Substitute House Bill No. 5403
Substitute House Bill No. 5403
PUBLIC ACT NO. 98-150
AN ACT CONCERNING CERTIFICATES OF NEED.
Be it enacted by the Senate and House of
Representatives in General Assembly convened:
Section 1. Section 19a-630 of the general
statutes is repealed and the following is
substituted in lieu thereof:
[(a)] As used in this chapter:
(1) "Health care facility or institution"
means any facility or institution engaged
primarily in providing services for the
prevention, diagnosis or treatment of human health
conditions, including, but not limited to,
outpatient clinics, free standing outpatient
surgical facilities, imaging centers, home health
[care] agencies, [homemaker-home health aide
agencies,] as defined in section 19a-490; clinical
laboratory or central service facilities serving
one or more health care facilities, practitioners
or institutions; hospitals; [personal] RESIDENTIAL
care homes; nursing homes; REST HOMES; nonprofit
health centers; diagnostic and treatment
facilities; rehabilitation facilities, and mental
health facilities; health care facility or
institution includes any parent company,
subsidiary, affiliate, or joint venture or any
combination thereof of a health care facility or
institution; but not including [any outpatient
clinic operated by a town, city or borough or any
state-operated hospital or any rehabilitation
center referred to in section 17b-243, or] any
health care facility operated by a nonprofit
educational institution solely for the students,
faculty and staff of such institution and their
dependents, or any Christian Science sanatorium
operated, or listed and certified, by the First
Church of Christ, Scientist, Boston,
Massachusetts. [;]
(2) ["state] "STATE health care facility or
institution" means a hospital or other such
facility or institution operated by the state
providing services which are eligible for
reimbursement under Title XVIII or XIX of the
federal Social Security Act, 42 USC Section 301 et
seq., as amended. [;]
(3) ["office"] "OFFICE" means the Office of
Health Care Access. [; and]
(4) ["commissioner"] "COMMISSIONER" means the
Commissioner of Health Care Access.
(5) "AFFILIATE" MEANS ANY HEALTH-CARE-RELATED
PERSON THAT DIRECTLY OR INDIRECTLY THROUGH ONE OR
MORE INTERMEDIARIES, CONTROLS OR IS CONTROLLED BY
OR IS UNDER COMMON CONTROL WITH, ANOTHER
HEALTH-CARE-RELATED PERSON. FOR PURPOSES OF THIS
SUBDIVISION, "PERSON" MEANS A CORPORATION, GENERAL
OR LIMITED PARTNERSHIP OR LIMITED LIABILITY
COMPANY CONTROLLED, DIRECTLY OR INDIRECTLY, BY
SUCH OTHER PERSON OR THE CORPORATION, PROVIDED, IN
ADDITION TO OTHER MEANS OF BEING CONTROLLED, A
GENERAL OR LIMITED PARTNERSHIP OR LIMITED
LIABILITY COMPANY SHALL BE DEEMED TO BE CONTROLLED
BY THE CORPORATION IF THE CORPORATION OR ONE OF
ITS AFFILIATES ACTS AS A GENERAL PARTNER OR A
MANAGER OF SUCH GENERAL OR LIMITED PARTNERSHIP OR
LIMITED LIABILITY COMPANY.
[(b) As used in this chapter for the purpose
of certificate of need, "clinical laboratory"
includes any clinical laboratory as defined in
section 19a-30, requiring a separate clinical
laboratory license from the Department of Public
Health, except laboratories designated as
laboratories performing waived tests, as defined
in 42 CFR 493.15 as from time to time amended, and
laboratories performing tests of moderate
complexity, as defined in 42 CFR 493.20 as from
time to time amended.]
Sec. 2. Section 19a-638 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) EXCEPT AS PROVIDED IN SECTIONS 4 TO 7,
INCLUSIVE, OF THIS ACT:
(1) [Any] EACH health care facility or
institution, [as defined in subsection (a) of
section 19a-490, which intends to transfer all or
part of its ownership or control prior to being
initially licensed, except a home health agency,
nursing home, residential care home, rest home or
residential facility for the mentally retarded
licensed pursuant to section 17a-227 and certified
to participate in the Title XIX Medicaid program
as an intermediate care facility for the mentally
retarded] THAT INTENDS TO (A) TRANSFER ALL OR PART
OF ITS OWNERSHIP OR CONTROL, (B) CHANGE THE
GOVERNING POWERS OF THE BOARD OF A PARENT COMPANY
OR AN AFFILIATE, WHATEVER ITS DESIGNATION, OR (C)
CHANGE OR TRANSFER THE POWERS OR CONTROL OF A
GOVERNING OR CONTROLLING BODY OF AN AFFILIATE,
shall submit to the office, prior to the proposed
date of such transfer [and in accordance with any
schedule established by the office pursuant to
subsection (c) of this section] OR CHANGE, a
request for permission to undertake such transfer
OR CHANGE.
(2) [Any] EACH health care facility or
institution or [any] state health care facility or
institution, including any inpatient
rehabilitation facility, [affiliated with the
Easter Seal Society of Connecticut, Inc., but
excluding a home health agency, nursing home,
residential care home, rest home or residential
facility for the mentally retarded licensed
pursuant to section 17a-227 and certified to
participate in the Title XIX Medicaid program as
an intermediate care facility for the mentally
retarded,] which intends to introduce any
additional function or service into its program of
health care [, except a program of ambulatory
services established and conducted by a health
maintenance organization or any outpatient
rehabilitation facility affiliated with the Easter
Seal Society of Connecticut, Inc.,] shall submit
to the office, prior to the proposed date of the
institution of such function or service, [or
increase in staff and in accordance with any
schedule established by the office pursuant to
subsection (c) of this section,] a request for
permission to undertake such function or service.
