HOUSE DOCKET, NO. 1809        FILED ON: 1/20/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1498

The Commonwealth of Massachusetts

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PRESENTED BY:

Jason M. Lewis

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act to promote prevention and wellness through a public health trust.

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PETITION OF:

HOUSE DOCKET, NO. 1809        FILED ON: 1/20/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1498

The Commonwealth of Massachusetts

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In the Year Two Thousand Eleven

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An Act to promote prevention and wellness through a public health trust.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1.   Chapter 111 of the General Laws, as appearing in the 2010 Official Edition, is hereby amended by inserting after section 2F the following section:–

Section 2G.  (a) There shall be established upon the books of the commonwealth a separate fund to be known as the Prevention and Cost Control Trust Fund to be expended, without further appropriation, by the department of public health.  The fund shall consist of all prevention and cost control surcharge revenues collected by the commonwealth in accordance with the provisions of subsection (g) of section 38 of chapter 118G, public and private sources such as gifts, grants and donations to further community-based prevention activities and interest earned on such revenues; provided, however, that this provision shall not preclude the appropriation from the General Fund of the commonwealth of additional amounts to support the administration of the fund.

The commissioner of the department of public health, as trustee, shall administer the fund.  The commissioner, in consultation with the Prevention and Cost Control Advisory Board established in subsection (c), shall make expenditures from this account consistent with the provisions of subsection (d); provided, that no more than 20 percent of the amounts held in the fund in any one year shall be used by the department for program administration, technical assistance to grantees, or program evaluation.

(b) Revenues deposited in the fund that are unexpended at the end of the fiscal year shall not revert to the General Fund and shall be available for expenditure in the following fiscal year.

(c) There shall be a Prevention and Cost Control Advisory Board constituted for the general purpose of making recommendations to the commissioner concerning the administration and allocation of the fund, establishing evaluation criteria, and performing any other functions specifically granted to it by law.

The board shall consist of 13 members who shall be appointed by the governor, including the following members:  the commissioner of the department of public health, who shall serve as chair of the board; the commissioner of the division of health care finance and policy or a designee; the secretary of the executive office of health and human services or a designee; a representative with expertise in the field of public health economics; a representative with expertise in public health research; a representative with expertise in the field of health equity; a representative from a local board of health for a city with population greater than 50,000; a representative of a board of health with a population under 50,000; a representative from the health insurance industry; a representative from a consumer health organization; a representative from a hospital association; a representative from a statewide public health organization and a representative from an accountable care organization. 

The board shall annually publish a report to be used by the commissioner in determining allocation of funds.  Said report shall include but not be limited to the following: (i) a list of the most prevalent preventable health conditions in the commonwealth, including health disparities experienced by populations based on race, ethnicity, gender, disability status, sexual orientation, or socio-economic status; (ii) a list of the most costly preventable health conditions in the commonwealth; (iii) a list of evidence-based or promising community-based interventions related to the conditions identified in (i) and (ii).  Where appropriate, the report shall reference goals and best practices established by the national prevention and public health promotion council and the centers for disease control and prevention, including, but not limited to the national prevention strategy, the healthy people report and the community prevention guide.

(d) The commissioner shall annually award no less than 80 percent of the fund through a competitive grant process to municipalities and community-based organizations that apply for the implementation, evaluation, and dissemination of evidence-based community preventive health activities, with a preference for activities that, based on findings of the board, will reduce rates of the most prevalent and costly preventable health conditions, address health disparities, and develop a stronger evidence-base of effective prevention programming.   To be eligible to receive a grant under this subsection, a recipient shall be: (i) a municipality or group of municipalities working in collaboration, or (ii) a community-based organization working in collaboration with one or more municipalities. Expenditures from the fund for such purposes shall complement and not replace existing local, state, or federal public health-related funding.

(e) Funding shall be allocated approximately proportionally by population to the 5 healthy communities regions in the commonwealth as designated by the department of public health; provided that no region shall receive less than 10 percent of the sum of annually allocated funds directed to all regions. 

(f) The department shall conduct an evaluation of funded activities on a yearly basis, consistent with goals and criteria that may be established by the prevention and cost control advisory board.

(g) The commissioner shall report annually on March 1 to the house and senate committees on ways and means and the joint committee on public health: (i) the revenue credited to the fund; (ii) the amount of fund expenditures that are attributable to the administrative costs of the department; (iii) an itemized list of the funds expended through grants and a description of the grantee activities; and (iv) the results of evaluation of the effectiveness of the activities funded through grants.  The report shall be made available to the public.

SECTION 2. Section 38 of chapter 118G of the General Laws is hereby amended by inserting after subsection (f) the following subsection:–

(g) (1) In addition to the surcharge assessed under subsection (a), acute hospitals and ambulatory surgical centers shall assess a prevention and cost control surcharge on all payments subject to surcharge as defined in section 34.  The prevention and cost control surcharge amount shall equal the product of (i) the prevention and cost control surcharge percentage and (ii) amounts paid for these services by a surcharge payor. The division shall calculate the prevention and cost control surcharge percentage by dividing $75,000,000 by the projected annual aggregate payments subject to the surcharge, excluding projected annual aggregate payments based on payments made by managed care organizations. The division shall determine the prevention and cost control surcharge percentage before the start of each fund fiscal year and may redetermine the prevention and cost control surcharge percentage before April 1 of each fund fiscal year if the division projects that the initial prevention and cost control surcharge established the previous October will produce less than $70,000,000 or more than $80,000,000. Before each succeeding October 1, the division shall redetermine the prevention and cost control surcharge percentage incorporating any adjustments from earlier years. In each determination or redetermination of the prevention and cost control surcharge percentage, the office shall use the best data available as determined by the division and may consider the effect on projected prevention and cost control surcharge payments of any modified or waived enforcement under subsection (e). The division shall incorporate all adjustments, including, but not limited to, updates or corrections or final settlement amounts, by prospective adjustment rather than by retrospective payments or assessments.

(2) Prevention and cost control surcharge payments shall be deposited in the Prevention and Cost Control Trust Fund, established in section 2G of chapter 111.

(3) All provisions of subsections (a) to (f) and section 34 shall apply to the prevention and cost control surcharge, to the extent not inconsistent with the provisions of this subsection.

SECTION 3.  Notwithstanding any general or special law to the contrary, the prevention and cost control advisory board shall undertake a review of the funding mechanism by which the prevention and cost control trust fund is funded.  This review shall include, but not be limited to an analysis of whether the amount of funding remains adequate and whether the funding mechanism should be altered to account for changes in the health care payment system.  Said report shall be filed with the house and senate committees on ways and means and the joint committee on public health, no later than March 1, 2014.