Compendium of Virginia Health Care Trade Associations

and Regulatory Agencies

Prepared by Health Law Section of

Virginia State Bar

February 17, 1999

Editors:

Patrick C. Devine, Jr.

Beth Hirsch Berman

Hofheimer Nusbaum, P.C.

999 Waterside Drive

Suite 1700

Norfolk, Virginia 23510

(757) 622-3366 (phone)

(757) 629-0660 (fax)

email: pdevine@hnlaw.com

INDEX

Health Care Trade Associations and Societies

Medical Society of Virginia................................................................................................................ 1

Virginia Academy of Family Physicians............................................................................................... 3

Virginia Association of Durable Medical Equipment Companies.......................................................... 4

Virginia Association of Health Plans................................................................................................... 7

Virginia Association for Home Care................................................................................................. 11

Virginia Association of Nonprofit Homes for the Aging..................................................................... 13

Virginia Birth-Related Neurological Injury Compensation Program.................................................... 15

Virginia College of Emergency Physicians......................................................................................... 18

Virginia Chapter of the American Academy of Pediatrics and The Virginia Pediatric Society.............. 19

Virginia Dental Association.............................................................................................................. 21

Virginia Health Care Association...................................................................................................... 22

Virginia Hospital and Healthcare Association.................................................................................... 25

Virginia Medical Group Management Association............................................................................. 27

Virginia Optometric Association, Inc................................................................................................ 28

Virginia Organization of Nurse Executives........................................................................................ 31

The Virginia Pharmacists Association............................................................................................... 33

Virginia Society of Health-System Pharmacists................................................................................. 34

Virginia Society of Radiologic Technologists..................................................................................... 39

Health Care Regulatory Agencies, Commissions and Contractors

Joint Commission on Health Care..................................................................................................... 41

Virginia Attorney General’s Office.................................................................................................... 43

Virginia Bureau of Insurance............................................................................................................ 46

Virginia Department of Emergency Medical Services........................................................................ 51

Virginia Department of Environmental Quality (Medical Wastes)....................................................... 53

Virginia Department of Health.......................................................................................................... 59

Virginia Department of Health - Center for Quality Health Care Services and Consumer Protection 63

The Virginia Department of Health- Division of Certificate of Public Need

The Virginia Medical Care Facilities Certificate of Public Need Program...................................... 71

The Virginia Department of Health-Office of the Chief Medical Examiner.......................................... 74

The Virginia Department of Health-Office of Water Programs........................................................... 77

Virginia Department of Health-Women, Infants and Children (WIC) Program................................... 81

Virginia Department of Health Professions........................................................................................ 84

*Virginia Department of Medical Assistance Services....................................................................... 92

Virginia Department of Mental Health, Mental Retardation & Substance Abuse Services................... 93

Virginia Department of Social Services: Adult Care Residences

and Adult Day Care Centers.............................................................................................. 100

Virginia Department for the Visually Handicapped.......................................................................... 106

Other Non-Provider Health Care Players

Virginia’s Business Health Coalitions.............................................................................................. 118

Virginia Monitoring, Inc................................................................................................................. 120

Virginia Health Information............................................................................................................. 123

Virginia Health Quality Center........................................................................................................ 132

Introduction

This Compendium is designed to identify the relevant trade associations, societies, regulatory agencies and commissions and other public and private sector contractors which focus on health care issues in the Commonwealth and to summarize their respective missions and jurisdiction. This Compendium is intended to serve as a convenient mechanism for Virginia State Bar members throughout the Commonwealth to identify and access those entities which may have relevance to particular client needs. The Compendium is also being made available to the contributing entities in order that they may make the information available to their membership, constituents and the general public, as appropriate.

This initial February 17, 1999 Compendium includes summaries of, and identifies relevant contact persons for, more than 35 of the most important of these health care regulatory agencies, associations and contractors. It is expected that the Compendium will be updated periodically and that additional trade associations, regulatory agencies and contractors will be identified and included in the Compendium on an on-going basis.

If you are aware of additional entities which you would like to see included, or if you have other suggestions as to how to improve the Compendium, please communicate with any member of the Board of Governors of the Virginia State Bar’s Health Law Section or the Editors identified on the cover page of the Compendium.

Hard copies of the Compendium are available from the Virginia State Bar at a charge designed to defray the copying cost by calling Elizabeth L. Keller at the Virginia State Bar at 804-775-0516.

Medical Society of Virginia

(as of November 1, 1998)

Paul Kitchen- Executive Vice President

4205 Dover Road

Richmond, Virginia 23221

(804) 353‑2721 phone

(804) 355‑6189 fax

www.msv.org

The Medical Society of Virginia (“MSV”) is a professional association of more than 6,500 Virginia physicians. Originally founded in December 1820, and incorporated in 1824, MSV is the only association in Virginia representing all medical doctors and doctors of osteopathy, regardless of specialty or type of practice setting.

Dedicated to Virginia’s physicians and their patients, the Medical Society of Virginia provides administrative, legislative and legal services to its members, and produces a monthly publication. MSV sponsors and accredits continuing medical education for physicians and serves as the liaison between local, national and specialty medical organizations.

The Medical Society of Virginia has been responsible for the creation of the State Board of Health, the State Board of Medical Examiners, the Board of Medicine, the MSV Review Organization known today as the Virginia Health Quality Center, and the Virginians Physician Network, a 100% physician‑owned HMO network. Each of these now independent entities had their beginnings within the Medical Society of Virginia.

The Medical Society of Virginia also created a Physicians Health and Effectiveness Committee, which was responsible for investigating impaired physicians, referring impaired physicians to appropriate treatment and monitoring their recovery progress. This committee was the basis for the development of the Virginia Health Practitioners Intervention Program.

Today, the Medical Society of Virginia leads the way in advocating for patient protection in the current managed care environment, access to health care for all Virginians, and ensuring the highest standards of quality for health care for Virginia’s citizens.

The Future of the Medical Society of Virginia

The Medical Society has refocused itself. We have added a Health Policy and Medical Economics Department and restructured every department to meet the changing needs of Virginia’s physicians.

We see the Society as the most credible advocate of health care quality in Virginia, as well as the foremost initiator and facilitator of dialogue between the political and healthcare communities throughout the Commonwealth.

Virginia Academy of Family Physicians

(as of November 1,1998)

1301 North Hamilton Street

Suite 312

Richmond, Virginia 23230

Phone: (804) 358-1721

Fax: (804)359-4184

The official website for the VAFP is www.vafp.org

The Virginia Academy of Family Physicians is a state-wide organization of 1300 actively practicing family physicians.

The organization was founded in 1948 and their mission is to:

. Improve the health care of patients, their families and the citizens of Virginia.

. Serve the unique needs of members with professionalism, leadership and creativity.

. Advance and represent the specialty of family practice.

The Virginia Academy of Family Physicians Headquarters office is located at 1301 North Hamilton Street, Suite 312, Richmond, Virginia 23230. Phone: (804) 358-1721 Fax: (804) 359-4184. The official website for the VAFP is www.vafp.org.

Virginia Association of Durable Medical Equipment Companies

(as of November 1, 1998)

Sam Clay, President

c/o Clay Home Medical

518 S. Sycamore Street

Petersburg, Virginia 23803

Phone: 804-733-5888

Fax:804-862-1254

Rebecca P. Snead, R.Ph., Executive Director

c/o Virginia Pharmacists Association

5501 Patterson Avenue, Suite 200

Richmond, Virginia 23230

Phone: (804)285-4145

Fax: (804)285-4227

E-mail: vphanow@erols.com

Website: http://pharmacy.su.edu/vpha

MISSION STATEMENT

The Virginia Association of Durable Medical Equipment Companies (VADMEC) is an association of privately owned and publicly held home medical equipment and service organizations. VADMEC promotes quality of service to consumers and the viability of its members through ethical standards, education, advocacy, and communication.

The purpose of VADMEC is to represent and strongly support the interests of the membership by:

1. Promoting compliance with accepted standards of practice and ethics for the industry.

2. Effecting positive change through regulation and legislation.

3. Promoting the financial viability of the membership.

4. Assuring that quality DME is an integral part of health care policy in the future.

5. Promoting appropriateness and quality of care.

6. Educating members, consumers, legislators, allied health care professionals, manufacturers and third party payors.

7. Serving as liaison between governing agencies, third party payors, and the membership.

8. Being politically pro-active.

Sam Clay, President

Clay Home Medical

518 S. Sycamore Street

Petersburg, Virginia 23803

Phone: 804-733-5888

Fax: 804-862-1254

Jamie Copenhaver, Treasurer

Community Health Care

190 W. Main Street

Wytheville, Virginia 24382

Phone: 540-228-3081

Fax: 540-228-8636

Marcia Pruner, Secretary

ARGO Medical Services

P.O. Box 1621

Lebanon, Virginia 24266

Phone: 540-889-3108

Fax: 540-889-3119

Lori Edmonds, Regulatory Chair

Advance Health-Care Services

58 N. Washington Avenue

Pulaski, Virginia 24301

Phone: 540-980-0505

Fax: 540-980-0757

Doug Ellis, Legislative Chair

Ellis Pharmacy & Home Health

217 W. Main Street

Abingdon, Virginia 24210

Phone: 540-628-8181

Fax: 540-628-6116

April Stover, Program Director

Clay Home Medical

518 S. Sycamore Street

Petersburg, Virginia 23803

Phone: 804-733-5888

Fax: 804-862-1254

Brian Wilson, Past President

Community Home Health Care

479 Piney Forest Road

Danville, Virginia 24540

Phone: 804-797-2332

Fax: 804-783-3916

Rick Baldridge

Choice Medical

P.O. Box 6235

Bluefield, WV 24701

Phone: 304-325-0476

Fax: 304-325-0478

Bob Evans

Roberts Home Medical

3917 Deep Rock Road

Richmond, Virginia 23233

Phone: 804-270-1511

Fax: 804-270-2328

Helen Farrell

Med-Emporium

2322 E. Little Creek Road

Norfolk, Virginia 23505

Phone: 757-480-0351

Fax: 757-588-6430

Virginia Association of Health Plans

(as of November 1,1998)

Executive Director - Mark C. Pratt

118 N. 8th Street

Richmond, Virginia 23219

Phone: 804-648-8466

Fax: 804-648-8036

vahp@pipeline.com

Visit our website at www.vahp.org.

Our Mission

The Virginia Association of Health Plans (VAHP) is a non-profit organization committed to enhancing the acceptance and understanding of managed care organizations as high quality, cost-effective options for providing comprehensive health care to Virginia citizens. Established in 1988 as the Virginia Association of Health Maintenance Organizations, the Association broadened its mission and changed its name to VAHP in 1998. The association assures that Virginia’s managed care health insurance plans have a voice in promoting quality and affordable care through advocacy, education, and research services. The Association is committed to cultivating a regulatory and marketplace environment that facilitates private sector health care solutions.

Our Philosophy

The Association and its members promote a philosophy of care that emphasizes active partnerships between patients and their physicians. We believe that comprehensive health care is best provided by networks of health care professionals who are willing to be held accountable for the quality of their services and the satisfaction of their patients. We are committed to high standards of quality and professional ethics, and to the principle that patients come first.

Our Scope

Currently, the Association represents 14 managed care organizations which, through their HMOs, PPOs and other managed care health insurance plans, provide heath care benefits for nearly 2.2 million Virginians. Our affiliation with the American Association of Health Plans provides us with an expansive national resource which tracks the managed care industry state by state and issue by issue.

Our Services

Representation and Advocacy

VAHP develops and promotes a legislative and regulatory agenda that advances the successful operation of health plans in the Commonwealth. We are actively involved in policy development and issues analysis before, during and after the General Assembly sessions each year. The Association issues position statements, educates legislators on health issues and organizes involvement of the health plan community in the legislative process. The Association also facilitates political involvement through a political action committee (PAC) to support candidates who are committed to the mission and policy positions espoused by the Association.

Communications

VAHP generates a number of health information resources to assist stakeholders in understanding the latest issues and the current marketplace in which managed health insurance plans work.

