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10 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 1 DIVISION 4 GUAM HEALTH ACT Chapter 80. Guam Memorial Hospital Authority. Chapter 81. Post-Mortem Examination Act. Chapter 82. Mentally Ill Persons. Chapter 83. Guam Uniform Anatomical Gift Act. Chapter 83A. Guam Organ Donor Registry Program. Chapter 83B. Uniform Determination of Death (Cessat ion of Life). Chapter 83C. Medical Standard for Determination of Cerebral Death Chapter 84. Emergency Medical Services. Chapter 85. Guam Memorial Health Plan. Chapter 86. Guam Behavioral Health and Wellness Cen ter. Chapter 87. Occupational Safety and Health Code. Chapter 88. Child Protective Act. Omitted. Chapter 89. [Left Blank Intentionally] Chapter 90. Natasha Protection Act of 2005. Chapter 90A. Importation and Sale of Ingestible Tob acco. Chapter 91. Natural Death Act. Chapter 91A. The Partial-Birth Abortion Ban Act of 2008. Chapter 92. Maternity Stay Act. Chapter 93. Guam System of Care Council for Childre n with Serious Emotional Disturbance. Chapter 95. Coordination of Benefits. Chapter 96. The Public Access to Automated External Defibrillation Act of 2000. Chapter 97. GMHA Healthcare Trust and Development F und.

s Emotional Disturbance. Chapter 95. Coordination of Benefits. Chapter 96. The Public Access to Automated External Defibrillation Act of 2000. Chapter 97. GMHA Healthcare Trust and Development F und. CHAPTER 80 GUAM MEMORIAL HOSPITAL AUTHORITY SOURCE: Entire chapter added as Title XLVII of the Govern ment Code by P.L. 7-101:6 (Feb. 26, 1964). Entire chapter repea led and reenacted by P.L. 14- 029:1 (May 27, 1977), and P.L. 30-190:1 (Aug. 28, 2 010). § 80101. Short Title. § 80102. Establishment. § 80103. Definitions. § 80104. Prohibition Against Discrimination. § 80105. Board of Trustees. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 2 § 80105.1. Duties of the Board of Trustees. § 80105.2. Meetings. § 80105.3. Term of Office. § 80105.4. Qualifications of Members of the Board o f Trustees. § 80105.5. Trustees Nominating Council; Establishme nt. [Repealed.] § 80105.6. Tenure of Members Currently Serving as T rustees. § 80106. Board Members Not Deemed Officers or Emplo yees of the Government of Guam. § 80107. Removal from Office. [Repealed.] § 80108. Officers. § 80109. Powers. § 80110. Administrator and Chief Executive Officer. § 80111.

Not Deemed Officers or Emplo yees of the Government of Guam. § 80107. Removal from Office. [Repealed.] § 80108. Officers. § 80109. Powers. § 80110. Administrator and Chief Executive Officer. § 80111. Chief Financial Officer. § 80112. Construction With Other Laws. § 80113. Employment Practices. § 80114. Attorney. § 80115. Exemption From Taxation. § 80116. Fiscal Authority; Accounting and Expenditu res. § 80117. Irreversible Renal Failure. § 80117.1. [Vacant.] § 80118. Patients’ Records Confidential. § 80119. Mandatory Annual Budget. § 80120. Solicitation, Acceptance, Utilization and Administration of Donations, Contributions, Gifts, and Bequests for S pecific Purposes. § 80121. Receiving of Revenues from Vending Machine s. § 80122. Net Pay Not Permitted. § 80123. Urgent Healthcare Center, Established. § 80124. Cancer Data Collection. § 80125. Authorization of One or More Series of Lim ited Obligation (Section 30) Bonds. § 80101. Short Title. This Chapter may be cited as the Guam Health Act of 2010. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 00. Codified as 10 GCA § 80101. Repealed and added by P.L. 30-190:1 ( Aug. 28, 2010). § 80102. Establishment.

as the Guam Health Act of 2010. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 00. Codified as 10 GCA § 80101. Repealed and added by P.L. 30-190:1 ( Aug. 28, 2010). § 80102. Establishment. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 3 There is established within the government of Guam a public corporation and an autonomous instrumentality calle d the Guam Memorial Hospital Authority. It shall have title to all re al and personal property now or hereafter set aside for or conveyed to it. Its property shall be administered and disposed of according to law. All the rights, immunities, franchises and endowments heretofore granted thereto by Guam are h ereby perpetuated unto the said Authority. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 49 002. Codified as 10 GCA § 80103. Repealed and added as 10 GCA § 80102 by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally entitled, 'Definitions.' Repealed and added to this section P.L. 30-190:1 (Aug. 28, 2010). § 80103. Definitions. As used in this Chapter, unless otherwise indicated : (a) Board means the Board of Trustees of the Guam Memorial Hospital Authority.

this section P.L. 30-190:1 (Aug. 28, 2010). § 80103. Definitions. As used in this Chapter, unless otherwise indicated : (a) Board means the Board of Trustees of the Guam Memorial Hospital Authority. (b) Administrator means the Administrator of the G uam Memorial Hospital Authority. (c) Hospital means the Guam Memorial Hospital Auth ority. (d) Health Professionals means those persons licen sed or certified to practice the healing art within Guam. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 01. Codified as 10 GCA § 80102. Repealed and added as 10 GCA § 80103 by P.L. 30-190:1(Aug. 28, 2010). 2013 NOTE: This section was originally entitled, 'Establishment.' Repealed and added to this section by P.L. 30-190:1 (Aug. 28, 20 10). § 80104. Prohibition Against Discrimination. It shall be the policy of the Guam Memorial Hospita l Authority that discrimination against any individual or group for reasons of age, race, color, sex, national origin, religious belief, marital sta tus, physical/mental disability, political affiliation and retaliation i s specifically prohibited under any program, employment or activity for which the B oard of Trustees is responsible.

rital sta tus, physical/mental disability, political affiliation and retaliation i s specifically prohibited under any program, employment or activity for which the B oard of Trustees is responsible. SOURCE: Added by P.L. 30-0190:1 (Aug. 28, 2010). COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 4 2013 NOTE: This section was originally entitled, 'Powers.' Repealed and added as 10 GCA § 80109 by P.L. 30-190:1 (Aug. 28, 2010). § 80105. Board of Trustees. (a) The governance and control of the Guam Memorial Hospital Authority are vested in a Board of Trustees (Board) . The Board shall be composed of ten (10) members: four (4) members repr esenting the general public, who shall possess a background and experience in healthcare, management, finance or any other business-related f ield; one (1) member representing the Allied Health Professions; two (2) members representing the Guam Nursing Association; and two (2) members r epresenting the Guam Medical Community, appointed by I Maga’lahen Guåhan as provided herein, with the advice and consent of I Liheslaturan Guåhan.

the Guam Nursing Association; and two (2) members r epresenting the Guam Medical Community, appointed by I Maga’lahen Guåhan as provided herein, with the advice and consent of I Liheslaturan Guåhan. In addition, one (1) member who shall be the President, or designee, of the Guam Memorial Hospital Volunteers Association, who shall be an ex-officio member with full participatory rights and privilege s, but without the right of voting. The GMH Volunteers Association President or designee shall have been a member of the GMH Volunteers Association for a minimum of five (5) years prior to assuming a position on the Board . (b) Each Trustee shall be entitled to receive the s um of One Hundred Dollars ($100.00) for his/her attendance at any mee ting of the Board, but such compensation shall not apply to more than four (4) meetings or exceed Four Hundred Dollars ($400) in any one (1) calendar month. No Trustee shall receive any other compensation, but shall be reimbursed for actual travel, subsistence and out-of-pocket expenses incu rred in the discharge of his or her responsibilities, including authorized a ttendance at meetings held away from Guam. SOURCE: Added by P.L.

