Health Planning Amendments

(Measure passed Senate, amended)

Health Planning Amendments - =Title I: Revision and Extension of National Health Planning and Development Authority= - Increases the membership of the National Council on Health Planning and Development from 15 to 20 members, to include as an ex officio member of the Council the Assistant Secretary for Rural Development of the Department of Agriculture, and to provide that at least eight Council members will be consumers, including members of urban and rural medical underserved populations.

Amends the Public Health Service Act to permit the Governor of any State which comprises part of an interstate health service area, such an area being an entity designed to facilitate health planning and development functions for a specified region, to request, without the concurrence of the Governors of other States which are part of such area, the redesignation of an interstate area made up of an entire standard metropolitan statistical area.

States that no proposed revision of the boundaries of a health service area (HSA) shall comprise an entire State without prior consent of the Governor.

Directs health systems agencies, such agencies being the bodies designated to provide health planning and development services in a health service area, and Statewide Health Coordinating Councils, to adopt procedures to ensure that no such agency or Council member, employee, consultant, or agent have any actual or apparent conflict of interests with any persons, organizations or other entities.

Sets forth criteria for selecting health system agency governing body and executive committee members. Directs that there be opportunity for residents of a health service area to participate in the selection process.

Excludes from the open meeting requirement confidential agency meetings on personnel issues.

Provides for the inclusion on the governing bodies of agencies of persons having their principal place of business within the health service area, doctors of medicine and osteopathy, and nonprofessional health workers.

Adds to the statement of goals to be included in the Health Systems Plan (HSP) of a health systems agency a description of institutional health services needed in the area, including but not limited to treatment for alcohol and drug abuse.

Requires a State health plan prepared by the Council to have the concurrence of the Governor.

Requires a State health coordinating council to coordinate the State health plan with the State mental health plan developed pursuant to the Community Mental Health Centers Act, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act, and the Drug Abuse Office and Treatment Act. Requires such plan to assess the minimum requirements for institutional health services and specified other health services.

Prohibits the Secretary of Health, Education, and Welfare from making any grant to a State health planning and development agency which does not have a State health plan in effect.

Stipulates that HSPs shall: (1) include identifiable alcohol abuse, drug abuse, and mental health components; and (2) address specifically the needs of all medically underserved populations in the health service area.

Provides procedures for public comment on such proposed HSPs before establishment, in the process of annual review, and before amendment. Directs that the same such procedures be used with respect to the annual implementation plans (AIPs) which describe objectives, and priorities, in achieving HSP goals.

Requires that health systems agencies submit to the State Health Planning and Development Agency, the Statewide Health Coordinating Council, and the Secretary a detailed statement of the reasons for any inconsistencies between their HSPs and AIPs and the national guidelines and priorities established under this Act.

Mandates health systems agencies to provide technical assistance in obtaining and filling out necessary forms to applicants applying for projects to achieve the HSP.

Allows funds granted for State health planning and development and for regulation of health care rates to be used in a period succeeding that for which it was granted without being deducted from the subsequent grant award.

Directs an HSA to coordinate its activities with entities which review rates and budgets of health care facilities in the health service area and with appropriate agencies on aging, local and regional alcohol abuse, drug abuse, and mental health planning agencies.

Extends the period of designation of a health systems agency from one to three years. Provides for a three year extension of such designation.

Requires the Secretary, before terminating an agreement with an entity for designation as the health systems agency for an HSA, to: (1) consult with the appropriate Governor(s) and Statewide Health Coordinating Council(s); (2) give the entity notice of the intention to terminate the agreement, specifying how the entity is not in compliance with the agreement and how it can comply; (3) provide the entity with a reasonable opportunity for a hearing before an officer or employee of the Department of Health, Education, and Welfare designated for such purpose; (4) provide that an agreement for the designation of a new agency has taken effect; and (5) allow the entity to terminate its affairs satisfactorily. Authorizes the Secretary to terminate such an agreement (or return such agency to a conditionally designated status for no more than one year, then terminate or enter into another agreement), if the Secretary determines, upon an appropriate review, that such agency's performance is unsatisfactory.

