SENATE AMENDED PRIOR PRINTER'S NOS. 198, 3223, 3299 PRINTER'S NO. 3505
No. 216 Session of 1995
INTRODUCED BY E. Z. TAYLOR, VANCE, FLEAGLE, CLARK, GEIST, PHILLIPS, SCHULER, WOZNIAK, D. W. SNYDER, HERSHEY, STERN, J. TAYLOR, BARLEY, MELIO, MUNDY, BOYES, COY, EGOLF, D. R. WRIGHT, LAWLESS, TRELLO, COLAFELLA, ARMSTRONG, JOSEPHS, BROWNE, DRUCE, PETTIT, FAIRCHILD, KAISER, L. I. COHEN, OLASZ, RUBLEY, BAKER, LEH, STETLER, CIVERA, MILLER, SCHRODER, MIHALICH, DeLUCA, FICHTER, TRUE, KUKOVICH, TULLI, WOGAN, DEMPSEY, MARSICO, McGILL, READSHAW, B. SMITH, FLICK, MERRY AND HALUSKA, JANUARY 24, 1995
SENATOR PETERSON, PUBLIC HEALTH AND WELFARE, IN SENATE, AS AMENDED, MAY 8, 1996
AN ACT 1 Establishing the Office of Physician General; providing for the <-- 2 appointment, term of office and powers and duties of the 3 Physician General, for the Secretary of Health, for a public 4 health dentist within the Department of Health, for continued 5 operation of State Health Care Centers and for a State Public 6 Health Laboratory; and making repeals. 7 AMENDING THE ACT OF APRIL 27, 1905 (P.L.312, NO.218), ENTITLED <-- 8 "AN ACT CREATING A DEPARTMENT OF HEALTH, AND DEFINING ITS 9 POWERS AND DUTIES," FURTHER PROVIDING FOR ORGANIZATION AND 10 FOR ADMINISTRATIVE POWERS AND DUTIES; AND MAKING REPEALS. 11 The General Assembly of the Commonwealth of Pennsylvania 12 hereby enacts as follows: 13 Section 1. Short title. <-- 14 This act shall be known and may be cited as the Office of 15 Physician General Act. 16 Section 2. Declaration of policy. 17 The General Assembly finds and declares as follows:
1 (1) Many geographic areas and populations of this 2 Commonwealth are inadequately served by health care services. 3 (2) The population of this Commonwealth should be 4 encouraged to engage in healthful habits and practices that 5 promote wellness to allow this Commonwealth's citizens to 6 lead fuller and more enriching lives and to reduce the 7 increasing costs of health care services and the loss of 8 workdays that negatively affect this Commonwealth's economy. 9 (3) Health care in this Commonwealth can best be served 10 by creating an office to promote coordination and cooperation 11 among Federal and State departments and entities providing 12 health care services, to promote healthful habits and 13 practices which reduce the need for the provision of health 14 care services, to keep the public informed on health care 15 matters and the prevention of illness and disease, to advise 16 and report to the General Assembly on health matters and the 17 delivery of health care services mandated by Federal and 18 State legislation and to attract public and private funding 19 for the advancement of healthful lifestyles and practices and 20 the provision of health care services. 21 Section 3. Office of Physician General. 22 (a) Establishment.