Article II
Purposes, Duties and Powers
Section 1
The purpose of the Council is to undertake health planning
and resource development in accordance with the provisions of Chapter 53 and
Chapter 55 of Title 18, V.S.A.
Section
2 The Council will undertake but not be limited to these duties:
(A) Make a continuing assessment of the
health needs of the residents of the state.
(B) Make a continuing assessment of the
resources available to meet the health needs of the residents of the
state.
(C) Beginning in 1990 and
every third year thereafter, prepare a State Health Plan identifying health
needs and costs and making recommendations concerning those needs and costs and
deliver the plan to the Governor and the general assembly before January 15.
(1) The plan shall assess the institutional
health services needed to provide for the well-being of people receiving care
within the state, including, at a minimum, acute inpatient, rehabilitation, and
long term care services; and also describe other health services needed to
provide for the well-being of persons receiving care within the state,
including at a minimum, preventive, ambulatory, and home health services, and
treatment for alcohol and drug abuse. The plan shall also assess the number and
type of resources, including facilities, major medical equipment, and other
resources required to meet the goals of the plan and shall generally describe
the extent to which existing health care facilities are in need of
modernization, conversion to other uses, or closure and the extent to which new
health care facilities need to be constructed or acquired.
(2) In the preparation of the State Health
Plan or a revision of the Plan, the Council shall conduct at least three public
hearings, in different regions of the State, on the Plan as proposed and shall
give interested persons an opportunity to submit their views orally and in
writing. Not less than 30 days prior to any such hearing, the Council shall
publish in the manner prescribed in section
839
of Title 3, the time and place of the hearing, the place at which interested
persons may review the Plan in advance of the hearing and the place and period
during which to direct written comment to the Council.
(3) The State Health Plan or any revised
State Health Plan adopted by the Council shall be the health plan for the State
after it is approved by the Governor or upon passage of three months from the
date the Governor receives the Plan, whichever occurs first, unless the
Governor disapproves the Plan, in whole or in part. If the Governor
disapproves, he or she shall specify the sections of the Plan which are
objectionable and the changes necessary to meet the objections. The sections of
the Plan that are not disapproved shall become part of the State Health
Plan.
(D) Consult with
and advise providers and third-party payers to develop procedures of health
care delivery and reimbursement that will promote both the effectiveness and
efficiency of the health care system;
(E) Advise the Secretary of Human Services in
matters concerning the planning, funding, and delivery of health
services
(F) On or before January
15, submit the Annual Implementation Plan to the Senate and House committees on
health and welfare; and
(G) Be a
party in any certificate of need review, and may file and participate in
appeals under section 2413 of Title 18.
(H) Make recommendations to the Hospital Data
Council according to the provisions of section 1957 of Title 18;
Section 3 Powers
(A) Consistent with
32 V.S.A. Sec.
5, the Council may apply for, receive or
accept grants, gifts, and other payments, including property and service, from
a governmental or other public or private entity or person, and may make
arrangements as to the use of those receipts, including the undertaking of
special studies and other projects relating to health care.
(B) The Council may provide technical
assistance or make grants to individuals and public and nonprofit private
entities, consistent with state and federal law, for the development of
projects and programs which the council determines are necessary to achieve the
objectives of its health plan.
(C)
The Council shall have the power to examine the books, accounts and papers of
any provider and may require the filing of reports, data, schedules, statistics
or information as needed to carry out its functions. Records or information
protected by the confidentiality provisions of the physician-patient privilege
under section
1612(a)
of Title 12 or otherwise required by law to be held confidential shall not be
subject to the provision of this section.
Article III Definitions
Section 1
"Annual Implementation Plan" means a plan adopted by the
Council which describes methods and objectives to be used to achieve the goals
of the State Health Plan adopted according to the provisions of Article II of
these rules.