Requires the Secretary, with regard to agreements with health systems agencies, to: (1) before renewal, allow the appropriate State agencies and Councils to make comments and recommendations on performance and renewal; (2) upon entrance or renewal, notify the appropriate Governor of the conditions of such agreements; and (3) during consideration of applications, give priority to any applications which have been recommended by a Governor or a Statewide Health Coordinating Council.

Raises minimum grants to such agencies.

Authorizes appropriations for fiscal years 1979, 1980, and 1981.

Extends eligibility for Federal matching of non-Federal contributions to minimally-funded health systems agencies.

Reduces by 25 percent per year for each year during which a State has not designated a State health planning and development agency, the amount of any allotment, grant, loan, or loan guarantee which the Secretary may have committed to a State under this Act.

Provides for judicial review of a final decision rendered by a State agency under a certificate of need or appropriateness review.

Sets forth the requirements a preliminary State health plan must include. States the Secretary's role in approving certificate of need programs. Requires certificate of need programs to provide enforcement procedures and penalties.

Provides for ex officio representation of the Veterans' Administration on the Statewide Health Coordinating Council (SHCC) when the State has at least one VA facility.

Increases authorization levels for grants to State health planning and development agencies.

Lists procedures and criteria for review of application for certificate of need programs.

Requires that such reviews of similar types of institutional health services affecting the same service area be considered in relation to each other.

Provides for Indian self-determination as related to health planning.

=Title II: Revision and Extension of Health Resources Development Authority= - Requires the Governor of a State, as well as the Statewide Health Coordinating Council, to approve any State medical facilities plan under Title XVI (Health Resources Development) of the Public Health Service Act.

Authorizes appropriations under such Title for fiscal years 1979, 1980, and 1981 for the modernization, conversion, and construction of medical facilities.

Directs the Secretary to establish a program of financial assistance to encourage the voluntary consolidation of duplicative hospital services and the discontinuance of unneeded hospital inpatient services.

Directs the Secretary to study the first 25 applications for assistance under such program to determine their effect on the elimination of unneeded hospital services.

Allows incentive payments received to be used for: (1) the planning, development, and delivery of ambulatory care services; (2) home health care services; (3) long-term services; (4) other services designated by the Secretary; (5) preparation of a hospital to serve patients of a closed hospital or reasonable termination pay for personnel who lose employment because of discontinued services; or (6) retraining personnel and assisting them in securing employment.

Sets forth provisions governing the application for such incentive payments and the administration of the payment plan.

=Title III: Miscellaneous Amendments= - Repeals Title IX (Education, Research Training, and Demonstration in the fields of Heart Disease, Cancer, Stroke, Kidney Disease, and Other Related Diseases) of the Public Health Service Act.

=Title IV: National Commission on Alcoholism= - Establishes a National Commission on Alcoholism and other Alcohol-Related Problems, composed of: (1) four members of the Senate appointed by the President of the Senate upon recommendation of the Majority and Minority Leaders; (2) four members of the House of Representatives appointed by the Speaker of the House of Representatives; (3) 11 members appointed by the President upon recommendation of the Secretary of Health, Education, and Welfare; and (4) ex officio members, appointed by the President, who are from Federal agencies with programs affecting the prevention and treatment of alcoholism and who have knowledge of such programs. Restricts the numbers of such members from the same political party.

Provides for pay and travel allowances for such Commission members.

Authorizes the Commission to secure directly from any Federal agency information to enable it to carry out its duties. Requires the agency heads to furnish such information consistent with applicable laws and regulations with respect to the privacy of medical records.

Requires the Commission to study alcoholism and related problems, including: (1) the relationship of alcoholism to the high rates of illnesses, particularly these with a stress component, among family members of alcoholics; (2) an evaluation of the effectiveness of prevention programs, including the relevance of alcohol control laws and regulations to alcoholism and alcohol-related problems; (3) an evaluation of the needs of special and underserved population groups; and (4) an evaluation of the needs of Native Americans. Requires the Commission to submit a final report to the President and Congress within 18 months after funds are available. Terminates the Commission 60 days after such submission.

Directs the Secretary of Health, Education, and Welfare to coordinate Commission activities. Authorizes the appropriation of $1,000,000 for such purposes.