An act to amend titles XV and XVI of the Public Health Service Act to revise and extend the authorities and requirements under those titles for health planning and health resources development, and for other purposes.

Summary

Health Planning Amendments of 1979 - Title I: Revision and Extension of National Health Planning and Development Authority - Amends title XV of the Public Health Service Act (National Health Planning and Development) to increase from 15 to 20 the membership of the National Council on Health Planning and Development. Increases from five to eight the minimum number of Council members who must be consumers, including members of urban and rural medical underserved populations. Permits the Governor of any State which comprises part of an interstate health service area to request that such area contain only part of a standard metropolitan statistical area, without the concurrence of the Governors of the other States which are part of such area, as required under current law. Requires that the national guidelines for health planning issued by the Secretary of Health, Education, and Welfare include standards which reflect the unique circumstances and needs of medical underserved populations including isolated rural communities. Revises the procedures for the redesignation of health service area boundaries. Directs the Secretary to review such boundaries on his own initiative, or at the request of any Governor or health systems agency (HSA), and provides that they may be redesignated if the boundaries of the proposed health service area meet the current requirements in a significantly more appropriate manner. Provides that no proposed revision of a health service area shall comprise an entire State without the prior consent of the Governor. Directs the Secretary to establish by January 1, 1980, criteria for revision of health service area boundaries. Eliminates the provision which gives priority for designation of health service areas which formerly had an area wide Comprehensive Health Planning Agency under previous health planning authority. Requires each health systems agency (HSA) and each Statewide Health Coordinating Council (SHCC) to adopt procedures in accordance with regulations promulgated by the Secretary to insure that no conflicts of interest exist with respect to their members, employees, consultants, or agents. Requires HSA staff to have expertise in mental health planning and resources, financial and economic analysis, and public health and disease prevention. Provides that at least one member of such staff shall be responsible for assisting the consumer members of the HSA governing body. Directs each HSA to establish and make public a process for the selection of the members of its governing body and any subarea advisory councils, which assures: (1) selection in accordance with concurrent composition requirements; and (2) the opportunity for, and encouragement of, broad participation of the residents of the health service area. Requires such process to prohibit the selection of members by other members of such body or councils. Provides that an HSA that is a public regional planning body or local government unit is not required to delegate to a separate governing body for health planning the exclusive authority to perform certain functions. Revises the requirements for the membership of HSA governing bodies with respect to government representatives. Authorizes such bodies to make advances to HSA members for reasonable expenses incurred in the performance of HSA duties. Excepts from the current requirement that HSA governing body meetings be public, meetings dealing with HSA employees which, if public, would be an unwarranted invasion of such employee's privacy. Extends similar scope of protection to HSA personnel records and data and to employees of State health planning and development agencies. Eliminates the current provision that consumers on HSA governing bodies cannot have been health care providers within the 12 months preceding appointment. Permits providers whose principal place of business is in an HSA area to be members of such HSA's governing body. Adds "non-professional health workers" and "other providers of health and mental health care" as additional provider categories with respect to HSA governing body composition. Requires that subcommittees or advisory groups of HSA boards have a consumer majority. Provides that no member, employee, consultant, or agent of a HSA or SHCC shall be personally liable for damages under any Federal or State law if such individual could have reasonably believed that he was acting in an official capacity and acted without gross negligence or malice. Requires any executive committee of a HSA, subarea advisory council, or other entities appointed under a HSA to conduct its business in public, give adequate notice of its meetings, and make its records available, upon request, to the public. Adds to the material to be included in the health systems plan (HSP) of an HSA a description of specified institutional and non-institutional health services and the extent to which facilities and equipment need to be modernized, converted to new uses, constructed, or acquired. Requires that the State health plan prepared by the Statewide Health Coordinating Council (SHCC) contain similar information and be coordinated with State health plans developed pursuant to certain other Federal laws. Requires certificate of need decisions to be consistent with the State health plan, except in emergency circumstances posing a threat to public health. Requires that the State health plan prepared by the SHCC have the concurrence of the Governor. Prohibits the Secretary from making any grant to a State health planning and development agency (State Agency) which does not have a State health plan in effect. Applies procedures for public comment on proposed health systems plans (HSPs) of an HSA to the annual review and amendment of HSPS. Requires that the same such procedures be used with respect to the annual implementation plans (AIPs) which describe objectives and priorities in achieving HSP goals. 