Bill Text: MS HB1305 | 2021 | Regular Session | Introduced


Bill Title: Health Care Certificate of Need Law; repeal.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2021-02-02 - Died In Committee [HB1305 Detail]

Download: Mississippi-2021-HB1305-Introduced.html

MISSISSIPPI LEGISLATURE

2021 Regular Session

To: Public Health and Human Services

By: Representative Yancey

House Bill 1305

AN ACT TO REPEAL SECTIONS 41-7-171 THROUGH 41-7-209, MISSISSIPPI CODE OF 1972, WHICH ARE THE MISSISSIPPI HEALTH CARE CERTIFICATE OF NEED LAW OF 1979; TO AMEND SECTIONS 23-15-625, 25-41-7, 35-1-19, 41-3-15, 41-4-18, 41-9-11, 41-9-23, 41-9-68, 41-9-209, 41-9-210, 41-71-7, 41-71-19, 41-73-5, 41-75-1, 41-75-5, 41-75-9, 41-75-25, 41-77-1, 41-77-5, 41-77-21, 41-77-23, 41-77-25, 41-95-3, 43-11-9, 43-11-19 AND 57-117-5, MISSISSIPPI CODE OF 1972, AND TO REPEAL SECTION 41-9-311, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISION; AND FOR RELATED PURPOSES.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

     SECTION 1.  Sections 41-7-171, 41-7-173, 41-7-175, 41-7-183, 41-7-185, 41-7-187, 41-7-188, 41-7-189, 41-7-190, 41-7-191, 41-7-193, 41-7-195, 41-7-197, 41-7-201, 41-7-202, 41-7-205, 41-7-207 and 41-7-209, Mississippi Code of 1972, which are the Mississippi Health Care Certificate of Need Law of 1979, are repealed.

     SECTION 2.  Section 23-15-625, Mississippi Code of 1972, is amended as follows:

     23-15-625.  (1)  The registrar shall be responsible for providing applications for absentee voting as provided in this section.  At least sixty (60) days before any election in which absentee voting is provided for by law, the registrar shall provide a sufficient number of applications.  In the event a special election is called and set at a date which makes it impractical or impossible to prepare applications for absent elector's ballot sixty (60) days before the election, the registrar shall provide applications as soon as practicable after the election is called.  The registrar shall fill in the date of the particular election on the application for which the application will be used.

     (2)  The registrar shall be authorized to disburse applications for absentee ballots to any qualified elector within the county where he or she serves.  Any person who presents to the registrar an oral or written request for an absentee ballot application for a voter entitled to vote absentee by mail, other than the elector who seeks to vote by absentee ballot, shall, in the presence of the registrar, sign the application and print on the application his or her name and address and the name of the elector for whom the application is being requested in the place provided for on the application for that purpose.  However, if for any reason such person is unable to write the information required, then the registrar shall write the information on a printed form which has been prescribed by the Secretary of State.  The form shall provide a place for such person to place his or her mark after the form has been filled out by the registrar.

     (3)  It shall be unlawful for any person to solicit absentee ballot applications or absentee ballots for persons staying in any skilled nursing facility * * * as defined in Section 41‑7‑173 unless the person soliciting the absentee ballot applications or absentee ballots is:

          (a)  A family member of the person staying in the skilled nursing facility; or

          (b)  A person designated by the person for whom the absentee ballot application or absentee ballot is sought, the registrar or the deputy registrar.

     As used in this subsection, "family member" means a spouse, parent, grandparent, sibling, adult child, grandchild or legal guardian.

     (4)  The registrar in the county wherein a voter is qualified to vote upon receiving by mail the envelope containing the absentee ballots shall keep an accurate list of all persons preparing such ballots.  The list shall be kept in a conspicuous place accessible to the public near the entrance to the registrar's office.  The registrar shall also furnish to each precinct manager a list of the names of all persons in each respective precinct voting absentee by mail and in person to be posted in a conspicuous place at the polling place for public notice.  The application on file with the registrar and the envelopes containing the ballots that voters mailed to the registrar shall be kept by the registrar in his or her office in a secure location.  At the time such boxes are delivered to the election commissioners or managers, the registrar shall also turn over a list of all such persons who have voted and whose mailed ballots are in the registrar's office.

     (5)  The registrar shall also be authorized to mail one (1) application to any qualified elector of the county, who is eligible to vote by absentee ballot, for use in a particular election.

     (6)  The registrar shall process all applications for absentee ballots by using the Statewide Election Management System.  The registrar shall account for all absentee ballots delivered to and received by mail as well as those who voted absentee in person from qualified voters by processing such ballots using the Statewide Election Management System.

     SECTION 3.  Section 35-1-19, Mississippi Code of 1972, is amended as follows:

     35-1-19.  There is * * *hereby authorized to be established by the State Veterans Affairs Board, the Mississippi State Veterans Home on a site to be determined by the State Veterans Affairs Board, with the approval of the Bureau of Building, Grounds and Real Property Management of the * * *Governor's Office of General Services Department of Finance and Administration, when funds are made available for such purpose by any agency of the federal government or other sources.  The object and purpose of the establishment of the Mississippi State Veterans Home shall be to provide domiciliary care and other related services for eligible veterans of the State of Mississippi.

     One or more additional veterans homes or domiciliaries are hereby authorized to be established by the State Veterans Affairs Board on sites in northern, central or southern Mississippi, to be determined by the State Veterans Affairs Board, with the approval of the Department of Finance and Administration, when funds are made available for such purpose by any agency of the federal government or other sources.  The Veterans Affairs Board shall give the three (3) regions, northern, southern and central priority as to where the veterans home shall be located, with the northern region having first priority, the southern region having the next level priority and the central region being third in order of priority.  The object and purpose of the establishment of such additional homes or domiciliaries shall be to provide domiciliary care and other related services for eligible veterans of the State of Mississippi. * * * The State Veterans Affairs Board shall not be required to obtain certificates of need to carry out the intent and purpose of this section.

     SECTION 4.  Section 25-41-7, Mississippi Code of 1972, is amended as follows:

     25-41-7.  (1)  Any public body may enter into executive session for the transaction of public business; however, all meetings of any public body shall commence as an open meeting, and an affirmative vote of three-fifths (3/5) of all members present shall be required to declare an executive session.

     (2)  The procedure to be followed by any public body in declaring an executive session shall be as follows:  Any member shall have the right to request by motion a closed determination upon the issue of whether or not to declare an executive session.  The motion, by majority vote, shall require the meeting to be closed for a preliminary determination of the necessity for executive session.  No other business shall be transacted until the discussion of the nature of the matter requiring executive session has been completed and a vote, as required in subsection (1) hereof, has been taken on the issue.

     (3)  An executive session shall be limited to matters allowed to be exempted from open meetings by subsection (4) of this section.  The reason for holding an executive session shall be stated in an open meeting, and the reason so stated shall be recorded in the minutes of the meeting.  Nothing in this section shall be construed to require that any meeting be closed to the public, nor shall any executive session be used to circumvent or to defeat the purposes of this chapter.

     (4)  A public body may hold an executive session pursuant to this section for one or more of the following reasons:

          (a)  Transaction of business and discussion of personnel matters relating to the job performance, character, professional competence, or physical or mental health of a person holding a specific position, or matters relating to the terms of any potential or current employment or services agreement with any physicians or other employees of public hospitals, including any discussion of any person applying for medical staff privileges or membership with a public hospital.

          (b)  Strategy sessions or negotiations with respect to prospective litigation, litigation or issuance of an appealable order when an open meeting would have a detrimental effect on the litigating position of the public body.

          (c)  Transaction of business and discussion regarding the report, development or course of action regarding security personnel, plans or devices.

