Opinion ID: 1701716
Heading Depth: 1
Heading Rank: 3

Heading: conclusion

Text: ¶ 27. In total, this Court finds that substantial evidence was offered throughout this proceeding to support the ultimate finding that DeSoto's application satisfied the CON Criteria and Standards for the Offering of MRI Services, the General Certificate of Need Policies, and the contested General Considerations. Given the MSDH's familiarity with the particularities and nuances of the problems committed to its care[,] Dunn, 708 So.2d at 72, this Court finds that it is obligated to defer to the MSDH's judgment in the absence of a breach of established requirements. Accordingly, this Court concludes that the chancery court erred in finding the MSDH's grant of DeSoto's application was arbitrary and capricious and contrary to the manifest evidence in the case. . . . II. Whether the MSDH committed reversible error in approving DeSoto's application after a new route was substituted following the recommended approval of the hearing officer but before the final order of the State Health Officer. ¶ 28. This Court previously has stated that: [a]dministrative agencies are ambiguous creatures born of necessity, mired in the tension between public policy and personal claims of right. They pursue pragmatically the public interest balancing the utilitarian (and expertly divined) calculus of aggregate net benefit against the individual's claim to fair opportunity and process. They address pressing questions of political economy and science where there are seldom easy answers and almost never only two points of view. Our administrators also regulate and facilitate individual enterprise without which the public interest will surely suffer. Here, as well, the life of the law has not been logic; it has been experience. McGowan v. Miss. State Oil & Gas Bd., 604 So.2d 312, 315-16 (Miss.1992) ( McGowan II ) (citations omitted) (emphasis added). Given that status: [t]his Court has generally accorded great deference to an administrative agency's construction of its own rules and regulations and the statutes under which it operates. . . . This Court has noted that an agency's interpretation of a regulation it has been authorized to promulgate is entitled to great deference and must be upheld unless it is so plainly erroneous or so inconsistent with either the underlying regulation or statute as to be arbitrary, capricious, an abuse of discretion or otherwise not in accordance with law.  Buelow v. Glidewell, 757 So.2d 216, 219 (Miss.2000) (quoting Tower Loan of Miss., Inc. v. Miss. State Tax Comm'n, 662 So.2d 1077, 1081 (Miss.1995)) (emphasis added). This duty of deference derives from our realization that the everyday experience of the administrative agency gives it familiarity with the particularities and nuances of the problems committed to its care which no court can hope to replicate. Dunn, 708 So.2d at 72. See also Int'l Bd. of Teamsters v. Daniel, 439 U.S. 551, 566, 99 S.Ct. 790, 58 L.Ed.2d 808 (1979) (administrative agency deference is a product both of an awareness of the practical expertise which an agency normally develops, and of a willingness to accord some measure of flexibility to such an agency as it encounters new and unforeseen problems over time. ) (emphasis added). A new and unforeseen problem arose in the case sub judice in that the proposed route which DeSoto was to join was rendered prospectively insufficient to produce the minimum number of annual procedures required by the State Health Plan by Gilmore's termination of its MRI Service Agreement with Alliance, after the hearing officer's recommendation to grant DeSoto's application, but before the State Health Officer ruled thereon. ¶ 29. The hearing officer was aware that Alliance was renegotiating the terms of its contract with Gilmore, which recently had been acquired by Healthcare Management Associates, and that their current proposal of three days (including a Saturday) had not yet been accepted. [19] Smith testified that Alliance was  operating right now with Gilmore on a month-to-month basis [,] further noting that  [i]t's a possibility that we could lose a contract at any point in time [,] but that [i]f we lose the Gilmore contract, we have many, many more contracts . . . and customers that we can put in those places. (Emphasis added). The hearing officer was well aware that [t]he route of which this new service will be a part is less than concrete[,] when he recommended approval of DeSoto's application. After Gilmore terminated its MRI Service Agreement with Alliance, a subsequent hearing was held to consider Baptist and Carvel's Joint Motion to Reopen and Supplement Record and for Reconsideration of Hearing Officer's Findings of Fact and Conclusions of Law. The hearing officer was aware of Smith's affidavit, which provided that [i]n the mobile MRI industry it is common for mobile MRI routes to be altered and/or for contracts for mobile MRI services to be amended or cancelled and that DeSoto would be added to a route which performed 2,323 MRI procedures in the previous twelve months. After due consideration, the hearing officer denied the motion and affirmed his recommendation to grant DeSoto's application. In so