2019 Session

SB1557

Board of Pharmacy; cannabidiol oil and tetrahydrocannabinol oil; regulation of pharmaceutical processors. Alters the definitions of cannabidiol oil and tetrahydrocannabinol (THC-A) oil to remove the five percent cap on the concentration of THC permitted to be contained in each oil. The bill allows licensed physician assistants and licensed nurse practitioners to issue a written certification for use of cannabidiol oil and THC-A oil. The bill requires the Board to promulgate regulations establishing dosage limitations, which shall require that each dispensed dose of cannabidiol oil or THC-A oil not exceed 10 milligrams and each dispensed package of cannabidiol oil or THC-A oil not exceed 100 milligrams. The bill removes the requirement that a licensed pharmacist provide on-premises supervision of pharmaceutical processors and clarifies who may be employed by pharmaceutical processors and the regulations governing such employees.

SB1596

Health insurance; cost-sharing payments. Requires any carrier issuing a health plan in the Commonwealth to include any amounts paid by the enrollee or paid on behalf of the enrollee by another person when calculating an enrollee’s overall contribution to any out-of-pocket maximum, deductible, copayment, coinsurance, or other cost-sharing requirement under the health plan.

SB1598

Board of Corrections; minimum standards for health care services in local correctional facilities. Authorizes the Board of Corrections (Board) to establish minimum standards for health care services in local, regional, and community correctional facilities and procedures for enforcing such minimum standards, with the advice of and guidance from the Commissioner of Behavioral Health and Developmental Services and State Health Commissioner. The bill provides that (i) such standards shall require that each local, regional, and community correctional facility submit a standardized quarterly continuous improvement report documenting the delivery of health care services, along with any improvements made to those services, to the Board and (ii) such reports shall be available to the public on the Board’s website. The bill also authorizes the Board to determine that a local, regional, or community correctional facility accredited by the American Correctional Association or National Commission on Correctional Health Care meets such minimum standards solely on the basis of such accreditation; however, without exception, the requirement to submit standardized quarterly continuous quality improvement reports shall be a mandatory minimum standard. This bill is a recommendation of the Joint Commission on Health Care.

SB1607

Health insurance; carrier business practices; authorization of health care services. Provides that if a carrier has previously authorized an invasive or surgical health care service as medically necessary and during the procedure the health care provider discovers clinical evidence prompting the provider to perform a less or more extensive or complicated procedure than was previously authorized, then the carrier shall pay the claim, provided that it is appropriately coded consistent with the procedure actually performed. The measure requires any provider contract between a carrier and a participating health care provider to contain certain specific provisions addressing how carriers interact with prior authorization requests. The measure clarifies that the 24-hour period during which a carrier must communicate to a prescriber if an urgent prior authorization request submitted telephonically or in an alternate method directed by the carrier has been approved, denied, or requires supplementation includes weekend hours. The bill provides that no prior authorization shall be required for substance abuse medication-assisted treatment or if the prescriber is using a clinical decision support system, defined as applications that analyze data to help providers make decisions and improve patient care.

SB1611

Health care shared savings; incentive programs. Requires health carriers to establish a comparable health care service incentive program under which savings are shared with a covered person who elects to receive a covered health care service from a lower-cost provider. Incentive payments are not required for savings of $25 or less. Programs are required to be approved by the Commissioner of Insurance. The measure also requires health carriers to make available an interactive mechanism on their website that enables a covered person to calculate estimated out-of-pocket costs for comparable health care services from network providers and obtain quality data for those providers, to the extent available.

SB1685

Health insurance; credentialing; mental health professionals. Requires health insurers and other carriers that credential the mental health professionals in their provider networks to establish reasonable protocols and procedures for reimbursing a mental health professional who has submitted a completed credentialing application to a carrier, after being credentialed by the carrier, for mental health services provided to covered persons during the period in which the applicant’s completed credentialing application is pending. The measure provides that health insurers that credential mental health professionals in their network may establish reasonable protocols and procedures for credentialing private mental health agencies. The bill establishes minimum standards that must be maintained by credentialed private mental health agencies.