[or increase its staff.]
(3) [Any] EACH health care facility or
institution or [any] state health care facility or
institution [except a home health agency, nursing
home, residential care home, rest home or
residential facility for the mentally retarded
licensed pursuant to section 17a-227 and certified
to participate in the Title XIX Medicaid program
as an intermediate care facility for the mentally
retarded,] which intends to terminate a health
service offered by such facility or institution or
decrease substantially its total bed capacity,
shall submit to the office, prior to the proposed
date of such termination or decrease, [and in
accordance with any schedule established by the
office pursuant to subsection (c) of this
section,] a request to undertake such termination
or decrease.
(4) [An] EACH applicant, prior to submitting a
certificate of need application UNDER THIS
SECTION, SECTION 19a-639, AS AMENDED BY SECTION 3
OF THIS ACT, OR UNDER BOTH SECTIONS, shall SUBMIT
A request, in writing, FOR application forms and
instructions [from] TO the office. The request
shall be known as a letter of intent. A letter of
intent shall include: (A) The name of the
applicant or applicants; (B) a statement
indicating whether the application is for a new,
REPLACEMENT OR ADDITIONAL facility, service or
function, THE expansion OR RELOCATION of an
existing facility, service or function, [and] A
CHANGE IN OWNERSHIP OR CONTROL, A TERMINATION OF A
SERVICE OR A REDUCTION IN LICENSED BED CAPACITY
AND THE BED TYPE, any new or additional beds and
their type, A CAPITAL EXPENDITURE OVER ONE MILLION
DOLLARS, THE ACQUISITION OF MAJOR MEDICAL
EQUIPMENT, IMAGING EQUIPMENT OR A LINEAR
ACCELERATOR COSTING OVER FOUR HUNDRED THOUSAND
DOLLARS, OR ANY COMBINATION THEREOF; (C) the
estimated capital cost, VALUE OR EXPENDITURE; (D)
the town where the project IS OR will be located;
and (E) a brief description of the proposed
project. No certificate of need application will
be considered [filed with] SUBMITTED TO the office
unless a current letter of intent, specific to the
proposal and in [accordance] COMPLIANCE with this
subsection, has been on file with the office at
least [ninety] SIXTY days. A current letter of
intent is a letter of intent which has been on
file at the office [no more than] UP TO AND
INCLUDING one hundred twenty days, EXCEPT THAT AN
APPLICANT MAY REQUEST A ONE TIME EXTENSION OF A
LETTER OF INTENT OF UP TO AN ADDITIONAL THIRTY
DAYS FOR A MAXIMUM TOTAL OF UP TO ONE HUNDRED
FIFTY DAYS IF, PRIOR TO THE EXPIRATION OF THE
CURRENT LETTER OF INTENT, THE OFFICE RECEIVES A
WRITTEN REQUEST TO SO EXTEND THE LETTER OF
INTENT'S CURRENT STATUS. THE EXTENSION REQUEST
SHALL FULLY EXPLAIN WHY AN EXTENSION IS REQUESTED.
THE OFFICE SHALL ACCEPT OR REJECT THE EXTENSION
REQUEST WITHIN FIVE BUSINESS DAYS AND SHALL SO
NOTIFY THE APPLICANT.
(b) The office shall make such review of a
request made pursuant to subdivision (1), (2) or
(3) of subsection (a) of this section as it deems
necessary. [, including, in] IN the case of a
proposed transfer of ownership or control, [prior
to initial licensure, such factors as, but not
limited to] THE REVIEW SHALL INCLUDE, BUT NOT BE
LIMITED TO, the financial responsibility and
business interests of the transferee and the
ability of the institution to continue to provide
needed services [,] or, in the case of the
introduction of [an] A NEW OR additional function
or service EXPANSION OR THE TERMINATION OF A
SERVICE OR FUNCTION, ascertaining the availability
of such service or function at other inpatient
rehabilitation facilities, health care facilities
or institutions or state health care facilities or
institutions OR OTHER PROVIDERS within the area to
be served, the need for such service or function
within such area and any other factors which the
office deems relevant to a determination of
whether the facility or institution is justified
in introducing OR TERMINATING such [additional]
functions or services into OR FROM its program.
[or increasing its staff.] The office shall grant,
modify or deny such request within ninety days of
the receipt [thereof] OF A COMPLETE APPLICATION,
except as provided for in this section. Upon the
request of the applicant, the review period may be
extended for an additional fifteen days if the
office has requested additional information
subsequent to the commencement of the review
period. The commissioner may extend the review
period for a maximum of thirty days if the
applicant has not filed in a timely manner
information deemed necessary by the office.
