I N T H E SUPR EM E C O UR T O F M I SS I SS I PPI NO. 2 0 0 6 - S A- 0 0 3 5 8 - S CT OKTI BBEHA COUNTY HO S PITAL
v. M I S S I S S I P P I S T AT E D EP AR T M EN T OF H EALTH , M I SS I SS I PPI STATE UN

I VER SITY AND PREM

I ER RADIOLOGY, P. A. D A T E O F JU D G M E N T : 02/ 02/ 2006 TRI AL J UDG E: HON
. W I LL I AM H. S I NGLET ARY COURT F ROM W HI CH APP EAL ED: HI NDS COUNTY CHANCERY COURT A TTO RN EY S FO R A PPELL A N T: CR A N E D . K I PP GE OR GE QUI NN E VANS AT T OR NE YS F OR AP P E L L E E : ANDY L OW RY AL L I S ON C AR T E R S I M P S ON T HOMAS L . KI RK L AND DO NA LD E. EI CH ER NA TUR E OF THE C ASE: CI VI L - STATE BO AR DS A ND AG ENC I ES D I SPO SI T I O N : A FFIRM E D - 05/ 17/ 2007 M OT I ON F OR RE HE AR I NG F I L E D: M ANDAT E I S S UE D: EN BA NC. DI CK I NSON, J UST I CE, FOR TH E COU RT: ¶1. T he O kt i bbeha C ounty H os pi t al app eal s the ent ry of a fi nal j udgm ent af f i r m i ng the gr antof a cert i f i cat e of ne ed ( “C O N ”) f

ora magnet i c r es onance i m agi ng uni tt o M i s s i s s i ppi St at e U ni ver s i ty and Pr emi erR adi ol ogy, P. A
. T hi s C our ti s as ked t o det erm i ne w hether M i s s . C ode A nn. § 41- 7- 191( 16) ( R ev. 2005) i s a l egi s l at i ve m andat e, and i f so, w hethers uch in te rp re ta tio n c o m p lie s w ith c e rt a in c o n s titu tio n a l p ro v is io n s .

### 2 B AC KGR OU ND F AC T S AN D P RO CE E DI NG S ¶2. O n J une 1, 2005, the M i s s i s s i ppi St at e D epart m entof H eal th r ece i ved an appl i cat i on f ora C O N f

r om M i s s i s s i pp i St a t e U ni ve r s i ty and Pr emi erR adi ol ogy, P. A
. , f orthe ac qui s i t i on and of f er i ng of m agnet i c r es onance i m agi ng ( M R I ) s ervi ces pur s uantt o H ou se B i l l 1345,
n o w co d if

ied a s M iss. C o d e A n n . § 4 1 -7-1 9 1 (16 )(R ev . 2 0 0 5 ). T he appl i cat i on w as s us pended on A ugus t19 as the St at e H eal th O f f i cersub m i t t ed a r eques tf oran of f i ci al opi ni on of

the A t t orney G ener al ’ s of f i ce r egar di ng cl ar i f

i cat i on of the sc ope of

thats t atut e. T he A t t orney G ener al r es ponded on Sept ember16, 2005, re as oni ng that§ 41- 7- 191( 16) w as a mandat e t o i s s ue the C O N t o M i s s i s s i ppi S t at e U ni ver s i ty and di d notr equi r e compl i ance
w ith o rd in a ry C O N a p p lica tio n p ro c e d u re s, in c lu d in g h e a rin g s. B ria n W . A m y , M .D ., M . H . A
. , M . P . H . , O p . A tt ’y G en . 2 0 0 5 -04 5 2 (S ep t. 1 6 , 2 0 0 5 ). ¶3. T he D epart m entgave publ i c not i ce on Sept ember26 of i t s i nt entt o acton the appl i cat i on ati t s O ct ober6, 2005, m eet i ng. O n O ct ober4, 2005, O kt i bbeha Count y H os pi t al ( “O C H ”) as ked the D epart m entf ora hea r i ng dur i ng the cour s e of re vi ew of the appl i cat i on. T h e D ep artm en t de n ied th e re q u est as n o t w ell take n b ase d o n the A tt o rne y G en era l’ s opi ni on r egar di ng the s cope a nd m andat e of § 41- 7- 191( 16)
. T he Stat e H eal t h O f f i cer appr oved the C O N appl i cat i on and i s s ued the ce r t i f i cat e t o M i s s i s s i ppi St at e U ni ver s i ty and Pr emi erR adi ol ogy, P. A
. , on O ct ober6, 2005. O C H t i m el y f i l ed a not i ce of

