HB 1695-FN - AS AMENDED BY THE SENATE
10Feb2016... 0323h
23Mar2016... 1058h
04/28/2016 1497s
04/28/2016 1653s
05/12/2016 1803s
05/12/2016 1964s
2016 SESSION
\t16-2554
\t01/09
HOUSE BILL\t1695-FN
AN ACT\trelative to a health system public data resource for New Hampshire and establishing a special fund, relative to cost effectiveness of programs implemented within state agencies, and relative to record management of abuse and neglect reports.
SPONSORS:\tRep. Sherman, Rock. 24
COMMITTEE:\tHealth, Human Services and Elderly Affairs
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AMENDED ANALYSIS
\tThis bill establishes a health system public data resource for New Hampshire. Under this bill, the commissioner of the department of health and human services, the insurance commissioner, and the attorney general shall enter into a memorandum of understanding to collaborate in the development of publicly available information on health care system patient safety, cost, quality, access, and system performance, and information pertaining to the delivery and financing of the health care system in New Hampshire. The bill establishes a health system public data resource planning council to provide consultation for the development of a public data resource for New Hampshire. The bill establishes a fund for the implementation and administration of the requirements of the plan.
\tThe bill requires the office of the legislative budget assistant to evaluate the feasibility of calculating and using cost effectiveness in evaluating new and existing state programs.
\tThis bill also revises the record retention requirements for founded, unfounded, and screened-out reports of abuse or neglect which is a request of the commission to review child abuse fatalities, established in 2015, 127.
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Explanation:\tMatter added to current law appears in bold italics.
\t\tMatter removed from current law appears [in brackets and struckthrough.]
\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10Feb2016... 0323h
23Mar2016... 1058h\t16-2554
04/28/2016 1497s
04/28/2016 1653s
05/12/2016 1803s\t01/09
05/12/2016 1964s
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT\trelative to a health system public data resource for New Hampshire and establishing a special fund, relative to cost effectiveness of programs implemented within state agencies, and relative to record management of abuse and neglect reports.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t1 New Subdivision; Health System Public Data Resource. Amend RSA 126-A by inserting after section 69 the following new subdivision:
Health System Public Data Resource
\t126-A:70 Health System Public Data Resource; Council Established.
\t\tI.(a) Pursuant to the memorandum of understanding set forth in paragraph V, the department of health and human services shall make publicly available through an Internet website consolidated information on health care system patient safety, cost, quality, access to coverage and care, system performance, and efficiency, and information pertaining to the delivery of the health care system in New Hampshire, including information on new health system projects and associated costs.
\t\t\t(b) The information made available shall be maintained as a resource for decision making and policy analysis by state and local planners, policy makers, health care system entities, purchasers of health care, and the public. The information shall also be used by the department, in consultation with the health system public data resource planning council established in paragraph III, to plan and monitor the health care system and the relevant factors that influence patient safety, cost, quality, access, and performance.
\t\tII. The commissioner, in consultation with the health system public data resource planning council, shall coordinate and provide support for the development of a public data resource for New Hampshire. The public data resource may be developed as an information resource for use by health care providers, health insurance carriers, health care purchasers, and the general court to develop and implement programs and policies and provide guidance to state agencies when implementing programs and policies. The public data resource shall include:
\t\t\t(a) Analysis of the health care needs of both the state as a whole and each geographic region of the state.
\t\t\t(b) Analysis of current health care system safety, cost, quality, access, system performance, and financing and including financial drivers uncompensated care and its constituent parts.
\t\tIII.(a) There is hereby established a health system public data resource planning council. The membership of the council shall be as follows:
\t\t\t\t(1) Two members of the house of representatives, appointed by the speaker of the house of representatives.
\t\t\t\t(2) One member of the senate, appointed by the senate president.
\t\t\t\t(3) The commissioner of the department of health and human services, or designee.
\t\t\t\t(4) The insurance commissioner, or designee.
\t\t\t\t(5) The attorney general, or designee.
\t\t\t\t(6) One member representing health care facilities, appointed by the New Hampshire Hospital Association.
\t\t\t\t(7) One member representing health care practitioners, appointed by the New Hampshire Medical Society.
\t\t\t\t(8) One member representing municipal planners, appointed by the New Hampshire Planners Association.
\t\t\t\t(9) One member representing public health practitioners, appointed by the New Hampshire Public Health Association.
\t\t\t\t(10) One member representing community services providers, appointed by the governor.
\t\t\t\t(11) One public member representing health care consumers, appointed by the governor.
\t\t\t\t(12) One member representing public purchasers of health insurance, appointed by the governor.
\t\t\t\t(13) One member representing private purchasers of health insurance, appointed by the governor.
\t\t\t\t(14) One member representing health insurance carriers, appointed by the governor.