          (d)  Investigative proceedings by any public body regarding allegations of misconduct or violation of law.

          (e)  Any body of the Legislature which is meeting on matters within the jurisdiction of that body.

          (f)  Cases of extraordinary emergency which would pose immediate or irrevocable harm or damage to persons or property, or both, within the jurisdiction of the public body.

          (g)  Transaction of business and discussion regarding the prospective purchase, sale or leasing of lands.

          (h)  Discussions between a school board and individual students who attend a school within the jurisdiction of the school board or the parents or teachers of the students regarding problems of the students or their parents or teachers.

          (i)  Transaction of business and discussion concerning the preparation of tests for admission to practice in recognized professions.

          (j)  Transaction of business and discussions or negotiations regarding the location, relocation or expansion of a business, medical service or an industry.

          (k)  Transaction of business and discussions regarding employment or job performance of a person in a specific position or termination of an employee holding a specific position.  The exemption provided by this paragraph includes transaction of business and discussion in executive session by the board of trustees of a public hospital regarding any employee or medical staff member or applicant for medical staff privileges and any such individual's credentialing, health, performance, salary, raises or disciplinary action.  The exemption provided by this paragraph includes the right to enter into executive session concerning a line item in a budget which might affect the termination of an employee or employees.  All other budget items shall be considered in open meetings and final budgetary adoption shall not be taken in executive session.

          (l)  Discussions regarding material or data exempt from the Mississippi Public Records Act of 1983 pursuant to Section 25-11-121.

          (m)  Transaction of business and discussion regarding prospective strategic business decisions of public hospitals, including without limitation, decisions to open a new service line * * *, or implement capital improvements * * *, or file applications for certificates of need or determinations of nonreviewability with the State Department of Health.

          (n)  Transaction of business of the boards of trustees of public hospitals that would require discussion of any identifiable patient information, including without limitation, patient complaints, patients' accounts, patients receiving charity care, or treatment that could be identified to a patient.

     (5)  The total vote on the question of entering into an executive session shall be recorded and spread upon the minutes of the public body.

     (6)  Any vote whereby an executive session is declared shall be applicable only to that particular meeting on that particular day.

     SECTION 5.  Section 41-3-15, Mississippi Code of 1972, is amended as follows:

     41-3-15.  (1)  (a)  There shall be a State Department of Health.

          (b)  The State Board of Health shall have the following powers and duties:

              (i)  To formulate the policy of the State Department of Health regarding public health matters within the jurisdiction of the department;

              (ii)  To adopt, modify, repeal and promulgate, after due notice and hearing, and enforce rules and regulations implementing or effectuating the powers and duties of the department under any and all statutes within the department's jurisdiction, and as the board may deem necessary;

              (iii)  To apply for, receive, accept and expend any federal or state funds or contributions, gifts, trusts, devises, bequests, grants, endowments or funds from any other source or transfers of property of any kind;

              (iv)  To enter into, and to authorize the executive officer to execute contracts, grants and cooperative agreements with any federal or state agency or subdivision thereof, or any public or private institution located inside or outside the State of Mississippi, or any person, corporation or association in connection with carrying out the provisions of this chapter, if it finds those actions to be in the public interest and the contracts or agreements do not have a financial cost that exceeds the amounts appropriated for those purposes by the Legislature;

              (v)  To appoint, upon recommendation of the Executive Officer of the State Department of Health, a Director of Internal Audit who shall be either a Certified Public Accountant or Certified Internal Auditor, and whose employment shall be continued at the discretion of the board, and who shall report directly to the board, or its designee; and

              (vi)  To discharge such other duties, responsibilities and powers as are necessary to implement the provisions of this chapter.

          (c)  The Executive Officer of the State Department of Health shall have the following powers and duties:

              (i)  To administer the policies of the State Board of Health within the authority granted by the board;

              (ii)  To supervise and direct all administrative and technical activities of the department, except that the department's internal auditor shall be subject to the sole supervision and direction of the board;

              (iii)  To organize the administrative units of the department in accordance with the plan adopted by the board and, with board approval, alter the organizational plan and reassign responsibilities as he or she may deem necessary to carry out the policies of the board;

              (iv)  To coordinate the activities of the various offices of the department;

              (v)  To employ, subject to regulations of the State Personnel Board, qualified professional personnel in the subject matter or fields of each office, and such other technical and clerical staff as may be required for the operation of the department.  The executive officer shall be the appointing authority for the department, and shall have the power to delegate the authority to appoint or dismiss employees to appropriate subordinates, subject to the rules and regulations of the State Personnel Board;

              (vi)  To recommend to the board such studies and investigations as he or she may deem appropriate, and to carry out the approved recommendations in conjunction with the various offices;

              (vii)  To prepare and deliver to the Legislature and the Governor on or before January 1 of each year, and at such other times as may be required by the Legislature or Governor, a full report of the work of the department and the offices thereof, including a detailed statement of expenditures of the department and any recommendations the board may have;

              (viii)  To prepare and deliver to the Chairmen of the Public Health and Welfare/Human Services Committees of the Senate and House on or before January 1 of each year, a plan for monitoring infant mortality in Mississippi and a full report of the work of the department on reducing Mississippi's infant mortality and morbidity rates and improving the status of maternal and infant health; and

              (ix)  To enter into contracts, grants and cooperative agreements with any federal or state agency or subdivision thereof, or any public or private institution located inside or outside the State of Mississippi, or any person, corporation or association in connection with carrying out the provisions of this chapter, if he or she finds those actions to be in the public interest and the contracts or agreements do not have a financial cost that exceeds the amounts appropriated for those purposes by the Legislature.  Each contract or agreement entered into by the executive officer shall be submitted to the board before its next meeting.

     (2)  The State Board of Health shall have the authority to establish an Office of Rural Health within the department.  The duties and responsibilities of this office shall include the following:

          (a)  To collect and evaluate data on rural health conditions and needs;

          (b)  To engage in policy analysis, policy development and economic impact studies with regard to rural health issues;

          (c)  To develop and implement plans and provide technical assistance to enable community health systems to respond to various changes in their circumstances;

          (d)  To plan and assist in professional recruitment and retention of medical professionals and assistants; and

          (e)  To establish information clearinghouses to improve access to and sharing of rural health care information.

     (3)  The State Board of Health shall have general supervision of the health interests of the people of the state and to exercise the rights, powers and duties of those acts which it is authorized by law to enforce.

     (4)  The State Board of Health shall have authority:

          (a)  To make investigations and inquiries with respect to the causes of disease and death, and to investigate the effect of environment, including conditions of employment and other conditions that may affect health, and to make such other investigations as it may deem necessary for the preservation and improvement of health.

          (b)  To make such sanitary investigations as it may, from time to time, deem necessary for the protection and improvement of health and to investigate nuisance questions that affect the security of life and health within the state.

          (c)  To direct and control sanitary and quarantine measures for dealing with all diseases within the state possible to suppress same and prevent their spread.

          (d)  To obtain, collect and preserve such information relative to mortality, morbidity, disease and health as may be useful in the discharge of its duties or may contribute to the prevention of disease or the promotion of health in this state.

          (e)  To charge and collect reasonable fees for health services, including immunizations, inspections and related activities, and the board shall charge fees for those services; however, if it is determined that a person receiving services is unable to pay the total fee, the board shall collect any amount that the person is able to pay.  Any increase in the fees charged by the board under this paragraph shall be in accordance with the provisions of Section 41-3-65.