ctual travel, subsistence and out-of-pocket expenses incu rred in the discharge of his or her responsibilities, including authorized a ttendance at meetings held away from Guam. SOURCE: Added by P.L. 14-029:1(May 27, 1977) as GC § 4900 4. Subsection (a) amended by P.L. 15-041:1 (June 21, 1979). Subsecti on (b) amended by P.L. 15-055:6 (Aug. 10, 1979). Codified as 10 GCA § 80106. Subs ection (d) amended by P.L. 19- 004:16 (May 21, 1987). Subsection (f) added by P.L . 19-004:17 (May 21, 1987). Subsection (a) amended by P.L. 25-150:9 (July 7, 20 00). Subsection (b) amended by by P.L. 25-150:10 (July 7, 2000). Subsections (g) added by P.L. 25-150:11 (July 7, 2000). Subsection (h) added by P.L. 25-150:12 (Jul y 7, 2000). Subsection (i) added by P.L. 28-068:II:III:35 (Sept. 30, 2005). Repeale d and added by P.L. 30-190:1 (Aug. 28, 2010). Subsection (a) amended by P.L. 32-154:2 (May 21, 2014). 2013 NOTE: This section was originally entitled, 'Hospital Rates.' Added by P.L. 14-148:3 (Sept. 30, 1978). Repealed and added by P .L. 18-026:8 (Dec. 31, 1985) and P.L. 25-005:7 (May 10, 1999). Repealed by P.L. 30-190 (Aug. 28, 2010). COL29201710 GCA HEALTH AND SAFETY CH.

y P.L. 14-148:3 (Sept. 30, 1978). Repealed and added by P .L. 18-026:8 (Dec. 31, 1985) and P.L. 25-005:7 (May 10, 1999). Repealed by P.L. 30-190 (Aug. 28, 2010). COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 5 § 80105.1. Duties of the Board of Trustees. (a) The Board shall be liable for the negligent act of any hospital employee or officer, if the Board knew or had notic e that said employee or officer was inefficient and incompetent to perform the services for which he was hired, or said Board retained such inefficient or incompetent person after knowledge or notice of such inefficiency or i ncompetency. (b) No Trustee shall be liable for any decision mad e in the good faith, non-malicious fulfillment of his duties. (c) The Board shall be liable as fiduciaries in the execution of their duties. (d) No Trustee shall be actively engaged in the sel ling of services or goods to the Hospital without the express approval of the Board of Trustees. The form of approval shall be by the adoption of a Board Resolution confirming said approval. This restriction shall n ot apply to health care professionals who provide direct patient care servi ces to the Hospital.

oval shall be by the adoption of a Board Resolution confirming said approval. This restriction shall n ot apply to health care professionals who provide direct patient care servi ces to the Hospital. (e) No Trustee shall act when a conflict of interes t occurs. The Trustee shall disclose the nature of the conflict o f interest to the members present and abstain from any discussion or voting o n the issue until it has been disposed of by action of the remaining members present. If a Trustee knowingly fails to disclose a conflict of interest in the manner listed herein and subsequently votes on an action to be taken by the Board, then the vote of the conflicted Trustee shall not be counted for purposes of constituting official Board action. Any Trustee who knowingly d fails to disclose a conflict of interest in the manner listed herein sh all be subject to removal from the Board, pursuant to § 80107 of this Chapter . (f) [Repealed.] SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). Subsection (f) repealed by P.L. 31-014:4 (Apr. 4, 2011). 2013 NOTE: This section, originally entitled 'Fees,' was apparently added as untitled and uncodified law by P.L 19-005:55 (Aug.

ug. 28, 2010). Subsection (f) repealed by P.L. 31-014:4 (Apr. 4, 2011). 2013 NOTE: This section, originally entitled 'Fees,' was apparently added as untitled and uncodified law by P.L 19-005:55 (Aug. 21, 1987), and codified as § 80105.1 by the Compiler. Repealed and added by P.L. 23-22:2 (May 30, 1995), and repealed by P.L. 25-005:8 (May 10, 1999). The autho rity to set fees is found in § 80109 of this Chapter. § 80105.2. Meetings. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 6 Meetings of the Board shall be held at a regular ti me and place as determined by the Board. Special meetings may be c alled by the Chairman or by a majority of the members, as often as may be necessary. Meetings of the Board, regular or special, shall be subject to the Open Government Law of Guam. A majority of the members shall constitut e a quorum and an affirmative vote of five (5) members is required fo r any action to be valid. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally entitled, 'Health Care Professional Fees Schedule.' Added by P.L. 24-032:3 (May 19, 1997). Repealed by P.L. 30-190:1 (Aug. 28, 2010). § 80105.3. Term of Office.

2013 NOTE: This section was originally entitled, 'Health Care Professional Fees Schedule.' Added by P.L. 24-032:3 (May 19, 1997). Repealed by P.L. 30-190:1 (Aug. 28, 2010). § 80105.3. Term of Office. The members of the Board of Trustees shall serve st aggered terms of six (6) years. On the expiration of the term of an y member, or in the event of a vacancy on the Board due to resignation, death or any other cause, I Maga’lahi shall, in the manner provided herein and with the advice and consent of I Liheslatura , appoint another member for a full term in the fir st instance, or for the remainder of the unexpired ter m. When there is a change of administration of the government of Guam after a gubernatorial election, no courtesy resignation shall be requested by the n ew administration nor offered by any member of the Board. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). § 80105.4. Qualifications of Members of the Board of Trustees. The composition of the members of the Board shall b e broadly based in terms of its members’ personal expertise and shall strive for a balanced representation of the general population.

of Trustees. The composition of the members of the Board shall b e broadly based in terms of its members’ personal expertise and shall strive for a balanced representation of the general population. Trustees , and Trustee candidates, must be United States citizens or permanent residen t aliens domiciled in Guam for at least three (3) years prior to appointm ent to the Board. No person shall sit on the Board as a member who is an employee of the Guam Memorial Hospital Authority. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). § 80105.5. Trustees Nominating Council; Establishm ent. [Repealed.] SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). Repealed by P.L. 31 -014:2 (Apr. 4, 2011). COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 7 § 80105.6. Tenure of Members Currently Serving as Trustees. The current members of the Board shall continue to serve until the expiration of their term as set out in § 80105.3 of this Chapter and in the event of a vacancy, said vacancy shall be filled in accordance with this Chapter. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). § 80106. Board Members Not Deemed Officers or Empl oyees of the Government of Guam.

ancy, said vacancy shall be filled in accordance with this Chapter. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). § 80106. Board Members Not Deemed Officers or Empl oyees of the Government of Guam. The members of the Board shall not, by reason of su ch membership, be deemed employees of the government of Guam. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). CROSS-REFERENCE: See also 17 GCA § 16105. 2013 NOTE: This section was originally entitled, 'Board of Trustees.' Repealed and added as 10 GCA § 80105 by P.L. 30-190 (Aug. 28 , 2010). § 80107. Removal from Office. [Repealed.] SOURCE: Repealed by P.L. 31-014:3 (Apr. 4, 2011). 2013 NOTES: This section was originally entitled, 'Administrator.' Subsection (b)(9) added by P.L. 15-112:3 (Mar. 14, 1980). Cod ified as 10 GCA § 80107. Repealed and added by P.L. 25-150:8 (July 7, 2000). Subsection (b) amended by P.L. 25-183:1 (July 8, 2001). P.L. 28-068:42 (Sept. 30, 2005) transferred duties and responsibilities assigned to the Civil Service Commission to the Director of Adminis tration, effective January 1, 2006 pursuant to P.L. 28-068:47 and 48. § 80108. Officers.

5) transferred duties and responsibilities assigned to the Civil Service Commission to the Director of Adminis tration, effective January 1, 2006 pursuant to P.L. 28-068:47 and 48. § 80108. Officers. The Board shall elect a Chairman, a Vice-Chairman, a Secretary and a Treasurer from among its membership every two (2) y ears. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 06. Subsection (d) amended by P.L. 16-098:6 (July 2, 1982). Codified a s 10 GCA § 80108. Repealed and added by P.L. 30-190:1 (Aug. 28, 2010). § 80109. Powers. The Hospital shall have and exercise each and all o f the following powers: COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 8 (a) Maintain and operate a facility providing acute , chronic and all other health care services, including those ser vices specifically provided by contract for the Department of Mental H ealth and Substance Abuse, for the people of Guam. (b) (1) Establish a schedule of fees, in accordanc e 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 suc h revenue as is

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 suc h revenue as is necessary to enable the Hospital to meet its financ ial obligations, operating expenses and capital improvement needs. The Guam Public Utilities Commission shall not have any purv iew over the Authority rates. The rates established per fee sch edule may be increased by the Board of Trustees up to five perce nt (5%) per year; provided, that the total revenues from all in creases 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 s hall 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 Boar d of Trustees, public hearings must be conducted by the Authority for any new fee or rate increase of more than five percent (5%) .