SB1717

State Corporation Commission; Commonwealth Care Division; Commonwealth Care Health Benefits Program. Directs the State Corporation Commission (the Commission), through a division within the Commission designated as the Commonwealth Care Division (the Division), to establish a nonprofit corporation (the Corporation) to establish, implement, and administer the Commonwealth Care Health Benefits Program (the Program), through which individuals may purchase individual health insurance coverage through qualifying health plans offered by the Corporation as a self-insuring entity. The measure identifies the parameters of the Program, including, in part, the following elements: (i) implementation of the Program shall be contingent on the approval of the U.S. Secretary of Health and Human Services of a state innovation waiver under § 1332 of the Affordable Care Act; (ii) the Commission shall retain staff sufficient to establish and implement the Program; (iii) the Program shall arrange for a number of third-party administrators, sufficient to ensure competition but in no event fewer than two; (iv) the Program shall design and implement health plans that replace the existing individual market; (v) the covered benefits provided under a plan offered through the Program shall provide coverage that a large group plan or association health plan subject to ERISA is required to provide so long as one or more health plans provide additional benefits as may be required to provide coverage that is at least as comprehensive and affordable as plans currently offered on the exchange pursuant to the ACA or otherwise to comply with the Guardrail requirements of the ACA; (vi) the Program shall address the establishment of a reinsurance program; (vii) health plan premiums for individuals with a household income between 100 percent and 400 percent of the federal poverty level shall be subsidized; (viii) the Program shall offer a cost-sharing reduction feature that removes disincentives to Program participation by low-income individuals who are enrolled in the Medicaid program; (ix) individuals will still be able to purchase individual health insurance coverage outside of the Program; (x) premiums for the plans offered through the Program shall be set by the third-party administrators, subject to approval by the Commission with assistance of qualified actuaries; (xi) the Program shall be designed and operated in order to ensure that any shortfall in revenues is addressed by the reinsurance program and by self-funding a reserve that is determined by the Corporation’s actuary to be adequate, and (xii) the Program shall include premium incentives for compliance with wellness or chronic disease management benefit programs.. The measure directs the Commissioner of Insurance to apply to the U.S. Secretary of Health and Human Services for a state innovation waiver under § 1332 of the Affordable Care Act. The bill has a contingent effective date of 30 days following the date the Commissioner of Insurance notifies the Governor and the Chairmen of the House Committees on Appropriations and Commerce and Labor and the Senate Committees on Finance and Commerce and Labor of federal approval of the state innovation request required to be submitted.

SB1773

Health regulatory boards; conversion therapy. Directs the Board of Counseling, the Board of Medicine, the Board of Nursing, the Board of Psychology, and the Board of Social Work to each promulgate regulations or guidance documents defining conversion therapy and the unprofessional conduct in the practice of conversion therapy with any person under 18 years of age. The bill requires such regulations or guidance documents to ensure any interventions in such practice are patient-centered and align with relevant primary sources or policy statements from the relevant professional association.

SB1258

School boards; personnel; behavior analysts. Requires local school boards to employ one full-time equivalent licensed behavior analyst or licensed assistant behavior analyst per five schools in the school division.

SB1313

Early childhood care and education; licensing. Requires the Board of Education to establish a statewide unified public-private system for early childhood care and education in the Commonwealth to be administered by the Board of Education, the Superintendent of Public Instruction, and the Department of Education. The bill transfers the authority to license and regulate child day programs and other early child care agencies from the Board of Social Services and Department of Social Services to the Board of Education and the Department of Education. The bill maintains current licensure, background check, and other requirements of such programs. The bill establishes the Early Childhood Innovation Fund for the purpose of facilitating regional public-private collaboration and to field test innovative strategies and evidence-based practices that support a robust system of comprehensive early childhood care and education services to deliver measurable school readiness outcomes and meet regional workforce support needs. Such provisions of the bill have a delayed effective date of July 1, 2021.
The bill requires the Superintendent of Public Instruction to establish a plan for implementing the statewide unified early childhood care and education system and requires the Department of Social Services and the Department of Education to enter into a cooperative agreement to coordinate the transition. The bill provides that, beginning July 1, 2021, the Department of Education will be the lead agency for the administration of the Child Care and Development Block Grant and the Head Start Collaboration Office. Finally, the bill requires the Board of Education and the Board of Social Services to promulgate regulations to implement the provisions of the bill to become effective on July 1, 2021.

