The Hospital shall have and exercise each and all of the following powers:

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(a) Maintain and operate a facility providing acute, chronic and all other health care services, including those services specifically provided by contract for the Department of Mental Health and Substance Abuse, for the people of Guam.

(b) (1) Establish a schedule of fees, in accordance with Title 10
GCA § 80105, to be charged for care and services at or by the Hospital. The schedule of fees shall be sufficient to recover the operating costs and fixed costs and to generate such revenue as is necessary to enable the Hospital to meet its financial obligations, operating expenses and capital improvement needs. The Guam Public Utilities Commission shall not have any purview over the Authority rates. The rates established per fee schedule may be increased by the Board of Trustees up to five percent (5%) per year; provided, that the total revenues from all increases per fee schedule shall not exceed five percent (5%) of the total revenues adopted by the Board in the Authority’s budget for that fiscal year, or decreased as necessary.

(2) Fees for new services, medications, or supplies, or rate increases of more than five percent (5%) annually shall be established by the Authority, approved and ratified by the Board of Trustees and forwarded to I Liheslaturan Guåhan for approval. Prior to the approval and ratification by the Board of Trustees, public hearings must be conducted by the Authority for any new fee or rate increase of more than five percent (5%).

(3) I Liheslaturan Guåhan shall have forty-five (45) days from the receipt of the proposed new fee or rate increase to conduct a public hearing and approve the increase or new fee. If I Liheslaturan Guåhan does not disapprove or amend the proposed new fee or increase in rates within the forty-five (45) days, the new fee or rate increase will immediately become effective.

(c) The Authority may establish interim fees for new, untariffed services, medication and supplies, without prior legislative approval and without compliance with the Administrative Adjudication Law; provided, that:

(1) the interim fees are consistent with the Authority’s Net
Revenue Enhancement Engagement Pricing Model, as prepared by

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Deloitte & Touche, dated February 7, 1992, or such other protocol as may be approved by the Board of Trustees; and

(2) a petition for permanent approval of the interim fees is filed by the Authority with I Liheslaturan Guåhan within three (3) months of the Authority’s establishment of the interim fee.

(d) Forward the billings for the cost of medical care and services rendered to any person under the Old Age Assistance for the Aged Program, Aid to the Blind Program, and Aid to the Permanently and Totally Disabled Program of the Social Security Act, as well as those persons considered medically indigent as the term is defined in Chapter
2 of this Title, of which shall be paid by the Department of Public
Health and Social Services.

(e) Acquire, subject to the laws of Guam, by grant, purchase, gift, devise or lease, and hold and use any real property necessary or convenient or useful for the carrying on of any of its powers pursuant to the provisions of this Article; upon written certification of the Administrator, that specified and specialized medical equipment and related supplies are needed immediately for the health and welfare of the patients of the Hospital in particular, and the people of Guam in general, the Guam Memorial Hospital Authority shall be exempt from the provisions of §§ 5210 and 5211 of Title 5, Guam Code Annotated, in the acquisition of the medical equipment and related supplies specified in such written certification of the Administrator; provided, that the Hospital shall use its best judgment and efforts to secure the best equipment and supplies at the lowest cost, utilizing businesses licensed to do business on Guam whenever possible.

(f) Establish its internal organization and management;

(g) Perform such acts as may be reasonably necessary to accomplish the purpose for which it was formed;

(h) Adopt a seal;

(i) Sue or be sued in its own corporate name;

(j) Employ, retain or contract for the services of qualified managers, specialists or as individuals or as organizations;

(k) Adopt such rules and regulations pursuant to the
Administrative Adjudication Act as may be necessary for the exercise

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of the Hospital’s powers, performance of its duties and administration of its operations;

(l) Adopt and maintain a uniform system of accounting;

(m) Adopt and maintain a travel authorization policy, notwithstanding any law to the contrary;

