District of Columbia Financial
Responsibility and
Management Assistance Authority
Washington, D.C.
441 4th Street, NW, Room 570, Washington, DC
20001, 202 504-3400
("AUTHORITY")
RESOLUTION AND
ORDER CONCERNING THE
PUBLIC BENEFIT CORPORATION
WHEREAS, there exists a health
care crisis facing the uninsured residents of the District of Columbia;
WHEREAS, the Chief Financial
Officer of the District of Columbia (the "CFO") found in
November 2000 that:
At its current rate of
spending, PBC will exhaust its $45.3 million FY 2001 subsidy by the
middle of March 2001. If money is set aside to maintain PBC's clinics
throughout the fiscal year. D.C. General Hospital will be forced to
close even sooner, perhaps by as early as two months from today. In
either case, [the CFO] will be unable to redirect funds from any source
to continue PBC operations unless a plan to restructure PBC is approved
by Congress.
WHEREAS, the District of Columbia
Health and Hospitals Public Benefit Corporation ("PBC"), as of
March 24, 2001, in fact exhausted its Fiscal Year 2001 subsidy;
WHEREAS, the District of Columbia Appropriations
Act, 2001, Pub. L. 106-522, requires:
That no appropriated amounts and
no amounts from or guaranteed by the District of Columbia Government
(including the District of Columbia Financial Responsibility and
Management Assistance Authority) may be made available to the [PBC]
(through reprogramming, transfers, loans, or any other mechanism) which
are not otherwise provided for under this heading until a restructuring
plan for D.C. General Hospital has been approved by the Mayor of the
District of Columbia, the Council of the District of Columbia, the
Authority, the Chief Financial Officer of the District of Columbia, and
the Chair of the Board of Directors of the [PBC] .... (Pub. L. 106-522,
H.R. 5633, 106th Cong., 2d
Sess., p. 17 (Nov. 22, 2000)).
WHEREAS, the District of Columbia
Appropriations Act, 2001. Pub. L. 106-522. further requires:
That notwithstanding any other
provision of law. to augment the District of Columbia Subsidy for the
District of Columbia Health and Hospitals Public
Benefit Corporation [PBC], the District may transfer from other
non-Federal funds appropriated under this Act to the Human Support
Services appropriation under this Act an amount not to exceed
$90,000,000 for the purpose of restructuring the delivery of health
services in the District: Provided
further, That such
restructuring shall be pursuant to a restructuring plan approved by the
Mayor, the Council, the Authority, and the Board of Directors of the
PBC: Provided further, That —
(1) the restructuring plan
reduces personnel levels of D.C. General Hospital and of the [PBC]
consistent with the reduction in force set forth in the August 25, 2000,
resolution of the Board of Directors of the [PBC] regarding personnel
structure, by reducing personnel by at least 500 fulltime equivalent
employees, without replacement by contract personnel;
(2) no transferred funds are
expended until 10 calendar days after the restructuring plan has
received final approval and a copy evidencing final approval has been
submitted by the Mayor to the Committee on Government Reform of the
House of Representatives, the Committee on Governmental Affairs of the
Senate, and the Committees on Appropriations of the House of
Representatives and the Senate; and
(3) the plan includes a
certification that the plan does not request and does not rely upon any
current or future request
for additional appropriation of Federal funds. (Pub. L. 106-522, H.R.
5633, 106th Cong.,
2d Sess., p. 13 (Nov. 22, 2000)).
WHEREAS, the
Mayor of the District of Columbia (the "Mayor"), the Council of
the District of Columbia (the "Council"), and the Authority
worked to restructure and contract out certain health care services
currently provided by the PBC, including D.C. General Hospital and the
public clinics, pursuant to a restructuring plan approved by the Mayor,
the Council, the Authority and the Board of the PBC, which has been
submitted to the Committee on Appropriations and the Committee on
Government Reform and Governmental Affairs of the United States House of
Representatives and the Senate, respectively (a copy of the restructuring
plan is attached as Exhibit A);
WHEREAS, the
Authority adopted on December 4, 2000 a comprehensive Resolution,
Recommendations and Orders concerning the Public Benefit Corporation to
deal with the health care crisis (attached as Exhibit B);
WHEREAS, the Authority
recommended on December 4, 2000, pursuant to Section 207 of Public Law
104-8. that the Council, pursuant to its statutory authority under the
Home Rule Act, repeal D.C. Act 13-454, "District of Columbia Health
and Hospitals Public Benefit Corporation Emergency Amendment Act of
2000";
WHEREAS, the Authority recommended on December 4,
2000, pursuant to Section 207 of Public Law 104-8. that the Council.
pursuant to its statutory authority under the Home Rule Act. repeal D. C.
Act 1 1-389 (the District of Columbia Health and
Hospitals Public Benefit
Corporation Act) codified at Title 32 of the D.C. Code, §§261.1 and
262.1 through 262.20, et. seq. (attached as Exhibit C);
WHEREAS, the
Authority recommended on December 4, 2000, pursuant to Section 207 of
Public Law 104-8, that the Council work with the Mayor to prepare and
approve a plan to establish an alternative publicly-financed health-care
delivery system in the District of Columbia that a) is consistent with the
current multi-year financial plan and budget for the District of Columbia,
b) provides for equivalent volumes and types of health care services as
currently provided by the PBC to uninsured District residents, and c)
ensures that the health-care services meet standards of quality and
accessibility;
WHEREAS, the Authority
recommended on December 4, 2000, pursuant to Section 207 of Public Law
104-8, that the Council, pursuant to its statutory authority under the
Home Rule Act, approve and/or enact legislation, regulations, and
reprogrammings, and take any and all other actions necessary to authorize
and implement an alternative publicly-financed health-care delivery
system;
WHEREAS, all
of the above Recommendations were required to be enacted by the Council
and approved by the Mayor within 90 calendar days of the adoption of the
December 4, 2000 Recommendations by the Authority;
WHEREAS, the Council has failed
to adopt the Authority's December 4, 2000 Recommendations, pursuant to
Section 207 of Public Law 104-8, set forth above;
WHEREAS, the
Authority has consulted with the appropriate Congressional Committees;
WHEREAS, the process leading up
to the restructuring and contracting out of health care services delivered
by the PBC has involved a complex contract analysis, award and negotiating
process which has already been delayed; and
WHEREAS, the Authority must act
immediately to sustain the District's commitment to maintain the delivery
of health care services in conformity with Federal law, including the
Fiscal Year 2001 D.C. Appropriations Act, the Federal Anti-deficiency Act,
and Federal appropriations law; therefore, the Authority hereby
implements, by Order below, its December 4, 2000 recommendations set forth
above.
