§254. Powers and duties of the secretary of the Louisiana Department of Health
A. In addition to the functions, powers, and duties otherwise vested in the secretary
by law, he shall:
(1) Represent the public interest in the administration of this Chapter and shall be
responsible to the governor, the legislature, and the public therefor.
(2) Determine the policies of the department, except as otherwise provided by this
Title. For this purpose, he shall conduct such studies and investigations as are necessary for
the formulation of programs, plans, department procedures, rules and regulations, or for the
implementation of remedial actions.
(3) In accordance with the Administrative Procedure Act, make, alter, amend, and
promulgate rules and regulations necessary for the administration of the functions of the
department, except as otherwise provided by this Title.
(4) Organize, plan, supervise, direct, administer, execute, and be responsible for the
functions and programs vested in the department, in the manner and to the extent provided
by this Title.
(5) Advise the governor on problems concerning the administration of the
department.
(6)(a) Act as the sole agent of the state or, in necessary cases, designate one of the
offices within the department or its assistant secretary to cooperate with the federal
government and with other state and local agencies in matters of mutual concern and in the
administration of federal funds granted to the state or directly to the department or an office
thereof to aid in the furtherance of any function of the department or its offices, including but
not limited to funding for the Medical Assistance Program, Title XIX of the Social Security
Act. For this purpose he may take such actions, in accordance with any applicable state law,
necessary to meet such federal standards as are established for the administration and use of
such federal funds, except as otherwise specifically provided in this Title or by the
constitution and laws of this state.
(b) Act as the sole agent of the state or, in necessary cases, designate one of the
offices within the department or its assistant secretary to cooperate with the federal
government and with other state and local agencies in the administration of federal funds
granted to the state pursuant to the State Children's Health Insurance Program, Title XXI of
the Social Security Act. For this purpose he may take such actions, in accordance with any
applicable state law, necessary to meet such federal standards as are established for the
administration and use of such federal funds, except as otherwise specifically provided in this
Title or by the constitution and laws of this state, and provided that if the department
develops a private health insurance model, the department and the Department of Insurance
shall jointly promulgate the necessary rules in accordance with the Administrative Procedure
Act to establish the private health insurance model. Any rules or regulations promulgated
pursuant to the private health insurance model shall be subject to review by the House
Committee on Health and Welfare, the Senate Committee on Health and Welfare, the House
Committee on Insurance, and the Senate Committee on Insurance.
(7) Make and publish an annual report to the governor and the legislature concerning
the operations of the department and submit with each report such recommendations as he
deems necessary for the more effective internal structure and administration of the
department, and make other reports and recommendations on his own initiative or upon the
request of the governor, the legislature, or any committee or member thereof.
(8) Provide for the ongoing merger and consolidation of the agencies and functions
transferred to his department and submit a report thereon to the governor and the legislature,
which report shall accompany the budget request which he submits under provisions of R.S.
39:33. Such report shall include a statement of the goals of the department and of the
programs thereof and shall summarize the accomplishments of the department in meeting
such goals and implementing such programs. The report shall also contain a specific
statement of the reorganization and consolidation plan for the department for the next year
and shall include a report on the implementation of such reorganization and consolidation
plan for the previous year. The report concerning reorganization shall specifically detail the
extent to which the department has achieved goals stated the previous year with respect to
merger and consolidation of functions, abolition of agencies, consolidation of offices,
elimination of job positions, and efficiency and economy in delivery of services. The report
shall contain any recommendations with respect to reorganization which may require
legislative action under the provisions of this Title. A copy of the report and recommended
legislation shall also be submitted by the secretary to the presiding officer of each house of
the legislature. The presiding officer shall refer the report to the appropriate committee
having jurisdiction of the subject matter as provided in the rules of the respective house.
(9) Conduct hearings and pass upon complaints that may be made in relation to the
administration of this Chapter; provided, however, that the secretary shall have the authority
to delegate this authority to one of the offices of the department or to one of the agencies
therein.
(10) Perform the functions of the state relating to:
(a) Licensing of health-related professionals.
(b) Licensing of health facilities, including hospitals and nursing homes.
(c) Licensing of institutions for persons with intellectual disabilities.
(d) Licensing of systems of distribution for controlled dangerous substances.
(e) Licensing of child care institutions funded under Title XIX of the Social Security
Act.
(f) Any required certification for Medicare or Medicaid funding.
(g) Certification of emergency medical services.
(h) In accordance with R.S. 15:1501 et seq., provision of adult protective services
to adults with disabilities.