--There is hereby created the cabinet 23 position of Office of Physician General of the Commonwealth 24 which shall be under the control and direction of the Physician 25 General. There shall be in the Office of Physician General a 26 Physician General of the Commonwealth, who shall exercise the 27 powers and perform the duties set forth in this act. 28 (b) Appointment.--The Governor shall appoint a Commonwealth- 29 licensed physician who shall maintain a clinical practice to the 30 position of Physician General with the advice and consent of a 19950H0216B3505 - 2 -
1 majority of the members of the Senate. 2 (c) Personnel.-- 3 (1) The Physician General shall appoint and fix the 4 compensation of employees as are required to assist in 5 carrying out the duties of the Physician General. 6 (2) The Physician General may appoint advisory task 7 forces as the Physician General deems necessary to carry out 8 the duties and responsibilities of the Physician General 9 under this act. The Physician General or the Physician 10 General's designee shall serve as chairman of each task 11 force. When actually engaged in official meetings or 12 otherwise in the performance of the member's official duties 13 as directed by the Physician General, each member of a task 14 force shall receive reimbursement for expenses incurred. 15 (d) Compensation.--The compensation of the Physician General 16 shall be the equivalent of a salary of $100,000 a year if the 17 position were full-time. 18 (e) Ethics law.--The Physician General shall be subject to 19 the act of October 4, 1978 (P.L.883, No.170), referred to as the 20 Public Official and Employee Ethics Law. 21 Section 4. Powers and duties of Physician General. 22 (a) Generally.--The Physician General shall: 23 (1) Advise the Governor on health care services provided 24 or regulated by the departments, including provision of 25 benefits, prevention, early intervention and wellness. 26 (2) Advise the Governor on better coordination of health 27 care services provided or regulated by the departments. 28 (3) Implement appropriate health care initiatives as 29 requested by the Governor, the General Assembly or the 30 departments. 19950H0216B3505 - 3 -
1 (4) Sponsor and administer programs for the development 2 of health care resources and identify Federal and private 3 funding sources, grants and other resources for health care 4 services and programs. 5 (b) Boards, commissions and councils.-- 6 (1) If the Secretary of Health is not a physician, the 7 Physician General or the Physician General's designee shall 8 be a voting member of the State Board of Medicine and the 9 State Board of Osteopathic Medicine. At all other times the 10 Physician General shall serve as an ex-officio member without 11 a vote. 12 (2) The Physician General or the Physician General's 13 designee shall attend such meetings of other boards, 14 commissions and councils considering matters affecting health 15 care as the Physician General deems appropriate. 16 Section 5. Secretary of Health. 