Bill Summary – FastDemocracy

67th Legislature                                                                                                     HB 231.1
                                                     HOUSE BILL NO. 231
                                                INTRODUCED BY M. REGIER
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   A BILL FOR AN ACT ENTITLED: “AN ACT REVISING CERTIFICATES OF NEED TO INCLUDE ONLY LONG-
   TERM CARE FACILITIES AND SERVICES; AND AMENDING SECTIONS 50-5-101, 50-5-301, 50-5-302, 50-5-
   304, 50-5-307, 50-5-308, 50-5-309, AND 53-6-110, MCA.”
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   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
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              Section 1. Section 50-5-101, MCA, is amended to read:
              "50-5-101.    Definitions. As used in parts 1 through 3 of this chapter, unless the context clearly
   indicates otherwise, the following definitions apply:
              (1)   "Accreditation" means a designation of approval.
              (2)   "Accreditation association for ambulatory health care" means the organization nationally
   recognized by that name that surveys outpatient centers for surgical services upon their requests and grants
   accreditation status to the outpatient centers for surgical services that it finds meet its standards and
   requirements.
              (3)   "Activities of daily living" means tasks usually performed in the course of a normal day in a
   resident's life that include eating, walking, mobility, dressing, grooming, bathing, toileting, and transferring.
              (4)   "Adult day-care center" means a facility, freestanding or connected to another health care facility,
   that provides adults, on a regularly scheduled basis, with the care necessary to meet the needs of daily living
   but that does not provide overnight care.
              (5)   (a) "Adult foster care home" means a private home or other facility that offers, except as provided
   in 50-5-216, only light personal care or custodial care to four or fewer disabled adults or aged persons who are
   not related to the owner or manager of the home by blood, marriage, or adoption or who are not under the full
   guardianship of the owner or manager.
              (b)   As used in this subsection (5), the following definitions apply:
              (i)   "Aged person" means a person as defined by department rule as aged.
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              (ii) "Custodial care" means providing a sheltered, family-type setting for an aged person or disabled
   adult so as to provide for the person's basic needs of food and shelter and to ensure that a specific person is
   available to meet those basic needs.
              (iii) "Disabled adult" means a person who is 18 years of age or older and who is defined by department
   rule as disabled.
              (iv) (A) "Light personal care" means assisting the aged person or disabled adult in accomplishing such
   personal hygiene tasks as bathing, dressing, and hair grooming and supervision of prescriptive medicine
   administration.
              (B)   The term does not include the administration of prescriptive medications.
              (6)   "Affected person" means an applicant for a certificate of need, a health long-term care facility
   located in the geographic area affected by the application, an agency that establishes rates for health long-term
   care facilities, or a third-party payer who reimburses health long-term care facilities in the area affected by the
   proposal.
              (7)   "Assisted living facility" means a congregate residential setting that provides or coordinates
   personal care, 24-hour supervision and assistance, both scheduled and unscheduled, and activities and health-
   related services.
              (8)   "Capital expenditure" means:
              (a)   an expenditure made by or on behalf of a health care long-term care facility that, under generally
   accepted accounting principles, is not properly chargeable as an expense of operation and maintenance; or
              (b)   a lease, donation, or comparable arrangement that would be a capital expenditure if money or any
   other property of value had changed hands.
              (9)   "Certificate of need" means a written authorization by the department for a person to proceed with
   a proposal subject to 50-5-301.
              (10) "Chemical dependency facility" means a facility whose function is the treatment, rehabilitation, and
   prevention of the use of any chemical substance, including alcohol, that creates behavioral or health problems
   and endangers the health, interpersonal relationships, or economic function of an individual or the public health,
   welfare, or safety.
              (11) "Clinical laboratory" means a facility for the microbiological, serological, chemical, hematological,
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   radiobioassay, cytological, immunohematological, pathological, or other examination of materials derived from
   the human body for the purpose of providing information for the diagnosis, prevention, or treatment of a disease
   or assessment of a medical condition.
              (12) "College of American pathologists" means the organization nationally recognized by that name
   that surveys clinical laboratories upon their requests and accredits clinical laboratories that it finds meet its
   standards and requirements.
