date of the termination in order to enable the meeting to be held.

(5) Upon completion of the meeting, the designated official shall promptly recommend to the Secretary whether or not such termination should become effective.

(6) If the Secretary, taking into consideration any information submitted and the recommendation of the designated official, determines that good cause for termination does not exist, he will withdraw the notice of termination and notify the member of his decision.

(7) If the Secretary determines that good cause does exist, he will confirm the termination date by written notice to the member.

(d) Vacancy. When a vacancy on the Statewide Council occurs, whether by reason of expiration of membership term, death, resignation or termination, the Secretary will fill the vacancy in accordance with the applicable procedures specified in § 478.4. If a vacancy occurs for reasons other than expiration of membership term, appointment will be made for the remainder of the unexpired term.

§ 478.6 Duties and functions.

(a) Coordination of PSRO activities. Each Statewide Council shall coordinate the activities of the PSROS in its State to assure efficient PSRO operations and to support combined PSRO efforts in activities of mutual concern to the PSROS in the State. Each Statewide Council shall also assist PSROS to coordinate their activities with other health activities in the State. These coordination activities shall involve (1) identifying where cooperative efforts between or among PSROS are needed, (2) determining with the PSROS the appropriate mechanisms for coordination, and (3) assuring that the necessary support services for implementation are provided.

(b) Dissemination of information. (1) Each Statewide Council shall disseminate information and data, with reasonable frequency and in a reasonable form, among the PSROS in its State.

(2) Dissemination may include: (i) Data and information which are avail

able from other agencies and organizations and are relevant to PSRO operations; and (ii) data and information generated within the PSRO program, consistent with section 1166 of the Act and applicable confidentiality regulations of this part.

(3) This activity shall involve: (i) Identifying the information and data desired by PSROS; (ii) the sources of such information and data, and the appropriate methods of making such information and data available; and (iii) assuring that the necessary support services are provided so that the dissemination occurs in an effective manner.

(c) Data gathering procedures and operating procedures. Each Statewide Council shall, at the request of the Secretary or the PSROS, assist in:

(1) Developing and coordinating effective uniform PSRO data collection and processing procedures among the PSROS in the State; and

(2) Coordinating PSRO data activities in the State with other programs of the Department of Health, Education, and Welfare, including Cooperative Health Systems, Health Systems Agencies, and the programs under Titles V, XVIII, and XIX of the Act.

(d) Evaluation. Each Statewide Council shall assist the Secretary at his request in evaluating the performance of the PSROS in its State according to criteria and procedures developed by the Secretary in consultation with the Statewide Council.

(e) Replacement of a PSRO. If the Secretary finds it necessary to replace a PSRO in a State where a Statewide Council exists, the Statewide Council in such State shall assist in developing and arranging for a qualified replacement PSRO.

(f) Assistance in assuring practitioner and provider compliance. (1) Each Statewide Council shall help assure compliance with the obligations imposed by section 1160(a) of the Act on practitioners and other providers of health care services for which payment may be made under Title V, XVIII, or XIX of the Act.

(2) In order to carry out this responsibility, the Council shall, in accordance with section 1161(c) of the Act:

(i) Use whatever authority or influence it may possess as a professional organization;

(ii) Enlist the support of other professional or governmental organizations;

(iii) Use educational and other appropriate means; and

(iv) Work cooperatively with PSROS in the State.

(g) Appeals. When an adverse PSRO determination has been reconsidered and reaffirmed pursuant to section 1159(a) of the Act and the amount in controversy is $100 or more, the professional members of each Statewide Council shall review such determination on appeal, in accordance with regulations to be published by the Secretary.

(h) Sanctions. Each Statewide Council shall

(1) Receive reports and recommendations from PSROS under section 1157 of the Act concerning violations of obligations under Section 1160(a) of the Act; and

(2) Promptly transmit those reports to the Secretary, with any comments or recommendations they deem appropriate, in accordance with regulations to be published by the Secretary.

(i) Confidentiality of data. (1) The purpose of the confidentiality requirements is to assure adequate protection of the rights and interests of patients, health care practitioners, and providers of health care.

(2) The confidentiality requirements apply to:

(i) Any information acquired by the Statewide Council in the exercise of its own duties and functions or through the exercise of PSRO functions and duties; and

(ii) Sanction reports and recommendations made by the Statewide Council.

