Medical University Hospital Authority: An Overview
The Medical University Hospital Authority (MUHA) operates as an integral part of the Medical University of South Carolina (MUSC), a leading health sciences university located in Charleston. This article provides an overview of the Medical University Hospital Authority, its establishment, governance, powers, and relationship with the Medical University of South Carolina.
Historical Context and Establishment
The Medical University of South Carolina has a rich history, with its origins tracing back to the Medical College of South Carolina. Over time, the institution's focus has evolved to exclusively concentrate on health-related programs.
Name Change: Formally, The Medical College of South Carolina was renamed to "The Medical University of South Carolina," with the express intent to limit its programs to those in the health area (SECTION 59-123-10).
Governance and Structure
The management and control of the university are vested in a board of trustees (SECTION 59-123-40).
Board of Trustees Composition: The board is composed of the Governor or his designee, ex officio, fourteen members elected by the General Assembly in joint assembly, and one member appointed by the Governor. (SECTION 59-123-40).
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Election and Terms: Members representing the medical profession (medical doctor, dentist, registered nurse, or licensed pharmacist) and lay members are elected by the General Assembly (SECTION 59-123-50). Their terms are staggered, with some initially serving four years and others two years, ensuring continuity and experience on the board. Vacancies are filled in a similar manner, with the term of the successor expiring on the last day of June of the year in which the unexpired term terminates. The term of the at-large trustee appointed by the Governor is effective upon certification to the Secretary of State and is four years. Any vacancy in the office of the member appointed by the Governor must be filled by appointment for the unexpired term in the same manner of original appointment. (SECTION 59-123-50).
Board Authority: The board of trustees elects a chairman from its members and is authorized to elect a university president, one or more vice presidents, and a secretary, prescribe their duties and terms of office, and fix their compensation (SECTION 59-123-60). It also elects teachers of professorial rank in the various colleges and other officers and employees as necessary for the proper conduct of the university, fixing their compensation, the fees and charges of students, and the rules for the government of the university. (SECTION 59-123-60).
Medical University Hospital Authority (MUHA)
The Board of Trustees of the Medical University of South Carolina, as provided in an implementing resolution, becomes the governing body of the Medical University hospitals, clinics, and other health care and related facilities. (SECTION 59-123-60). This governing body is constituted and designated as the Medical University Hospital Authority, an agency of the State of South Carolina. (SECTION 59-123-60).
Powers and Responsibilities of MUHA:
- Contractual Authority: MUHA has the power to make contracts and guarantees, to incur liabilities, to issue its notes, bonds, and other obligations, and secure any of its obligations by mortgage or pledge of any of its property, or income in a manner to be in the best interest of the authority (SECTION 59-123-60).
- Property Management: MUHA can have, hold, purchase, and lease real estate and personal property for corporate purposes; and sell and dispose of personal property and any buildings that are considered by it as surplus property or no longer needed and any buildings that it may need to do away with for the purpose of making room for other construction (SECTION 59-123-60). It can also sell, convey, mortgage, lease, exchange, and otherwise dispose of any real property subject to the authority and approval of the State Fiscal Accountability Authority or the Department of Administration, as appropriate. These activities are exempt from all regulations and general laws governing disposal of surplus government property. The proceeds derived from the lease of any real property, net of transaction costs and payment of any debts secured by such property, are remitted to the MUSC Board of Trustees to be used exclusively for the support of the Medical University (SECTION 59-123-60).
- Financial Authority: The authority can utilize all provisions of the Hospital Revenue Bond Act for the purpose of effectuating the provisions of making contracts and guarantees, to incur liabilities, to issue its notes, bonds, and other obligations, and secure any of its obligations by mortgage or pledge of any of its property, or income in a manner to be in the best interest of the authority (SECTION 59-123-60). The issuance by the authority of any bonds, notes, or other obligations or indebtedness, except as provided in this subitem, shall be subject to the approval thereof by resolution of the State Fiscal Accountability Authority. Except for such approving resolution, the requirements of Section 44-7-1590 of the Hospital Revenue Bond Act shall be applicable to obligations issued by the authority. (SECTION 59-123-60).
- Personnel Management: MUHA appoints officers, employees, personnel, and agents and defines their duties and fixes their compensation as necessary to carry out its activities and affairs (SECTION 59-123-60). The policies of MUHA's personnel and employees are exempt from Department of Administration personnel policies and applicable laws; all personnel employed by the authority are exempt from the provisions of Article 5, Chapter 17 of Title 8, the State Employee Grievance Procedure, but the board shall adopt a grievance procedure substantially similar to the provisions of that article to govern personnel and employees of the authority, and this procedure must be filed with and approved by the State Department of Administration. (SECTION 59-123-60).
- Corporate Structure: MUHA can establish not-for-profit corporations as the board considers necessary to assist the authority in carrying out its functions, provided that any entity created pursuant to this subsection is considered to be an entity of the authority and subject to all laws and regulations applicable to the authority under this section (SECTION 59-123-60).