an for approval. Prior to the approval and ratification by the Boar d 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 in crease to conduct a public hearing and approve the increase o r 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 ef fective. (c) The Authority may establish interim fees for ne w, untariffed services, medication and supplies, without prior le gislative approval and without compliance with the Administrative Adju dication Law; provided, that: (1) the interim fees are consistent with the Author ity’s Net Revenue Enhancement Engagement Pricing Model, as pr epared by COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 9 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 interi m fees is filed by the Authority

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 interi m fees is filed by the Authority with I Liheslaturan Guåhan within three (3) months of the Authority’s establishment of the inte rim fee. (d) Forward the billings for the cost of medical ca re and services rendered to any person under the Old Age Assistance for the Aged Program, Aid to the Blind Program, and Aid to the P ermanently and Totally Disabled Program of the Social Security Act , as well as those persons considered medically indigent as the term i s defined in Chapter 2 of this Title, of which shall be paid by the Depa rtment 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 pr operty necessary or convenient or useful for the carrying on of any of its powers pursuant to the provisions of this Article; upon written certif ication of the Administrator, that specified and specialized medic al equipment and related supplies are needed immediately for the hea lth and welfare of the patients of the Hospital in

itten certif ication of the Administrator, that specified and specialized medic al equipment and related supplies are needed immediately for the hea lth 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 rel ated supplies specified in such written certification of the Admi nistrator; provided, that the Hospital shall use its best judgment and e fforts to secure the best equipment and supplies at the lowest cost, uti lizing businesses licensed to do business on Guam whenever possible. (f) Establish its internal organization and managem ent; (g) Perform such acts as may be reasonably necessar y 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 organ izations; (k) Adopt such rules and regulations pursuant to th e Administrative Adjudication Act as may be necessary for the exercise COL29201710 GCA

anagers, specialists or as individuals or as organ izations; (k) Adopt such rules and regulations pursuant to th e Administrative Adjudication Act as may be necessary for the exercise COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 10 of the Hospital’s powers, performance of its duties and administration of its operations; (l) Adopt and maintain a uniform system of accounti ng; (m) Adopt and maintain a travel authorization polic y, notwithstanding any law to the contrary; (n) Adopt rules and regulations governing selection , compensation, promotion, performance evaluation, di sciplinary action and other terms and conditions of employment affect ing personnel, subject to the provisions of the Administrative Adj udication 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 establishm ent 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.

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 c ertificated therapists of any sort, laboratory technicians, personnel cert ificated 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 Revie w proceeding shall be conducted in strict compliance with the Health Care Quality Improvement Act, as amended (HCQIA), o f Title IV of Public Law 99-660 (42 U.S.C. 11101 et seq.) auth orizing the Secretary of the U.S. Department of Healt h and Hum an Services to establish a National Practitioner Data Bank (NPD B) to collect and release certain information relating to the pro fessional competence and conduct of physicians, dentists and other health care practitioners; and §1921 of the Social Securi ty Act (42 U.S.C.

lect and release certain information relating to the pro fessional competence and conduct of physicians, dentists and other health care practitioners; and §1921 of the Social Securi ty Act (42 U.S.C. 1396r-2) (§1921) requiring each state to ado pt a system of reporting to the Secretary of adverse licensure act ions 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 COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 11 physician who is the subject of a peer review asser ts 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 Practitione r Data Bank, as provided pursuant to Title 45 – Publi c Welfare, Part 60, Code of Federal Regulations, and as the regulat ions and authorizing statutes may be revised; (3) No 'Void' or Reversal of Professional Peer Revi ew Action by Board Without Successful Appeal; Mandator y. No GMHA medical peer review action that adversely affe cts the clinical privileges of physicians, dentists and oth er health

sional Peer Revi ew Action by Board Without Successful Appeal; Mandator y. No GMHA medical peer review action that adversely affe cts the clinical privileges of physicians, dentists and oth er health care practitioners shall be reversed by the Board, nor s hall a 'void' be sought with the National Practitioners Data Bank: (A) without the appellant having successfully appea led the initial action before a subsequent GMHA peer re view 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 Me dical Examiners, wherein the appellant successfully appea led the GMHA medical peer review action; or (C) without the appellant having successfully appea led the GMHA medical peer review action before the Judi ciary of Guam; any one of which may be deemed satisfactory to reve rse the initial GMHA medical peer review action and seek a 'void' w ith 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 feder al law, rules and

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 feder al law, rules and regulations. (4) Personal Liability - No Waiver of Immunity. The members of the Board of Trustees, and the GMHA Lega l Counsel, shall not be personally immune from legal and civil liabilit y for a knowing violation of Items (1), (2) and (3) of this Subsection (n). COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 12 (o) Do any and all other things necessary to the fu ll 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 authori zed by § 80108 of this Chapter, if the Board so chooses; (q) Acquire in accordance with the Procurement Law (5 GCA Chapter 5) and hold and use any personal property o r construct any projects necessary or convenient or useful for carr ying 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 (Secret ary of Defense,

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 (Secret ary of Defense, officials of Tripler Army Hospital, etc.) for the i mplementation 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 intere sts 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 Twe nty-five Million Dollars ($25,000,000), with banks or other lending institutions licensed to do business on Guam. All terms of the line of cr edit, a revolving loan fund, and/or a direct loan agreement shall be negot iated 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 follow ing: (1) the line of credit, a revolving loan fund, and/ or a

t 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 follow ing: (1) the line of credit, a revolving loan fund, and/ or a direct loan shall be used by the Authority when a cash sho rtage threatens the operation of the Hospital, and provided that th e loan shall not be used for the hiring of non-health care professio nals not involved with providing direct patient care or pati ent care support; (2) no charge shall be levied by a lender for makin g the loan; (3) the interest rate shall be subjected to negotia tion between the Authority or designee as authorized by the Board of COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 13 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 f rom taxation by the government of Guam. (5) I Maga’lahen Guåhan is authorized to pledge funds which Guam shall receive from the State Attorneys G eneral Tobacco Litigation, as provided by Public Law 24-17 4, or the General Fund, or both funds

I Maga’lahen Guåhan is authorized to pledge funds which Guam shall receive from the State Attorneys G eneral Tobacco Litigation, as provided by Public Law 24-17 4, 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 meth odology 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 de termined by the negotiated agreement. (8) Any money borrowed shall be repaid in accordanc e with the terms established in the negotiated agreement, but not to exceed an amortization period of more

de termined by the negotiated agreement. (8) Any money borrowed shall be repaid in accordanc e with the terms established in the negotiated agreement, but not to exceed an amortization period of more than twenty-f ive (25) years. In no case shall any amount borrowed be refinanced permitting repayment more than twenty-five (25) years after th e 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 official s and employees of the government Guam. For the purposes of this pr ovision 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 COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 14 the lender to enforce any right or obligation incur red under the loan authorized hereby or in connection with the en forcement of any agreement, note or pledge that arises directly from the indebtedness authorized hereby.

ny right or obligation incur red under the loan authorized hereby or in connection with the en forcement 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 th e government of Guam. The Guarantor consents to any and all extensi on of time and waiver or modification of obligations guarantee d 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 Mi llion Dollar line of credit, revolving loan fund, and/or a direc t loan authorized in this Act to be used for the reduction of the Gua m Memorial Hospital Authority's vendor payables. (t) Notwithstanding any other provision of law, ma ke, negotiate and enter into a commercial lease, or issue a permi t or license for the use of its real property and other related faciliti es for a term not to exceed five (5) years.

ision of law, ma ke, negotiate and enter into a commercial lease, or issue a permi t or license for the use of its real property and other related faciliti es for a term not to exceed five (5) years. (u) Retain or contract, in accordance with applica ble procurement law, services relative to the providing of cafeteri a andor other food vendor services, in whole or in part as determined to be necessary and appropriate. This shall include, but not be limite d 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 servi ces may include, to the extent deemed practicable, appropri ate 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 r eplacing, supplanting andor eliminating GMHA's in-house Diete tic Services

etain and contract services relative to the providing of cafeteria andor other food services shall not apply or pertain to r eplacing, supplanting andor eliminating GMHA's in-house Diete tic Services COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 15 department currently providing nutritional food ser vices for inpatients. (v) Notwithstanding Subsection (s) of this Section, to arrange a line of credit, a revolving loan fund, and/or a dir ect loan, the amount not to exceed Nine Million Two Hundred Thousand Dol lars ($9,200,000), to finance the Guam Memorial Hospital Authority Labor and Delivery Ward renovation Phases One through Fou r, and to include the 'Arts In Public Buildings and Facilities' fee a s required by § 852 of Article 2 of Chapter 8, Title 1, Guam Code Annotate d, 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 Developmen t Authority and I Maga’låhen Guåhan (the Governor) in the best interests of the people of Guam.