Section 2
"Provider" means an individual -
(A) Who is direct provider of health care
(including a physician, dentist, nurse, podiatrist, physician assistant or
ancillary personnel employed under the supervision of a physician) in that the
individual's primary current activity is the provision of health care to
individuals or the administration of facilities or institutions (including
hospitals, long-term care facilities, rehabilitation facilities, alcohol and
drug abuse treatment facilities, outpatient facilities, and health maintenance
organizations) in which such care is provided and, when the individual has
received professional training in the provision of such care or in such
administration and is licensed or certified for such provision or
administration, and is accordingly licensed or certified; or
(B) Who is an indirect provider of health
care in that he or she:
(i) hold a fiduciary
position with, or has a fiduciary interest in, any entity described in (II) or
(IV) of paragraph (ii) of this section, provided that this subdivision shall
not apply to a board member of an entity described in section 501(c)(3) of the
Internal Revenue Code of 1954, as amended, so long as the person is not
otherwise a provider;
(ii) receives
(either directly or through his or her spouse) more than one-fifth of his or
her gross annual income from any one or combination of the following:
(I) fees or other compensation for research
into or instruction in the provision of health care.
(II) entities engaged in the provision of
health care or in research or instruction in the provision of health
care;
(III) producing or supplying
drugs or other articles for individuals or entities for use in the provision of
or research into or instruction in the provision of health care;
(IV) entities engaged in producing drugs or
such other articles;
(C) who is a member of the immediate family
of an individual described in this subdivision; or
(D) who is engaged in issuing any policy or
contract of individual or group health insurance or hospital or medical service
benefits.
Section 3
"Public member" means an individual who represents the public
and who is not a provider as defined above.
Section 4
"Third-party payor" means any health insurer or non-profit
hospital or medical insurance corporation as defined by Title 8.
Article IV Health Policy Council
Board
Section 1 Membership
The Board of the Council shall consist of such members as
defined by 18 V.S.A. Section 2352. At no time shall the number of members be
decreased or increased beyond statutory limits.
Section 2 Selection of Members
(A) A Council Membership Committee shall be
established to solicit nominations to the Governor pursuant to 18 V.S.A.
Section 2352(f) for his or her consideration in appointments to the Board,
except for at-large, legislative and ex-officio members, and to perform other
such functions as defined by the Council.
(B) It shall be the responsibility of the
Council Membership Committee to convene nominating committees for purposes of
initiating the selection of representatives from the following categories:
physicians, hospitals, nurses, dentists, providers of mental health services,
the allied health professions, third-party payors, providers of mental health
services, long term health care facilities, providers of community health
services, low income Vermonters, the elderly, major purchasers of health care
from the private sector, the handicapped, labor, and environmental health. The
Council membership committee shall notify organizations of which it is aware in
each category and shall through notices published in the manner prescribed in
Section
803(a)(2)
of Title 3 invite additional organizations to participate. The Council
Membership Committee shall decline to accept an organization whose stated
purposes do not coincide with the interests of the designated constituency, but
no organization shall be excluded for any other reason. A grievance procedure
for organizations excluded under this section is established by rule. The
Council Membership Committee shall also adopt temporary rules for the
organizational meetings of nominating committees. Thereafter, the nominating
committees may adopt their own rules of procedure, provided that all matters to
be decided by a nominating committee shall be decided by a majority vote of
individuals present at a duly warned and convened meeting and not by a majority
of organizations represented and provided that nominees shall be limited to
members of categories to be represented.
(C) Members of the general assembly shall be
appointed as follows, pursuant to 18 V.S.A. Section 2352(d): two
Representatives appointed by the Speaker of the House of Representatives, and
two Senators appointed by the Committee on Committees of the Senate.
(D) The Director of the Veterans
Administration Center shall be a non voting member.
(E) Ex-officio members may designate in
writing a permanent representative who shall have all of the privileges and
duties of Council membership pursuant to these rules.
(F) The Chairperson shall appoint when
necessary a grievance committee to hear and act on grievances as provided in 18
V.S.A. Section 2352(f). The grievance committee shall not include any member of
the Council Membership Committee. Appeals from a decision by the grievance
committee shall be made in writing to the Council within ten days.
Section 3 Terms
Members who are members of the General Assembly shall be
appointed for two years or until their successors are appointed, beginning
February 15 in the first year of each biennium. The other members shall be
appointed for three years or until their successors are appointed, beginning
February 15 in the year in which the appointments are made. Initial
appointments shall be for terms of one, two or three years so that no more than
seven terms expire in any one year. Except for ex-officio members, no member of
the Health Policy Council may serve for more than six years whether or not
consecutive.