17 The Secretary of Health must be an individual with 18 professional experience in the field of public health, health 19 services delivery or education and training of health service 20 professionals. The secretary shall not be required to be a 21 graduate of a medical college. 22 Section 6. State Health Care Centers. 23 The Department of Health shall operate a system of State 24 Health Care Centers which shall provide, at the minimum, those 25 public health services in effect as of July 1, 1995. The 26 department shall not enter into contracts with private providers 27 that would result in the elimination of these centers, nor 28 reduce the scope of services currently provided, nor reduce the 29 number of centers unless specifically authorized and approved by 30 the General Assembly. 19950H0216B3505 - 4 -
1 Section 7. Public Health Laboratories. 2 The Department of Health shall maintain and operate a State 3 Public Health Laboratory that shall assure the availability of 4 reliable, clinical laboratory services and laboratory-based 5 information that are needed by clinicians and other health 6 providers for proper diagnosis and treatment, the prevention of 7 disease, and promotion of the health of the citizens of this 8 Commonwealth. The State Public Health Laboratory shall arrange 9 for and perform clinical tests to identify diseases and provide 10 epidemiological and surveillance support. However, it shall not 11 contract with outside laboratories to perform testing in rabies, 12 measles, rubella, Lyme disease, influenza and tuberculosis 13 identification. In addition, the public health laboratory shall 14 be administered and maintained in a manner in effect as of July 15 1, 1995. 16 Section 8. Dental health districts and officers. 17 The Department of Health shall apportion the Commonwealth 18 into dental health districts, administered by a public health 19 dentist within the Department of Health, who shall implement 20 dental health policies and programs for the various counties and 21 political subdivisions within this Commonwealth. 22 Section 9. Repeals. 23 (a) Absolute.--The third sentence of section 1 of the act of 24 April 27, 1905 (P.L.312, No.218), entitled "An act creating a 25 Department of Health, and defining its powers and duties," is 26 repealed. 27 (b) General.--All other acts and parts of acts are repealed 28 insofar as they are inconsistent with this act. 29 Section 10. Effective date. 30 This act shall take effect July 1, 1996. 19950H0216B3505 - 5 -
1 SECTION 1. SECTION 1 OF THE ACT OF APRIL 27, 1905 (P.L.312, <-- 2 NO.218), ENTITLED "AN ACT CREATING A DEPARTMENT OF HEALTH, AND 3 DEFINING ITS POWERS AND DUTIES," AMENDED MARCH 17, 1921 (P.L.37, 4 NO.18), IS AMENDED TO READ: 5 SECTION 1. BE IT ENACTED, &C., [THAT THE] (A) THE 6 DEPARTMENT OF HEALTH SHALL CONSIST OF A [COMMISSIONER] SECRETARY 7 OF HEALTH [AND], AN ADVISORY BOARD AND A PHYSICIAN GENERAL. 