Public Health Committee
AN ACT CONCERNING CERTIFICATES OF NEED
SUMMARY: This act amends the state's certificate of need (CON) process by (1) requiring the Office of Health Care Access (OHCA) to give public notice of completed letters of intent for CON applications and (2) making OHCA public hearings on CON applications optional unless the public requests one or the completed application meets certain criteria specified in the act.
CON is a regulatory process, administered by OHCA, for reviewing certain proposed capital expenditures by heath care facilities, acquisition of major medical equipment, institution of new services or functions, termination of services, transfer of ownership, and decreases in bed capacity. Generally, a CON is a formal OCHA statement that a health care facility, medical equipment purchase, or service change is needed.
EFFECTIVE DATE: October 1, 2003
LETTERS OF INTENT AND PUBLIC NOTICE
By law, the CON process begins when an applicant submits a "letter of intent" to OHCA. A letter of intent must be filed with OHCA before the CON application can be submitted. It must include:
1. the applicant's name;
2. a statement indicating that the CON application is for:
(a) a new, replacement, or additional facility, service, or function;
(b) the expansion or relocation of an existing facility, service, or function;
(c) a change in ownership or control;
(d) a termination of a service or a reduction in licensed bed capacity and bed type (the act changed this to a reduction in "total" bed capacity);
(e) any new or additional beds and their type;
(f) a capital expenditure over $1 million;
(g) acquisition of major medical equipment, imaging equipment, or a linear accelerator costing over $400,000; or
(h) a combination of these;
3. the estimated capital cost, value, or expenditure;
4. the town where the project is located; and
5. a brief description of the project.
The act requires OHCA to give public notice of any completed letter of intent by publishing a notice in a newspaper with a substantial circulation in the area served, or to be served, by the applicant. The notice must be submitted for publication within 15 days after OHCA determine that the letter of intent is complete. By law, a letter of intent must be on file with OHCA for at least 60 days before a CON application can be considered submitted to OHCA.
PUBLIC HEARINGS ON COMPLETED CON APPLICATIONS
CONs for Capital Expenditures and Major Medical Equipment
OHCA was previously required to hold a public hearing on any completed CON application for capital expenditures over $1 million or acquisition of major medical equipment over $400,000. It was required to give at least two weeks' notice of the hearing to the applicant by certified mail, and to the public by newspaper publication in a paper having substantial circulation in the area served by the applicant.
The act instead requires OHCA to hold a public hearing if (1) the proposal has "associated total capital expenditures" or "total capital costs" exceeding $20 million for land, building, or nonclinical equipment acquisition, new building construction, or building renovation; (2) the proposal has associated total per-unit capital expenditures or capital costs exceeding $1 million for major medical equipment, imaging equipment, or linear accelerators that use new technology or technology being introduced to the state; or (3) three people, or one person representing an entity of five or more people, ask for it in writing.
If OHCA holds a hearing, the act requires that (1) the applicant receive two weeks' written notice of it and (2) the public receive the same two-week notice through a newspaper with substantial circulation in the applicant's service area. By law, the hearing must be held in Hartford or in the area to be served, at OHCA's discretion.
CONs for New Functions or Services, Termination of Services, Transfer of Ownership, and Decreases in Bed Capacity
The act explicitly allows OHCA to hold a public hearing on a completed CON application involving institution of new services or functions, termination of services, transfer of ownership or control, or a substantial decrease in bed capacity. Hearing notice must be given to (1) the CON applicant in writing and (2) the public through a newspaper with substantial circulation in the applicant's service area. The act allows OHCA to hold the hearing in Hartford or in the area to be served.
In deciding whether to hold a hearing, the act requires OHCA to consider, at a minimum, whether the CON proposal involves (1) new or additional health care functions or services through use of new technology or technology being introduced into the state; (2) new or additional health care functions or services not provided in a region designated by the applicant or in its existing primary service area as defined by OHCA; or (3) termination of an existing health care function or service, reduction of total beds, or a facility's closing.
Under the act, OHCA must hold a public hearing on a completed CON application if three people or one person representing an entity with five or more people submit a written request for a public hearing after publication of the notice of the completed letter of intent.