SB1589

Education and workforce development; Virginia Works Portal created Creates the Virginia Works Portal, administered by the Virginia Economic Development Partnership Authority, to provide one-stop access to information regarding career paths, education, workforce development, and employment opportunities in the Commonwealth. The bill creates the five-person Virginia Works Board to oversee the Portal and the Virginia Works Advisory Committee of public and private sector stakeholders to advise the Board.

SB1590

Virtual Virginia. Requires that the Virtual Virginia program, the statewide electronic classroom established by the Department of Education, be made available to all public schools. Currently, the program is available only to high schools. The bill requires the Department to utilize a learning management system for the purposes of implementing Virtual Virginia. The bill also authorizes the Department to charge a per-student fee to school divisions for each student enrolled in a full-time Virtual Virginia program beyond an initial allotment of 15 such students per school division and prohibits the Department from limiting the total number of such students by school division.

SB1591

Virginia Center for School and Campus Safety; guidelines on information sharing. Directs the Virginia Center for School and Campus Safety (the Center) to convene a work group to develop guidelines and best practices for the sharing of information between a local school board or public institution of higher education and law enforcement regarding a student whose behavior may pose a threat to the safety of a school or institution or the community. Such guidelines and best practices shall seek to balance the interests of safety and student privacy and shall be consistent with the provisions of the federal Family Educational Rights and Privacy Act and Health Insurance Portability and Accountability Act, as applicable. The bill requires the Center to develop such guidelines and best practices, report to the Chairmen of the House Committee on Education and the Senate Committee on Education and Health, and make such guidelines available to local school boards, public institutions of higher education, law enforcement, and the public by October 1, 2019.

SB1593

State Council of Higher Education for Virginia; financial aid award notification. Requires any comprehensive financial aid award notification provided to a student by a public institution of higher education or private institution of higher education to meet the requirements and best practices established by the Council in its Financial Award Letters Policies and Guidance.

SB1595

Family life education; special education. Requires the Board of Education to adapt its family life education Standards of Learning and curriculum guidelines, as necessary, to meet the needs of students in special education. The bill also requires a local school board offering a family life education curriculum to ensure that students in special education receive appropriate instruction consistent with any such adaptations.

SB1628

Public institutions of higher education; innovation. Establishes the Innovative Internship Fund and Innovative Internship Pilot Program, to be administered by the State Council of Higher Education for Virginia, for the purpose of awarding grants on a competitive basis to public institutions of higher education that partner with at least one private sector entity that agrees to provide matching funds to facilitate innovative internship programs for students enrolled at the institution that accomplish one or more enumerated goals related to the workforce. The bill also permits any public institution of higher education to propose in conjunction with the six-year plan process, and the General Assembly to adopt by reference in the general appropriation act, an institutional partnership performance agreement (agreement) that advances the objectives of the Virginia Higher Education Opportunity Act of 2011 by aligning the strategies, activities, and investments of the institution, the Commonwealth, and any identified partners concerning (i) college access, affordability, cost predictability, and employment pathways for undergraduate Virginia students and (ii) strategic talent development and other high-priority economic initiatives of the Commonwealth. The bill contains provisions relating to mandatory and permissive contents of, the approval process for, and the legal effect of any such agreement.

SB1425

Local license tax; mobile food units. Provides that when the owner of a mobile food unit, defined as a restaurant mounted on wheels and readily moveable at any time during its operation, pays any license tax in the county or city in which the mobile food unit is registered and in which property taxes are paid, no other license shall be required in any other county, city, or town in the Commonwealth.

SB1565

Travel Insurance. Establishes procedures and requirements for travel protection plans and travel administrators. The measure defines a “travel protection plan” as any plan that provides travel insurance, travel assistance services, or cancellation fee waivers and defines a “travel administrator” as a person who directly or indirectly underwrites, collects, charges collateral or premiums from, or adjusts or settles claims on residents of the Commonwealth, in connection with travel insurance. The measure establishes a premium tax on travel insurance premiums paid by residents of the Commonwealth and establishes acceptable practices for the sale and advertising of travel insurance. The measure has a delayed effective date of October 1, 2019.