- Succession: The authority and the board of trustees as the governing body of the authority succeed to all of the rights, duties, and obligations of the Medical University of South Carolina and the board of trustees, respectively, as owner and operator of the hospital. All property, real, personal, tangible, or intangible (including, without limitation, deposits, investments, and accounts receivable) of the Medical University relating to the hospital becomes the property of the authority (SECTION 59-123-60).
Financial Oversight and Accountability:
- Public Purpose: All revenues of the Medical University of South Carolina, the Medical University Hospital, and any funds transferred to the Medical University from a practice plan must be expended for a public purpose as that purpose is defined in the applicable state law and regulations (SECTION 59-123-60).
- Audit and Review: Upon review of the audit report required in Section 59-123-60(E)(10), the legislature, by joint resolution, or the Governor, by Executive Order, may request audits to be completed by the State Auditors Office or the Legislative Audit Council (SECTION 59-123-60).
Removal of Officials: A member of the Medical University Board, an officer in the administration of the university, including deans of the various colleges, the President of the Medical University, or any other officer of the authority or any of its affiliates who have been found guilty of malfeasance, misfeasance, incompetence, absenteeism, conflict of interest, misconduct, persistent neglect of duty in office, or incapacity is subject to removal by the Governor upon any of the foregoing causes being made to appear to the satisfaction of the Governor. But before removing any such person, the Governor shall inform him in writing of the specific charges against him and give him an opportunity on reasonable notice to be heard. The Governor shall appoint a successor to fill the vacancy created by his removal (SECTION 59-123-60).
Funding and Appropriations: Beginning in fiscal year 2000-2001 state appropriations to the Medical University of South Carolina for support of the Medical University hospitals and clinics are redirected to the Department of Health and Human Services. These funds are used as match funds for the disproportionate share for the hospital's federal program. Any excess funding may be used for hospital base rate increases. The Department of Health and Human Services pays to the Medical University of South Carolina Hospital Authority an amount equal to the amount appropriated for its disproportionate share to the Department of Health and Human Services. This payment is in addition to any other funds that are available to the authority from the Medicaid program inclusive of the disproportionate share for the hospital's federal program (SECTION 59-123-60).
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Expenditure of Public Funds: The board, as the governing body of the authority, adopts a written policy for the hospital for the expenditure of public funds. Public funds may be expended for events which recognize academic and research excellence and noteworthy accomplishments of members of the faculty and staff, students, and distinguished guests of the authority. Sources of the funds for these expenditures include only nonappropriated state funds (SECTION 59-123-60).
MUSC Health and Clinical Operations
MUSC Health, as the clinical enterprise of the Medical University of South Carolina, operates a 750-bed medical center. (SECTION 59-123-60).
Components of MUSC Health:
- Nationally recognized Childrenâs Hospital
- Ashley River Tower (cardiovascular, digestive disease, and surgical oncology)
- Hollings Cancer Center (an NCI-designated cancer center)
- Level I Trauma Center
- Institute of Psychiatry
Magnet Status: The MUSC Medical Center is one of only three Magnet® designated hospitals in South Carolina. Magnet status is awarded to health care organizations that strive for quality patient outcomes, while providing safe and positive work environments for care team members across the entire institution.
Patient and Visitor Services: MUSC Health aims to exceed the expectations of patients, families, and visitors. The university provides free wireless internet access for patients and visitors at the Medical Center campus in downtown Charleston. Effective March 1, 2012, MUSC was designated a tobacco-free campus, prohibiting smoking in any areas on campus.
Other Powers and Provisions
Rights-of-Way: The board of trustees of The Medical University of South Carolina may grant rights-of-way, easements, or otherwise convey to the city council of Charleston such property as they deem necessary and required for the purpose of widening and extending streets through The Medical University land when it shall be to the advantage of The Medical University (SECTION 59-123-80).
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Eminent Domain: The board of trustees of The Medical University of South Carolina is vested with the power of eminent domain, which applies only to private lands. The lands condemned must be used by The Medical University in the performance of its functions in the acquisition, construction, and operation of facilities for the University (SECTION 59-123-90).
Borrowing for Equipment: The Board of Trustees of the University with the approval of the State Fiscal Accountability Authority of South Carolina may borrow amounts required to pay the cost of diagnostic and therapeutical equipment for use in the hospital operated by The Medical University of South Carolina. The borrowing is authorized in the form of notes of The Medical University payable solely from charges for the service or use rendered by the equipment. All moneys received from the charges are remitted to the State Treasurer and deposited in a special fund to be applied to the payment of the principal and interest on the notes (SECTION 59-123-95).
Rural Physician Program: The funds appropriated to the Medical University of South Carolina for the "Rural Physician Program" are administered by the South Carolina Area Health Education Consortium (AHEC). (SECTION 59-123-125).
Statewide Family Practice Residency System: Statewide Family Practice Residency System funds appropriated for faculty salaries, teaching services, and consultant fees may only be expended when these activities are accomplished for educational purposes in the family practice centers; however, the Medical University of South Carolina may expend these funds in hospital-based clinical settings apart from the consortium hospital, when these settings are determined by the president of the Medical University of South Carolina, with approval of the Medical University board, to provide appropriate educational experience and opportunities to the family practice residents (SECTION 59-123-115).
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