(n) Adopt rules and regulations governing selection, compensation, promotion, performance evaluation, disciplinary action and other terms and conditions of employment affecting personnel, subject to the provisions of the Administrative Adjudication Law. Such rules and regulations shall provide for the employment and retention of persons on the basis of merit, and shall include an orderly and systematic method of recruitment and the establishment of a list of qualified applicants for employment purposes, except that compensation for non-medical personnel shall remain consistent with compensation plans and pay scales as determined by the Civil Service Commission or its successor. Non-medical personnel are defined as personnel employed by the Authority who are not physicians, nurses, medical technicians or technologists, licensed or certificated therapists of any sort, laboratory technicians, personnel certificated in any medical or nursing field, nurse practitioners, pharmacists or other medical personnel. It is further provided:

(1) that the conduct of any GMHA Medical Peer Review proceeding shall be conducted in strict compliance with the Health Care Quality Improvement Act, as amended (HCQIA), of Title IV of Public Law 99-660 (42 U.S.C. § 11101 et seq.) authorizing the Secretary of the U.S. Department of Healt h and Human Services to establish a National Practitioner Data Bank (NPDB) to collect and release certain information relating to the professional competence and conduct of physicians, dentists and other health care practitioners; and §1921 of the Social Security Act (42
U.S.C. 1396r-2) (§1921) requiring each state to adopt a system of reporting to the Secretary of adverse licensure actions taken against health care practitioners and entities;

(A) The Board shall provide for third-party peer review services for those peer review proceedings wherein the

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physician who is the subject of a peer review asserts that an impartial proceeding cannot otherwise be achieved.

(2) A medical peer review shall not be overturned by the Board, except as strictly prescribed by the National Practitioner Data Bank, as provided pursuant to Title 45 – Public Welfare, Part
60, Code of Federal Regulations, and as the regulations and authorizing statutes may be revised;

(3) No “”Void”” or Reversal of Professional Peer Review Action by Board Without Successful Appeal; Mandatory. No GMHA medical peer review action that adversely affects the clinical privileges of physicians, dentists and other health care practitioners shall be reversed by the Board, nor shall a “”void”” be sought with the National Practitioners Data Bank:

(A) without the appellant having successfully appealed the initial action before a subsequent GMHA peer review committee duly conducted by medical professionals authorized to conduct the appeal proceeding; or

(B) without the finding(s) of the GMHA medical peer action having been reversed by the Guam Board of Medical Examiners, wherein the appellant successfully appealed the GMHA medical peer review action; or

(C) without the appellant having successfully appealed the GMHA medical peer review action before the Judiciary of Guam;

any one of which may be deemed satisfactory to reverse the initial GMHA medical peer review action and seek a “”void”” with the NPDB; provided, that the conduct of the appeal and action taken in granting the appeal is legally acceptable to the National Practitioner Data Bank pursuant to applicable federal law, rules and regulations.

(4) Personal Liability – No Waiver of Immunity. The members of the Board of Trustees, and the GMHA Legal Counsel, shall not be personally immune from legal and civil liability for a knowing violation of Items (1), (2) and (3) of this Subsection (n).

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(o) Do any and all other things necessary to the full and convenient exercise of the above powers;

(p) Contract with a corporation to exercise any or all the powers of the Administrator, and of those officers authorized by § 80108 of this Chapter, if the Board so chooses;

(q) Acquire in accordance with the Procurement Law (5 Guam Code Ann., Chapter 5) and hold and use any personal property or construct any projects necessary or convenient or useful for carrying on of any of its powers pursuant to the provisions of this Chapter;

(r) (1) With the concurrence of I Maga’lahen Guahan [Governor], negotiate with appropriate federal official (Secretary of Defense, officials of Tripler Army Hospital, etc.) for the implementation of
§ 105(k) of the Compact of Free Association Act of 1985 with the
Freely Associated States of Micronesia.

(2) All terms of the agreement shall be negotiated by the Guam Memorial Hospital Authority in the best interests of the people of Guam. The agreement must be submitted to I Maga’lahi for his review and approval.

