Hospitals and Health Care Facilities - As enacted, establishes regulations regarding the licensing and regulating of certain medically related facilities. - Amends TCA Title 4; Title 33; Title 68 and Title 71.
SB0858 has been assigned Public Chapter Number 466 by the Secretary of State.
  • Bill History
  • Amendments
  • Video
  • Summary
  • Fiscal Note
  • Votes
  • Actions For SB0858Date
    Effective date(s) 05/17/2023, 07/01/2023, 07/01/202405/24/2023
    Pub. Ch. 46605/24/2023
    Signed by Governor.05/17/2023
    Transmitted to Governor for action.05/09/2023
    Signed by H. Speaker05/05/2023
    Signed by Senate Speaker05/03/2023
    Enrolled and ready for signatures04/28/2023
    Passed H., Ayes 93, Nays 0, PNV 104/20/2023
    Am. withdrawn. (Amendment 2 - HA0325)04/20/2023
    Am. withdrawn. (Amendment 1 - HA0324)04/20/2023
    Subst. for comp. HB.04/20/2023
    Rcvd. from S., held on H. desk.04/06/2023
    Engrossed; ready for transmission to House04/04/2023
    Sponsor(s) Added.04/03/2023
    Passed Senate as amended, Ayes 32, Nays 004/03/2023
    Senate adopted Amendment (Amendment 1 - SA0324)04/03/2023
    Senate adopted Amendment (Amendment 2 - SA0325)04/03/2023
    Placed on Senate Regular Calendar for 4/3/202303/31/2023
    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 003/22/2023
    Placed on Senate Health and Welfare Committee calendar for 3/22/202303/15/2023
    Action deferred in Senate Health and Welfare Committee to 3/22/202303/15/2023
    Placed on Senate Health and Welfare Committee calendar for 3/15/202303/08/2023
    Action deferred in Senate Health and Welfare Committee to 3/15/202303/08/2023
    Placed on Senate Health and Welfare Committee calendar for 3/8/202303/01/2023
    Action deferred in Senate Health and Welfare Committee to 3/8/202302/22/2023
    Placed on Senate Health and Welfare Committee calendar for 2/22/202302/15/2023
    Passed on Second Consideration, refer to Senate Health and Welfare Committee02/06/2023
    Introduced, Passed on First Consideration02/02/2023
    Filed for introduction01/31/2023
    Actions For HB0952Date
    Comp. became Pub. Ch. 46605/24/2023
    Sponsor(s) Added.04/20/2023
    Comp. SB subst.04/20/2023
    H. Placed on Regular Calendar 2 for 4/19/202304/18/2023
    Placed on cal. Calendar & Rules Committee for 4/18/202304/18/2023
    Rec. for pass; ref to Calendar & Rules Committee04/18/2023
    Placed on cal. Finance, Ways, and Means Committee for 4/18/202304/18/2023
    Rec. for pass by s/c ref. to Finance, Ways, and Means Committee04/18/2023
    Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/18/202304/12/2023
    Assigned to s/c Finance, Ways, and Means Subcommittee04/12/2023
    Rec. for pass; ref to Finance, Ways, and Means Committee04/10/2023
    Placed on cal. Government Operations Committee for 4/10/202304/05/2023
    Rec. for pass. if am., ref. to Government Operations Committee03/29/2023
    Placed on cal. Health Committee for 3/29/202303/22/2023
    Rec for pass if am by s/c ref. to Health Committee03/21/2023
    Placed on s/c cal Health Subcommittee for 3/21/202303/15/2023
    Action Def. in s/c Health Subcommittee to 3/21/202303/14/2023
    Placed on s/c cal Health Subcommittee for 3/14/202303/08/2023
    Assigned to s/c Health Subcommittee02/07/2023
    Sponsor(s) Added.02/02/2023
    P2C, ref. to Health Committee -- Government Operations for Review02/02/2023
    Intro., P1C.02/01/2023
    Filed for introduction01/30/2023
  • AmendmentsFiscal Memos
    SA0324Amendment 1-0 to SB0858Fiscal Memo for SA0324 (5864)  
    SA0325Amendment 2-0 to SB0858Fiscal Memo for SA0325 (5507)  Fiscal Memo for SA0325 (5507)  
    AmendmentsFiscal Memos
    HA0324Amendment 1-1 to HB0952Fiscal Memo for HA0324 (5507)  Fiscal Memo for HA0324 (5507)  
    HA0325Amendment 2-2 to HB0952Fiscal Memo for HA0325 (5864)  

    NOTE: Each fiscal memorandum applies only to the amendment(s) identified in the memorandum. The fiscal memorandum must be matched to any amendments that have been adopted.