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 HSA. Eliminates the requirement that the HSP of an HSA be consistent with the national guidelines issued by the Secretary, but requires the HSA to submit to the State Agency, the SHCC, and the Secretary a detailed statement of reasons for any inconsistencies between its HSP and AIP and such guidelines. Directs, rather than allows, HSAs to provide technical assistance in obtaining and filling out necessary forms to applicants applying for projects to achieve the HSP. Allows grants made by an HSA for planning and developing projects to be used in a period succeeding that for which it was granted without being deducted from the subsequent grant award. Requires each 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. Directs, rather than allows, the Secretary to provide technical assistance to entities which have the potential to become HSAs. Eliminates the provision giving priority for HSA designation to agencies and regional medical programs formerly authorized under certain other titles of the Public Health Service Act. Extends from one to three years the period of the designation and redesignation of an HSA. Revises the procedures for the designation and termination of health systems agencies, including requiring the Secretary to: (1) give priority to an application for HSA designation which has been recommended by the Governor or the Statewide Health Coordinating Council; (2) permit the appropriate State Agency and the SHCC to comment on the performance of an HSA before its designation is renewed; (3) consult with the Governor and the SHCC before terminating an HSA's designation. Authorizes the Secretary to terminate a designation agreement for an HSA whose performance is unsatisfactory. Increases the minimum planning grants to HSAs, and authorizes appropriations for such purpose. Extends eligibility for Federal matching of non-Federal contributions to minimally-funded HSAs. Extends from one to three years the period of the designation of a State health planning and development agency (State Agency). Authorizes the Secretary to terminate such designation (or return such Agency to a conditionally designated status for no more than one year), if the Secretary determines upon an appropriate review that such Agency's performance is unsatisfactory. Reduces by 25 percent per year for each year in which a State has not designated a State Agency, the amount of any allotment, grant, loan, or loan guarantee which has been committed to the State under this Act, the Community Mental Health Centers Act, or the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 for the development of health resources. Provides for judicial review of a final decision rendered by a State Agency under a certificate of need or appropriateness review, and requires affirmance of the State Agency's decision unless it is arbitrary, capricious, or was made not in conformity with applicable law. Requires a State Agency to provide technical assistance in obtaining and filling out the necessary forms to individuals and public and private entities for the development of projects and programs. Directs the appropriate authorities to prepare alcohol abuse, drug abuse, and mental health components to be included in the preliminary State health plan. Requires a State certificate of need program to: (1) be consistent with standards established by the Secretary by regulation; (2) provide for enforcement procedures and penalties; (3) provide for periodic review of certificates which have already been issued in order to monitor the progress of the service or facility; (4) provide for the withdrawal of any such certificate where substantial progress is not being made; and (5) provide for review and determination of need prior to the acquisition of diagnostic or therapeutic equipment under specified circumstances. Prohibits such program from reviewing and determining the need of health maintenance organization (HMO) services except for new institutional health services of hospitals controlled directly or indirectly by HMOs and diagnostic or therapeutic equipment of HMOs. Requires the issuance of certificates to be based solely on the record established in administrative and judicial proceedings. Directs the Statewide Health Coordinating Council (SHCC) to establish in consultation with the health systems agencies (HSAs) and the State Agency a uniform format for health system plans (HSPs) and annual implementation plans (AIPs). Provides for ex officio representation of the Veterans' Administration on the SHCC when the State has at least one VA facility, instead of two facilities as currently provided. Requires members of the SHCC who are consumers to include individuals from rural and urban medical underserved populations