PRINTER'S NO. 2362
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1623
Session of
2015
INTRODUCED BY SCHEMEL, WARD, TURZAI, BLOOM, COX, CUTLER,
DIAMOND, DUNBAR, DUSH, EVERETT, FEE, GABLER, GILLEN,
GINGRICH, GREINER, GROVE, HELM, HENNESSEY, HICKERNELL,
PHILLIPS-HILL, IRVIN, KAUFFMAN, KLUNK, KNOWLES, KRIEGER,
MALONEY, MARSHALL, McGINNIS, METCALFE, B. MILLER, NESBIT,
OBERLANDER, PICKETT, PYLE, RADER, RAPP, ROAE, ROTHMAN,
SANKEY, TALLMAN, TOPPER, ZIMMERMAN, BARRAR, YOUNGBLOOD AND
M. K. KELLER, OCTOBER 15, 2015
REFERRED TO COMMITTEE ON HEALTH, OCTOBER 15, 2015
AN ACT
Providing for prioritization of public funds to certain health
care entities and for enforcement.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Whole Woman's
Health Funding Priorities Act.
Section 2. Declaration of purpose.
The General Assembly finds and declares as follows:
(1) Limited Federal and State funds exist for family
planning and preventive health services for women generally
and for maternal and fetal patients in particular.
(2) Fiscal constraints mandate that the Commonwealth
allocate available funds efficiently by ensuring the funds
are distributed by priority to the most efficient point-of-
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service health care providers.
(3) The Patient Protection and Affordable Care Act
(Public Law 111-148, 124 Stat.119) requires all women's
health services, including preventive care, cancer screenings
and sexually transmitted infection screenings, to be covered
as an essential health benefit.
(4) Public and private providers of primary and
preventive care utilize public funds more effectively than
providers of health care services that are specialized to
particular medical services or discrete patient populations.
(5) It is the intent of the General Assembly through
this act to prioritize the distribution and utilization of
public funds for family planning, reproductive health care
and maternal and fetal care to public and private primary and
preventive care providers.
(6) Prioritization of public health care funding to
primary and preventive care furthers sound health care
policy.
(7) Individuals who have a primary care clinician are
more likely to access health care services, leading to more
favorable long-term outcomes.
(8) Health care costs are lowered when primary and
preventive care is provided by primary care clinicians in a
setting that addresses the whole person through counseling,
screening and early detection of leading causes of morbidity
and mortality, including diabetes, hypertension, obesity,
cardiovascular and renal diseases and asthma.
(9) Integrated delivery of health services, including
integration among preventive care, primary care, prenatal
care, cancer screenings and other women's health issues, has
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been repeatedly found to be the most superior model of care
as well as the most cost-effective model.
(10) Less fragmented health care will reduce indirect
costs, such as lost worker productivity and employer health
care costs, and will result in individual citizens leading
longer, healthier and happier lives.
(11) It is the public policy of this Commonwealth to
ensure delivery of comprehensive preconception and prenatal
care for maternal and fetal patients in order to reduce
maternal and fetal morbidity and mortality.
(12) The United States Department of Health and Human
Services Centers for Disease Control and Prevention states,
"Comprehensive preconception and prenatal care includes
encouraging women to stop smoking, refrain from using alcohol
and other drugs, eat a healthy diet, take folic acid
supplements, maintain a healthy weight, control high blood
pressure and diabetes, and reduce exposure to workplace and
environmental hazards."
(13) Moreover, the United States Department of Health
and Human Services Centers for Disease Control and Prevention
states, "In addition, screening and providing services to
prevent intimate partner violence and infections (e.g., HIV,
STI and viral hepatitis) help to improve the health of the
mother and the baby."
(14) Delivery of these critical services is best
accomplished through a single point-of-service provider, such
as a primary care provider, and directed by a primary care
clinician who has knowledge of the patient's medical history
and personal, familial and environmental health factors,
including through an integrated delivery model or patient-
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centered model of care.
(15) Medical intervention models that emphasize the
provision of services to discrete patient subpopulations,
such as women of child-bearing age, to address discrete
patient conditions or provide particular therapies, conflict
with the utilization of public funding to maximize effective
delivery of holistic prenatal and maternal health care.