A sample of current resources includes:

Viewpoint - A quarterly newsletter which covers business and health trends, association news and managed care education information.

Annual Directory of Health Plans - A comprehensive reference guide to health plans operating in Virginia which includes overall managed care information regarding national, regional and state trends in enrollment and utilization as well as individual profiles on Virginia health plans.

Annual Report Of Legislation - This post-session report summarizes the legislation tracked by the Association and describes how health plans fared on laws passed, bills killed and

issues tabled for study.

Website: www.vahp.org - Our website posts our newsletter, information from our directory, and policy statements and positions from the organization. It also offers industry links and more detailed information about staff and Association membership.

Partnerships

VAHP collaborates with other health organizations to foster progressive partnerships which will help accomplish our mission. We pursue constructive dialogue and joint efforts with medical societies, health associations, employer groups, and state regulatory agencies to promote comprehensive and fair discussion of current health policy issues.

VAHP contributes to charitable causes that demonstrate the commitment of the Association to the community through its Charitable Fund. One ongoing example of a partnership in action is the joint sponsorship of scholarships for minority medical students. VAHP co-sponsors these scholarships with the Old Dominion Medical Society and the Virginia Health Care Foundation.

Our Membership

Full Members

Every managed care health insurance plan licensee in Virginia is asked to join the association as a full voting member.

Associate Members

Plans pursuing licensure in Virginia can join as associate members. Associate members enjoy all the benefits of full membership except for committee and executive voting privileges, which are activated upon licensure.

Corporate Affiliate Members

Because many types of organizations are interested in promoting market acceptance and consumer support for managed health insurance plans, the Association also offers non-voting levels of membership to other types of organizations interested in health issues. These affiliate members support the philosophy and goals of the Association and want to benefit from the activities and programs developed to further the Association's mission.

Corporate affiliate members may be managed care entities, provider organizations, large and small businesses, pharmaceutical companies, medical groups, health care information management firms, or other entities involved in the health care system.

1998 VAHP Members

Blue Cross & Blue Shield of the National Capital Area

CIGNA Corporation, Inc.

John Deere Health Care/Heritage National Health Plan

George Washington University Health Plan, Inc.

INOVA Health System

Kaiser Foundation Health Plan of the Mid-Atlantic

Mid-Atlantic Medical Services, Inc. (MAMSI)

NYLCare Health Plans of the Mid-Atlantic, Inc.

PARTNERS National Health Plans of North Carolina, Inc.

QualChoice of Virginia Health Plan, Inc.

Sentara Health System

Trigon Blue Cross Blue Shield

United HealthCare of Virginia

Virginia Chartered Health Plan, Inc.

VAHP 1998-99 Officers/Executive Committee

Chairman of the Board - Michael M. Dudley, Sentara Health Management

President - Greg Bowman, CIGNA HealthCare Corp.

Vice President - Thomas P. Barbera, MAMSI

Secretary - Kathleen McNalty, Kaiser Foundation Health Plan of the Mid-Atlantic

Treasurer - Thomas B. Jones, John Deere Health Care/Heritage National Health Plan

At-Large - Ellen C. Harrison, Trigon Blue Cross Blue Shield

At-Large - Gail M. Thompson, Blue Cross Blue Shield of the National Capital Area

Staff

Executive Director - Mark C. Pratt, MBA

Director of Policy - Lynn M. Warren, RN, MPH

Executive Assistant - Melissa Throckmorton

For More Information

Phone: 804-648-8466

Fax: 804-648-8036

E-Mail: vahp@pipeline.com

Website: www.vahp.org

Virginia Association for Home Care

(as of November 1, 1998)

5407 Patterson Avenue, Suite 200-B

Richmond, VA 23226

Phone: 800-755-8636

Phone: 804-285-8636

Mission Statement

We advocate for and improve home care in Virginia.

The Virginia Association for Home Care is a 501 (c)(6) not-for-profit organization chartered in 1983. The Association has a separate Foundation, a 501 (c)(3) that provides educational support for the members. An eighteen member Board of Directors establishes policy for the association. Standing committees include the Executive Committee, Legislative Committee, Finance Committee, Quality Assurance and Improvement Committee, Membership Committee, and Nominating Committee. The Association also sponsors two caucuses, the Proprietary Caucus and the Institutional-Based Caucus.

The philosophy of the Virginia Association for Home Care (VAHC) is unity of purpose with regard to the promotion and delivery of quality home care in the Commonwealth. Furthermore, VAHC believes that home care is the best possible way to care for people who are sick and disabled and to promote wellness and independence in matters related to health care.

In representing the home care industry in Virginia, the Association’s goals are to increase and maintain a unified membership representing the full spectrum of provider services, strengthen the image and value of home care, represent effectively the needs and requirements of home care in the legislative and regulatory processes, promote member ownership and involvement in VAHC, and strengthen the image and value of VAHC.

VAHC supports state legislative efforts to increase Medicaid reimbursement for Personal Care services, an essential means of helping Virginians who need assistance to remain at home and are otherwise at risk of nursing home placement. Medicaid reimbursement for this service has not kept pace with the cost of proving the care. A recent study ordered by the General Assembly resulted in an audit of thirty providers, each of whose costs exceeded Medicaid reimbursement.

VAHC represents more than 200 home care organizations, or provider members, and associate members that provide goods and supportive services to home care organizations. VAHC has members from the full spectrum of home care including home health, private duty, personal care (including Medicaid-waivered services), infusion therapy, home medical equipment, and hospice.

Home health care organizations are heavily regulated and monitored by a number of entities, some required and others voluntary. State licensure is required by the Code of Virginia except for entities that are exempted because they are 1) certified by Medicare; 2) accredited by the Joint Commission on Accreditation for Healthcare Organizations or the National League of Nursing’s Community Health Accreditation program; or 3) providing services under Title XIX, including Medicaid-waivered services. Staff from the Health Care Financing Administration, the Virginia Department of Health, the Virginia Department of Medical Assistance Services, and other entities provide regular inspections, and the providers are also subject to rules of the Occupational Safety and Health Administration, the Ombudsman Program, Adult Protective Services, and the Fair Labor and Standards Administration. In recent years, providers have been required to obtain a criminal records check on all employees at the time of hiring. Providers must also ensure the training and competency of all staff who are responsible for patient care.

To assist its members in ensuring the highest quality of care, VAHC has adopted a Code of Ethics for providers of home care services. Additionally, the Association has produced a pamphlet with Virginia-specific information, entitled “How to Choose a Home Care Agency.” This material is available both to the VAHC membership and to the public.

In serving its members, VAHC is a member of the Prospective Payment System Work Group, the National Association for Home Care, the Home Health Services and Staffing Association, the National Association of Medical Equipment Services, the Society for Ambulatory Care Professionals, the National Hospice Organization, and the Health Industry Distributors Association.

The Association has had a full-time Executive Director since 1991.

Currently it has four staff members: the Executive Director, a Director of

Regulatory Affairs, an Administrative Director/Meeting Planner, and an Office Assistant.

For more information, call (800) 755-8636 or (804) 285-8636, or write to:

Virginia Association for Home Care

5407 Patterson Avenue, Suite 200-B

Richmond, VA 23226

Virginia Association of Nonprofit

Homes for the Aging

(as of November 1, 1998)

Sandra Levin, President

Website: Vanha.org

E-mail: Vanha@erols.com

Phone: 804-965-5500

Fax: 804-965-9089

Overview

The Virginia Association of Nonprofit Homes for the Aging (VANHA) is a statewide association that represents the interests of not-for-profit continuing care retirement communities, nursing facilities, adult care residences, and retirement housing. VANHA advocates for and educates its members through ongoing development of an effective association.

History

VANHA was founded in 1973 by a group of nursing home administrators who believed that nonprofit homes were unique in their needs and they wanted their own organization to help assure that these needs were met. As nonprofit organizations, their primary goal is to provide the highest quality of care for residents in the most cost effective manner.

Joint Membership

VANHA is affiliated with the American Association of Homes and Services for the Aging (AAHSA) through a joint membership agreement. AAHSA represents over 5,000 facilities nationwide.

Current Membership

VANHA represents almost 100 nonprofit facilities with over 100 businesses, community service providers, and individuals in fields related to caring for the elderly.

Benefits for Membership

. Opportunity for information sharing with other members

. Informative publications, including a monthly newsletter, weekly legislative reports during the General Assembly session, and an annual VANHA Voice

. Networks for Activity Directors, Development Directors, Food Service Directors, Directors of Human Resources, Marketing Directors, Directors of Nursing Social Workers, and Volunteer Directors

Council meetings that focus on specific issues for: Nursing Homes, Continuing Care Retirement Communities, Adult Care Residences and Retirement Housing

VANHA Education

VANHA offers its members a wide variety of educational seminars with topics ranging from care of Alzheimer’s patients, marketing strategies and exploring new ideas in the health care industry like the "Eden Alternative." In the last year, VANHA provided 68 continuing education credits for Nursing Home Administrators, Food Service Directors, Activity Directors, and CPAs. VANHA brought nationally respected speakers to the Virginia area. Members enjoy a reduced rate for VANHA sponsored programs.

VANHA Legislation

Representing the Commonwealth of Virginia’s nonprofit homes at state and national levels for the last 25 years, VANHA has brought about changes in state legislature to include the signing of HB 2870, the "Return to Home" legislation, in 1997. During the General Assembly, VANHA members receive up-to-the-minute reports on legislative issues. This allows VANHA members not only to follow legislation but to become engaged in the process.

VANHA Shared Services

VANHA’s Group Purchasing and Services Program provides members the opportunity to save substantially on all types of purchasing decisions. Preferred Vendors offer a wide array of products and services. Through use of this program, members realize a cost savings for their facilities, lowering the bottom line. VANHA receives an administrative fee from the Preferred Vendors which helps to keep annual dues from increasing, benefiting all involved.

Virginia Birth-Related Neurological Injury

Compensation Program

(as of November 1, 1998)

Elinor J. Pyles, R.N.

Executive Director

Virginia Birth-Related Neurological Injury Compensation Program

7400 Beaufont Springs Drive, Suite 425

Richmond, Virginia 23219

1-800-260-5352

(804) 330-3054 Fax

Every year a small number of babies are born with serious birth-related neurological injuries.

Virginia has a program to help parents take care of these babies for life.

The program covers what insurance and other programs do not -- necessary medical expenses, hospital expenses, rehabilitation expenses, residential and custodial care and service expenses, special equipment or facilities expenses, and related travel expenses for eligible babies -- through infancy, through childhood, through adulthood, for a lifetime, it pays compensation for lost earnings between ages 18 and 65, reimburses costs of filing a claim, including reasonable attorneys’ fees, works quickly, privately, confidentially. It's an exclusive remedy and it's no-fault. We hope your family never needs this program. But we also hope you'll find it reassuring to know that, if you ever should, it's there.

The Virginia Birth-Related Neurological Injury Compensation Fund is an example of a private-public partnership endeavor that is working. Known as the Birth Injury Fund, the Program provides a wide range of benefits to a child who is in need of permanent assistance in all activities of daily living, and who has sustained a brain or spinal cord injury caused by oxygen deprivation or mechanical injury during labor, delivery, or in the immediate post-delivery period in a hospital which renders the child permanently (1) motorically disabled, and (2) developmentally disabled or cognitively disabled.

The First Injury Fund was initiated for two principal reasons: (1) to provide benefits to eligible children over their lifetime without having to resort to the tort law system for recovery and (2) to insure that the medical community would be able to continue to provide obstetric services within the Commonwealth.

The benefits of the Birth Injury Fund are limited to “medically necessary and reasonable expenses” of medical and hospital, rehabilitative, residential and custodial care and service, special equipment and facilities. The Birth Injury Fund is a payer of last resort; that is, the Fund pays after available insurance or governmental programs have paid. A unique feature of the Program provides for payments as “loss of earnings” to the child when he or she reaches the age of eighteen years based upon a formula set by law.

The Birth Injury Fund is financed by assessments, in varying amounts, upon hospitals that have obstetric units, licensed physicians who practice obstetrics or perform obstetrical services, including licensed nurse-midwives, all other licensed physicians, and the insurance industry within the Commonwealth.