(11) Direct and be responsible for grants management, staff development, and policy
planning and evaluation for the department and all of its offices, including all agencies
transferred to the Louisiana Department of Health.
(12)(a) Provide targeted health care programs in priority health care zones upon one
hundred percent federal funding for such purpose. Such targeted programs shall:
(i) Be intended to lower infant mortality, teenage pregnancy, and substance abuse.
(ii) Be of the type determined by the secretary.
(iii) Be in addition to programs already in existence or any programs that may have
been implemented in these areas by the department under normal circumstances.
(b) "Priority health care zone" means any parish or municipality listed as one of the
ten parishes or twenty-five municipalities with the highest rates of infant mortality, teenage
pregnancy, or substance abuse in Louisiana as of July first of any given year according to
statistics compiled by the Louisiana Department of Health and the Department of Children
and Family Services.
(c) The secretary shall submit annually, to the health and welfare committees of the
House of Representatives and Senate, a report detailing actions taken by the Louisiana
Department of Health in compliance with this Paragraph.
(13)(a) Develop and implement targeted programs, if and when federal funds become
available, to enhance basic care facilities as defined in R.S. 40:2175 and comprehensive
regional treatment centers that may exist and be located in the ten most populated
municipalities in the state, excepting the city of New Orleans.
(b) These targeted programs should be of the type developed by the secretary and be
intended to enhance the available and accessible health care of the citizens of the more rural
areas of the state.
(14) Determine how funding for residency positions, residency supervision, and other
medical education resources shall be allocated among institutions which provide medical
education at hospitals in the health care services division of the Louisiana State University
Health Sciences Center, including the Medical Center of Louisiana at New Orleans, to ensure
that there is an equitable distribution among medical education programs providing services
in public institutions. In making such determinations, the secretary shall consider the
historical distribution of graduate medical education resources, the long-term effects of the
allocation of medical education resources to each program, and the clinical workload of each
program.
(15)(a) On an annual basis, provide all of the following information to the legislature
no later than fifteen days prior to the convening of each regular session:
(i) A full organizational chart for the department which is current as of the date of
submission to the legislature and which shows each staff position, whether filled or vacant,
that comprises the department.
(ii) The current salary of the person occupying each filled position shown on the
organizational chart.
(b) The secretary may submit the report required by this Paragraph in electronic
format and is further authorized, but is not required, to submit the report at the time of
submission of the annual report required by Paragraph (7) of this Subsection.
B. The secretary shall have authority to:
(1)(a) Except as otherwise specifically provided in R.S. 36:801 and 803:
(i) Employ, appoint, remove, assign, and promote such personnel as is necessary for
the efficient administration of the executive office of the secretary and the performance of
its powers, duties, functions, and responsibilities and such other personnel, who are not
assigned to an office, as may be necessary for the efficient administration of the department
and for the performance of the responsibilities, powers, duties, and functions of agencies
transferred to it.
(ii) Employ, assign, and remove all personnel employed for the department on a
contractual basis.
(iii) Transfer the personnel of the department as necessary for the efficient
administration of the department and its programs.
(b) All of the functions provided for in this Paragraph shall be accomplished in
accordance with applicable civil service law, rules, and regulations, and with policies and
rules of the department, and all are subject to budgetary control and applicable laws.
(2) Appoint, subject to gubernatorial approval, advisory councils, boards, and
commissions necessary in the administration of the department, except as otherwise provided
by law or by executive order.
(3) Accept and use, in accordance with law, gifts, grants, bequests, and endowments
for purposes consistent with the responsibilities and functions of the department and take
such actions as are necessary to comply with any conditions required for such acceptance.
(4) Formulate and promulgate rules of administration for the department relating to
employment and management.
(5) Act as legal custodian of any child placed with the department by a court of law.
(6) Grant rights of way, servitudes, and easements across state-owned lands under
his jurisdiction to other public bodies, either state or local, for any public purpose. The
secretary shall also have authority to grant rights of way, servitudes, and easements across
state lands under his jurisdiction to any other person or entity for the purpose of laying
pipelines, gas lines, and water lines, and for the transmission of electricity for power and
light, and also for telephone and telegraph lines, for railroad lines or tracks, for road
construction, and for drainage purposes, and to enter into the necessary contracts therefor,
which shall provide for the payment of an adequate consideration. Such payment, in order
to be considered as adequate consideration, shall be based on payments made for other
comparable contracts in the vicinity, when available, providing compensation for rights of
way, servitudes, easements, and for damages relative thereto.