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It is therefore ORDERED, pursuant
to Public Law 104-8, as amended, the District of Columbia Appropriations
Act 2001, Pub. L. 106-522, and other provisions of applicable law, that:
1. The Authority hereby declares
that a state of emergency exists in the District of Columbia concerning
the delivery of health care services to uninsured District residents;
2. Pursuant to Section 207 of
Public Law 104-8, D.C. Act 13-454, "District of Columbia Health and
Hospitals Public Benefit Corporation Emergency Amendment Act of
2000", is hereby repealed;
3. Pursuant to Section 207 of
Public Law 104-8, D.C. Act 11-389, the District of Columbia Health and
Hospitals Public Benefit Corporation Act, codified at Title 32 of the D.C.
Code, §§261.1 and 262.1 through 262.20, et. seq., as amended, (Exhibit
C) is hereby repealed;
4. Pursuant to Section 207 of
Public Law 104-8, the reorganization of the Department of Health is
authorized and directed, establishing an office to administer and monitor
a contract or contracts with a health care entity to deliver health care
services formerly provided by the Public Benefit Corporation;
5. Pursuant to Section 207 of
Public Law 104-8, a plan is hereby authorized and directed to establish an
alternative publicly-financed health-care delivery system in the District
of Columbia that a) is consistent with the FY 2001 District of Columbia
Appropriations Act and the financial plan and budget for the District of
Columbia, b) provides for equivalent volumes and types of health care
services as currently provided by the PBC to District residents, and c)
ensures that the health care services meet standards of quality and
accessibility (embodied in the contract attached as Exhibit D); and funds
to operate the office administering and monitoring the contract or
contracts are hereby authorized and directed;
6. Pursuant to Section 207 of
Public Law 104-8, legislation is hereby enacted to authorize and implement
the Authority's recommendations concerning restructuring the delivery of
health care services to District residents, including abolition of the PBC
and establishment of the Healthcare Safety Net Administration (a copy of
the emergency, temporary and permanent legislation is attached as Exhibit
E);
7. Pursuant to Section 207 of
Public Law 104-8, any proposal to offer or develop a new institutional
health care service, obligate a new capital expenditure, or reduce or
terminate a health care service that would otherwise be subject to the
certificate of need requirements of Section 8 of the Health Services
Planning Program Reestablishment Act of 1996, effective April 9, 1997
(D.C. Law 11-191; D.C. Code §32-357), by a health care entity that has
contracted with the Authority, or with the Mayor, to provide new health
care services, shall be exempt from the certificate of need requirements
only for the piErp6se of providing health care services formerly delivered
by the PBC;
8. Pursuant to Section 207 of Public Law 104-8, the Mayor, the Chief
Financial Officer of the District of Columbia and all other officials,
agents and employees of the District government are authorized and
directed to take any and all appropriate actions, including but not
limited to, transfer of funds, expenditures, and reprogrammings, to
implement an alternative publicly-financed health care delivery system,
and
9. If any provision, section, sentence, clause, phrase, or word of this
Order or the application thereof to any person or circumstance, is held
invalid, the invalidity shall not affect any other provision, section,
sentence, clause, phrase, word, or application of this 0rder which can be
given effect without regard to the invalid provision, section, sentence,
clause, phrase, word, or application. To this end the provisions of this
Order are severab1e.
10. This Order is effective immediately.
Adopted this 30th day of April, 2001.
Alice M. Rivlin
Chair
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AN ACT IN THE DISTRICT OF COLUMBIA
FINANCIAL RESPONSIBILITY AND
MANAGEMENT ASSISTANCE AUTHORITY ("Authority")
To reorganize, on an emergency basis, the Department
of Health by establishing a Health Care Safety Net Administration in the
Department of Health and to transfer functions of the District of Columbia
Health and Hospitals Public Benefit Corporation ("Public Benefit
Corporation") to the Department of Health; to authorize the Mayor to
contract out any of the health care functions of the Public Benefit
Corporation; to exempt any contract to provide comprehensive
community-centered health care and medical services for District of
Columbia residents provided by the Public Benefit Corporation entered into
by the Mayor from certain provisions of the District of Columbia
Procurement Procedures Act of 1985; to amend the Health Services Planning
Program Re-establishment Act of 1996 to establish authority for
establishing requirements for charity care and to exempt the District
government, the Public Benefit Corporation, and any contractor that
provides health care services provided by the Public Benefit Corporation
pursuant to a health care privatization contract from certain provisions
of the Health Services Planning Program Re-establishment Act of 1996; and
to repeal the Health and Hospitals Public Benefit Corporation Act of 1996
and abolish the Public Benefit Corporation.
BE IT ENACTED BY THE DISTRICT OF COLUMBIA
FINANCIAL RESPONSIBILITY AND MANAGEMENT ASSISTANCE AUTHORITY,
Sec. l . This act is enacted pursuant to Section
207 of Public Law 104-8 and may be cited as the "Health Care
Privatization Emergency Amendment Act of 2001 ".
Sec. 2. Findings and purpose.
The Authority finds and declares the following:
(1) The District of Columbia Health and Hospitals
Public Benefit Corporation ("Public Benefit Corporation") has
operated with increasing deficits and has depleted its $45.3 million FY
2001 subsidy.
(2) The District of Columbia Appropriations Act,
2001, Public Law 106-522, ("Appropriations Act"), approved
November 22, 2000, requires that no appropriated amounts and no amounts
from or guaranteed by the District of Columbia government (including the
District of Columbia Financial Responsibility and Management Assistance
Authority) may be made available to the [PBC] (through reprogramming,
transfers, loans, or any other mechanism) which are not otherwise provided
for under-this heading until a restructuring plan for D.C. General
Hospital has been approved. The appropriations act also authorizes the
spending of non-Federal funds not to exceed $90 million for the purpose of
restructuring health care delivery pursuant to a December 15, 2000
restructuring plan approved by the Mayor, the Council, the District of
Columbia Financial Responsibility and Management Assistance Authority, and
the Board of Directors of the Public Benefit Corporation, and prohibits
making available such funds or any other appropriated funds to the Public
Benefit Corporation except pursuant to the restructuring plan.