  • Videos containing keyword: SB0858

  • Fiscal Summary

    NOT SIGNIFICANT


    Bill Summary

    ON APRIL 3, 2023, THE SENATE ADOPTED AMENDMENTS #2 AND #1 AND PASSED SENATE BILL 858, AS AMENDED.

    AMENDMENT #2 removes the provisions of amendment 1 that revised present law concerning the powers and authority granted generally to the health facilities commission and, instead, adds that:

    (1) The commission may license, for purposes of providing acute care services, a facility that is additionally licensed by the department of mental health and substance abuse services;

    (2) The commission may promulgate rules to govern the process of licensing, for purposes of providing acute care services, a facility that is or may become additionally licensed by the department of mental health and substance abuse services and that is not otherwise exempt from licensing under the laws of this state or federal law;

    (3) The commission must consult with the department of mental health and substance abuse services when promulgating rules described in (2) above;

    (4) (1)-(3) above do not alter or preclude the requirement that a facility, not otherwise exempt, obtain licensure from the department of mental health and substance abuse services; and

    (5) The board for licensing health care facilities is authorized to promulgate rules governing the designation of rural emergency hospitals in a manner consistent with the federal regulations of the federal centers for medicare and medicaid services.

    AMENDMENT #1 rewrites this bill to establish regulations regarding the licensing and regulating of certain medically related facilities.

    HEALTH FACILIITIES COMMISSION

    Present law provides that the commission is empowered to license and regulate hospitals, recuperation centers, nursing homes, homes for the aged, residential HIV supportive living facilities, assisted-care facilities, home care organizations, residential hospices, birthing centers, prescribed child care centers, renal dialysis clinics, ambulatory surgical treatment centers, outpatient diagnostic centers, adult care homes, and traumatic brain injury residential homes. This amendment expands the authority of the health facilities commission to include the licensing and regulating of assisted-care facility administrators.

    BOARD OF LICENSING HEALTH CARE FACILITIES

    Under present law, until the board adopts building and fire safety rules pursuant to this section, the codes and rules in effect on July 1, 1981, apply to those facilities licensed under this part. A facility that complies with the required applicable building and fire safety regulations at the time the board adopts new codes or rules is, as long as compliance is maintained, either with or without waivers of specific provisions, considered to be in compliance with the new codes or rules.

    This amendment removes these provisions in their entirety and instead provides that a majority of members, not including vacant positions on the board, constitutes a quorum for the transaction of all business. This amendment further clarifies that for the purposes of contested base hearings and disciplinary matters, three or more members constitute a necessary quorum, and the board chairperson is authorized, when it is deemed necessary, to split the board into panels of three or more members each to conduct contested case hearings or disciplinary matters. A majority vote of the members present on a duly constituted panel is required to authorize board action in disciplinary matters and contested case hearings. The board chairperson has the authority to appoint board members to serve, as necessary, on the panels regardless of the professional category from which the appointed member was chosen or the member’s status as a physician, administrator, or citizen member. The existence of a non-physician or non-administrator board member creates no rights in any individual concerning the composition of a panel in any disciplinary matter or contested case hearing. However, the unavailability of a member of a panel before rendition of a final order must not require the substitution of another member unless the unavailability results in there being less than the quorum required by statute for contested case hearings or disciplinary matters. A substitute must use any existing record and may conduct further proceedings as is necessary in the interest of justice. In addition, this amendment removes the provision that requires that two members of the commission must be ex officio members.

    PENALTIES FOR A FACILITY’S OR INVIDIVIUAL’S NONCOMPLIANCE

    This amendment provides that an action to recover or collect a civil monetary penalty owed pursuant to this amendment by a noncomplying facility or individual must not be taken until the facility or individual has waived the right to a contested case hearing; the time allowed for the facility or individual to demand a contested case hearing has expired without a demand being made or a denial filed; or a final administrative order has been entered pursuant to statute.