(7) Adopt and promulgate rules and regulations providing for certification of
laboratories providing chemical analysis, analytical results, or other appropriate test data to
the department which is required as a part of any permit application, required by order of the
department or any agency in the department, required to be included on any monitoring
reports submitted to the department or any such agency, or otherwise required by the
regulations adopted pursuant to state or federal laws. The regulations shall provide for
appropriate fees to be charged to develop and operate the laboratory certification program.
(8) Do such other things, not inconsistent with law, as are necessary to properly
perform the functions vested in him.
(9) Assign the function of diagnosis and case management of persons suffering from
substance abuse, persons with intellectual disabilities, persons with developmental
disabilities, and persons with autism to the appropriate office with the Louisiana Department
of Health or the appropriate level of government.
C. The secretary shall have no power to buy and sell lands, incur debt or issue bonds,
or to lease or mortgage property under his control except as may be provided by the general
laws of the state or as hereafter specifically conferred by law upon him.
D.(1)(a)(i) The secretary shall direct and be responsible for the Medical Assistance
Program, Title XIX of the Social Security Act, including eligibility determination and those
health planning and resource development functions as are permissible under provisions of
Title XIX of the Social Security Act, Title XXI of the Social Security Act, and R.S. 46:976.
Any modification to the Medical Assistance Program approved by waiver by the United
States Department of Health and Human Services, Health Care Financing Administration or
its successor, that provides for a managed care or voucher system shall be implemented by
the secretary but only after the approved plan and any modifications thereto have been
approved by the House and Senate committees on health and welfare and the Joint
Legislative Committee on the Budget. Unless approved by such committees as provided in
this Subparagraph, modifications to the medical assistance program as provided in this
Subparagraph shall not be considered avoidance of a budget deficit in the case of medical
assistance programs, shall not be considered a means of securing new or enhanced federal
funding in medical assistance programs, and shall not be considered necessary to avoid
imminent peril to the public health, safety, or welfare; such modification shall not be
promulgated as emergency rules under the provisions of R.S. 49:962 unless approved by such
committees.
(ii) Any state Medicaid plan amendment shall provide assurances that for the
provisions of the plan being amended, the state's payment rates for hospital, nursing facility,
and institutional services shall be reasonable and adequate to meet the costs that must be
incurred by efficiently and economically operated facilities, and any state Medicaid plan
amendment shall comply with Section 1902(a)(13)(A) of the Social Security Act, known as
the Boren amendment. The requirements of this Item shall not apply to state Medicaid plan
amendments to implement a waiver approved by both houses of the legislature in accordance
with Item (i) of this Subparagraph.
(b) The secretary is authorized to enter into interagency agreements for the
performance of eligibility determination services to determine client eligibility for the
Medical Assistance Program.
(2) Except as otherwise limited by a specific provision of law, the secretary is
authorized to perform all of the following relative to or concerning the Medical Assistance
Program:
(a) Adopt and promulgate rules and regulations related to the program in accordance
with the Administrative Procedure Act.
(b) Develop and implement criteria, policies, and procedures concerning the
program.
(c) Investigate, audit, and impose sanctions and other remedial measures on health
care providers and others concerning the program.
(d) File suit on behalf of the Medical Assistance Program and select legal counsel
employed by the department and other counsel as permitted by law to represent the secretary
and the Medical Assistance Program in any such actions.
(3) The secretary may adopt rules and regulations for health care providers, in
accordance with the Administrative Procedure Act and not inconsistent with state or federal
law, governing their participation in the Medical Assistance Program. Such rules and
regulations may include but shall not be limited to the following:
(a) The requirement that any health care provider who wishes to participate in the
state Medical Assistance Program shall:
(i) Enter into an agreement with the secretary prior to receipt of any payment or
reimbursement for services rendered to persons eligible for the Medical Assistance Program.
(ii) Provide specified information and provide authorization for the secretary to
verify such information prior to entering into the agreement with the secretary.
(iii) Provide a letter of credit, surety bond, or a combination thereof, not to exceed
fifty thousand dollars.
(b) General terms and conditions to which any provider shall agree in order to enter
into a health care provider agreement with the secretary.
(c) Terms and conditions for the suspension, denial, or revocation of a health care
provider agreement.
(d) Sanctions for violations of federal and state laws and rules applicable to the
Medical Assistance Program.
E.(1) The functions relative to the operation and management of mental health,
intellectual disabilities, and substance abuse services for Jefferson Parish having been
transferred by department rules to the Jefferson Parish Human Services Authority in
accordance with Part I of Chapter 21 of Title 28 of the Louisiana Revised Statutes of 1950
shall be the responsibility of and shall be performed by the Jefferson Parish Human Services
Authority.