revolving loan fund, and/or a direct loan agreement shall be negotiated by the Guam Economic Developmen t 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 revolvi ng 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 Wa rd (GMHA Maternal and Child Healthcare (MCH) Renovatio n Project); (B) such line of credit shall not be authorized, no r shall any borrowing be initiated that incurs interest exp enses until the architectural and engineering specifications ar e 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 comme nce renovation is pending funding; (2) no charge shall be levied by a lender for makin g the loan; (3) the interest rate shall be subject to negotiati on 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

te shall be subject to negotiati on 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 f rom taxation by the government of Guam. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 16 (5) The line of credit, a revolving loan fund, muni cipal 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 Privil ege Tax Law' (namely, 11 GCA Chapter 25, excluding the alcoholic beverage taxes, liquid fuel taxes, automotive surcharges, to bacco taxes and real property taxes). The Business Privilege Tax pl edged or reserved may only be pledged or reserved on a basis that is subordinate to the pledge of revenues from the Busi ness Privilege Tax that secure the Government’s Business Privilege Tax Bonds (currently, the Business Privilege Tax Bonds, Serie s 2011A, 2012B-1, 2012B-2, 2013C and 2015D, as well as any f uture bonds (collectively, the 'Business

the Government’s Business Privilege Tax Bonds (currently, the Business Privilege Tax Bonds, Serie s 2011A, 2012B-1, 2012B-2, 2013C and 2015D, as well as any f uture bonds (collectively, the 'Business Privilege Tax Bo nds')) issued under the indenture relating to the Business Privil ege Tax Bonds (the 'Indenture'), as well as any parity obligation s permitted to be issued under such Indenture, on a basis that is in accordance with and complies with such Indenture. The sum of Six H undred Thousand Dollars ($600,000) will be continuously ap propriated annually to pay for the principal, interest, and de bt reserve for the line of credit, a revolving loan fund, and/or a dir ect 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 accordanc e with the terms established in the negotiated agreement, but not to exceed an amortization period of more than twenty-f ive (25) years. (7) Notwithstanding the provisions of Chapter 6 of Title 5 of the Guam Code Annotated, the government of Guam hereby

nt, but not to exceed an amortization period of more than twenty-f ive (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 official s and employees of the government of Guam. For the purpose of this provision only, immunity is also waived as to the award of at torney fees and related costs in connection with any suit brought t o enforce any right or obligation incurred under the loan authori zed hereby or in connection with the enforcement of any agreement, n ote or pledge that arises directly from the indebtedness authoriz ed hereby. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 17 (8) This Guarantee is a general obligation of the g overnment of Guam, subject to the full faith and credit of th e government of Guam. The Guarantor consents to any and all extensi on of time and waiver or modification of obligations guarantee d hereunder. (9) Alternative Financing.

full faith and credit of th e government of Guam. The Guarantor consents to any and all extensi on of time and waiver or modification of obligations guarantee d 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 St ates 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 Developmen t Authority, is authorized to enter into a municipal lease financing as defined under Title 5, Guam Code Annot ated, 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 al ready identified and earmarked for the Guam Memorial Hosp ital Authority, limited to the amounts in this Act, and utilize such source for the purposes of renovating the labor, de livery, recovery, postpartum ward where our babies are born .

am Memorial Hosp ital Authority, limited to the amounts in this Act, and utilize such source for the purposes of renovating the labor, de livery, 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 provisio n no later than ten (10) working days after identification of funds. (10) The GMHA Board of Trustees shall cause an upda te of its facilities master plan that will guide the capi tal improvement of the Guam Memorial Hospital. The Trustees shall allo cate sufficient funds from the amount obtained from the line of credit, revolving fund, and/or direct loan authorized by th is 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 sh all be completed within one hundred eighty (180) days from the date of enactment of this statute. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 18 (11) That, if the labor and delivery ward operation s or facilities are privatized, to include any public-pr ivate partnership, then, as a condition

SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 18 (11) That, if the labor and delivery ward operation s or facilities are privatized, to include any public-pr ivate partnership, then, as a condition of such privatization agreemen t, 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 Authorit y for any incurred expenses that were financed under this Sub section. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 03. Subsection (b) amended by P.L. 14-091:2 (Dec. 27, 1977). Subsecti on (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). Subse ction (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). Subs ection (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, 1 983). Subsection (b) amended by P.L. 17-083:1 (Dec. 21, 1984).

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, 1 983). Subsection (b) amended by P.L. 17-083:1 (Dec. 21, 1984). Codified as 10 G CA § 80104. Subsection (b) repealed and reenacted by P.L. 18-026:7 (Dec. 31, 1 985). Subsections (o) (1, 5 & 6) amended by P.L. 18-026:10 (Dec. 31, 1985). Subsect ion (q) added by P.L. 18-026:13 (Dec. 31, 1985). Subsection (c) amended by, P.L. 2 0-228:1 (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)(1 0) 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 § 4900 7, entitled 'Employment Practices.' Repealed and added as 10 GCA § 80113 by P.L. 30-1 90:1 (Aug. 28, 2010).

P.L. 33-151:1 (May 13, 2016). 2013 NOTE: This section was originally codified as GC § 4900 7, entitled 'Employment Practices.' Repealed and added as 10 GCA § 80113 by P.L. 30-1 90:1 (Aug. 28, 2010). Numbers and/or letters were added or altered to adh ere to the Compiler’s alpha- numeric scheme in accordance to 1 GCA § 1606. NOTE: P.L. 20-228:1 (Jan. 30, 1991) amended 10 GCA § 80 103(c). This appeared to be a manifest error. The correct section is § 80 104(e). NOTE: The authority to establish fees was also found in § 80105.1 of this Chapter, which was apparently added as untitled and uncodifi ed 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). § 80110. Administrator and Chief Executive Officer. (a) The Board shall hire or contract an Administrat or, who shall be its Chief Executive Officer. The Administrator’s dutie s and compensation, salary and endowments, shall be determined by the B oard. The Administrator shall meet the following minimum qual ifications: COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 19 (1) shall have graduated from a recognized college or

The Administrator shall meet the following minimum qual ifications: COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 19 (1) shall have graduated from a recognized college or university with a Master’s Degree in hospital administration, health services management or a related field, plus six (6) years o f experience in hospital administration or healthcare services mana gement, of which three (3) years must have been experience as an adm inistrator in a hospital setting; or (2) shall have graduated from a recognized college or university with a Bachelor’s Degree in hospital administration , health services management, or a related field, plus eight (8) year s of experience in hospital administration or healthcare services mana gement, of which five (5) years must have been experience as an admi nistrator in a hospital setting; (3) shall have experience in negotiating and direct ing activities related to obtaining reimbursement from government programs, such as Medicare, Medicaid or the Medically Indigent Progra m of the government of Guam; and (4) shall have experience in negotiating contracts with external parties, including third party payers, vendors,

s Medicare, Medicaid or the Medically Indigent Progra m of the government of Guam; and (4) shall have experience in negotiating contracts with external parties, including third party payers, vendors, ins urance carriers and other contracting parties. (b) The Board shall set the tenure of office for th e Administrator of the Guam Memorial Hospital Authority. The Board may hi re the Hospital Administrator by direct employment as an unclassifi ed employee of the government of Guam, or by personal services contrac t, as the Board deems necessary to attract and retain a qualified Adminis trator. However, the term of employment for the position of Administrator sha ll not end six (6) months prior to nor six (6) months after an election for S enators, and Governor and Lt. Governor. The Board by an affirmative vote of at least five (5) members may renew the contract of the Administrator. Simil arly, the affirmative vote of at least five (5) members may terminate the serv ices of the Administrator for cause in the same manner and procedure as a Tru stee may be removed pursuant to § 80107 of this Chapter.