Failure of the office to act on such request
within such review period shall be deemed approval
thereof. The ninety-day review period, pursuant to
this subsection, for an application filed by a
hospital, as defined in section 19a-490, and
licensed as a short-term acute-care general
hospital or children's hospital by the Department
of Public Health OR AN AFFILIATE OF SUCH A
HOSPITAL OR ANY COMBINATION THEREOF, shall not
apply if, in the certificate of need application
or request, the hospital OR APPLICANT projects
[that the implementation of such application or
request will require future budget adjustments]
EITHER (1) THAT, FOR THE FIRST THREE YEARS OF
OPERATION TAKEN TOGETHER, THE TOTAL IMPACT OF THE
PROPOSAL ON THE OPERATING BUDGET OF THE HOSPITAL
OR AN AFFILIATE OF SUCH A HOSPITAL OR ANY
COMBINATION THEREOF WILL EXCEED ONE PER CENT OF
THE ACTUAL OPERATING EXPENSES OF THE HOSPITAL FOR
THE MOST RECENTLY COMPLETED FISCAL YEAR AS FILED
WITH OR DETERMINED BY THE OFFICE, OR (2) THAT THE
TOTAL CAPITAL EXPENDITURE FOR THE PROJECT WILL
EXCEED FIFTEEN MILLION DOLLARS. IF THE OFFICE
DETERMINES THAT AN APPLICATION IS NOT SUBJECT TO
THE NINETY-DAY REVIEW PERIOD PURSUANT TO THIS
SUBSECTION, IT SHALL REMAIN SO EXCLUDED FOR THE
ENTIRE REVIEW PERIOD OF THAT APPLICATION, EVEN IF
THE APPLICATION OR CIRCUMSTANCES CHANGE AND THE
APPLICATION NO LONGER MEETS THE STATED TERMS OF
THE EXCLUSION. Upon a showing by such facility or
institution that the need for such function, [or]
service or [increase in staff] TERMINATION OR
CHANGE OF OWNERSHIP OR CONTROL is of an emergency
nature, in that the function, [or] service or
[increase in staff] TERMINATION OR CHANGE OF
OWNERSHIP OR CONTROL is necessary to comply with
requirements of any federal, state or local
health, fire, building or life safety code, the
commissioner may waive the letter of intent
requirement, [and the requirement that the request
for such permission be submitted, in accordance
with any schedule established by the office
pursuant to subsection (c) of this section,]
provided such request shall be submitted at least
ten business days before the proposed date of
institution of the function, [or] service OR
TERMINATION OR CHANGE OF OWNERSHIP OR CONTROL.
(c) In conducting its activities under this
section, [and] section 19a-639, AS AMENDED BY
SECTION 3 OF THIS ACT, OR UNDER BOTH SECTIONS, the
office may hold hearings on applications of a
similar nature at the same time. [The office may
adopt regulations in accordance with the
provisions of chapter 54, to establish a schedule
for the submission of such applications which (1)
requires applications to be submitted in cycles
that allow applications to be heard and reviewed
at times when hospital budget reviews are not in
progress, and (2) may provide for all completed
applications pertaining to similar types of
services, facilities or equipment affecting the
same health service area to be considered in
relation to each other and reviewed at least twice
a year.]
(d) For the purposes of this section, SECTION
19a-639, AS AMENDED BY SECTION 3 OF THIS ACT, OR
BOTH SECTIONS, construction shall be deemed to
have begun if the following have occurred and the
office has been so notified in writing within the
thirty days prior to the date by which
construction is to begin: (1) All necessary town,
state and federal approvals required to begin
construction have been obtained, including all
zoning and wetlands approvals; (2) all necessary
town and state permits required to begin
construction or site work have been obtained; (3)
financing approval, as defined in subsection [(i)]
(e) of this section, has been obtained; and (4)
construction of a structure approved in the
certificate of need has begun. For the purposes of
this subsection, commencement of construction of a
structure shall include, at a minimum, completion
of a foundation. Notwithstanding the provisions of
this subsection, upon receipt of an application
filed at least thirty days prior to the date by
which construction is to begin, the office may
deem construction to have begun if (A) an owner of
a certificate of need has fully complied with the
provisions of subdivisions (1), (2) and (3) of
this subsection; (B) such owner submits clear and
convincing evidence that he has complied with the
provisions of this subsection sufficiently to
demonstrate a high probability that construction
shall be completed in time to obtain licensure by
the Department of Public Health on or before the
date required [pursuant to subsection (d) of this
section] IN THE CERTIFICATE OF NEED AS THE OFFICE
MAY AMEND IT FROM TIME TO TIME; (C) construction
of a structure cannot begin due to unforseeable
circumstances beyond the control of the owner; and
(D) at least ten per cent of the approved total
capital expenditure or two hundred fifty thousand
dollars, whichever is greater, has been expended.
(e) [On and after March 1, 1993, financing]
FINANCING shall be deemed to have been obtained
for the purposes of this section if the owner of
the certificate of need has (1) received a final
commitment for financing in writing from a lender,
or (2) provided evidence to the office that the
owner has sufficient funds available to construct
the project without financing.
