MISSISSIPPI LEGISLATURE

1999 Regular Session

To: Public Health and Welfare; Appropriations

By: Senator(s) Burton

AN ACT TO AMEND SECTION 43-11-1, MISSISSIPPI CODE OF 1972, TO DEFINE THE TERMS "ASSISTED LIVING FACILITY," "ADULT DAY SERVICES FACILITY" AND "RESIDENTIAL FACILITY FOR THE AGED" FOR PURPOSES OF INSTITUTIONAL LICENSURE BY THE STATE DEPARTMENT OF HEALTH; TO AMEND SECTION 43-11-13, MISSISSIPPI CODE OF 1972, TO DIRECT THE STATE BOARD OF HEALTH TO PROMULGATE RULES, REGULATIONS AND STANDARDS REGARDING THE OPERATION OF ASSISTED LIVING FACILITIES WHICH INCORPORATE THE MOST CURRENT "GUIDELINES TO STATES ON SETTING MINIMUM STANDARDS FOR PROVIDERS OF ASSISTED LIVING" DEVELOPED AND ISSUED BY THE ASSISTED LIVING QUALITY COALITION, AND TO PROMULGATE REGULATIONS REGARDING THE OPERATION OF ADULT DAY SERVICES FACILITIES WHICH INCORPORATE THE MOST CURRENT RANGES AND LEVELS OF CARE DEVELOPED BY THE NATIONAL ADULT DAY SERVICES ASSOCIATION; AND FOR RELATED PURPOSES.

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

SECTION 1. Section 43-11-1, Mississippi Code of 1972, is amended as follows:

43-11-1. When used in this chapter, the following words shall have the following meaning:

(a) "Institutions for the aged or infirm" means a place either governmental or private which provides group living arrangements for four (4) or more persons who are unrelated to the operator and who are being provided food, shelter and personal care whether any such place be organized or operated for profit or not. The term "institution for aged or infirm" includes nursing homes, pediatric skilled nursing facilities, psychiatric residential treatment facilities, convalescent homes, * * * homes for the aged, assisted living facilities, adult day services facilities and residential facilities for the aged, provided that these institutions fall within the scope of the definitions set forth above. The term "institution for the aged or infirm" does not include hospitals, clinics or mental institutions devoted primarily to providing medical service.

(b) "Person" means any individual, firm, partnership, corporation, company, association or joint stock association, or any licensee herein or the legal successor thereof.

(c) "Personal care" means assistance rendered by personnel of the home to aged or infirm residents in performing one or more of the activities of daily living, which includes, but is not limited to, the bathing, walking, excretory functions, feeding, personal grooming and dressing of such residents.

(d) "Psychiatric residential treatment facility" means any nonhospital establishment with permanent facilities which provides a 24-hour program of care by qualified therapists including, but not limited to, duly licensed mental health professionals, psychiatrists, psychologists, psychotherapists and licensed certified social workers, for emotionally disturbed children and adolescents referred to such facility by a court, local school district or by the Department of Human Services, who are not in an acute phase of illness requiring the services of a psychiatric hospital, and are in need of such restorative treatment services. For purposes of this paragraph, the term "emotionally disturbed" means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects educational performance:

1. An inability to learn which cannot be explained by intellectual, sensory or health factors;

2. An inability to build or maintain satisfactory relationships with peers and teachers;

3. Inappropriate types of behavior or feelings under normal circumstances;

4. A general pervasive mood of unhappiness or depression; or

5. A tendency to develop physical symptoms or fears associated with personal or school problems. An establishment furnishing primarily domiciliary care is not within this definition.

(e) "Pediatric skilled nursing facility" means an institution or a distinct part of an institution that is primarily engaged in providing to inpatients skilled nursing care and related services for persons under twenty-one (21) years of age who require medical or nursing care or rehabilitation services for the rehabilitation of injured, disabled or sick persons.