    If the full amount of the civil monetary penalty owed has not been received in full within 60 days from the occurrence of an event described in law or received by the due date specified by order, then the executive director of the health care facilities commission must immediately proceed to recover such amount, plus interest computed at the applicable formula rate approved by statute, retroactive to the earliest data of occurrence of a noncomplying event by one or more of following means: directing the reduction of the amount owed from any balance otherwise due from the state to the facility and directing a remittance of the amount to the health facilities commission; adding such amounts to the licensing fee, with renewal of the license contingent upon the prior payment of such costs; or bringing an action in circuit or chancery court to recover such amounts.

    PROBATIONARY PERIOD

    This amendment authorizes the executive director to, by written order, extend the probationary period beyond the standard 12 months for a facility to come into compliance.

    HEARINGS BEFORE BOARD

    Present law generally provides that any licensee, or applicant for license, aggrieved by a decision or action of the commission or board, may request a hearing before the board. This amendment removes this provision and, instead, provides, that the commission and each board, committee, or council under the authority of this amendment that does not already have authority to utilize screening panels may utilize one or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and appropriate.

    In addition, this amendment specifies that the activities of a screening panel and any mediation or arbitration sessions must not be construed as an open meeting of an agency and remain confidential. The members of a screening panel, mediators, and arbitrators have a deliberative privilege and the same immunity as provided by law for the boards and are not subject to deposition or subpoena to testify regarding any matter or issue raised in any contested case, criminal prosecution, or civil lawsuit that may result from or that is incident to cases processed before the panel. A screening panel has the authority to administer an oath to witnesses. Any documents or records produced at the screening panel are exempt from disclosure as a public record until there is a filing of a notice of charges and such documents or records form the basis for the filing of a notice of charges.

    This amendment also provides that members of a screening panel may be drawn from among the membership of the relevant board, and members may be appointed by the relevant board. Non-board members must meet the requirements of membership for the relevant board and may include a consumer member. However, a board member serving on a panel is prohibited from participating in a contested case involving any matter heard by the panel.


    Each screening panel is required to be instructed as to the statutes, rules, and philosophies of the relevant board as it pertains to disciplinary action and procedures that must be followed by the panel. Each screening panel must be provided a copy of Tennessee Supreme Court Rule 31 for review by members of the screening panel for general guidance as to the principles of mediation and alternative dispute resolution.

    Furthermore, a board is also prohibited from compelling any party to participate in a screening panel, and no prejudice is incurred if a party chooses not to participate in a screening panel or to accept the offer of a screening panel.

    In addition, on or after July 1, 2024, a licensee or applicant for a license aggrieved by a decision or action of the commission pursuant to this bill may request a hearing before the commission. The amendment goes on further to clarify that the chair of the health facilities commission may appoint a five-member ad hoc litigation committee composed of members of the commission when deemed necessary by the chair or the commission.

    INJUNCTIONS AND PENALTIES

    Currently, based upon a complaint that a home for the aged, assisted-care living facility, adult care home or traumatic brain injury residential home, subject to licensure under this part may be operating without a license, the commission, with consent of an owner, operator, manager, or person who participates in the operation, or patient or resident, or the guardian of the patient or resident, may enter the facility in order to investigate or inspect the complaint for the necessity of or compliance with licensure under law.

    However, this amendment removes these provisions entirely and instead, specifies that within five working days after concluding an inspection or investigation, the executive director may initiate type A civil penalty proceedings by mailing a notice to the facility, stating the executive director’s decision to suspend the admissions of new patients. However, within 10 working days after concluding an inspection or investigation, the health facilities commission must mail to the nursing home the executive director’s order, which must also inform the nursing home of its right to contest the action.

    INITIATION OF TYPE B OR C PENALTY HEARING FOR DEFICIENT NURSING HOMES

    Within three working days after concluding the inspection or investigation, the health facilities commission may initiate type B or type C civil penalty proceedings by mailing to the nursing home a written statement citing the relevant provisions that the health facilities commission alleges to have been violated, stating the amount of the penalty being assessed, and informing the facility of its right to contest the penalty. In addition, the present law also provides that within eight working days after concluding the inspection or investigation, the health facilities commission is required to mail to the nursing home a more detailed statement describing the findings with particularity and citing the law with specificity. This amendment increases the number of days the health facilities commission has to initiate the civil proceedings from 3 to 5 working days; and increases the number of days the health facilities commission has to mail to the nursing home a more detailed statement from 8 to 10 working days.

