Friday, November 13, 2009

Final Draft

Be it enacted by the General Assembly of Virginia:
1. That §§ 32.1122.7 and 32.1122.21 of the Code of Virginia are amended and reenacted and that the Code of Virginia is amended by adding a section numbered 32.1122.7:1 as follows:

§ 32.1122.7. Virginia Health Workforce Development Authority. purpose; Board of Directors.
A. There is hereby created as a public body corporate and as a political subdivision of the Commonwealth the Virginia Health Workforce Development Authority, with such public and corporate powers as are set forth in § 32.1122.7: 1. The Authority is hereby constituted a public instrumentality, exercising public and essential governmental functions with the power and purpose to provide for the health, welfare, convenience, knowledge, benefit, and prosperity of the residents of the Commonwealth and such other persons who might be served by the Authority. The Authority is being established to move the Commonwealth forward in achieving its vision of ensuring a quality health workforce for all Virginians.

The mission of the Authority is to facilitate the development of a statewide health professions pipeline that identifies, educates, recruits and retains a diverse, appropriately geographically distributed and culturally-competent quality workforce. The mission of the Authority is accomplished by: (i) providing the statewide infrastructure required for health workforce needs assessment and planning that maintains engagement by health professions training programs in decision-making and program implementation; (ii) serving as the advisory board and setting priorities for the Virginia Area Health Education Center (AHEC) Program; (iii) coordinating with and serving as a resource to relevant state, regional and local entities; including the Department of Health Professions Workforce Data Center, JLARC, and the Joint Commission on Health Care, the Southwest Virginia Graduate Medical Education Consortium, the Southwest Virginia Health Authority or any similar regional Health Authority that may in the future be developed and legislatively authorized; (iv) informing state and local policy development as it pertains to health care delivery, training and education; (v) identifying and promoting evidence based strategies for health workforce pipeline development and interdisciplinary health care service models, particularly those affecting rural and other underserved areas; (vi) supporting communities in their health workforce recruitment and retention efforts, and developing partnerships and promoting models of participatory engagement with businesses and community-based and social organizations to foster the integration of health care training and education; (vii) advocating for programs that will result in reducing the debt-load of newly trained health professionals; (viii) identifying high priority target areas within each region of the Commonwealth and working toward health workforce development initiatives that improve health measurably in those areas; and (ix) fostering or creating innovative health workforce development models that provide both health and economic benefits to the regions they serve.

B. The Authority shall be governed by a Board of Directors. The Commissioner of Health, with the assistance of recommendations from the Health Workforce Advisory Committee, shall appoint the Board of Directors within three months of the enactment of this legislation. The composition of the Board shall accurately reflect the geographic, racial and ethnic diversity found within the Commonwealth to the extent possible, with an emphasis on those areas and populations that are underserved and under-represented. Members of the Board of Directors shall serve as the chair of a subcommittee comprised of stakeholders of their respective sectors and shall be responsible for obtaining input and representing the members of their sector during their term in Office. The Board shall establish by-laws for the Authority within six months of their appointment. The by-laws should ensure continuity of representation by all sectors as reflected by the composition of the  Board.

The Board shall be comprised of seventeen (17) members and five ad hoc members, each representing a particular sector of the workforce pipeline. These include:

Health Professions Education Sector
• Dean from a dental school located in Virginia, or executive level designee – representing oral health
• Dean from an allopathic medical school located in Virginia, or executive level designee – representing allopathic training programs and physicians
• Dean from an osteopathic medical school located in Virginia, or executive level designee – representing osteopathic training programs and physicians
• Dean from a mid-level training program located in Virginia, or executive designee – representing mid-level health professionals
• Department Chair or designee in an educational institution located in Virginia that trains mental health professionals – representing mental health professionals
• Dean from a school of pharmacy located in Virginia, or executive level designee – representing pharmacy
• Dean from a school of nursing located in Virginia, or executive level designee – representing nursing
• Dean from a school of allied health located in Virginia, or executive level designee – representing allied health professions such as health administration, health information technology, occupational therapy, physical therapy, emergency medical technicians

Health Facilities and Employer Sector
• A representative from a mental health agency or facility in an underserved area – representing community mental health
• A hospital industry representative from an underserved area – representing health facilities
• A representative from the Virginia Community Healthcare Association, or designee – representing the healthcare safety net
• A representative from a provider association (e.g., AAFP, AAP, VDA, VPHA, VOMA, MSV ) – representing the health professions industry