A seven member Board of Directors manages the Fund, and they employ an Executive Director. They are assisted by a number of professionals to provide eligible children with medically necessary services. The Board meets regularly, and all meetings are open to the public.

Claims for compensation under the Fund are made to and awarded by the Virginia Workers’ Compensation Commission. Once a claim has been awarded, the Program will communicate with the parents or caregivers of the child. A home visit will be made to determine the needs of the child and the family.

Counseling can be provided, initially and ongoing, and the Board strongly urges members of the family to avail themselves to this benefit. If the situation warrants, individual counseling will be considered.

The Program at A Glance

Repays Necessary

. Medical expenses

. Hospital expenses

. Rehabilitation expenses

. Residential and custodial care and service expenses

. Compensation for lost earnings, ages 18 to 65

. Special equipment or facilities expenses

. Reasonable claim-filing expenses

. Reasonable attorneys' fees

. Related travel expenses

. For all awarded claims

Does Not Repay

. Expenses covered by other government programs

. Expenses covered by prepaid health plans or HMOs

. Expenses covered by private insurance

. Maternal substance abuse

Eligibility

. Babies delivered by a participating doctor

. And/or at a participating hospital

. With serious birth-related neurological injury, as defined by Virginia law

Procedure

. Quick

. Private

. Confidential

. Exclusive remedy

. No-fault

For More Information

Elinor J. Pyles, R.N.

Executive Director

Virginia Birth-Related Neurological Injury Compensation Program

7400 Beaufont Springs Drive, Suite 425

Richmond, Virginia 23225

1-800-260-5352

Additional Information

Virginia law, §38-2-5001 et. seq., defines a birth-related neurological injury as:

. an injury to the brain or spinal cord of an infant caused by the deprivation of oxygen or mechanical injury,

. occurring in the course of labor, delivery or the immediate post-delivery period,

. in a hospital,

. which renders the infant permanently motorically disabled and

(i) developmentally disabled or

(ii) for infants sufficiently developed to be cognitively evaluated, cognitively disabled

In order to constitute a “birth-related neurological injury”, such disability shall cause the infant to be permanently in need of assistance in all activities of daily living.

Virginia College of Emergency Physicians

(as of November 1, 1998)

Gwen E. Messler Harry, Executive Director

Phone: (757) 220-4911

Fax: (757) 258-3042

E-mail: vacep@erols.com

Virginia College of Emergency Physicians (VACEP) is the medical specialty society for physicians who practice Emergency Medicine. We are not a trade association. We are in the process of updating our mission statement. Briefly, we seek to promote and protect the interests of emergency physicians and the patients they serve. We currently have 430 members. Our 16 member Board meets quarterly. We have the usual committees all medical associations have. Melanie Gerheart is our lobbyist. Anyone with an issue that they feel directly or indirectly impacts emergency medical care is welcome to contact the Executive Director.

Virginia Chapter of the American Academy of Pediatrics

and The Virginia Pediatric Society

(as of November 1, 1998)

9291 Laurel Grove Road, Suite 10

Mechanicsville, Virginia 23116

Phone: (804) 730-6851

Fax: (804) 730-6853

E-mail: vapedsoc@erols.com

Website: http://www.virginiapediatrics.org

Vision

To be the leading authority, advocate and voice for the health of Virginia’s children and for the profession of pediatrics.

Mission

The mission of the Virginia Chapter, American Academy of Pediatrics and The Virginia Pediatric Society is the attainment of optimal health, safety and well-being of Virginia’s children and promotion of pediatricians as the best qualified of all health professionals to provide child health care.

NOTE: Use of the term “children” refers to infants, children, adolescents, and young adults; use of the term “pediatrician” refers to the primary care pediatrician, pediatric medical subspecialist, and pediatric surgical specialist.

Membership

The association is comprised of over 900 pediatricians and allied health professionals in private practice, academia and public health.

Structure

The association is governed by a 16-member Executive Committee and programs are carried out by the following committees:

ADOLESCENCE HEMATOLOGY/ONCOLOGY

BREASTFEEDING COORDINATORS HOSPITAL CARE

CATCH COORDINATOR IMMUNIZATIONS AND INFECTIOUS DISEASES

CHILD ABUSE & DEPENDENT CARE MEMBERSHIP

CHILD HEALTH FINANCING PROS COORDINATOR

CHILDREN WITH DISABILITIES PUBLIC RELATIONS

Virginia Dental Association

(as of November 1, 1998)

Bill Zepp, Executive Director

5006 Monument Avenue

P.O. Box 6906

Richmond, Virginia 23230

1-804-358-4927

1-800-552-3886 (In state)

1-804-353-7342 (Fax)

www.vadental.org

Mission Statement

The Virginia Dental Association:

Representing and Serving Member Dentists By Fostering Quality Oral Health Care and Education.

Goals

To improve and expand membership services.

To promote the policy of the Association through proactive legislative and regulatory advocacy on behalf of the public and the members of the Association.

To increase membership recruitment and retention.

To enhance membership communications.

To increase access to quality oral health care.

Virginia Health Care Association

(as of November 1, 1998)

Mary Lynne Bailey, Vice President

Legal & Government Affairs

2112 W. Laburnum Avenue, Suite 206

Richmond, VA 23227

Phone: (804) 353‑9101

Fax: (804)353‑3098

E-mail: ml.bailey@vhca.org

Website: www.vhca.org

The Virginia Health Care Association (“VHCA”) is a statewide, voluntary, not‑for‑profit association of long‑term care providers. VHCA is comprised of licensed nursing facilities, adult care residences, continuing care retirement communities, individual professionals and students, and the suppliers of products and services that support the goal of dedicated service to the elderly and disabled in Virginia.

Advocacy

VHCA provides for its members legislative and regulatory advocacy, accredited quality education, an annual convention and trade show, and a full array of communications services. In addition, the VHCA strives to aid the general public in understanding the different levels of long‑term care and the unique benefits and services provided by each.

As an advocacy group for the long‑term care industry and its residents, VHCA concentrates on assuring the delivery of quality care, reasonable government regulations and adequate Medicaid and Medicare funding for long‑term care. In addition, VHCA actively promotes the development of a stable alternative private source for the funding of long‑term care, such as long‑term care insurance.

Education

Educational programs provided by VHCA are another valuable service to our members. Nursing Home Administrators are required by state law to renew their licenses each year with a minimum of 20 hours of continuing education through sponsors approved by the Virginia Board of Nursing Home Administrators or the National Association of Boards of Examiners of Nursing Home Administrators. VHCA also provides educational opportunities for other long‑term care staff through workshops and conferences specifically designed to bring up‑to‑date information on best standards of practice and regulatory changes to nurses, social workers, activity professionals, reimbursement specialists, human resources personnel, dietary managers, and rehabilitation personnel.

Networking

VHCA’s annual convention and trade show offers members not only an opportunity for educational seminars, but also an opportunity to preview a wide array of new products and services that are available and which contribute to the delivery of quality care for their residents. In addition, it offers an excellent opportunity for members to network with other professionals in the field.

Public Policy

VHCA’s management demonstrates leadership by identifying and communicating good practice models in the field and representing industry interests by shaping public policy aimed at optimum care and quality of life. The VHCA’s efforts are spurred by a commitment to stability, self regulation, and public confidence. VHCA encourages an exchange of information that benefits both those within the industry and the public by working closely with advocacy groups, regulatory agencies, and other health care organizations on long‑term care issues, especially quality of care, quality of life, and funding. Medicaid funding is a particularly important issue in this industry.

Medicaid and Medicare

Approximately two out of three Virginia nursing facility patients depend on Medicaid to fund their care. It is a common misconception among the American public that Medicare will take care of their long‑term care needs when they become elderly. Unfortunately, a majority of the elderly and disabled who need nursing facility care find that they must “spend down” their assets and apply for Medicaid. These elderly Medicaid patients typically are people who have simply “outlived” their savings.

Because of budget concerns at both the federal and the state level, Medicaid funding has come under great scrutiny and pressure. At the federal level, the current goal is to severely constrain the growth of Medicaid funding. The Commonwealth of Virginia is recognized for having operated a very efficient, low-cost Medicaid program, as compared to other states, and is constantly looking for ways to slow the growth of Medicaid funding. In fact, Virginia is among the lowest states in spending on Medicaid for long term care.

Regulatory Issues

Congress has recently made, and is further considering, many changes to the Medicare program to control its spending growth. Needless to say, VHCA is carefully monitoring and participating in the Congressional debate as decisions are being made about the future of Medicaid and Medicare and any resulting reform legislation that could affect the federal regulations under which nursing homes are regulated. Proposed changes to these two programs could result in unprecedented changes for the elderly, the disabled, and those providers of their care.

Other legislative and regulatory issues facing the long‑term care industry include state revisions to the nursing facility Medicaid reimbursement payment system, consolidation of state agencies providing services to the aged and disabled, and state certificate of need laws and regulations. Nursing homes are among the most heavily regulated industries, being monitored by multiple state and federal regulatory agencies, such as the Departments of Medical Assistance Services, Social Services, Health, Labor, Aging, as well as the Ombudsman Program and Health Care Financing Administration. The list of rules and regulations requiring compliance range from licensing inspections and surveys for Medicaid and Medicare, and life safety surveys by fire officials, to OSHA inspections and abuse and neglect investigations by Adult Protective Service workers. Surveys of nursing homes are conducted at least annually by the Virginia Department of Health to ensure that standards for quality of life, quality of care, and facility practices are met.

Assisted Living

VHCA has also been a major stakeholder in the evolving assisted-living industry in developing standards for Adult Care Residences, which are licensed and regulated by the Department of Social Services. This emerging part of the long‑term care system offers care and services to an increasingly older and frail population who want to remain in these settings as they “age in place”. VHCA’s advocacy role in all of these areas requires frequent interaction with the regulatory agencies.

Changes that are foreseen for the long‑term care field include an increasing number of residents in nursing facilities other than the traditional elderly, chronically ill or disabled individual. A growing number of far younger residents are benefiting from nursing home care. The 20‑year‑old accident victim with traumatic brain injury, the 48‑year‑old stroke or heart attack victim, and the post surgical rehabilitation patient are treated in nursing facilities as effectively as the elderly. Insurers no longer allow extended hospital stays to ensure optimum recovery and rehabilitation. Many short-term residents, young and old alike, receive the necessary health care, 24-hour per day nursing supervision, and rehabilitation services at a nursing facility at a fraction of hospital costs. This expanding environment will permit nursing facilities to link readily with other community health providers as part of an integrated health care system.

Staff

VHCA’s nine member staff is divided into two groups: an advocacy group and a member services group. The advocacy staff lobbies Virginia's Congressional Delegation and the Virginia General Assembly and works with state and federal agencies in the development of proposed legislation and regulations. The member services staff concentrates on education, membership development, and numerous services to the industry. The offices are located at 2112 W. Laburnum Avenue, Suite 206, Richmond, Virginia 23227. The telephone number is (804) 353‑9101 and the fax number is (804)353‑3098. The Association's web page may be accessed at www.vhca.org.

Virginia Hospital and Healthcare Association

(as of November 1, 1998)

P.O. Box 31394

Richmond, VA 23294-1394

Phone: (804) 747-8600

Fax: (804) 965-0475

The Virginia Hospital & Healthcare Association (VHHA) was created in 1926 as a trade association of Virginia hospitals. It was called the Virginia Hospital Association until 1995, when members voted to change the name to reflect its changing membership, which now includes not only rural and urban acute care and specialty hospitals, but also integrated health care delivery systems and their long-term care facilities and services, ambulatory care sites, home health services, insurance subsidiaries and other health system-related entities.

The VHHA's mission is "to help its members as they strive to improve the health status of communities they serve by offering comprehensive, accessible, quality, cost-effective health services...." Its activities in this endeavor focus on representation and advocacy, education, communication and health care data, as summarized below.

Representation and Advocacy

. Develop overall goals for state health policy sad promote initiatives to help achieve these goals.

