MISSISSIPPI LEGISLATURE

1999 Regular Session

To: Public Health and Welfare; Finance

By: Senator(s) Bean

AN ACT TO CREATE THE MISSISSIPPI QUALIFIED HEALTH CENTER GRANT PROGRAM TO PROVIDE SERVICE GRANTS TO MISSISSIPPI QUALIFIED HEALTH CENTERS; TO PROVIDE THAT SUCH PROGRAM SHALL BE ADMINISTERED BY THE DEPARTMENT OF ECONOMIC AND COMMUNITY DEVELOPMENT; TO PRESCRIBE THE PROCEDURE TO APPLY FOR SERVICE GRANTS; TO PROVIDE THE PURPOSES FOR WHICH SUCH GRANTS MAY BE USED; TO ESTABLISH AN ADVISORY PANEL TO REVIEW AND MAKE RECOMMENDATIONS ON THE AWARDING OF SERVICE GRANTS; TO CREATE A SPECIAL FUND TO BE KNOWN AS THE MISSISSIPPI QUALIFIED HEALTH CENTER GRANT PROGRAM INTO WHICH ALL MONEY RECEIVED FROM THE ISSUANCE OF BONDS PURSUANT TO THIS ACT SHALL BE DEPOSITED; TO PROVIDE FOR THE ISSUANCE OF $20,000,000.00 IN GENERAL OR LIMITED OBLIGATION BONDS OF THE STATE TO FUND THE PROGRAM; AND FOR RELATED PURPOSES.

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

SECTION 1. For purposes of this act:

(a) "Mississippi qualified health center" means a public or nonprofit entity which provides comprehensive primary care services that:

(i) Has a community board of directors, the majority of whom are users of such centers;

(ii) Accepts all patients that present themselves despite their ability to pay and uses a sliding-fee-schedule for payments; and

(iii) Serves a designated medically undeserved area or population, as provided in Section 330 of the Public Health Service Act.

(b) "Uninsured or medically indigent patient" means a patient receiving services from a Mississippi qualified health center who is not eligible for Medicaid, Medicare or any other type of governmental reimbursement for health care costs or receiving third-party payments via an employer.

(c) "DEAD" means the Mississippi Department of Economic and Community Development.

(d) "Primary care" means the basic entry level of health care provided by health care practitioners or non-physician health care practitioners, which is generally provided in an outpatient setting.

(e) "Medically undeserved area or population" means an area designated by the Secretary of the United States Department of Health and Human Services as an area with a shortage of professionals, health services or a population group designated by the secretary as having a shortage of such services.

(f) "Service grant" means a grant by the DEAD to a Mississippi qualified health center in accordance with this act.

(g) "Program" means the Mississippi Qualified Health Center Grant Program established in this act.

SECTION 2. The Mississippi Qualified Health Center Grant Program is hereby established, under the direction and administration of the DEAD, for the purpose of making service grants to Mississippi qualified health centers for their use in providing care to uninsured or medically indigent patients in Mississippi.

SECTION 3. (1) Any Mississippi qualified health center desiring to participate in the program shall make application for a grant to the DEAD in a form satisfactory to the DEAD. The DEAD shall receive grant proposals from Mississippi qualified health centers. All proposals shall be submitted in accordance with the provisions of grant procedures, criteria and standards developed and made public by the DEAD.

(2) The DEAD shall use the funds provided by this act to make grants during the next five (5) years to Mississippi qualified health centers upon proposals made pursuant to subsection (1) of this section. Grants that are awarded to Mississippi qualified health centers shall only be used by such centers to:

(a) Increase access to preventative and primary care services by uninsured or medically indigent patients that are served by such centers; and

(b) Create new services or augment existing services provided to uninsured or medically indigent patients, including, but not limited to, primary care medical and preventive services, dental services, optometric services, in-house laboratory services, diagnostic services, pharmacy services, nutritional services and social services.

