Bill Text: NC H1073 | 2011-2012 | Regular Session | Introduced
Bill Title: Modify UNCHCS Board
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2012-07-12 - Ch. SL 2012-174 [H1073 Detail]
Download: North_Carolina-2011-H1073-Introduced.html
H.B. 1073 May 22, 2012 HOUSE PRINCIPAL CLERK
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2011
H D
HOUSE DRH90202-RCz-8 (04/06)
Short Title: UNCHCS Changes. |
(Public) |
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Sponsors: |
Representative Moffitt. |
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Referred to: |
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A BILL TO BE ENTITLED
AN ACT to clarify the purpose of the University of north CAROLINA health care system, to increase the authority of the university of north carolina board of governors to govern the health care system, to reduce the number and change the composition of the members of the Board of Directors of the Health Care system, to increase the system's accountability and transparency, to clarify its status as a state agency, and to limit future expansion, as recommended by the House select committee on state‑owned assets.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 116‑37 reads as rewritten:
"§ 116‑37. University of North Carolina Health Care System.
(a) Creation of System. –
(1) There is hereby established the University of North
Carolina Health Care System, effective November 1, 1998, which shall be governed
and administered as an affiliated enterprise of The University of North
Carolina governed by the Board of Governors and administered by the board of
directors created in subsection (b) of this section. Consistent with State
statutes and policy and without unduly competing with non‑State-owned
health care systems, the purpose of the University of North Carolina Health
Care System is to in accordance with the provisions of this section, to
provide patient care, facilitate the education of physicians and other health
care providers, conduct research collaboratively with the health sciences
schools of the University of North Carolina at Chapel Hill, and render other
services designed to promote the health and well‑being of the citizens of
North Carolina. meet the goals of education, research, patient care, and
community service.
(2) As of November 1, 1998, all of the rights, privileges, liabilities, and obligations of the board of directors of the University of North Carolina Hospitals at Chapel Hill, not inconsistent with the provisions of this section, shall be transferred to and assumed by the board of directors of the University of North Carolina Health Care System.
(3) The University of North Carolina Hospitals at Chapel Hill and the clinical patient care programs established or maintained by the School of Medicine of the University of North Carolina at Chapel Hill shall be governed by the Board of Governors and administered by the board of directors of the University of North Carolina Health Care System.
(4) With respect to the provisions of subsections (d),
(e), (f), (h), (i), (j), and (k) of this section, the board of
directors Board of Governors may adopt or may delegate to the
board of directors the authority to adopt policies that make the
authorities and responsibilities established by one or more of said subsections
applicable to the University of North Carolina Hospitals at Chapel Hill, to the
clinical patient care programs of the School of Medicine of the University of
North Carolina at Chapel Hill, to both, or to other persons or entities
affiliated with or under the control of the University of North Carolina Health
Care System.
(5) To effect an orderly transition, the policies and procedures of the clinical patient care programs of the School of Medicine of the University of North Carolina at Chapel Hill and of the University of North Carolina Hospitals at Chapel Hill effective as of October 31, 1998, shall remain effective in accordance with their terms until changed by the Board of Directors of the University of North Carolina Health Care System.
(b) Board of Directors. – There is hereby
established a board of directors of the University of North Carolina Health Care
System, effective November 1, 1998.The Board of Governors of The
University of North Carolina is directed to reconstitute the board of directors
for the University of North Carolina Health Care System, effective November 1,
2012.
(1) The reconstituted board of directors shall be composed of 12 members as follows:
a. A minimum of sixThree members ex
officio of said board shall be the President of The University of North
Carolina (or the President's designee); the State Treasurer or the
Treasurer's designee; the Chief Executive Officer of the University of
North Carolina Health Care System; the Chancellor of the University of North
Carolina at Chapel Hill and one additional administrative officer of the
University of North Carolina at Chapel Hill designated by the Chancellor; and
two members of the faculty of the and the Dean of the School of
Medicine of the University of North Carolina at Chapel Hill designated by
the Dean of the School of Medicine; Hill; provided, that if the
Dean is already not such a member ex officio by virtue of holding
one or more of the offices aforementioned, additional ex officio memberships
shall be held by the President of the University of North Carolina Hospitals at
Chapel Hill, the faculty member responsible for leading the clinical
patient care programs of the School of Medicine, and the Dean of the School
of Medicine of the University of North Carolina at Chapel Hill. Medicine
shall serve as the third member ex officio.