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

(g) "Assisted living facility" means an establishment which is a residential setting that provides or coordinates personal services, 24-hour supervision, scheduled and unscheduled assistance, activities and health-related services, which is (i) designed to minimize the residents' need to move; (ii) designed to accommodate individual residents' changing needs and preferences; (iii) designed to maximize residents' dignity, autonomy, privacy and independence; and (iv) designed to encourage family and community involvement.

(h) "Adult day services facility" means a community-based group program for six (6) or more adults for any part of the 24-hour day, designed to meet the needs of adults with impairments through individual plans of care, which are structured, comprehensive, planned, nonresidential programs providing a variety of health, social and related support services in a protective setting, enabling participants to live in the community.

(i) "Residential facility for the aged" means a building, establishment, complex or distinct part thereof which accepts primarily aged persons for domiciliary care and which provides on site to its residents room, board, non-medical living assistance services appropriate to the residents' respective needs and medical needs as prescribed by each resident's treating physician. Residents in need of the following services may not be admitted or retained in the residential facilities for the aged:

(i) Latter stages of Alzheimer's disease or related disorders;

(ii) Physical or chemical restraints;

(iii) Poses a serious threat to self or others;

(iv) Required hypodermoclysis;

(v) Requires nasopharyngeal and tracheotomy aspiration;

(vi) Requires initial phases of a regimen involving administration of medical gases;

(vii) Requires a Levin tube;

(viii) Requires arterial blood gas monitoring; or

(ix) Unable to communicate their needs.

SECTION 2. Section 43-11-13, Mississippi Code of 1972, is amended as follows:

43-11-13. (1) The licensing agency shall adopt, amend, promulgate and enforce such rules, regulations and standards, including classifications, with respect to all institutions for the aged or infirm to be licensed hereunder as may be designed to further the accomplishment of the purpose of this chapter in promoting adequate care of individuals in such institutions in the interest of public health, safety and welfare. Such rules, regulations and standards shall be adopted and promulgated by the licensing agency and shall be recorded and indexed in a book to be maintained by the licensing agency in its main office in the State of Mississippi, entitled "Rules, Regulations and Minimum Standards for Institutions for the Aged or Infirm" and said book shall be open and available to all institutions for the aged or infirm and the public generally at all reasonable times. Upon the adoption of such rules, regulations and standards, the licensing agency shall mail copies thereof to all such institutions in the state which have filed with said agency their names and addresses for this purpose, but the failure to mail the same or the failure of the institutions to receive the same shall in nowise affect the validity thereof. Said rules, regulations and standards may be amended by the licensing agency from time to time as necessary to promote the health, safety and welfare of persons living in said institutions.

(2) The licensee shall keep posted in a conspicuous place on the licensed premises all current rules, regulations and minimum standards applicable to fire protection measures as adopted by the licensing agency. The licensee shall furnish to the licensing agency at least once each six (6) months a certificate of approval and inspection by state or local fire authorities. Failure to comply with state laws and/or municipal ordinances and current rules, regulations and minimum standards as adopted by the licensing agency, relative to fire prevention measures, shall be prima facie evidence for revocation of license.

(3) The State Board of Health shall promulgate rules and regulations restricting the storage, quantity and classes of drugs allowed in personal care homes. Residents requiring administration of Schedule II Narcotics as defined in the Uniform Controlled Substances Law may be admitted to a personal care home. Schedule drugs may only be allowed in a personal care home if they are administered or stored utilizing proper procedures under the direct supervision of a licensed physician or nurse.

(4) The State Board of Health shall promulgate rules and regulations and standards regarding the operation of assisted living facilities which incorporate, but are not limited to, the most current "Guidelines to States on Setting Minimum Standards for Providers of Assisted Living" developed by the Assisted Living Quality Coalition.

(5) The State Board of Health shall promulgate rules and regulations and standards regarding the operation of adult day services facilities which incorporate, but are not limited to, the most current ranges and levels of care developed by the National Adult Day Services Association (NADSA).

SECTION 3. This act shall take effect and be in force from and after July 1, 1999.