Authority: §§ 32.1-102.1 through 32.1-102.11; 32.1-122.01 through 32.1-122.08; and 32.1-123 through 32.1-138.5, Code of Virginia; and P.L. 96-79, as amended, Federal Code; and Title XVIII and Title XIX of the U.S. Social Security Act, Federal Code.

A. Supplemental funding for the regional health planning agencies shall be provided from the following sources:

1. Special funds from Certificate of Public Need (40608) application fees in excess of those required to operate the COPN Program, provided the program may retain special fund balances each year equal to one month's operational needs in case of revenue shortfalls in the subsequent year.

2. The Department of Health shall revise annual agreements with the regional health planning agencies to require an annual independent financial audit to examine the use of state funds and the reasonableness of those expenditures.

B. Failure of any regional health planning agency to establish or sustain business operations shall cause funds to revert to the Central Office to support health planning and Certificate of Public Need functions.

C. The State Health Commissioner shall continue implementation of the "Five-Year Action Plan: Improving Access to Primary Health Care Services in Medically Underserved Areas and Populations of the Commonwealth." A minimum of $690,000 the first year and $690,000 the second year from the general fund shall be provided to the Virginia Office of Rural Health, as the state match for the federal Office of Rural Health Policy Grant. The commissioner is authorized to contract for services to accomplish the plan.

D. Out of this appropriation, $278,000 the first year and $278,000 the second year shall be appropriated to the department from statewide indirect cost recoveries to match federal funds and support the programs of the Office of Licensure and Certification. Amounts recovered in excess of the special fund appropriation shall be deposited to the general fund.

E. The Virginia Department of Health (VDH) in collaboration with the Department of Health Professions shall issue risk mitigation guidelines on the prescription of the class of potent pain medicines known as extended-release and long-acting (ER/LA) opioid analgesics to include co-prescription of an opioid antagonist, approved by the U.S. Food and Drug Administration (FDA), for administration by family members or caregivers in a non-medically supervised environment.

F. The Virginia Department of Health shall provide administrative and technical support to the Virginia Partners in Prayer Program through its Office of Health Equity. The cost of this support is estimated to be approximately $20,000 per year and shall be funded within its existing appropriation.

G. The provisions of § 32.1-102.4 (B), Code of Virginia, shall not apply to nursing homes.

H.1. Out of this appropriation, $300,000 the first year and $300,000 the second year from the general fund shall be transferred to the Virginia Health Workforce Development Authority for operational costs.

2. Out of this appropriation, $600,000 the first year from the general fund shall be transferred to the Virginia Health Workforce Development Authority to establish a workgroup to conduct a study on addressing primary care workforce issues and potential solutions, including but not limited to the feasibility of loan forgiveness programs. The workgroup shall be comprised of relevant stakeholders including representatives of the State Council of Higher Education for Virginia (SCHEV), Virginia Community College System (VCCS), the Secretary of Health and Human Resources, the Secretary of Education, the Secretary of Labor, the Virginia Department of Health, and the Department of Health Professions. All agencies of the Commonwealth, including institutions of higher education, shall lend assistance to the workgroup as called upon. Such workgroup shall review current and projected nursing shortages, as well as clinical and preceptor shortages, and offer recommendations to address these issues, including but not limited to alternative educational approaches to preparing and retaining nurses and nurse educators. An initial report shall be submitted to the Governor, Chairs of the House Appropriations and Senate Finance and Appropriations Committees, and the Director, Department of Planning and Budget by November 1, 2022. A final report shall be submitted to the Governor, Chairmen of the House Appropriations and Senate Finance and Appropriations Committees, and the Director, Department of Planning and Budget, detailing findings and recommendations by October 1, 2023.

I. Out of this appropriation, $60,000 the first year and $60,000 the second year from the general fund shall be provided to contract with the Virginia Telehealth Network to provide consultation to advisory groups, track implementation and facilitate changes to the Statewide Telehealth Plan.