          (f)  (i)  To establish standards for, issue permits and exercise control over, any cafes, restaurants, food or drink stands, sandwich manufacturing establishments, and all other establishments, other than churches, church-related and private schools, and other nonprofit or charitable organizations, where food or drink is regularly prepared, handled and served for pay; and

              (ii)  To require that a permit be obtained from the Department of Health before those persons begin operation.  If any such person fails to obtain the permit required in this subparagraph (ii), the State Board of Health, after due notice and opportunity for a hearing, may impose a monetary penalty not to exceed One Thousand Dollars ($1,000.00) for each violation.  However, the department is not authorized to impose a monetary penalty against any person whose gross annual prepared food sales are less than Five Thousand Dollars ($5,000.00).  Money collected by the board under this subparagraph (ii) shall be deposited to the credit of the State General Fund of the State Treasury.

          (g)  To promulgate rules and regulations and exercise control over the production and sale of milk pursuant to the provisions of Sections 75-31-41 through 75-31-49.

          (h)  On presentation of proper authority, to enter into and inspect any public place or building where the State Health Officer or his representative deems it necessary and proper to enter for the discovery and suppression of disease and for the enforcement of any health or sanitary laws and regulations in the state.

          (i)  To conduct investigations, inquiries and hearings, and to issue subpoenas for the attendance of witnesses and the production of books and records at any hearing when authorized and required by statute to be conducted by the State Health Officer or the State Board of Health.

          (j)  To promulgate rules and regulations, and to collect data and information, on (i) the delivery of services through the practice of telemedicine; and (ii) the use of electronic records for the delivery of telemedicine services.

          (k)  To enforce and regulate domestic and imported fish as authorized under Section 69-7-601 et seq.

     (5)  (a)  The State Board of Health shall have the authority, in its discretion, to establish programs to promote the public health, to be administered by the State Department of Health. Specifically, those programs may include, but shall not be limited to, programs in the following areas:

               (i)  Maternal and child health;

              (ii)  Family planning;

              (iii)  Pediatric services;

              (iv)  Services to crippled and disabled children;

              (v)  Control of communicable and noncommunicable disease;

              (vi)  Chronic disease;

              (vii)  Accidental deaths and injuries;

              (viii)  Child care licensure;

              (ix)  Radiological health;

              (x)  Dental health;

              (xi)  Milk sanitation;

              (xii)  Occupational safety and health;

              (xiii)  Food, vector control and general sanitation;

              (xiv)  Protection of drinking water;

              (xv)  Sanitation in food handling establishments open to the public;

              (xvi)  Registration of births and deaths and other vital events;

              (xvii)  Such public health programs and services as may be assigned to the State Board of Health by the Legislature or by executive order; and

              (xviii)  Regulation of domestic and imported fish for human consumption.

          (b)  The State Board of Health and State Department of Health shall not be authorized to sell, transfer, alienate or otherwise dispose of any of the home health agencies owned and operated by the department on January 1, 1995, and shall not be authorized to sell, transfer, assign, alienate or otherwise dispose of the license of any of those home health agencies, except upon the specific authorization of the Legislature by an amendment to this section.  However, this paragraph (b) shall not prevent the board or the department from closing or terminating the operation of any home health agency owned and operated by the department, or closing or terminating any office, branch office or clinic of any such home health agency, or otherwise discontinuing the providing of home health services through any such home health agency, office, branch office or clinic, if the board first demonstrates that there are other providers of home health services in the area being served by the department's home health agency, office, branch office or clinic that will be able to provide adequate home health services to the residents of the area if the department's home health agency, office, branch office or clinic is closed or otherwise discontinues the providing of home health services.  This demonstration by the board that there are other providers of adequate home health services in the area shall be spread at length upon the minutes of the board at a regular or special meeting of the board at least thirty (30) days before a home health agency, office, branch office or clinic is proposed to be closed or otherwise discontinue the providing of home health services.

          (c)  The State Department of Health may undertake such technical programs and activities as may be required for the support and operation of those programs, including maintaining physical, chemical, bacteriological and radiological laboratories, and may make such diagnostic tests for diseases and tests for the evaluation of health hazards as may be deemed necessary for the protection of the people of the state.

     (6)  (a)  The State Board of Health shall administer the local governments and rural water systems improvements loan program in accordance with the provisions of Section 41-3-16.

          (b)  The State Board of Health shall have authority:

              (i)  To enter into capitalization grant agreements with the United States Environmental Protection Agency, or any successor agency thereto;

              (ii)  To accept capitalization grant awards made under the federal Safe Drinking Water Act, as amended;

              (iii)  To provide annual reports and audits to the United States Environmental Protection Agency, as may be required by federal capitalization grant agreements; and

              (iv)  To establish and collect fees to defray the reasonable costs of administering the revolving fund or emergency fund if the State Board of Health determines that those costs will exceed the limitations established in the federal Safe Drinking Water Act, as amended.  The administration fees may be included in loan amounts to loan recipients for the purpose of facilitating payment to the board; however, those fees may not exceed five percent (5%) of the loan amount.

     (7)  Notwithstanding any other provision to the contrary, the State Department of Health shall have the following specific powers:  The department shall issue a license to Alexander Milne Home for Women, Inc., a 501(c)(3) nonprofit corporation, for the construction, conversion, expansion and operation of not more than forty-five (45) beds for developmentally disabled adults who have been displaced from New Orleans, Louisiana, with the beds to be located in a certified ICF-MR facility in the City of Laurel, Mississippi.  There shall be no prohibition or restrictions on participation in the Medicaid program for the person receiving the license under this subsection (7).  The license described in this subsection shall expire five (5) years from the date of its issue.  The license authorized by this subsection shall be issued upon the initial payment by the licensee of an application fee of Sixty-seven Thousand Dollars ($67,000.00) and a monthly fee of Sixty-seven Thousand Dollars ($67,000.00) after the issuance of the license, to be paid as long as the licensee continues to operate. * * *  The initial and monthly licensing fees shall be deposited by the State Department of Health into the special fund created under Section 41‑7‑188.

     (8)  Notwithstanding any other provision to the contrary, the State Department of Health shall have the following specific powers:  The State Department of Health is authorized to issue a license to an existing home health agency for the transfer of a county from that agency to another existing home health agency, and to charge a fee for reviewing and making a determination on the application for such transfer not to exceed one-half (1/2) of the authorized fee assessed for the original application for the home health agency * * *, with the revenue to be deposited by the State Department of Health into the special fund created under Section 41‑7‑188.

 * * *(9)  Notwithstanding any other provision to the contrary, the State Department of Health shall have the following specific powers:  For the period beginning July 1, 2010, through July 1, 2017, the State Department of Health is authorized and empowered to assess a fee in addition to the fee prescribed in Section 41‑7‑188 for reviewing applications for certificates of need in an amount not to exceed twenty‑five one‑hundredths of one percent (.25 of 1%) of the amount of a proposed capital expenditure, but shall be not less than Two Hundred Fifty Dollars ($250.00) regardless of the amount of the proposed capital expenditure, and the maximum additional fee permitted shall not exceed Fifty Thousand Dollars ($50,000.00).  Provided that the total assessments of fees for certificate of need applications under Section 41‑7‑188 and this section shall not exceed the actual cost of operating the certificate of need program.

(10)  Notwithstanding any other provision to the contrary, the State Department of Health shall have the following specific powers:  The State Department of Health is authorized to extend and renew any certificate of need that has expired, and to charge a fee for reviewing and making a determination on the application for such action not to exceed one‑half (1/2) of the authorized fee assessed for the original application for the certificate of need, with the revenue to be deposited by the State Department of Health into the special fund created under Section 41‑7‑188.

     ( * * *119)  Notwithstanding any other provision to the contrary, the State Department of Health shall have the following specific powers:  The State Department of Health is authorized and empowered, to revoke, immediately, the license and require closure of any institution for the aged or infirm, including any other remedy less than closure to protect the health and safety of the residents of * * *said the institution or the health and safety of the general public.

