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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.