(3) The information specified in paragraph (h)(2)(i) of this section shall not be disclosed to any person except:

(i) To the extent that may be necessary to carry out the purposes of Title XI, Part B of the Act and of this subpart; or

(b) Articles of Incorporation. The Articles of Incorporation of each Statewide Council and any subsequent amendments thereto, shall be approved by the Secretary prior to filing and shall be in conformance with State law, Title XI, Part B of the Act, and the requirements of this part.

(c) Bylaws. Bylaws of each

Statewide Council shall be in conformance with the requirements of this part.

(d) Purposes. The purposes of the Statewide Council shall be limited to those duties and functions specified in § 478.6, except where other functions related to such purposes shall be specifically approved by the Secretary.

(e) Income. (1) The sole sources of income of each Statewide Council shall be (i) the funds paid by the Secretary under section 1162(d) of Title XI of the Act; and (ii) any other sources of funding approved by the Secretary.

(2) Neither the whole, nor any portion of the assets or income of the Statewide Council shall be used for objects or purposes other than those set forth in § 478.6 or those specifically approved by the Secretary.

(f) Officers. Each Statewide Council shall elect a chairperson and such other officers from its membership as it deems necessary.

(g) Committees. (1) Each Statewide Council shall establish an Advisory Group Nominating Committee as provided for under section 1162(e) of the Act.

(2) A Statewide Council may establish an Executive Committee which

shall consist of members of the Statewide Council including at least one PSRO representative, one physician representative, and one public

representative.

(3) The composition, selection, powers, duties, and membership terms of each standing committee of a Statewide Council shall be defined in its bylaws. The bylaws shall specify a procedure for the establishment of ad hoc committees.

(4) A Statewide Council may appoint non-Statewide Council members to ad hoc committees, but non-Statewide Council members may not serve as members of Statewide Council standing committees.

(h) Advisory Group. Each Statewide Council shall actively seek advice from its Statewide Council Advisory Group, established pursuant to section 1162(e) of the Act.

(i) Planning PSROs. The Statewide Council may seek advice, regarding Council activities, from any organization within the State that has an agreement with the Secretary to prepare to meet the requirements for designation as a PSRO (section 1169 of the Act).

(j) Executive Secretary. The Statewide Council shall select and appoint an Executive Secretary to be employed on either a full or part-time basis.

§ 478.8 Operational requirements.

(a) Calling of meetings. (1) The Chairperson of each Statewide Council shall convene a meeting of its members at least 4 times a year, and as often as necessary in order to perform those functions specified in § 478.6.

(2) Each Statewide Council shall establish a method for the calling of a special meeting of the full Statewide Council.

(3) Meetings shall be held at a reasonable time and at a reasonable place with an adequate amount of space to allow for public access to, and participation in, said meetings to the extent not inconsistent with the provisions of paragraph (d) of this section.

(b) Quorum and voting. (1) Each Statewide Council shall determine quorum and voting requirements for meetings of the whole Statewide

Council and for meetings of the committees consistent with the provisions of State law applicable to the corporation.

(2) For Statewide Council matters there shall be no proxy voting, whereby the voting privilege of one member is exercised by another person.

(c) Notice of meetings. (1) Each Statewide Council shall provide public notice of each of its regular meetings and, to the extent practicable, for each special meeting.

(2) The notice shall indicate at least: (i) The time, date, place, and purpose of the meeting; and

(ii) The extent to which the public will be permitted to attend or participate in the meeting.

(3) If all or part of the meeting is to be closed to the public, the notice shall state the reason for closing.

(d) Public participation at meetings. (1) All or part of Statewide Council meetings shall be open to the public, except when the meeting concerns:

(i) Review of sanction reports or recommendations, forwarded to the Statewide Council pursuant to section 1157 of the Act;

(ii) Review of PSRO reconsiderations pursuant to section 1159(a) of the Act;

(iii) Information which could cause financial injury if disclosed;

(iv) Internal personnel rules and practices of the Statewide Council;

(v) Financial information obtained from a person and privileged or confidential;

(vi) Matters prohibited from disclosure by statute;

(vii) Information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; and

(viii) Information that, if prematurely disclosed, would be likely to significantly frustrate implementation of a Statewide Council action, unless:

(A) The Council has already disclosed to the public the content or nature of the action; or

(B) The Council is required by law to disclose the information prior to taking final Statewide Council action.

(2) Before or after a meeting, members of the public shall be permitted

to file written statements with the Statewide Council.