(f) The General Assembly finds evidence of
insufficient need for all the nursing home beds
approved by the Office of Health Care Access but
not yet constructed and finds allowing unnecessary
beds and facilities to be built will result in
severely damaging economic consequences to the
state and to consumers. All certificates of need
for nursing home beds granted pursuant to this
section shall expire on June 9, 1993, except (1)
beds for which an application for financing was
received and deemed complete by the Connecticut
Health and Educational Facilities Authority prior
to March 1, 1993; (2) beds restricted to use by
patients with acquired immune deficiency syndrome
or traumatic brain injury; (3) beds associated
with a continuing care facility which guarantees
life care for its residents as defined in
subsection [(e) of this section] (b) OF SECTION
17b-354; (4) beds authorized under a certificate
of need for an addition of five beds in a facility
which has undertaken the addition of ten beds
pursuant to section 17b-351, AS AMENDED BY SECTION
13 OF THIS ACT; and (5) beds for which twenty-five
per cent of project costs have been expended prior
to June 9, 1993, as submitted to the Office of
Health Care Access in the form of a report
prepared by a certified public accountant having
no affiliation with the owner of the certificate
of need or the developer of the project. A
certificate of need which has expired pursuant to
this subsection may be reauthorized by the Office
of Health Care Access, provided need for nursing
home beds exists and twenty per cent or more of
the project costs have been expended by June 9,
1993. A request for reauthorization shall be
submitted to the Office of Health Care Access no
later than July 15, 1993. The office shall issue a
decision on such request within forty-five days of
receipt of documentation necessary to determine
expended project costs. Project expenditures shall
cease from June 9, 1993, until reauthorization by
the office. Evidence of project costs expended
shall be submitted in the form of a report
prepared by a certified public accountant having
no affiliation with the owner of the certificate
of need or the developer of the project. For the
purposes of this section, "need for nursing home
beds" means there is a demonstrated bed need in
the towns within twenty miles of the town in which
the facility is proposed to be located, including
the town of the proposed location, as listed in
the March 1, 1974, official mileage table of the
Public Utilities Commission. Bed need shall be
projected no more than five years into the future
at ninety-seven and one-half per cent occupancy
using the latest official population projections
by town and age as published by the Office of
Policy and Management and the latest available
nursing home utilization statistics by age cohort
from the Department of Public Health. For the
purposes of this subsection, "project costs" means
the capital costs approved by the Office of Health
Care Access in the certificate of need, exclusive
of the cost of land acquisition. Owners of
certificates of need for nursing home beds which
have expired may apply to the Commissioner of
Social Services for compensation on or after June
29, 1993, but no later than September 1, 1993.
Such compensation shall be limited to actual
verifiable losses which directly result from the
expiration of the certificate of need pursuant to
this subsection and which cannot be otherwise
recouped through the mitigating efforts of the
owner, excluding consequential and incidental
losses such as lost profits. Such compensation
shall not exceed an amount approved by the office
within the certificate of need unless the
commissioner determines it is reasonable or
cost-effective to compensate the excess amount.
Notwithstanding any provision of this subsection,
no compensation shall be provided to an owner of a
certificate of need whose ability to implement the
certificate of need is contingent on the outcome
of a legal action taken against the owner until
the owner obtains a final decision in his favor.
An owner aggrieved by the amount of compensation
determined by the commissioner may request a
hearing in accordance with the provisions of
sections 17b-61 and 17b-104. The commissioner may
so compensate an owner of a certificate of need
for nursing home beds who volunteers to relinquish
such a certificate, provided the request for
compensation is received by the commissioner prior
to July 15, 1993. The commissioner shall notify
such an owner as to whether he will be compensated
within forty-five days from receipt of notice of
voluntary relinquishment or forty-five days of
June 29, 1993, whichever is later.
Sec. 3. Section 19a-639 of the general
statutes, as amended by public act 97-159, is
repealed and the following is substituted in lieu
thereof:
(a) Except [for (1) a program of ambulatory
services established and conducted by a health
maintenance organization, (2) any outpatient
rehabilitation facility affiliated with the Easter
Seal Society of Connecticut, Inc., (3) a home
health agency or (4) a nursing home, residential
care home, rest home or residential facility for
the mentally retarded licensed pursuant to section
17a-227 and certified to participate in the Title
XIX Medicaid program as an intermediate care
facility for the mentally retarded] AS PROVIDED IN
SECTIONS 4 TO 7, INCLUSIVE, OF THIS ACT, EACH
HEALTH CARE FACILITY OR INSTITUTION, INCLUDING,
BUT NOT LIMITED TO, any inpatient rehabilitation
facility, [affiliated with the Easter Seal Society
of Connecticut, Inc.,] any health care facility or
institution or any state health care facility or
institution proposing a capital expenditure
exceeding one million dollars, or the acquisition
of major medical equipment requiring a capital
expenditure, as defined in regulations adopted
pursuant to section 19a-643, AS AMENDED BY SECTION
9 OF THIS ACT, in excess of four hundred thousand
dollars, including the leasing OR DONATION of
equipment or a facility, shall submit a request
for approval of such expenditure to the office,
with such data, information and plans as the
office requires in advance of the proposed
initiation date of such project. [and in
accordance with any schedule established by the
office pursuant to subsection (c) of this
section.]