    TRANSFERABILITY OF CERTIFICATE OF NEED

    Present law does not prohibit a change of control, if the commission determines, upon petition of the prospective owner or owners of the entity, that the prospective owner or owners demonstrate that they meet the criteria of economic feasibility, contribution of orderly development, and the relevant considerations mandated by statue. This amendment revises the evidence the new owners must demonstrate to the commission before the change of control is permitted. The prospective owners must demonstrate the owner or owners will provide health care that meets appropriate quality standards, and that the transfer would not reduce access to consumers, particularly those in underserved communities; those who are uninsured or underinsured; women and racial and ethnic minorities; TennCare or Medicaid recipients; and low-income groups.

    REPORT ON NURSING HOME INSPECTION AND ENFORCEMENT ACTIVITIES

    Under current law, the commissioner is required to submit a report by not later than February 1 of each year to the governor and to each house of the general assembly regarding the department's nursing home inspection and enforcement activities during the previous year. The report must analyze trends in compliance with nursing home standards and residents' rights by nursing homes in the state, and must be limited to identifying those trends through aggregate and quantitative data only. In preparing the report, the commissioner may utilize quantitative data compiled by nursing homes pursuant to federal or state regulations. In addition, the commissioner must ensure that the report is promptly made available to the public by dissemination via the internet and that the report is available for members of the public to copy.

    This amendment removes these provisions and, instead, requires that the executive director of the health facilities commission submit a report no later than February 1 of each year to the governor, the chief clerk of the house of representatives, and the chief clerk of the senate, regarding the commission's nursing home inspection and enforcement activities during the previous year. The executive director must also ensure that the report is promptly made available to the public by dissemination via the internet and that the report is available for members of the public to copy.

    FIRE SAFETY

    This amendment shifts the duties and responsibilities regarding the fire safety in assisted living facilities and in licensed homes for the aged from the department of health to the health facilities commission.

    RECORDS REQUIRED TO BE KEPT BY LICENSEES AND PERMITTEES

    Present law provides that:

    (1) Notwithstanding any other provision of law to the contrary, an ambulance service provider must furnish to a patient or a patient's authorized representative a copy of such patient's run record or records within five business days upon request in writing by the patient or such representative; and

    (2) Except as otherwise provided by law, such patient's run record or records must not constitute a public record, and nothing contained in this part will be deemed to impair any privilege of confidentiality conferred by law on patients, their personal representatives or heirs. Nothing in this (2) will impair or abridge the right of the patient or the patient's authorized representative to obtain copies of the patient's hospital records in the manner provided in statute. Nothing in (2) should be construed as prohibiting a patient's run record or records from being subpoenaed by a court of competent jurisdiction. As used in (1)-(2), “run record” includes any list of patients that is compiled or maintained by or for such patient's ambulance service provider, but shall not include the dispatch log.

    This amendment revises (1) by also requiring that an ambulance service provider must furnish a copy of a patient’s run record or records to a surveyor employed by the health facilities commission within five business days upon request in writing by the surveyor or health facilities commission staff.

    This amendment revises (2) by providing that (2) does not prohibit a health facilities commission surveyor investigating an incident in a certified or licensed healthcare facility from obtaining a copy of this record without a subpoena incident to a health facility investigation.

    STATE PALLIATIVE CARE AND QUALITY OF LIFE COUNCIL MEMBERSHIP

    Present law provides that the council membership must be appointed by the executive director, after consulting with Tennessee Hospice Association, Tennessee Hospital Association, Tennessee Medical Association, Tennessee Nursing Association, Tennessee Health Care Association, Tennessee Association of Home Care, and the Tennessee Chapter of American Cancer Society, and shall include interdisciplinary palliative care medical, nursing, social work, pharmacy, and spiritual professional expertise; patient and family caregiver advocate representation; and any other relevant appointees the executive director determines appropriate. The council must also consist of no more than 11 members. The executive director must also consider the racial, geographic, urban/rural, and economic diversity of the state when appointing members. Membership shall specifically include health professionals having palliative care work experience or expertise in palliative care delivery models in a variety of inpatient, outpatient, and community settings such as acute care, long-term care, and hospice, and with a variety of populations, including pediatric, youth, and adult. At least one council member must be a board-certified hospice and palliative medicine physician; at least one council member is required to be a licensed certified registered nurse practitioner with expertise in palliative care; and one council member must be from the department of health. Council members must also be appointed for a term of three years. The members must elect a chair and vice chair, whose duties shall be established by the council. The council must fix a time and place for regular meetings that meet no less than twice yearly.