8 (B) THE [COMMISSIONER OF HEALTH] SECRETARY SHALL BE THE HEAD 9 OF THE DEPARTMENT, AND SHALL BE APPOINTED BY THE GOVERNOR, WITH 10 THE ADVICE AND CONSENT OF THE SENATE. [HE SHALL BE A PHYSICIAN 11 OF AT LEAST TEN YEARS PROFESSIONAL EXPERIENCE AND A GRADUATE OF 12 A LEGALLY CONSTITUTED MEDICAL COLLEGE. 13 THE TERM OF THE COMMISSIONER FIRST APPOINTED HEREUNDER SHALL 14 EXPIRE ON THE FIRST DAY OF MARCH, ONE THOUSAND NINE HUNDRED AND 15 SEVEN, AND THE TERM OF OFFICE OF EVERY COMMISSIONER THEREAFTER 16 APPOINTED SHALL BE FOUR YEARS, BEGINNING ON FIRST DAY OF MARCH 17 OF THE YEAR IN WHICH HE IS APPOINTED. 18 UPON THE APPOINTMENT AND QUALIFICATION OF THE COMMISSIONER OF 19 HEALTH, THE TERMS OF THE MEMBERS OF THE STATE BOARD OF HEALTH 20 AND THE SECRETARY OF SUCH BOARD SHALL EXPIRE, AND NO 21 APPOINTMENTS SHALL THEREAFTER BE MADE TO THOSE OFFICES.] THE 22 SECRETARY SHALL BE AN INDIVIDUAL WITH PROFESSIONAL EXPERIENCE IN 23 THE FIELD OF PUBLIC HEALTH, HEALTH SERVICES DELIVERY OR 24 EDUCATION OR TRAINING OF HEALTH SERVICE PROFESSIONALS. THE 25 SECRETARY SHALL SERVE AT THE PLEASURE OF THE GOVERNOR. 26 (C) THERE SHALL BE AN OFFICE OF PHYSICIAN GENERAL WITHIN THE 27 ADMINISTRATIVE STRUCTURE OF THE DEPARTMENT. THE PHYSICIAN 28 GENERAL SHALL BE APPOINTED BY THE GOVERNOR. THE DEPARTMENT SHALL 29 PROVIDE ADEQUATE STAFF AND OTHER SUPPORT AS NEEDED. THE 30 PHYSICIAN GENERAL SHALL BE A GRADUATE OF AN ACCREDITED MEDICAL 19950H0216B3505 - 6 -
1 OR OSTEOPATHIC MEDICAL SCHOOL AND SHALL BE A PRACTICING 2 PHYSICIAN LICENSED BY THE COMMONWEALTH. THE PHYSICIAN GENERAL 3 SHALL SERVE AT THE PLEASURE OF THE GOVERNOR. THE PHYSICIAN 4 GENERAL SHALL: 5 (1) ADVISE THE GOVERNOR AND THE SECRETARY ON HEALTH POLICY. 6 (2) PARTICIPATE IN THE DECISION MAKING PROCESS OF THE 7 DEPARTMENT ON POLICIES RELATING TO ALL MEDICAL AND PUBLIC 8 HEALTH-RELATED ISSUES AND IN THE DECISION MAKING PROCESS OF 9 OTHER EXECUTIVE BRANCH AGENCIES AS DIRECTED BY THE GOVERNOR. 10 (3) REVIEW PROFESSIONAL STANDARDS AND PRACTICES IN MEDICINE 11 AND PUBLIC HEALTH WHICH ARE RELATED TO MATTERS WITHIN THE 12 JURISDICTION OF THE DEPARTMENT AND OTHER EXECUTIVE BRANCH 13 AGENCIES. 14 (4) CONSULT WITH RECOGNIZED EXPERTS ON MEDICAL AND PUBLIC 15 HEALTH MATTERS WHICH ARE WITHIN THE JURISDICTION OF THE 16 DEPARTMENT AND OTHER EXECUTIVE BRANCH AGENCIES. 17 (5) PROVIDE ADVICE ON MEDICAL AND PUBLIC HEALTH ISSUES TO 18 THE SECRETARY AND TO OTHER EXECUTIVE BRANCH AGENCIES. 19 (6) COORDINATE EDUCATIONAL, INFORMATIONAL AND OTHER PROGRAMS 20 FOR THE PROMOTION OF WELLNESS, PUBLIC HEALTH AND RELATED MEDICAL 21 ISSUES IN THIS COMMONWEALTH AND SERVE AS THE PRIMARY ADVOCATE 22 FOR THESE PROGRAMS. 23 (7) CONSULT WITH EXPERTS IN THIS COMMONWEALTH AND OTHER 24 STATES REGARDING MEDICAL RESEARCH, INNOVATION AND DEVELOPMENT 25 WHICH RELATE TO PROGRAMS AND ISSUES OF IMPORTANCE TO THE 26 DEPARTMENT AND THE COMMONWEALTH. 27 (8) PERFORM SUCH OTHER DUTIES AS DIRECTED BY THE GOVERNOR. 28 (9) WHEN THE SECRETARY IS NOT A PHYSICIAN, SERVE AS A VOTING 29 MEMBER OF THE STATE BOARD OF MEDICINE AND THE STATE BOARD OF 30 OSTEOPATHIC MEDICINE. THE PHYSICIAN GENERAL MAY PROVIDE A 19950H0216B3505 - 7 -