. Work with state and federal legislative, regulatory and policy-setting entities on issues affecting the delivery, quality, accessibility, and cost-effectiveness of health care.

Education

. Educate members about changes in health care delivery and regulation.

. Help members evolve into effective health delivery systems.

Communication

. Communicate with media representatives and the public about important health care issues in which hospitals and health systems are involved.

. Form partnerships and coalitions with other community and business groups to achieve common goals.

Virginia Medical Group Management Association

(as of November 1, 1998)

_Cindy Soueidan, MBA, CMPE, President

_P.O. Box 17171

_Richmond, VA 23226-7171

_Phone (804) 353-7061

_Fax (804) 355-6189

_Toll-free in Virginia (800) 842-0250

_The Virginia Medical Group Management Association (VMGMA) is a professional association of medical practice managers and administrators. Founded in 1974, VMGMA has grown to more than 240 members from all sections of the Commonwealth. VMGMA has formal affiliations with the national Medical Group Management Association, the oldest and largest medical practice management, and the Medical Society of Virginia, the largest physician organization in the Commonwealth.

_VMGMA’s mission is to advance medical practice management in order to improve the delivery of healthcare. Educational conferences are held twice a year at rotating sites across Virginia, providing informative sessions and networking opportunities. VMGMA also provides a quarterly newsletter for its membership

_VMGMA is active from an advocacy perspective, working with the Medical Society of Virginia in the legislative arena on behalf of the patients and medical practices of Virginia. Recent areas of focus include fair business practices, patient protection, and the medical malpractice cap.

_VMGMA membership is open to medical practice managers and to persons interested in this field. Its diverse membership includes managers of practices ranging in size from one physician to one hundred physicians, healthcare attorneys, practice consultants, and vendors with an interest in medical practices.

_VMGMA 1998-99 Board of Directors

_President - Cindy C. Soueidan, MBA, CMPE

_President Elect - Cheryl C. Ange, FACMPE

_Vice President - Lucien W. Roberts, III, MHA, CMPE

_Secretary - Glenda Q. Hampton

_Treasurer - Robin E. Moore, MSA

_Past President - James M. Palazzo, MHA, CMPE

_At-Large - Judy S. Berryman

_At-Large - Leslie Stasio

_At-Large - Ronald R. Eagle, MBA, CMPE

Virginia Optometric Association, Inc.

(as of November 1, 1998)

Bruce B. Keeney, Sr., Executive Director

Virginia Optometric Association, Inc.

118 North Eighth Street

Richmond, VA 23219

Phone: 804-643-0309

Fax: 804-643-0311

Organization

The Virginia Optometric Association (VOA) is Virginia's only statewide professional membership organization representing the Commonwealth's actively practicing doctors of optometry. Founded in 1912 and incorporated in 1918, the VOA presently represents over 80% of all actively practicing optometrists in Virginia.

The VOA has ten local optometric societies (representing geographic regions) which are affiliated with the state professional society. The VOA is also affiliated with the Southern Council of Optometrists (Atlanta, GA) and the American Optometric Association (St. Louis, MO).

Membership

Active membership in the VOA requires the doctor of optometry to be engaged in active clinical practice in Virginia. Associate membership is restricted to those Virginia licensed optometrists whose principal practice is in a neighboring state but who also maintain a practice in Virginia. Student members are those persons enrolled in an accredited school or college of optometry. Associate Retire members are those Virginia licensed optometrists no longer actively practicing.

Active members must maintain membership in their VOA affiliated local optometric society, the VOA, the Southern Council of Optometrists and the American Optometric Association.

Mission

The objects of the VOA are to assist in improving the vision care and general health care of the public and to promote the art and science of the profession of optometry; to promote the welfare of VOA members; to support the laws and regulations of Virginia governing the profession; to assist the Virginia Board of Optometry in the proper discharge of their duties; to advance the theory and practice of the profession and to improve the delivery of quality vision care services; to coordinate national, regional, state and local activities within the profession; to encourage the development and innovations in health care delivery systems; and to promote conduct by Virginia doctors of optometry in their practices which exhibit the highest standards and competency and integrity.

Association Activities

In addition to normal activities provided by a state professional membership association, the VOA is the major sponsor of continuing education programs for Virginia optometrists. The VOA publishes an award-winning newsletter, is extremely active in the legislative process, and provides assistance to members as they face changes in the third-party health care reimbursement system, including managed care. The VOA maintains a subsidiary organization, Virginia Eyesite, which provides a statewide network of vision care specialists to market eye and vision care services to third party insurance carriers, HMOs, PPOs and self funded businesses.

Resource Services For Attorneys

Attorneys often contact the VOA as a resource in the attorney's representation of an optometrist. Examples of resource information are: establishing values related to the sale or purchase of a practice; employment, associate or partnership agreements; disciplinary proceedings by the Virginia Board of Optometry; corporate practice prohibitions; sales and use tax exemptions; discrimination against an optometrist seeking to participate in a third-party health insurance plan; arranging for expert witnesses; and professional conduct issues.

Optometry - The Primary Vision Care Provider

Upon completing their undergraduate education, the optometrists must successfully complete a four year doctoral degree program at an accredited school or college of optometry (earning the O.D. or doctor of optometry degree). To obtain a license to practice in Virginia, the doctor of optometry must successfully complete all portions of the national boards and a jurisprudence section of the Virginia Board of Optometry. Applicants for licensure must meet educational and clinical training requirements for certification in diagnostic pharmaceutical agents. Further, separate examination and certification by the Virginia Board of Optometry is then required for the optometrist to administer and prescribe pharmaceutical agents to treat abnormal conditions and diseases of the human eye and vision system.

Doctors of optometry serve approximately 70% of the nation's population. The optometrist examines and evaluates the human vision system to ascertain refractive error and, when necessary, prescribes and dispenses eyeglasses and contact lenses. The comprehensive eye health examination evaluates and diagnoses the presence of any disease or abnormalities such as cataracts, glaucoma, macular degeneration, foreign body, detached retina, visual dysfunction, etc. The optometrist also administers and prescribes medications to treat eye diseases such as pink eye, conjunctivitis, corneal abrasions, infections, glaucoma, and removes foreign bodies from the eye. When medically appropriate, the optometrist will refer patients to specialists for surgical treatment of certain conditions. Often the optometrist will provide the pre-surgical evaluation and render post-operative care for conditions such as cataracts.

Virginia Organization of Nurse Executives

(as of November 1, 1998)

Pat Conway

c/o: Carilion Roanoke Community Hospital

101 Elm Street

Roanoke, Virginia 24013

Phone: (540) 985-8453

Fax: (540) 985-0475

E-mail: pconway@carilion.com

The Virginia Organization of Nurse Executives (VONE) established in 1974 to give nursing administrators an opportunity for closer interaction with their peers. The group was formed with 12 members representing all areas of Virginia. Membership grew as more nurse executives found that this organization met their unique interests, problems, and needs. In 1976, the Virginia group became the ninth chapter admitted to the American Society of Nursing Service Administrators. The VONE was incorporated October 31, 1983 as the Virginia Society for Nursing Service Administrators, Inc. The name was changed to the Virginia Organization of Nurse Executives on December 12, 1985. In 1995, the VONE merged with the Virginia Council of Nurse Managers. The VONE is closely aligned with the American Organization of Nurse Executives.

The purpose of the VONE is to advance the development of effective administration and management of the nursing practice in health care institutions and agencies in Virginia by:

1. Providing a medium for the interchange of ideas and dissemination of information and materials relative to nurse executives/managers.

2. Providing a platform within the healthcare field from which nurse executives/managers may speak on nursing and health care issues.

3. Identifying and defining health care issues that affect nursing and establishing position statements on these issues.

4. Promoting educational programs and activities to strengthen nursing executive/manager practice.

5. Providing consultation for nursing education programs.

6. Influencing legislative and public policy pertaining to nursing and health care issues.

The Virginia Pharmacists Association

(as of November 1, 1998)

Rebecca P. Snead, R.Ph.,

Executive Director

5501 Patterson Avenue, Suite 200

Richmond, Virginia 23230

Phone: (804)285-4145

Fax: (804)285-4227

E-mail: vphanow@erols.com

Website: http://pharmacy.su.edu/vpha

The Virginia Pharmacists Association founded in 1881, is the professional association representing the pharmacists of Virginia. Its 1700 members represent pharmacists in metropolitan and rural areas across the Commonwealth practicing in community pharmacies, hospital pharmacies, mail-order pharmacies, industry and education.

The purpose of the Association is to assure the viability and vitality of the profession of pharmacy by maximizing its contribution to patient care, promoting the competency of its practitioners, and increasing an awareness of these contributions and capabilities and their value.

Monthly Publication:

The Virginia Pharmacists

Annual Publication:

Virginia Pharmacy Directory

For more information:

5501 Patterson Avenue, Suite 200

Richmond, Virginia 23230

Phone: (804)285-4145

Fax: (804)285-4227

E-mail: vphanow@erols.com

Web site: http://pharmacy.su.edu/vpha

Virginia Society of Health-System Pharmacists

(as of November 1, 1998)

Janet A. Silvester, VSHP President

Martha Jefferson Hospital Pharmacy

459 Locust Avenue

Charlottesville, VA 22902

Work: 804-982-7055

Home: 804-973-7094

FAX: 804-982-7060

E-Mail: jasilvester@mjh.org

Mission Statement

The mission of the VSHP is to represent its members and to provide leadership that will enable pharmacists in organized health-care settings (1) to provide high quality pharmaceutical care that fosters the efficacy, safety, and cost-effectiveness of drug use; (2) to contribute to programs and services that emphasize the health needs of the public and the prevention of disease; and (3) to promote pharmacy as an essential component of the health-care team. VSHP endeavors to create an environment in which pharmacists are expected to focus the full potential of their knowledge and expertise on patient care.

In support of the mission statement, VSHP has established the following goals:

1. To advance rational patient-oriented drug therapy.

2. To promote pharmacists as integral members of the health-care team in order to allow full utilization of their clinical and drug-use control functions that would be beneficial in each health-care setting.

3. To serve as a primary advocate for advancing professional practice, increasing the cost-effectiveness of pharmaceutical care, and improving the quality of patient care.

4. To advocate the pharmacist's value to patients in ensuring that appropriate clinical services and drug-use control processes are applied to their benefit.

5. To foster the optimal and responsible use of drugs, including prevention of improper or uncontrolled use of drugs.

6. To assure sufficient, competent manpower in the profession by offering continuing education and training programs.

7. To provide leadership in the identification, analysis, and evaluation of pharmacy trends and in the development of policy statements, and to address legislative and regulatory initiatives of concern to pharmacy.

8. To facilitate information exchange between the members, health-care professions, and consumers.

9. To maintain lines of communication between the organization and its membership so that needs are accurately represented and to provide a full complement of services and products of the membership.

Goals and Objectives

1. Establish proactive stances on issues affecting the profession at the state level in order to develop a system to provide timely responses to public professional concerns and inquiries.

2. Remove barriers to the use of technical support in the safe and efficient distribution of medications in organized health-care organizations.

3. Support increased and standardized education of pharmacy technicians to meet current and future responsibilities.

4. Expand public information activities (designed to communicate the positions and actions of the VSHP) to members, health-care practitioners, policy makers, and consumers.

5. Provide timely and accessible continuing education that addresses the needs and interests of the members.

6. Assure that professional service and dedications to safe/effective drug use are afforded high visibility to persons considering pharmacy as a career path.

7. Provide the VSHP membership with a unified voice on professional practice issues which are the subject of legislative/regulatory actions.

8. Build effective liaisons and associations which will allow VSHP to access to input into the decision making process for pertinent legislative and regulatory actions.

9. Provide opportunities for VSHP members to "network" ideas related to pharmacy practice issues.

10. Perpetuate high quality membership service and representation through effective leadership promotion within VSHP.

11. Accurately represent and advance the interest of the membership.

12. Determine and develop guidelines to maximize VSHP investment income and determine acceptable levels of risk.

13. Maintain a reserve fund for contingency purposes.

Constitution

Article I. Name, Objectives, and Definitions

(a) This organization shall be known as the “Virginia Society of Health-System Pharmacists,” hereinafter referred to as the State Society.