              (13) "Commission on accreditation of rehabilitation facilities" means the organization nationally
   recognized by that name that surveys rehabilitation facilities upon their requests and grants accreditation status
   to a rehabilitation facility that it finds meets its standards and requirements.
              (14) "Comparative review" means a joint review of two or more certificate of need applications that are
   determined by the department to be competitive in that the granting of a certificate of need to one of the
   applicants would substantially prejudice the department's review of the other applications.
              (15) "Congregate" means the provision of group services designed especially for elderly or disabled
   persons who require supportive services and housing.
              (16) "Construction" means the physical erection of a new health care facility and any stage of the
   physical erection, including groundbreaking, or remodeling, replacement, or renovation of:
              (a)   an existing health care facility; or
              (b)   a long-term care facility as defined in 50-5-301.
              (17) "Council on accreditation" means the organization nationally recognized by that name that
   surveys behavioral treatment programs, chemical dependency treatment programs, residential treatment
   facilities, and mental health centers upon their requests and grants accreditation status to programs and
   facilities that it finds meet its standards and requirements.
              (18) "Critical access hospital" means a facility that is located in a rural area, as defined in 42 U.S.C.
   1395ww(d)(2)(D), and that has been designated by the department as a critical access hospital pursuant to 50-
   5-233.
              (19) "Department" means the department of public health and human services provided for in 2-15-
   2201.
              (20) "DNV healthcare, inc." means the company nationally recognized by that name that surveys
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   hospitals upon their requests and grants accreditation status to a hospital that it finds meets its standards and
   requirements.
              (21) "Eating disorder center" means a facility that specializes in the treatment of eating disorders.
              (22) "End-stage renal dialysis facility" means a facility that specializes in the treatment of kidney
   diseases and includes freestanding hemodialysis units.
              (23) "Federal acts" means federal statutes for the construction of health care facilities.
              (24) "Governmental unit" means the state, a state agency, a county, municipality, or political
   subdivision of the state, or an agency of a political subdivision.
              (25) "Healthcare facilities accreditation program" means the program nationally recognized by that
   name that surveys health care facilities upon their requests and grants accreditation status to a health care
   facility that it finds meets its standards and requirements.
              (26) (a) "Health care facility" or "facility" means all or a portion of an institution, building, or agency,
   private or public, excluding federal facilities, whether organized for profit or not, that is used, operated, or
   designed to provide health services, medical treatment, or nursing, rehabilitative, or preventive care to any
   individual. The term includes chemical dependency facilities, critical access hospitals, eating disorder centers,
   end-stage renal dialysis facilities, home health agencies, home infusion therapy agencies, hospices, hospitals,
   infirmaries, long-term care facilities, intermediate care facilities for the developmentally disabled, medical
   assistance facilities, mental health centers, outpatient centers for primary care, outpatient centers for surgical
   services, rehabilitation facilities, residential care facilities, and residential treatment facilities.
              (b)   The term does not include offices of private physicians, dentists, or other physical or mental health
   care workers regulated under Title 37, including licensed addiction counselors.
              (27) "Home health agency" means a public agency or private organization or subdivision of the agency
   or organization that is engaged in providing home health services to individuals in the places where they live.
   Home health services must include the services of a licensed registered nurse and at least one other
   therapeutic service and may include additional support services.
              (28) "Home infusion therapy agency" means a health care facility that provides home infusion therapy
   services.
              (29) "Home infusion therapy services" means the preparation, administration, or furnishing of
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   parenteral medications or parenteral or enteral nutritional services to an individual in that individual's residence.
   The services include an educational component for the patient, the patient's caregiver, or the patient's family
   member.
              (30) "Hospice" means a coordinated program of home and inpatient health care that provides or
   coordinates palliative and supportive care to meet the needs of a terminally ill patient and the patient's family
   arising out of physical, psychological, spiritual, social, and economic stresses experienced during the final
   stages of illness and dying and that includes formal bereavement programs as an essential component. The
   term includes:
              (a)   an inpatient hospice facility, which is a facility managed directly by a medicare-certified hospice
   that meets all medicare certification regulations for freestanding inpatient hospice facilities; and
              (b)   a residential hospice facility, which is a facility managed directly by a licensed hospice program
   that can house three or more hospice patients.