appea l t o the Hi n d s Co u n ty Ch a n c e ry Co u r tp u r s u a n tt o M i s s . Co d e An n . § 4 1
- 7
- 2 0 1 ( 2 ) ( Re v . 2 0 0 5 )
. On J anuary 27 , 2006, thatcourti s s ued i t s opi ni on af f i r m i ng the f

i nal or derof

the M i s s i s s i ppi S t at e D epart m ent of

H eal th. A gg ri eved by this rul i ng , O C H app eal s.

### 3

¶4. A l though O C H r ai s es num er ous i s s ues on appea l , w e need addr es s onl y the f ol l ow i ng thr ee: ( 1) w hetherM i s s . C ode A nn. § 41- 7- 191( 16) i s a l egi s l at i ve mandat e t o the M i s s i s s i ppi S tate D e p a rtm e n t o f H e a lth to iss u e a C O N fo r M iss iss ip p i S tate U n iv e rsity ’s M R I p rojec t; ( 2) w hetherM i s s . C ode A nn. § 47- 7- 191( 16) vi ol at es the M i s s i s s i ppi C ons t i tut i on orthe Co n s t i tu t i o n o f

th e Un i t e d S t a t e s ; a n d ( 3 ) wh e th e rth e De p a r t me n to f He a l th v i o l a t e d i t s o wn
r e g u l a t i o n s i n i s s u i n g th e CO N wi th o u tp r o v i d i n g f o ra h e a r i n g d u r i n g th e c o u r s e o f r e v i e w. DI S CU S S I ON I. ¶5. J udi ci al r evi ew of a f i nal or derof

the St at e D epart m entof H eal th i s cont r ol l ed by M i s s . C ode A nn. § 41- 7- 201( 2) ( f ) ( R ev. 2005) , w hi ch pr ovi des thata r evi ew i ng courtm ay vaca t e the age ncy’ s or deri f i tfi nd s t hat t he f

i nal or deri s bas ed on an e rr orof l aw , “i s not
s u p p o rt e d b y s u b s ta n tia l e v id e n c e , [o r] is c o n tr a ry to th e m a n if e s t w e ig h t o f t h e e v id e n c e .” S in ging R i ver H

osp. S ys. v. B ilox iR eg’l

Med. Ctr. , 928 So. 2d 810, 811- 12 ( M i s s . 2006) ( quot i ng St

. D om ini c-Jacks on Mem ’l Hos p. v. Miss . S ta te D e

p ’t o f He a lth , 728 So. 2d 81, 83 ( M i s s . 1998) ) ; M i s s . C ode A nn. § 41- 7-201( 2) ( f ) ( R ev. 2005)
. G ener al l y, w e af f or d the D epart m entof

H eal th’ s deci s i ons gr eatdef er ence on r evi ew , ho w ever , beca us e the i s s ues her e pos e ques t i ons of

l aw , w e conduc ta de novo re v ie w . Saliba v. Saliba , 753 S o. 2d 1095, 1 0 9 8 (M iss. 2 0 0 0 ).

### 4

¶6. T he M i ssi ssi pp i L egis l ature has defi ned “cert i fi cat e of need ” as:
a w r i t t en or derof

the St at e D epart m entof H eal th s ett i ng f or th the af

f i r m at i ve f i ndi ng thata pr opos al i n pr es cr i bed appl i cat i on f or m , s uf f i ci ent l y s at i s f

i es the pl ans , s t andar ds and cr i t er i a pr es cr i bed f ors uch s ervi ce a nd otherpr oj ectby Sect i on 41- 7- 171, et . s eq. , and by rul es a nd r egul at i ons pr om ul gat ed ther eunderby the St at e D epart m entof H eal th. M iss. C o d e A n n . § 4 1 -7-1 7 3 (b)(R ev . 2 0 0 5 ). ¶7. A ti s s ue her e i s w hetherone s uch r egul at i on pr om ul gat ed by the St at e D epart m entof H eal th r equi r es a C O N t o i s s ue ors i m pl y w ai ves por t i ons of the appl i cat i on pr oces s . I n or der t o r es ol ve thes e i s s ues , w e mustl ook f i r s tt o the t extof the st atut e. T he per t i nentpar t s of the st atute ar e as f