\t\t\t\t(15) A representative of community health centers, appointed by the Bi-State Primary Care Association.
\t\t\t(b) Members of the council shall serve without compensation, except that legislative members shall receive mileage at the legislative rate when attending to the duties of the council. The members, other than those representing state agencies and the legislature, shall serve 3-year terms and shall not serve more than 2 full consecutive terms. Those members representing state agencies shall serve as nonvoting members on the council.
\t\t\t(c) The council may meet as often as necessary to effectuate its goals. The first meeting shall be called by the commissioner of health and human services within 45 days of the effective date of this subdivision. At the first meeting, a chairman shall be elected by the members. Seven members of the council shall constitute a quorum.
\t\t\t(d) The council shall:
\t\t\t\t(1) Provide advice and consultation to the commissioner regarding the development, implementation, and maintenance of the health system public data resource.
\t\t\t\t(2) Review and evaluate best practices to make publicly available consolidated information on health care system patient safety, cost, quality, access to coverage and care, system performance, and efficiency, and information pertaining to the delivery and financing of the health care system in New Hampshire, including information on new health system projects and associated costs.
\t\t\t\t(3) Monitor the health care system and the relevant factors that influence patient safety, cost, quality, access, and performance. The council’s authority and duties shall be limited to the provisions of this subdivision.
\t\t\t\t(4) The council shall make an initial report on November 1, 2016 with an annual report on each November 1 thereafter, relative to the health system public data resource plan and information Internet website. The reports shall include the council’s findings and any recommendations for proposed legislation and shall be submitted to the oversight committee on health and human services established in RSA 126-A:13, the chairpersons of the house and senate standing committees having jurisdiction over health and human services issues, the speaker of the house of representatives, the president of the senate, and the governor.
\t\tIV. The commissioner, in consultation with the council, shall release the initial version of the health system public data resource no later than January 1, 2017 or 8 months after the effective date of this subdivision, whichever is later.
\t\tV. The commissioner, in consultation with the council, shall enter into a memorandum of understanding with the insurance commissioner and attorney general for collaboration in the development of the publicly available information specified in paragraph I. The memorandum of understanding shall include a description of the resources that shall be made available to the department and shall specifically identify data and reports which shall be shared with the department. The commissioner shall submit a report on the implementation of the memorandum of understanding, including the cost to make the health system public data resource and to meet other requirements set forth in this subdivision, to the fiscal committee of the general court, established in RSA 14:30-a, on or before October 1, 2016. The report shall be subject to review and comment by the fiscal committee.
\t\tVI. Pursuant to the memorandum of understanding under paragraph V, the commissioner, in consultation with the council, shall adopt rules under RSA 541-A, as may be necessary, relative to collecting aggregate information from health care providers and the insurance department that is not proprietary information on new health system projects, and associated costs under the provisions of this subdivision.
\t\tVII. The department, in consultation with the council, shall make the health system public data resource and meet other requirements set forth in this subdivision, subject to sufficient and available funding. No additional general funds shall be appropriated for this subdivision for the biennium ending June 30, 2017.
\t126-A:71 Health System Public Data Resource Plan Fund; Established. There is established the health system public data resource plan fund, which shall be nonlapsing and continually appropriated to the department and administered by the commissioner for the purposes of this subdivision. Pursuant to the memorandum of understanding under RSA 126-A:70, V, the fund shall be used for costs incurred by the department in carrying out the requirements under this subdivision. All monetary funds, grants, gifts, donations, or interest generated by the fund shall be deposited with the state treasurer in the fund.
\t2 Office of Legislative Budget Assistant; Cost Effectiveness of Programs Within State Agencies.
\t\tI. The legislative budget assistant, in collaboration with the department of administrative services and such other organizations as he or she may wish to consult, shall evaluate the feasibility of calculating and using cost effectiveness in evaluating new and existing state-funded programs. The process for determining cost effectiveness shall include, but not be limited to, the following steps:
\t\t\t(a) Systematically assessing high-quality studies from the United States and elsewhere to identify policy options that have been tried and tested and found to achieve improvements in outcomes.
\t\t\t(b) Determining the cost to produce the results found in subparagraph (a) in this state, determining the benefits from such an improved outcome, and calculating the net present value thereof.
\t\t\t(c) Assessing the risk in the estimates to determine the probability that a particular policy option's benefits will outweigh its costs.
\t\t\t(d) Ranking programs in state agencies based on net present value and risk.
\t\tII. The department of administrative services and each state agency shall furnish to the legislative budget assistant information, excluding information otherwise confidential under law, he or she may request in the course of carrying out the duties under this section in a mutually agreeable and compatible format.