b. No less than nine and no more than 21Nine
members at large, which number shall be determined by the board of
directors, large who shall be appointed by the Board of Governors
for four‑year terms, commencing on November 1 of the year of appointment;
provided, that appointment. In order to effectuate staggered terms and
to provide continuity of board membership, a minimum of five members of the
initial class of at‑large members of the reconstituted board shall
include be selected by the Board of Governors from the persons
who hold the appointed memberships on the board of directors of the University
of North Carolina Hospitals at Chapel HillHealth Care System
incumbent as of October 31, 1998,2012, whose terms shall expire on
October 31, 2014. with their terms of membership on the board of
directors of the University of North Carolina Health Care System to expire on
the last day of October of the year in which their term as a member of the
board of directors of the University of North Carolina Hospitals at Chapel Hill
would have expired.The Board of Governors shall appoint individuals to the
remaining at‑large positions of the reconstituted board whose terms shall
expire on October 31, 2016. Vacant As the terms of the initial at-large
members of the reconstituted board expire, the Board of Governors shall
appoint individuals to fill the vacant at‑large positions shall be
filled by the appointment of persons from the business and professional
public at large who have special competence in business management, hospital
administration, health care delivery, or medical practice or who otherwise have
demonstrated dedication to the improvement of health care in North Carolina,
and who are neither members of the Board of Governors, members of the board of
trustees of a constituent institution of The University of North Carolina, nor
officers or employees of the State. Members shall be appointed by the
President of the University, and ratified by the Board of Governors, from among
a slate of nominations made by the board of directors of the University of
North Carolina Health Care System. No member may be appointed to more than
two full four‑year terms in succession; provided, that persons holding
appointed memberships on November 1, 1998,2012, by virtue of
their previous membership on the board of directors of the University of North
Carolina Hospitals at Chapel Hill, Health Care System on October 31,
2012, shall not be eligible, for a period of one year following
expiration of their term, eligible to be reappointed to the board of
directors of the University of North Carolina Health Care System. Any vacancy
in an unexpired term shall be filled by an appointment made by the
President, and ratified by the Board of Governors, upon the nomination
of the board of directors,Governors for the balance of the term
remaining.
(2) The board of directors, with each ex officio and at‑large
member having a vote, shall elect a chairman only from among the at‑large
members, for a term of two years. Notwithstanding the foregoing limitation,
the Chancellor of the University of North Carolina at Chapel Hill may serve as
Chairman. No person shall be eligible to serve as chairman for more than
three terms in succession.
(3) The board of directors of the University of North Carolina Health Care System shall meet at least every 60 days and may hold special meetings at any time and place within the State at the call of the chairman. Board members, other than ex officio members, shall receive the same per diem and reimbursement for travel expenses as members of the State boards and commissions generally.
(4) In meeting the patient‑care, educational,
research, and public‑service goals of the University of North Carolina
Health Care System, the Board of Governors board of directors is
authorized or may delegate to the board of directors the authority to exercise
such authority and responsibility to adopt policies, rules, and regulations
that are as it deems necessary and appropriate, not inconsistent
with the provisions of this section or the policies of the Board of Governors
or, to the extent the board's actions affect employees of the University
of North Carolina at Chapel Hill, not inconsistent with the policies of
the University of North Carolina at Chapel Hill. The Board of Governors board
may authorize or may delegate to the board of directors the authority to
authorize any component of the University of North Carolina Health Care
System, including the University of North Carolina Hospitals at Chapel Hill, to
contract in its individual capacity, subject to such policies and procedures as
the board of directors may direct. The board of directors may enter into formal
agreements with the University of North Carolina at Chapel Hill with respect to
the provision of clinical experience for students and for the provision of
maintenance and supporting services. The board's action on matters within its
jurisdiction is final, except that appeals may be made, in writing, to the
Board of Governors with a copy of the appeal to the Chancellor of the
University of North Carolina at Chapel Hill. The board of directors shall keep
the Board of Governors and the board of trustees of the University of North
Carolina at Chapel Hill fully informed about health care policy and recommend
changes necessary to maintain adequate health care delivery, education, and
research for improvement of the health of the citizens of North Carolina.