(s) Arrange a line of credit, a revolving loan fund, and/or a direct loan, the total cumulative amount not to exceed Twenty-five Million Dollars ($25,000,000), with banks or other lending institutions licensed to do business on Guam. All terms of the line of credit, a revolving loan fund, and/or a direct loan agreement shall be negotiated by the Authority and I Maga’lahen Guåhan [Governor] in the best interests of the people of Guam. The terms of the line of credit, a revolving loan fund, and/or a direct loan shall include the following:

(1) the line of credit, a revolving loan fund, and/or a direct loan shall be used by the Authority when a cash shortage threatens the operation of the Hospital, and provided that the loan shall not be used for the hiring of non-health care professionals not involved with providing direct patient care or patient care support;

(2) no charge shall be levied by a lender for making the loan;

(3) the interest rate shall be subjected to negotiation between the Authority or designee as authorized by the Board of

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Trustees, I Maga’lahen Guåhan and the lender; such interest rate shall be computed on a monthly average and based on the actual amount extended to the Authority; and

(4) interest earned by the lender shall be exempt from taxation by the government of Guam.

(5) I Maga’lahen Guåhan is authorized to pledge funds which Guam shall receive from the State Attorneys General Tobacco Litigation, as provided by Public Law 24-174, or the General Fund, or both funds in any combination, as a security for repayment of the loan, in addition to any revenues which may be pledged by the Authority. I Maga’lahen Guåhan and the Authority are hereby authorized to execute the loan agreement, a revolving loan fund, and/or a direct loan agreement and other necessary documentation.

(6) The line of credit authorized in this Act shall not be used in the calculation for rate relief in any rate methodology for any rate case before the Public Utilities Commission.

(7) The primary source of repayment for the line of credit, revolving loan fund, and/or a direct loan shall be as authorized in Public Law 30-196, Chapter III, Part I, Section 6(b) (the FY 2011
Budget Act). If required, the Authority may pledge, in addition, only its revenues as a security for repayment as determined by the negotiated agreement.

(8) Any money borrowed shall be repaid in accordance with the terms established in the negotiated agreement, but not to exceed an amortization period of more than twenty-five (25) years. In no case shall any amount borrowed be refinanced permitting repayment more than twenty-five (25) years after the loan is made.

(9) Notwithstanding the provisions of Chapter 6 of Title 5 of the Guam Code Annotated, the government of Guam hereby waives immunity from any suit or action in contract upon the loan and guaranty but does not waive sovereign immunity as to the personal liability of elected or appointed officials and employees of the government Guam. For the purposes of this provision only, immunity is also waived as to the award of attorney fees and related costs of the lender in connection with any suit brought by

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the lender to enforce any right or obligation incurred under the loan authorized hereby or in connection with the enforcement of any agreement, note or pledge that arises directly from the indebtedness authorized hereby.

(10) This Guarantee is a general obligation of the government of Guam, subject to the full faith and credit of the government of Guam. The Guarantor consents to any and all extension of time and waiver or modification of obligations guaranteed hereunder.

(11) I Maga’lahen Guåhan, the Governor of Guam, at his discretion and with his consent, may pledge Compact Impact Funds received from the Department of Interior as a source of funding to secure the balance of the Twenty-five Million Dollar line of credit, revolving loan fund, and/or a direct loan authorized in this Act to be used for the reduction of the Guam Memorial Hospital Authority’s vendor payables.

(t) Notwithstanding any other provision of law, make, negotiate and enter into a commercial lease, or issue a permit or license for the use of its real property and other related facilities for a term not to exceed five (5) years.

(u) Retain or contract, in accordance with applicable procurement law, services relative to the providing of cafeteria andor other food vendor services, in whole or in part as determined to be necessary and appropriate. This shall include, but not be limited to, the management and operation of services for cafeteria, snack bar, restaurant, andor other food related services or activities as deemed appropriate for non- inpatient visitors, patrons and GMHA staff.

(1) The solicitation and contracting for food services may include, to the extent deemed practicable, appropriate and necessary, the use of assets, real property andlor facilities, and as further provided for in accordance with Subsection (t) of this § 80109.

(2) The authorization pursuant to this Subsection (u) to retain and contract services relative to the providing of cafeteria andor other food services shall not apply or pertain to replacing, supplanting andor eliminating GMHA’s in-house Dietetic Services

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department currently providing nutritional food services for inpatients.