oll ow s: T he St at e D epart m entof H eal th sh a ll i s s ue any ce rt if icates o f ne ed n ec essa ry fo r M iss iss ip p i S tate U n iv e rsity a n d a p u b lic o r p riv a te h e a lth c a re p ro v id e r to j oi nt l y acqui r e and ope r at e a l i nearacc el er at or and a m agnet i c r es onance im a g in g u n it.

. . . . For purpo s e s of

thi s s ub s e c t i on , the pr oj e c t i on of ne e d a s r e po r t e d i n the curr entSt at e H eal th Pl an ar e w ai ved. M iss. C o d e A n n . § 4 1 -7-1 9 1 (16 )(R ev . 2 0 0 5 ) (em p h asis ad d ed ). ¶8. O C H ar gues thatthe l anguage i n t he st atut e i s am bi guous and t hatthe f i r s ts ent ence i s i ncons i s t entw i th the l as ts ent ence quot ed above
. O C H sug gest s us i ng the ca nons of sta tu to ry c o n stru c tio n to in terp re t th is s tatu te a s a llo w in g o n ly th e w a iv e r o f c e rta in p ro v isio n s b y M iss iss ip p i S tate U n iv e rsity a n d th e p riv a te h e a lth c a re p ro v id e r o f th e ir cho i ce. F i rs t , w e m ustdeterm i ne if the st atute i s am biguou s.Subsection (2) outlin es numer ous such di screti onary direc tives. For example, seeMis s. 1 Co deAnn . § 41 -7- 19 1(2 )(b ) (“[ t] hedepartment mayis su e cer tif icates o f n eed

in H arriso n C ounty to p rov ideskill ed

nursing home care f

or A lzh eimer’ s dise asepatie nts an d o ther patie nts , n ot to exceed one hundred fifty (150) beds.”) (emphasis added); Mi ss. Code Ann. § 41-7-191(2)( c) (“[t]he department mayissue a certificate of need for the addition t o or exp an si on of any skilled nurs ing facility that is part of an existing continui ng care retirement community located in Madison County.

. . ”) ( em ph asi s adde d); and Miss. CodeAnn. § 4 1-7 -19 1(2 )(f ) (“ [t ]h e S tate D ep artm ent of He alth mayiss uea certi fi cat e o f n eed fo r co nv ers ion

of a co unty hos pit al f

aci lity in Itawamba County to a nurs ingfa cil ity
. . .” ) (e m ph asi s adde d). Miss. Code Ann. § 41-7-193(1) (Rev. 2005). 2 

### 5 ¶ 9 . T h ro u g h o u t M iss . C o d e A n n . § 4 1 -7 -1 9 1 , th e L e g isla tu re p ro v id e d fo r a n in c re a se in
s uppl ement al m edi cal s ervi ces thr ou gh di s cr et i onary ( “may”) and mandat ory ( “s hal l ”) cl aus es . D i s cr et i onary s ect i ons of M i s s . C ode A nn. § 41- 7- 193( 1) a r e t o be appl i ed by the 1 St at e D epart m entof

H eal th; how ever , f

orm andat ory pr ovi s i ons , l i ke M i s s . C ode A nn. § 41- 7- 191( 16) , the Legi s l atur e has w ai ved the nec es s i ty of s at i s f yi ng “the speci fi cat i ons and
c r i t e r i a e s t a b l i s h e d b y th e S t a t e De p a r t me n to f He a l th ” b y d i r e c t i n g th e i s s u a n c e o f a CO N. 2 ¶1 0. B y m andat i ng the i s s ua nc e of “ a ny ” CO N i n M i s s . Code A nn . § 41
- 7- 19 1( 16) , t he L e g isla tu re p re e m p tiv e ly o rd e re d its iss u a n c e w ith o u t th e re q u ire m e n t t h a t t h e S tate D epart m entof