(c) Officers. –
(1) The executive and administrative head of the University of North Carolina Health Care System shall have the title of "Chief Executive Officer." The board of directors, the board of trustees, and the Chancellor of the University of North Carolina at Chapel Hill, following such search process as the boards and the Chancellor deem appropriate, shall identify two or more persons as candidates for the office, who, pursuant to criteria agreed upon by the boards and the Chancellor, have the qualifications for both the positions of Chief Executive Officer of the University of North Carolina Health Care System and Vice‑Chancellor for Medical Affairs of the University of North Carolina at Chapel Hill. The names of the candidates so identified, once approved by the board of directors and the board of trustees, shall be forwarded by the Chancellor to the President of The University of North Carolina, who if satisfied with the quality of one or more of the candidates, will nominate one as Chief Executive Officer, subject to selection by the Board of Governors. The individual serving as Chief Executive Officer shall have complete executive and administrative authority to formulate proposals for, recommend the adoption of, and implement policies governing the programs and activities of the University of North Carolina Health Care System, subject to all requirements of the board of directors. That same individual, when serving as Vice‑Chancellor for Medical Affairs, shall have all authorities, rights, and responsibilities of a vice‑chancellor of the University of North Carolina at Chapel Hill.
(2) The executive and administrative head of the University of North Carolina Hospitals at Chapel Hill shall have the title of "President of the University of North Carolina Hospitals at Chapel Hill."
(3) The board of directors shall elect, on nomination of the Chief Executive Officer, the President of the University of North Carolina Hospitals at Chapel Hill, and such additional administrative and professional staff employees of the University of North Carolina Health Care System as may be deemed necessary to assist in fulfilling the duties of the office of the Chief Executive Officer, all of whom shall serve at the pleasure of the Chief Executive Officer.
(d) Personnel. – Employees of the University of North Carolina Health Care System shall be deemed to be employees of the State and shall be subject to all provisions of State law relevant thereto; provided, however, that except as to the provisions of Articles 5, 6, 7, and 14 of Chapter 126 of the General Statutes, the provisions of Chapter 126 shall not apply to employees of the University of North Carolina Health Care System, and the policies and procedures governing the terms and conditions of employment of such employees shall be adopted by the board of directors; provided, that with respect to such employees as may be members of the faculty of the University of North Carolina at Chapel Hill, no such policies and procedures may be inconsistent with policies established by, or adopted pursuant to delegation from, the Board of Governors of The University of North Carolina.
(1) The board of directors Board of Governors
shall fix or approve or may delegate to the board of directors the
authority to fix or approve the schedules of pay, expense allowances, and
other compensation and adopt position classification plans for employees of the
University of North Carolina Health Care System.
(2) The board of directors Board of Governors
may adopt or provide or may delegate to the board of directors the
authority to adopt or provide for rules and regulations concerning, but not
limited to, annual leave, sick leave, special leave with full pay or with
partial pay supplementing workers' compensation payments for employees injured
in accidents arising out of and in the course of employment, working
conditions, service awards and incentive award programs, grounds for dismissal,
demotion, or discipline, other personnel policies, and any other measures that
promote the hiring and retention of capable, diligent, and effective career
employees. However, an employee who has achieved career State employee status
as defined by G.S. 126‑1.1 by October 31, 1998, shall not have his
or her compensation reduced as a result of this subdivision. Further, an
employee who has achieved career State employee status as defined by G.S. 126‑1.1
by October 31, 1998, shall be subject to the rules regarding discipline or
discharge that were effective on October 31, 1998, and shall not be subject to
the rules regarding discipline or discharge adopted after October 31, 1998.
(3) The board of directorsBoard of Governors may
prescribe or may delegate to the board of directors the authority to
prescribe the office hours, workdays, and holidays to be observed by the
various offices and departments of the University of North Carolina Health Care
System.