rmative vote of at least five (5) members may terminate the serv ices of the Administrator for cause in the same manner and procedure as a Tru stee may be removed pursuant to § 80107 of this Chapter. Upon a change of administration of the government of Guam after a gubernatorial election, no courtesy resignation shall be requested by the new administration nor of fered by the Administrator of the Hospital. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 20 (c) The Administrator shall have full charge and co ntrol of the operations and maintenance of the Hospital. The po wers of the Administrator shall include: (1) to recommend rules and regulations for adoption by the Board of Trustees, and to see that all rules and re gulations of the Hospital are enforced; (2) to ensure compliance with all federal and local regulations; (3) to act as liaison to the governing body for the medical, nursing, and other professional staff and all facil ity departments; (4) to attend, unless excused by the Board, all mee tings of the Board and to submit written reports on the affairs of the Hospital each month; (5) to keep the Board advised on the needs of the H ospital and

ttend, unless excused by the Board, all mee tings of the Board and to submit written reports on the affairs of the Hospital each month; (5) to keep the Board advised on the needs of the H ospital and approve demands for payment of obligations within t he purposes and amounts authorized by the Board; (6) to prepare and cause to be prepared all plans a nd specifications for purchased services and the const ruction and repair of equipment and facilities operated by the Hospital a nd serve as the Hospital’s Chief Procurement Officer; (7) to devote that person’s time to the business of the Hospital, to select and appoint the employees of the Hospital, e xcept as otherwise provided in this Chapter, and to plan, organize, co ordinate and control the services of such employees in the exercise of t he powers of the Hospital under the general direction of the Board; (8) to prepare, within one hundred twenty (120) day s from the end of each fiscal year, an annual report of the re sults of the operations for the preceding fiscal year and the financial sta tus of the Hospital on the last day thereof; (9) to perform and issue such other additional duti es as the Board may require; and (10) to

perations for the preceding fiscal year and the financial sta tus of the Hospital on the last day thereof; (9) to perform and issue such other additional duti es as the Board may require; and (10) to arrange for the burial of any fetus not cla imed by its mother or father within thirty (30) days. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 05. Subsection (b)(9) added by P.L. 15-112:3 (Mar. 14, 1980). Cod ified as 10 GCA § 80107. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 21 Repealed and added by P.L. 25-150:8 (July 7, 2000). Repealed and added by P.L. 30- 190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally codified as GC § 4900 8, entitled, 'Exemption from Taxation.' Codified as 10 GCA § 80110. Repealed and reenact ed as 10 GCA § 80115 by P.L. 30-190 (Aug. 28, 2010). § 80111. Chief Financial Officer. (a) The position of Chief Financial Officer is esta blished within the Guam Memorial Hospital Authority. The Chief Financ ial Officer shall meet the following minimum qualifications: (1) possession of a Certified Public Accountant (CP A) certificate in the United States and a Bachelor’s Degree in Hea lth Services Management (HSM)

r shall meet the following minimum qualifications: (1) possession of a Certified Public Accountant (CP A) certificate in the United States and a Bachelor’s Degree in Hea lth Services Management (HSM) or health related work experience, plus one (1) year supervisory experience; or (2) graduation from a recognized college or univers ity with a Master’s Degree in accounting, finance, economics, business administration or a related field, plus four (4) ye ars experience as an administrator for general accounting and fiscal ser vices of which one (1) year must be management-level fiscal experience in a hospital or health care facility; or (3) graduation from a recognized college or univers ity with a Bachelor’s Degree in accounting finance, economics, business administration or a related field, plus five (5) ye ars as an administrator responsible for general accounting and fiscal servi ces of which two (2) years must be management-level fiscal experience in a hospital or health care facility; and (4) shall have experience in negotiating contracts with external parties, including third party payers, vendors, ins urance carriers and other contracting parties.

spital or health care facility; and (4) shall have experience in negotiating contracts with external parties, including third party payers, vendors, ins urance carriers and other contracting parties. (b) The Chief Financial Officer shall report direct ly to the Hospital Administrator. The Hospital Administrator shall hi re the Chief Financial Officer by direct employment as an unclassified emp loyee of the government of Guam, or by personal services contract, as is de emed necessary by the Hospital Administrator to attract and retain a qual ified Chief Financial Officer. The Chief Financial Officer’s duties and compensation shall be determined by the Hospital Administrator, in consul tation with the Board of Trustees. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 22 SOURCE: Added as uncodified law by P.L. 25-150:13 (July 7 , 2000). Codified by Compiler as 10 GCA § 80107.1. Amended by 29-014:3 (Sept. 7, 2007). Repealed and added by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally codified from GC § 490 09, entitled, 'Contracts and Purchases.' Subsection (d) amended by P.L. 16-098:7 (July 2, 1982). Codified as 10 GCA § 80111.

. 28, 2010). 2013 NOTE: This section was originally codified from GC § 490 09, entitled, 'Contracts and Purchases.' Subsection (d) amended by P.L. 16-098:7 (July 2, 1982). Codified as 10 GCA § 80111. Repealed by P. L. 16-124:23 (Dec. 29, 1982). NOTE: P.L. 28-068:42 (Sept. 30, 2005) transferred duties and responsibilities assigned to the Civil Service Commission to the Dir ector of Administration, effective January 1, 2006 pursuant to P.L. 28-068:47 and 48. § 80112. Construction With Other Laws. Insofar as the provisions of this Chapter are incon sistent with the provisions of any other law, the provisions of this Chapter shall be controlling; and in particular but not by way of li mitation, except as may be provided in this Chapter, no provision of any law w ith respect to employment of personnel, shall be applicable to the Guam Memorial Hospital Authority unless I Liheslatura shall specifically so state; provided, however, that the Guam Memorial Hospital Authority may utilize in its operations the procedures and facilities provided b y any such law or by the executive agencies of the government of Guam. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010).

Authority may utilize in its operations the procedures and facilities provided b y any such law or by the executive agencies of the government of Guam. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally codified from GC § 49 010, entitled, 'Fiscal Authority; Accounting and Expenditures.' Codified as 10 GCA § 80112. Repealed and added as 10 GCA § 80115 by P.L. 30-190 (Aug. 28 , 2010). § 80113. Employment Practices. (a) The Board shall establish and administer rules and regulations governing the compensation and classification of he alth professionals of the hospital. (b) All employees of the hospital, except physicians and healthcare administrators, the Hospital Administrator, Associa te Administrators for Clinical, Operations and Medical Services, and the Chief Financial Officer, shall be members of the classified service of the govern ment of Guam. (1) This Subsection shall include Allied Health providers, as defined pursuant to Chapter 12, Part 1 and Part 2, of Title 10, Guam Code Annotated, practicing in their specialty and e mployed as Health Care Administrators (HCA) for their department who shall be members of the classified service of the

nd Part 2, of Title 10, Guam Code Annotated, practicing in their specialty and e mployed as Health Care Administrators (HCA) for their department who shall be members of the classified service of the government of Guam . These positions COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 23 are herein referenced, but not limited to, as follo ws: Chief Respiratory Therapist (HCA), Chief Hospital Radiology Technolog ist (HCA), Chief Hospital Pharmacist (HCA), Administrator of Laborat ory Services (HCA), Chief of Rehabilitative Services (HCA), and Administrator of Hospital Food Services (HCA) . (c) Each hospital employee shall be eligible to con tinue to be or to become a member of the government of Guam Retiremen t Fund pursuant to Chapter 8 of Title 4 of the Guam Code Annotated. T he hospital shall pay for the employer’s contribution to the Retirement F und that is assessed by the Fund’s Board of Trustees for the benefit of hos pital employees who are members of the Fund. (d) Each hospital employee shall be eligible to par ticipate in any government of Guam health and life insurance plan o r prepaid health plan. SOURCE: Added by P.L.