(b) The office shall [thereupon] hold a public
hearing with respect to [such request] ANY
COMPLETE CERTIFICATE OF NEED REQUEST UNDER THIS
SECTION, at least two weeks' notice of which shall
be given to the facility, [or] institution OR
PROVIDER by certified mail and to the public by
publication in a newspaper having a substantial
circulation in the area served by the facility,
[or] institution OR PROVIDER. The commissioner
shall notify the Commissioner of Social Services
of any application that may impact on expenditures
under the state medical assistance program. Such
hearing shall be held at the discretion of the
office in Hartford or in the area so served OR TO
BE SERVED. The office shall consider such request
in relation to the community or regional need for
such capital program or purchase of land, the
possible effect on the operating costs of the
health care facility or institution and such other
relevant factors as the office deems necessary. In
approving or modifying such request, the
commissioner may not prescribe any condition, such
as but not limited to, any condition or limitation
on the indebtedness of the facility or institution
in connection with a bond issue, the principal
amount of any bond issue or any other details or
particulars related to the financing of such
capital expenditure, not directly related to the
scope of such capital program and within control
of the facility or institution. An applicant,
prior to submitting a certificate of need
application, shall SUBMIT A request, in writing,
FOR application forms and instructions [from] TO
the office. The request shall be known as a letter
of intent. A letter of intent shall [include: (A)
The name of the applicant or applicants; (B) a
statement indicating whether the application is
for a new facility, service or function, expansion
of an existing facility, service or function and
any new or additional beds and their type; (C) the
estimated capital cost; (D) the town where the
project will be located; and (E) a brief
description of the proposed project] CONFORM TO
THE LETTER OF INTENT REQUIREMENTS OF SUBDIVISION
(4) OF SUBSECTION (a) OF SECTION 19a-638, AS
AMENDED BY SECTION 2 OF THIS ACT. No certificate
of need application will be considered [filed
with] SUBMITTED TO the office unless a current
letter of intent, specific to the proposal and in
[accordance] COMPLIANCE with this subsection, [has
been] IS on file with the office at least [ninety]
SIXTY days. A current letter of intent is a letter
of intent which has been on file at the office no
more than one hundred twenty days, EXCEPT THAT AN
APPLICANT MAY REQUEST A ONE TIME EXTENSION OF A
LETTER OF INTENT OF UP TO AN ADDITIONAL THIRTY
DAYS FOR A MAXIMUM TOTAL OF UP TO ONE HUNDRED
FIFTY DAYS IF, PRIOR TO THE EXPIRATION OF THE
CURRENT LETTER OF INTENT, THE OFFICE RECEIVES A
WRITTEN REQUEST TO SO EXTEND THE LETTER OF
INTENT'S CURRENT STATUS. THE EXTENSION REQUEST
SHALL FULLY EXPLAIN WHY AN EXTENSION IS REQUESTED.
THE OFFICE SHALL ACCEPT OR REJECT THE EXTENSION
REQUEST WITHIN FIVE BUSINESS DAYS AND SHALL SO
NOTIFY THE APPLICANT. Upon a showing by such
facility or institution that the need for such
capital program is of an emergency nature, in that
the capital expenditure is necessary to comply
with any federal, state or local health, fire,
building or life safety code, the commissioner may
waive the letter of intent requirement [and the
requirement that the request be submitted in
accordance with any schedule established by the
office pursuant to subsection (c) of this section]
and that a public hearing be held, [thereon,]
provided such request shall be submitted at least
ten business days before the proposed initiation
date of the project. The commissioner shall grant,
modify or deny such request within ninety days or
within ten business days, as the case may be, of
receipt thereof, except as provided for in this
section. Upon the request of the applicant, the
review period may be extended for an additional
fifteen days if the office has requested
additional information subsequent to the
commencement of the review period. The
commissioner may extend the review period for a
maximum of thirty days if the applicant has not
filed, in a timely manner, information deemed
necessary by the office. Failure of the office to
act thereon within such review period shall be
deemed approval of such request. The ninety-day
review period, pursuant to this section, for an
application filed by a hospital, as defined
[under] IN section 19a-490, and licensed as a
short-term acute-care general hospital or a
children's hospital by the Department of Public
Health OR AN AFFILIATE OF SUCH A HOSPITAL OR ANY
COMBINATION THEREOF, shall not apply if, in the
certificate of need application or request, the
hospital OR APPLICANT projects [that the
implementation of such application or request will
require future budget adjustments] EITHER (1)
THAT, FOR THE FIRST THREE YEARS OF OPERATION TAKEN
TOGETHER, THE TOTAL IMPACT OF THE PROPOSAL ON THE
OPERATING BUDGET OF THE HOSPITAL OR AN AFFILIATE
OR ANY COMBINATION THEREOF WILL EXCEED ONE PER
CENT OF THE ACTUAL OPERATING EXPENSES OF THE
HOSPITAL FOR THE MOST RECENTLY COMPLETED FISCAL
YEAR AS FILED WITH THE OFFICE, OR (2) THAT THE
TOTAL CAPITAL EXPENDITURE FOR THE PROJECT WILL
EXCEED FIFTEEN MILLION DOLLARS. IF THE OFFICE
DETERMINES THAT AN APPLICATION IS NOT SUBJECT TO
THE NINETY-DAY REVIEW PERIOD PURSUANT TO THIS
SUBSECTION, IT SHALL REMAIN SO EXCLUDED FOR THE
ENTIRE PERIOD OF THAT APPLICATION, EVEN IF THE
APPLICATION OR CIRCUMSTANCES CHANGE AND THE
APPLICATION NO LONGER MEETS THE STATED TERMS OF
THE EXCLUSION. The office shall adopt regulations
to establish an expedited hearing process to be
used to review requests by any facility or
institution for approval of a capital expenditure
to establish an energy conservation program or to
comply with requirements of any federal, state or
local health, fire, building or life safety code
OR FINAL COURT ORDER. The office shall adopt
regulations in accordance with the provisions of
chapter 54 to provide for the waiver of a hearing,
for any part of a request by a facility or
institution for a capital expenditure, provided
such facility or institution and the office agree
upon such waiver.