which exist in the State. Authorizes appropriations through fiscal year 1982 for grants to State health planning and development agencies. Extends authorization of appropriations for grants for State rate regulation experiments. Stipulates that an individual shall not be considered an indirect provider of health care (and for this reason a direct provider of health care under current law) solely because such person is a member of a governing board of an entity engaged in the provision of, or research or instruction in, health care, or in the production of drugs. Redefines "institutional health services" for purposes of title XV of the Public Health Service Act (National Health Planning and Development) to mean: (1) health services entailing annual operating costs of $50,000 or more which are provided through health care facilities as defined in regulations by the Secretary; and (2) diagnostic or therapeutic equipment valued in excess of $150,000 at time of acquisition and used in the delivery of health care services. Revises procedures and criteria for reviews, including reviews of certificate of need applications and appropriateness of services, by HSAs and State Agencies. Adds to the existing criteria the quality of care provided in the past by existing services or facilities, and the extent to which proposed services will be accessible to all the residents of the area to be served. Establishes criteria under which the certificate of need applications of HMOs are to be reviewed and approved. Extends and increases the authorization of appropriations for grants for planning and developing new centers for health planning. Directs the Secretary in reviewing an HSA and State Agency to consider the comments submitted by any interested person. Provides for Indian self-determination as related to health planning. Defines "health maintenance organization", "medical underserved population", and "rehabilitation facility" for purposes of this Act. Stipulates that the "healthful environment" which an HSA is directed in current law to describe in a detailed statement of goals means primarily with respect to health care equipment, and health services provided by health care institutions, facilities, and other providers and resources. Title II: Revision and Extension of Health Resources Development Authority - Amends title XVI of the Public Health Service Act (Health Resources Development) to require the Governor of a State, as well as the Statewide Health Coordinating Council (SHCC), to approve any State medical facilities plan. Provides that the Secretary make funds appropriated but unexpended for allotments in fiscal year 1976 available for special project grants for public hospitals with safety hazards or accreditation problems. Extends and increases the authorization of appropriations for project grants through fiscal year 1982. Extends the authorization of appropriations through fiscal year 1982 for: (1) loan and loan guarantee fund providing loans for medical facilities; and (2) Area Health Services Development Funds (established to enable HSAs to make planning grants). 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. Allows any hospital in operation on the date of enactment and which intends to: (1) discontinue providing inpatient health services; (2) discontinue an identifiable unit of the hospital which provides inpatient services; or (3) convert part of the hospital into providing ambulatory care services, long term care services, or any other service designated by the Secretary, to apply for a debt payment, an incentive payment, or a conversion payment, as appropriate. Specifies the authorized uses of the incentive payment. Specifies application procedures and formulas for determining the amounts of such payments. Directs a HSA and a State Agency, in determining the need for the service proposed to be discontinued under such program, to give special consideration to unmet needs and existing access patterns of urban or rural poverty populations. Requires the Secretary of Labor to certify that fair and equitable arrangements have been made to protect the interests of employees affected by the discontinuance of such services before payments can be made. Authorizes appropriations through fiscal year 1982 for the purpose of making payments under such program. Directs the Secretary of Health, Education, and Welfare to study the first 25 applications for assistance under such program to determine their effect on the elimination of unneeded hospital services and to report the results of such study to Congress. Title III: Miscellaneous Amendments - Repeals title IX of the Public Health Service Act (Education, Research, Training, and Demonstrations in the Fields of Heart Disease, Cancer, Stroke, Kidney Disease, and Other Related Diseases).

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Documents

5 official files

• Public Law (PDF)

  Public Law · EN · 5 October 1979

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• Conference report filed in House

  summary · EN · 5 September 1979

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• Passed House amended

  summary · EN · 19 July 1979

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• Reported to Senate with amendment(s)

  summary · EN · 26 April 1979

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• Introduced in Senate

  summary · EN · 5 March 1979

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