|Chairman Linda Cropp At
the request of the Mayor
A PROPOSED RESOLUTION IN THE
COUNCIL OF THE DISTRICT OF COLUMBIA
To approve, on an emergency basis, the recommendations of the
Health Care System Development Commission.
RESOLVED, BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That
this resolution may be cited as the "Health Care System Development Commission
Recommendations Emergency Approval Resolution of 2000".
Sec. 2. Pursuant to section 1306 of the Service Improvement
and Fiscal Year 2000 Budget Support Act of 1999, DC Law 13-38, effective October 20, 1999,
to be codified at D.C. Code Section 6-155, the Mayor transmitted to the Council for
approval the following recommendations of the Health Care System Development Commission to
develop the District's health care system.
(1) Improve the health care delivery system and services for
vulnerable populations by:
(A) Establishing a certification program that designates local
health centers (and planned centers) as DC Qualified Health Centers (DCQHC). This program
will be guided by the state health plan, the certificate of need (CON) program, and
community input. The certification would include practice standards and reporting
requirements and would ensure that the centers are part of an integrated, comprehensive
system of health care providers that includes hospitals, laboratories, pharmacies, and
other health services and their patients would have increased access to needed secondary
and tertiary care. The certification process will include community input.
(B) Using new Disproportionate Share Hospital (DSH) dollars,
consistent with federal standards, to increase the accessibility of local medical homes
that provide preventative and primary care to all District residents. Hospitals receiving
DSH will be held responsible for increasing the availability of outpatient and primary
care services, for formalizing relationships with local health centers (including hospital
health centers) that lead to greater patient access to secondary and tertiary care, and
for reporting to DOH the number of patients serviced and services provided with the
hospitals' DSH dollars.
(C) Activating provisions of existing laws that enable the
District to contract with the Public Benefits Corporation to provide hospital-based and
clinic-based health services for the uninsured. This contract would use cost-effective
reimbursement methodologies for in-patient services as well as comparable methodologies
for outpatient and clinical services. Service quality and outcome measures will be
incorporated in the contract. A comprehensive assessment, overseen jointly by the District
and the PBC, will be conducted. The results of that assessment will provide the basis for
refining/reviewing the PBC's structure and function within the District's health care
(D) Establishing a public/private capital fund that will help
build the capacity of the District's community-based delivery system. Because the District
has a public trust, District funds would be available initially to public clinics and
public/private partnerships. Every effort would be made to establish finding to meet the
needs of public and private health centers and hospital clinics that are DCQHCs or have
DOH-approved plans for becoming DCQHCs. The health centers receiving capital funds will be
approved under the CON process based on DOH's determination that their improvement or
construction helps meet state plan-identified needs. These centers will also receive
technical assistance. The capital fund will be developed using District capital fluids
that will be matched by the private sector.
(E) Providing a higher Medicaid reimbursement rate for
community health centers certified as DCQHCs or with DOH-approved plans to become DCQHCs.
This will allow the District to provide additional funding to those centers that serve
large percentages of uninsured individuals and centers that provide care in areas of the
District where too few primary care providers operate.
(F) Developing a pharmaceutical program that continues the
existing program for the uninsured when it expires in 2002. The program will work through
participating pharmacies to provide free or discounted prescription drugs to uninsured
(2) Expand Health Insurance Coverage by:
(A) Expanding DC Healthy Families coverage to adults without
dependent children in phases once enrollment increases have been achieved and experiences
assessed from the current implementation. Phase I will cover adults with incomes up to 50%
of the federal poverty level (FPL); Phase II will cover adults with incomes up to 100%
(B) Providing tax credits to businesses offering health
coverage to District residents, subject to actuarial estimates.
(C) Establishing a "brand" insurance coverage
program which could include Medicaid beneficiaries and D.C. government employees and could
be open to small businesses. A "Brand" insurance card will be issued to all
participating individuals and will include a code to distinguish among benefit plans. The
ultimate goal is to create a `seamless system care'.
(D) Proposing a change in the Federal Employee Health Benefit
Program (FEHBP) to permit the inclusion of District of Columbia small businesses and
District government employees. .This would require Congressional legislation.
(3) Build the Capacity of the Department of Health to ensure
the public's health and better manage the health system by:
(A) Increasing enrollment in DC Healthy Families (DCHF)
(1) implementation of an electronic (web-based) enrollment
system, improved training, and outreach efforts to register Medicaid eligible and
uninsured patients at hospitals and DCQHCs and to provide a greater level of
(2) maximization of TANF and CHIP funds earmarked for
(3) implementation of presumptive eligibility for all children
(4) implementation of a 1-year continuous enrollment program
for all, including parents of DCHF and fixture DCHF expansion populations, including
adults without dependent children
(B) Developing the Department of Health's monitoring and
management capacity through,
(1) development of a state-of-the-art, outcomes
measures-based, MIS system that links DOH to health care providers throughout the District
and the provision needed staff development/training to implement this system
(2) rewriting the District's State Health Plan and Medicaid
(3) restructuring the Certificate of Need process and the
reassessment, and rewriting if appropriate, of regulatory and reporting requirements
Sec. 3. Goals to be accomplished include to:
(A) Improve the health care system and services for vulnerable
(B) Increase insurance coverage and decrease the number of
uninsured District residents.
(C) Improve the capacity of the Department of Health to
monitor and assess the quality and effectiveness of the health system.
Sec. 4. Fiscal impact statement. Health Care System
Development Commission recommendations are subject to enabling legislation, regulation,
and appropriations. Therefore, there is no fiscal impact.
Sec. 5. The Secretary of the Council shall transmit a copy of
this resolution to Mayor upon its adoption.
Sec. 6. This resolution shall take effect immediately.