(3) Grants received by Mississippi qualified health centers pursuant to this act shall not be used:

(a) To supplant federal funds traditionally received by such centers, but shall be used to supplement them;

(b) For speculative land or real estate investments;

(c) To finance or satisfy any existing debt; or

(d) Unless the health center specifically complies with a definition of a Mississippi qualified health center contained in Section 1 of this act.

(4) The DEAD shall develop regulations, procedures and application forms to govern how grants will be awarded, shall develop a plan to ensure that grants are equitably distributed among all Mississippi qualified health centers, and shall develop an audit process to assure that grant monies are used to provide and expend care to the uninsured and medially indigent.

(5) The DEAD shall establish a five-year fund for the purpose of providing service grants to Mississippi qualified health centers in accordance with this act and the following terms and conditions:

(a) The total amount of grants issued pursuant to this act shall not exceed Four Million Dollars ($4,000,000.00) in one (1) calendar year.

(b) No Mississippi qualified health center shall receive assistance under this program in excess of Two Hundred Thousand Dollars ($200,000.00) per calendar year.

(c) Each Mississippi qualified health center receiving a service grant shall provide a yearly report to the DEAD which details the number of additional uninsured and medically indigent patients that are cared for and the types of services that are provided.

(6) The DEAD shall establish an advisory council to review and make recommendations to the DEAD on the awarding of any grants to Mississippi qualified health centers. Such recommendations by the advisory council shall not be binding upon the DEAD, but when a recommendation by the advisory council is not followed by the DEAD, the DEAD shall place in its minutes reasons for not accepting the advisory council's recommendation, and provide for an appeals process.

(7) The composition of the advisory council shall be the following:

(a) Two (2) employees of the DEAD, one (1) of whom must have experience in reviewing and writing grant proposals;

(b) Two (2) executive employees of Mississippi qualified health centers, one (1) of whom must be a chief financial officer;

(c) Two (2) health care providers who are affiliated with a Mississippi qualified health center; and

(d) One (1) health care provider who is not affiliated with a Mississippi qualified health center nor the DEAD but has training and experience in primary care.

(8) The DEAD may use a portion of any grant monies received under this act to administer the program and to pay reasonable expenses incurred by the advisory council; provided, however, in no case shall more than two and one-half percent (2-1/2%) or One Hundred Thousand Dollars ($100,000.00) annually, whichever is less, be used to absorb program expenses.

(9) No assistance shall be provided to a Mississippi qualified health center under this act unless the Mississippi qualified health center certifies to the DEAD, that it will not discriminate against any employee or against any applicant for employment because of race, religion, color, national origin, sex or age.

SECTION 4. There is hereby created a special fund in the State Treasury to be known as the Mississippi Qualified Health Center Grant Program out of which grants and expenditures authorized in connection with the program shall be disbursed. All monies received by issuance of bonds to carry out the purposes of this act shall be deposited into the Mississippi Qualified Health Center Grant Program.

SECTION 5. (1) All bonds issued under the authority of this act shall be redeemed at maturity, together with all interest due, on the bonds, and these principal and interest payments shall be paid from the General Fund.

(2) In the event that all or any part of the bonds and notes are purchased, they shall be canceled and returned to the loan and transfer agent as canceled and paid bonds and notes; and thereafter all payments of interest thereon shall cease and the canceled bonds, notes and coupons, together with any other canceled bonds, notes and coupons, shall be destroyed as promptly as possible after cancellation but no later than two (2) years after cancellation. A certificate evidencing the destruction of the canceled bonds, notes and coupons shall be provided by the loan and transfer agent to the seller.

(3) The State Treasurer shall determine and report to the Department of Finance and Administration and Legislative Budget Office by September 1 of each year the amount of money necessary for payment of the principal and interest on outstanding obligations for the following fiscal year and the times and amounts of the payments. It shall be the duty of the Governor to include in every executive budget submitted to the Legislature full information relating to the issuance of bonds and notes under the provisions of this act and the status of the General Fund for the payment of the principal and interest on the bonds and notes.