(3) On December 4, 2000, the Authority issued a
Resolution, Recommendations and Orders, pursuant to Section 207 of the
District of Columbia Financial Responsibility and Management Assistance
Act, approved April 17, 199 (Public Law 104-8, 109 Stat. 133; D.C. Code
§47-392.7), concerning the Public Benefit Corporation, that, among other
things, required the following to occur within 90 days of December 4,
2000:
(A) Repeal of Titles I and II of the Health and
Hospitals Public Benefit Corporation Act of 1996, effective April 9,
1997 (D.C. Law 11-212; D.C. Code §§32-261.1-32-262.20).
(B) Council enactment of legislation and
regulations and approval of reprogrammings and any other actions
necessary to authorize and implement an alternative publicly-financed
health care delivery system.
(4) On December 15, 2000, pursuant to the
Appropriations Act, the Mayor submitted to the Committee on Government
Reform of the House of Representatives and the Committee on Government
Affairs of the Senate a health care delivery restructuring plan that was
approved by the Authority, the Mayor, the Council, and the Board of
Directors of the Public Benefit Corporation.
(5) The purpose of this act is to authorize
implementation of an alternative publicly financed health care delivery
system to replace the health care services formerly provided by the Public
Benefit Corporation, as recommended by the Authority in its Resolution,
Recommendations and Orders of December 4, 2000, and in accordance with the
restructuring plan of December 15, 2000.
Sec. 3. Health Care Safety Net Administration
establishment.
(a) There is established within the Department of
Health a Health Care Safety Net Administration to administer and monitor
compliance with any contract that the Mayor makes, pursuant to section 7,
or that the Authority makes, with a health care entity to provide any of
the health care functions provided by the Public Benefit Corporation
pursuant to the Health and Hospitals Public Benefit Corporation Act of
1996, effective April 9, 1997 (D.C. Law 11-212; D.C. Code § 32262.7(a)),
and to perform such other functions as are set forth herein.
(b) The Health Care Safety Net Administration
shall be responsible for all transition activities
that result from contracting out the functions of the Public Benefit
Corporation and that remain
to be completed after abolition of the Public Benefit Corporation pursuant
to section 9, including the following:
(1) Termination and winding down of existing
contracts of the Public Benefit Corporation;
(2) Completion of administrative proceedings
and court litigation previously handled by the Office of the General
Counsel of the Public Benefit Corporation or by private counsel retained
by the Public Benefit Corporation.
(3) Coordination of court litigation involving
the Public Benefit Corporation that is being handled by the Office of
the Corporation Counsel;
(4) Assessment of outstanding claims against
the Public Benefit Corporation; and
(5) Arrangement for payment of lawful
obligations of the Public Benefit Corporation that are assumed by the
District of Columbia pursuant to section 5.
(c) The Health Care Safety Net Administration
shall exercise oversight of the services contracted by the Mayor pursuant
to section 7, or by the District of Columbia Financial Responsibility and
Management Assistance Authority, to ensure that the health of the
population is maintained and that the financial viability of the health
care entity providing services exempted pursuant to section 8 is
addressed.
Sec. 4. Transfers.
(a) The functions, personnel, the real and
personal property, unexpended balances of appropriations, and records of
the Public Benefit Corporation shall be transferred to the Department of
Health.
(b) Any monies remaining in the Health and
Hospitals Public Benefit Corporation Fund
after the effective date of this act shall revert to the General Fund to
the credit of the De Department of Health.
(c) The Department of Health shall recognize
collective bargaining representatives that have been duly certified by the
District of Columbia Public Employees Relations Board and shall assume and
be bound by all existing collective bargaining agreements entered into by
the Public Benefit Corporation.
(d) Every employee of the Public Benefit
Corporation shall be transferred to the Department of Health. All
employees so transferred shall be under the direction and control of the
Director of the Department of Health or that director's designee or
designees. Transferred employees shall retain the same rights and
privileges that they had as employees of the Public Benefit Corporation
before the effective date of this act and shall not obtain any additional
rights or privileges as a result of the transfer. They shall have all the
duties and responsibilities that they had as employees of the Public
Benefit Corporation in addition to whatever duties and responsibilities
they acquire as employees of the Department of Health. Transferred
employees shall constitute a
separate competitive area within the Department of Health for purposes of
reductions in force only pursuant to section 2408 of the District of
Columbia Government Comprehensive Merit Personnel Act of 1978, effective
March 3, 1979, D.C. Law 2-139, D.C. Code §1-625.7, and Chapter 24 of the
District of Columbia Personnel Manual. Lesser competitive areas may be
established by the personnel authority for these employees. The Mayor
shall be the personnel authority for all employees of the Public Benefit
Corporation who are transferred to the Department of Health, except that
the personnel authority for accounting, budget, and financial management
personnel who are transferred shall continue to be the Chief Financial
Officer of the District of Columbia.
Sec. 5. Liabilities of the Public Benefit
Corporation.
All liabilities of the Public Benefit Corporation
shall be assumed by the District of Columbia.
Sec. 6. Health Care Safety Net Fund and
Appropriations.
(a) There is established the Health Care Safety
Net Fund ("Fund") as a nonlapsing, revolving fund, to be
administered by the Mayor as an agency fund as defined in section
373(2)(1) of Title 47 of the District of Columbia Code, to be used
exclusively for the purposes stated in section 3. Revenues deposited into
the Fund shall not revert to the General Fund at the end of any fiscal
year or at any other time but shall be continually available to the
Department of Health for the uses and purposes set forth in this act,
subject to authorization by Congress in an appropriations act.
(b) The Fund shall be financed through
appropriations, federal and other grants, the accounts receivable of the
Public Benefit Corporation, and gifts or donations.
(c) The Fund shall be accounted for under
procedures established pursuant to subchapter V of Chapter 3 of Title 47
of the District of Columbia Code.
(d) There are authorized to be appropriated from
the general revenues of the District of Columbia funds necessary to carry
out the purposes of this act.
