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2017 Session

Budget Amendments - HB1500 (Floor Approved)

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ED Care Coordination Technology Solution

Item 300 #1h

Item 300 #1h

First Year - FY2017 Second Year - FY2018
Health and Human Resources
Department of Health FY2017 $0 FY2018 $370,000 GF
FY2017 $0 FY2018 $3,330,000 NGF

Language
Page 282, line 4, strike "$19,552,502" and insert "$23,252,502".

Page 282, after line 27, insert:

"C.1. Out of this appropriation, $370,000 from the general fund and $3,330,000 from nongeneral federal HITECH funds the second year shall be provided to implement the provisions of House Bill 2209 which establishes the Emergency Department Care Coordination Program.  The Department of Medical Assistance Services, in cooperation with the Department of Heath, shall apply for federal HITECH matching funds and seek any additional eligible federal matching funds supporting provider electronic health record implementation and integration in order to implement the program.

2. The Department of Health shall contract or amend an existing contract with a non-profit entity as necessary in order to implement the program. The contractor may utilize an existing governance, legal and trust framework in order to fulfill the requirements of House Bill 2209 and to expedite the implementation of the program.

3. Pursuant to House Bill 2209, the Emergency Department Care Coordination Advisory Council (ED Council) shall: (i) specify the necessary functionalities of the system to meet the needs of all key stakeholders; (ii) develop and oversee a competitive selection process for a vendor or vendors that will provide a single, statewide technology solution to fulfill the required functionalities and advance the goals of the initiative; and (iii) oversee the implementation of successful information technologies, with implementation no later than December 31, 2017.

4. In fiscal year 2018, all hospitals operating emergency departments in the Commonwealth and all Medicaid managed care contracted health plans shall participate in the program.  All hospitals operating emergency departments in the Commonwealth, all Medicaid contracted managed care health plans, the State Employee Health Plan, all Medicare plans operating in the Commonwealth, and all commercial plans operating in the Commonwealth, excluding ERISA plans, shall participate in the program in fiscal year 2019.  The Department, in coordination with the Department of Medical Assistance Services, shall determine the amount of federal funds available to support program operations in fiscal year 2019, and in cooperation with the ED Council, recommend a funding structure for program operations by October 15, 2017 that apportions program costs across the Commonwealth, participating hospitals, and participating health plans in fiscal year 2019 and annually thereafter.

5. The Department, in coordination with the ED Council,  shall report annually beginning November 1, 2017 to the Secretary of Health and Human Resources, the Chairmen of the House Appropriations Committee and Senate Finance Committee on progress, including, but not limited to: (i) the participation rate of hospitals and health systems, physicians and subscribing health plans; (ii) strategies for sustaining the program and methods to continue to improve care coordination; and (iii) the impact on health care utilization and quality goals such as reducing the frequency of visits by high-volume Emergency Department utilizers and avoiding duplication of prescriptions, imaging, testing or other health care services."



Explanation

(This amendment adds $370,000 from the general fund and $3.3 million from federal HITECH funds and language to implement the provisions of House Bill 2209 which establishes an emergency department care coordination program. Language directs the development and implementation of a single, statewide technology solution that connects all the emergency departments in the Commonwealth to enable real time communication and collaboration between physicians, providers and other clinical or care management personnel for patients receiving services in hospital emergency departments for the purpose of improving the quality of patient care services, and lowering costs. Language also sets out specific responsibilities of the Emergency Department Care Coordination Advisory Council (ED Council) which is created in the legislation.

The program is phased in with participation by hospital emergency departments and Medicaid managed care organizations in fiscal year 2018 and would expand to include all health plans operating in Virginia, excluding ERISA plans in fiscal year 2019. Language directs the Department of Health, with cooperation of the Department of Medical Assistance Services and the ED Council, to develop a funding structure for program operations in fiscal year 2019 that apportions program costs across the Commonwealth, participating hospitals, and participating health plans.

Pursuant to House Bill 2209, implementation of this initiative is contingent upon the receipt of HITECH matching funds, and neither the Department nor its contractor will be obligated to implement the Program without HITECH matching funds.)