(v) Notwithstanding Subsection (s) of this Section, to arrange a line of credit, a revolving loan fund, and/or a direct loan, the amount not to exceed Nine Million Two Hundred Thousand Dollars ($9,200,000), to finance the Guam Memorial Hospital Authority Labor and Delivery Ward renovation Phases One through Four, and to include the “”Arts In Public Buildings and Facilities”” fee as required by § 852 of Article 2 of Chapter 8, Title 1, Guam Code Annotated, with banks or other lending institutions licensed to do business on Guam. All terms of the line of credit, a revolving loan fund, and/or a direct loan agreement shall be negotiated by the Guam Economic Development Authority and I Maga’låhen Guåhan (the Governor) in the best interests of the people of Guam. The terms of the line of credit, a revolving loan fund, and/or a direct loan shall include the following:

(1) (A) the line of credit, a revolving loan fund, and/or a direct loan shall be used by the Authority for the renovation of the Guam Memorial Hospital Labor and Delivery Ward (GMHA Maternal and Child Healthcare (MCH) Renovation Project);

(B) such line of credit shall not be authorized, nor shall any borrowing be initiated that incurs interest expenses until the architectural and engineering specifications are completed and approved by the Board of Trustees of the Guam Memorial Hospital Authority (GMHA), and the Request for Proposal or Invitation for Bid to commence renovation is pending funding;

(2) no charge shall be levied by a lender for making the loan;

(3) the interest rate shall be subject to negotiation between the Board of Directors of GEDA, I Maga’låhen Guåhan, and the lender; and such interest rate shall be computed on a monthly average and based on the actual amount extended for the Authority; and

(4) interest earned by the lender shall be exempt from taxation by the government of Guam.

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(5) The line of credit, a revolving loan fund, municipal lease financing, and/or a direct loan may be secured by a pledge or other reservation of revenues collected by the government of Guam from the taxes collected under the “”Business Privilege Tax Law”” (namely, 11 Guam Code Ann., Chapter 25, excluding the alcoholic beverage taxes, liquid fuel taxes, automotive surcharges, tobacco taxes and real property taxes). The Business Privilege Tax pledged or reserved may only be pledged or reserved on a basis that is subordinate to the pledge of revenues from the Business Privilege Tax that secure the Government’s Business Privilege Tax Bonds (currently, the Business Privilege Tax Bonds, Series 2011A,
2012B-1, 2012B-2, 2013C and 2015D, as well as any future bonds (collectively, the “”Business Privilege Tax Bonds””)) issued under the indenture relating to the Business Privilege Tax Bonds (the “”Indenture””), as well as any parity obligations permitted to be issued under such Indenture, on a basis that is in accordance with and complies with such Indenture. The sum of Six Hundred Thousand Dollars ($600,000) will be continuously appropriated annually to pay for the principal, interest, and debt reserve for the line of credit, a revolving loan fund, and/or a direct loan. I Maga’låhen Guåhan and the Guam Economic Development Authority are hereby authorized to execute the loan agreement, a revolving loan fund, and/or a direct loan agreement and other necessary documentation.

(6) Any money borrowed shall be repaid in accordance with the terms established in the negotiated agreement, but not to exceed an amortization period of more than twenty-five (25) years.

(7) Notwithstanding the provisions of Chapter 6 of Title 5 of the Guam Code Annotated, the government of Guam hereby waives immunity from any suit or action in contract upon the loan and guaranty, but does not waive sovereign immunity as to the personal liability of elected or appointed officials and employees of the government of Guam. For the purpose of this provision only, immunity is also waived as to the award of attorney fees and related costs in connection with any suit brought to enforce any right or obligation incurred under the loan authorized hereby or in connection with the enforcement of any agreement, note or pledge that arises directly from the indebtedness authorized hereby.

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(8) This Guarantee is a general obligation of the government of Guam, subject to the full faith and credit of the government of Guam. The Guarantor consents to any and all extension of time and waiver or modification of obligations guaranteed hereunder.

(9) Alternative Financing. I Maga’låhen Guåhan and the Guam Economic Development Authority are authorized to utilize the following alternative financing if necessary:

(A) Federal Guaranteed Loan or Community Facilities Loan and Grants, instrumentalities of the United States Department of Agriculture, if such financing better serves the needs of the people of Guam; and/or

(B) Municipal Lease Financing. I Maga’låhen Guåhan, with the assistance of the Guam Economic Development Authority, is authorized to enter into a municipal lease financing as defined under Title 5, Guam Code Annotated, Division 5, Chapters 58, 58A, 58B, 58D and 58E.