    This amendment increases the number of members from 11 to 12 and further adds that one of the council members must be the executive director of the health facilities commission or the executive director’s designated representative.

    ALZHEIMER’S DISEASE AND RELATED DEMENTIA ADVISORY COUNCIL

    The current law provides that the council must be composed of no less than 11 members but must not exceed 16 members. This amendment raises the maximum number of members from 16 to 17, which must include the executive direct of the Tennessee health facilities commission.

    REGULATION OF HEALTH AND RELATED FACILITIES

    This amendment shifts the duties and responsibilities of licensing and regulating adult care facilities; adult care home providers, including resident managers; assisted-care living facilities; a home care organization qualified to provide home health services, home medical equipment or hospice services; residential homes for the aged; hospitals that provide certain services; recuperation center; and residential hospice from the board of licensing health care facilities to the health facilities commission. This amendment also shifts the duties and responsibilities of reviewing facilities, construction planned by facilities, standards regulating accessibility by disabled, branch offices of home care organizations, the use of endoscopy technicians, and other radiological staff at ambulatory surgical treatment centers, and other related provisions from the board of licensing health care facilities to the health facilities commission.

    In addition, this amendment removes the present law that requires the commission to accomplish licensing and regulation through the board for licensing healthcare facilities to be created in a manner provided by statute and other employees as are provided for in statute.

    This amendment also provides that the definitions of board and department for the purposes of health facilities and resources statutes no longer apply and adds for the purpose of reporting incidents of abuse, neglect, and misappropriate, the term commission should be included to mean the health facilities commission. In addition, for the purposes of this bill, the amendment defines certain terminology:

    (1) A “conflict of interest” means a matter before the commission in which the member or employee of the commission has a direct interest or indirect interest that is in conflict or gives the appearance of conflict with the discharge of the member's or employee's duties;

    (2) “Direct interest” refers to a pecuniary interest in the persons involved in a matter before the commission, and applies to the commission member or employee, the commission member's or employee's relatives, or an individual with whom or business in which the member or employee has a pecuniary interest. As used in this bill, "relative" means a spouse, parent, child, stepparent, stepchild, grandparent, grandchild, brother, sister, half-brother, half-sister, aunt, uncle, niece, or nephew by blood, marriage, or adoption;

    (3) “Ex parte communications” means communications in violation of present law;

    (4) “Indirect interest” means a personal interest in the persons involved in a matter before the commission that is in conflict with the discharge of the commission member's or employee's duties;

    (5) “Needs assessment” means an annual report that measures access to health care in this state, particularly as to emergency and primary care; identifies access gaps; and serves to inform the criteria and standards for the issuance of certificates of need;

    (6) “Nonresidential substitution-based treatment center for opiate addiction” includes, but is not limited to, stand-alone clinics that offer methadone, products containing buprenorphine, such as Subutex and Suboxone, or products containing another formulation designed to treat opiate addiction by preventing symptoms of withdrawal;

    (7) “Nursing home bed” means a licensed bed within a nursing home, regardless of whether the bed is certified for Medicare or Medicaid services and a bed at a healthcare institution that is used as a swing bed under federal regulation;

    (8) “Rehabilitation facility” means an inpatient or residential facility that is operated for the primary purpose of assisting in the rehabilitation of physically disabled persons through an integrated program of medical and other services that are provided under professional supervision.

    These revisions (and the remaining revisions in this summary) take effect July 1, 2024.