(b) Objectives

The objectives of the State Society shall be:

(1) To advance public health by promoting the professional interests of pharmacists practicing in health systems through:

a. Fostering pharmaceutical services aimed at drug-use control and rational therapy.

b. Developing professional standards for pharmaceutical services.

c. Fostering an adequate supply of well-trained competent pharmacists and associated personnel.

d. Developing and conducting programs for maintaining and improving the competence of pharmacists and associated personnel.

e. Disseminating information about pharmaceutical services and rational drug use.

f. Improving communication among pharmacists, other members of the health-care industry, and the public.

g. Promoting research in the health and pharmaceutical sciences and in pharmaceutical services.

h. Promoting the economic welfare of pharmacists and associated personnel.

(2) To foster rational drug use in society such as through advocating appropriate public policies toward that end.

(3) To pursue any other lawful activities that may be authorized by the Board of Directors.

Article II. Membership

The membership of the State Society shall consist of active, associate, and honorary members as provided in the Bylaws. Active members shall be licensed pharmacists who have paid dues as established by the State Society and support the purposes of the Virginia Society of Health-System Pharmacists as stated in Article I of the Constitution. Other Requirements for active membership shall be stated in the Bylaws.

Article III. Officers

The officers of the State Society shall be a President, an Immediate Past President, a President-Elect, a Secretary, and a Treasurer. The President-Elect shall be elected annually for a term of one year and shall ascend successfully to the office of President and Past President, serving one year in each position. The Secretary and the Treasurer shall be elected on alternate years for two-year terms of office.

Article IV. Affiliated Regional Chapters

There shall be geographic regions with each region having a chapter and officers as defined in the Bylaws.

Article V. Affiliated Student Chapter

There shall be an affiliated student chapter or chapters as defined in the Bylaws.

Article VI. Board of Directors

There shall be a Board of Directors of the State Society consisting of Officers, Regional Vice-Presidents, and Ex-Officio members as provided in the Bylaws.

Article VII. Amendments

Every proposition to alter or amend this Constitution shall be submitted in writing by two or more voting members at any Board of Directors business meeting and shall be approved by a majority of votes cast. A copy shall be submitted to the American Society of Hospital Pharmacists before it is submitted to the active membership for vote by mail ballot, in the same manner as in the balloting for officers as provided in the Bylaws, and shall be sent out as part of the ballot for officers.

Current Board of Directors

Janet A. Silvester, VSHP President

Martha Jefferson Hospital Pharmacy

459 Locust Avenue

Charlottesville, VA 22902

Work: 804-982-7055

Home: 804-973-7094

FAX: 804-982-7060

E-Mail: jasilvester@mjh.org

Thomas E. Hughes, VSHP President-Elect

1121 Snowden Drive

Charlottesville, VA 22901

Work: 804-982-3849

Home: 804-914-6935

FAX: 804-982-1682

E-Mail: teh2j@virqinia.edu

Gill B. Abernathy, VSHP Past President

1013 N Terrill Street

Alexandria, VA 22104-1938

Work: 703-698-2238

Home: 703-824-8186

FAX: 701-698-3015

E-Mail: aberngi@erols.com

Bobby J. Ison, VSHP Secretary

526 Mowbray Arch

Norfolk, VA 23507

Work: 757-482-6l68

Home: 757-625-7432

FAX: 757-482-6125

E-Mail: bison@exis.net

Michael M. Hayter, VSHP Treasurer

Johnston Memorial Hospital Pharmacy

351 Court Street, N.E.

Abingdon, VA 24210

Work: 540-676-7102

Home: 540-944-4509

FAX: 540-676-7241

E-Mail: mhayter@naxs.com

Virginia Society of Radiologic Technologists

(as of November 1, 1998)

Lloyd E. Bittinger, Executive Secretary

P.O. Box 547

Alexandria, Virginia 22313-0547

(800) 929-8778

(800) 929-8778 (press * for fax)

The Virginia Society of Radiologic Technologists was formed in 1948. Active membership is open to individuals who are certified by the American Registry of Radiologic Technologists, the Registry of Diagnostic Medical Sonographers, or the Nuclear Medicine Technology Certification Board. There are also student and associate member categories. The primary purposes of the organization are to advance the science of radiologic technology to support high standards of education, to elevate the quality of care, and to improve the welfare of technologists.

Current Officers are:

Jane O. Carpenter, R.T. (R)

Chair of the Board of Directors

804‑295‑3872

Ferrell Justice, B.S., R.T.(R)

Chair‑Elect Board of Directors

804‑329‑7417

Kevin Murray, R.T.(R)

President

Angie Dopkowski, R.T. (R), (CT)

President‑Elect

David Gilmore, R.T.(R), (CT)

Vice‑President

Lora Bryant Gilmore, R.T.(R) (CT)

Recording Secretary

Radiologic technologists is a general term applied to individuals who are qualified to use x‑rays (radiographers) or radioactive substances (nuclear medicine technologists) to produce images of internal body parts for interpretation by a physician. It also applies to those who use x‑rays or radioactive substances in the treatment of disease (radiation therapists) and those who use sound waves for imaging (sonographers). Radiography encompasses diagnostic x‑ray as well as computed tomography (CT) and magnetic resonance imaging (MRI). According to the American Registry of Radiologic Technologists, the primary certifying agency for radiologic technology, as of 3‑16‑98, there were 5,454 registered technologists. The Virginia Society has a membership of 1,633 technologists, of whom 132 are student members.

The VSRT's primary legislative issue for the last twenty plus years has been the enactment of some form of regulation of medical radiation workers, a measure VSRT has always felt necessary to protect Virginia's citizens from exposure to unnecessary ionizing radiation. This goal was realized in a limited way in 1994 with the passage of House Bill 1300 which makes it "unlawful for a person to practice or hold himself out as a radiologic technologist or radiologic technologist, limited, unless he holds a license as such issued by the Board". The law, which became effective on January 1, 1997, unfortunately does not apply to employees or independent contractors of licensed hospitals. Efforts by the VSRT will continue to effect an amendment to the Bill to eliminate the hospital exemption. As the largest employer or radiologic technologists, it is important that the assurance of minimum standards is met in these facilities as well as in small clinics and in physician offices.

The primary concerns relative to the proposed regulations that need to be addressed are the lack of restrictions on the examinations and procedures, which can be performed by limited licensees, and the lack of any assessment of learning or competence for them. The regulations permit acquiring a license in one of two ways: (a) after a minimum of two years of education and passing of a national certification exam (radiologic technologist) or (b) after approximately 50 hours of education with no examination of any kind (radiologic technologist, limited). Regulations as implemented create a two‑tiered system; holders of both restricted and unrestricted licenses will be performing the same studies. When the individual is reasonably well‑educated in the radiologic sciences, an exam is required. If the individual is minimally educated, there is no requirement for documentation or assurance of that knowledge or competence prior to achieving licensure, and there are virtually no restrictions on practice. The VSRT believes these inadequacies need to be addressed.

The VSRT is firmly committed to quality patient care, to providing continuing education for its members and the radiologic technology community in general, and to increasing awareness of radiologic technology among the general public. Any questions or concerns may be directed to a member of the Board of Directors or to the Executive Secretary.

Joint Commission on Health Care

(as of January 18, 1998)

Patrick W. Finnerty, Executive Director

William L. Murray, Ph.D. and Joseph J. Hilbert

Senior Health Policy Analysts

1001 E. Broad Street, Suite 115

Old City Hall Building

Richmond, Virginia 23219

804-786-5445 Phone

804-786-5538 Fax

http://legis.state.va.us/jchc/jchchome.htm -website

The Joint Commission on Health Care was created by the 1992 Session of the Virginia General Assembly to study, report and make recommendations on a wide range of health care issues. Each year, the Joint Commission has an extensive agenda of health care studies, policy analyses and reviews that it conducts throughout the year. At the conclusion of the year, the Joint Commission develops a legislative package of bills and resolutions that it presents to the General Assembly during its annual legislative session.

The Joint Commission is composed of 16 legislative members, several of whom are from the Tidewater area. The Secretary of Health and Human Resources serves in an ex officio capacity. The current members of the Joint Commission are:

Delegate Kenneth R. Melvin (Chairman)

Senator Jane H. Woods (Vice-Chairman)

Senator William T. Bolling

Senator Joseph V. Gartlan, Jr.

Senator Benjamin J. Lambert, III

Senator Stephen H. Martin

Senator Edward L. Schrock

Senator Stanley C. Walker

Delegate Thomas G. Baker, Jr.

Delegate Robert H. Brink

Delegate John J. Davies, III

Delegate Jay W. DeBoer

Delegate Alan A. Diamonstein

Delegate Franklin P. Hall

Delegate Phillip A. Hamilton

Delegate Harvey B. Morgan

The Honorable Claude A. Allen (ex-officio)

The work of the joint Commission falls primarily into five major areas: (i) health insurance/access for uninsured, (ii) medical education, (iii) health care cost and quality, (iv) health workforce issues, and (v) long-term care.

During 1998, the Joint Commission conducted numerous studies, including: (i) a study of quality of care and reimbursement issues related to telemedicine; (ii) a review of the need for a centralized planning and funding mechanism for health workforce initiatives; (iii) a review of licensing and financing issues involving long-term care; (iv) a study of whether there is a need for an external appeals mechanism or ombudsman program for managed care enrollees; (v) a study of pooled purchasing arrangements for small employers, community health centers and free clinics; (vi) a review of the feasibility of establishing a high risk insurance pool in Virginia; (vii) a study of academic health centers’ participation in managed care provider networks; (viii) a review of health care coverage for eating disorders; (ix) a review of regulation and laws relating to midwifery; (x) a review of organ transplant issues; and (xi) a review of the health status and conditions of African-Americans in the Commonwealth.

The Joint Commission’s full-time staff is headed by its Executive Director, Patrick W. Finnerty. William L. Murray, Ph.D. and Joseph J. Hilbert serve as Senior Health Policy Analysts. Mr. Murray is the primary contact for long-term care issues.

The staff may be contacted at (804) 786-5445. The mailing address for the Joint Commission is: Suite 115, Old City Hall, 1001 E. Broad Street, Richmond, Virginia 23219. You may also visit the Joint Commission web site at http://legis.state.va.us/jchc/jchchome.htm.

Once the 1999 General Assembly Session is completed, the Joint Commission will resume its monthly meetings which are generally held in Senate Room A of the General Assembly Building in Richmond. For additional information you may contact the Joint Commission directly or visit its web site.

Virginia Attorney General’s Office

(as of November 1, 1998)

Mark L. Earley, Attorney General

900 E. Main Street

Richmond, Virginia 23219

(804) 786-2071

The Attorney General provides all legal service in civil matters for the Commonwealth, the Governor, and every state official, agency, and board, as well as the courts and judges. (Va. Code § 2.1-118.) The Commonwealth’s ubiquity as regulatory overseer in almost every matter with which the health care community is involved increases the chances that health care attorneys may eventually have reason to deal with the Office of the Attorney General. Knowing the organization and players works to everyone’s advantage.

Under Attorney General Mark L. Earley and his Chief Deputy Randolph A. Beales are five Deputy Attorneys General, each directing a major division within the Office. Deputy Attorneys General Ashley L. Taylor, Jr., Stephen J. Telfeyan, Judith W. Jagdmann, E. Montgomery Tucker, and Francis Ferguson respectively head the Divisions of Health, Education, and Social Services, Government Operations, Civil Litigation, Criminal Law, and Local and Intergovernmental Affairs. In addition, major litigation and special projects are handled by Senior Counsel William H. Hurd, Counsel David E. Johnson, and Counsel Robert C. Metcalf.