     ( * * *1210)  Notwithstanding any other provision to the contrary, the State Department of Health shall have the following specific powers:  The State Department of Health is authorized and empowered * * *, to require the temporary detainment of individuals for disease control purposes based upon violation of any order of the State Health Officer, as provided in Section 41-23-5.  For the purpose of enforcing such orders of the State Health Officer, persons employed by the department as investigators shall have general arrest powers.  All law enforcement officers are authorized and directed to assist in the enforcement of such orders of the State Health Officer.

     SECTION 6.  Section 41-4-18, Mississippi Code of 1972, is amended as follows:

     41-4-18.  (1)  Notwithstanding * * *Section 41‑7‑191(11) and Section 41‑7‑171 et seq., Mississippi Code of 1972, or any other section of law, the Department of Mental Health shall have the authority to contract with private and/or public entities to transfer beds within Intermediate Care Facilities for the Mentally Retarded owned and operated by the Department of Mental Health to locations owned and operated by private and/or public entities for the purpose of serving individuals with intellectual disabilities in the settings most appropriate to meet their needs.

     (2)  Any license granted to the Department of Mental Health by the Department of Health for the operation of transferred Intermediate Care Facility for the Mentally Retarded beds shall remain in the name of the Department of Mental Health * * *and shall not be transferred into the name of the contractor unless the contractor has received the appropriate certificates of need.

     SECTION 7.  Section 41-9-11, Mississippi Code of 1972, is amended as follows:

     41-9-11.  Upon receipt of an application for license and the license fee, the licensing agency shall issue a license if the applicant and hospital facilities meet the requirements established under Sections 41-9-1 through 41-9-35 * * *, and the requirements of Section 41‑7‑173 et seq., where determined by the licensing agency to be applicable.  A license, unless suspended or revoked, shall be renewable annually, upon filing by the licensee, and approval by the licensing agency of an annual report upon such uniform dates and containing such information in such form as the licensing agency prescribes by regulation and upon paying the annual fee for such license as determined by the schedule and provisions of Section 41-9-9.  Each license shall be issued only for the premises and persons or governmental units named in the application and shall not be transferable or assignable except with the written approval of the licensing agency.  Licenses shall be posted in a conspicuous place on the licensed premises.

     SECTION 8.  Section 41-9-23, Mississippi Code of 1972, is amended as follows:

     41-9-23.  Information received by the licensing agency through filed reports, inspection, or as otherwise authorized under Sections 41-9-1 through 41-9-35 shall not be disclosed publicly in such manner as to identify individuals, except in a proceeding involving the questions of licensure; however, the licensing agency may utilize statistical data concerning types of services and the utilization of these services for hospitals in performing the * * *statutory duties imposed upon it * * *by Section 41‑7‑171, et seq. and by Section 41-9-29.

     SECTION 9.  Section 41-9-68, Mississippi Code of 1972, is amended as follows:

     41-9-68.  (1)  Except as otherwise provided in subsection (2) of this section, records maintained by public hospitals shall be exempt from the provisions of the Mississippi Public Records Act of 1983. 

     (2)  The following records of public hospitals shall not be exempt from the Mississippi Public Records Act of 1983:

          (a)  The official minutes of the board of trustees of a public hospital;

          (b)  Financial reports not otherwise exempt that are required by state or federal statute or regulation to be filed with the owner of the public hospital or with any other agency of state or federal government; and

          (c)  Any other record maintained by a public hospital that does not fall within the definition of the term "hospital records" as that term is defined in Section 41-9-61, except for the following records, which shall be exempt:

              (i)  Records directly relating to the terms of any potential or current employment or services agreement with any physicians or other employees of a public hospital, including any application for medical staff privileges or membership with a public hospital;

              (ii)  Records directly relating to the credentialing, health, performance, salary, raises or disciplinary action of any employee or medical staff member or applicant for medical staff privileges at a public hospital;

              (iii)  Records directly relating to prospective strategic business decisions of a public hospital, including without limitation, decisions to open a new service line * * *, or implement capital improvements * * *, or file applications for certificates of need or determinations of nonreviewability with the State Department of Health; and

              (iv)  Records directly relating to individual patient billing and collection information.

     SECTION 10.  Section 41-9-209, Mississippi Code of 1972, is amended as follows:

     41-9-209.  (1)  Any hospital is authorized to seek designation as a critical access hospital.  Subject to federal law, there shall be no requirement or limitation regarding the distance that a critical access hospital must be located from another hospital.  The bed-size limit for a critical access hospital is twenty-five (25) operational acute care beds, and the average maximum length of stay for patients in a critical access hospital is ninety-six (96) hours, unless a longer period is required because of inclement weather or other emergency conditions.  * * * In the event If the critical access hospital is a swing bed facility, any of the twenty-five (25) acute care beds allowed in a critical access hospital may be used for the provision of extended care services or acute care inpatient services so long as the furnishing of such services does not exceed twenty-five (25) beds and so long as the hospital does not seek Medicaid reimbursement for more than fifteen (15) acute care inpatient beds. 

     (2)  A critical access hospital (a) must make available twenty-four-hour emergency care services, as described in the state rural health care plan, for ensuring access to emergency care services in the rural area served by the critical access hospital, and (b) must be a member of a rural health network.  Any hospital that has a distinct-part skilled nursing facility, certified under Title XVIII of the federal Social Security Act, at the time it applies for designation as a critical access hospital, may continue its operation of the distinct-part skilled nursing facility and is not required to count the beds in the distinct-part skilled nursing facility for purposes of the allowed twenty-five (25) acute care inpatient beds. 

     (3)  * * * To the extent permitted under Section 41‑7‑171 et seq. aA critical access hospital may establish a distinct-part psychiatric unit and a distinct-part rehabilitation unit, each of which must be certified under Title XVIII of the federal Social Security Act and each of which may consist of no more than ten (10) beds.  No bed in the critical access hospital's distinct-part psychiatric unit or distinct-part rehabilitation unit shall be counted for purposes of the twenty-five (25) bed limitation.  Each distinct-part unit in a critical access hospital must comply with all applicable state licensure laws and federal certification laws.

     SECTION 11.  Section 41-9-210, Mississippi Code of 1972, is amended as follows:

     41-9-210.  If a hospital seeks a new license from the department in order to be designated as a critical access hospital, the department shall maintain a record of the acute care beds of that hospital that have been delicensed as a result of that designation and continue counting those beds as part of the state's total acute care bed count for health care planning purposes.  If a critical access hospital later desires to relicense some or all of its delicensed acute care beds, it shall notify the department of its intent to increase the number of its licensed acute care beds.  The department shall survey the hospital within thirty (30) days of that notice and, if appropriate, issue the hospital a new license reflecting the new contingent of beds. * * * That change may be accomplished without the need of the hospital to seek certificate of need approval under Section 41‑7‑171 et seq.  However, in no event may a hospital that has delicensed some of its acute care beds in order to be designated as a critical access hospital be reissued a license to operate acute care beds in excess of its acute care bed count before the delicensure of some of its beds without seeking certificate of need approval.

     This section shall apply to all hospitals that are designated as critical access hospitals on July 1, 2003, and all hospitals that may become designated as critical access hospitals after July 1, 2003.