(C) I Maga’låhen Guåhan is authorized to identify a fund source, except for funding sources that are already identified and earmarked for the Guam Memorial Hospital Authority, limited to the amounts in this Act, and utilize such source for the purposes of renovating the labor, delivery, recovery, postpartum ward where our babies are born. I Maga’låhi shall notify I Liheslatura (the Legislature) of the fund source(s) identified pursuant to this provision no later than ten (10) working days after identification of funds.

(10) The GMHA Board of Trustees shall cause an update of its facilities master plan that will guide the capital improvement of the Guam Memorial Hospital. The Trustees shall allocate sufficient funds from the amount obtained from the line of credit, revolving fund, and/or direct loan authorized by this Subsection for the purpose of completing a master plan update. Review and approval of the completed master plan update shall be in accordance with the AAL. Said master plan update shall be completed within one hundred eighty (180) days from the date of enactment of this statute.

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(11) That, if the labor and delivery ward operations or facilities are privatized, to include any public-private partnership, then, as a condition of such privatization agreement, the party or parties which have assumed control or ownership of the operations or facilities shall assume any outstanding debt and provide compensation to the Guam Memorial Hospital Authority for any incurred expenses that were financed under this Subsection.

SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 49003. Subsection (b) amended by P.L. 14-091:2 (Dec. 27, 1977). Subsection (l) repealed and reenacted by P.L. 14-140:28 (Aug. 31, 1978), repealed by P.L. 16-098:1 (July 2, 1982). Subsection (o) added by P.L. 15-135:11 (Aug. 22, 1980). Subsection (e) amended P.L. 16-007:10 (Apr. 24, 1981), repealed and reenacted by P.L. 16-098:4 (July 2, 1982). Subsection (n) amended by P.L. 16-098:5 (July 2, 1982). Subsection (c) amended by P.L. 16-
124:21 (Dec. 29, 1982). Subsection (p) added by P.L. 16-124:22 (Dec. 29, 1982). Subsection (a) amended by P.L. 17-021:1 (Aug. 18, 1983). Subsection (b) amended by P.L. 17-083:1 (Dec. 21, 1984). Codified as 10 Guam Code Ann. § 80104. Subsection (b) repealed and reenacted by P.L. 18-026:7 (Dec. 31, 1985). Subsections (o) (1, 5 & 6) amended by P.L. 18-026:10 (Dec. 31, 1985). Subsection (q) added by P.L. 18-026:13 (Dec. 31, 1985). Subsection (c) amended by, P.L. 20-228:1 (Jan. 30, 1991), P.L. 29-
014:2 (Sept. 7, 2007). Subsection (s) added by P.L. 25-150:2 (July 7, 2000), amended by P.L. 30-200:2 (Dec. 9, 2010). Subsections (s)(10) and (11) added by P.L. 32-043:2 (July 2, 2013). Subsection (s)(9) amended by P.L. 32-105:1 (Jan. 14, 2014). Subsection (u) added by P.L. 31-002:2 (Mar. 8, 2011). Subsection (n) amended by P.L. 32-158:2 (May 21, 2014). Subsection (v) added by P.L. 32-204:1 (Oct. 13, 2014), and P.L. 33-151:1 (May 13, 2016).

2013 NOTE: This section was originally codified as GC § 49007, entitled “”Employment Practices.”” Repealed and added as 10 Guam Code Ann. § 80113 by P.L. 30-190:1 (Aug. 28, 2010).

Numbers and/or letters were added or altered to adhere to the Compiler’s alpha- numeric scheme in accordance to 1 Guam Code Ann. § 1606.

NOTE: P.L. 20-228:1 (Jan. 30, 1991) amended 10 Guam Code Ann. § 80103(c). This appeared to be a manifest error. The correct section is § 80104(e).

NOTE: The authority to establish fees was also found in § 80105.1 of this Chapter, which was apparently added as untitled and uncodified law by P.L 19-005:55 (Aug.
21, 1987), repealed and added by P.L. 23-22:2 (May 30, 1995), and repealed by P.L.
25-005:8 (May 10, 1999).