              (31) (a) "Hospital" means a facility providing, by or under the supervision of licensed physicians,
   services for medical diagnosis, treatment, rehabilitation, and care of injured, disabled, or sick individuals.
   Except as otherwise provided by law, services provided must include medical personnel available to provide
   emergency care onsite 24 hours a day and may include any other service allowed by state licensing authority.
   A hospital has an organized medical staff that is on call and available within 20 minutes, 24 hours a day, 7 days
   a week, and provides 24-hour nursing care by licensed registered nurses. The term includes:
              (i)   hospitals specializing in providing health services for psychiatric, developmentally disabled, and
   tubercular patients; and
              (ii) specialty hospitals.
              (b)   The term does not include critical access hospitals.
              (c) The emergency care requirement for a hospital that specializes in providing health services for
   psychiatric, developmentally disabled, or tubercular patients is satisfied if the emergency care is provided within
   the scope of the specialized services provided by the hospital and by providing 24-hour nursing care by
   licensed registered nurses.
              (32) "Infirmary" means a facility located in a university, college, government institution, or industry for
   the treatment of the sick or injured, with the following subdefinitions:
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              (a)   an "infirmary--A" provides outpatient and inpatient care;
              (b)   an "infirmary--B" provides outpatient care only.
              (33) (a) "Intermediate care facility for the developmentally disabled" means a facility or part of a facility
   that provides intermediate developmental disability care for two or more persons.
              (b)   The term does not include community homes for persons with developmental disabilities that are
   licensed under 53-20-305 or community homes for persons with severe disabilities that are licensed under 52-
   4-203.
              (34) "Intermediate developmental disability care" means the provision of intermediate nursing care
   services, health-related services, and social services for persons with a developmental disability, as defined in
   53-20-102, or for persons with related problems.
              (35) "Intermediate nursing care" means the provision of nursing care services, health-related services,
   and social services under the supervision of a licensed nurse to patients not requiring 24-hour nursing care.
              (36) "Licensed health care professional" means a licensed physician, physician assistant, advanced
   practice registered nurse, or registered nurse who is practicing within the scope of the license issued by the
   department of labor and industry.
              (37) (a) "Long-term care facility" means a facility or part of a facility that provides skilled nursing care,
   residential care, intermediate nursing care, or intermediate developmental disability care to a total of two or
   more individuals or that provides personal care.
              (b)   The term does not include community homes for persons with developmental disabilities licensed
   under 53-20-305; community homes for persons with severe disabilities, licensed under 52-4-203; youth care
   facilities, licensed under 52-2-622; hotels, motels, boardinghouses, roominghouses, or similar accommodations
   providing for transients, students, or individuals who do not require institutional health care; or juvenile and
   adult correctional facilities operating under the authority of the department of corrections.
              (38) "Medical assistance facility" means a facility that meets both of the following:
              (a)   provides inpatient care to ill or injured individuals before their transportation to a hospital or that
   provides inpatient medical care to individuals needing that care for a period of no longer than 96 hours unless a
   longer period is required because transfer to a hospital is precluded because of inclement weather or
   emergency conditions. The department or its designee may, upon request, waive the 96-hour restriction
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   retroactively and on a case-by-case basis if the individual's attending physician, physician assistant, or nurse
   practitioner determines that the transfer is medically inappropriate and would jeopardize the health and safety
   of the individual.
               (b)   either is located in a county with fewer than six residents a square mile or is located more than 35
   road miles from the nearest hospital.
               (39) "Mental health center" means a facility providing services for the prevention or diagnosis of mental
   illness, the care and treatment of mentally ill patients, the rehabilitation of mentally ill individuals, or any
   combination of these services.
               (40) "Nonprofit health care facility" means a health care facility owned or operated by one or more
   nonprofit corporations or associations.
               (41) "Offer" means the representation by a health care facility that it can provide specific health
   services.
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