finding, the hearing officer determined that if a CON had been issued, a changed route would not constitute a change in scope under Section 100.01 of the CON Review Manual, as it was immaterial given the frequency of changes in mobile MRI routes, especially when combined with the need requirement sufficiency of the new route. The State Health Officer adopted this finding. The chancery court reversed the MSDH's decision. The chancellor specifically concluded that fundamental notions of due process, as well as the requirements of the CON statutes themselves[,] should have required DeSoto to file a new application, proposing a new route which satisfied the State Health Plan's requirements. ¶ 30. Baptist argues that the hearing officer's denial of its motion to reopen and supplement the record and accompanying recommendation to grant DeSoto's application, adopted by the State Health Officer, contravened Mississippi Code Annotated Section 41-7-197(2) in that any person affected by the proposal being reviewed was not given the opportunity to conduct reasonable questioning of persons who make relevant factual allegations concerning the proposal. See Miss.Code Ann. § 41-7-197(2) (Rev.2005). Additionally, on appeal, Baptist and Carvel incorporated a due-process argument in that: [t]he new route proposed by [DeSoto] has never been part of any CON application. It has never been reviewed by the MSDH staff. It has never been disclosed to the public. Affected parties have never been notified that this proposed route was even being considered by the MSDH. [Appellees] have never had the opportunity to challenge this route through subpoenas of documents and questioning of witnesses. Despite all of this, the MSDH has, in effect, approved an application based on an MRI route which has never been subjected to administrative nor public scrutiny. The chancery court agreed, relying upon the perceived applicability of Mississippi Code Annotated Section 41-7-197 and fundamental notions of due process, in finding the MSDH did not have the legal authority . . . to approve a new proposal for an MRI service in a post-hearing affidavit format, without requiring the applicant to submit a full, new substantive application and subjecting the new route to public and regulatory scrutiny. ¶ 31. DeSoto and the MSDH respond that: [n]othing changed in [DeSoto's] application except for the identities of the other two providers on the route. The CON laws require that a hearing be afforded to challengers of a CON application or a staff analysis, and a hearing was provided. The laws do not require that an application be rejected, or that a new hearing be held, if any facts in the application change after that hearing. [20] As to due process, DeSoto and the MSDH argue: the [MSDH] made its position known, as regards the negligible effect of the new route on [DeSoto's] CON application, in its motion of August 9, 2005. The details of the new route had been made available to the Appellees even earlier, on July 26, when [DeSoto] provided the Cindy Smith affidavit. The hearing officer heard the motion on August 11, 2005. Thus, Appellees cannot maintain that they were not afforded notice, and an opportunity to be heard. Under the unusual circumstances, and given the flexibility afforded the [MSDH], that sufficed for due process. DeSoto and the MSDH further argue, [t]his case involved an unusual circumstance not foreseen by the CON statutes or by the [MSDH's] regulations. Therefore, it was exactly the kind of case in which the [MSDH's] expertise should have been afforded great deference as it decided how to handle the situation before it. . . . Finally, DeSoto and the MSDH maintain that: the chancery court awarded relief that the Appellees never sought from the [MSDH]. In their joint motion to reopen the record, the Appellees sought only to supplement the record with the fact of Gilmore's withdrawal from the proposed route, and to seek the rejection of the application on that basis. . . . [T]hey never moved the hearing officer or the [MSDH] for a new hearing. (Emphasis added). As such, DeSoto and the MSDH argue that any applicable right to a hearing was waived. ¶ 32. Mississippi Code Annotated Section 41-7-197 provides, in pertinent part, that: (1) The [MSDH] shall adopt and utilize procedures for conducting certificate of need reviews. Such procedures shall include, inter alia, the following: (a) written notification to the applicant; (b) written notification to health care facilities in the same health service area as the proposed service; (c) written notification to other persons who prior to the receipt of the application have filed a formal notice of intent to provide the proposed service in the same service area; and (d) notification to members of the public who reside in the service area where the service is proposed, which may be provided through newspapers or public information channels. (2) . . . Any such hearing shall be conducted by a hearing officer designated by the [MSDH]. At such hearing, the hearing officer and any person affected by the proposal being reviewed may conduct reasonable questioning of persons who make relevant factual allegations concerning the proposal. . . . A record of the