(4) The board of directorsBoard of Governors may
establish or may delegate to the board of directors the authority to
establish boards, committees, or councils to conduct hearings upon the
appeal of employees who have been suspended, demoted, otherwise disciplined, or
discharged, to hear employee grievances, or to undertake any other duties
relating to personnel administration that the board of directors may direct.
The board of directors shall submit all initial
classification and pay plans and other rules and regulations adopted pursuant
to subdivisions (1) through (4) of this subsection to the Office of State Personnel
for review upon adoption by the board. Any subsequent changes to these plans,
rules, and policies adopted by the board shall be submitted to the
Office of State Personnel for review. Any comments by the Office of State
Personnel shall be submitted to the Chief Executive Officer and to the
President of The University of North Carolina.
(e) Finances. – The University of North Carolina
Health Care System shall be subject to the provisions of the State Budget Act,
except for trust funds as provided in G.S. 116‑36.1 and G.S. 116‑37.2.
Act. The Chief Executive Officer, subject to the board of
directors, Board of Governors, shall be responsible for all aspects
of budget preparation, budget execution, and expenditure reporting. All
operating funds of the University of North Carolina Health Care System may be
budgeted and disbursed through special fund codes, maintaining separate
auditable accounts for the University of North Carolina Hospitals at Chapel
Hill and the clinical patient care programs of the School of Medicine of the
University of North Carolina at Chapel Hill. All receipts of the University of
North Carolina Health Care System may be deposited directly to the special fund
codes, and except for General Fund appropriations, all receipts of the University
of North Carolina Hospitals at Chapel Hill may be invested pursuant to G.S. 116‑37.2(h).
General Fund appropriations for support of the University of North Carolina
Hospitals at Chapel Hill shall be budgeted in a General Fund code under a
single purpose, "Contribution to University of North Carolina Hospitals at
Chapel Hill Operations" and be transferable to a special fund operating
code as receipts.
(f) Finances – Patient/Health Care System Benefit. – The Chief Executive Officer of the University of North Carolina Health Care System, or the Chief Executive Officer's designee, may expend operating budget funds, including State funds, of the University of North Carolina Health Care System for the direct benefit of a patient, when, in the judgment of the Chief Executive Officer or the Chief Executive Officer's designee, the expenditure of these funds would result in a financial benefit to the University of North Carolina Health Care System. Any such expenditures are declared to result in the provision of medical services and create charges of the University of North Carolina Health Care System for which the health care system may bill and pursue recovery in the same way as allowed by law for recovery of other health care systems' charges for services that are unpaid.
These expenditures shall be restricted (i) to situations in which a patient is financially unable to afford ambulance or other transportation for discharge; (ii) to afford placement in an after‑care facility; (iii) to assure availability of a bed in an after‑care facility after discharge from the hospitals; (iv) to secure equipment or other medically appropriate services after discharge; or (v) to pay health insurance premiums. The Chief Executive Officer or the Chief Executive Officer's designee shall reevaluate at least once a month the cost‑effectiveness of any continuing payment on behalf of a patient.
To the extent that the University of North Carolina Health Care System advances anticipated government entitlement benefits for a patient's benefit, for which the patient later receives a lump‑sum "back‑pay" award from an agency of the State, whether for the current admission or subsequent admission, the State agency shall withhold from this back pay an amount equal to the sum advanced on the patient's behalf by the University of North Carolina Health Care System, if, prior to the disbursement of the back pay, the applicable State program has received notice from the University of North Carolina Health Care System of the advancement.
(f1) Provision of Indigent Care. – The University of North Carolina Health Care System shall provide a proportionate share of the indigent care, as compared with non‑State-owned health care systems, in each county where it provides medical services. By July 1, 2013, the Board of Governors, in conjunction with the North Carolina Hospital Association, shall develop methods to measure the provision of indigent care services that allow for direct and accurate comparison between health care systems.
(g) Reports. – The Chief Executive Officer and the
President of The University of North Carolina jointly shall report by
September 30 of each year on the operations and financial affairs of the
University of North Carolina Health Care System to the Board of Governors.
The Board of Governors shall report by November 30 of each year on the
operations and financial affairs of the University of North Carolina Health
Care System to the Joint Legislative Commission on Governmental Operations.
