HB 1525

AN ACT establishing a legislative oversight committee to review the procedures of the health services planning and review board.

SPONSORS: Rep. Batula, Hills 18; Rep. Wendelboe, Belk 2; Rep. Donovan, Sull 11; Rep. Haettenschwiller, Hills 29; Rep. M. Fuller Clark, Rock 36; Sen. D'Allesandro, Dist 20; Sen. Roberge, Dist 9; Sen. Squires, Dist 12; Sen. Johnson, Dist 3

This bill establishes a legislative oversight committee to review and make recommendations relative to the policies and procedures of the health services planning and review board.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT establishing a legislative oversight committee to review the procedures of the health services planning and review board.

Be it Enacted by the Senate and House of Representatives in General Court convened:

I. The regulatory structure for New Hampshire's health care delivery system was established within the Federal Health Service Act of 1974. The federal legislation was intended to stop unnecessary health facility construction and acquisition of expensive major medical equipment and was predicated on the idea that the most satisfactory means of controlling health care costs was the allocation of health care resources by government through a highly centralized health planning mechanism.

II. Although supporters of the program believed it helped curb rising health care expenditures, others opposed government intervention and control of supply as unnecessary. Critics prevailed during Congressional debate in 1986, when federal mandates for state health planning agencies were repealed. Since that time, 13 states (Arizona, California, Colorado, Idaho, Kansas, Minnesota, New Mexico, North Dakota, Pennsylvania, South Dakota, Texas, Utah, and Wyoming) have abolished their health planning agencies all together. Recognizing the sweeping changes in the health care industry, several more states are considering similar action or, at the very least, liberalizing the requirements of these agencies, which, if they remain as originally charged, will become obsolete.

III. A highly regulated environment has evolved into a market-based means of controlling costs. Notably, the growth of managed care, restructured repayment mechanisms, and the rapid development of new medical techniques and innovations in medical technology exposed the inefficiencies inherent in centralized health care planning, which was unable to respond quickly to the changing needs of the health care system.

IV. The state of New Hampshire's health services planning and review board has substantive expertise in the health care services market. Decisions relative to health care services, the acquisition of medical technology, and the expansion of facilities have been carried out by the board with all due deliberation.

V. For reasons of maintaining the quality of certain health care services, to protect the role of certain institutions, whose importance to the statewide health care delivery system is essential, and to guard against the closing of important facilities and the transfer of services from facilities in a manner which is harmful to the public interests, the role of the health services planning and review board is valuable.

VI. Nevertheless, the general court remains concerned that the regulatory structure of the health services planning and review board, operating under its current rules of engagement, is not as adaptable as the rapidly changing world of medical technology, choice of health care services, and expansion of medical facilities dictates.

VII. Because it is essential that New Hampshire promote the greatest efficiency in the state's health care delivery system and because the structure of the current system remains protracted, the general court hereby establishes a joint committee on health care oversight.

2 New Section; Oversight Committee Established. Amend RSA 151-C by inserting after section 15 the following new section:

I. There is hereby established a legislative oversight committee to review the policies and procedures of the board.

II. The committee shall consist of 6 members, 3 of whom shall be members of the house of representatives, appointed by the speaker of the house, and 3 of whom shall be senators appointed by the president of the senate. Members shall be appointed for their term of office. All members shall be eligible for reappointment so long as they are qualified under this section. Members shall be appointed no later than December 30 of the year of their election to the general court, except that vacancies shall be filled for an unexpired term within 30 days of the creation of such vacancy, and the initial appointments under this section shall be made within 30 days of the effective date of this section. The members shall choose from their number a chairperson, provided that the chair shall rotate biennially between the house and senate members. Members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.

III. The committee shall consider the need to review the policies and procedures of the board and shall make recommendations as it deems necessary. The committee may also investigate the possibility of requiring the executive branch to create an additional appeal mechanism.

IV. The committee shall have the same investigatory powers as the general court.