     SECTION 12.  Section 41-71-7, Mississippi Code of 1972, is amended as follows:

     41-71-7.  Upon receipt of an application for a license and the license fee, and a determination by the licensing agency that the application is * * * in compliance with Section 41‑7‑173 et seq. and in compliance with the provisions of this chapter, such license shall be issued.  A license, unless suspended or revoked, shall be renewable annually upon payment by the licensee of a renewal fee of One Thousand Dollars ($1,000.00) and upon approval by the licensing agency of an annual report, required to be submitted by the licensee, containing such information in such form and at such time as the licensing agency prescribes by rule or regulation.  Any increase in the fee charged by the licensing agency under this section shall be in accordance with the provisions of Section 41-3-65.  Each license shall be issued only for the home health agency and person or persons or other legal entity or entities named in the application and shall not be transferable or assignable except with the written approval of the licensing agency.  Licenses shall be posted in a conspicuous place in the designated business office of the licensee.  Each licensee shall designate, in writing, one (1) individual person as the responsible party for the conducting of the business of the home health agency with the licensing agency.

     SECTION 13.  Section 41-71-19, Mississippi Code of 1972, is amended as follows:

     41-71-19.  Information received by the licensing agency through filed reports, inspection, or as otherwise authorized under this chapter, shall not be disclosed publicly in such manner as to identify individuals, except in proceedings involving the question of licensure; however, the licensing agency may utilize statistical data concerning types of services and the utilization of those services for home health care agencies in performing the * * *statutory duties imposed upon it by * * *Section 41‑7‑171 et seq., and regulations necessarily promulgated for participation in the Medicare or Medicaid programs.

     SECTION 14.  Section 41-73-5, Mississippi Code of 1972, is amended as follows:

     41-73-5.  When used in this act, unless the context requires a different definition, the following terms shall have the following meanings:

          (a)  "Act" means the Mississippi Hospital Equipment and Facilities Authority Act.

          (b)  "Authority" means the Mississippi Hospital Equipment and Facilities Authority created by this act and any successor to its functions.

          (c)  "Bonds" means bonds, notes or other evidences of indebtedness of the authority issued pursuant to this act, including refunding bonds.

          (d)  "Cost" as applied to hospital equipment means any and all costs of such hospital equipment and, without limiting the generality of the foregoing, shall include the following:

              (i)  All costs of the acquisition, repair, restoration, reconditioning, refinancing or installation of any such hospital equipment and all costs incident or related thereto;

              (ii)  The cost of any property interest in such hospital equipment including an option to purchase or leasehold interest;

              (iii)  The cost of architectural, engineering, legal and related services; the cost of the preparation of plans, specifications, studies, surveys and estimates of cost and of revenue; and all other expenses necessary or incident to planning, providing or determining the need for or the feasibility and practicability of such hospital equipment; and the cost of providing or establishing a reasonable reserve fund for the payment of principal and interest on bonds;

              (iv)  The cost of financing charges, including premiums or prepayment penalties, if any, and interest accrued prior to the acquisition and installation or refinancing of such hospital equipment and after such acquisition and installation or refinancing and start-up costs related to hospital equipment;

              (v)  Any and all costs paid or incurred in connection with the financing of such hospital equipment, including out-of-pocket expenses, the cost of financing, legal, accounting, financial advisory and consulting fees, expenses and disbursements; the cost of any policy of insurance; the cost of printing, engraving and reproduction services; and the cost of the initial or acceptance fee of any trustee or paying agent;

              (vi)  All direct or indirect costs of the authority incurred in connection with providing such hospital equipment, including, without limitation, reasonable sums to reimburse the authority for time spent by its agents or employees with respect to providing such hospital equipment and the financing thereof; and

              (vii)  Any and all costs paid or incurred for the administration of any program for the purchase or lease of or the making of loans for hospital equipment, by the authority and any program for the sale or lease of or the making of loans for such hospital equipment to any participating hospital institution.

          (e)  "Cost," as applied to hospital facilities, means any and all costs of such hospital facilities and, without limiting the generality of the foregoing, shall include the following:

              (i)  All costs of the establishment, demolition, site development of new and rehabilitated buildings, rehabilitation, reconstruction repair, erection, building, construction, remodeling, adding to and furnishing of any such hospital facilities and all costs incident or related thereto;

              (ii)  The cost of acquiring any property interest in such hospital facilities including the purchase thereof, the cost of an option to purchase or the cost of any leasehold interest;

              (iii)  The cost of architectural, engineering, legal and related services; the cost of the preparation of plans, specifications, studies, surveys and estimates of cost and of revenue; all other expenses necessary or incident to planning, providing or determining the need for or the feasibility and practicability of such hospital facilities or the acquisition thereof; and the cost of providing or establishing a reasonable reserve fund for the payment of principal of and interest on bonds;

              (iv)  The cost of financing charges, including premiums or prepayment penalties, if any, and interest accrued prior to the acquisition and completion or refinancing of such hospital facilities and after such acquisition and completion or refinancing and start-up costs related to hospital facilities;

              (v)  Any and all costs paid or incurred in connection with the financing of such hospital facilities, including out-of-pocket expenses, the cost of financing, legal, accounting, financial advisory and consulting fees, expenses and disbursement; the cost of any policy of insurance; the cost of printing, engraving and reproduction services; and the cost of the initial or acceptance fee of any trustee or paying agent;

              (vi)  All direct or indirect costs of the authority incurred in connection with providing such hospital facilities, including, without limitation, reasonable sums to reimburse the authority for time spent by its agents or employees with respect to providing such hospital facilities and the financing thereof;

              (vii)  Any and all costs paid or incurred for the administration of any program for the purchase or lease of or the making of loans for hospital facilities, by the authority and any program for the sale or lease of or the making of loans for such hospital facilities to any participating hospital institution; and

              (viii)  The cost of providing for the payment or the making provision for the payment of, by the appropriate escrowing of monies or securities, the principal of and interest on which when due will be adequate to make such payment, any indebtedness encumbering the revenues or property of a participating hospital institution, whether such payment is to be effected by redemption of such indebtedness prior to maturity or not.

          (f)  "Hospital equipment" means any personal property which is found and determined by the authority to be required or necessary or helpful for medical care, research, training or teaching, any one (1) or all, in hospital facilities located in the state, irrespective of whether such property is in existence at the time of, or is to be provided after the making of, such finding. * * * Provided further, that major medical equipment as defined in Section 41‑7‑173(n), shall require a certificate of need prior to the approval of the authority to contract with said hospital.

          (g)  "Hospital facility" or "hospital facilities" means buildings and structures of any and all types used or useful, in the discretion of the authority, for providing any types of care to the sick, wounded, infirmed, needy, mentally incompetent or elderly and shall include, without limiting the generality of the foregoing, out-patient clinics, laboratories, laundries, nurses', doctors' or interns' residences, administration buildings, office buildings, facilities for research directly involved with hospital care, maintenance, storage or utility facilities, parking lots, and garages and all necessary, useful, or related furnishings, and appurtenances and all lands necessary or convenient as a site for the foregoing.

          (h)  "Participating hospital institution" or "hospital institution" means a public or private corporation, association, foundation, trust, cooperative, agency, body politic, or other person or organization which provides or operates or proposes to provide or operate hospital facilities not for profit, and which, pursuant to the provisions of this act, contracts with the authority for the financing or refinancing of the lease or other acquisition of hospital equipment or hospital facilities, or both.

          (i)  "State" means the State of Mississippi.

     The use of singular terms herein shall also include the plural of such term and the use of a plural term herein shall also include the singular of such term unless the context clearly requires a different connotation.