The report shall include the actions taken by the Board of Governors or the
board of directors under the authority granted in subsections (d), (h), (i),
and (j) subsection (d) of this section.
All nonprofit corporations that are part of the University of North Carolina Health Care System must complete an Internal Revenue Service Form 990 annually and submit a copy to the Board of Governors.
(h) Purchases. – Notwithstanding the
provisions of Articles 3, 3A, and 3C of Chapter 143 of the General Statutes to
the contrary, the board of directors shall establish policies and regulations
governing the purchasing requirements of the University of North Carolina
Health Care System. These policies and regulations shall provide for requests
for proposals, competitive bidding, or purchasing by means other than
competitive bidding, contract negotiations, and contract awards for purchasing
supplies, materials, equipment, and services which are necessary and
appropriate to fulfill the clinical, educational, research, and community
service missions of the University of North Carolina Health Care System. The
board of directors shall submit all initial policies and regulations adopted
pursuant to this subsection to the Division of Purchase and Contract for review
upon adoption by the board. Any subsequent changes to these policies and
regulations adopted by the board shall be submitted to the Division of Purchase
and Contract for review. Any comments by the Division of Purchase and Contract
shall be submitted to the Chief Executive Officer and to the President of The University
of North Carolina.
(i) Property. – The board of directors
shall establish rules and regulations for acquiring or disposing of any
interest in real property for the use of the University of North Carolina
Health Care System. These rules and regulations shall include provisions for
development of specifications, advertisement, and negotiations with owners for
acquisition by purchase, gift, lease, or rental, but not by condemnation or
exercise of eminent domain, on behalf of the University of North Carolina
Health Care System. This section does not authorize the board of directors to
encumber real property. The board of directors shall submit all initial
policies and regulations adopted pursuant to this subsection to the State
Property Office for review upon adoption by the board. Any subsequent changes
to these policies and regulations adopted by the board shall be submitted to
the State Property Office for review. Any comments by the State Property Office
shall be submitted to the Chief Executive Officer and to the President of The
University of North Carolina. After review by the Attorney General as to form
and after the consummation of any such acquisition, the University of North
Carolina Health Care System shall promptly file a report concerning the
acquisition or disposition with the Governor and Council of State. Acquisitions
and dispositions of any interest in real property pursuant to this section
shall not be subject to the provisions of Article 36 of Chapter 143 of the
General Statutes or the provisions of Chapter 146 of the General Statutes.
(j) Property – Construction. –
Notwithstanding G.S. 143‑341(3) and G.S. 143‑135.1, the
board of directors shall adopt policies and procedures with respect to the
design, construction, and renovation of buildings, utilities, and other
property developments of the University of North Carolina Health Care System
requiring the expenditure of public money for:
(1) Conducting the fee negotiations for all
design contracts and supervising the letting of all construction and design
contracts.
(2) Performing the duties of the Department
of Administration, the Office of State Construction, and the State Building
Commission under G.S. 133‑1.1(d), Article 8 of Chapter 143 of the
General Statutes, and G.S. 143‑341(3).
(3) Using open‑end design agreements.
(4) As appropriate, submitting construction
documents for review and approval by the Department of Insurance and the
Division of Health Service Regulation of the Department of Health and Human
Services.
(5) Using the standard contracts for design
and construction currently in use for State capital improvement projects by the
Office of State Construction of the Department of Administration.
The board of directors shall submit all initial policies
and procedures adopted under this subsection to the Office of State
Construction for review upon adoption by the board. Any subsequent changes to
these policies and procedures adopted by the board shall be submitted to the
Office of State Construction for review. Any comments by the Office of State
Construction shall be submitted to the Chief Executive Officer and to the
President of The University of North Carolina.
(k) Patient Information. – The University of North Carolina Health Care System shall, at the earliest possible opportunity, specifically make a verbal and written request to each patient to disclose the patient's social security number, if any. If the patient does not disclose that number, the University of North Carolina Health Care System shall deny benefits, rights, and privileges of the University of North Carolina Health Care System to the patient as soon as practical, to the maximum extent permitted by federal law or federal regulations. The University of North Carolina Health Care System shall make the disclosure to the patient required by Section 7(b) of P.L. 93‑579. This subsection is supplementary to G.S. 105A‑3(c).