Community and Community Health Sector
• A representative appointed by the Board of the Older Dominion Partnership who has health or health care expertise - representing the needs of the aging population
• A representative from the Virginia Consortium for Health Philanthropy – representing health philanthropies
• An AHEC Center director or designee – representing the AHECs
• The Executive Director of the Virginia Rural Health Association or designee – representing rural health
• One citizen representative from an underserved area

Ad Hoc Members
• One member of the Senate to be appointed by the Senate Committee on Rules;
• One member of the House of Delegates to be appointed by the Speaker of the House of Delegates
• Chancellor of the Virginia Community College System, or executive level designee
• The Commissioner of Health or executive level designee
• The Director of the Department of Health Professions or executive level designee

§ 32.1122.7:1. Powers and duties of the Virginia Health Workforce Development Authority.
A. The Authority is authorized to serve as the incorporated Consortium of allopathic and osteopathic medical schools in Virginia as required by federal statute to qualify for the receipt of Area Health Education Center funding from the Health Resources and Services Administration Area Health Education Centers programs, legislatively mandated under the Public Health Service Act as amended, Title VII, Section 751, and (42 U.S.C. 294a); and to administer federal, state, and local programs as needed to carry out its public purpose and objectives. The Authority is further authorized to exercise independently the powers conferred by this section in furtherance of its corporate and public purposes,to benefit citizens and such other persons who might be served by the Authority.

B. The Authority is authorized to monitor, collect and track data pertaining to health care delivery, training and education from Virginia educational institutions and other entities as needed to carry out its public purpose and objectives in areas where such data efforts do not already exist.

C. The Authority shall have the authority to assess policies, engage in policy development and make policy recommendations.

D. The Authority shall have the authority to apply for and accept Federal, State and local (public and private) grants, loans, appropriations and donations; hire and compensate staff, including an Executive Director; rent, lease, buy, own, acquire and dispose of property, real or personal; participate in joint ventures, including to make contracts and other agreements, with public and private entities in order to carry out its public purpose and objectives; and make bylaws for the management and regulation of its affairs.

E. The Board of Directors shall report biennially the activities and recommendations of the Authority to the Secretary of Health and Human Resources, Secretary of Education, Secretary of Commerce and Trade, the State Board of Health, the Commissioner of Health, the State Council of Higher Education for Virginia, the Governor, the Joint Commission on Health Care and the General Assembly. In any reporting period where state general funds are appropriated to the Authority, the annual report shall include a detailed summary of how state general funds appropriated to the Authority were expended.

F. The Authority shall be exempt from the Personnel Act, Workforce Transition Act, Administrative Process Act, and Public Procurement Act. The provisions of Chapter 29 (§ 2.2-2900 et seq.) of Title 2.2, Chapter 32 (§ 2.2-3200 et seq.) of Title 2.2, Chapter 40 (§ 2.2-4000 et seq.) of Title 2.2, and Chapter 43 (§ 2.2-4300 et seq.) of Title 2.2 shall not apply to the Authority in the exercise of any power conferred under this chapter.

G. Exemption from taxes or assessments. The exercise of the powers granted by this article shall be in all respects for the benefit of the people of the Commonwealth, for the increase of their commerce and prosperity, and for the improvement of their health and living conditions, and as the operation and maintenance of projects by the Authority and the undertaking of activities in furtherance of the purpose of the Authority constitute the performance of essential governmental functions, the Authority shall not be required to pay any taxes or assessments upon any project or any property acquired or used by the Authority under the provisions of this article or upon the income therefrom, including sales and use taxes on tangible personal property used in the operations of the Authority. The exemption granted in this section shall not be construed to extend to persons conducting, on the premises of the facility, businesses for which local or state taxes would otherwise be required.

