthcare" refers to a system of

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healthcare that:

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     (1) Delivers healthcare according to latest scientific evidence, using current evidence-

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based guidelines where available;

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     (2) Improves the quality, efficiency, and accessibility of healthcare services;

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     (3) Improves affordability by ensuring efficient utilization of healthcare providers and

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services;

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     (4) Partners with the consumer in managing his/her healthcare;

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     (5) Orients the system towards person-centered care, with family involvement as

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appropriate;

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     (6) Responds to the healthcare needs of the community, in terms of access and cultural

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and linguistic competence; and

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     (7) Improves the health status of the population.

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     (b) "Affordable" means costs are consistent with the affordability standards set by the

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office of the health insurance commissioner, including:

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     (1) Emphasis on primary care, prevention and wellness;

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     (2) Use of least cost most effective setting for care;

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     (3) Use of evidence-based medicine; and

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     (4) Active management of chronic diseases.

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     SECTION 4. This act shall take effect upon passage.

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LC01745

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO HEALTH AND SAFETY - RHODE ISLAND COORDINATED HEALTH

PLANNING ACT OF 2006

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     This act would amend existing law to adopt the findings of the 2007 department of health

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report "Coordinated Health Planning in Rhode Island" in order to, among other things, establish a

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Rhode Island health planning authority.

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     This act would take effect upon passage.

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LC01745

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