Section 3. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Abortion." The use of any means to terminate the clinically
diagnosable pregnancy of a woman with knowledge that the
termination by those means will cause, with reasonable
likelihood, the death of the unborn child. The term does not
include birth control devices, oral contraceptives used to
inhibit or prevent ovulation, conception or the implantation of
a fertilized ovum in the uterus or the use of any means to
increase the probability of a live birth, to preserve the life
or health of the child after a live birth, to terminate an
ectopic pregnancy or to remove a dead fetus.
"Department." The Department of Health of the Commonwealth.
"Federally qualified abortion." An abortion qualified for
Federal matching funds under the Medicaid program.
"Federally qualified health center." An entity as defined
under section 1905(1)(2)(B) of the Social Security Act (49 Stat.
620, 42 U.S.C. § 1396d(1)(2)(B)) that is eligible to receive
Federal funds.
"Hospital." A primary or tertiary care facility licensed
under State law.
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"Public funds." State funds from whatever source, including
without limitation, State general revenue funds, State special
account and limited purpose grants or loans and Federal funds
provided under Title X of the Public Health Service Act (58
Stat. 682, 42 U.S.C. § 300 et seq.) and Titles IV, V and XX of
the Social Security Act (49 Stat. 620, 42 U.S.C. § 300 et seq.
and § 701 et seq.).
"Rural health clinic." A health care provider that is
eligible to receive Federal funds as defined in section 1861(aa)
(2) of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1395x
(aa)(2)).
Section 4. Prioritization of public funds to health care
entities.
(a) General rule.--Subject to any applicable requirements of
Federal statutes, rules, regulations or guidelines:
(1) Any expenditures or grants of public funds for
family planning services by the Commonwealth by and through
the department shall be made in the following order of
priority:
(i) To public entities.
(ii) To nonpublic hospitals and federally qualified
health centers.
(iii) To rural health clinics.
(iv) To State health centers.
(v) To nonpublic health providers that have as their
primary purpose the provision of the primary health care
services enumerated under section 254b(a)(1) of the
Public Health Service Act (58 Stat. 68, 42 U.S.C. §
254b(a)(1)).
(2) The department may not enter into a contract with or
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make a grant to any entity that performs abortions that are
not federally qualified abortions or maintains or operates a
facility where such abortions are performed, except as
required by Federal law when the services are provided under
Medicaid and by a qualified provider approved by the Centers
for Medicaid and Medicare services.
(b) Construction.--Nothing in this section shall be
construed to apply to the receipt or administration of public
funds pursuant to Title XIX of the Social Security Act (49 Stat.
620, 42 U.S.C. § 1396 et seq.).
Section 5. Enforcement.
(a) Attorney General.--The Attorney General may bring an
action in law or equity to enforce the provisions of this act
and relief shall be available in appropriate circumstances,
including, but not limited to, recoupment and declaratory and
injunctive relief, including, but not limited to, suspension or
debarment.
(b) Standing.--Any entity eligible for the receipt of public
funds shall possess standing to bring any action that the
Attorney General has authority to bring under the provisions of
subsection (a), provided, however, if an expenditure or grant of
public funds made in violation of this act results in the
reduction of public funds and a court awards monetary relief,
the amount recovered shall be deposited into one or more
accounts maintained by the Commonwealth for public funds.
(c) Attorney fees and costs.--In an action brought under
this section, a prevailing plaintiff shall be entitled to an
award of reasonable attorney fees and costs.
Section 6. Right of intervention.
The General Assembly, through one or more members duly
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appointed by resolution of their respective chamber, may
intervene as a matter of right in any case in which the
constitutionality of this act is challenged.
Section 7. Severability.
It is the intent of the General Assembly that every provision
of this act shall operate with equal force and shall be
severable one from the other and that in the event that any
provision of this act is held invalid or unenforceable by a
court of competent jurisdiction, that provision shall be
accordingly deemed severable and the remaining provisions deemed
fully enforceable.
Section 8. Effect on appropriations.
Any encumbrance of public funds made by the department in
derogation of the provisions of section 4 shall be null and void
as of the effective date of this section, and the funds so
encumbered shall be reallocated to eligible entities.
Section 9. Effective date.
This act shall take effect in 60 days.
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