     SECTION 15.  Section 41-75-1, Mississippi Code of 1972, is amended as follows:

     41-75-1.  For the purpose of this chapter:

          (a)  "Ambulatory surgical facility" means a publicly or privately owned institution that is primarily organized, constructed, renovated or otherwise established for the purpose of providing elective surgical treatment of "outpatients" whose recovery, under normal and routine circumstances, will not require "inpatient" care.  The facility defined in this paragraph does not include the offices of private physicians or dentists, whether practicing individually or in groups, but does include organizations or facilities primarily engaged in that outpatient surgery, whether using the name "ambulatory surgical facility" or a similar or different name.  That organization or facility, if in any manner considered to be operated or owned by a hospital or a hospital holding, leasing or management company, either for profit or not for profit, is required to comply with all licensing agency ambulatory surgical licensure standards governing a "hospital affiliated" facility as adopted under Section 41-9-1 et seq., provided that the organization or facility does not intend to seek federal certification as an ambulatory surgical facility as provided for at 42 CFR, Parts 405 and 416.  If the organization or facility is to be operated or owned by a hospital or a hospital holding, leasing or management company and intends to seek federal certification as an ambulatory facility, then the facility is considered to be "freestanding" and must comply with all licensing agency ambulatory surgical licensure standards governing a "freestanding" facility.

     If the organization or facility is to be owned or operated by an entity or person other than a hospital or hospital holding, leasing or management company, then the organization or facility must comply with all licensing agency ambulatory surgical facility standards governing a "freestanding" facility.

          (b)  "Hospital affiliated" ambulatory surgical facility  means a separate and distinct organized unit of a hospital or a building owned, leased, rented or utilized by a hospital and located in the same county in which the hospital is located, for the primary purpose of performing ambulatory surgery procedures.  The facility is not required to be separately licensed under this chapter and may operate under the hospital's license in compliance with all applicable requirements of Section 41-9-1 et seq.

          (c)  "Freestanding" ambulatory surgical facility means a separate and distinct facility or a separate and distinct organized unit of a hospital owned, leased, rented or utilized by a hospital or other persons for the primary purpose of performing ambulatory surgery procedures.  The facility must be separately licensed as defined in this section and must comply with all licensing standards promulgated by the licensing agency under this chapter regarding a "freestanding" ambulatory surgical facility.  Further, the facility must be a separate, identifiable entity and must be physically, administratively and financially independent and distinct from other operations of any other health facility, and shall maintain a separate organized medical and administrative staff. * * *  Furthermore, once licensed as a "freestanding" ambulatory surgical facility, the facility shall not become a component of any other health facility without securing a certificate of need to do that.

          (d)  "Ambulatory surgery" means surgical procedures that are more complex than office procedures performed under local anesthesia, but less complex than major procedures requiring prolonged postoperative monitoring and hospital care to ensure safe recovery and desirable results.  General anesthesia is used in most cases.  The patient must arrive at the facility and expect to be discharged on the same day.  Ambulatory surgery shall only be performed by physicians or dentists licensed to practice in the State of Mississippi.

          (e)  "Abortion" means the use or prescription of any instrument, medicine, drug or any other substances or device to terminate the pregnancy of a woman known to be pregnant with an intention other than to increase the probability of a live birth, to preserve the life or health of the child after live birth or to remove a dead fetus.  Abortion procedures after the first trimester shall only be performed at a Level I abortion facility or an ambulatory surgical facility or hospital licensed to perform that service.

          (f)  "Abortion facility" means a facility operating substantially for the purpose of performing abortions and is a separate identifiable legal entity from any other health care facility.  Abortions shall only be performed by physicians licensed to practice in the State of Mississippi.  All physicians associated with the abortion facility must have admitting privileges at a local hospital and staff privileges to replace local hospital on-staff physicians.  All physicians associated with an abortion facility must be board certified or eligible in obstetrics and gynecology, and a staff member trained in CPR shall always be present at the abortion facility when it is open.  The term "abortion facility" includes physicians' offices that are used substantially for the purpose of performing abortions.  An abortion facility operates substantially for the purpose of performing abortions if any of the following conditions are met:

              (i)  The abortion facility is a provider for performing ten (10) or more abortion procedures per calendar month during any month of a calendar year, or one hundred (100) or more in a calendar year.

              (ii)  The abortion facility, if operating less than twenty (20) days per calendar month, is a provider for performing ten (10) or more abortion procedures, or performing a number of abortion procedures that would be equivalent to ten (10) procedures per month, if the facility were operating twenty (20) or more days per calendar month, in any month of a calendar year.

              (iii)  The abortion facility holds itself out to the public as an abortion provider by advertising by any public means, such as newspaper, telephone directory, magazine or electronic media, that it performs abortions.

              (iv)  The facility applies to the licensing agency for licensure as an abortion facility.

          (g)  "Licensing agency" means the State Department of Health.

          (h)  "Operating" an abortion facility means that the facility is open for any period of time during a day and has on site at the facility or on call a physician licensed to practice in the State of Mississippi available to provide abortions.

     An abortion facility may apply to be licensed as a Level I facility or a Level II facility by the licensing agency.  Level II abortion facilities shall be required to meet minimum standards for abortion facilities as established by the licensing agency.  Level I abortion facilities shall be required to meet minimum standards for abortion facilities and minimum standards for ambulatory surgical facilities as established by the licensing agency.

     Any abortion facility that begins operation after June 30, 1996, shall not be located within one thousand five hundred (1,500) feet from the property on which any church, school or kindergarten is located.  An abortion facility shall not be in violation of this paragraph if it is in compliance with this paragraph on the date it begins operation and the property on which a church, school or kindergarten is located within one thousand five hundred (1,500) feet from the facility.

          (i)  "Freestanding emergency room" is a facility open twenty-four (24) hours a day for the treatment of urgent and emergent medical conditions which is not located on a hospital campus.  In order to be eligible for licensure under this chapter, the freestanding emergency room shall be located at least fifteen (15) miles from the nearest hospital-based emergency room in any rural community where the federal CMMS had previously designated a rural hospital as a critical access hospital and that designation has been revoked.

          (j)  "Post-acute residential brain injury rehabilitation facility" is a facility containing no more than twelve (12) beds providing medically directed long-term but nonacute rehabilitation to patients who have acquired brain injury.  In order to be eligible for licensure under this chapter, the post-acute residential brain injury rehabilitation facility shall be located at least twenty-five (25) miles from the nearest acute care rehabilitation hospital and at least five (5) miles from the boundaries of any municipality having a population of ten thousand (10,000) or more, according to the most recent federal decennial census, at the time that facility is established.

     SECTION 16.  Section 41-75-5, Mississippi Code of 1972, is amended as follows:

     41-75-5.  No person * * * as defined in Section 41‑7‑173 or other entity, acting severally or jointly with any other person or entity, shall establish, conduct, operate or maintain an ambulatory surgical facility or an abortion facility or a freestanding emergency room or a post-acute residential brain injury rehabilitation facility in this state without a license under this chapter.

     In order to receive a license for a post-acute residential brain injury rehabilitation facility under this chapter, the recipient of the license must agree in writing that the facility will not at any time participate in the Medicaid program (Section 43-13-101 et seq.) or admit or keep any patients in the facility who are participating in the Medicaid program.  This written agreement by the recipient of the license shall be fully binding on any later owner of the facility, if the ownership of the facility is transferred at any time after the issuance of the license.  Agreement that the facility will not participate in the Medicaid program shall be a condition of the issuance of a license for a post-acute residential brain injury rehabilitation facility to any person under this chapter, and if such facility at any time after the issuance of the license, regardless of the ownership of the facility, participates in the Medicaid program or admits or keeps any patients in the facility who are participating in the Medicaid program, the licensing agency shall revoke the license of the facility, at the time that the department determines, after a hearing complying with due process, that the facility has failed to comply with any of the conditions upon which the license was issued, as provided in this section and in the written agreement by the recipient of the license.