1 DESIGNEE TO SERVE IN HIS OR HER STEAD. THE SALARY AND OTHER 2 CONDITIONS OF EMPLOYMENT SHALL BE SET BY THE EXECUTIVE BOARD. 3 (D) THE [DEPARTMENT OF HEALTH] DEPARTMENT SHALL HAVE AN 4 OFFICIAL SEAL. 5 SECTION 2. SECTION 8 OF THE ACT IS AMENDED TO READ: 6 SECTION 8. (A) IT SHALL BE THE DUTY OF THE [COMMISSIONER] 7 DEPARTMENT OF HEALTH TO PROTECT THE HEALTH OF THE PEOPLE OF THE 8 STATE, AND TO DETERMINE AND EMPLOY THE MOST EFFICIENT AND 9 PRACTICAL MEANS FOR THE PREVENTION AND SUPPRESSION OF DISEASE. 10 (B) THE [COMMISSIONER] SECRETARY OF HEALTH SHALL CAUSE 11 EXAMINATION TO BE MADE OF NUISANCES OR QUESTIONS AFFECTING THE 12 SECURITY OF LIFE AND HEALTH IN ANY LOCALITY, AND FOR THAT 13 PURPOSE THE [COMMISSIONER] SECRETARY, AND ANY PERSON AUTHORIZED 14 BY HIM SO TO DO, MAY, WITHOUT FEE OR HINDRANCE, ENTER, EXAMINE 15 AND SURVEY ALL GROUNDS, VEHICLES, APARTMENTS, BUILDINGS, AND 16 PLACES WITHIN THE STATE, AND ALL PERSONS SO AUTHORIZED BY HIM 17 SHALL HAVE THE POWERS AND AUTHORITY CONFERRED BY LAW UPON 18 CONSTABLES. 19 (C) (1) WITH THE EXCEPTION OF THE FOUR STATE HEALTH CENTERS 20 SELECTED FOR THE REVIEW PROGRAM ESTABLISHED IN PARAGRAPH (2), 21 THE DEPARTMENT SHALL OPERATE THOSE PUBLIC STATE HEALTH CENTERS 22 AND PROVIDE, AT A MINIMUM, THOSE PUBLIC HEALTH SERVICES IN 23 EFFECT AS OF JULY 1, 1995. EXCEPT AS PROVIDED IN PARAGRAPH (2), 24 THE DEPARTMENT SHALL NOT ENTER INTO CONTRACTS WITH ANY 25 ADDITIONAL PRIVATE PROVIDERS THAT WOULD RESULT IN THE 26 ELIMINATION OF ANY STATE HEALTH CENTER, NOR REDUCE THE SCOPE OF 27 SERVICES CURRENTLY PROVIDED, NOR REDUCE THE NUMBER OF CENTERS. 28 (2) THE DEPARTMENT SHALL ESTABLISH A REVIEW PROGRAM TO 29 DETERMINE THE FEASIBILITY AND EFFECTIVENESS OF ENTERING INTO 30 CONTRACTS WITH LOCAL HEALTH CARE PROVIDERS FOR THE OPERATION OF 19950H0216B3505 - 8 -
1 STATE HEALTH CENTERS OR THE PROVISION OF EQUIVALENT SERVICES. 2 THE PROGRAM SHALL UTILIZE THE EQUIVALENT SERVICES PROVIDED BY A 3 MAXIMUM OF FOUR EXISTING STATE HEALTH CENTERS ON THE EFFECTIVE 4 DATE OF THIS ACT, TWO OF WHICH SHALL BE IN URBAN AREAS OF THIS 5 COMMONWEALTH AND TWO OF WHICH SHALL BE IN SUBURBAN AREAS OF THIS 6 COMMONWEALTH, AS DETERMINED BY THE DEPARTMENT. THE REVIEW 7 PROGRAM SHALL BEGIN ON NOVEMBER 1, 1996, AND SHALL CONTINUE FOR 8 A PERIOD OF TWELVE MONTHS. 9 (3) THE DEPARTMENT SHALL IDENTIFY THE TWO URBAN AND TWO 10 SUBURBAN STATE HEALTH CENTERS UNDER PARAGRAPH (2) AND CONTRACT 11 WITH ONE OR MORE LOCAL HEALTH CARE PROVIDERS FOR THE OPERATION 12 OF THE CENTERS OR FOR THE PROVISION OF EQUIVALENT SERVICES. THE 13 CONTRACT SHALL BE EFFECTIVE NOVEMBER 1, 1996, AND SHALL BE FOR A 14 PERIOD OF TWELVE MONTHS. THE DEPARTMENT MAY RENEW OR EXTEND THE 15 CONTRACT AS NEEDED EITHER TO PHASE OUT OR TO CONTINUE THE 16 PROVISION OF THESE PUBLIC HEALTH SERVICES PENDING REVIEW OF THE 17 REPORT REQUIRED IN PARAGRAPH (4). THE CONTRACT SHALL PROVIDE FOR 18 OVERSIGHT BY THE DEPARTMENT OF ALL SERVICES PROVIDED UNDER THE 19 REVIEW PROGRAM. 