\t\tIII. The legislative budget assistant shall make an initial report by November 1, 2016, on the feasibility of calculating and using cost effectiveness in evaluating new and existing state programs. If the legislative budget assistant determines that calculating cost effectiveness is feasible, he or she shall make a final report on or before November 1, 2017, including recommendations for legislation, to the commissioner of administrative services, the chairpersons of the house and senate finance committees, the speaker of the house of representatives, the president of the senate, the state library, and the governor.
\t3 New Subparagraph; Application of Receipts; Health System Public Data Resource Plan Fund. Amend RSA 6:12, I(b) by inserting after subparagraph (331) the following new subparagraph:
\t\t\t\t(332) Moneys deposited in the health system public data resource plan fund, established in RSA 126-A:71.
\t4 New Paragraph; Child Protection Act; Definition of Screened-Out Report. Amend RSA 169-C:3 by inserting after paragraph XXVII-a the following new paragraph:
\t\tXXVII-b. “Screened-out report” means a report made pursuant to this chapter that the department has determined does not rise to the level of a credible report of abuse or neglect and is not referred for assessment.
\t5 Child Protection Act; Records Management of Abuse and Neglect Reports. RSA 169-C:35-a is repealed and reenacted to read as follows:
\t169-C:35-a Records Management of Abuse and Neglect Reports.
\t\tI. The department shall retain a screened-out report for 7 years from the date that the report was screened out. If during the 7-year retention period, the department receives a subsequent report of abuse or neglect concerning the same alleged perpetrator or the same child or any siblings or other children in the same household or in the care of the same adults, the department shall retain information from the prior and subsequent reports for an additional 7 years from the date a subsequent report is screened out, an additional 10 years from the date a subsequent report is deemed unfounded, and indefinitely if the subsequent report is deemed founded. The department shall delete or destroy all electronic and paper records of the reports when the retention period for the most recent report expires.
\t\tII. The department shall retain an unfounded report for 10 years from the date that the department determined the case to be unfounded. If during the 10-year retention period, the department receives a subsequent report of abuse or neglect concerning the same alleged perpetrator or the same child or any siblings or other children in the same household or in the care of the same adults, the department shall retain the information from the prior and subsequent reports for an additional 10 years from the date the subsequent report is screened out or deemed unfounded, or indefinitely if the subsequent report is deemed founded. The department shall delete or destroy all electronic and paper records of the reports when the most recent report expires.
\t\tIII. The department shall retain a founded report indefinitely.
\t\tIV. Nothing in this section shall prevent the department from retaining generic, non-identifying information which is required for state and federal reporting and management purposes.
\t\tI. Sections 4 and 5 of this act shall take effect January 1, 2017.
\t\tII. The remainder of this act shall take effect upon its passage.
\t\t\t\t\t\t\t\t\t\t\t16-2554
\t\t\t\t\t\t\t\t\t\t\tAmended 4/13/16
HB 1695-FN- FISCAL NOTE
AN ACT\t(Second New Title) relative to a health system public data resource plan for New Hampshire and establishing a special fund and relative to cost effectiveness of programs implemented within state agencies.
FISCAL IMPACT:
The Department of Health and Human Services and Department of Information Technology state this bill, as amended by the House (Amendment #2016-1058h), may increase state restricted revenue and expenditures by an indeterminable amount in FY 2017 and each year thereafter. There will be no impact on county and local expenditures or revenue.
This bill establishes a continually appropriated, nonlapsing dedicated fund.
METHODOLOGY:
The Department of Health and Human Services states this bill requires it to make available on a website consolidated information on health care system patient safety, cost, quality, access to coverage and care, system performance, and efficiency, as well as information pertaining to the delivery and financing of the health care system in New Hampshire. The bill establishes a health system public data resource planning council, which is charged with evaluating best practices in the development and provision of the aforementioned information, providing annual reports to the Legislature, working with the Department to develop a 10-year health system data resource plan for New Hampshire, and entering into memoranda of understanding (MOU) with various state agencies in order to accomplish said goals. The bill also establishes a health system public data resource plan fund, which shall be used for costs incurred by the Department in carrying out its responsibilities under the bill. The fund is authorized to accept grants, gifts, donations. In addition, the bill states the Department's responsibilities for developing and implementing the data resource plan are subject to sufficient and available funding. Finally, the bill as amended states that no general funds shall be appropriated for this purpose for the FY 2016/17 biennium. For these reasons, although the Department states there may be an indeterminable cost associated with meeting the bill's requirements, it assumes those costs will only be incurred subject to available funding in the newly-established fund, and the Department will not be required to proceed if sufficient funds are unavailable.
The Department of Information Technology states that while the bill will result in an indeterminable increase in state expenditures, it is unable to provide an estimate of the increase at the current time.
The Office of Legislative Budget Assistant states the bill as amended requires the Office to evaluate the feasibility of calculating and using cost effectiveness in evaluating new and existing state-funded programs. The Office states this provision will have no fiscal impact.
The Insurance Department states the bill will have no fiscal impact.