SB1592

Department of Small Business and Supplier Diversity; certification of a small business as a micro business. Directs the Director of the Department of Small Business and Supplier Diversity to amend its regulation regarding the certification of businesses as micro businesses to provide that a business that is certified as a small business pursuant to the small business certification program administered by the Director pursuant to subdivision 8 of § 2.2-1606 may be certified as a micro business if it, together with its affiliates, has 25 or fewer full-time equivalents and average annual gross receipts of $3 million or less averaged over the previous three years.

SB1594

Local boundary agreements. Allows all localities, in adopting a voluntary boundary agreement, to attach to their petitions to the circuit court a Geographic Information System (GIS) map depicting the boundary change. Under current law, such use of a GIS map is permitted only regarding the boundaries of certain named localities.

SB1631

Virginia income tax; emergency. Advances conformity of the Commonwealth’s tax code with the federal tax code to December 31, 2018, starting with taxable year 2018. The bill increases, starting with taxable year 2018, the amount of the standard deduction (i) from $3,000 to $6,000 for an individual or for married persons filing separately and (ii) from $6,000 to $12,000 for married persons filing jointly. Starting in 2019, the bill adjusts Virginia’s standard deduction by the percentage increase in the Chained Consumer Price Index for All Urban Consumers (C-CPI-U) for the previous taxable year. In taxable year 2026, the standard deduction would return to $3,000 for an individual or a married person filing jointly and $6,000 for married persons filing jointly, coincident with the expiration of the individual income tax provisions of the federal Tax Cuts and Jobs Act (TCJA). Beginning in taxable year 2020, the individual tax brackets and the personal deductions will also be adjusted by the percentage increase of the C-CPI-U for the previous taxable year.
The bill reduces the corporate income tax from its current rate of six percent to five and one-half percent in 2018 and to five percent in 2019 and subsequent years and establishes subtractions from Virginia corporate taxable income for the amount of global intangible low-taxed income that is included in federal taxable income and the amount of business interest that is disallowed as a deduction from federal taxable income.
The bill provides that any additional revenues generated by the TCJA, beyond those revenues necessary to offset the reduction in revenues resulting from the provisions of the bill, shall be transferred to the Tax Policy Fund, created by the bill, to be used to provide tax reform to Virginia taxpayers starting in fiscal year 2020. The bill contains an emergency clause.

SB1690

Designating the Trooper Mark Barrett Memorial Bridge. Designates the bridge on Meadow Road over Interstate 64 at mile marker 202 in Henrico County the “Trooper Mark Barrett Memorial Bridge.”

SJ310

Commending Hanover County.

SJ324

Celebrating the life of Bradford Turner Clark.

SJ325

Commending Voices for Virginia’s Children.

Item 0 #7S Multiple Income Tax Changes

This amendment accompanies Senate Bill 1631 which would make multiple income tax changes, including doubling the standard deduction, reducing the corporate income tax to 5.5 percent, and creating subtractions for the amount of global intangible low-taxed income that is included in federal taxable income and the amount of business interest that is disallowed as a deduction from federal taxable income. This amendment assumes a general fund revenue reduction of $1.5 billion in the second year. The actual revenue impact is to be determined.

Item 38 #3S Henrico CAP Program

This amendment provides $140,000 each year from the general fund for the Community Alternative Program which provides a second chance for first time felony drug offenders.

Item 119 #1S Electronic Credentials

This amendment adds language authorizing the Department of Professional and Occupational Regulation to provide electronic credentials to individuals and organizations it regulates. Requires a verification of those electronic credentials.

Item 122 #2S Virginia Works Portal

This amendment accompanies Senate Bill 1589, which establishes a five-person Virginia Works Board to oversee the development and implementation of the Virginia Works Portal, an interactive tool to provide students, educators, job-seekers and employers information regarding education pathways, career opportunities, and workforce development information. This amendment would provide $300,000 GF each year to the Virginia Economic Development Partnership for staff support and technical assistance to the Board.