H eal th “s et [ ] f

or th.
. . af

f i r m at i ve f

i ndi ng[ s ] ” that“the pl ans , s t andar ds , and
cr i t er i a pr es cr i bed” a nd “rul es and r egul at i ons pr om ul gat ed” by the St at e D epar t m entof H eal th w er e s uf

f i ci ent l y s at i s f

i ed. T her e i s no l anguage i n thi s ora ny otherst at ute w hi ch i dent i f i es condi t i ons underw hich t he S t at e D epart m entof H eal th m ay r ef

us e t o i s s ue the
ce rt if icates o f ne ed m en ti o n ed in § 4 1 -7-1 9 1 (16 ). ¶11. W e f

i nd no ambi gui ty i n the l anguage of M i s s . C ode A nn. § 41- 7- 191( 16)
. W i thout l i s t i ng a s i ngl e exc ept i on orqual i f i cat i on, t he st atut e cl ear l y m andat es the St at e D epart m ent

### 6

o f H e a lth to iss u e th e C O N . A lth o u g h th e s tatu te sin g les o u t “ p rojec tio n o f n e e d ” fo r sp e c ific
w ai ver , w e do notr ead i nt o the s t atut e the l egi s l at i ve i nt entt o w ai ve nothi ng el s e, part i cul ar l y i n l i ghtof the st atut ory l anguage (“ T he St at e D epart m entof H eal th sh a ll i s s ue any cert i fi cat es of need n ecessary . . . . ”) w hich cl earl y m and at es i ssuance o f the C O N . T hu s, ther e i s no r eas on t o engage the pr i nci pl es of s t atut ory cons truct i on. II. ¶ 1 2 . O C H n e x t co n ten d s th a t if the sta tu te is d e ter m in e d to b e a leg isla tiv e m a n d a te, it vi ol at es the M i s s i s s i ppi C ons t i tut i on and the C ons t i tut i on of the U ni t ed St at es . Speci f i cal l y, O CH a r gu e s tha tM i s s . Code Ann. § 4 1- 7- 19 1( 16 ) i s a c l e a ri nf r i ng e mento f

Ar t i c l e 4, S e c tio n 8 7 ; A rticle 3 , S e c tio n 1 4 o f th e M iss iss ip p i C o n stitu tio n o f 1 8 9 0 ; an d th e F o u rte e n th A m e n d m e n t d u e p ro c e s s c la u s e o f t h e U n ite d S ta te s C o n s titu tio n . ¶13. T he M i s s i s s i ppi St at e D epart m entof H eal th count er s thatO C H i s pr ocedur al l y barr ed f rom r ai s i ng thes e cons t i tut i onal i s s ues pur s uantt o R ul e 24( d) of the M i s s i s s i ppi R ul es of C iv il P ro c e d u re . U n d e r th a t se c tio n , w h e re a n a c tio n se e k s to “ re stra in o r e n jo in enf or cement , opera t i on, orexec ut i on of any s t atut e of

the St at e of

M i s s i s s i ppi ” by chal l engi ng the cons t i tut i onal i ty, the party a s s ert i ng the uncons t i tut i onal i ty “s hal l not i f y the A t t orney G ener al of

the St at e of

M i ssi ssi ppi w i thi n s uch t i m e as t o af f or d hi m [ orher ] an oppor tuni ty t o i nt ervene a nd ar gue the ques t i on of cons t i tut i onal i t y. ” T he D epart m entof H e a lth n o tes th at th e A tt o rne y G en era l w as n o t n o ti fi ed an d , th ere fore , th is d efe n se is pr ocedur al l y barr ed. I n r es pons e, O C H cont ends thatbeca us e a s peci al as s i s t antatt orney

### 7

gener al r epr es ent ed the St at e D epart m entof H eal th, the A t t orney G ener al ther eby had not i ce an d O C H h as c o m p li ed w ith R u le 24 (d). ¶14. T he not i ce r equi r ementof R ul e 24( d) i s s tr enuous . W e have procedur al l y barr ed p rev iou s ch all en g es to th e co n sti tuti o n ali ty of a statu te be ca u se o f a pa rty ’s f ail u re t o n o ti fy th e A tto rn e y G e n e ra l o f th e c o n s titu tio n a l a tta c k
. See P ow ers v. T iebauer , 939 So. 2d 749, 754- 55 ( M i s s . 2005) ( s endi ng A t t orney G ener al the appe l l at e br i ef perM i s s . R . A pp. P. 44
w a s n o t su ffic ien t n o tice u n d e r M iss . R . C iv . P . 2 4 (d )); Cockre l l v. Pear l Ri verValley W