    HEALTH FACILITIES COMMISSION JURISDICTION AND POWERS

    This amendment removes all provisions dealing with the members and authority of the board of licensing health care facilities and instead provides that a health facilities commission must be established that has jurisdiction and powers relating to the licensing and regulation of healthcare facilities as defined in present law; the certificate of need program; the development of the criteria and standards to guide the commission when issuing certificates of need; conducting of studies related to health care, which must include a needs assessment; and related reporting of healthcare institutions. In addition, the commission consists of 15 members, including:

    (1) The comptroller of the treasury, or an employee of the office of the comptroller of the treasury, designated by the comptroller;

    (2) The executive director of the commission on aging and disability, or an employee of the commission on aging and disability, designated by the director;

    (3) The director of TennCare, or an employee of the division of TennCare, designated by the director;

    (4) Four members appointed by the speaker of the senate that includes one consumer member, one individual who has recent experience as an executive officer of a hospital or hospital system who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association; one representative of the nursing home industry who may be appointed from lists of qualified persons submitted by interested healthcare groups, including, but not limited to, the Tennessee Health Care Association; and one duly licensed physician who may be appointed from lists of qualified persons submitted by interested medical groups, including, but not limited to, the Tennessee Medical Association; and

    (5) Four members appointed by the speaker of the house of representative, to include the same qualifications listed in (4) as well as one representative of the assisted-care living facility industry, and one representative of the ambulatory surgical treatment center industry.

    This amendment also requires that the governor and speakers consult with interested groups including, but not limited to, the organizations listed above in (1)-(5) to determine qualified persons to fill positions with the commission. In making appointments to the health facilities commission, the governor and the speakers must strive to ensure that racial minorities, females, persons 60 years of age and older, and the three grand divisions are represented. This amendment goes on to specify that the consumer members must be persons who are knowledgeable of health needs and services and who are further knowledgeable by training or experience in healthcare facility design or construction, financing of healthcare services or construction, reimbursement of healthcare services, or general healthcare economics. However, the consumer members must not be a direct provider of healthcare goods or services.

    A member of the commission must not serve beyond the expiration of the member's term, whether or not a successor has been appointed by the governor or the speakers of the senate and the house of representatives. This amendment also specifies that the commission members are appointed for three-year terms, which may be served consecutively without a limitation upon the number of consecutive or non-consecutive terms a member may serve. In addition, the comptroller of the treasury, the executive director of the commission on aging and disability, and the director of TennCare, or their respective designees, are not limited to a term of years. In order to stagger the initial terms of the consumer members of the commission, the initial term for the consumer member appointed under (4) is three years while the initial term for the consumer member appointed under (5) is two years.

    This amendment also removes all provisions in present law that deal with and establish the current health facilities commission and replaces it with those enumerated above.

    EXECUTIVE DIRECTOR

    The commission is required to appoint an executive director qualified by education and experience. The executive director must demonstrate knowledge and experience in the areas of public administration and health policy development. The executive director of the commission on June 30, 2026, will remain executive director on July 1, 2026, without the need for reappointment by the commission.

    This amendment also provides that the executive director is the chief administrative officer of the commission, exercising general supervision over all persons employed by the commission. The commission's staff is subject to personnel rules and policies that are applicable to state employees in general, including leave, compensation, classification, and travel rules and policies. The commission must fix the salary of the executive director; any adjustments to the executive director's salary due to administration changes to multiple employees in the executive director's job classification do not require commission approval. The commission has the sole authority to appoint, terminate, and control the work of the executive director. The executive director has the exclusive authority to appoint, terminate, and control staff employees. The commission's employees are executive service and serve at the pleasure of the executive director. This amendment lists specific duties granted to the executive director, including submitting an annual report, no later than January 15 of each year, to the chairs of the health and welfare committee of the senate and the health committee of the house of representatives that includes, but is not limited to, a comparison of the actual payer mix and uncompensated care provided by special health services licensees with the projections the licensees submitted in the licensee's special health services license application.

    This amendment clarifies that in addition to the duties granted to the executive director, the commission has the authority to delegate certain duties listed in the bill to the executive director, which will continue until specifically revoked by the commission. The executive director is required to notify the commission of an action taken pursuant to a delegation of authority at the commission’s next regularly scheduled meeting.

    The commission is required to review an action by the executive director if the executive director receives a written request for commission review or a commission member requests a commission review. If a request for commission review is received within 15 days of the date the executive director provides notice of the action, then the action does not become final until the commission has rendered its final decision. If, however, the request is made by a commission member and is not received pursuant to the specifications mentioned above, then the executive director’s action becomes final as if the action was taken by the commission.