Sec. 7. Authorization to contract for
comprehensive health care services.
(a) The Mayor is authorized to provide by
contract or by other means comprehensive community-centered health care
and medical services for residents of the District of Columbia.
(b) A contract entered into by the Mayor pursuant
to subsection (a) of this section shall be exempt from the requirements of
the District of Columbia Procurement Practices Act of
1985, effective February
21, 1986 (D.C. Law 6-85; D.C. Code §1-1181.1 et
seq.), except that the
contract shall be subject to section 105a of that act.
Sec. 8. Health services planning program
amendments.
The Health Services Planning Program
Re-establishment Act of 1996, effective April 9, 1997 (D.C. Law 11-191;
D.C. Code § 32-351 et
seq.). is amended as
follows:
(1) Section 2 (D.C. Code § 32-351) is amended by
adding a new paragraph (3A) to read as follows:
"(3A) "Charity care" means the
physician and hospital medical services provided to persons who are
unable to pay for the cost of services, especially those persons who are
low income, uninsured and underinsured, but excluding those services
determined to be caused by, or categorized as, bad debt.".
(2) Section 3(b) (D.C. Code § 32-352(b)) is
amended as follows:
(A) Paragraph (3) is amended by striking the word
"and" at the end.
(B) Paragraph (4) is amended by striking the
period at the end and inserting the phrase and"
in its place.
(C) A new paragraph (5) is added to read as
follows:
"(5) Establishing, determining, and
developing, in accordance with section 22, requirements and standards
for the implementation of unreimbursed charity care by all health care
facilities that receive a certificate of need, including an annual
mechanism for monitoring the provision of that charity care by the
health care facilities.".
(3) Section 8 (D.C. Code §32-357) is amended by
adding new subsections (e), (f), and (g)
to read as follows:
"(e) Any proposal to offer or develop a
new institutional health service, obligate a new capital expenditure, or
reduce or terminate a health service that would otherwise be subject to
certificate of need requirements, by a health care entity that has
contracted with the District of Columbia Financial Responsibility
Management Assistance Authority, or with the Mayor pursuant to section 7
of the Health Care Privatization Emergency Amendment Act of 2001, to
provide new health care services shall be exempt from certificate of
need requirements only for the purpose of maintaining the same level of
care and services provided by the District of Columbia Health and
Hospitals Public Benefit Corporation ("Public Benefit
Corporation").
"(f) The Administrator of the Health Care
Safety Net Administration ("Administrator"), established
pursuant to section 3 of the Health Care Privatization Emergency
Amendment Act of 2001, shall determine which new institutional health
services, capital expenditures, and reductions or terminations of health
services qualify as health care services being taken over from the
Public Benefit Corporation.
"(g) The District government and the
Public Benefit Corporation are exempt from certificate of need
requirements for any changes in health care service that may result from
the abolishment of the Public Benefit Corporation.".
Sec. 9. Repeaters.
(a) The Health and Hospitals Public Benefit
Corporation Act of 1996, effective April 9, 1997 (D.C. Law 11-212; D.C.
Code §32-261.1 et seq.), as amended, is repealed, and the Public Benefit
Corporation is abolished.
(b) Section 851(1)(D) of the District of Columbia
Government Comprehensive Merit Personnel
Act of 1978, effective April 20, 1999 (D.C. Law 12-260; D.C. Code
§1-609.5(1)(D)), is repealed.
(c) Section 2(e)(9) of the Confirmation Act of
1978, effective March 3, 1979 (D.C. Law 2-142;
D.C. Code §1-633.7(e)(9)), is repealed.
(d) Section 320(k) of the District of Columbia
Procurement Practices Act of 1985, effective April 15, 1997 (D.C. Law
11-259; D.C. Code §1-1183.20(k)), is repealed.
Sec. 10. Fiscal impact statement.
The Authority adopts the attached fiscal impact
statement of the District Chief Financial Officer as the fiscal impact
statement required by section 602(c)(3) of the District of Columbia Home
Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Code §
1-233(c)(3)).
Sec. 11. Effective date.
This act shall take effect immediately and shall
remain in effect for no longer than 90 days, as provided for emergency
acts of the Council of the District of Columbia in section 412(a) of the
District of Columbia Home Rule Act, approved December 24, 1973 (87 Stat.
788; D.C. Code §1-229(a)).
Enacted this 30th day of April, 2001 by the
Authority.
Alice M. Rivlin
Chair
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AN ACT
THE DISTRICT OF COLUMBIA FINANCIAL
RESPONSIBILITY AND MANAGEMENT
ASSISTANCE AUTHORITY ("Authority")
To reorganize, on an temporary
basis, the Department of Health by establishing a Health Care Safety Net
Administration in the Department of Health and to transfer functions of
the District of Columbia Health and Hospitals Public Benefit Corporation
("Public Benefit Corporation") to the Department of Health; to
authorize the Mayor to contract out any of the health care functions of
the Public Benefit Corporation; to exempt any contract to provide
comprehensive community-centered health care and medical services for
District of Columbia residents provided by the Public Benefit Corporation
entered into by the Mayor from certain provisions of the District of
Columbia Procurement Procedures Act of 1985; to amend the Health Services
Planning Program Re-establishment Act of 1996 to establish authority for
establishing requirements for charity care and to exempt the District
government, the Public Benefit Corporation, and any contractor that
provides health care services provided by the Public Benefit Corporation
pursuant to a health care privatization contract from certain provisions
of the Health Services Planning Program Re-establishment Act of 1996; and
to repeal the Health and Hospitals Public Benefit Corporation Act of 1996
and abolish the Public Benefit Corporation.
BE IT ENACTED BY THE DISTRICT OF
COLUMBIA FINANCIAL RESPONSIBILITY AND MANAGEMENT ASSISTANCE AUTHORITY,
Sec. 1. This act is enacted
pursuant to Section 207 of Public Law 104-8, and may be cited as the
"Health Care Privatization Temporary Amendment Act of 2001".
Sec. 2. Findings and purpose.
The Authority finds and declares
the following:
(1) The District of Columbia
Health and Hospitals Public Benefit Corporation ("Public
Benefit Corporation") has operated with increasing deficits and has
depleted its $45.3 million FY 2001 subsidy.