ater S u p p ly D ist. , 8 6 5 S o . 2 d 3 5 7 , 3 6 0 (M iss . 20 0 4 ) (ho lding that co n sti tuti o n al claim s are p ro c e d u ra lly b a rre d w h e n n o tice is n o t p ro v id e d to th e A tto rn e y G e n e ra l); P i ckens v. D ona lds on , 7 4 8 S o . 2 d 6 8 4 , 6 9 1 -9 2 (M iss . 1 9 9 9 ) (s a m e ); B ar nes v. Singing R i verHos p. Sys . , 7 3 3 S o . 2 d 1 9 9 , 2 0 2 -0 3 (M is s . 1 9 9 9 ) ( s a m e ). ¶15 . Si m i l ar l y, R ul e 44( a) of the M i ssi ssi pp i R ules of A pp el l at e P rocedu re r equi r es s ervi ce o f a n y a p p e llate b rie f c h a llen g in g th e v a lid ity o f a sta tu te “ o n th e A tto rn e y G e n e ra l, th e c ity
a t t orne y, orothe rc hi e f

l e ga l of f i c e rof the g ov e rnmen t a l b od y i nv ol ve d. ” M i s s . R. A pp . P. 4 4 (a ). T h a t R u le f

u rth e r sta tes : E xceptby s peci al or derof the courtt o w hi ch the ca s e i s as s i gned, i n the a b se n c e o f su c h n o tice n e ith e r th e S u p re m e C o u rt n o r th e C o u rt o f A p p e a ls w i l l deci de t he ques t i on unt i l the not i ce a nd r i ghtt o r es pond cont empl at ed by thi s rul e has been gi ven t o the appr opr i at e governm ent al body. M iss. R . A p p . P . 4 4 (c). ¶16. H er e, O C H di d no tco m ply w i th ei therR ul e. Suppose d “not i ce” t o the s peci al
as s i s t antatt orney gene r al i s nots uf f i ci entunderM i s s i s s i ppi R ul e of C i vi l Pr ocedur e 24( d)

### 8

o r M iss iss ip p i R u le o f A p p e llate P ro c e d u re 4 4 . T o c o m p ly w ith th e se ru les , a p a rty chal l engi ng the cons t i tut i onal i ty of a l egi s l at i ve enac t m entmusts erve of copy of hi s orher br i ef on t he A t t orney G eneral . M i s s . R. Ci v. P. 24( d) ; M i s s . R. A pp. P. 44( a)
. T hus , the O kti bb eha C ou nty H ospit al i s precl ud ed fro m rais i ng a con st i tuti on al chall eng e t o M i ss. C o d e A n n . § 4 1 -7 -1 9 1 (1 6 ) w ith o u t p rio r n o tice to th e A tto rn e y G e n e ra l. III . ¶ 1 7 . O C H n e x t co n ten d s th e S tate D e p a rtm e n t o f H e a lth v io late d its o w n re g u latio n s in iss u in g th e C O N w ith o u t p ro v id in g fo r a h e a rin g d u rin g th e c o u rse o f re v iew . W e re itera te th a t u p o n p a ss in g M iss . C o d e A n n . § 4 1 -7 -1 9 1 (1 6 ), th e L e g isla tu re e ffe c tiv e ly w a iv e d a ll C O N r equi r ement s as they r el at e t o any ende avorent er ed i nt o betw een M i s s i s s i ppi St at e and
an y pu bl i c o rp r i va t e h e a l th c a r e p r ov i de ri n the a c qu i s i t i on o f a “ l i ne a ra c c e l e r a t ora nd a
m agnet i c r es onance i m agi ng uni t . ” See M iss. C o d e A n n . § 4 1 -7-1 9 1 (16 )(R ev . 2 0 0 5 ). A cc o rdin g ly, this issue i s w ith o u t m eritbe ca u se the L eg isl ature ha d th e ab il ity t o an d d id
w ai ve such requi rem ents . CO NC L US I ON ¶ 1 8 . W e fin d th a t, un d e r th e fa c ts o f th is c a se , S e c tio n 4 1 -7 -1 9 1 (1 6 ) m a n d a ted th e S tate D epart m entof

H eal th t o gr antthe C O N t o M i s s i s s i pp i S t at e U ni ver s i ty, and thatal l other i s s ues r ai s ed by O C H ar e w i thoutm er i t . T her ef or e, w e af

f i r m the C hance ry C our tof H i nds C ounty. ¶ 1 9 . AF F I RM ED .