[(b) Except as provided for in subsection (a)
of this section, any person]
(c) NOTWITHSTANDING SECTION 4 OR 5 OF THIS
ACT, EACH PERSON OR FACILITY, OTHER THAN A HEALTH
CARE OR STATE HEALTH CARE FACILITY OR INSTITUTION
SUBJECT TO SUBSECTION (a) OF THIS SECTION,
proposing to acquire OR REPLACE imaging equipment
OR A LINEAR ACCELERATOR, requiring a capital
expenditure, as defined in regulations adopted
pursuant to section 19a-643, AS AMENDED BY SECTION
10 OF THIS ACT, in excess of four hundred thousand
dollars, including the leasing OR DONATION of such
equipment and facility and including all capital
expenditures, as defined in regulations adopted
pursuant to said section, associated with the
provision of the imaging service [, which imaging
equipment will not be owned by or located in a
health care facility or institution, or state
health care facility or institution,] OR OPERATION
OF A LINEAR ACCELERATOR, shall submit a request
for approval of any such imaging equipment OR
LINEAR ACCELERATOR acquisition pursuant to the
provisions of subsection (a) of this section. IN
DETERMINING THE CAPITAL COST OR EXPENDITURE FOR AN
APPLICATION UNDER THIS SECTION OR SECTION 19a-638,
AS AMENDED BY SECTION 2 OF THIS ACT, THE OFFICE
SHALL USE THE GREATER OF (1) THE FAIR MARKET VALUE
OF THE EQUIPMENT AS IF IT WERE TO BE USED FOR
FULL-TIME OPERATION, WHETHER OR NOT THE EQUIPMENT
IS TO BE USED, SHARED OR RENTED ON A PART-TIME
BASIS, OR (2) THE TOTAL VALUE OR ESTIMATED VALUE
DETERMINED BY THE OFFICE OF ANY CAPITALIZED LEASE
COMPUTED FOR A THREE-YEAR PERIOD. EACH METHOD
SHALL INCLUDE THE COSTS OF ANY SERVICE OR
FINANCING AGREEMENTS PLUS ANY OTHER COST
COMPONENTS OR ITEMS THE OFFICE SPECIFIES IN
REGULATIONS, ADOPTED IN ACCORDANCE WITH CHAPTER
54, OR DEEMS APPROPRIATE.
[(c)] (d) Notwithstanding the provisions of
section 19a-638, AS AMENDED BY SECTION 2 OF THIS
ACT, or subsection (a) of this section, [any] NO
community health center, as defined in section
19a-490a, shall [not] be subject to the provisions
of said SECTION 19a-638 OR subsection (a) OF THIS
SECTION if the community health center is: (1)
Proposing a capital expenditure not exceeding one
million dollars; [and] (2) EXCLUSIVELY PROVIDING
PRIMARY CARE OR DENTAL SERVICES; AND (3) EITHER
(A) one-third or more of the cost of [such] THE
PROPOSED project is financed by the state of
Connecticut, [or (2)] (B) THE PROPOSED PROJECT IS
receiving funds from the Department of Public
Health, [and] OR (C) THE PROPOSED PROJECT is
located in an area designated by the federal
Health Resources and Services Administration as a
health professional shortage area, a medically
underserved area or an area with a medically
underserved population. EACH COMMUNITY HEALTH
CENTER SEEKING AN EXEMPTION UNDER THIS SUBSECTION
SHALL PROVIDE THE OFFICE WITH DOCUMENTATION
VERIFYING TO THE SATISFACTION OF THE OFFICE,
QUALIFICATION FOR THIS EXEMPTION. EACH COMMUNITY
HEALTH CENTER PROPOSING TO PROVIDE ANY SERVICE
OTHER THAN A PRIMARY CARE OR DENTAL SERVICE AT ANY
LOCATION, INCLUDING A DESIGNATED COMMUNITY HEALTH
CENTER LOCATION, SHALL FIRST OBTAIN A CERTIFICATE
OF NEED FOR SUCH ADDITIONAL SERVICE IN ACCORDANCE
WITH THIS SECTION AND SECTION 19a-638, AS AMENDED
BY SECTION 2 OF THIS ACT. EACH SATELLITE,
SUBSIDIARY OR AFFILIATE OF A FEDERALLY QUALIFIED
HEALTH CENTER, IN ORDER TO QUALIFY UNDER THIS
EXEMPTION, SHALL: (i) BE PART OF A FEDERALLY
QUALIFIED HEALTH CENTER, THAT MEETS THE
REQUIREMENTS OF THIS SUBSECTION; (ii) EXCLUSIVELY
PROVIDE PRIMARY CARE OR DENTAL SERVICES; AND (iii)
BE LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA
OR A MEDICALLY UNDERSERVED AREA. IF THE
SUBSIDIARY, SATELLITE OR AFFILIATE DOES NOT SO
QUALIFY, IT SHALL OBTAIN A CERTIFICATE OF NEED.
