Senate Bill NO. 2500

By Representative(s) Committee

SECTION 1. For purposes of Sections 1 through 4 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 underserved 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) "Department" means the Mississippi State Department of Health.

(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 underserved 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 department to a Mississippi qualified health center in accordance with Sections 1 through 4 of this act.

(g) "Program" means the Mississippi Qualified Health Center Grant Program established in Sections 1 through 4 of this act.

SECTION 2. The Mississippi Qualified Health Center Grant Program is established, under the direction and administration of the department, 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. The Mississippi Qualified Health Center Grant Program shall be established with such state funds as may be appropriated by the Legislature.

SECTION 3. (1) Any Mississippi qualified health center desiring to participate in the program shall make application for a grant to the department in a form satisfactory to the department. The department 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 department.

(2) The department shall use the funds provided by Sections 1 through 4 of this act to make grants during the next five (5) years to Mississippi qualified health centers upon proposals made under 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 under Sections 1 through 4 of 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 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 department 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 department shall establish a fund for the purpose of providing service grants to Mississippi qualified health centers in accordance with Sections 1 through 4 of this act and the following terms and conditions:

(a) The total amount of grants issued under Sections 1 through 4 of this act shall be Four Million Dollars ($4,000,000.00) per state fiscal 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 department 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 department shall establish an advisory council to review and make recommendations to the department on the awarding of any grants to Mississippi qualified health centers. Such recommendations by the advisory council shall not be binding upon the department, but when a recommendation by the advisory council is not followed by the department, the department shall place in its minutes reasons for not accepting the advisory council's recommendation, and provide for an appeals process. All approved grants shall be awarded within thirty (30) days of approval by the department.

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

(a) Two (2) employees of the department, 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 department but has training and experience in primary care.

(8) The department may use a portion of any grant monies received under Sections 1 through 4 of this act to administer the program and to pay reasonable expenses incurred by the advisory council; however, in no case shall more than one and one-half percent (1-1/2%) or Sixty Thousand Dollars ($60,000.00) annually, whichever is less, be used to absorb program expenses.

(9) No assistance shall be provided to a Mississippi qualified health center under Sections 1 through 4 of this act unless the Mississippi qualified health center certifies to the department 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 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 legislative appropriation to carry out the purposes of Sections 1 through 4 of this act shall be deposited into the Mississippi Qualified Health Center Grant Program.

SECTION 5. This article shall be known and may be cited as the "Mississippi Health Care Trust Fund Act of 1999."

SECTION 6. It is declared by the Legislature that the monies received by the State of Mississippi from tobacco companies in settlement of a certain lawsuit brought against those companies by the State of Mississippi, or as a result of the settlement of any lawsuit brought against tobacco companies by another state, should be applied toward improving the health and health care of the citizens and residents of the state. It is the intent of the Legislature by this article to provide the manner and means necessary to carry out those purposes.

SECTION 7. When used in this article, the following definitions shall apply, unless the context requires otherwise:

(a) "Act" means the Mississippi Health Care Trust Fund Act of 1999.

(b) "Health Care Trust Fund" means the trust fund established by Section 8 of this act for the deposit of the monies received by the State of Mississippi as a result of the tobacco settlement and any other monies as the state may determine are appropriate.

(c) "Tobacco settlement" means the settlement of the case of Mike Moore, Attorney General ex rel. State of Mississippi v. The American Tobacco Company et al. (Chancery Court of Jackson County, Mississippi, Cause No. 94-1429) and the settlement of any case brought against tobacco companies by another state.

SECTION 8. (1) In accordance with the purposes of this article, there is established in the State Treasury the Health Care Trust Fund, into which shall be deposited all monies that are received by the State of Mississippi as a result of the tobacco settlement for which the use or purpose for expenditure is not restricted by the terms of the settlement, all interest earnings on those monies, and any other monies as the state may determine are appropriate. Monies in the Health Care Trust Fund that are subject to expenditure shall be expended exclusively for health issues.

(2) The principal of the Health Care Trust Fund shall remain inviolate and shall never be expended. The Legislature may appropriate all of the income from the Health Care Trust Fund in furtherance of the purposes of this article, less six percent (6%) of the annual income of the Health Care Trust Fund, which shall be added to the principal of the fund each year.

SECTION 9. (1) The State Treasurer shall invest the monies of the Health Care Trust Fund in any of the investments authorized for the Mississippi Prepaid Affordable College Tuition Program under Section 37-155-9, and those investments shall be subject to the limitations prescribed by Section 37-155-9.

(2) All interest derived from investments and any gains from the sale or exchange of investments shall be credited to the account of the Health Care Trust Fund.

(3) For the purpose of meeting disbursements for funding health issues and the costs and expenses of administering the Health Care Trust Fund, cash may be kept available, not exceeding the requirements of the Health Care Trust Fund for a period of ninety (90) days, on deposit in one or more banks or trust companies organized under the laws of the State of Mississippi or the laws of the United States, provided that the sum on deposit in any one (1) bank or trust company shall not exceed thirty-five percent (35%) of the paid-up capital and regular surplus of the bank or trust company.

SECTION 10. Sections 5 through 10 of this act shall be inserted as a new article in Title 43, Chapter 13, Mississippi Code of 1972.

SECTION 11. Sections 1 through 4 of this act shall take effect and be in force from and after July 1, 1999, and Sections 5 through 10 of this act shall take effect and be in force from and after the passage of this act.

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 STATE DEPARTMENT OF HEALTH; 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 LEGISLATIVE APPROPRIATION PURSUANT TO THIS ACT SHALL BE DEPOSITED; TO ESTABLISH A HEALTH CARE TRUST FUND IN THE STATE TREASURY INTO WHICH SHALL BE DEPOSITED MONIES FROM THE SETTLEMENT OF THE LAWSUIT AGAINST TOBACCO COMPANIES BY THE STATE OF MISSISSIPPI; TO PROVIDE THAT THE PRINCIPAL OF THE TRUST FUND SHALL REMAIN INVIOLATE AND SHALL NEVER BE EXPENDED; TO PROVIDE THAT MONIES IN THE TRUST FUND THAT ARE SUBJECT TO EXPENDITURE SHALL BE EXPENDED EXCLUSIVELY FOR HEALTH ISSUES; TO PROVIDE THAT MONIES IN THE TRUST FUND SHALL BE INVESTED IN ANY OF THE INVESTMENTS AUTHORIZED FOR THE MISSISSIPPI PREPAID AFFORDABLE COLLEGE TUITION PROGRAM; AND FOR RELATED PURPOSES.