H. Exemption from VITA. (specific language to be determined).

§ 32.1122.21. Health Workforce Advisory Committee.
The Commissioner shall establish a Health Workforce Advisory Committee to advise him on all aspects of the Department’s health workforce duties and responsibilities identified in this article. The Health Workforce Advisory Committee shall include representatives of (i) each of the Commonwealth’s academic health centers; (ii) the Statewide Area Health Education Center (AHEC) Program Healthcare Workforce Authority; (iii) the Virginia Primary Care Association; (iv) the Virginia Health Care Foundation; (v) the Virginia Association of Free Clinics; (vi) the Virginia Association of Nurse Executives; (vii) health care providers; (viii) health professions residents and students; and (ix) other organizations as deemed appropriate by the Commissioner. The Health Workforce Advisory Committee shall be dissolved upon appointment of the Board of Directors for the Authority.

It was suggested that the Board elect an executive committee that would be elected by the Board and comprised of several members of each of the three major sectors. The Executive Committee would be empowered by the Board to make and implement major organizational decisions. This would make the issue of a quorum and the larger size of the Board less unwieldy. This is not something we need to insert into the Code, but something to keep in mind as the Board develops by-laws.

11 comments:

  1. ... monitor, collect and track data pertaining to health care delivery, training and education from Virginia educational institutions and other entities as needed to carry out its public purpose and objectives where such data efforts do not already exist in order ...

    I see this as duplicative state agency activity and suggest that whatever the authority anticipates they'll need for it to be included in the workplan for the other healthcare workforce data center. I realize this may be more of an administrative challenge but in this economic climate, sharing state resources may gain more ground than the perceived hassle it may cause.

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  2. Ann –



    The entire reason for the existence of the clause in caps:

    B. The Authority is authorized to monitor, collect and track data pertaining to health care delivery, training and education from Virginia educational institutions and other entities as needed to carry out its public purpose and objectives in areas WHERE SUCH DATA EFFORTS DO NOT ALREADY EXIST

    is to address the issues you raised. We don’t want to duplicate efforts and want to leverage resources. However, if there is an immediate data need, the Authority needs to have the authority to request the data. For example, one of the issues raised at the various stakeholder meetings was the need for data regarding residents – where do they go, how many stay in Virginia, where do they go after residency. This is not something presently collected by anyone. If the Authority feels a need to look at this data for planning purposes, it needs to have the authority to go to the individual schools and make that request. If the Dept of Health Professions decides it wants to collect this data at some point, then by all means, it should and this Authority would gladly stop. That’s simply all that is within the context of this.

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  3. I think we also need to be conscious of the fact that DHP funding is through a grant.

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  4. Makes good sense to me.

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  5. Makes sense to me!

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  6. Thank you for producing such a professionally prepared document. And, thank you for addressing our AHEC concerns and incorporating them into the final proposed language. This proposal has the potential for achieving many of the goals and objectives we have all been unsuccessfully pursuing. I am encouraged that this may be our golden opportunity.

    As the PAG AHEC Chair, I thank you profusely on behalf of all AHEC Center Directors. You have provided us with the opportunity to finally achieve great things.

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  7. Michelle Whitehurst-CookNovember 16, 2009 at 1:06 AM

    This looks fine, lots of potential.

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  8. I think its important not to have competing data collection or analysis between state entities.

    In my view, it is very important for the DHP licensing and educ. accred. and reporting function to be strengthened and its data resource (previously underutilized) to serve the needs of the state. If DHP has source data (current and historical) from admin. systems and other analyses/reports it is responsible for, this data should be kept indef. and made available to agencies/depts to support a broad array of planning and other purposes.

    I would be strongly in favor of any leg. language that gives the Authority the option of making use of extant data or collecting data not otherwise available. If you think this does that, I am in support.

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  9. I am in agreement with the language you propose below and support this position. Have been reading but not commenting until now. Recently I've been asked to take another look at dental healthcare provision in PD 1 and 2 and once again found that, based on a sampling of practicing FTEs of licensed professionals in the workforce compared to numbers of active licenses to residents in PD 1 and 2 available from DHP, the picture of the workforce was rather impressively different. I may be ignorant of this aspect of dhp data, but am not aware that workforce has been defined in any way other than active licenses, not reflecting the percent of time actually in the workforce in Virginia. Additionally, I believe the issue of dually licensed professionals whose license renewal is mailed to an address out of state may be working out of state or working in practices part time across state lines. (this occurs in my district). So I can appreciate that this language is necessary and vital to the work of the authority.

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  10. Very interesting topi. It make sense to me. I am thankful to drop by. I have learned few things.

    General Practice clinics

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