(2) The District of Columbia
Appropriations Act, 2001, Public Law 106-522, ("Appropriations
Act"), approved November 22, 2000, requires that no appropriated
amounts and no amounts from or guaranteed by the District of Columbia
government (including the District of Columbia Financial Responsibility
and Management Assistance Authority) may be made available to the [PBC]
(through reprogramming, transfers, loans, or any other mechanism) which
are not otherwise provided for under this heading until a restructuring
plan for D.C. General Hospital has been approved. The appropriations act
also authorizes the spending of non-Federal funds not to exceed $90
million for the purpose of restructuring health care delivery pursuant to
a December 15, 2000 restructuring plan approved by the Mayor, the Council,
the District of Columbia Financial Responsibility and Management
Assistance Authority, and the Board of Directors of the Public Benefit
Corporation, and prohibits making available such funds or any other
appropriated funds to the Public Benefit Corporation except pursuant to
the restructuring plan.
(3) On December 4, 2000, the
Authority issued a Resolution, Recommendations and Orders, pursuant to
Section 207 of the District of Columbia Financial Responsibility and
Management Assistance Act, approved April 17, 1995 (Public Law 104-8, 109
Stat. 133; D.C. Code §47-392.7), concerning the Public Benefit
Corporation, that, among other things, required the following to occur
within 90 days of December 4, 2000:
(A) Repeal of Titles I and II
of the Health and Hospitals Public Benefit Corporation Act of 1996,
effective April 9, 1997 (D.C. Law 11-212; D.C. Code
§§32-261.1-32-262.20).
(B) Council enactment of legislation and
regulations and approval of reprogrammings
and any other actions necessary to authorize and implement an
alternative publicly-financed health care delivery system.
(4) On December 15, 2000, pursuant to the
Appropriations Act, the Mayor submitted to the Committee on Government
Reform of the House of Representatives and the Committee on Government
Affairs of the Senate a health care delivery restructuring plan that was
approved by the Authority, the Mayor, the Council, and the Board of
Directors of the Public Benefit Corporation.
(5) The purpose of this act is to authorize
implementation of an alternative publicly financed health care delivery
system to replace the health care services formerly provided by the Public
Benefit Corporation, as recommended by the Authority in its Resolution,
Recommendations and Orders of December 4, 2000, and in accordance with the
restructuring plan of December 15, 2000.
Sec. 3. Health Care Safety Net Administration
establishment.
(a) There is established within the Department of
Health a Health Care Safety Net Administration to administer and monitor
compliance with any contract that the Mayor makes, pursuant to section 7,
or that the District of Columbia Financial Responsibility Management
Assistance Authority makes, with a health care entity to provide any of
the health care functions provided by the Public Benefit Corporation
pursuant to the Health and Hospitals Public Benefit Corporation Act of
1996, effective April 9, 1997 (D.C. Law 11-212; D.C. Code §32-262.7(a)),
and to perform such other functions as are set forth herein.
(b) The Health Care Safety Net Administration
shall be responsible for all transition activities that result from
contracting out the functions of the Public Benefit Corporation and that
remain to be completed after abolition of the Public Benefit Corporation
pursuant to section 9, including the following:
(1) Termination and winding down of existing
contracts of the Public Benefit Corporation;
(2) Completion of administrative proceedings
and court litigation previously handled by the Office of the General
Counsel of the Public Benefit Corporation or by private counsel retained
by the Public Benefit Corporation;
(3) Coordination of court litigation involving
the Public Benefit Corporation that is being handled by the Office of
the Corporation Counsel;
(4) Assessment of outstanding claims against
the Public Benefit Corporation; and
(5) Arrangement for payment of lawful
obligations of the Public Benefit Corporation that are assumed by the
District of Columbia pursuant to section 5.
(c) The Health Care Safety Net Administration
shall exercise oversight of the services contracted by the Mayor pursuant
to section 7, or by the District of Columbia Financial Responsibility and
Management Assistance Authority, to ensure that the health of the
population is maintained and that the financial viability of the health
care entity providing services exempted pursuant to section 8 is
addressed.
Sec. 4. Transfers.
(a) The functions, real and personal property,
personnel, unexpended balances of appropriations, and records of the
Public Benefit Corporation shall be transferred to the
Department of Health.
(b) Any monies remaining in the Health and
Hospitals Public Benefit Corporation Fund after the effective date of this
act shall revert to the General Fund to the credit of the Department of
Health.
(c) The Department of Health shall recognize
collective bargaining representatives that have been duly certified by the
District of Columbia Public Employees Relations Board and shall assume and
be bound by all existing collective bargaining agreements entered into by
the Public Benefit Corporation.
(d) Every employee of the Public Benefit
Corporation shall be transferred to the Department of Health. All
employees so transferred shall be under the direction and control of the
Director of the Department of Health or that director's designee or
designees. Transferred employees shall retain the same rights and
privileges that they had as employees of the Public Benefit Corporation
before the effective date of this act and shall not obtain any additional
rights or privileges as a result of the transfer. They shall have all the
duties and responsibilities that they had as employees of the Public
Benefit Corporation in addition to whatever duties and responsibilities
they acquire as employees of the Department of Health. Transferred
employees shall constitute a separate competitive area within the
Department of Health for purposes of reductions
in force only pursuant to section 2408 of the District of Columbia
Government Comprehensive Merit Personnel Act of 1978, effective March 3,
1979, D.C. Law 2-139, D.C. Code §1-625.7, and Chapter 24 of the District
of Columbia Personnel Manual. Lesser competitive areas may be established
by the personnel authority for these employees. The Mayor shall be the
personnel authority for all employees of the Public Benefit Corporation
who are transferred to the
Department of Health, except that the personnel authority for accounting,
budget, and financial management personnel who are transferred shall
continue to be the Chief Financial Officer of the District of Columbia.
Sec. 5. Liabilities of the Public Benefit
Corporation.
All liabilities of the Public Benefit Corporation
shall be assumed by the District of Columbia.
Sec. 6. Health Care Safety Net Fund and
Appropriations.
(a) There is established the Health Care Safety
Net Fund ("Fund") as a nonlapsing, revolving
fund, to be administered by the Mayor as an agency fund as defined in
section 373(2)(I) of Title 47 of the District of Columbia Code, to be used
exclusively for the purposes stated
in section 3. Revenues deposited into the Fund shall not revert to the
General Fund at the end of any fiscal year or at any other time but shall
be continually available to the Department of Health for the uses and
purposes set forth in this act, subject to authorization by Congress in an
appropriations act.