20 (4) ON OR BEFORE DECEMBER 31, 1997, THE DEPARTMENT SHALL 21 SUBMIT A REPORT TO THE GENERAL ASSEMBLY, WHICH SHALL INCLUDE, 22 BUT NOT BE LIMITED TO, THE FOLLOWING: 23 (I) A REVIEW AND ANALYSIS OF THE FOUR HEALTH CARE CENTERS OR 24 OF THE PROVISION OF EQUIVALENT SERVICES IN THE REVIEW PROGRAM, 25 INCLUDING PATIENT UTILIZATION AND SERVICES PROVIDED. 26 (II) AN ANALYSIS OF THE PERFORMANCE OF EACH LOCAL HEALTH 27 CARE PROVIDER, INCLUDING PATIENT SATISFACTION WITH THE PROVISION 28 OF SERVICES. 29 (III) A REVIEW OF OTHER DELIVERY SYSTEMS FOR HEALTH SERVICES 30 IN THE COMMUNITY, BOTH PUBLIC AND PRIVATE. 19950H0216B3505 - 9 -
1 (IV) A COMPARISON OF THE COST AND EFFECTIVENESS OF THE 2 OPERATION OF EACH OF THE FOUR HEALTH CARE CENTERS BY THE 3 COMMONWEALTH WITH THE COST OF THE PROVISION OF EQUIVALENT 4 SERVICES BY LOCAL HEALTH CARE PROVIDERS. 5 (V) RECOMMENDATIONS REGARDING CONTINUATION OF THE PROVISION 6 OF THE SERVICES PREVIOUSLY PROVIDED BY THE FOUR HEALTH CARE 7 CENTERS INCLUDED IN THE STUDY PROGRAM BY LOCAL HEALTH CARE 8 PROVIDERS. 9 (VI) RECOMMENDATIONS REGARDING THE PUBLIC AND PRIVATE 10 OPERATION OF ALL REMAINING HEALTH CARE CENTERS, OR THE PROVISION 11 OF EQUIVALENT SERVICES, IN THIS COMMONWEALTH. 12 (D) THE DEPARTMENT SHALL MAINTAIN AND OPERATE A STATE PUBLIC 13 HEALTH LABORATORY THAT SHALL ASSURE THE AVAILABILITY OF 14 RELIABLE, CLINICAL LABORATORY SERVICES AND LABORATORY-BASED 15 INFORMATION THAT ARE NEEDED BY CLINICIANS AND OTHER HEALTH 16 PROVIDERS FOR PROPER DIAGNOSIS AND TREATMENT, PREVENTION OF 17 DISEASE AND PROMOTION OF THE HEALTH OF THE CITIZENS OF THIS 18 COMMONWEALTH. THE STATE PUBLIC HEALTH LABORATORY SHALL ARRANGE 19 FOR AND PERFORM CLINICAL TESTS TO IDENTIFY DISEASES AND PROVIDE 20 EPIDEMIOLOGICAL AND SURVEILLANCE SUPPORT. THE STATE PUBLIC 21 HEALTH LABORATORY SHALL NOT CONTRACT WITH OUTSIDE LABORATORIES 22 TO PERFORM TESTING IN RABIES, MEASLES, RUBELLA, LYME DISEASE, 23 INFLUENZA AND TUBERCULOSIS IDENTIFICATION. THE STATE PUBLIC 24 HEALTH LABORATORY SHALL BE ADMINISTERED AND MAINTAINED IN A 25 MANNER IN EFFECT AS OF JULY 1, 1995. 26 (E) THE DEPARTMENT SHALL APPORTION THIS COMMONWEALTH INTO 27 DENTAL HEALTH DISTRICTS, ADMINISTERED BY A PUBLIC HEALTH DENTIST 28 WITHIN THE DEPARTMENT, WHO SHALL IMPLEMENT DENTAL HEALTH 29 POLICIES AND PROGRAMS FOR THE VARIOUS COUNTIES AND POLITICAL 30 SUBDIVISIONS WITHIN THIS COMMONWEALTH. 19950H0216B3505 - 10 -
1 SECTION 3. THE FOLLOWING ACTS AND PARTS OF ACTS ARE REPEALED 2 INSOFAR AS THEY ARE INCONSISTENT WITH THIS ACT: 3 SECTION 2.1 OF THE ACT OF OCTOBER 5, 1978 (P.L.1109, NO.261), 4 KNOWN AS THE OSTEOPATHIC MEDICAL PRACTICE ACT. 5 SECTION 3 OF THE ACT OF DECEMBER 20, 1985 (P.L.457, NO.112), 6 KNOWN AS THE MEDICAL PRACTICE ACT OF 1985. 7 SECTION 4. THIS ACT SHALL TAKE EFFECT IMMEDIATELY. L9L71PJP/19950H0216B3505 - 11 -