The Division most involved with health matters is the Division of Health, Education, and Social Services, which provides counsel to the following agencies: the Departments of Medical Assistance Services, Health Professions and its professional boards, Mental Health, Mental Retardation, and Substance Abuse Services, Health, Rehabilitative Services and the Woodrow Wilson Rehabilitation Center, Deaf and Hard of Hearing, Visually Handicapped and Aging. The Department of Social Services, its Division of Child Support Enforcement, and the state’s public school system, community colleges, and institutions of higher learning are also advised by counsel in the Division of Health, Education and Social Services. The Division’s three sections are Mental Health and Health Services headed by Section Chief Jane D. Hickey, Medicaid and Social Services headed by Section Chief Siran S. Faulders, and Education headed by Section Chief Ronald C. Forehand.

Attorneys representing the Department of Mental Health, Mental Retardation, and Substance Abuse Services are Jane D. Hickey, Garland L. Bigley, Evelyn R. (“Lynne”) Fleming, Roscoe C. Roberts, and Rita R. Woltz.

The Board of Medicine, the Board of Psychology, the Board of Social Work, and the Board of Licensed Professional Counselors, receive counsel from Lynne Fleming, who is also legal counsel to the Intervention Committee for the Health Practitioners Intervention Program.

Howard Casway represents the Board of Dentistry, Joint Boards of Medicine and Nursing, Joint Boards of Nursing, Board of Examiners in Optometry, Board of Pharmacy, Board of Veterinary Medicine, Board of Health Professions, and the Virginia Voluntary Formulary Board. Advisory opinions with respect to physician self-referrals fall within the responsibilities of the Board of Health Professions, advised by Howard Casway.

The Boards of Audiology and Speech-Language Pathology, Nursing Home Administrators, and Funeral Directors and Embalmers fall under the legal oversight of Roscoe Roberts.

All activities of the Department of Health, except for environmental services, and of the Board of Health and the Advisory Board of Emergency Medical Services are assigned to Carol Nance. Those activities include epidemiology, vital records and health statistics, the Office of the Chief Medical Examiner, the local health districts and local health departments, emergency medical services, family health services, public health nutrition and WIC, healthcare facilities licensure and certification, certificate of public need, and certification of quality assurance of managed care health insurance plans.

Among smaller departments, Rita Woltz provides legal advice to the Department of Rehabilitative Services, including the Woodrow Wilson Rehabilitation Center, the Department for the Deaf and Hard of Hearing, the Department for the Visually Handicapped, the Rehabilitation Center for the Blind, the Board for People with Disabilities, and the Virginia Assistive Technology Loan Authority. Rita Woltz additionally serves as legal counsel for the Comprehensive Services Act. Carol Nance advises the Department for the Aging and the Governor’s Employment and Training Department.

Section Chief Siran Faulders, Paige Fitzgerald, Brian McCormick, and Kim Piner represent Medicaid matters within the ambit of the Department of Medical Assistance Services. Daniel Poynor, also in the Medicaid and Social Services Section, represents the licensing services of the Department of Social Services, including adult care residences with assisted living.

Of related interest, Francis Ferguson represents the Birth-Related Neurological Injuries Board. Occupational Safety and Health is advised by Stewart Leeth. The Medical College of Virginia Hospitals Authority is advised by Jean Reed and the University of Virginia by Paul Forch and Beth Hodsdon.

Environmental programs and agencies, including the Department of Environmental Quality, the Air Board, the Department of Health’s water programs, air quality, septic systems and sewage handling, wells, restaurants, swimming pools, campgrounds, shellfish sanitation, are assigned to the Government Operations Division’s Natural Resources Section, with counsel from Section Chief Roger Chaffe, John Butcher, Deborah Love-Feild, Mary Jo Leugers, Karen Lebo, Stewart Leeth, Carl Josephson, and Fred Fisher.

Health-related Professions and Occupations include asbestos and lead contractors and workers, barbers, cosmetologists, hearing aid specialists, opticians, soil scientists, waste management facility operators, waterworks and waste water works operators, and fall under the Government Operations Division, Commerce and Trade Section, headed by Richard Zorn and served by Bill Diamond, Lisa Rowley, John Purcell, Sandra Riggs, and J. C. “Max” Wilkinson. John Purcell advises the Department of Agriculture and Consumer Services.

To assure complete dissociation of prosecutorial counsel from advisory counsel to the health professional boards, attorneys in the separate Division of Criminal Law prosecute licensees of those boards. Criminal violations of the basic statutes and regulations are referred to the Commonwealth’s Attorney for the jurisdiction in which the violation took place. Rhonda McGarvey is the Chief of this Section of Investigative Enforcement, and prosecuting counsel are Frank Pedrotty, Trish Munro, and Steve Baer. In the case of Medicaid Fraud, the Commonwealth’s Attorneys often refer the cases back to the Medicaid Fraud Unit for prosecution after indictment. At the present time, legal counsel for the unit is provided by John Moriarty, who will soon be joined by two other assistant attorneys general.

A new area of review of asset disposition by not-for-profit healthcare facilities has been assigned to Deputy Attorney General Judy Jagdman, who has designated Natalie Harris of the Division of Civil Litigation’s Antitrust and Consumer Affairs Section, Donald Ferguson of the Government Operations Division’s Section Finance and Taxation, and Carol Nance of the Health, Education, and Social Services’ Mental Health and Health Services Section to the review team. David Irvin is Senior Chief of the Antitrust and Consumer Affairs Section and oversees all antitrust issues.

The Administrative Process Act Committee is composed of Roger Chaffe, Section Chief of the Natural Resources Section in the Government Operations Division, Richard Zorn, Section Chief of the Section for Commerce and Trade in the Government Operations Division, Terri Manning serving the Racing Commission, the Charitable Gaming Commission, and the Lottery in the Government Operations Division, Deputy Attorney General Francis Ferguson, and Howard Casway and Carol Nance in the Mental Health and Health Services Section of the Division of Health, Education, and Social Services.

The Division of Civil Litigation customarily handles claims under the Virginia Tort Claims Act and EEO claims (including disability, workers’ compensation, grievances, and other employment issues). The Attorney General has established contracts with a number of pre-eminent medical malpractice attorneys across the state who may be requested or appointed to defend medical malpractice claims against officers, agents, and institutions of the Commonwealth.

Virginia Bureau of Insurance

(as of November 1, 1998)

Alfred W. Gross, Commissioner of Insurance

1300 East Main Street

Richmond, VA 23219; or

P. O. Box 1157

Richmond, VA 23218

(804) 371-9206

(800) 552-7945

(804) 371-9944 Fax

THE SCC's BUREAU OF INSURANCE

In Virginia, regulatory functions normally associated with a state's department of insurance are the responsibility of the State Corporation Commission (SCC). The SCC was created by Article IX of the Virginia State Constitution, which empowers the "Commission" to administer laws concerning the regulation and control of corporations transacting business in the Commonwealth. Three Commissioners who are appointed to six-year terms by the General Assembly direct the SCC. In addition to setting policy for the SCC, the three Commissioners hear regulatory cases that come before them. The SCC is sometimes described as a fourth branch of government because it has legislative, administrative, and judicial powers. It is a court of record, and the decisions made by the Commissioners may only be appealed to the Virginia Supreme Court.

By statute, the SCC is responsible for registering corporations and monitoring the activities of those providing financial services, public utilities and transportation. Insurance concerns fall within the general category of "financial services." The SCC's regulatory responsibilities in the area of insurance are handled primarily through the Bureau of Insurance.

The Bureau of Insurance is the largest division of the SCC. It is headed by a "Commissioner of Insurance” who is appointed pursuant to § 12.1-12 of the Code of Virginia and charged generally with the administration of the insurance laws of the Commonwealth, most of which may be found in Title 38.2 of the Code. Alfred W. Gross is the current Commissioner of Insurance.

Approximately 185 people are employed in the SCC's Bureau of Insurance. From the SCC's offices in Richmond, the Bureau regulates all companies transacting the business of insurance in Virginia; conducts financial condition and market conduct examinations of domestic companies; issues licenses to agents and agencies; reviews life and health and property and casualty policy forms and rates; and helps consumers resolve disputes with insurance companies. In terms of health insurance matters alone, this activity involves over 880 insurers and approximately 54,000 agents or agencies that are authorized to underwrite or sell health insurance in Virginia. Some are classified as “life and health” insurers or agents; others are classified as “property and casualty” insurers or agents; all are authorized specifically to offer “accident and sickness” insurance in Virginia. But these numbers are only part of the picture. In addition to overseeing the activities of traditional health insurers, the Bureau has regulatory responsibility for:

. 31 heath maintenance organizations (HMOs);

. 9 pre-paid health services plans, including plans which offer health services generally or which specialize in dental or optometric services;

. 51 continuing care retirement communities (CCRCs);

. 238 multiple employer welfare associations and trusts (MEWAs);

. 17 workers' compensation group self-insurers plus 489 licensed insurers which also offer workers’ compensation insurance coverages; and

. 49 property and casualty insurers, including reciprocal insurers, which offer medical liability and medical malpractice insurance.

The nature and extent of regulatory activities varies depending on the type of health insurance entity being regulated. Generally speaking, provisions applicable to traditional life and health insurance companies may be found throughout Title 38.2 of the Code of Virginia. Special chapters in Title 38.2 may address unique types of operations or forms of organization; e.g., Chapter 18 for agents, Chapter 43 for HMOs, Chapters 42 and 45 for prepaid health services plans, Chapter 49 for CCRCs. However, each of these entities is subject also to many of the more general statutes that comprise much of Title 38.2, including for instance, licensing provisions in Chapter 10, provisions in Chapter 34 concerning accident and sickness insurance, and the MCHIP statutes in Chapter 58 affecting health carriers operating managed care health insurance plans.

Administration of the insurance statutes is aided frequently by rules and regulations, which are promulgated and adopted by order of the SCC after publication and notice of hearing. The SCC's "Rules Governing Multiple Employer Welfare Arrangements" (14 VAC 5-410-10 et seq.) and the "Rules Governing Health Maintenance Organizations" (14 VAC 5-210-10 et seq.) are particularly relevant for MEWAs and HMOs. The SCC has adopted additional regulations with broader application in matters such as insurance rates, policy forms and mandated benefits, reserving methodology and market conduct expectations. All of these regulations are filed in the Clerk's Office at the SCC in Richmond. Commission regulations are published in the Virginia Administrative Code, a compilation of agency rules and regulations of the Commonwealth published by West Group Publishing. The NILS Publishing Company, a private publishing company located in Chatsworth, California, also publishes most of the insurance rules and regulations, as well as administrative letters issued by the Bureau. Proposed regulations, orders adopting new regulations and administrative letters are published also in the Virginia Register of Regulations, a monthly publication of the Commonwealth. Current regulatory material is available also through the SCC’s internet website at http://www.state.va.us/scc. Statutes and other legislative information are also available on-line through the state’s Legislative Information System at http://Legis.state.va.us.

Although Title 38.2 and the Bureau play significant roles in the regulation of insurance matters in Virginia, other portions of the Code of Virginia and other regulatory agencies can be significant. For example, the SCC's licensing responsibilities with respect to workers' compensation group self-insurance associations (GSIAs) are set forth in § 65.2-802 of Chapter 8 of Title 65.2 of the Code. Related provisions in this chapter make it clear both the SCC and the Workers' Compensation Commission shall exercise regulatory oversight over these GSIAs. Other entities may also come under the regulatory umbrella of multiple agencies. CCRCs subject to Chapter 49 in Title 38.2 must be registered with the Bureau; however, they can be affected by provisions in Title 32.1 that are administered primarily by the Department of Medical Assistance Services or the Commissioner of Health. As discussed in the following paragraph, the State Health Commissioner can play a role in the regulation of HMOs and other health carriers as well. The federal government, as a consequence of ERISA, can be involved in the regulation of MEWAs, but it does not obviate the need for state regulation via the Bureau in matters of solvency.