oyees who are members of the Fund. (d) Each hospital employee shall be eligible to par ticipate in any government of Guam health and life insurance plan o r prepaid health plan. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 07. Subsection (b) amended by P.L. 16-023:13 (Aug. 11, 1981), and P.L. 16-041:5 (Sept. 28, 1981) (amending P.L.16-023:13). Codified as 10 GCA § 801 09. Repealed and added by by P.L. 30-190:1 (Aug. 28, 2010). Subsection (b) amen ded by P.L. 33-023:1 (May 7, 2015). Subsection (b)(1) added by P.L. 33-023:1 (M ay 7, 2015). 2015 NOTE: Pursuant to P.L. 33-023:2: Section 2. Classification Without Loss or Reductio n in Salary, Status or Benefits. As provided pursuant to Section 1 of thi s Act, and notwithstanding any provision of law, rule, or regu lation, the personnel in the positions identified in Item (1) of § 80113(b) of Chapter 80 of Division 4, Title 10, Guam Code Annotated, shall have their admission as members in the classified service of the government of Guam occur without a disruption in service, or loss or reducti on in salary, status or benefits. 2013 NOTE: This section was originally codified from GC § 49 010, entitled, 'Fiscal Authority;

ment of Guam occur without a disruption in service, or loss or reducti on in salary, status or benefits. 2013 NOTE: This section was originally codified from GC § 49 010, entitled, 'Fiscal Authority; Accounting and Expenditures.' Codified as 10 GCA § 80112. Repealed and added as 10 GCA § 80116 by P.L. 30-190:1 (Aug. 28, 2010). § 80114. Attorney. (a) The Guam Memorial Hospital Authority may employ an attorney to assist and represent the Hospital and to advise the Board in all civil matters in which the Hospital is a party or in which the Ho spital is legally interested; provided that the Attorney General shall represent the Hospital in litigation concerning the affairs of the Authority, unless he or she delegates this duty to the Attorney of the Hospital, with respect to an y such litigation. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 24 (b) The Guam Memorial Hospital Authority may set th e terms and conditions of employment for the attorney, his or h er compensation, and whether he or she will be appointed as a full-time employee, or an independent consultant. In the alternative, the Ho spital may utilize the services of a law firm.

ney, his or h er compensation, and whether he or she will be appointed as a full-time employee, or an independent consultant. In the alternative, the Ho spital may utilize the services of a law firm. (c) The Attorney so employed or engaged shall be ad mitted to practice before the courts of Guam under the same conditions as are attorneys employed by the government pursuant to 7 GCA Sectio n 9A114 and 9A114A. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally codified from GC § 49 011, entitled, 'Patients’ Records.' Codified as 10 GCA § 80114, entitled, 'Patients’ Records Confidential . Repealed and added as 10 GCA § 80118 by P.L. 30 -190:1 (Aug. 28, 2010). § 80115. Exemption From Taxation. As an instrumentality of the government of Guam, th e Hospital and all property acquired by or for the Hospital, and all r evenues and income there- from are exempt from taxation by the government of Guam, or by any political subdivision or public corporation thereof , and from all taxes of Guam imposed under the authority of I Liheslatura , or with respect to which I Liheslatura is authorized to grant exemption. SOURCE: Added by P.L.

r public corporation thereof , and from all taxes of Guam imposed under the authority of I Liheslatura , or with respect to which I Liheslatura is authorized to grant exemption. SOURCE: Added by P.L. 14-029:1 (May 27, 1977) as GC § 490 08. Codified as 10 GCA § 80110. Repealed and added to this section b y P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally entitled 'Mandatory Annual Budget.' Repealed and reenacted as 10 GCA § 80119 by P.L. 30 -190:1 (Aug. 28, 2010). § 80116. Fiscal Authority; Accounting and Expenditu res. (a) There is hereby established a fund to be known as the 'Hospital Operations Fund' (Fund), which shall be maintained separate and apart from other funds of the government of Guam and independe nt records and accounts shall be maintained in connection therewit h; (b) All moneys received by the Hospital from whatev er source derived shall be deposited in said Fund and eligible banks as defined in Title 5 GCA § 21112. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 25 (c) All appropriations, if any, by I Liheslaturan Guåhan from the General Fund to the Hospital shall be transferred t o the Fund on a quarterly basis upon

Y CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 25 (c) All appropriations, if any, by I Liheslaturan Guåhan from the General Fund to the Hospital shall be transferred t o the Fund on a quarterly basis upon certification by the Hospital of the nee d therefore; (d) All expenditures, including payments into sinki ng or other special accounts and debts, liabilities, obligations and op erational expenses of the Hospital shall be paid from the Fund; (e) The Hospital shall report to I Maga’lahi and I Liheslatura concerning administration of the affairs of the Hos pital. The annual report shall be presented within one hundred twenty (120) days after the end of each fiscal year and special reports, if any, shall be presented within thirty (30) days after the end of each intervening quarter . The financial information presented in the reports shall be in ac cordance with the uniform system of accounting adopted by the Hospital. (f) Bi-weekly Receivables Updates. The Hospital shall post on its official website, and shall update such postings on a bi-weekly basis, a complete listing of each of its accounts receivable , aged according to established accounting practices, and further defin ed as

icial website, and shall update such postings on a bi-weekly basis, a complete listing of each of its accounts receivable , aged according to established accounting practices, and further defin ed as follows: (1) Government receivables, billings and payments, which include amounts due and paid from the U.S. Governme nt (Medicare), from the Government of Guam (Medicaid, Medically In digent Program, Worker’s Compensation), and from other governments, including the various Freely Associated States. Receivables from each entity shall be individually labeled and entered. (2) Health insurance receivables, billings and paym ents, which include all amounts due and paid from individual pr ivate sector health insurance providers. Receivables from each entity s hall be individually labeled and entered when the total amount due from each entity amounts to Ten Thousand Dollars ($10,000) or more. Receivables from entities in this category amounting to less th an Ten Thousand Dollars ($10,000) shall be entered as a lump sum. (3) Self-payer receivables, billings and payments, which include amounts due and paid from entities, including indiv iduals, corporations, organizations, or other business

l be entered as a lump sum. (3) Self-payer receivables, billings and payments, which include amounts due and paid from entities, including indiv iduals, corporations, organizations, or other business entities without a ny reference to specific names of such entities. Receivables from entities in this category shall be labeled as 'Self-payer Receivable s', 'Self-payer COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 26 Billings', and 'Self-payer Payments', each of which shall be entered as a lump sum. (4) All discounts granted to all payers in the repo rts under this Subsection (f) shall be made a part of the report. (5) Nothing in this reporting mandate shall authori ze the Hospital to violate the federal Health Insurance Portability and Accountability Act (HIPAA) Law. SOURCE: Added by 14-029:1 (May 27, 1977) as GC § 49010, e ntitled, 'Fiscal Authority; Accounting and Expenditures.' Codified as 10 GCA § 80112. Subsection (f) added by P.L. 31-036:2 (Apr. 18, 2011). Repeal ed and added as 10 GCA § 80116 by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally entitled 'Insurance Coverage.' Added by P.L. 20-017:8 (June 9, 1989).

2 (Apr. 18, 2011). Repeal ed and added as 10 GCA § 80116 by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally entitled 'Insurance Coverage.' Added by P.L. 20-017:8 (June 9, 1989). Repealed by P.L. 24- 011:2 (Mar. 21, 1997). § 80117. Irreversible Renal Failure. Citizens of Guam afflicted with irreversible renal failure who are medically indigent, as determined by the Department of Public Health and Social Services by regulations, shall receive hospi talization, medical treatment and drugs for the treatment of irreversib le renal failure, and any conditions directly or indirectly caused thereby, w ithout charge, provided, however, that this Section shall not apply to those persons whose treatments are chargeable to health and medical insurance prog rams or medical assistance programs. Nothing in this Section shall be construed or used as a basis for the exclusion or limitation of any privat e or government third party health or medical insurance coverage, or benefits f or hospitalization, medical treatment and drugs for the treatment of irreversib le renal failure and any condition directly or indirectly caused thereby. SOURCE: Added by P.L. 30-190:1 (Aug.