(b) The Fund shall be financed through
appropriations, federal and other grants, the accounts receivable of the
Public Benefit Corporation, and gifts or donations.
(c) The Fund shall be accounted for under procedures
established pursuant to subchapter V of Chapter 3 of Title 47 of the
District of Columbia Code.
(d) There are authorized to be appropriated from
the general revenues of the District of Columbia funds necessary to carry
out the purposes of this act.
Sec. 7. Authorization to contract for
comprehensive health care services.
(a) The Mayor is authorized to provide by
contract or by other means comprehensive
community-centered health care and medical services for residents of the
District of Columbia.
(b) A contract entered into by the Mayor pursuant
to subsection (a) of this section shall be exempt from the requirements of
the District of Columbia Procurement Practices Act of 1985, effective
February 21, 1986 (D.C. Law 6-85; D.C. Code §1-1181.1 et
seq.); except that the contract
shall be subject to section 105a of that act.
Sec. 8. Health services planning program
amendments.
The Health Services Planning Program
Re-establishment Act of 1996, effective April 9, 1997 (D.C. Law 11-191;
D.C. Code § 32-351 et seq.),
is amended as follows:
(1) Section 2 (D.C. Code §32-351) is amended by
adding a new paragraph (3A) to read as follows:
"(3A) "Charity care" means the
physician and hospital medical services provided to persons who are
unable to pay for the cost of services, especially those persons who are
low-income, uninsured and underinsured, but excluding those services
determined to be caused by, or categorized as, bad debt.".
(2) Section 3(b) (D.C. Code §32-352(b)) is
amended as follows:
(A) Paragraph (3) is amended by striking the word
"and" at the end.
(B) Paragraph (4) is amended by striking the
period at the end and inserting the phrase and" in its place.
"(5) Establishing, determining, and
developing, in accordance with section 22, requirements and standards
for the implementation of unreimbursed charity care by all health care
facilities that receive a certificate of need, including an annual
mechanism for monitoring the
provision of that charity care by the health care facilities."
(3) Section 8 (D.C. Code § 32-357) is amended by
adding new subsections (e), (f), and (g) to read as follows:
"(e) Any proposal to offer or develop a
new institutional health service, obligate a new capital expenditure, or
reduce or terminate a health service that would otherwise be subject to
certificate of need requirements, by a health care entity that has
contracted with the District of Columbia Financial Responsibility
Management Assistance Authority, or with the Mayor pursuant to section 7
of the Health Care Privatization Temporary Amendment Act of 2001, to
provide new health care services shall be exempt from certificate of
need requirements only for the purpose of maintaining the same level of
care and services provided by the District of Columbia Health and
Hospitals Public Benefit Corporation ("Public Benefit
Corporation").
"(f) The Administrator of the Health Care
Safety Net Administration ("Administrator"), established
pursuant to section 3 of the Health Care Privatization Temporary
Amendment Act of 2001, shall determine which new institutional health
services, capital expenditures, and reductions or terminations of health
services qualify as health care services being taken over from the
Public Benefit Corporation.
"(g) The District government and the
Public Benefit Corporation are exempt from certificate of need
requirements for any changes in health care service that may result from
the abolishment of the Public Benefit Corporation.".
Sec. 9. Repealers.
(a) The Health and Hospitals Public Benefit
Corporation Act of 1996, effective April 9, 1997 (D.C. Law 11-212; D.C.
Code §32-261.1 et seq.), as amended, is repealed, and the Public Benefit
Corporation is abolished.
(b) Section 851(1)(D) of the District of Columbia
Government Comprehensive Merit Personnel Act of 1978, effective April 20,
1999 (D.C. Law 12-260; D.C. Code §1-609.51(1)(D)), is repealed.
(c) Section 2(e)(9) of the Confirmation Act of
1978, effective March 3, 1979 (D.C. Law 2-142; D.C. Code §1-6333(e)(9)),
is repealed.
(d) Section 320(k) of the District of Columbia
Procurement Practices Act of 1985, effective April 15, 1997 (D.C. Law
11-259; D.C. Code §1-1183.20(k)), is repealed.
Sec. 10. Fiscal impact statement.
The Authority adopts the attached fiscal impact
statement of the District Chief Financial Officer as the fiscal impact
statement required by section 602(c)(3) of the District of Columbia Home
Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Code §
1-233(c)(3)).
Sec. 11. Effective date.
(a) This act shall take effect following a 30-day
period of Congressional review as provided in section 602(c)(1) of the
District of Columbia Home Rule Act, approved December 24, 1973 (87 Stat.
813; D.C. Code §1-233(c)(1)),and publication in the District of Columbia
Register.
(b) This act shall expire after 225 days of its
having taken effect or upon the effective date of the Health Care
Privatization Amendment Act of 2001, whichever occurs first.
Enacted this 30th day of April, 2001 by the
Authority.
Alice M. Rivlin
Chair
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AN ACT
THE DISTRICT OF COLUMBIA FINANCIAL RESPONSIBILITY
AND MANAGEMENT ASSISTANCE AUTHORITY ("AUTHORITY")
To reorganize the Department of Health by
establishing a Health Care Safety Net Administration in the Department of
Health and to transfer functions of the District of Columbia Health and
Hospitals Public Benefit Corporation ("Public Benefit
Corporation") to the Department
of Health; to authorize the Mayor to contract out any of the health care
functions of the Public Benefit Corporation; to exempt any contract to
provide comprehensive community-centered health care and medical services
for District of Columbia residents provided by the Public Benefit
Corporation entered into by the Mayor
from certain provisions
of the District of Columbia Procurement Procedures Act of 1985;
to amend the Health
Services Planning Program Re-establishment Act of 1996 to establish
authority for establishing requirements for charity care and to exempt the
District government, the Public Benefit Corporation, and any contractor
that provides health
care services provided by the Public Benefit Corporation pursuant to a
health care privatization
contract from certain provisions of the Health Services Planning Program
Re-establishment Act of
1996; and
to repeal the Health and Hospitals Public Benefit
Corporation Act of 1996
and abolish the Public Benefit Corporation.
BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF
COLUMBIA FINANCIAL
RESPONSIBILITY AND MANAGEMENT ASSISTANCE AUTHORITY,
Sec. 1. This act is enacted pursuant to Section
207 of Public Law 104-8, and may be
cited as the
"Health Care Privatization Amendment Act of 2001 ".
Sec. 2. Findings and purpose.
The Authority finds and declares the following:
(1) The District of Columbia Health and Hospitals
Public Benefit Corporation ("Public Benefit Corporation") has
operated with increasing deficits and has depleted its 545.3 million FY
2001 subsidy.
(2) The District of Columbia Appropriations Act,
2001, Public Law 106-522, ("Appropriations Act"), approved
November 22, 2000, requires that no appropriated amounts and no amounts
from or guaranteed by the District of Columbia government (including the
District of Columbia Financial Responsibility and Management Assistance
Authority) may be made available to the [PBC] (through reprogramming,
transfers, loans, or any other mechanism) which are not otherwise provided
for under this heading until a restructuring plan for D.C. General
Hospital has been approved. The appropriations act also authorizes the
spending of non-Federal funds not to exceed $90 million for the purpose of
restructuring health care delivery pursuant to a December 15, 2000
restructuring plan approved by the Mayor, the Council, the District of
Columbia Financial Responsibility and Management Assistance Authority, and
the Board of Directors of the Public Benefit Corporation, and prohibits
making available such funds or any other appropriated funds to the Public
Benefit Corporation except pursuant to the restructuring plan.
(3) On December 4, 2000, the Authority issued a
Resolution, Recommendations and Orders, pursuant to Section 207 of the
District of Columbia Financial Responsibility and Management Assistance
Act, approved April 17, 1995 (Public Law 104-8, 109 Stat. 133; D.C. Code
§47-392.7), concerning the Public Benefit Corporation, that, among other
things, required the following to occur within 90 days of December 4,
2000:
(A) Repeal of Titles I and II of the Health and
Hospitals Public Benefit Corporation Act of 1996, effective April 9,
1997 (D.C. Law 11-212; D.C. Code §§32-261.1-32-262.20).
(B) Council enactment of legislation and
regulations and approval of reprogrammings and any other actions
necessary to authorize and implement an alternative publicly-financed
health care delivery system.
(4) On December 15, 2000, pursuant to the
Appropriations Act, the Mayor submitted to the Committee on Government
Reform of the House of Representatives and the Committee on Government
Affairs of the Senate a health care delivery restructuring plan that was
approved by the Authority, the Mayor; the Council, and the Board of
Directors of the Public Benefit Corporation.
(5) The purpose of this act is to authorize
implementation of an alternative publicly financed health care delivery
system to replace the health care services formerly provided by the Public
Benefit Corporation, as recommended by the Authority in its Resolution,
Recommendations and Orders of
December 4, 2000, and in accordance with the restructuring plan of
December 15, 2000.
Sec. 3. Health Care Safety Net Administration
establishment.
(a) There is established within the Department of
Health a Health Care Safety Net Administration to administer and monitor
compliance with any contract that the Mayor makes, pursuant to section 7,
or that the District of Columbia Financial Responsibility Management
Assistance Authority makes, with a health care entity to provide any of
the health care functions provided by the Public Benefit Corporation
pursuant to the Health and Hospitals Public Benefit Corporation Act of
1996, effective April 9, 1997 (D.C. Law 11-212; D.C. Code § 32-262.7(a)),
and to perform such other functions as are set forth herein.
(b) The Health Care Safety Net Administration
shall be responsible for all transition activities that result from
contracting out the functions of the Public Benefit Corporation and that
remain to be completed after abolition of the Public Benefit Corporation
pursuant to section 9, including the following:
(1) Termination and winding down of existing
contracts of the Public Benefit Corporation;
(2) Completion of administrative proceedings and
court litigation previously handled by the Office of the General Counsel
of the Public Benefit Corporation or by private counsel retained by the
Public Benefit Corporation;
(3) Coordination of court litigation involving
the Public Benefit Corporation that is being handled by the Office of
the Corporation Counsel;
(4) Arrangement of outstanding claims against
the Public Benefit Corporation; and
(5) Arrangement for payment of lawful
obligations of the Public Benefit Corporation that are assumed by the
District of Columbia pursuant to section 5.
(c) The Health Care Safety Net Administration
shall exercise oversight of the services contracted by the Mayor pursuant
to section 7, or by the District of Columbia Financial Responsibility and
Management Assistance Authority, to ensure that the health of the
population is maintained and that the financial viability of the health
care entity providing services exempted pursuant to section 8 is
addressed.
Sec. 4. Transfers.
(a) The functions, real and personal property,
personnel, unexpended balances of appropriations,
and records of the Public Benefit Corporation shall be transferred to the
Department of Health.
(b) Any monies remaining in the Health and
Hospitals Public Benefit Corporation Fund after the effective date of this
act shall revert to the General Fund to the credit of the Department of
Health.
(c) The Department of Health shall recognize
collective bargaining representatives that have been duly certified by the
District of Columbia Public Employees Relations Board and shall assume and
be bound by all- existing collective bargaining agreements entered into by
the Public Benefit Corporation.
10 (d) Every employee of the Public Benefit Corporation shall be
transferred to the Department of Health. All employees so transferred
shall be under the direction and control of the Director of the Department
of Health or that director's designee or designees. Transferred employees
shall retain the same rights and privileges that they had as employees of
the Public Benefit Corporation before the effective date of this act and
shall not obtain any additional rights or privileges as a result of the
transfer. They shall have all the duties and responsibilities that they
had as employees of the Public Benefit Corporation in addition to whatever
duties and responsibilities they acquire as employees of the Department of
Health. Transferred employees shall constitute a separate competitive area
within the Department of Health for purposes of reductions in force only
pursuant to section 2408 of the District of Columbia Government
Comprehensive Merit Personnel Act of 1978, effective March 3, 1979, D.C.
Law 2-139, D.C. Code §1-625.7, and Chapter 24 of the District of Columbia
Personnel Manual. Lesser competitive areas may be established by the
personnel authority for these employees. The
Mayor shall be the personnel authority for all employees of the Public
Benefit Corporation who are transferred to the Department of Health,
except that the personnel authority for accounting, budget, and financial
management personnel who are transferred shall continue to be the Chief
Financial Officer of the District of Columbia.