(2) Funds appropriated by the legislature for the costs of providing those functions
and services transferred from the department to the authority shall be included in the
department budget and shall be transferred from the department to the authority at the
beginning of each state fiscal year. The secretary shall provide for the inclusion of such
funds in the department budget request. Funding for the authority from such source shall be
at least at the same level as provided for similar programs funded through the department
budget in other parishes or regions of the state.
F.(1) The functions relative to the operation and management of community-based
mental health, developmental disabilities, substance abuse services, and certain
community-based public health services for the parishes of Ascension, East Baton Rouge,
East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, and West Feliciana transferred
in accordance with R.S. 28:910 et seq., shall be the responsibility of and shall be performed
by the Capital Area Human Services District. If funds are not appropriated by the legislature
for the district to perform these functions in those parishes, the functions shall be the
responsibility of and shall be performed by the department in those parishes.
(2) Funds appropriated by the legislature for the costs of providing those functions
and services transferred from the department to the district shall be included in the
department budget and shall be transferred from the department to the district in accordance
with the agreement between the secretary of the department and the district. The secretary
shall provide for the inclusion of such funds in the department budget request. Funding for
the district from such source shall be at least at the same level and from the same means of
financing as provided for similar programs funded through the department budget in other
parishes or regions of the state. The agreement between the secretary and the district shall
also provide for the gradual assumption of community-based public health functions by the
district.
G. Repealed by Acts 2006, No. 465, §3, eff. June 15, 2006.
H.(1) The functions relative to the operation and management of community-based
mental health, developmental disabilities, and addictive disorder services for the parishes of
Livingston, St. Helena, St. Tammany, Tangipahoa, and Washington transferred in accordance
with R.S. 28:910 et seq. shall be the responsibility of and shall be performed by the Florida
Parishes Human Services Authority. If funds are not appropriated by the legislature for the
authority to perform these functions in those parishes, the functions shall be the
responsibility of and shall be performed by the department in those parishes.
(2) Funds appropriated by the legislature for the costs of providing those functions
and services transferred from the department to the authority shall be included in the
department budget and shall be transferred from the department to the authority in
accordance with the agreement between the secretary of the department and the authority.
The secretary shall provide for the inclusion of such funds in the department budget request.
Funding for the authority from such source shall be at least at the same level and from the
same means of financing as provided for similar programs funded through the department
budget in other parishes or regions of the state.
I.(1) The functions relative to the operation and management of community-based
mental health, developmental disabilities, and addictive disorder services for the parishes of
Orleans, St. Bernard, and Plaquemines transferred in accordance with R.S. 28:910 et seq.
shall be the responsibility of and shall be performed by the Metropolitan Human Services
District. If funds are not appropriated by the legislature for the district to perform these
functions in those parishes, the functions shall be the responsibility of and shall be performed
by the department in those parishes.
(2) Funds appropriated by the legislature for the costs of providing those functions
and services transferred from the department to the district shall be included in the
department budget and shall be transferred from the department to the district in accordance
with the agreement between the secretary of the department and the district. The secretary
shall provide for the inclusion of such funds in the department budget request. Funding for
the district from such source shall be at least at the same level and from the same means of
financing as provided for similar programs funded through the department budget in other
parishes or regions of the state.
J.(1) The functions relative to the operation and management of community-based
mental health, developmental disabilities, and addictive disorder services for the parishes of
Assumption, Lafourche, St. Charles, St. James, St. John the Baptist, St. Mary, and
Terrebonne transferred in accordance with R.S. 28:910 et seq., shall be the responsibility of
and shall be performed by the South Central Louisiana Human Services District. If funds are
not appropriated by the legislature for the district to perform these functions in those
parishes, the functions shall be the responsibility of and shall be performed by the department
in those parishes.
(2) Funds appropriated by the legislature for the costs of providing those functions
and services transferred from the department to the district shall be included in the
department budget and shall be transferred from the department to the district in accordance
with the agreement between the secretary of the department and the district. The secretary
shall provide for the inclusion of such funds in the department budget request. Funding for
the district from such source shall be at least at the same level and from the same means of
financing as provided for similar programs funded through the department budget in other
parishes or regions of the state.