nefits f or hospitalization, medical treatment and drugs for the treatment of irreversib le renal failure and any condition directly or indirectly caused thereby. SOURCE: Added by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: Added by P.L. 24-176:4 (April 17, 1998), entitled, 'Solicitation, Acceptance, Utilization and Administration of Donat ions, Contributions, Gifts, and Bequests for Specific Purposes.' Repealed and added as 10 GCA § 80120 by P.L. 30- 190:1 (Aug. 28, 2010). This section was originally entitled, 'Insurance Payments. Agreements. Deposits. Patient Treatment Costs.' Added by P.L. 23-128:27 (Dec. 12, 1996). Repeale d by P.L. 24-011:2 (Mar. 21, 1997). § 80117.1. [Vacant.] COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 27 2013 NOTE: Formerly entitled 'Cancer Data Collection,' this section was codfied to § 80124 by the Compiler pursuant to the authority granted by 1 GCA § 1606. § 80118. Patients’ Records Confidential. Patients’ medical records are confidential, and cop ies thereof may be released only upon the written consent of the patie nt involved or by written order of the Superior Court of Guam; provided, howe ver, that any information, data

fidential, and cop ies thereof may be released only upon the written consent of the patie nt involved or by written order of the Superior Court of Guam; provided, howe ver, that any information, data or reports with respect to cases of malignant diseases may be furnished to, or procured by, the Guam Tumor Reg istry-Tumor Clinic, Guam Memorial Hospital for statistical, scientific and medical research, and no physician, surgeon, dentist, institution or hosp ital, furnishing such information, data or reports to the Guam Tumor Regi stry-Tumor Clinic, Guam Memorial Hospital, shall by reason of such fur nishing be deemed to have violated the provisions of this Section, or ha ve violated any confidential relationship or be held liable therefore. SOURCE: Added by 14-029:1 (May 27, 1977) as GC § 49011, e ntitled, 'Patient Records Confidential.' Codified as 10 GCA § 80114. Repealed and added a s 10 GCA § 80118 by P.L. 30-190:1 (Aug. 28, 2010). 2013 NOTE: This section was originally entitled, 'Receiving of Revenues from Vending Machines.' Added by P.L. 24-0176:5 (April 17, 1998). Repeal ed and added as 10 GCA § 80121 by P.L. 30-190:1 (Aug. 28, 2010). § 80119. Mandatory Annual Budget.

led, 'Receiving of Revenues from Vending Machines.' Added by P.L. 24-0176:5 (April 17, 1998). Repeal ed and added as 10 GCA § 80121 by P.L. 30-190:1 (Aug. 28, 2010). § 80119. Mandatory Annual Budget. On March 30, 2010 for Fiscal Year 2011, and March 3 0 for the succeeding fiscal years, the Board shall submit a c omprehensive program and financial plan to I Liheslaturan Guåhan in a budget format utilized by the Bureau of Budget and Management Research for th e Executive Branch. If I Liheslaturan Guåhan does not reject the comprehensive program and financial plan by September 30, the program and pla n is deemed approved. SOURCE: Added by P.L. 19-005-54 (Aug. 21, 1987) as 10 GCA § 80115. Amended by P.L. 19-010:XI:35 (Nov. 17, 1987). Amended by P .L. 28-068:27 (Sept. 30, 2005). Repealed and reenacted to this section by P.L. 30-190:1 (Aug. 28, 2010). § 80120. Solicitation, Acceptance, Utilization and Administration of Donations, Contributions, Gifts, and Bequests for S pecific Purposes. (a) The Administrator of the Guam Memorial Hospital Authority (GMHA), with the concurrence of the GMHA Board of T rustees, shall be authorized to solicit, accept, utilize and administ er on behalf of

(a) The Administrator of the Guam Memorial Hospital Authority (GMHA), with the concurrence of the GMHA Board of T rustees, shall be authorized to solicit, accept, utilize and administ er on behalf of GHMA, donations, contributions, gifts and bequests for an y specific purpose relative COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 28 to medical care, and may expend any sums so receive d for the purposes intended by the giver, or donor, in addition to the regular appropriations made for such purposes. Such donations, contributi ons, gifts and bequests received, or income accrued on a continuing basis, shall, as a matter of policy, be reflected in the annual budget of the re ceiving agency as credit to offset the expense budget request for that agency f or the fiscal year under consideration. (b) GMHA shall promulgate rules and regulations to reflect the purpose of this Act, and shall biannually report co ntributions, donations, gifts and bequests actually received to I Maga’lahi and the Speaker of I Liheslaturan Guåhan for proper acknowledgment purposes. SOURCE: Added by P.L. 24-176:4 (April 17, 1998) as 10 GCA § 80117.

ns, gifts and bequests actually received to I Maga’lahi and the Speaker of I Liheslaturan Guåhan for proper acknowledgment purposes. SOURCE: Added by P.L. 24-176:4 (April 17, 1998) as 10 GCA § 80117. Repealed and added as 10 GCA § 80120 by P.L. 30-190:1 (Aug. 28, 2010). § 80121. Receiving of Revenues from Vending Machine s. GMHA is hereby authorized to install vending machin es or similar machines, which can be contractual, for the purpose of serving the Hospital and its employees, and shall be entitled to all rev enues from such activities. The Hospital Administrator shall use such revenues for the Hospital employees’ health or other services for the benefit of its employees. SOURCE: Added as 10 GCA § 80118 by P.L. 24-176:5 (April 1 7, 1998). Repealed and added as 10 GCA § 80121 by P.L. 30-190:1 (Aug. 28, 2010). § 80122. Net Pay Not Permitted. Notwithstanding any other provisions of law, rule, or regulation, no certifying officer, administrator, or employee of t he Guam Memorial Hospital Authority shall authorize the issuance of net pay at the authority. For the purpose of this Section, 'net pay' shall me an the remaining amount after deductions from the gross salary, where net m

tal Authority shall authorize the issuance of net pay at the authority. For the purpose of this Section, 'net pay' shall me an the remaining amount after deductions from the gross salary, where net m eans ultimate and an amount is issued to an employee without the full pa yment of all payroll deductions due to each employee at the Authority. T he issuance of net pay by any certifying officer, administrator, or employ ee of the Guam Memorial Hospital Authority shall be grounds for termination . SOURCE: Added as uncodified law by P.L. 32-043:3 (July 1, 2013). Codified to this section by the Compiler pursuant to the authority g ranted by 1 GCA § 1606. § 80123. Urgent Healthcare Center, Established. COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 29 (a) The Guam Memorial Hospital Authority shall est ablish, within the premises of the hospital facility, an urgent health care medical services center for non-emergency outpatient medical services. The urgent care center shall serve as a center to treat patients who have an inj ury or illness that requires immediate care, but are not apparently serious enou gh to require emergency room attention.

e urgent care center shall serve as a center to treat patients who have an inj ury or illness that requires immediate care, but are not apparently serious enou gh to require emergency room attention. (b) Criteria for Urgent Healthcare Center. The Urg ent Healthcare Center shall seek to develop and maintain a standar d of medical care that meets the minimum criteria and requirements for pri mary care or urgent care services, as set forth by the Joint Commission and the CMS. (c) The Guam Memorial Hospital Authority (GMHA) sh all within thirty (30) days of enactment of this Act: establis h a working group comprised of the necessary expertise, including the Chairperson of the GMHA Emergency Medicine Department or his designee to develop: (1) Urgent Healthcare Center operational criteria; (2) identify adequate, available space for the esta blishment of the Urgent Healthcare Center; and, (3) a plan of action, inclusive of the financial re quirements to commence the requisite processes necessary for GMHA to establish an Urgent Healthcare Center. (d) Within ninety days of the establishment of the working group, the Administrator shall present a report addressing ite ms (1), (2) and (3) of

ary for GMHA to establish an Urgent Healthcare Center. (d) Within ninety days of the establishment of the working group, the Administrator shall present a report addressing ite ms (1), (2) and (3) of Subsection (c) to the GMHA Board of Trustees for th eir approval of the execution to establish the Urgent Healthcare Center . (e) The Administrator shall, upon approval of the plan of action by the GMHA Board of Trustees, submit to I Liheslaturan Guåhan a copy of the final report. SOURCE: Added as § 80122 by P.L. 32-060:5 (July 9, 20 13), recodified to this section by the Compiler pursuant to the authority g ranted by 1 GCA § 1606. § 80124. Cancer Data Collection. The Guam Memorial Hospital Authority (GMHA) and the GMHA Medical Staff shall continue to collect information regarding cancer cases with relevant data for the Cancer Registry, as esta blished by the Department COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 30 of Public Health and Social Services (DPHSS). GMHA shall provide DPHSS cancer information semiannually. SOURCE: Repealed and reenacted as 10 GCA 80113.1 by P.L. 24-198:3 (May 6, 1998), and P.L. 30-190:1 (Aug. 28, 2010).

