PRINTER'S NO. 805
No. 728 Session of 1991
INTRODUCED BY E. Z. TAYLOR, WOZNIAK, FLEAGLE, S. H. SMITH,
HERMAN, FARGO, DALEY, JOHNSON, BILLOW, PETRONE, BARLEY,
D. R. WRIGHT, HALUSKA, GANNON, BATTISTO, SEMMEL, NOYE, GEIST,
WILSON, BELARDI, FOX, COY, GODSHALL, VROON, TRELLO, PESCI,
KASUNIC, STEELMAN, CLARK, SAURMAN, MELIO, HARPER, PETRARCA,
COLAIZZO AND STRITTMATTER, MARCH 13, 1991
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, MARCH 13, 1991
AN ACT
1 Establishing a system of primary health care in this
2 Commonwealth; providing for assistance, coordination and
3 support of the development of comprehensive primary health
4 care services for low-income citizens.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Short title.
8 This act shall be known and may be cited as the Primary
9 Health Care Services Act.
10 Section 2. Legislative findings and intent.
11 (a) Findings.--The General Assembly finds that access to
12 primary health care services for low-income citizens is in the
13 public interest. The General Assembly further finds that
14 Federal, State and local primary health care dollars are being
15 spent in an uncoordinated and inefficient fashion.
16 (b) Intent.--
17 (1) It is the intent of the General Assembly and the
1 purpose of this act to enhance the effectiveness and
2 efficiency of primary health care services which shall be
3 accessible on a uniform basis to all low-income Pennsylvania
4 residents.
5 (2) The General Assembly further intends to channel
6 Federal and State funding for primary health care through
7 designated local and regional primary health care centers to
8 assure the efficient use of government funding.
9 Section 3. Definitions.
10 The following words and phrases when used in this act shall
11 have the meanings given to them in this section unless the
12 context clearly indicates otherwise:
13 "Community health center." A nonprofit entity which, either
14 through its staff and supporting resources or through contracts
15 or cooperative arrangements with other public or private
16 entities, provides all of the following:
17 (1) Primary health services.
18 (2) Referral to providers of supplemental health
19 services.
20 (3) Information on the availability and proper use of
21 health services.
22 "Council." The Primary Health Care Advisory Council, created
23 and empowered under this act.
24 "Department." The Department of Health of the Commonwealth.
25 "Primary health care services." Organized services provided
26 by licensed health care professionals, to include, as a minimum,
27 the following:
28 (1) Preventive health services, including children's eye
29 and ear examinations to determine the need for vision and
30 hearing correction, prenatal and perinatal services, well
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1 child services, family planning services, vaccinations,
2 preventive dental services and early periodic screening
3 diagnosis and treatment.
4 (2) Emergency and routine health care services.
5 (3) Limited pharmaceutical services as may be
6 appropriate for certain medical conditions.
7 (4) Health screening and testing.
8 "Secretary." The Secretary of Health of the Commonwealth.
9 "Supplemental health services." Services not included as
10 primary health services, such as hospital care, home health
11 services, rehabilitative services, mental health services, drug
12 and alcohol treatment and ambulatory surgical services.
13 Section 4. Primary health care services system.
14 The primary health care system administered by the department
15 shall:
16 (1) Provide primary health care services for low-income
17 Pennsylvanians through a network of primary health care
18 centers.
19 (2) Be available within a reasonable and convenient
20 travel distance for all low-income Pennsylvanians.
21 (3) Provide for the effective utilization of existing
22 primary health care centers and primary health care
23 financing.
24 (4) Be capable of assuring that primary health care
25 services are available to low-income individuals and
26 families.
27 (5) Establish appropriate arrangements with private
28 health care providers and health care facilities.
29 Section 5. Duties of department.
30 The department shall:
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1 (1) Create a plan to develop, improve and maintain
2 primary health care services throughout this Commonwealth.
3 (2) Establish, by regulation, standards and criteria
4 governing the award and administration of contracts for
5 primary health care services with community health centers
6 under this act.
7 (3) Administer contracts authorized under this act and
8 distribute grants pertaining to primary health care services.
9 (4) Coordinate a Commonwealth plan for primary health
10 care services in consultation with local planning efforts.
11 (5) Establish a quality assurance program to monitor the
12 quality of publicly financed primary health care services
13 provided in each county or multicounty region.
14 (6) Coordinate activities with the Department of Aging,
15 the Department of Education and the Department of Public
16 Welfare.
17 (7) Develop a program in consultation with the
18 Pennsylvania Higher Education Assistance Agency to encourage
19 health care professionals to practice in primary health care
20 centers in this Commonwealth
21 Section 6. Primary Health Care Advisory Council.
22 (a) Creation.--The Primary Health Care Advisory Council is
23 hereby created to act as consultants to the department in the
24 implementation and administration of this act.