    A commission review of action taken by the executive director must be conducted at the next regularly scheduled commission meeting that is scheduled for a date no less than two weeks after the date the request for review is received. This is under the de novo standard, and the commission is required to use the then-current edition of Robert’s Rules of Order as the rules of parliamentary procedure applicable to a commission review.

    MEETINGS

    Each member and necessary staff and faculty of the commission must be reimbursed for all travel and other necessary expenses. Expenditures must be claimed and paid in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration, and approved by the attorney general and reporter. If a member is absent from three consecutive, regularly scheduled public meetings of the commission, then the individual's membership is automatically terminated, and the position is considered vacant.


    At the first meeting in each even-numbered year, the commission is required to elect officers. The chair of the commission must be a consumer member to serve a term as chair for two years. A member must not serve more than two consecutive terms as chair and a member of the commission may serve as vice chair, which is a term of two years. In addition, a member is prohibited from serving more than two consecutive terms as vice chair.

    This amendment also provides that meetings of the commission must be held as frequently as its duties may require, and no less frequently than eight times each fiscal year. A majority of appointed members, not including vacant positions, constitute a quorum. This amendment also clarifies that an action of the commission is not effective unless the action is concurred in by a majority of commission members present and voting. The chair may only vote if there is a tie among the other members present and voting and the commission must record by name the votes taken on all actions of the commission.

    All commission members shall annually review and sign a statement acknowledging the statute, rules, and policies concerning conflicts of interest. A member, upon determining that a matter scheduled for consideration by the commission results in a conflict with a direct interest, must immediately notify the executive director and is recused from any deliberation of the matter, from making any recommendation, from testifying concerning the matter, or from voting on the matter. The member must then join the public during the proceedings. However, a member with an indirect interest must publicly acknowledge such interest, unless the member is recused from deliberation on, making a recommendation regarding, testifying concerning, or voting on the matter. All members are required to make every reasonable effort to avoid even the appearance of a conflict of interest. If a member is uncertain whether the relationship justifies recusal, then the member must follow the determination by the legal counsel for the commission.

    A determination by the commission or a court that a member of the commission with a direct interest failed to provide notice and be recused from deliberations of the matter, from making any recommendation, from testifying concerning the matter, or from voting on the matter, results in the member's automatic termination from the commission and the position is considered vacant. The member is not eligible for appointment to any commission, board, or commission of this state for a period of two years. The executive director, upon determining that a conflict exists for the executive director or a member of the staff, must notify the chair of the commission and take such action as the chair prescribes and pursuant to this bill.

    DUTIES AND RESPONSIBILITIES

    In addition to the powers granted elsewhere in this amendment, the commission has the duty and responsibility to:

    (1) Promulgate rules and policies deemed necessary by the commission for the fulfillment of its duties and responsibilities under this amendment;

    (2) Promulgate rules and policies deemed necessary by the commission for the fulfillment of its duties and responsibilities, including, but not limited to, criteria to guide the commission in the issuance of certificates of need;

    (3) Conduct studies related to health care, including a needs assessment that must be updated at least annually; and

    (4) Contract when necessary for the development of criteria and standards to guide the commission when issuing certificates of need and for the implementation of the certificate of need program.

    In addition, this amendment shifts the authorization with respect to the inspection of administrative, clerical employees and other facility, and the authority to suspend or revoke a license of a center that terminates pregnancies onto the commission. In addition, this amendment removes the provision that requires the board to promulgate rules requiring the board to adopt and appropriately utilize universal precautions for prevention of HIV transmission.

    LICENSURE REQUIREMENTS

    Present law provides that the board, in its discretion, must be authorized to issue licenses to several licensees in such form as it may deem necessary to distinguish between and identify any of the facilities required to be licensed by the commission. It also provides that board administrative staff must maintain a file of reported complaints. The file must include the name of the facility against whom the complaint is filed, the date the complaint is filed, the action taken by the board, if any, on the complaint, and the date of the action taken.

    This amendment shifts this authorization mentioned above, the authorization for approving applications for licensure, the responsibility of maintaining a file of reported complaints, the authority to issue injunctions and penalties, and the requirement to post and update the required information regarding the facilities it licenses on the internet onto the commission established by this bill. This amendment also removes the requirement that the board conduct either one joint inspection for each licensing period or accept the investigation of one of the enumerated entities.