Social Services (DPHSS). GMHA shall provide DPHSS cancer information semiannually. SOURCE: Repealed and reenacted as 10 GCA 80113.1 by P.L. 24-198:3 (May 6, 1998), and P.L. 30-190:1 (Aug. 28, 2010). Renumber ed by the Compiler to this section pursuant to authority granted by 1 GCA § 16 06. § 80125. Authorization of One or More Series of Lim ited Obligation (Section 30) Bonds. (a) I Liheslaturan Guåhan , pursuant to § 50103(k) of Article 1, Chapter 50 of Title 12, Guam Code Annotated, hereby authorizes I Maga’låhen Guåhan to issue one or more additional series of tax-exem pt and/or taxable Limited Obligation (Section 30) Bond s of the government of Guam, as provided in this Section, in an aggregate principal amount not to exceed (1) Forty-five Million Dollars ($45,000,000) for t he following: (A) up to Thirty Million Dollars ($30,000,000) for the express authorization of paying off Guam Memorial H ospital Authority account payables; and (B) Fifteen Million Dollars ($15,000,000) for Guam Memorial Hospital Authority Fiscal Year 2017 accoun t payables subject to legislative authorization and appropriat ion in the General Appropriations Act of FY 2017; (2) the principal amount

for Guam Memorial Hospital Authority Fiscal Year 2017 accoun t payables subject to legislative authorization and appropriat ion in the General Appropriations Act of FY 2017; (2) the principal amount necessary in order to pro vide for one or more of the following purposes: (A) to finance a reserve fund; (B) to refund all of the 2009A Bonds with a final m aturity that does not exceed the existing final maturity of the 2009A Bonds; (C) to refinance the outstanding loan of the Bank o f Guam to the Guam Memorial Hospital Authority currently outs tanding in the approximate principal amount of 20.1 Million Do llars, with a final maturity that does not exceed the existing fi nal maturity of the outstanding loan of the Bank of Guam to the Gua m Memorial Hospital; COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 31 (D) to refinance all of the Government’s obligation s with respect to the Series 2013B Guam Education Financin g Foundation II, Inc. Certificates of Participation ( Okkodo High School Expansion Project) (the 2013 Certificates), with a final maturity that does not exceed the existing final ma turity of the 2013B Certificates; and (E) to pay expenses

rticipation ( Okkodo High School Expansion Project) (the 2013 Certificates), with a final maturity that does not exceed the existing final ma turity of the 2013B Certificates; and (E) to pay expenses relating to the authorization, sale and issuance of the bonds, including without limitation , printing costs, costs of reproducing documents, credit enhancement fees, underwriting, legal, feasibility, financial advisor y and accounting fees and charges, fees paid to banks or other finan cial institutions providing credit enhancement, costs of credit ratin gs and other costs, charges and fees in connection with the issu ance, sale and delivery of the bonds, not to exceed 1.5% of the PA R and subject to the following additional conditions: (i) The terms and conditions of the bonds shall be as determined by I Maga’låhen Guåhan by the execution of a certificate or indenture authorizing the issuance o f the bonds, prior to the issuance of the bonds and shall be iss ued under the master indenture pursuant to which the 2009A Bo nds were issued (including any amendments thereto) or u nder a new master indenture; provided, however, that such terms and conditions shall be consistent with this

ure pursuant to which the 2009A Bo nds were issued (including any amendments thereto) or u nder a new master indenture; provided, however, that such terms and conditions shall be consistent with this Sectio n, that the bonds shall mature not later than thirty-one (31) y ears after their date of issuance, shall bear interest at such rates and be sold for such price or prices as shall result in a yield to the bondholders that does not exceed five percent (5%) per annum; and that the combined present value of debt service on the bonds issued to refund the 2009A Bonds, the above- referenced Bank of Guam loan and the 2013B Certific ates shall be at least two percent (2%) less than the pr esent value of debt service on the bonds and loan being refunde d or refinanced. (ii) The proceeds from such bonds shall be used and are hereby appropriated (aa) to finance the payment of the Guam Memorial Hospital Authority outstanding vendor payables; COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 32 (bb) to fund a reserve fund; (cc) to refund all of the 2009A Bonds and the 2013B Certificates; (dd) to refinance the outstanding loan of the Bank of Guam to the Guam Memorial

AL HOSPITAL AUTHORITY 32 (bb) to fund a reserve fund; (cc) to refund all of the 2009A Bonds and the 2013B Certificates; (dd) to refinance the outstanding loan of the Bank of Guam to the Guam Memorial Hospital Authority, currently outstanding in the approximate principal amount of 20.1 Million Dollars; and (ee) to pay expenses relating to the authorization, sale and issuance of the bonds including, without limitation, printing costs, costs of reproducing documents, credit enhancement fees, underwriting, legal, feasibility, financial advisory and accounti ng fees and charges, fees paid to banks or other financial institutions providing credit enhancement, costs of credit ratings and other costs, charges and fees in connection with the issuance, sale and delivery of the bonds. (iii) No bonds authorized by this Section shall be sold until the Board of Directors of Guam Economic Development Authority has approved the sale by reso lution. (iv) The issuance of bonds pursuant to this Section shall not be subject to the approval of the voters of Gua m. (b) All bonds issued pursuant to this Section shall be secured by a statutory lien on all revenues derived by the gover nment of Guam under

hall not be subject to the approval of the voters of Gua m. (b) All bonds issued pursuant to this Section shall be secured by a statutory lien on all revenues derived by the gover nment of Guam under Section 30 of the Organic Act (Section 30 revenues) . This lien shall arise automatically without the need for any action or au thorization by I Maga’låhen Guåhan , the government of Guam, or any other person or entity. Such lien shall be valid and binding from t he time such bonds are issued. The Section 30 revenues shall immediately b e subject to such lien, and the lien shall automatically attach to the Sect ion 30 revenues and be effective, binding, and enforceable against I Maga’låhen Guåhan , the government of Guam, their successors, assignees, an d creditors, and all others asserting the rights therein, irrespective o f whether those parties have notice of the lien and without the need for any phy sical delivery, recordation, filing, or further Act. Section 30 revenues that ar e not required to make payments on the bonds shall automatically, and with out the need for any COL29201710 GCA HEALTH AND SAFETY CH.

recordation, filing, or further Act. Section 30 revenues that ar e not required to make payments on the bonds shall automatically, and with out the need for any COL29201710 GCA HEALTH AND SAFETY CH. 80 GUAM MEMORIAL HOSPITAL AUTHORITY 33 further action, be released from such lien and shal l be available for appropriation for any other lawful purpose of the g overnment. The statutory lien described in this Subsection shall not be subj ect to Division 9 of Title 13, Guam Code Annotated, or any successor statute. The Section 30 revenues received by the government of Guam or by a ny trustee, depository or custodian shall be deposited in accordance with the provisions of the applicable indenture. (c) In addition to the statutory lien provided for above, all or any part of the Section 30 revenues may be pledged, if and to t he extent determined by I Maga’låhen Guåhan , to secure the payment of any bonds issued pursuan t to this Section. Any such pledge shall be valid and bi nding against all parties in accordance with its terms and have priority against all parties in accordance with its terms from the time the pledge is made, an d property so pledged shall immediately be subject to

all parties in accordance with its terms and have priority against all parties in accordance with its terms from the time the pledge is made, an d property so pledged shall immediately be subject to the lien of the ple dge without the need for physical delivery, recordation, filing, or other fu rther Act. The pledge shall not be subject to Division 9 of Title 13, Guam Code Annotated, or any successor statute. The indenture by which such pled ge is created need not be recorded. All Section 30 revenue so pledged is here by appropriated for the purpose for which it has been pledged. Indebtedness issued by the government pursuant to this Section and that is pay able from Section 30 revenue may not be issued in an amount that would c ause a violation of the debt limitation provisions of Section 11 of the Org anic Act. SOURCE: Added by P.L. 33-183:1 (July 22, 2016). 2016 NOTE: P.L. 33-183 stated further: Section 3. All elements contained in Section 2 of t his Act shall be included in the indenture pursuant to this Act. Add itionally, the trustee shall not release the Fifteen Million Dollars ($15, 000,000) until such authorization and appropriation in the General Appr opriation Act of

indenture pursuant to this Act. Add itionally, the trustee shall not release the Fifteen Million Dollars ($15, 000,000) until such authorization and appropriation in the General Appr opriation Act of FY 2017 is duly passed by I Liheslaturan Guåhan . Section 4. Any fee(s) to be paid to the Guam Econo mic Development Authority for their assistance in refinancing the S eries 2009 A Limited Obligation (Section 30) Bonds, the Series 2013B Gua m Education Financing Foundation II, Inc. Certificates of Parti cipation (Okkodo High School Expansion Project), and the Guam Memorial Ho spital Authority Bank of Guam Loan shall be from the source of debt service for these bonds, certificates and loan. --------- COL292017