The Honorable Edward M. Kennedy Section 1531(5) Section 1531(5) defines the term institutional health service. The definition is important in that health care providers who fall within the definition are thereby covered by the terms of PL 93-641. We urge that the definition of institutional health service be broadened to include hospital facilities, organized ambulatory facilities, skilled nursing facilities, intermediate care facilities and any other facility defined in regulations of the Secretary and services in connection with major medical equipment valued at more than $100,000 acquired through purchase, lease, or otherwise by any person or organization including, but not limited to any health care service regardless of ownership and regardless of situs of such major medical equipment. Section 1532(c)(2) Section 1532 develops criteria which the state agency and the HSA must include in conducting reviews pursuant to subsections (e), (f), and (g) of 1513 and Section 1523. Subsection (c)(2) states that the HSA and the state agency must consider the relationship of services reviewed to the long-range development plan (if any) of the person providing or proposing such services. We request that subsection (c)(2) be clarified as to what type of documentation is necessary to indicate that the proposed service is indeed in conformance with the institution's long-range plan. We applaud your interest and efforts to improve the law and would be pleased to meet with you or staff members concerning these or other matters affecting the Act. Respectfully, Vaughan A. Smith Exécutive Vice President WAS:WC Dr. Stuart Shapiro TESTIMONY of Louis A. Finney, M.D. in behalf of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons BEFORE SUBCOMMITTEE ON HEALTH COMMITTEE ON HUMAN RESOURCES UNITED STATES SENATE Mr. Chairman I am Louis A. Finney, Chairman of the Washington Committee for Neurosurgery. I represent the American Association of Neurological Surgeons, the Congress of Neurological Surgeons and their affiliated state and fraternal organizations. I speak for a combined membership of over 2,500 neurological surgeons in the United States. The adequate At this time the neurosurgical community wishes to comment on extension of the Health Planning and Resources Development Act. delivery of health care in the future will require a system approach based upon catchment referral areas for economical function. Such systems will be dependent on realistic goals, assured funding, and creative planning. This planning should be decentralized and originate within the local area. Further, it is wise for this planning process to have input from all segments of society, competent staffing, informed leadership and a minimum of conflict of interest. The planning process should result in a report of authorization which will lead to appropriations or allocations from the elements in our pluralistical delivery system which fund health care. All of these activities are worthwhile. (2) However, we have significant concern regarding the health planning process. Congress will have to review the function of the existing bodies annually to determine if changes are needed. We are concerned over excessive government influence at the federal, state and local levels and fear the autocratic use of governmental power. We are disturbed over duplicative planning emanating from government sources other than those specified under this Act. All provider groups seem to feel that they are deserving of more input into any governmentally regulated planning activity. Every involved entity fears that the planning process may ultimately lead to regulation of the health care industry in ways similar to the current regulation of utilities. Congress must guard against all of these undesirable considerations and using their power of oversight, must extend the Health Planning and Resources Development Act for one year only. We urge Congress to carefully monitor activities of of the various authorized entities to see if additional health care expertise should not be provided by future amendments. The neurosurgical community (3) has advocated a National Advisory Panel for Neurosurgical Data. In order to improve the national health planning effort in a realistic fashion it would be quite germane for Congress at this time to consider a National Advisory Panel for Neurosurgical Planning and similar panels for other specialties. Until passage of the Health Planning & Resources Development Act federal health programs were approved by Congress, managed by the administration, and the responsiblity of the Public Health Service and Surgeon General. The Health Planning and Resources Development Act created a series of advisory bodies which might best be considered as an attempt both at decentralization and a response to the desire for a consensus opinion at local and state levels in planning for the proper delivery of health care. Unfortunately, this has resulted in health care planning becoming ever more political. It would appear that results will not be the desired consensus but will be a never ending series of political compromises between competing entities. 25-122 78 pt. 2-2 |