Reports - Mississippi Renewal

134 |HEALTH AND HUMAN SERVICESThe impactof HurricaneKatrina haspresented newand significantchallenges toall health careproviders, particularlythosewhich serve asthe safety-netfor the indigentand uninsured.published its Proposed Resolution to Enactthe Consumer Directed Long Term CareReform Act, which advocates the preservationof Medicaid for the truly needy,providing incentives for private savingsfor long-term care, and providing forconsumer choice in long-term care.The Commission supports legislationthat would protect Medicaid’s viability.Hospitals and other health care providersneed further education abouthow to utilize the “uncompensatedcare pool” created in the Section 1115waiver granted for Mississippi. TheCommission makes the following recommendations:■ The pool should cover services providedfor dates of service through atleast the next two years;■ Reimbursement from the federal uncompensatedcare pool should be definedas uncompensated care providedto any individual from a designateddisaster area; and■ Services provided by all health careproviders which are not covered ina Medicaid beneficiary’s home stateshould qualify for the uncompensatedcare pool.The Commission supports measuresthat are available to protect andstrengthen Mississippi’s Medicaid program,including the support of federallegislation to provide 100% federalfunding for all Medicaid expendituresfor individuals who are Katrina survivorsand for associated administrativecosts.Certifi cate of NeedMany health care facilities that receivedextensive damage during HurricaneKatrina are addressing a myriad ofissues to restore operations so they canmeet the health care needs of the communitiesthey serve. Certificate of Need(CON) regulations currently requirethat providers go through an applicationprocess to determine need beforecommitting to any capital expenditurein excess of $2 million.The CON program has been, andcontinues to be, an invaluable tool inhelping Mississippi protect access toservices in underserved areas and bycontrolling health care costs by preventingoverutilization of services. Theprocess, however, including requestedhearings and appeals, is time-consumingand expensive. Moreover, the currentemergency CON statute was notdesigned for a disaster of this scale andshould be amended and updated.The Commission recommends that:■ The Mississippi State Departmentof Health (DOH) adopt a CON exemptionor waiver for rebuilding aftercertain qualifying disasters. The exemptionshould be subject to carefulreview by the DOH and should carrystrong limitations as to expendedamounts, location of reconstruction,and additional capacity. This processshould be public, subject to reviewby the DOH staff to ensure a requestdoes not contemplate capacity or servicesnot existing before the disaster,and expedited. Any health care providerwanting to add capacity or servicesnot existing prior to the disastershould be required to go through theCON process as currently structured.■ The DOH should adopt a policy thatallows for an expedited CON reviewfor expenditures related exclusivelyto future disaster planning. The processshould be public and subject tostaff review, and receive an expeditedreview following its submission forapproval. The applications should beclearly related to disaster planning and