25 (b) Powers.--The council shall, wherever feasible,
26 incorporate and consolidate existing advisory boards within the
27 department responsible for oversight, planning and approval of
28 expenditures for primary health care services.
29 (c) Appointment.--The secretary shall appoint members after
30 consultation with the Secretary of Aging, the Secretary of
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1 Education, the Secretary of Public Welfare and appropriate
2 health care provider and consumer organizations. The members of
3 the council shall be geographically representative and shall
4 include primary health care providers, administrators and low-
5 income consumers.
6 (d) Size.--Council shall not exceed 21 members.
7 (e) Duties.--The council shall:
8 (1) Elect its own officers.
9 (2) Advise the department on matters relating to the
10 delivery of primary health care and promotion of optimal
11 health of Pennsylvania's low-income citizens.
12 (3) Serve as a forum for discussion on the content of
13 the Statewide primary health care services plan and for any
14 proposed revisions to the plan.
15 (f) Open meetings.--All meetings of the council shall be
16 held in accordance with the provisions of the act of July 3,
17 1986 (P.L.388, No.84), known as the Sunshine Act.
18 (g) Terms.--A voting member of the council shall serve a
19 three-year term. A voting member shall not serve more than two
20 consecutive terms.
21 (h) Quorum.--A simple majority of the voting members of the
22 council will constitute a quorum for the transaction of
23 business.
24 (i) Compensation.--Members of the council shall serve
25 without compensation, except the department may pay necessary
26 and reasonable expenses incurred by members while performing
27 official duties.
28 Section 7. Community health centers.
29 (a) Purpose.--Community health centers shall assist the
30 department in carrying out the provisions of this act. Every
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1 community health center shall adhere to policy direction
2 established by the department.
3 (b) Organization.--For the purposes of this act, the
4 organizational structure of a community health center shall be
5 one of the following:
6 (1) A federally funded community health center meeting
7 requirements established by the department.
8 (2) A State or local health department.
9 (3) Any other public or private nonprofit entity which
10 meets requirements established by the department by
11 regulation.
12 (c) Duties.--A community health center shall:
13 (1) Be managed by a volunteer board of directors which
14 is representative of the health care providers and low-income
15 consumers in the geographic area served.
16 (2) Be available and accessible to residents of the
17 geographic area served by the center.
18 (3) Have organizational arrangements with referral
19 sources and supplemental health services.
20 (4) Have an ongoing quality assurance program for the
21 center's services.
22 (5) Maintain the confidentiality of patient records.
23 (6) Have a contractual arrangement with the Department
24 of Public Welfare to receive Federal and State funding under
25 Title XIX of the Social Security Act (Public Law 74-271, 42
26 U.S.C. § 301 et seq.) for persons who are eligible for
27 Medical Assistance under the State plan.
28 (7) Employ providers who agree to accept the fee
29 established under Title XVIII of the Social Security Act as
30 payment in full.
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1 (8) Have an established schedule of fees designed to
2 cover reasonable costs of operations and based on individual
3 patient or family ability to pay.
4 Section 8. Contracts for primary health care services.
5 (a) General power of secretary.--The secretary may enter
6 into contracts with community health centers or other
7 appropriate entities to initiate, expand, maintain or coordinate
8 primary health care services which are in accordance with the
9 State plan.
10 (b) Limitation.--
11 (1) All State agencies or departments shall contract
12 with community health centers for the delivery of government-
13 funded primary health care services, including, but not
14 limited to, early periodic screening diagnosis and treatment
15 funded by the Medical Assistance program in the Department of
16 Public Welfare, and programs funded by the Maternal and Child
17 Health Block Grant for primary health care.
18 (2) When any contracts are entered into under this
19 section for the delivery of primary health care services, no
20 other contract may be entered into for other primary health
21 care services for the same area in whole or substantial part
22 by State government with another primary health care
23 provider.
24 (c) Purposes.--State funding for contracts under subsection
25 (a) may be used only for:
26 (1) Providing programs of public education and
27 information on health promotion and the availability and
28 proper use of health services.
29 (2) Financing the delivery of primary health care
30 services when all other governmental and private financing
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1 have been exhausted.
2 (3) Reasonable costs associated with administering a
3 primary health care center.
4 (4) Reasonable costs associated with collection and
5 analysis of data as may be required by the department.
6 Section 9. Evaluation.
7 The department shall evaluate the effectiveness of the
8 primary health care plan and services developed under this act.
9 The General Assembly shall receive the evaluation report by
10 January 1, 1993.
11 Section 10. Appropriation.
12 The sum of $5,000,000, or as much thereof as may be
13 necessary, is hereby appropriated to the Department of Health to
14 expand primary health care services to all geographic regions of
15 this Commonwealth.
16 Section 11. Effective date.
17 This act shall take effect July 1, 1991.
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