(l) Expansion. – The University of North Carolina Health Care System shall not use any funds available to it, whether fees for provision of services, reserves, or assessments of entities affiliated with the system, to expand the geographic areas where it provides services without the specific authorization of the General Assembly. "
SECTION 2. G.S. 116‑37.2(b) reads as written:
"(b) The Board of Directors Governors is
responsible or may delegate the responsibility to the board of directors of
the University of North Carolina Health Care System, as established in G.S. 116‑37(b),
is responsible for the custody and management of the funds of the
University of North Carolina Hospitals at Chapel Hill. The Board of
Governors shall adopt or may delegate the authority to the board of
directors to adopt uniform policies and procedures applicable to the
deposit, investment, and administration of these funds, which shall assure that
the receipt and expenditure of such funds is properly authorized and that the
funds are appropriately accounted for. The Board of Governors may
delegate authority, through the Chief Executive Officer of the University of
North Carolina Health Care System to the President of the University of North
Carolina Hospitals at Chapel Hill, when such delegation is necessary or prudent
to enable the University of North Carolina Hospitals at Chapel Hill to function
in a proper and expeditious manner."
SECTION 3. G.S. 116‑37.2(h) reads as rewritten:
"(h) The Board of Governors may deposit or
invest, or may delegate to the board of directors the authority to deposit or
invest, Directors of the University of North Carolina Health Care System
may deposit or invest the funds under this section in interest‑bearing
accounts and other investments in the exercise of its sound discretion, without
regard to any statute or rule of law relating to the investment of funds by
fiduciaries."
SECTION 4. G.S. 143‑56 reads as rewritten:
"§ 143‑56. Certain purchases excepted from provisions of Article.
Unless as may otherwise be ordered by the Secretary of Administration, the purchase of supplies, materials and equipment through the Secretary of Administration shall be mandatory in the following cases:
(1) Published books, manuscripts, maps, pamphlets and periodicals.
(2) Perishable articles such as fresh vegetables, fresh fish, fresh meat, eggs, and others as may be classified by the Secretary of Administration.
Purchase through the Secretary of Administration shall not be
mandatory for information technology purchased in accordance with Article 3D of
Chapter 147 of the General Statutes, for a purchase of supplies, materials or
equipment for the General Assembly if the total expenditures is less than the
expenditure benchmark established under the provisions of G.S. 143‑53.1,
for group purchases made by hospitals, developmental centers, neuromedical
treatment centers, and alcohol and drug abuse treatment centers through a
competitive bidding purchasing program, as defined in G.S. 143‑129, by
the University of North Carolina Health Care System pursuant to G.S. 116‑37(h),
by the University of North Carolina Hospitals at Chapel Hill pursuant to G.S. 116‑37(a)(4),
by the University of North Carolina at Chapel Hill on behalf of the clinical
patient care programs of the School of Medicine of the University of North
Carolina at Chapel Hill pursuant to G.S. 116‑37(a)(4), or by
East Carolina University on behalf of the Medical Faculty Practice Plan
pursuant to G.S. 116‑40.6(c).
All purchases of the above articles made directly by the departments, institutions and agencies of the State government shall, whenever possible, be based on competitive bids. Whenever an order is placed or contract awarded for such articles by any of the departments, institutions and agencies of the State government, a copy of such order or contract shall be forwarded to the Secretary of Administration and a record of the competitive bids upon which it was based shall be retained for inspection and review."
SECTION 5. G.S. 146‑22(c) reads as rewritten:
"(c) Acquisitions on behalf of the University
of North Carolina Health Care System shall be made in accordance with G.S. 116‑37(i),
acquisitions on behalf of the University of North Carolina Hospitals at Chapel
Hill shall be made in accordance with G.S. 116‑37(a)(4),
acquisitions on behalf of the clinical patient care programs of the School of
Medicine of The University of North Carolina at Chapel Hill shall be made in
accordance with G.S. 116‑37(a)(4), and acquisitions on behalf of
the Medical Faculty Practice Plan of the East Carolina University School of
Medicine shall be made in accordance with G.S. 116‑40.6(d)."
SECTION 6. This act becomes effective October 1, 2012.