REPORT ON BILLS FAVORABLY REPORTED BY COMMITTEE

TITLE OF BILL:

AN ACT CONCERNING REVISIONS TO THE OFFICE OF HEALTH CARE ACCESS STATUTES.

SPONSORS OF BILL:

REASONS FOR BILL:

To revise regulations authorizing the Office of Health Care Access to grant waivers for the letter of intent process in emergency situations, from Certificate of Need (CON) for nonprofit facilities that intend to terminate an existing service, and amend an existing waiver process which addresses CON approval pertaining to equipment.

RESPONSE FROM ADMINISTRATION/AGENCY:

Leslie J. Gabel-Brett, Executive Director, The Permanent Commission on the Status of Women (PCSW), testified in opposition to this bill. Testimony was given urging the committee not to do anything that would weaken the Office of Health Care Access (OHCA) authority with respect to reducing or eliminating services. Sections of the bill causing the most concern are the changing of the rules regarding the need to obtain Certificate Of Need (CON) approval prior to a facility closing or reducing service are changed. The PCSW and other groups that advocate for women's health have relied heavily on that section of the CON statute several times in the past decade to protect vital health care services for women. A recent situation concerning Lawrence Memorial Hospital closing the clinic, which provides pre-natal health care for low income women, was forced by OHCA to continue providing these services.

Thomas A. Kirk, Jr., Commissioner, Department of Mental Health and Addiction Services (DMHAS), testified in support of this bill and the modified language under 19a-639b of the Connecticut General Statutes which expands the circumstances under which DMHAS can recommend a CON exemption, for a DMHAS-funded provider, to OHCA. DMHAS has provided on several occasions valuable information, concerning DMHAS-funded providers, to OHCA to assist in making the determination to grant an exemption or not. DHMAS collects data from all providers and can review performance at the programmatic and client levels making them valuable in the decision making process. Other statutory language changes in Section 19a-639b require that before any publicly funded service is terminated, an adequate review as to how those service needs will be met must be conducted. The same holds true for the proposed language changes under 17a-678 of the Connecticut General Statutes.

Cristine A. Vogel, Commissioner, Office of Health Care Access (OHCA), testified in support of this bill as it makes modifications to statutes that are out dated or no longer applicable due to replacement or deletion of programs. Modifications also being proposed are directed at statutes that govern hospital net revenue limits that are no longer regulated by OHCA.

“Sections 6 and 7 propose a modification to a current definition which allows for an applicant to request a waiver from the 60 day letter of intent (LOI) phase of the CON process. Currently, OHCA's statutes allow for the Commissioner in an “emergency situation” to waive the LOI phase if a health care facility is unable to, “comply with requirements of federal, state, or local health, fire, building or life safety code.” The proposal extends this statute to allow for a health care facility to request, in an emergency situation, for a waiver based on “maintaining continued access to health care service provided by the facility.” These are infrequent requests; however, there are occasions when the current definition does not apply to the situation and the agency is limited in its ability to expedite the CON process in an emergency. The waiver does not exempt the applicant from CON review, the public hearing or any other aspect of the CON process. This allows only a waiver from the LOI phase.”

Section 9 amends the existing waiver process for replacement of major medical and radiological equipment. The replacement can not exceed 10% of the original cost for each twelve month period since the original CON approval. This bill repeals that requirement from the current statute.

Sections 1 and 8 of the bill allow OHCA to grant an exemption from CON for nonprofit facilities, institutions, or providers to terminate a service as long as the termination will not have a negative impact on patient access and care, creating a more efficient process.

NATURE AND SOURCES OF SUPPORT:

Terry Edelstein, President/CEO, Connecticut Community Providers Association (CCPA), submitted testimony in support of Section 8 (a) (1) and (2), allowing exemptions from CON for non profit agencies that are currently under contract with a state agency or department. Testimony did state concerns with Section 8 (4), relating to termination of service or facility. This section requires the state agency contracting with a “nonprofit facility, institution or provider” that requests to terminate service, to confirm in writing that the needs of the area will continue to be met. The concerns are that if the provider seeking the termination due to inadequate funds may be forced to continue providing service at a financial loss, until a new vendor is found. In the event that the reason for termination is that funding is inadequate to meet the needs of the caseload, the state agency is not forced to find a new vendor, therefore servicing the needs is lost.

NATURE AND SOURCES OF OPPOSITION:

None