K.(1) The functions relative to the operation and management of community-based
mental health, developmental disabilities, and addictive disorder services for the parishes of
Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita,
Richland, Tensas, Union, and West Carroll transferred in accordance with R.S. 28:910 et
seq., shall be the responsibility of and shall be performed by the Northeast Delta Human
Services Authority. If funds are not appropriated by the legislature for the authority to
perform these functions in those parishes, the functions shall be the responsibility of and
shall be performed by the department in those parishes.
(2) Funds appropriated by the legislature for the costs of providing those functions
and services transferred from the department to the authority shall be included in the
department budget and shall be transferred from the department to the authority in
accordance with the agreement between the secretary of the department and the authority.
The secretary shall provide for the inclusion of such funds in the department budget request.
Funding for the authority from such source shall be on at least the same level and from the
same means of financing as provided for similar programs funded through the department
budget in other parishes or regions of the state.
L. Any salary adjustment or cost of living adjustment for any employee or board
member of a board, entity, agency, or commission transferred to the Louisiana Department
of Health and enumerated in R.S. 36:259 or any employee of a human services district or
authority established and enumerated in R.S. 28:912 shall not be granted in any year after a
deficit is declared without express written approval of two-thirds of the members of the
respective governing board. The express written approval shall be submitted to the secretary
in accordance with the reporting provided for in R.S. 36:803.
NOTE: R.S. 40:2175 repealed by Acts 1999, No. 4, §1.
NOTE: See Acts 2022, No. 271, §71, and Acts 2006, No. 449, §4, repealing
relative to effectiveness and powers and duties of the board of the South
Central La. Human Services District.
Acts 1976, No. 513, §1; Acts 1977, No. 83, §1, eff. June 22, 1977; Acts 1978, No.
786, §4, eff. July 17, 1978; Acts 1979, No. 355, §1; Acts 1983, 1st Ex. Sess., No. 13, §1, eff.
July 1, 1983; Acts 1984, No. 234, §1; Acts 1987, No. 736, §1; Acts 1988, 1st. Ex. Sess., No.
1, §2, eff. Mar. 28, 1988; Acts 1988, No. 772, §2, eff. July 17, 1988; Acts 1988, No. 858, §2,
eff. July 18, 1988; Acts 1989, No. 89, §1, eff. June 16, 1989; Acts 1989, No. 140, §1, eff.
June 22, 1989; Acts 1989, No. 231, §1, eff. June 26, 1989; Acts 1989, No. 458, §2; Acts
1990, No. 94, §2; Acts 1990, No. 219, §1; Acts 1990, No. 351, §1, eff. July 10, 1990; Acts
1992, No. 571, §1, eff. July 1, 1992; Acts 1992, No. 975, §2, eff. July 9, 1992; Acts 1993,
No. 170, §§2 and 3, eff. May 31, 1993; Acts 1993, No. 466, §2, eff. June 9, 1993; Acts 1993,
No. 554, §1; Acts 1993, No. 712, §2, eff. June 21, 1993; Acts 1993, No. 736, §1; Acts 1995,
No. 420, §1, eff. June 17, 1995; Acts 1995, No. 723, §2, eff. June 21, 1995; Acts 1996, 1st
Ex. Sess., No. 54, §2; Acts 1997, No. 3, §3, eff. July 1, 1997; Acts 1997, No. 953, §1, eff.
July 10, 1997; Acts 1997, No. 958, §1; Acts 1997, No. 1130, §1; Acts 1998, 1st Ex. Sess.,
No. 128, §1, eff. May 5, 1998; Acts 1999, No. 642, §1, eff. July 1, 1999; Acts 1999, No. 656,
§1, eff. July 1, 1999; Acts 1999, No. 802, §3, eff. July 2, 1999; Acts 2001, No. 826, §2, eff.
June 26, 2001; Acts 2003, No. 594, §3, eff. June 27, 2003; Acts 2003, No. 846, §3, eff. July
1, 2003; Acts 2006, No. 449, §2, eff. June 15, 2006; Acts 2006, No. 465, §3, eff. June 15,
2006; Acts 2006, No. 631, §2, eff. June 23, 2006; Acts 2010, No. 861, §17; Acts 2010, No.
877, §3, eff. July 1, 2010; Acts 2013, No. 220, §14, eff. June 11, 2013; Acts 2014, No. 811,
§18, eff. June 23, 2014; Acts 2016, No. 338, §1, eff. June 2, 2016; Acts 2016, No. 557, §2;
Acts 2018, No. 206, §2; Acts 2021, No. 211, §9; Acts 2022, No. 271, §7; Acts 2022, No.
592, §2A, eff. June 17, 2022.