(3) To the extent that the time available permits, and subject to the chairperson's approval for such participation, members of the public may make oral statements during the meeting.

(e) Conflicts of interest. (1) Each Statewide Council shall establish a procedure for announcing and deciding upon conflicts of interest. This procedure shall be specified in the bylaws.

(2) Restrictions on the participation of Statewide Council members in review of PSRO reconsiderations pursuant to section 1159(a) of the Act and in the review of Sanction reports pursuant to section 1157 of the Act are provided in Part 473 and regulations to be issued by the Secretary.

(f) Summaries of proceedings. (1) Summaries of proceedings of all meetings of the Statewide Council and of meetings of its standing and ad hoc committees shall be prepared prompt

ly.

(4) Other pertinent information which the Secretary may reasonably require.

(b) Each Statewide Council shall make such regular and special reports, in addition to the report required by paragraph (a) of this section, in such form and containing such information as the Secretary may reasonably require.

§ 478.10 Statewide Council Agreements.

(a) The Secretary will enter into an agreement with each Statewide Council appointed in accordance with this part.

(b) Each Statewide Council agreement shall provide that:

(1) The organization is designated by the Secretary as the Statewide Council for a particular State;

(2) The organization will perform all the duties and functions of Statewide Council under Title XI, Part B of the Act and the applicable regulations of this subchapter;

(3) The Secretary will make payments to the Statewide Council equal to the amount of expenses it has reasonably and necessarily incurred in carrying out the duties and functions specified in Part B of Title XI of the Act and in this part.

(4) The reasonableness and necessity of incurred expenditures and the reimbursement policies will be determined by the Secretary.

(5) The organization will establish an advisory group pursuant to section 1162 (e) of the Act; and

(6) The agreement may be terminated by the Secretary upon 90 days notice to the Statewide Council. 1

PART 479 [RESERVED]

1

'Attention is called to the requirements of Executive Order 11246 (42 U.S.C. 2000e) which prohibits discriminating against any employee or applicant for employment because of race, color, religion, sex or national origin. Regulations implementing such Executive Order 11246, which are applicable to Statewide Councils under this subpart, have been issued by the Secretary of Labor (41 CFR Chapter 60).

(a) Composition, Terms and Qualifications. (1) Each Advisory Group shall have a minimum of seven and a maximum of eleven members.

(2) Advisory Group members shall be appointed for terms of one year. An appointed member shall not be eligible to serve more than three consecutive full terms. To the extent practicable, no more than one-half of the members of an Advisory Group shall be appointed for an initial term in any year subsequent to the first year.

(3) The membership of e: ch Advisory Group shall consist of representatives of health care practitioners (other than physicians), of hospitals and of other health care facilities which provide within the Professional Standards Review Organization area health care services for which payment, in whole or in part, may be made under titles V, XVIII, of XIX of the Act and who are knowledgeable about the types of health care services being reviewed in the Professional Standards Review Organization area.

In addition, the membership of each Advisory Group shall meet the following requirements:

(i) Representatives of health care practitioners (other than physicians). At least one-half of the members of each Advisory Group shall be representatives of health care practitioners (other than physicians). For purposes of this part, health care practitioners (other than physicians) are those health professionals who do not hold a Doctor of Medicine or Doctor of Osteopathy degree, meet all applicable State or Federal requirements for practice of their profession, and are actively involved in the delivery of patient care or services which are directly or indirectly paid for under titles V, XVIII and/or XIX of the Act. Each such representative shall practice his or her profession in the Professional Standards Review Organization area.

(ii) Representatives of hospitals. One or more members of each Advisory Group shall be representatives of hospitals. Each such representative shall be actively involved in the administration of or provision of services in a hospital which is located in the Professional Standards Review Organization area, and which has arrangements for reimbursement for services under titles V, XVIII and/or XIX of the Act.

(iii) Representatives of other health care facilities. One or more members of each Advisory Group shall be representatives of health care facilities other than hospitals. At least one such member shall be a representative of a skilled nursing facility (as defined in section 1861(j) of the Act) or of an intermediate care facility (as defined in 42 CFR 449.10(b)(15)). Each such representative shall be actively involved in the administration of or provision of services in a health care facility other than a hospital which is located in the Professional Standards Review Organization area and which has in effect arrangements for reimbursement for services under titles V, XVIII and/or XIX of the Act.

(b) Selection procedures. (1) Each Professional Standards Review Organization in a State not having a Statewide Professional Standards