[(d)] (e) Notwithstanding the provisions of
section 19a-638, AS AMENDED BY SECTION 2 OF THIS
ACT, SUBSECTION (a) OF SECTION 4 OF THIS ACT, or
subsection (a) of this section, no school-based
health care center shall be subject to the
provisions of SECTION 19a-638, AS AMENDED BY
SECTION 2 OF THIS ACT OR subsection (a) of this
section if the center: (1) Is or will be licensed
by the Department of Public Health as an
outpatient clinic; (2) has been approved by the
Department of Public Health as meeting its
standard model for comprehensive school-based
health centers; (3) proposes capital expenditures
not exceeding one million dollars and does not
exceed such amount; (4) once operational,
continues to operate and provide services in
accordance with the department's standard model
for comprehensive school-based health centers; and
(5) is or will be located entirely on the property
of a functioning school.
[(e)] (f) In conducting its activities under
this section, [and] section 19a-638, AS AMENDED BY
SECTION 2 OF THIS ACT OR UNDER BOTH SECTIONS, the
office may hold hearings on applications of a
similar nature at the same time. [The office may
adopt regulations in accordance with the
provisions of chapter 54, to establish a schedule
for the submission of such applications which (1)
requires applications to be submitted in cycles
that allow applications to be heard and reviewed
at times when hospital budget reviews are not in
progress, and (2) may provide for all completed
applications pertaining to similar types of
services, facilities or equipment affecting the
same health service area to be considered in
relation to each other and reviewed at least twice
a year.]
Sec. 4. (NEW) (a) Except as required in
subsection (b) of this section, the provisions of
section 19a-638 of the general statutes, as
amended by section 2 of this act, and subsection
(a) of section 19a-639 of the general statutes, as
amended by section 3 of this act, shall not apply
to: (1) An outpatient clinic or program operated
exclusively by, or contracted to be operated
exclusively for, a municipality or municipal
agency, a health district, as defined in section
19a-240 of the general statutes, or a board of
education; (2) a residential facility for the
mentally retarded licensed pursuant to section
17a-227 of the general statutes and certified to
participate in the Title XIX Medicaid program as
an intermediate care facility for the mentally
retarded; (3) an outpatient rehabilitation service
agency that was in operation on January 1, 1998,
that is operated exclusively on an outpatient
basis and that is eligible to receive
reimbursement under section 17b-243 of the general
statutes; (4) a clinical laboratory; (5) an
assisted living services agency; (6) an outpatient
service offering chronic dialysis; (7) a program
of ambulatory services established and conducted
by a health maintenance organization; (8) a home
health agency; (9) a clinic operated by the
Americares Foundation; (10) a nursing home; (11) a
residential care home; or (12) a rest home.
However, the exemptions provided in this section
shall not apply when a nursing home, residential
care home or rest home is, or will be created,
acquired, operated or in any other way related to
or affiliated with, or under the complete or
partial ownership or control of a facility or
institution or affiliate subject to the provisions
of section 19a-638 of the general statutes, as
amended by section 2 of this act, or subsection
(a) of section 19a-639 of the general statutes, as
amended by section 3 of this act.
(b) Each health care facility or institution
exempted under this section shall register with
the office by filing the information required by
subdivision (4) of subsection (a) of section
19a-638 of the general statutes, as amended by
section 2 of this act, for a letter of intent at
least ten business days but not more than sixty
calendar days prior to commencing operations and
prior to changing, expanding, terminating or
relocating any facility or service otherwise
covered by section 19a-638 of the general
statutes, as amended by section 2 of this act,
subsection (a) of section 19a-639 of the general
statutes, as amended by section 3 of this act, or
covered by both sections or subsections, except
that, if the facility or institution is in
operation on the effective date of this act, said
information shall be filed not more than sixty
days after said date. Not later than ten business
days after the office receives a completed filing
required under this subsection, the office shall
provide the health care facility or institution
with written acknowledgement of receipt. Such
acknowledgment shall constitute permission to
operate or change, expand, terminate or relocate
such a facility or institution or to make an
expenditure consistent with an authorization
received under subsection (a) of section 19a-639
of the general statutes, as amended by section 3
of this act until the next September thirty. Each
entity exempted under this section shall renew its
exemption annually by filing current information
each September.
Sec. 5. (NEW) (a) The Commissioner of the
Office of Health Care Access or the commissioner's
designee may grant an exemption from the
requirements of section 19a-638 of the general
statutes, as amended by section 2 of this act, or
subsection (a) of section 19a-639 of the general
statutes, as amended by section 3 of this act, or
both, for any nonprofit facility, institution or
provider seeking to engage in any activity, other
than the termination of a service or a facility,
otherwise subject to said section or subsection
if:
(1) The nonprofit facility, institution or
provider is proposing a capital expenditure of not
more than one million dollars and the expenditure
does not in fact exceed one million dollars;
(2) The activity meets a specific service need
identified by a state agency or department and
confirmed as a current need by the Office of
Health Care Access; and
(3) The commissioner, executive director,
chairman or chief court administrator of the state
agency or department that has identified the
specific need confirms, in writing, to the office
that (A) the agency or department has identified a
specific need with a detailed description of that
need and that the agency or department believes
that the need continues to exist, (B) the activity
in question meets all or part of the identified
need and specifies how much of that need the
proposal meets, (C) in the case where the activity
is the relocation of services, the agency or
department has determined that the needs of the
area previously served will continue to be met in
a better or satisfactory manner and specifies how
that is to be done, (D) in the case where the
activity is the transfer of all or part of the
ownership or control of a facility or institution,
the agency or department has investigated the
proposed change and the person or entity
requesting the change and has determined that the
change would be in the best interests of the state
and the patients or clients, and (E) the activity
will be cost-effective and well managed.