     SECTION 17.  Section 41-75-9, Mississippi Code of 1972, is amended as follows:

     41-75-9.  Upon receipt of an application for license and the license fee, the licensing agency shall issue a license if the applicant and the institutional facilities meet the requirements established under this chapter * * * and the requirements of Section 41‑7‑173 et seq. where determined by the licensing agency to be applicable.  A license, unless suspended or revoked, shall be renewable annually upon payment of a renewal fee of Three Thousand Dollars ($3,000.00), which shall be paid to the licensing agency, and upon filing by the licensee and approval by the licensing agency of an annual report upon such uniform dates and containing such information in such form as the licensing agency requires.  Any increase in the fee charged by the licensing agency under this section shall be in accordance with the provisions of Section 41-3-65.  Each license shall be issued only for the premises and person or persons named in the application and shall not be transferable or assignable.  Licenses shall be posted in a conspicuous place on the licensed premises.

     SECTION 18.  Section 41-75-25, Mississippi Code of 1972, is amended as follows:

     41-75-25.  Any person or persons or other entity or entities establishing, managing or operating an ambulatory surgical facility or conducting the business of an ambulatory surgical facility without the required license, or which otherwise violate any of the provisions of this chapter * * *or the "Mississippi Health Care Commission Law of 1979," as amended, or the rules, regulations or standards promulgated in furtherance of any law in which the * * *commission licensing agency has authority therefor shall be subject to the following penalties and sanctions * * *of Section 41‑7‑209, Mississippi Code of 1972. :

          (a)  Revocation of the license of the ambulatory surgical facility or a designated section, component or service thereof; or

          (b)  Nonlicensure of a specific or designated service offered by the ambulatory surgical facility.

     In addition, any violation of any provision of this chapter or any rules or regulations promulgated in furtherance thereof by intent, fraud, deceit, unlawful design, willful and/or deliberate misrepresentation, or by careless, negligent or incautious disregard for such statutes or rules and regulations, either by persons acting individually or in concert with others, shall constitute a misdemeanor and shall be punishable by a fine not to exceed One Thousand Dollars ($1,000.00) for each such offense.  Each day of continuing violation shall be considered a separate offense.  The venue for prosecution of any such violation shall be in any county of the state in which any such violation, or portion thereof, occurred.

     SECTION 19.  Section 41-77-1, Mississippi Code of 1972, is amended as follows:

     41-77-1.  For purposes of this chapter:

          (a)  "Birthing center" * * *shall means a publicly or privately owned facility, place or institution constructed, renovated, leased or otherwise established where nonemergency births are planned to occur away from the mother's usual residence following a documented period of prenatal care for a normal uncomplicated pregnancy which has been determined to be low risk through a formal risk scoring examination.  Care provided in a birthing center shall be provided by a licensed physician, or certified nurse midwife, and a registered nurse.  Services provided in a birthing center shall be limited in the following manner:  (i) surgical services shall be limited to those normally performed during uncomplicated childbirth, such as episiotomy and repair, and shall not include operative obstetrics or caesarean sections; (ii) labor shall not be inhibited, stimulated or augmented with chemical agents during the first or second stage of labor; (iii) systemic analgesia may be administered and local anesthesia for pudental block and episiotomy repair may be performed.  General and conductive anesthesia shall not be administered at birthing centers; (iv) patients shall not remain in the facility in excess of twenty-four (24) hours.

     Hospitals are excluded from the definition of a "birthing center" unless they choose to and are qualified to designate a portion or part of the hospital as a birthing center, and nothing herein shall be construed as referring to the usual service provided the pregnant female in the obstetric-gynecology service of an acute care hospital.  Such facility or center, as heretofore stated, shall include the offices of physicians in private practice alone or in groups of two (2) or more; and such facility or center rendering service to pregnant female persons, as stated heretofore and by the rules and regulations promulgated by the licensing agency in furtherance thereof, shall be deemed to be a "birthing center" whether using a similar or different name.  Such center or facility if in any manner is deemed to be or considered to be operated or owned by a hospital or a hospital holding leasing or management company, for profit or not for profit, is required to comply with all birthing center standards governing a "hospital affiliated" birthing center as adopted by the licensing authority.

          (b)  "Hospital affiliated" birthing center * * *shall means a separate and distinct unit of a hospital or a building owned, leased, rented or utilized by a hospital and located in the same county as the hospital for the purpose of providing the service of a "birthing center."  Such center or facility is not required to be licensed separately, and may operate under the license issued to the hospital if it is in compliance with Section 41-9-1 et seq., where applicable, and the rules and regulations promulgated by the licensing agency in furtherance thereof.

          (c)  "Freestanding" birthing center * * *shall means a separate and distinct facility or center or a separate and distinct organized unit of a hospital or other * * *defined persons (Section 41‑7‑173(q)) entity for the purpose of performing the service of a "birthing center."  Such facility or center must be separately licensed and must comply with all licensing standards promulgated by the licensing agency by virtue of this chapter.  Further, such facility or center must be a separate, identifiable entity and must be physically, administratively and financially independent from other operations of any hospital or other health care facility or service and shall maintain a separate and required staff, including administrative staff. * * * Further, any "birthing center" licensed as a "freestanding" center shall not become a component of any hospital or other health care facility without securing a "certificate of need."

          (d)  "Licensing agency" * * * shallmeans the State Department of Health.

     SECTION 20.  Section 41-77-5, Mississippi Code of 1972, is amended as follows:

     41-77-5.  No person * * *as defined in Section 41‑7‑173(q), Mississippi Code of 1972, or other entity, acting severally or jointly with any other person or entity, shall establish, conduct or maintain a "birthing center" in this state without a license under this chapter.

     SECTION 21.  Section 41-77-21, Mississippi Code of 1972, is amended as follows:

     41-77-21.  Any applicant or licensee aggrieved by the decision of the licensing agency after a hearing may, within thirty (30) days after the mailing or serving of notice of the decision as provided in Section 43-11-11, * * *Mississippi Code of 1972, file a notice of appeal to the Chancery Court of the First Judicial District of Hinds County or in the chancery court of the county in which the institution is located or proposed to be located.  * * * If such notice of appeal is filed, it shall comply with Section 41‑7‑201(2), (3) and (4), Mississippi Code of 1972. Thereupon, the licensing agency shall * * *, within the time and in the manner prescribed in Section 41‑7‑201(2), certify and file with the court a copy of the record and decision, including the transcript of the hearings in which the decision is based.  No new or additional evidence shall be introduced in court; the case shall be determined upon the record certified to the court.  The court may sustain or dismiss the appeal, modify or vacate the order complained of in whole or in part, as the case may be; but in case the order is wholly or partly vacated, the court may also, in its discretion, remand the matter to the licensing agency for such further proceedings, not inconsistent with the court's order, as, in the opinion of the court, justice may require.  The order may not be vacated or set aside, either in whole or in part, except for errors of law, unless the court finds that the order of the licensing agency is not supported by substantial evidence, is contrary to the manifest weight of the evidence, is in excess of the statutory authority or jurisdiction of the licensing agency, or violates any vested constitutional rights of any party involved in the appeal.  Pending final disposition of the matter, the status quo of the applicant or licensee shall be preserved, except as the court otherwise orders in the public interest.  Rules with respect to court costs in other cases in chancery shall apply equally to cases hereunder.  Appeals in accordance with law may be had to the Supreme Court of the State of Mississippi from any final judgment of the chancery court.

     SECTION 22.  Section 41-77-23, Mississippi Code of 1972, is amended as follows:

     41-77-23.  Any person or persons or other entity or entities establishing, managing or operating a "birthing center" or conducting the business of a "birthing center" without the required license, or which otherwise violate any of the provisions of this chapter * * *or the Mississippi Health Care Commission Law of 1979, as amended, or the rules, regulations or standards promulgated in furtherance of any law in which the * * *commission licensing agency has authority therefor, shall be subject to the following penalties and sanctions * * *of Section 41‑7‑209, Mississippi Code of 1972.:

          (a)  Revocation of the license of the birthing center or a designated section, component or service thereof; or

          (b)  Nonlicensure of a specific or designated service offered by the birthing center.