    COLLABORATION WITH THE COMMITTEE ON PEDIATRIC EMERGENCY CARE

    The required collaboration with the committee on pediatric emergency care in order to support the legislative intent enumerated in statute and to also support the delivery of educational services and equipment to providers of emergency pediatric medical services in facilities it licenses is shifted onto the health facilities commission.

  • FiscalNote for SB0858/HB0952 filed under HB0952
  • House Floor and Committee Votes

    House moved to substitute and conform to SB0858

    SB0858 by Reeves - FLOOR VOTE: REGULAR CALENDAR 2 PASSAGE ON THIRD CONSIDERATION 4/20/2023
    Passed
              Ayes...............................................93
              Noes................................................0
              Present and not voting...................1

              Representatives voting aye were: Alexander, Barrett, Baum, Beck, Boyd, Bricken, Bulso, Burkhart, Butler, Campbell S, Camper, Capley, Carr, Carringer, Cepicky, Chism, Clemmons, Cochran, Crawford, Darby, Davis, Dixie, Doggett, Eldridge, Faison, Farmer, Freeman, Fritts, Gant, Garrett, Glynn, Grills, Hakeem, Hale, Hardaway, Harris, Haston, Hawk, Hazlewood, Helton-Haynes, Hemmer, Hicks G, Hicks T, Holsclaw, Howell, Hulsey, Hurt, Jernigan, Johnson C, Johnson G, Jones, Keisling, Kumar, Lafferty, Lamberth, Leatherwood, Littleton, Love, Lynn, Marsh, Martin B, Martin G, McCalmon, McKenzie, Miller, Mitchell, Moody, Parkinson, Powell, Powers, Ragan, Raper, Reedy, Richey, Rudd, Rudder, Russell, Shaw, Sherrell, Slater, Stevens, Terry, Thompson, Todd, Towns, Vaughan, Warner, White, Whitson, Williams, Wright, Zachary, Mr. Speaker Sexton -- 93.
              Representatives present and not voting were: Pearson -- 1.

              HB0952 by Boyd - HOUSE FINANCE, WAYS, AND MEANS COMMITTEE:
    Rec. for pass; ref to Calendar & Rules Committee 4/18/2023
              Voice Vote - Ayes Prevail

    HB0952 by Boyd - HOUSE FINANCE, WAYS, AND MEANS SUBCOMMITTEE:
    Rec. for pass by s/c ref. to Finance, Ways, and Means Committee 4/18/2023
    Failed
              Ayes................................................0
              Noes................................................0


              HB0952 by Boyd - HOUSE GOVERNMENT OPERATIONS COMMITTEE:
    Rec. for pass; ref to Finance, Ways, and Means Committee 4/10/2023
              Voice Vote - Ayes Prevail

              HB0952 by Boyd - HOUSE HEALTH COMMITTEE:
    Rec. for pass. if am., ref. to Government Operations Committee 3/29/2023
              Voice Vote - Ayes Prevail

              HB0952 by Boyd - HOUSE HEALTH SUBCOMMITTEE:
    Rec for pass if am by s/c ref. to Health Committee 3/21/2023
              Voice Vote - Ayes Prevail

    Senate Floor and Committee Votes

    SB0858 by Reeves - FLOOR VOTE: as Amended Third Consideration 4/3/2023
    Passed
              Ayes...............................................32
              Noes................................................0

              Senators voting aye were: Bailey, Bowling, Briggs, Campbell, Crowe, Gardenhire, Haile, Hensley, Jackson, Johnson, Kyle, Lamar, Lowe, Lundberg, Massey, Niceley, Oliver, Pody, Powers, Reeves, Roberts, Rose, Southerland, Stevens, Swann, Taylor, Walley, Watson, White, Yager, Yarbro, Mr. Speaker McNally -- 32.

    SB0858 by Reeves - SENATE HEALTH AND WELFARE COMMITTEE:
    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0 3/22/2023
    Passed
              Ayes................................................9
              Noes................................................0

              Senators voting aye were: Crowe, Haile, Hensley, Jackson, Massey, Reeves, Swann, Watson, Yarbro -- 9.