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H.512

Introduced by   Representatives Martin of Springfield, Emmons of Springfield, Fisher of Lincoln, Koch of Barre Town and Pugh of S. Burlington

Referred to Committee on

Date:

Subject:  Health; hospitals; community reports

Statement of purpose:  This bill proposes to require the commissioner of banking, insurance, securities, and health care administration to prepare a statewide hospital performance report.

AN ACT RELATING TO STATEWIDE HOSPITAL PERFORMANCE REPORTS

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1.  18 V.S.A. § 9402 is amended to read:

§ 9402.  DEFINITIONS

As used in this chapter, unless otherwise indicated:

* * *

(3)  “Community report” means the hospital report prepared under section 9405a of this title.

(4)  “Department” means the department of banking, insurance, securities, and health care administration.

(5)(4)  “Division” means the division of health care administration.

(6)(5)  “Expenditure analysis” means the expenditure analysis developed pursuant to section 9406 of this title.

(7)(6)  “Health care facility” means all institutions, whether public or private, proprietary or nonprofit, which offer diagnosis, treatment, inpatient, or ambulatory care to two or more unrelated persons, and the buildings in which those services are offered.  The term shall not apply to any facility operated by religious groups relying solely on spiritual means through prayer or healing, but includes all institutions included in subdivision 9432(7) of this title, except health maintenance organizations.

(8)(7)  “Health care provider” means a person, partnership or corporation, other than a facility or institution, licensed or certified or authorized by law to provide professional health care service in this state to an individual during that individual’s medical care, treatment, or confinement.

(9)(8)  “Health insurer” means any health insurance company, nonprofit hospital and medical service corporation, managed care organizations, and, to the extent permitted under federal law, any administrator of an insured,

self-insured, or publicly funded health care benefit plan offered by public and private entities.

(10)(9)  “Health maintenance organization” means any person certified to operate a health maintenance organization by the commissioner pursuant to chapter 139 of Title 8.

(11)(10)  “Health resource allocation plan” means the plan developed by the commissioner and adopted by the governor under section 9405 of this title.

(12)(11)  “Hospital” means an acute care hospital licensed under chapter 43 of this title and falling within one of the following four distinct categories, as defined by the commissioner by rule:

(A)  Category A1:  tertiary teaching hospitals.

(B)  Category A2:  regional medical centers.

(C)  Category A3:  community hospital systems.

(D)  Category A4:  critical access hospitals.

(12)  “Hospital performance report” means the statewide hospital performance report prepared under section 9405b of this title.

(13)  “Managed care organization” means any financing mechanism or system that manages health care delivery for its members or subscribers, including health maintenance organizations and any other similar health care delivery system or organization.

(14)  “Public oversight commission” means the commission established in section 9407 of this title.

(15)  “Unified health care budget” means the budget established in accordance with section 9406 of this title.

(16)  “State health plan” means the plan developed under section 9405 of this title.

Sec. 2.  18  V.S.A. § 9405b is amended to read:

§ 9405b.  STATEWIDE HOSPITAL COMMUNITY REPORTS

    PERFORMANCE REPORT

(a)  The commissioner, in consultation with representatives from the public oversight commission, hospitals, and other groups of health care professionals shall adopt rules establishing a standard format for community reports statewide hospital performance report, as well as the contents, which shall include:

(1)  measures of quality, including process and outcome measures, that are valid, reliable, and useful, including comparisons to appropriate national benchmarks for high quality and successful outcomes;

(2)  measures of patient safety that are valid, reliable, and useful, including comparisons to appropriate industry benchmarks for safety;

(3)  measures of the each hospital’s financial health, including comparisons to appropriate national benchmarks for efficient operation and fiscal health;

(4)  a summary of the hospital’s budget, including revenue by source and quantification of cost shifting to private payers; and

(5)  measures that provide valid, reliable, useful, and efficient information for payers and the public for the comparison of charges for higher volume health care services;

(6)  the hospital’s process for achieving openness, inclusiveness, and meaningful public participation in its strategic planning and decision-making;

(7)  the hospital’s consumer complaint resolution process, including identification of the hospital officer or employee responsible for its implementation;

(8)  information concerning recently completed or ongoing quality improvement and patient safety projects;

(9)  a summary of the community needs assessment, including a description of strategic initiatives discussed with or derived from the assessment; the one-year and four-year capital expenditure plans; and the depreciation schedule for existing facilities; and

(10)  information on membership and governing body qualifications, a listing of the current governing body members, and means of obtaining a schedule of meetings of the hospital’s governing body, including times scheduled for public participation.

(b)  On or before January 1, 2005 June 1, 2006, and annually thereafter, the board of directors or other governing body of each hospital licensed under chapter 43 of this title commissioner shall publish its community report in a uniform format approved by the commissioner, and the hospital performance report in accordance with the standards and procedures adopted by rule under this section, and.  Each hospital shall hold one or more public hearings to permit community members to comment on the report.  Notice of meetings shall be by publication, consistent with section 174 of Title 1.  Hospitals located outside this state which serve a significant number of Vermont residents, as determined by the commissioner, shall be invited to participate in the community hospital performance report process established by this subsection.

(c)  The community reports shall be provided to the public oversight commission and the commissioner.  The commissioner shall publish the reports hospital performance report on a public website and shall develop and include a format for comparisons of hospitals within the same categories of quality and financial indicators.  The website shall include also a summary of each hospital’s budget, including revenue by source.

(d)  Each hospital shall include on its website the following:

(1)  its process for achieving openness, inclusiveness, and meaningful public participation in its strategic planning and decision-making; and

(2)  information on membership and governing body qualifications, a listing of the current governing body members and means of obtaining a schedule of meetings of the hospital’s governing body, including times scheduled for pubic participation.



Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont


www.leg.state.vt.us