SECTION 6. (1) The seller is authorized to borrow, on the credit of the state, money not exceeding the aggregate sum of Twenty Million Dollars ($20,000,000.00), not including money borrowed to refund outstanding bonds, notes or replacement notes, as may be necessary to carry out the purposes of this act. The rate of interest on any such bonds or notes which are not subject to taxation shall not exceed the rates set forth in Section 75-17-101, Mississippi Code of 1972, for general obligation bonds.

(2) As evidence of indebtedness authorized in this act, general or limited obligation bonds of the state shall be issued from time to time to provide monies necessary to carry out the purposes of this act for such total amount, in such form, in such denominations, payable in such currencies (either domestic or foreign or both), and subject to such terms and conditions of issue, redemption and maturity, rate of interest and time of payment of interest as the seller directs, except that such bonds shall mature or otherwise be retired in annual installments beginning not more than five (5) years from date thereof and extending not more than twenty (20) years from the date thereof.

(3) All bonds and notes issued under authority of this act shall be signed by the chairman of the seller or by his facsimile signature, and the official seal of the seller shall be affixed thereto, attested by the secretary of the seller.

(4) All bonds and notes issued under authority of this act may be general or limited obligations of the state, and the full faith and credit of the State of Mississippi as to general obligation bonds, or the revenue derived from projects assisted as to limited obligation bonds, are hereby pledged for the payment of the principal of and interest on such bonds and notes.

(5) Such bonds and notes and the income therefrom shall be exempt from all taxation in the State of Mississippi.

(6) The bonds may be issued as coupon bonds or registered as to both principal and interest as the seller may determine. If interest bonds are attached, they shall contain the facsimile signature of the chairman and the secretary of the seller.

(7) As to bonds issued hereunder and designated as taxable bonds by the seller, any immunity of the state to taxation by the United States government of interest on bonds or notes issued by the state is hereby waived.

SECTION 7. (1) Whenever bonds are issued, they shall be offered for sale at not less than par value and accrued interest and shall be sold by the seller at public or private sale, from time to time, in such manner and at such price as may be determined by the seller to be most advantageous.

(2) Any portion of any bond issue so offered and not sold or subscribed for at public sale may be disposed of by private sale by the seller in such manner and at such prices not less than par and accrued interest, as the seller shall direct.

(3) When bonds are issued from time to time, the bonds of each issue shall constitute a separate series to be designated by the seller or may be combined for sale as one (1) series with other general obligation bonds of the State of Mississippi.

(4) Until permanent bonds can be prepared, the seller may in its discretion issue, in lieu of permanent bonds, temporary bonds in such form and with such privileges as to registration and exchange for permanent bonds as may be determined by the seller.

(5) Pending their application to the purposes authorized, bond proceeds held or deposited by the State Treasurer may be invested or reinvested as are other funds in the custody of the State Treasurer in the manner provided by law. All earnings received from the investment or deposit of such funds shall be paid into the State Treasury to the credit of the Mississippi Qualified Health Center Assistance Fund.

(6) The State Treasurer shall prepare the necessary registry book to be kept in the office of the duly authorized loan and transfer agent of the state for the registration of any bonds, at the request of owners thereof, according to the terms and conditions of issue directed by the seller.

(7) All costs and expenses in connection with the issue of, sale and registration of the bonds and notes in connection with this act, and all costs and expenses in connection with implementation of the program and development of application forms, procedures and requirements for use in connection with the program may be paid from the proceeds of bonds and notes issued under this act.

(8) The seller may provide in the resolution authorizing the issuance of such bonds for the employment of one or more persons or firms to assist in the sale of the bonds; to enter into contracts with financial institutions located either within or without the State of Mississippi to act as registrar, paying agents, transfer agents or otherwise; for rating of the bonds; and to purchase insurance.