Legislation enacted during the 1998 session of the Virginia General Assembly has significantly increased the role of the Virginia Department of Health (VDH) in the regulation of health insurance. The State Health Commissioner now has the authority to regulate private review agents, oversee utilization review and certify the quality of care provided through managed care health insurance-service plans (MCHIPS). This authority will impact licensed health insurers and health services plans as well as HMOs. The VDH, acting primarily through its Center for Quality Health Care Services and Consumer Protection, will handle complaints involving quality of care issues for covered persons while the Bureau will continue its regulation of health carriers as to issues of solvency and market regulation. The Bureau of Insurance will continue to handle complaints dealing with policy coverage issues, and also shall ensure that each health carrier has lived up to the representations and disclosures it has made to enrollees concerning the availability of a complaint system. It is anticipated that this restructuring of existing laws involving the regulatory oversight of health carriers and managed care health insurance plans will provide for a more consistent and coordinated regulatory oversight of HMOs and other health carriers offering health care services to Virginia’s citizens.

The Bureau is structured into three large divisions and one smaller division. Those divisions are Property and Casualty Market Regulation, Life and Health Market Regulation, Financial Regulation, and Administration.

The Financial Regulation division is responsible for company licensing, ongoing financial analysis and monitoring, and financial condition field examinations. The division processes company applications for licensing, annual financial statement filings, holding company and other material transaction disclosures and approvals, and the preparation and filing of financial condition examination reports of companies domiciled in Virginia. The mission of the Financial Regulation division is to identify troubled companies as quickly as possible and to take steps to resolve problems before a company becomes insolvent. The deputy commissioner in charge of the division is Douglas C. Stolte. The division's offices are located on the 6th floor of the Tyler Building at 13th and Main Streets in Richmond. Primary contact numbers are:

Questions concerning company licensing (804) 371-9637

Questions concerning domestic L&H insurance companies (804) 371-9637

Questions concerning foreign L&H insurance companies (804) 371-9636

Appointments to copy or inspect filings (804) 371-9546

Questions concerning HMOs, health service plans, MEWAs

and CCRCs (804) 371-9637

Questions concerning GSIAs (workers' compensation groups) (804) 371-9063

Financial examination matters (804) 371-9061

Financial Regulation Division Fax (804) 371-9511

The Life and Health (L&H) Market Regulation division reviews and approves most health policy forms prior to their use in Virginia, and also reviews and approves rates for individual health insurance policies. Market conduct examiners assigned to the division conduct on-site examinations of health insurers and others licensed in Virginia. In addition, the L&H division administers the qualification, licensing and appointment of insurance agents and consultants in Virginia. It also assists consumers in resolving problems with insurers and agents and provides information about insurance to the general public. Its activities include the publication of various consumer guides, including a Health Insurance Consumer's Guide and a Senior Citizen's Guide to Insurance. Gerald A. Milsky is the deputy commissioner in charge of the L&H Market Regulation division. The division's offices are located on the 5th floor of the Tyler Building at 13th and Main Streets in Richmond. Primary contact numbers are:

Requests for Consumer Guides (804) 371-9691

Agents, brokers and consultants (804) 371-9631

(Fax (804) 371-9349)

Life and health forms, rates and policy approval (804) 371-9110

Market conduct matters (804) 371-9691

(Fax (804) 371-9944)

In Virginia, a life insurer may be authorized to write accident and sickness insurance but not a class of property and casualty insurance. A property and casualty insurer may be licensed to write accident and sickness insurance, but not life insurance. Also, only non-life insurers may be licensed to write the related coverages for workers' compensation insurance and medical malpractice insurance. As a consequence, those inquiring about health insurance matters will usually find themselves talking with employees in either the Financial Regulation or L&H Market Regulation divisions of the SCC's Bureau of Insurance. However, if the question involves a P&C insurer or a line of property, casualty or liability insurance, calls should be placed to the Bureau's Property and Casualty Market Regulation division. Deputy Commissioner Mary M. Bannister heads the division. The division's offices are located on the 5th floor of the Tyler Building at 13th and Main Streets in Richmond. Primary contact numbers are:

P&C consumer services and market conduct matters (804) 371-9185

(Fax (804) 371-9349)

P&C policy approval and rates (804) 371-9965

(Fax (804) 371-9396)

Administration, the fourth and smallest division, handles administrative matters for the Bureau and also processes premium tax filings and the reports due from surplus lines brokers. Brian P. Gaudiose manages administrative services and tax matters. His office is located on the 6th floor of the Tyler Building at 13th and Main Streets in Richmond. Primary contact numbers are:

Insurance company premium taxes (804) 371-9096

Surplus lines broker filings (804) 371-9192

Tax and surplus lines fax (804) 371-9821

The Bureau welcomes inquiries, and has a "hotline" and automated directory service which may be reached by an in-state toll free number (1-800-552-7945). TDD (telecommunications device for the deaf and hard of hearing) may be reached on the toll-free number or (804) 371-9206. Callers should remember, however, that many questions and problems cannot be adequately addressed until inquiries and specific concerns are submitted in writing. Written inquiries may be directed to the attention of a specific division or employee and should be addressed to the SCC Bureau of Insurance at either 1300 East Main Street, Richmond VA 23219 or P. O. Box 1157, Richmond, VA 23218.

Virginia Department of Emergency Medical Services

(as of November 1, 1998)

Michael Cline, Director

10501 Trade Court

Richmond, Virginia 23236

(804) 897-6500

(804) 897-6506

Mission Statement

To reduce death and disability resulting from sudden or serious injury and illness in the Commonwealth through planning and development of a comprehensive, coordinated statewide emergency medical services (EMS) system; and provision of other technical assistance and support to enable the EMS community to provide the highest quality emergency medical care possible to those in need.

Emergency Medical Services At A Glance

(July 1, 1996 to June 30, 1997)

720 Licensed EMS agencies serve Virginia

269 Volunteer Rescue Squads

133 Volunteer Fire Departments

64 Volunteer Fire & Rescue

145 Commercial

58 Government/Municipal

13 Hospital

11 Air Ambulance

13 Industrial

5 Correctional

9 Non‑Profit

36,577 EMS providers

4,555 First Responders

25,139 Emergency Medical Technicians

1,578 Shock Trauma Technicians,

2,661 Cardiac Technicians

2,099 Paramedics

545 Certified EMS instructors

472 EMT courses taught (322 basic, 140 refresher).

9,153 Candidates tested for certification as a First Responder, EMT‑B, EMT‑Shock Trauma, Cardiac Technician or Paramedic.

120 Emergency Vehicle Operators courses taught.

64,348 Continuing education credit hours awarded through 2,222 EMS training programs.

11 Virginia hospitals are certified as trauma centers for providing specialized care to severely injured patients.

195 VDH Rescue Squad Assistance Fund grants totaling $3,097,924.59 were awarded to non‑profit EMS agencies/organizations to buy ambulances and EMS equipment.

54 VDH grants totaling $100,000 awarded to EMS agencies for recruitment, retention and public awareness programs.

339 Prospective EMS providers referred to volunteer and/or career EMS agencies

$2,548,900 Two for Life Funds returned to localities for EMS activities.

$1,000,000 Two for Life Funds awarded for regional EMS operations.

$385,750 Two for Life Funds awarded for training programs:

$105,750 Regional training grants

$280,000 ALS training

Virginia Department of Environmental Quality (Medical Wastes)

(as of November 1, 1998)

William Hayden

P.O. Box 10009

Richmond, Virginia 23240

(804) 698-4000

Mission

The mission of the Department of Environmental Quality is to protect the environment of Virginia in order to promote the health and well-being of the citizens of the Commonwealth. To accomplish this, DEQ administers state and federal environmental programs; issues environmental permits and ensures compliance with regulations; and coordinates planning among the Commonwealth's environmental programs.

Citizen Boards

Three citizen regulatory boards are responsible for adopting Virginia's environmental regulations: the Waste Management Board, the Air Pollution Control Board and the State Water Control Board. The DEQ staff administers the regulations as approved by the boards.

Environmental Permits and Regulations

Water Quality

DEQ administers the federal Clean Water Act and enforces state laws to improve the quality of Virginia's streams, rivers, bays and groundwater for aquatic life, human health and other water uses. Permits take into account physical, chemical and biological standards for water quality. Water

programs address:

Pollution Discharges

Permits set limits for pollutant discharges from point sources, such as ditches or pipes (including discharges from storm water systems), by businesses, governments and individuals.

Groundwater

DEQ oversees the withdrawal of large amounts of groundwater within designated groundwater management areas.

Surface water

Withdrawals of large amounts of water in designated surface water management areas are issued permits to ensure adequate stream flows during droughts.

Land application of treated waste

The treatment, storage and spreading on land of industrial and sewage sludge, animal waste and treated wastewater are regulated. Permits typically are issued to industry and large animal feeding operations.

Dredged material

Permits are issued for discharges of dredged material into waterways or wetlands, and for other in stream activities.

Air Quality

DEQ administers the requirements of the federal Clean Air Act, and enforces state law and

regulations to improve Virginia's air quality. Programs include:

Issuing permits to new and modified sources of air emissions.

An enhanced vehicle emissions inspection and maintenance program for Northern Virginia.

Voluntary ozone reduction efforts in Northern Virginia, Richmond and Hampton Roads, through ozone forecasts and advisories.

The Small Business Assistance Program, which provides technical assistance to help small businesses understand and comply with the Clean Air Act and state air regulations. The Small Business Assistance Program Compliance Advisory Panel provides oversight and advice to the Small Business Assistance Program.

Waste Management

DEQ administers waste management programs created by legislation such as the federal Resource Conservation and Recovery Act and the Virginia Waste Management Act. DEQ's activities are coordinated with the U.S. Environmental Protection Agency.

Regulations establish standards for the siting, design, construction, operation, closure and post-closure care of solid waste management facilities. A permit is required by all public and private facilities that operate a waste management facility. These permits follow federal and state standards to protect the land, water and air from pollutants.

The state has regulations for solid waste landfills, transfer stations, incinerators, composting, medical waste, material recovery facilities, and managing solid waste from industrial, construction and demolition activities. In addition, there are state regulations for developing and implementing local and regional solid waste management plans.

Hazardous waste management

State regulations follow federal standards established under RCRA and require a permit for storage, treatment and disposal of hazardous waste. Regulations also govern the issuance of transportation permits for hazardous waste and the siting of hazardous waste management facilities. There currently are no permitted hazardous waste disposal sites in Virginia.

Petroleum storage tanks

DEQ ensures that aboveground and underground storage tanks are registered, inspected and maintained, and have leak and spill detectors. Tank owners are responsible for developing spill contingency plans, and demonstrating sufficient financial capability to handle cleanups and remediation.

DEQ sponsors voluntary remediation and cleanups at federal facilities and Superfund sites. The Voluntary Remediation Program encourages hazardous substance cleanups that might not otherwise take place, enabling site owners or operators to voluntarily enter into an agreement with DEQ to clean up the property and restore it to productive use. DEQ also works with the federal government to ensure proper cleanup of hazardous wastes at federal facilities, including military bases. EPA administers the Superfund program in Virginia, and DEQ performs necessary activities mandated by the Superfund law. DEQ is not involved in day-to-day activities.

Management of regulated medical waste

DEQ establishes standards for the storage, transportation and treatment of regulated medical waste. Regulated medical waste may be stored, steam sterilized or incinerated only at a permitted facility. Alternative treatment technology may be allowed if the effectiveness of the treatment can be demonstrated.

Coal ash

Regulations establish standards for the use, storage and disposal of coal combustion byproducts, known as coal ash. Alternative uses and reuses of the ash are allowed under the regulations.

Waste tires

DEQ is responsible for developing and implementing a plan to properly manage waste tires. The plan will include short-term and long-term recommendations for addressing tire stockpiles. The Waste Tire Trust Fund administered by DEQ provides money to several regions to help them manage the current flow of waste tires. Virginia also has regulations to provide for cost reimbursements to waste tire end-users.

Litter prevention and recycling

DEQ administers an annual grant program that provides funding to local litter prevention and recycling program efforts.

Monitoring and Inspection

DEQ conducts extensive monitoring to ensure that state and federal standards for water quality, air quality and waste management are met. DEQ also oversees monitoring by permit holders and conducts inspections of permitted sites to ensure that sources such as water discharges, air emissions and waste management facilities meet permit requirements. Activities include:

Monitoring water quality in rivers, lakes and estuaries at some 1,100 locations to detect pollutants and to assess pollution prevention efforts. In addition, a stream gauging network provides important flow data for streams throughout Virginia.