Item 132 #1S VDOE – Individualized Student Progress Evaluation

This amendment provides $500,000 GF in each year to support an individualized student progress evaluation system to start the first phase of the program with at least 100,000 students.

Item 132 #2S VDOE – Learning Management System

This amendment adds $5.0 million GF in the second year for a statewide learning management system to provide equity and access across all 132 school divisions by allowing all teachers access to digital content through Virtual Virginia.

Item 136 #28S Direct Aid – School Behaviorists

This amendment provides $15.0 million GF in the second year to fund one behaviorist per five schools.

Item 143 #3S SCHEV – Lumina Study Reporting (language only)

This amendment requires SCHEV and Lumina to report to the Joint Committee on the Future Competitiveness of Higher Education on recommendations and strategies for Virginia to achieve higher education outcomes.

Item 143 #4S SCHEV – Innovative Internship Fund and Pilot Program

This amendment provides an additional $500,000 GF in the second year for the internship pilot program at the State Council of Higher Education for Virginia. The amendment would bring total funding for the program to $700,000 GF in the second year.

Item 143 #6S SCHEV – Data Exchange for Wage Outcomes (language only)

This amendment specifies certain needed data exchange with the U.S. Census in order to get wage outcomes for graduates working outside the Commonwealth.

Item 162 #4S GMU – Fund Accessible Pathways – Advance Program

This amendment provides $600,000 GF and $600,000 NGF in the second year for the Advance NOVA Mason Partnership Program at George Mason University. This program is to support the challenges related to the two-to-four year transfer model, allowing for systems integration and a more seamless transition between the two institutions.

Item 292 #1S Modify LARC Pilot Program (language only)

This amendment modifies the Long-Acting Reversible Contraception (LARC) program to limit the use of the funds to only the purchase of the IUDs and to encourage partnerships with other organizations to access 340B pricing or other innovative methods to reduce the average cost of the device. In addition, the amendment directs the Virginia Department of Health to allow other organizations to apply for the second-year funding.

Item 303 #2S Increase Medicaid Primary Care and Pediatric Physician Rates

This amendment proposes to increase the Medicaid rates for primary care, family practice and pediatric physician rates to 88 percent Medicare reimbursement.

Item 303 #16S Increase Adult Day Health Care Rates

This amendment provides $1.4 million from the general fund and a like amount of federal Medicaid matching funds to provide a 25 percent increase in the Medicaid waiver reimbursement rate for adult day health services. Adult day health care is much less expensive than alternative care in a nursing facility for which these clients qualify. Providers of adult day health care report a gap between actual costs and Medicaid reimbursement, which must be made up through contributions from individuals, churches, corporations, and foundations. These services are almost exclusively provided to Medicaid waiver recipients. This amendment increases by 25 percent the statewide rate paid for Medicaid adult day health care services, which is currently in Northern Virginia $61.60 and $57.04 in the rest of the state.

Item 303 #21S Managed Care Notification and Training Requirements for Certain Providers (language only)

This amendment directs the Department of Medical Assistance Services to require the Medicaid managed care organizations to provide written notification and training to agency-directed personal care providers at least 60 days prior to the implementation of all changes to Quality Management Review and prior authorization policies and processes.

Item 303 #22S Review of Agency Directed Personal Care Rates (language only)

This amendment directs the Department of Medical Assistance Services to review the rates paid to personal care service providers and determine if those rates adequately reimburse providers for the costs incurred to deliver care and are appropriate to maintain an adequate provider network in all geographic areas of the Commonwealth.

Item 303 #23S Minimum Pharmacy Reimbursement Requirements for Managed Care (language only)

This amendment requires the Department of Medical Assistance Services to ensure a minimum reimbursement to pharmacies in the Medicaid program to at least cover the costs of dispensing.

Item 303 #24S Pharmacy Carve Out from Managed Care (language only)

This amendment proposes language that provides for a review and consideration of pharmacy benefit management realignment in the Medicaid and Children’s Health Insurance Program pharmacy benefit. The language requires the contracted actuary of the Department of Medical Assistance Services to determine potential cost savings. If cost savings are available, then, effective January 1, 2020, the department may carve out the pharmacy benefit from managed care.