### 9

S M I TH, C. J . , W AL LE R AND D I AZ , P . J J . , AND RA NDOL P H, J . , CONCUR. CARL S ON, J . , DI S S EN TS W I TH S EP ARAT E W RI TT EN OP I NI ON. EA S LE Y AND GR AV E S , J J . , NO T P AR T I CI P AT I NG . CA RL S ON , J US T I CE , DI S S E NT I NG : ¶20 . B ecause the m aj ori ty fi nd s tha t M iss. C o d e A n n . § 4 1 -7- 19 1(16) ( R ev. 20 05 ) i s a leg isla tiv e m a n d a te r e q u irin g th e M iss iss ip p i S tate D e p a rtm e n t o f H e a lth to iss u e a C O N to M iss iss ip p i S tate U n iv e rsity a n d P re m ier R a d io lo g y , P .A ., I re sp e c tfu lly d iss e n t. ¶ 2 1 . In 2 0 0 4 , M iss
. C o d e A n n . § 4 1 -7 -1 9 1 w a s a m e n d e d b y th e M iss iss ip p i L e g isla tu re to add s ect i on ( 16) , w hi ch s t at es i n t ot o: T h e S tat e D ep artm en t of H ea th sh all i ssu e an y certi fi ca tes of n ee d n ec essa ry fo r M iss iss ip p i S tate U n iv e rsity a n d a p u b lic o r p riv a te h e a lth c a re p ro v id e r to j oi nt l y acqui r e and ope r at e a l i nearacc el era t orand a magnet i c r es onance i m agi ng uni t . T hos e ce r t i f i cat es of need s hal l coverall capi t al expendi tur es related to the p rojec t b etw ee n M issi ssipp i S tat e U n iversity an d the h ea lth ca re p rov ider, i n clud ing , bu t n o t li m it ed t o , th e ac q u isi ti o n of th e li n ea r ac ce lerator, the magnet i c r es onance i m agi ng uni tand otherr adi ol ogi cal m odal i t i es ; the of f er i ng of l i nearacc el er at or a nd m agnet i c r es onance i m agi ng s ervi ces ; and the cos tof

cons truct i on of

f aci l i t i es i n w hi ch t o l ocat e these servi ces . T he l i nearacc el er at orand the magnet i c r es onance i m agi ng uni ts hal l be ( a) l ocat ed in th e C ity o f S tar k v ill e , O k tib b e h a C o u n ty , M iss iss ip p i; (b ) o p e ra ted jo in tly by M i s s i s s i ppi St at e U ni ver s i ty a nd the publ i c orpr i vat e heal th c ar e pr ovi der s e l e c t e d b y M i s s i s s i pp i St a t e U ni ve r s i ty thr ou gh a r e qu e s tf orpr op os a l s ( RFP) pr oces s i n w hi ch M i s s i s s i ppi St at e U ni vers i ty s el ect s , and the B oar d of T rustee s o f S tat e In sti tuti o n s o f H igh er L ea rnin g ap p rov es , th e h ea lth ca re p ro v id e r th a t m a k e s th e b e st o v e ra ll p ro p o sa l; (c) a v a ilab le to M iss iss ip p i S tate U ni ver s i ty f

orr es ear ch purpos es tw o-thir ds ( 2/ 3) of the t i m e thatthe l i near acc el er at orand magnet i c r esona nce i m agi ng uni tar e oper at i onal ; and ( d) avai l abl e t o the publ i c orpr i vat e hea l th car e pr ovi ders el ect ed by M i s s i s s i ppi St at e U ni ver s i ty and appr ov ed by the B oar d of T rus t ees of