A network of air monitors throughout the state to measure for specific pollutants in the atmosphere. DEQ analyzes air quality data and maintains an inventory of stationary air emission sources.

Monitoring landfills to ensure that groundwater is not contaminated. Permitted hazardous waste storage sites also are monitored to ensure permit compliance.

Chesapeake Bay and Coastal Programs

DEQ participates in numerous state and federal programs aimed at restoring the Chesapeake Bay and improving Virginia's coastal resources.

DEQ works with other state agencies, other state governments and the federal government as part of the Chesapeake Bay Program. Among other initiatives, the Bay program is working to reduce the amount of nutrient pollution in the Bay and its tributaries, and to reduce the amounts of toxic substances entering the Bay.

DEQ monitors Virginia's coastal regulatory programs and administers federally funded grants for projects to preserve coastal resources.

Pollution Prevention and Compliance Assistance

DEQ promotes technological innovation and science-based approaches to preventing pollution and better managing Virginia's natural resources. Citizens and business are encouraged to develop efficient ways to reduce or eliminate waste materials before they are released to the air, water or land. DEQ is helping accomplish this through technical assistance, and partnerships with industry and local governments.

Environmental Impact Review

DEQ coordinates recommendations to the Governor to ensure that new state facilities are constructed in an environmentally sound manner. DEQ also coordinates review of new airport construction proposals, oil and gas drilling in Tidewater, state agency farmland preservation plans, and the environmental impacts of federal projects.

Regional Operations

DEQ has consolidated operations at the agency's regional offices in Abingdon, Harrisonburg, Richmond, Roanoke, Woodbridge and Virginia Beach. Satellite offices in Fredericksburg, Kilmarnock and Lynchburg support the regional operations. In addition, there is a stream flow monitoring office in Charlottesville and an air monitoring office in Richmond.

Each regional office houses DEQ's air, water and waste programs, provides permit assistance and emergency response, and ensures compliance with regulations.

Environmental Education

DEQ sponsors an annual education conference, produces printed resource materials, promotes a statewide network of teachers and other environmental educators, and coordinates teacher training on environmental subjects.

Online Communications And Media Relations

Virginia Department of Health

(as of November 1, 1998)

Douglas R. Harris, Advisor to the Commissioner

Commonwealth of Virginia

Department of Health

P.O. Box 2448

Richmond, Virginia 23218

1-804-786-1124 Telephone

1-804-786-4616 Fax

www.vdh.state.va.us

Overview of Regulatory Programs

The State Board of Health and the State Health Commissioner, assisted by the State Department of Health, are authorized to administer and provide a comprehensive program of preventive, curative, restorative and environmental health services; educate the citizenry in health and environmental matters; develop and implement health resource plans; collect and preserve vital records and health statistics; provide medicolegal investigation of deaths that occur suddenly, unexpectedly, violently, or in an otherwise suspicious manner; assist in research; investigate outbreaks of disease; and abate hazards and nuisances to the public health and to the environment. Code of Virginia, Title 32.1, Chapters 1, 2 and 8. Regulatory activities are noted below as vested in the department, without distinction among those vested in the State Board of Health or the State Health Commissioner. In furtherance of its mission to protect public health, the department administers numerous programs and engages in many regulatory activities. These regulatory activities include:

(i) Establishing standards and requirements for research on human participants conducted or authorized by the department, or any facility or other entity operated, funded, or licensed by the department;

(ii) Establishing a statewide and unified emergency medical care system, composed of various facilities and resources; establishing a statewide poison control system; licensing emergency medical services agencies, vehicles and personnel in order to improve the delivery of emergency medical services and reduce morbidity, hospitalization, disability and mortality;

(iii) Compiling a list of human diseases required to be reported to the department; prescribing the manner and time of such reporting; maintaining a confidential statewide cancer registry; issuing orders to combat epidemics and communicable disease and to address other public health emergencies so that disease may be controlled and investigated epidemiologically; and requiring the immunization of children in order to prevent certain diseases;

(iv) Establishing and maintaining a system of screening tests for newborn infants that detects various inborn errors of metabolism in order to prevent disability and death and establishing and maintaining a system to identify hearing loss at the earliest possible age among newborns; monitoring infants identified as having hearing impairment so that they may receive appropriate early intervention through treatment, therapy, training and education;

(v) Prescribing standards, examinations and analyses governing the taking and marketing of crustacea, finfish, and shellfish; conducting inspections of shellfish planting grounds and seafood packing houses; and establishing the boundaries of and condemning growing areas in which crustacea, finfish or shellfish are unfit for market;

(vi) Establishing a methodology for the review and measurement of the efficiency and productivity of health care institutions; administering a patient level data system for consumers, employers, providers and purchasers of health care to improve the quality, appropriateness, and accessibility of health care; and providing information useful in making decisions relating to health care;

(vii) Establishing procedures and policies for soliciting and receiving applications for grants from the Commonwealth Neurotrauma Initiative Trust Fund and criteria for reviewing and ranking such applications in order to prevent traumatic spinal cord and brain injuries and to improve the treatment and care of persons with such injuries;

(viii) Defining the income limitations within which a person shall be deemed to be medically indigent so that such persons may receive the medical care services of the department without charge; and prescribing a scale of charges, based on ability to pay, for departmental patients who are not deemed to be medically indigent;

(ix) Establishing procedures and fees for the review of applications for certificates of public need; and, upon finding public need for the construction of or specified modifications to medical care facilities, issuing such certificates, conditioned upon an agreement to provide medical care to indigents where warranted, as well as providing for limitations on the time for completion and on capital expenditures;

(x) Licensing, prescribing minimal standards of construction, maintenance and operation for, and inspecting hospitals, nursing facilities, hospices, and other medical care facilities; and licensing and prescribing minimal standards governing the activities and services provided by home care organizations;

(xi) Prescribing requirements for permitting the practice of midwifery by persons who are not registered nurses and who were permitted pursuant to the Board’s standards before January 1, 1977;

(xii) Prescribing standards that ensure the quality of managed health care insurance plans offered by entities that are licensed by the State Corporation Commission; and issuing certificates of quality assurance to such licensees;

(xiii) Licensing restaurants, hotels and other lodging facilities, summer camps, campgrounds and migrant labor camps; inspecting these establishments, along with public swimming pools, for compliance with sanitary requirements;

(xiv) Regulating and controlling sources of radiation; licensing the use, production and possession of radioactive materials; and requiring the registration, inspection and certification of diagnostic therapeutic x-ray machines used in the healing arts;

(xv) Granting conditional scholarships for the training of certain physicians, nurses, dentists and dental hygienists; defining the obligations scholarship recipients must fulfill, including their practice in areas undeserved by medical and dental professionals, as such areas are delineated by the department;

(xvi) Uniformly administering the statewide system for maintaining vital records, i.e., birth, adoption, marriage, divorce, death, and fetal death records; and allowing access and necessary changes to these records;

(xvii) Issuing permits for and regulating the design and operation of public water systems; and establishing standards for protecting the quality and safety of the drinking water produced by such systems;

(xviii) Prescribing standards for the location, construction and abandonment of residential wells used for drinking and domestic purposes; and

(xix) Supervising the collection, transportation, treatment and disposal of sewage; regulating the construction and operation of sewage disposal and treatment facilities; setting standards for and approving residential sewage disposal systems; and prescribing requirements for the disposal of sewage at marinas and for the application of bestialities to agricultural lands.

The department operates under the supervision of the Secretary of Health and Human Resources. All regulations adopted by the State Board of Health appear in Title 12 of the Virginia Administrative Code.

Virginia Department of Health

Virginia Center for Quality Health Care Services and

Consumer Protection

(as of November 1, 1998)

Nancy Hofheimer, Director

3600 West Broad Street, Suite 216

Richmond, Virginia 23230

(804) 367-2102

(804) 367-2149

Phone

Director 804/367-2102

Deputy Director 804/367-2104

Acute Care 804/367-2104

Long Term Care 804/367-2100

Complaint Hotline 1-800/955-1819

COPN 804/367-2126

FAX Number 804/367-2149

Mission

The Center for Quality Health Care Services and Consumer Protection (the Center) performs the following functions:

. Determines and certifies the public need (COPN) for new construction and renovations and new health care services in acute and long term care medical facilities.

. Promotes the delivery of quality health care services and protects health care consumers through the conduct of routine onsite inspections and complaint investigation.

. Enforces state licensure regulations related to (5) medical care provider categories.

. Promotes state quality of care standards governing insurers and providers which offer health care benefits through managed care health insurance plans (MCHIPS). Also enforces quality of care standards for Professional Utilization Review Agents (PRAs).

. Certifies (23) medical care provider categories for federal financial participation in the Medicare, Medicaid, and the Clinical Laboratory Improvement Programs.

. Provides training and education programs for the health care provider community, consumers and Center staff.

Functional Areas

The Center has a main office located at Suite 216, 3600 West Broad Street in Richmond, Virginia and (50) home based, surveyor offices located around the state. The CQHCCP consists of the following functional areas: Licensing and Certification/MCHIPS, Policy, Education and Administration:

FUNCTIONAL AREAS STAFFING

LICENSING/CERTIFICATION 67

COPN/POLICY DIVISION 12

EDUCATION 5

ADMINISTRATION 4

TOTAL 88

Licensing/Certification/MCHIPS

Acute Care/Complaint Division (AC)

Consists of Medical Facilities Inspectors and Supervisor/Management staff. Conducts onsite inspections and complaint investigations in acute medical care facilities throughout Virginia. Inspects general hospitals, managed care organizations and acute medical care facilities throughout Virginia. Inspects general hospitals, outpatient hospitals, home care organizations and hospices comprising about 250 providers for compliance with state licensing quality of care standards. Enforces quality of care licensing regulations governing approximately 400 managed care plans and 75 private utilization review agents.

Certifies and enforces federal Medicare/Medicaid regulations governing 23 medical provider types in Virginia comprising over 2000 medical care providers. Also investigates fraudulent practices in home health, nursing homes and homes for the aged under the federal Operation Restore Trust Program. The cost of an average acute care onsite inspection is $3000.

Oversees complaint handling for the CQHCCP. Processes all complaints and investigates those complaints falling outside of the Divisions' routine onsite inspection schedules. Processes over 1400 complaints and facility reported incidents annually.

Long Term Care Services Division (LTC)

Consists of Medical Facilities Inspectors and Supervisor/Management Staff. Conducts onsite inspections and complaint investigations in long term care facilities throughout Virginia. Licenses nursing homes and enforces federal Medicare/Medicaid regulations governing four (4) LTC federal provider categories, as well as the nursing home components of general hospitals, mental hospitals and institutions for the mentally retarded.

The inspection workload comprises onsite inspections and complaint investigations at approximately 360 providers locations. The average cost of inspecting and licensing a nursing home is $2,000 per provider. The average cost of surveying and federally certifying a nursing home is approximately $3,000 per provider. The combined cost of licensing and federally surveying a nursing home is approximately $5,000.

COPN/Policy Division

Consists of the COPN Division’s Project Review Analysts, an Architect and a Policy Analyst. Reviews certificate of public need (COPN) applications and makes recommendations to the Commissioner of Health. Decisions by the Commissioner of Health are made on approximately 60 COPN applications annually. Reviews the architectural drawings of new construction and renovations in general hospitals, outpatient hospitals and nursing homes for compliance with state licensure regulations. Architectural plans on over 50 projects are reviewed and approved annually. Includes promulgation and review of twenty six (26) sets of state regulations.

Education

Consists of a Training Coordinator, Agency Management Analyst, MDS/RAI Coordinator, Computer Engineer and Help Desk Technician. Provides statewide training and educational programs to health care provider community, consumers and staff. Furnishes routine technical support and assistance to nursing homes and home health agencies, as well as interested public and private entities related to the MDS/RAI and OASIS statewide patient data base systems.

Administration

Consists of the Office Director, the Fiscal Unit, and an Executive Secretary. Provides overall direction, guidance and interpretation of the state/federal licensure/federal certification/COPN programs in Virginia.