Section 4
Compensation
(A) Members of the Council,
except for legislative members while the general assembly is in session,
ex-officio members of the Council and those Council members otherwise regularly
employed by the state, shall be entitled to a per diem in the amount provided
in
32 V.S.A. sec.
1010 and their necessary and actual
expenses.
(B) Pursuant to Section
1010 of 32 V.S.A. ex-officio members of the Council and those Council members
otherwise regularly employed by the state, shall receive their necessary and
actual expenses.
Section
5 Vacancies
(A) Appointed members
of the Council may be recommended for removal only for good cause. Good cause
includes, but is not limited to, malfesance and lack of attendance as set out
in part (F) of this section. In the event that a recommendation for the removal
of a member is being considered, the member in question shall be allowed to
provide testimony on his/her behalf. A vote for a recommendation for removal
shall be by 2/3 majority vote.
(B)
Following an affirmative vote for removal, the Chair shall notify the
appointing authority of the Council's action and request removal of the
member.
(C) Vacancies on the
Council shall be considered to exist in the event of death, resignation, or
removal of any member.
(D)
Resignation of a member will take effect upon receipt of a letter of
resignation, or on the date specified therein.
(E) In the event of a vacancy occurring in
the membership of the Council, the vacancy shall be filled in the same manner
as the original appointment with a person whose appointment shall terminate on
the date on which the original appointment would have terminated if the vacancy
had not occurred.
(F) Lack of
attendance shall be considered to occur in the event the member fails during
any six (6) month period to attend 50% of the regularly scheduled meetings and
committee meetings of the Council to which he or she has accepted assignment,
unless said member has notified the Chairperson of the circumstances which
necessitate his or her absence. An excused absence shall be counted as an
attended meeting. A majority vote of the Council may nullify this
provision.
Section 6
Liability
Claims against members of the Council arising from the
performance of their duties are governed by the provisions of Chapter 29 of
Title 3, "Claims Against State Employees".
Section 7 Duties and Responsibilities
The members of the Council shall exercise the powers of the
Council and conduct its affairs. It shall be the duty of the Council to:
(A) Authorize the entering into contracts,
working agreements or statements of agreement with such entities as from time
to time may be deemed necessary or useful to carry out the functions, plans,
and the purposes of the Council.
(B) Approve the annual work plan and budget
of the Council as submitted to the Agency of Administration.
(C) Employ an Executive Director who shall be
an exempt employee, to manage the Council and to assist in realizing the
objectives of the Council.
(D)
Supervise the Executive Director to assure that his or her duties are
performed.
(E) Meet at such times
and places as required by these rules.
Article V Meetings
Section 1 Regular Meetings
(A) The Council shall schedule regular
monthly meetings unless resolved otherwise by the Council. However, the Council
shall not hold less than one meeting in each calendar quarter, nor less than
six (6) in each calendar year.
(B)
The Clerk shall send a written notice of the Council regular meetings to the
residence of each member not less than fifteen days prior to such meeting,
unless previously scheduled.
(C)
The Clerk shall provide notice of the regular meetings of the Council through
the "Notice of Government meetings" published by the Agency of
Administration.
(D) All meetings of
the Council shall be open to the public, except such meetings held according to
the provisions of Article V, Section 5(F).
Section 2 Special Meetings
(A) Special meetings of the Council may be
called by or at the request of the Chairperson, or in his or her absence the
Vice-chairperson, or by a written petition signed by six (6) of the members,
and filed with the Clerk or Executive Director.
(B) Notice of any special meeting of the
Council shall be given, if possible, at least 14 days previously thereto by
written notice to each member. In no case shall notice be given less than 3
days prior to the meeting. Any member may waive written notice of any meeting.
The business to be transacted at a special meeting shall be specified in the
notice of such meeting.
Section
3 Committee Meetings
All standing and ad hoc committees of the Council shall
conduct their affairs, activities, and meetings in a manner consistent with
these rules and the specific charge to the committee.
Section 4 Quorum and Voting
A majority of the members of the Council shall constitute a
quorum provided that seven of the members present are public members. The
Council shall act only by vote of a majority of its members present and voting
at a meeting called upon adequate notice to all its members at which a quorum
is in attendance.
