Senate Bill 2505

AN ACT TO ESTABLISH THE MISSISSIPPI CRITICAL ACCESS HOSPITAL GRANT PROGRAM UNDER THE ADMINISTRATION OF THE STATE DEPARTMENT OF HEALTH FOR THE PURPOSE OF MAKING GRANTS TO EXISTING FACILITIES THAT QUALIFY AS A CRITICAL ACCESS HOSPITAL; TO PRESCRIBE THE POWERS OF THE DEPARTMENT FOR THE ADMINISTRATION OF THE PROGRAM; TO CREATE A SPECIAL FUND IN THE STATE TREASURY TO BE KNOWN AS THE MISSISSIPPI CRITICAL ACCESS HOSPITAL GRANT PROGRAM FUND FROM WHICH GRANTS AND EXPENDITURES AUTHORIZED IN CONNECTION WITH THE PROGRAM SHALL BE DISBURSED; AND FOR RELATED PURPOSES.

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

SECTION 1. For purposes of this act:

(a) "Critical access hospital" means a hospital which has been designated as a critical access hospital by the department in accordance with the Medicare Rural Hospital Flexibility Program, as provided for in Section 4201 of the Balanced Budget Act of 1997, Public Law 105-33, and which has entered into an agreement with at least one (1) full-service hospital to form a rural health network. The agreement or agreements must include provisions regarding patient referral and transfer, communications and patient transportation. A critical access hospital in a rural health network must also have an agreement for credentialing and quality assurance with at least one (1) hospital that is a member of the rural health network, or with a peer review organization or equivalent entity, or with another appropriate and qualified entity identified in the Rural Health Care Plan for the State of Mississippi.

(b) "Department" means the State Department of Health.

SECTION 2. The Mississippi Critical Access Hospital Grant Program is established, under the direction and administration of the State Department of Health, for the purpose of making grants to existing facilities that qualify as Critical Access Hospitals (CAH) in this state. The Mississippi Critical Access Hospital Grant Program shall be established with such state funds as may be appropriated by the Legislature and will be prorated based on the level of appropriated funds.

SECTION 3. 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 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. 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.

SECTION 4. (1) The department shall receive grant proposals and all proposals shall be submitted in accordance with the provisions of grant procedures, criteria and standards developed and made public by the department. Organizations that submit a grant application:

(a) Must have an IRS designation of 501(c)(3) or be a public entity in the place at the time of the application.

(b) Are expected to demonstrate that they have received CAH status.

(c) Must provide documentation to the department that they will be able to comply with Public Health Services Act Section 330 and with all of the rules and regulations as required.

(2) Grants that are awarded shall only be used for:

(a) Planning, training and technical assistance grants for education of board members and staff regarding development and operations of a CAH.

(b) Development grants for various activities related to assisting organizations in meeting CAH requirements, including health needs assessments and feasibility studies.

(c) Improvement grants for renovation and remodeling and equipment acquisition, but may not be used for new construction.

(d) Transitional operating support grants may be awarded for the hiring of key administrative staff, such as CEO, CFO, and CMO, and the hiring of clinical providers who will increase services and expand access to new patients.

(3) If the applicant receives federal grants, these funds shall not be used to supplant federal funds traditionally received by those entities, but shall be used to supplement them.

(4) The department shall:

(a) Develop regulations, procedures and application forms to govern how the competitive grants will be awarded.

(b) Structure an objective review committee to ensure that grants are competitively awarded and distributed based on need and feasibility. The objective review committee shall include individuals who have knowledge and experience of CAH operations and management, grant writing and administration and of major policy and access issues involving primary care services. No member of the review committee shall participate if he or she could have any monetary effect on any business with which that member is associated, as defined in Section 25-4-103.

(d) Use criteria based on HRSA new access points criteria and health professional shortage area designations for guidance in developing and promulgating rules and regulations.

(e) Review and consider in developing program parameters and criteria the growth priorities as contained and identified in the CAH statewide strategic growth plan.

(5) The department may establish an advisory council to make recommendations regarding the development and promulgation of regulations, procedures, application forms, object review committee structuring and timeline for the program.

(6) The total amount of grants issued under this act shall be Twenty Million Dollars ($20,000,00.00) per state fiscal year, and no individual grant shall exceed twenty-five percent (25%) of the annual award unless there are not enough qualified applicants. All approved grants shall be awarded within thirty (30) days of approval by the department. Each Mississippi entity receiving a grant shall provide a yearly report to the department that details the use of the funds, as required by the department.

(7) The department may use a portion of any grant monies received under this act to administer the program and to pay reasonable expenses incurred by the objective review committee and any established advisory council; however, in no case shall more than one and one-half percent (1-1/2%) or Fifty Thousand Dollars ($50,000.00) annually, whichever is greater, be used for program expenses.

(8) No assistance shall be provided under this act unless the entity 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 5. There is created a special fund in the State Treasury to be known as the Mississippi Critical Access Hospital Grant Program Fund, from 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 this act shall be deposited into the Mississippi Critical Access Hospital Grant Program Fund.

SECTION 6. This act shall take effect and be in force from and after its passage.