Sec. 5. Liabilities of the Public Benefit
Corporation.
All liabilities of the Public Benefit Corporation
shall be assumed by the District of Columbia.
Sec. 6. Health Care Safety Net Fund and
Appropriations.
(a) There is established the Health Care Safety
Net Fund ("Fund") as a nonlapsing, revolving fund, to be
administered by the Mayor as an agency fund as defined in section
373(2)(1) of Title 47 of the District of Columbia Code, to be used
exclusively for the purposes stated in section 3. Revenues deposited into
the Fund shall not revert to the General Fund .at the end of any fiscal
year or at any other time but shall be continually available to the
Department of Health for the uses and purposes set forth in this act,
subject to authorization by Congress in an appropriations act.
(b) The Fund shall be financed through
appropriations, federal and other grants, the accounts receivable of the
Public Benefit Corporation, and gifts or donations.
(c) The Fund shall be accounted for under
procedures established pursuant to subchapter V of Chapter 3 of Title 47
of the District of Columbia Code.
(d) There are authorized to be appropriated from
the general revenues of the District of Columbia funds necessary to carry
out the purposes of this act.
Sec. 7. Authorization to contract for
comprehensive health care services.
(a) The Mayor is authorized to provide by
contract or by other means comprehensive community-centered health care
and medical services for residents of the District of Columbia.
(b) A contract entered into by the Mayor pursuant
to subsection (a) of this section shall be exempt from the requirements of
the District of Columbia Procurement Practices Act of 1985, effective
February 21, 1986 (D.C. Law 6-85; D.C. Code §1-1181.1 et seq.), except
that the contract shall be subject to section 105a of that act.
Sec. 8. Health services planning program
amendments.
The Health Services Planning Program
Re-establishment Act of 1996, effective April 9, 1997 (D.C. Law 11-191;
D.C. Code §32-351 et seq.), is amended as follows:
(1) Section 2 (D.C. Code §32-351) is amended by
adding a new paragraph (3A) to read as follows:
"(3A) "Charity care" means the
physician and hospital medical services provided to persons who are
unable to pay for the cost of services, especially those persons who are
low income, uninsured and underinsured, but excluding those services
determined to be caused by, or categorized as, bad debt.".
(2) Section 3(b) (D.C. Code §32-352(b)) is
amended as follows:
(A) Paragraph (3) is amended by striking the
word "and" at the end.
(B) Paragraph (4) is amended by striking the
period at the end and inserting the phrase "; and" in its
place.
(C) A new paragraph (5) is added to read as
follows:
"(5) Establishing, determining, and
developing, in accordance with section 22, requirements and standards for
the implementation of unreimbursed charity care by all health care
facilities that receive a certificate of need, including an annual
mechanism for monitoring the provision of that charity care by the health
care facilities.".
(3) Section 8 (D.C. Code § 32-357) is amended by
adding new subsections (e), (f), and (g) to read as follows:
"(e) Any proposal to offer or develop a
new institutional health service, obligate a new capital expenditure, or
reduce or terminate a health service that would otherwise be subject to
certificate of need requirements, by a health care entity that has
contracted with the District of Columbia Financial Responsibility
Management Assistance Authority, or with the Mayor pursuant to section 7
of the Health Care Privatization Amendment Act of 2001, to provide new
health care services shall be exempt from certificate of need
requirements only for the purpose of maintaining the same level of care
and. services provided by the District of Columbia Health and Hospitals
Public Benefit Corporation ("Public Benefit Corporation"). The
exemptions granted by this subsection shall be for a period of 225 days
from the effective date of the Health Care Privatization Amendment Act
of 2001, except that proposals to develop trauma I capability to match
the levels existing at D.C. General Hospital as of January 1, 2001,
shall be exempt from certificate
of need requirements for a period of 1 year from the effective date of
the Health Care Privatization Amendment Act of 2001.
"(f) The Administrator of the Health Care
Safety Net Administration ("Administrator"), established
pursuant to section 3 of the Health Care Privatization Amendment Act of
2001, shall determine which new institutional health services, capital
expenditures, and reductions or terminations of health services qualify
as health care services being taken over from the Public Benefit
Corporation. The Administrator's authority to make determinations and
the exemptions from
certificate of need review pursuant to subsection (e) shall expire 1
year after the date the first contract for health care services entered
into pursuant to section 7 of the Health Care Privatization Amendment
Act of 2001 is signed.
"(g) The District government and the Public
Benefit Corporation are exempt from certificate of need requirements for
any changes in health care service that may result from the abolishment of
the Public Benefit Corporation.".
Sec. 9. Repealers.
(a) The Health and Hospitals Public Benefit
Corporation Act of 1996, effective April 9, 1997 (D.C. Law 11-212; D.C.
Code §32-261.1 et seq.), as amended, is repealed, and the Public Benefit
Corporation is abolished.
(b) Section 851(1)(D) of the District of Columbia
Government Comprehensive Merit Personnel Act of 1978, effective April 20,
1999 (D.C. Law 12-260; D.C. Code §1-609.51(1)(D)), is repealed.
(c) Section 2(e)(9) of the Confirmation Act of
1978, effective March 3, 1979 (D.C. Law 2-142; D.C. Code §1-633.7(e)(9)),
is repealed.
(d) Section 320(k) of the District of Columbia
Procurement Practices Act of 1985, effective April 15, 1997 (D.C. Law
11-259; D.C. Code §1-1183.20(k)), is repealed.
Sec. 10. Fiscal impact statement.
The Authority adopts the attached fiscal impact
statement of the District Chief Financial Officer as the fiscal impact
statement required by section 602(c)(3) of the District of Columbia Home
Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Code §
1-233(c)(3)).
Sec. 11. Effective date.
This act shall take effect following a 30-day
period of Congressional review as provided in section 602(c)(1) of the
District of Columbia Home Rule Act, approved December 24, 1973 (87 Stat.
813; D.C. Code §1-233(c)(1)), and publication in the District of Columbia
Register.
Enacted this 30th day of April, 2001 by the
Authority.
Alice M. Rivlin
Chair |