Item 307 #3S Funding Source for the Administrative Costs of 1115 Waiver

This amendment proposes language that provides for a review and consideration of pharmacy benefit management realignment in the Medicaid and Children’s Health Insurance Program pharmacy benefit. The language requires the contracted actuary of the Department of Medical Assistance Services to determine potential cost savings. If cost savings are available, then, effective January 1, 2020, the department may carve out the pharmacy benefit from managed care.

Item 307 #3S Funding Source for the Administrative Costs of 1115 Waiver

This amendment supplants $1.7 million the first year and $10.2 million the second year from the general fund with funding from the Provider Coverage Assessment fund for the Department of Medical Assistance Services’ administrative costs related to the Section 1115 Medicaid waiver that is part of the coverage expansion pursuant to the Affordable Care Act. The introduced budget funded the administrative costs of the waiver from the general fund. This action funds it from revenue from the hospital provider assessment. An amendment to language in Part 3 clarifies that the Provider Coverage Assessment is responsible for the costs of administering the provisions of the Section 1115 Waiver.

Item 307 #5S Medicaid Program Growth Rate (language only)

This amendment modifies the annual spending target included in the introduced budget and creates a Medicaid Growth Rate each year that the Department of Medical Assistance Services is responsible to ensure that annual Medicaid expenditures do not exceed. If expenditures are likely to exceed the Medicaid Growth Rate, the department would provide notice and develop a plan within 30 days to reduce spending in the current year. The Governor is directed to not exceed the Medicaid Growth Rate in his annual budget bill.

Item 312 #3S Henrico Transitional Recovery Center Pilot Program

This amendment adds $7.5 million from the general fund (GF) the second year as the state match to Henrico County for a 300-bed Transitional Recovery Center pilot program. The project will create a strategic partnership with Henrico Mental Health to successfully transition jail inmates with serious addiction issues back to the community.

Item 340 #2S Increase TANF Benefit Payments by 10 Percent

This amendment adds almost $38 million in nongeneral funds the second year from the federal Temporary Assistance to Needy Families (TANF) block grant to increase the TANF benefit payment (standards of assistance) for families participating in the TANF program by 10 percent and establishes cost of living adjustments until the standards of assistance equals 50 percent of the federal poverty level. The current monthly TANF benefit averages $314 per month for a family. If TANF payments had kept pace with the rate of inflation since 1985, the monthly assistance would be approximately $676 per month. The standards of assistance also impacts initial eligibility for TANF. With lower standards, fewer families are eligible for assistance. In 1985, a three person family in a level III locality could be eligible with net income below 48 percent of the federal poverty level. To qualify now, the family’s net income must be less than 20 percent of the federal poverty limit.

Item 344 #6S Implement SNAP Broad Based Eligibility

This amendment provides $961,579 from the general fund and $1.3 million from federal Temporary Assistance to Needy Families block grant funds the second year to implement a broad based categorical eligibility in the Supplemental Nutrition Assistance Program (SNAP) to streamline the application process and increase the availability of federally-funded nutrition benefits for low-income families with incomes below 138 percent of the federal poverty level. Broad Based Categorical Eligibility (BBCE) is a state option in SNAP, by which every household member receiving a TANF funded service is assumed to qualify for SNAP. Currently, 42 states have implemented BBCE.

Item 361 #1S Capital Bike Trail (language only)

This amendment directs the Secretaries of Natural Resources and Transportation to investigate the feasibility of moving support for the Capital Bike Trail from VDOT to DCR.

Item 419 #4S School Safety Application

This amendment provides $300,000 GF per year for the Fusion Center to develop an application in conjunction with the Magellan 24-hour mental health hotline to allow ready access to report both mental health crises and requests for assistance and school safety concerns.

Item 481 #1S Commonwealth Care Health Benefits Program

This amendment provides $500,000 from the general fund the second year for start-up costs related to implementing the Commonwealth Care Health Benefits Program per legislation in the 2019 Session.

Item 3-5.15 #1S Clarify 1115 Waiver Costs Be Paid with Provider Assessment Revenue (language only)

This amendment clarifies the hospital provider assessment language such that the administrative costs that are part of the full costs of coverage include administering and implementing the provisions of the Section 1115 waiver.