Section 5
Procedures and Policies
(A) Unless otherwise
required by a special situation as approved by the Council, all meetings of the
Council shall be held within the State of Vermont at an appropriate location or
locations to facilitate public accessibility to such meetings.
(B) All voting shall be in person except as
specifically authorized by these rules and use of proxies is
prohibited.
(C) The election of
officers shall be by ballot. Otherwise voting shall be by voice, but if
requested by any member voting shall be by roll call or show of
hands.
(D) The Clerk shall maintain
a current list of members of (a) the general membership; and (b) the members of
standing and ad hoc committees.
(E)
Minutes shall be kept of all Council and committee meetings and proceedings,
and such minutes shall be filed with the Clerk within a reasonable time. Such
minutes and records shall be available for public inspection subject to the
limitations of part (F) below, and the provisions of Section 312 of 1
V.S.A.
(F) The Council and its
consituent [constituent] committees shall conduct their business meetings in
public. The Council shall give adequate notice of such meetings, and make its
data and records available to the public in accordance with the provisions of
the Chapter 5 of 1 V.S.A. The Council shall retain the right to hold executive
sessions solely in accordance with the provisions of Section 313 of 1
V.S.A.
(G) All meetings of the
Council and its committees shall be conducted in accordance with the most
current edition of Robert's Rules of Order, in all cases to which they are
applicable, except as otherwise provided in these rules or by law or any
special rules of order the Council may adopt.
Article VI Officers
Section 1 Officers
The Council shall elect a Chairperson, Vice-chairperson, and
Clerk from its membership who shall serve for one year or until their
successors are elected. This shall be done in the first meeting after the
beginning of the fiscal year.
Section
2 Removal and Resignation of Officers
Any officer may be removed for just cause by vote of
two-thirds (2/3) majority of the members at any meeting of the Council called
specifically for such purpose and such officer shall be removed and shall cease
to be qualified for the office as herein required. Any officer may resign at
any time by giving written notice to the Council or to the Chairperson or Clerk
of the Council. Any such resignation shall take effect on the date of the
receipt of such notice or at any later time specified therein, and, unless
otherwise specified therein, the acceptance of such resignation shall not be
necessary to make it effective.
Section
4 Filling Vacancies
Any vacancy caused by death, resignation, removal,
disqualification, or otherwise, of any officer shall be filled by the Council
for the unexpired portion of the term. In the event of a vacancy in any office
other than the Chairperson, such vacancy may be filled by appointment by the
Chairperson until such time as the Council shall fill the vacancy.
Section 5 Duties of the
Chairperson
The Chairperson shall have general supervision of the affairs
of the Council, preside at all meetings of the Council, perform those duties
falling to the office by custom and law, preserve decorum, decide questions of
order, and appoint committees and ad hoc task forces as provided herein with
the consent of the members. The Chairperson shall be an ex-officio member of
all standing and ad hoc committees except that the Chairperson may not
participate in the preparation of any slate of officers for the Council.
Section 6 Duties of the
Vice-Chairperson
In the absence of the Chairperson, or in the event of his
inability or refusal to act, or if the office be vacant, the Vice-chairperson
shall perform all the duties of the Chairperson, and when so acting shall have
all the powers, and be subject to all the restrictions of the Chairperson. The
Vice-chairperson shall have such other powers and perform such other duties as
may be prescribed by law, or by these rules, or as may be assigned to him/her
from time to time by the Council.
Section 7 Duties of the Clerk
The Clerk shall be responsible for the records of the Council
and shall perform those duties falling to the office by custom and law.
Article VII Committees
Section 1 Committees
The Council may establish such committees as it deems
appropriate to carry out the purposes of the Council. The Council may also
establish subcommittees or ad hoc groups to carry out special short term
studies and projects.
Section
2 Council Membership Committee
The Council Membership Committee is responsible for
organizing and carrying out the Council nominating process according to the
provisions of Section 2352(f) of 18 V.S.A. and Article IV of these rules, and
preparing a slate of nominees for officers for the Council.
Section 3 Appointment of Committee Members
and Chairperson
Except as otherwise provided by these rules, the Council may
from time to time fix the number of members of all committees. Committee
members and chairpersons shall be appointed by the chairperson of the Council
with the approval of the Council. The Committee chairperson shall serve for a
term of one year or until the Committee is disolved [dissolved], whichever
occurs first, provided, however that the Chairperson, with the approval of the
Council by majority vote, may remove any Committee chairperson or any Committee
member from a Committee for good cause only.