St at e I ns t i tut i ons of H i gherL earni ng one- thi r d ( 1/ 3) of the t i m e f

orcl i ni cal , di agnost i c and tr eatm entpurpos es . Forpurpos es of thi s s ubs ect i on, the pr ovi s i ons of Sect i on

### 10

41- 7- 193( 1) r equi r i ng s ubs t ant i al compl i ance w i th the p roj ect i on of need a s r eport ed i n the curr entSt at e H eal th Pl an ar e w ai ved. M iss. C o d e A n n . § 4 1 -7-1 9 1 (R ev . 2 0 0 5 ). ¶ 2 2 . B a se d o n th is s tatu te, M iss is s ip p i S ta te D e p a rt m e n t o f H e a lth is s u e d a C O N to M i ssi ssi pp i S t at e U niver si ty and P rem i er w i tho ut f oll ow i ng no rm al C O N revi ew proced ures. I r es pect f ul l y s ubm i tthi s w as err or . T he maj or i ty f ai l s t o s tr i ct l y c ons true the ent i r e s t atut e. T he l as ts ent ence of

M i s s . C ode A nn . § 4 1-7-191( 16) i s an expr es s w ai verof compl i ance
w i th the pr oj ect i on of

need r equi r ement , and nothi ng m or e. ¶ 2 3 . M iss . C o d e A n n . § 4 1 -7 -1 9 3 (1 ) (R e v . 2 0 0 5 ) sta tes in p a rt: A cert i f i cat e of need s hal l notb e g rant ed ori s s ued t o any per s on f orany pr opos al , caus e orr eas on, unl es s the p roposa l has been r evi ew ed f or c o n sist en cy w ith the s p ec if icati o n s an d the c ri teri a e stab li sh ed b y the S tate D epart m entof

H eal th and

s ubs t ant i al l y c om pl i es w i th the pr oj ect i on of need as r eport ed i n the s t at e hea l th pl an i n ef f ectatt he t i m e the appl i cat i on f orthe pr opos al w as s ubm i t t ed. ( E m phas i s added)
. Iti s w el l
- es t abl i s hed i n M i s s i s s i ppi t hata s t atut e i s i nt erpr et ed ac cor di ng to it s p la in m e a n in g if

n o a m b ig u ity e x is ts . H ar r is on Count

y Sc h. D is t

. v. Long Bea c h Sc h. D ist. , 700 So. 2d 286, 288- 89 ( M i s s . 1997)
. T her ef or e, thi s C our ts houl d f i r s tcons i der
w h e th e r t h e s ta tu te is a m b ig u o u s . Miss. D ep’t of Heal th v. A l lr ed , 928 So. 2d 152, 154 ( M i s s . 2006)
. I f

an ambi gui ty do es exis t , thi s C our tw i l l then turn t o the pr i nci pl es of
s ta tu to ry c o n s tru c tio n . I d. “ W h e th e r th e sta tu te is a m b ig u o u s o r n o t, th e u lti m a te g o a l o f th is C our ti s t o di scern and gi ve ef f ectt o the l egi s l at i ve i nt ent . ” I d. ( q u o t i n g f

r o m Cit y of N atchezv. Sulli van , 612 So. 2d 1087, 1089 (M i s s . 1992) )
. T he bes tevi dence of the

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le g is la tiv e in te n t c o m e s d ir e c tly fr o m th e te x t o f t h e s ta tu te . I d. at155 ( quot i ng P egr am v. B ailey , 7 0 8 S o . 2 d 1 3 0 7 , 1 3 1 4 (M iss. 1 9 9 7 )). ¶24 . H ow ever, of ut m osti m po rt ance is the co m m on m axim that s t atutes in p a r i m a te ria
s h o u ld b e c o n s tru e d to g e th e r. I d. “W hen a st atute i s in p a ri m a ter ia w ith a l ater o n e , itis
s i m pl y partof

i t s cont extt o be cons i der ed by the C our ti n deci di ng w hetherthe meani ng of a pr ovi s i on i n the l at ers t atut e i s pl ai n. ” I d. C o n sid e rin g S e c tio n 4 1 -7 -1 9 3 (1 ) a n d its appl i cabi l i ty t o Se c t i on 41
- 7- 19 1( 16 ) , i ti s a bu nd a nt l y c l e a rtha tthe l e gi s l a t i ve i nt e ntw as t o w ai ve onl y the pr oj ect i on of need r equi r ement . T he C O N appl i cat i on w as s t i l l r equi r ed t o be “revi ew ed f