SECTION 8. (1) Pending the issuance of bonds of the state as authorized under this act, the seller is hereby authorized in accordance with the provisions of this act and on the credit of the state, to make temporary borrowings not to exceed two (2) years in anticipation of the issue of bonds in order to provide funds in such amounts as may, from time to time, be deemed advisable prior to the issue of bonds. In order to provide for and in connection with such temporary borrowings, the seller is hereby authorized in the name and on behalf of the state to enter into any purchase, loan or credit agreement or agreements, or other agreement or agreements with any financial institution or persons in the United States having power to enter into the same, which agreements may contain such provisions not inconsistent with the provisions of this act as may be authorized by the seller.

(2) All temporary borrowings made under this section shall be evidenced by notes of the state which shall be issued, from time to time, for such amounts not exceeding in the aggregate the applicable statutory and constitutional debt limitation, in such form and in such denominations and subject to terms and conditions of sale and issue, prepayment or redemption and maturity, rate or rates of sale and time of payment of interest as the seller shall authorize and direct and in accordance with this act. Such authorization and direction may provide for the subsequent issuance of replacement notes to refund, upon issuance thereof, such notes, and may specify such other terms and conditions with respect to the notes and replacement notes thereby authorized for issuance as the seller may determine and direct.

(3) When the authorization and direction of the seller provide for the issuance of replacement notes, the seller is hereby authorized in the name and on behalf of the state to enter into agreements with any financial institutions or persons in the United States having the power to enter into the same:

(a) To purchase or underwrite an issue or series of issues of notes.

(b) To enter into any purchase, loan or credit agreements, and to draw monies pursuant to any such agreements on the terms and conditions set forth therein and to issue notes as evidence of borrowings made under any such agreements.

(c) To appoint or act as issuing and paying agent or agents with respect to notes.

(d) To do such other acts as may be necessary or appropriate to provide for the payment, when due, of the principal of and interest on such notes.

Such agreements may provide for the compensation of any purchasers or underwriters of notes or replacement notes by payment of a fixed fee or commission at the time of issuance thereof, and for all other costs and expenses, including fees for agreements related to the notes issuing and paying agent costs. Costs and expenses of issuance may be paid from the proceeds of the notes.

(4) When the authorization and direction of the seller provides for the issuance of replacement notes, it shall, at or prior to the time of delivery of these notes or replacement notes, determine the principal amounts, dates of issue, interest rate or rates, rates of discount, denominations and all other terms and conditions relating to the issuance. The State Treasurer shall perform all acts and things necessary to pay or cause to be paid, when due, all principal of and interest on the notes being refunded by replacement notes and to assure that the same may draw upon any monies available for that purpose pursuant to any purchase loan or credit agreements established with respect thereto, all subject to the authorization and direction of the seller.

(5) Outstanding notes evidencing such borrowings may be funded and retired by the issuance and sale of the bonds of the state as hereinafter authorized. The refunding bonds must be issued and sold not later than a date two (2) years after the date of issuance of the first notes evidencing such borrowings to the extent that payment of such notes has not otherwise been made or provided for by sources other than proceeds of replacement notes.

(6) The proceeds of all such temporary borrowing shall be paid to the State Treasurer to be held and disposed of in accordance with the provisions of Section 4 of this act.

SECTION 9. (1) The proceeds realized from the sale of bonds and notes under this act, other than refunding bonds and replacement notes, shall be paid to the State Treasurer and deposited into the Mississippi Qualified Health Center Grant Program and specifically dedicated to the purposes enumerated in this act.

(2) All non-federal funds which may become available for the purposes of this act shall be deposited into the Mississippi Qualified Health Center Grant Program and shall be allocated for the purposes of this act.

(3) The proceeds of the sale of refunding bonds and replacement notes shall be applied solely to the payment of the principal of and the accrued interest on and premium, if any, and costs of redemption of the bonds and notes for which such obligations have been issued.

SECTION 10. The Attorney General of the State of Mississippi shall represent the seller in issuing, selling and validating bonds or notes herein provided for, and the seller is hereby authorized and empowered to expend from the proceeds derived from the sale of the bonds or notes authorized hereunder all necessary administrative, legal and other expenses incidental and related to the issuance of bonds or notes authorized under this act.

SECTION 11. This act shall take effect and be in force from and after July 1, 1999.