Section 4 Powers and Duties
Any Committees created under this article shall have such
powers and duties as are specifically provided in these rules and such as may
be given to them from time to time by the Council. Each Committee may conduct
hearings, perform studies and will make written reports on all such activities,
provided, however, all such Committee work shall be in accordance with the
purposes of the Council. Committees are authorized to establish subcommittees
or ad hoc groups to carry out short term studies and projects. Reports of
Committees shall be advisory only and shall not be binding on the Council until
ratified by the Council.
Article VIII
Staff
Section 1 Executive Director
The Council shall employ an Executive Director, who shall be
an exempt employee. The Executive Director shall be recommended for selection
by a majority vote of the Council. Appointment of the Executive Director shall
be subject to the approval of the governor.
Section 2 Other Staff
The Council may employ such other professional and support
staff as are required to carry out its functions and may employ consultants and
contract with individuals and entities for the provision of services.
Section 3 Employment of Other
Staff
The executive director shall be the appointing authority for
all other staff. Staff shall function according to the Personnel Rules and
Regulations of the State of Vermont and the contract between the State of
Vermont and the designated bargaining unit.
Section 4 Evaluation
A designated committee of the Council shall annually review
the performance of the Executive Director and shall recommend to the Council
any increase in compensation based on performance within the applicable
provisions of the Pay Act for exempt employees.
Section 5 Position Description
The Council shall maintain a position description for the
Executive Director.
Section
6 Removal
The Executive Director may be dismissed by a 2/3 majority
vote of the Council at a legally constituted meeting.
Article IX Conflicts of Interest
Section 1 Intent
It is the intent of this article to *[preclude a member's use
of their position as a Council or Council Committee member for purposes which
are, or may give the appearance of being, motivated by desire for private
gain.]* require that a member disclose conflicts of interest and to encourage
members to abstain from voting on matters before the Council or a Council
committee when a conflict exists.
Section 2 Definition
(A) A conflict of interest on a particular
matter before the Council or committee or any entity appointed by the Council
or a Council committee, shall exist under the following circumstances:
(i) When the action concerns:
(I) Any agency, institution, corporation,
association or partnership in which the member is or has been within the past
twelve months, an owner, stockholder, partner, officer, employee, member of the
board of directors or trustees, professional staff affiliate, serves as a
consultant or otherwise has a significant financial interest; or
(II) Any agency, department of subdivision
thereof of State government in which the member is or has been within the past
twelve months, employed or over which the member has some administrative
control; or
(III) A local
government or department or instrumentality thereof in which the member is or
has been within the past twelve months, an elected or appointed official,
employee or paid consultant thereto; or
(ii) When the appearance would be given that
the member is otherwise motivated by private gain.
(B) The fact that an action on a matter by
the Council or a committee may benefit or injure providers, consumers or a
sub-group thereof, as a class, shall not by itself establish that a conflict of
interest exists for a particular member.
Section 3 Announcing Conflict of Interest
When a member of committee member has any substantial
relationship set out in Article IX, Sec. 2, he or she shall disclose that
relationship, and shall be asked to abstain from voting on such a
matter.
Section 4 Possible
Conflict of Interest
Whenever a member or committee member has any relationship
set out in Article IX, Sec. 2 but has a doubt as to whether the relationship is
sufficiently substantial to warrent [warrant] *[disqualification]* a conflict
but has cause to believe that a matter to be voted on might involve him or her
in a possible conflict of interest, he or she shall set forth the matter and
ask for a decision on the question. The question of whether an actual conflict
exists shall be decided by a majority vote of the members or committee members
present, excluding the member or committee member announcing the possible
conflict of interest. *[and excluding any other members or committee members
present who have already been disqualified from voting on the issue because of
their own conflict of interest.]*
Section 5 Other Persons
Any other person may raise the question of conflict of
interest or possible conflict of interest with respect to any member or
committee member present and the question so raised shall be decided in the
same manner as if the director or committee member himself or herself had
announced the conflict of possible conflict.