     In addition, any violation of any provision of this chapter or any rules or regulations promulgated in furtherance thereof by intent, fraud, deceit, unlawful design, willful and/or deliberate misrepresentation, or by careless, negligent or incautious disregard for such statutes or rules and regulations, either by persons acting individually or in concert with others, shall constitute a misdemeanor and shall be punishable by a fine not to exceed One Thousand Dollars ($1,000.00) for each such offense.  Each day of continuing violation shall be considered a separate offense.  The venue for prosecution of any such violation shall be in any county of the state in which any such violation, or portion thereof, occurred.

     SECTION 23.  Section 41-77-25, Mississippi Code of 1972, is amended as follows:

     41-77-25.  Upon receipt of an application for license and the license fee, the licensing agency shall issue a license if the applicant and the institutional facilities meet the requirements established under this chapter * * * and the requirements of Section 41‑7‑173 et seq., where determined by the licensing agency to be applicable.  A license, unless suspended or revoked, shall be renewable annually upon payment of a renewal fee of Three Hundred Dollars ($300.00), which shall be paid to the licensing agency, and upon filing by the licensee and approval by the licensing agency of an annual report upon such uniform dates and containing such information in such form as the licensing agency requires.  Any increase in the fee charged by the licensing agency under this section shall be in accordance with the provisions of Section 41-3-65.  Each license shall be issued only for the premises and person or persons named in the application and shall not be transferable or assignable.  Licenses shall be posted in a conspicuous place on the licensed premises.

     SECTION 24.  Section 41-95-3, Mississippi Code of 1972, is amended as follows:

     41-95-3.  As used in this chapter:

          (a)  "Authority" means the Mississippi Health Finance Authority created under Section 41-95-5.

          (b)  "Board" means the Mississippi Health Finance Authority Board created under Section 41-95-5.

          (c)  "Health care facility" means all facilities and institutions, whether public or private, proprietary or nonprofit, which offer diagnosis, treatment, inpatient or ambulatory care to two (2) or more unrelated persons * * *, and shall include, but shall not be limited to, all facilities and institutions included in Section 41‑7‑173(h).

          (d)  "Health care provider" means a person, partnership or corporation, other than a facility or institution, licensed or certified or authorized by state or federal law to provide professional health care service in this state to an individual during that individual's health care, treatment or confinement.

          (e)  "Health insurer" means any health insurance company, nonprofit hospital and medical service corporation, health maintenance organization and, to the extent permitted under federal law, any administrator of an insured, self-insured or publicly funded health care benefit plan offered by public and private entities.

          (f)  "Resident" means a person who is domiciled in Mississippi as evidenced by an intent to maintain a principal dwelling place in Mississippi indefinitely and to return to Mississippi if temporarily absent, coupled with an act or acts consistent with that intent. 

          (g)  "Primary care" or "primary health care" includes those health care services provided to individuals, families and communities, at a first level of care, which preserve and improve health, and encompasses services which promote health, prevent disease, treat and cure illness.  It is delivered by various health care providers in a variety of settings including hospital outpatient clinics, private provider offices, group practices, health maintenance organizations, public health departments and community health centers.  A primary care system is characterized by coordination of comprehensive services, cultural sensitivity, community orientation, continuity, prevention, the absence of barriers to receive and provide services, and quality assurance.

     SECTION 25.  Section 43-11-9, Mississippi Code of 1972, is amended as follows:

     43-11-9.  (1)  Upon receipt of an application for license and the license fee, the licensing agency shall issue a license if the applicant and the institutional facilities meet the requirements established under this chapter * * * and the requirements of Section 41‑7‑173 et seq., where determined by the licensing agency to be applicable.  A license, unless suspended or revoked, shall be renewable annually upon payment by (a) the licensee of an institution for the aged or infirm, except for personal care homes, of a renewal fee of Twenty Dollars ($20.00) for each bed in the institution, with a minimum fee per institution of Two Hundred Dollars ($200.00), or (b) the licensee of a personal care home of a renewal fee of Fifteen Dollars ($15.00) for each bed in the institution, with a minimum fee per institution of One Hundred Dollars ($100.00), which shall be paid to the licensing agency, and upon filing by the licensee and approval by the licensing agency of an annual report upon such uniform dates and containing such information in such form as the licensing agency prescribes by regulation.  Any increase in the fee charged by the licensing agency under this subsection shall be in accordance with the provisions of Section 41-3-65.  Each license shall be issued only for the premises and person or persons or other legal entity or entities named in the application and shall not be transferable or assignable except with the written approval of the licensing agency.  Licenses shall be posted in a conspicuous place on the licensed premises.

     (2)  A fee known as a "User Fee" shall be applicable and shall be paid to the licensing agency as set out in subsection (1) of this section.  Any increase in the fee charged by the licensing agency under this subsection shall be in accordance with the provisions of Section 41-3-65.  This user fee shall be assessed for the purpose of the required reviewing and inspections of the proposal of any institution in which there are additions, renovations, modernizations, expansion, alterations, conversions, modifications or replacement of the entire facility involved in such proposal.  This fee includes the reviewing of architectural plans in all steps required.  There shall be a minimum user fee of Fifty Dollars ($50.00) and a maximum user fee of Five Thousand Dollars ($5,000.00).

     (3)  No governmental entity or agency shall be required to pay the fee or fees set forth in this section.

     SECTION 26.  Section 43-11-19, Mississippi Code of 1972, is amended as follows:

     43-11-19.  Information received by the licensing agency through filed reports, inspection, or as otherwise authorized under this chapter, shall not be disclosed publicly in such manner as to identify individuals, except in a proceeding involving the questions of licensure; however, the licensing agency may utilize statistical data concerning types of services and the utilization of those services for institutions for the aged or infirm in performing the * * *statutory duties imposed upon it * * *by Section 41‑7‑171, et seq. and by Section 43-11-21.

     SECTION 27.  Section 57-117-5, Mississippi Code of 1972, is amended as follows:

     57-117-5.  (1)  The MDA may certify an area as a health care industry zone if the following requirements are met:

          (a)  The area is located within:

              (i)  Three (3) contiguous counties which have * * *certificates of need of hospitals located within the counties that have more than three hundred seventy-five (375) acute care hospital beds; and/or

              (ii)  A county which has a hospital with a minimum capital investment of Two Hundred Fifty Million Dollars ($250,000,000.00) and for which construction is completed before July 1, 2017;

          (b)  The health care industry facility is located within a five-mile radius of:

              (i)  A facility with a * * *certificate of need license for hospital beds; and/or

              (ii)  A university or college that is: 

                   1.  Accredited by the Southern Association of Colleges and Schools and awards degrees and/or trains workers for jobs in health care or pharmaceutical fields of study and/or work, and

                   2.  Located along or near Mississippi Highway 67 within a master planned community as defined in Section 19-5-10; and

          (c)  The zoning of the local government unit, if applicable, allows the construction or operation in the proposed health care industry zone of the health care industry facility.

 * * *(2)  A health care industry facility that engages in an activity for which a certificate of need is required must comply with the provisions of Section 41‑7‑191 in order to be certified as a qualified business.

     ( * * *32)  The MDA may adopt and promulgate such rules and regulations, in compliance with the Mississippi Administrative Procedures Law, as are necessary for the efficient and effective administration of this section in keeping with the purposes for which it is enacted.

     SECTION 28.  Section 41-9-311, Mississippi Code of 1972, which provides that nothing in the Rural Health Availability Act exempts hospitals from compliance with the certificate of need law, is repealed.

     SECTION 29.  This act shall take effect and be in force from and after July 1, 2021.


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