hearing shall be made, which shall consist of a transcript of all testimony received, all documents and other material introduced by any interested person, the staff report and recommendation and such other material as the hearing officer considers relevant, including his own recommendation, which he shall make within a reasonable period of time after the hearing is closed and after he has had an opportunity to review, study and analyze the evidence presented during the hearing. The completed record shall be certified to the State Health Officer, who shall consider only the record in making his decision, and shall not consider any evidence or material which is not included therein. All final decisions regarding the issuance of a certificate of need shall be made by the State Health Officer. The State Health Officer shall make his written findings and issue his order after reviewing said record. Miss.Code Ann. § 41-7-197 (Rev.2005) (emphasis added). Regarding Changes in Scope of Approved Project, the CON Review Manual states, [a]pplicants for a CON should clearly understand that if an approved project is changed substantially in scope-in construction, services, or capital expenditure the existing CON is void, and a new CON application is required before the proponent can lawfully proceed further. CON Review Manual § 100.01 at 54. [21] ¶ 33. Due process always stands as a constitutionally grounded procedural safety net in administrative hearings. McGowan II, 604 So.2d at 318 (citations omitted). However, [t]he due process clauses of our constitutions must not be construed so as to put the state and federal governments into a straight-jacket and prevent them from adapting life to the continuous change in social and economic conditions. Miss. Power Co. v. Goudy, 459 So.2d 257, 273 (Miss.1984) (Hawkins, J., specially concurring) (quoting Albritton v. City of Winona, 181 Miss. 75, 178 So. 799 (1938)). [22] In the administrative setting, minimum procedural due process . . . is (1) notice, and (2) opportunity to be heard. State Oil & Gas Bd. v. McGowan, 542 So.2d 244, 248 (Miss.1989) ( McGowan I ) (citations omitted). ¶ 34. The great deference extended to the MSDH, Buelow, 757 So.2d at 219, reaches to the new and unforeseen problems it encounters over time. Daniel, 439 U.S. at 566, 99 S.Ct. 790. There can be no legitimate dispute that the procedures outlined in Mississippi Code Annotated Section 41-7-197(1) were satisfied with respect to DeSoto's application. Following a route change, which was not a substantial change in scope and which would have required a new CON application had CON Review Manual § 100.01 been applicable, a hearing was held to consider Baptist and Carvel's Joint Motion to Reopen and Supplement Record and for Reconsideration of Hearing Officer's Findings of Fact and Conclusions of Law. Significantly, no parties to the proceeding, no health care facilities in the same health care service area, and no others originally noticed, appeared to request a new hearing. ¶ 35. Procedurally, this Court finds that given the absence of a request for a hearing, the due process contention of Baptist and Carvel is much ado over nothing, the proverbial red herring. Addressing the due process argument substantively, this Court finds the administrative procedural due process requirements of (1) notice, and (2) opportunity to be heard[,] McGowan I, 542 So.2d at 248, were satisfied. Baptist and Carvel were on notice of the new route. A motion hearing on Baptist and Carvel's Joint Motion to Reopen and Supplement Record and for Reconsideration of Hearing Officer's Findings of Fact and Conclusions of Law accorded them due process. Had any other individual or entity entitled to notice sought intervention in the proceeding at any stage complaining a lack of due process, the chancellor might have been required to undertake a separate due process analysis. However, no such claim was advanced. Finally, at the post-hearing motion proceeding, Smith's sworn affidavit provided substantial evidence, i.e., more than a scintilla or a suspicion[,] Natchez Cmty. Hosp., 743 So.2d at 977, that a new route would meet the need requirements of the State Health Plan. This Court finds that this sworn statement of Alliance's Director of Operations is more than a mere factual allegation, thereby rendering the contested portion of subsection (2) inapplicable. The issue of import to satisfy the requirements of the State Health Plan is not the specific route, but rather the number of procedures. Whether considering evidence based upon the previous twelve-month period (the historical number of procedures performed) or the proposed route change (the formula projection), the result is the same. The minimum number of procedures required was met. [23] ¶ 36. While this Court commends the chancellor's careful examination of all issues, the chancellor erroneously granted relief which was not sought by the parties to the agency proceeding, i.e., a new hearing. Additionally, the applicable standard of review renders this a matter of deference, not equity. Accordingly, this Court defers to the judgment of the MSDH. Therefore, this Court concludes that the chancery court erred in remanding to the MSDH.