orcons i s t ency w i th the s peci f i cat i ons and the cr i t er i a es t abl i s hed by the S tat e D ep artm en t of H ea lth
. ” M iss. C o d e A n n . § 4 1 -7-1 9 3 (1) (R ev . 2 0 0 5 ). T h e L eg isl ature had the oppor tuni ty t o i ns ertl anguage w i thi n Sect i on 41- 7- 191( 16) w hi ch expl i ci t l y w ai ved al l of the r equi r ement s of

Sect i on 41- 7- 193; how ever, the L egi s l atur e chos e nott o do s o. T her ef or e, a pl ai n r eadi ng of

the s t atut e r evea l s thatthe cl earl egi s l at i ve i nt entw as t o w ai ve o n ly th e p rojec tio n o f n e e d re q u ire m e n t. ¶ 2 5 . F u rth e rm o re , the w o rd “ sh a ll” in su b se c tio n (1 6 ) is ins tru c tiv e to th e M iss iss ip p i S tate D e p a rtm e n t o f H e a lth a n d th is C o u rt. T h e “ sh a ll” la n g u a g e in S e c tio n 4 1 -7 -1 9 1 (1 6 ) sim p ly i n s tru c t s t h e M i s s i s s i p p i S t a t e De p a r t me n to f He a l th th a ti f

th e a p p l i c a n tme e t s a l l CO N revi ew cri t eri a, then the M i ssi ssi pp i S t at e D epart m ent of H eal th has n o dis cret i on and m ust i s s ue the C O N . H ow ever , unt i l s uch cr i t er i a ar e met , no C O N can be i s s ued.

### 12

¶2 6 . T h u s, th e M iss iss ip p i S tate D e p artm en t of H ea lth ’s fi n al ord er a n d the ch an ce ry court ’ s f i nal j udgm entw er e arbi tr ary and capr i ci ous and nots uppor t ed by s ubs t ant i al evi dence
. T her ef

or e, I f i nd thatthe chanc ery c our t ’ s f i nal j udgm ents houl d be vac at ed and this m att er rem an d ed t o M issi ssipp i S tat e D ep artm en t o f H ea lth , w h ich sh o u ld th en p erfo rm i t s neces s ary f

unct i ons and abi de by the C O N r evi ew cr i t er i a, w hi ch w oul d i ncl ude perm i t t i ng O C H a hea r i ng o n t he C O N appl i cat i on. T he M i s s i s s i ppi St at e D epart m entof H eal th m us tf

ol l ow the f

i r s tpr ong of

M i s s . C ode A nn. § 41- 7- 193, w hi ch s t at es : “A
cert i f i cat e of need s hal l notbe gr anted ori s s ued t o any per s on f orany pr opos al , caus e or
r eas on, unl es s the pr opos al has be en r evi ew ed f orc ons i s t ency w i th the s peci f i cat i ons and the
c ri te ri a e s ta b lis h e d b y th e S ta te D e p a rt m e n t o f H e a lth .” ¶2 7 . T h u s, for the rea so n s stated, I w o u ld rev erse the fina l j u d g m en t of th e C h an ce ry C o u rt fo r th e F irst Ju d icia l D istric t of H in d s C o u n ty , a n d rem a n d this m a tter to the M iss iss ip p i S tate D epart m entof

H eal th f orf ur therproc eedi ngs consi s t entw i th thi s opi ni on, i ncl udi ng, butnot l i m i t ed t o, r evi ew i ng M i s s i s s i ppi St at e U ni ver s i ty’ s C O N a ppl i cat i on i n acc or dance w i th the
s t a tu t o ry a n d r e g u l a t o ry p r o c e d u r e s o f M i s s i s s i p p i S t a t e De p a r t me n to f He a l th ’ s CO N pr ogr am, f

orcons i s t ency w i th al l appl i cabl e, dul y- adopt ed cr i t er i a and s t andar ds and f or conf or m i ty w i th the 2005 Stat e H eal th P lan . B e c a u s e th e m a jo r it y f in d s o th e rw is e , I
re sp e c tfu lly d iss e n t.