(b) A nonprofit facility, institution or
provider seeking an exemption under this section
shall provide the office with any information it
needs to determine exemption eligibility. An
exemption granted under this section shall be
limited to part or all of any services, equipment,
expenditures or location directly related to the
need or location that the state agency or
department has identified.
(c) The office may revoke or modify the scope
of the exemption at any time following a public
review that allows the state agency or department
and the nonprofit facility, institution or
provider to address specific, identified, changed
conditions or any problems that the state agency,
department or the office has identified. A party
to any exemption modification or revocation
proceeding and the original requesting agency
shall be given at least fourteen calendar days
written notice prior to any action by the office
and shall be furnished with a copy, if any, of a
revocation or modification request or a statement
by the office of the problems that have been
brought to its attention. If the requesting
commissioner, executive director, chairman or
chief court administrator or the Commissioner of
Health Care Access certifies that an emergency
condition exists, only forty-eight hours written
notice shall be required for such modification or
revocation action to proceed.
Sec. 6. (NEW) Notwithstanding the provisions
of section 19a-638, as amended by section 2 of
this act, or section 19a-639, as amended by
section 3 of this act, prior to October 1, 2000,
the office may waive the requirements of those
sections and grant a certificate of need to any
health care facility or institution or any state
health care facility for purchases necessary for
year-2000 computer capability:
(1) The purchase is for physical plant or
nonmedical equipment and the total aggregate cost
under this subdivision is less than three million
dollars;
(2) The purchase is for computer diagnostic or
therapeutic medical equipment components or
medical equipment year-2000 capability and the
total aggregate cost for all equipment and
components under this subdivision is less than two
million dollars; or
(3) The purchase is for computer hardware or
software that is used for data collection or to
interface between medical equipment and data
equipment and the data equipment is to be used for
medical records, data collection, data storage,
business functions or other similar uses as part
of an information system or project and the total
aggregate cost under this subdivision is less than
three million dollars.
Sec. 7. (NEW) Notwithstanding the provisions
of section 19a-638, as amended by section 2 of
this act, or section 19a-639, as amended by
section 3 of this act, the office may waive the
requirements of those sections and grant a
certificate of need to any health care facility or
institution or any state health care facility,
institution or provider proposing to replace major
medical equipment, imaging equipment or a linear
accelerator if:
(1) The facility, institution or provider has
previously obtained a certificate of need for the
equipment or accelerator being replaced;
(2) The replacement value or expenditure for
the replacement equipment or accelerator is not
more than the original cost plus an increase of
ten per cent for each twelve-month period that has
elapsed since the date of the original certificate
of need; and
(3) The replacement value or expenditure is
less than two million dollars.
Sec. 8. Subsection (a) of section 19a-653 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(a) (1) Any [health care facility or
institution, or] health care provider which owns,
operates or is seeking to acquire a [CAT] COMPUTER
AXIAL TOMOGRAPHY (CT) scanner, [or] medical
imaging equipment, OR A LINEAR ACCELERATOR OR ANY
HEALTH CARE FACILITY, INSTITUTION OR PROVIDER THAT
IS required to file data OR INFORMATION UNDER ANY
PUBLIC OR SPECIAL ACT OR under chapter 368z [,] or
any regulation adopted or order issued thereunder,
which fails to so file within prescribed time
periods, shall be subject to a civil penalty of up
to one thousand dollars a day for each day such
information is missing, incomplete or inaccurate.
Any civil penalty authorized by this section shall
be imposed by the Office of Health Care Access in
accordance with subsections (b) to (e), inclusive,
of this section.
(2) IF AN APPLICANT OR PROVIDER IS UNSURE
WHETHER A CERTIFICATE OF NEED IS REQUIRED UNDER
SECTION 19a-638, AS AMENDED BY SECTION 2 OF THIS
ACT, OR SECTION 19a-639, AS AMENDED BY SECTION 3
OF THIS ACT, OR UNDER BOTH SECTIONS, IT SHALL SEND
A LETTER TO THE OFFICE DESCRIBING THE PROJECT AND
REQUESTING THAT THE OFFICE MAKE SUCH A
DETERMINATION. A PERSON MAKING A REQUEST FOR A
DETERMINATION AS TO WHETHER A CERTIFICATE OF NEED,
WAIVER OR EXEMPTION IS REQUIRED SHALL PROVIDE THE
OFFICE WITH ANY INFORMATION THE OFFICE REQUESTS AS
PART OF ITS DETERMINATION PROCESS.
Sec. 9. Subsection (c) of section 19a-643 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(c) The regulations adopted by the Office of
Health Care Access concerning requests or
proposals pursuant to [sections 19a-638 and]
SECTION 19a-639, AS AMENDED BY SECTION 3 OF THIS
ACT, shall include a fee schedule for certificate
of need review under section [19a-638 or] 19a-639,
AS AMENDED BY SECTION 3 OF THIS ACT. The fee
schedule shall (1) contain a minimum filing fee
for all applications under said [sections] SECTION
19a-639, (2) be based on a percentage of the
requested authorization in addition to the minimum
filing fee, and (3) apply to new requests and
requests for modification of prior decisions
[under said sections] IF THE MODIFICATION REQUEST
HAS A PROPOSED ADDITIONAL COST OF ONE HUNDRED
THOUSAND DOLLARS OR MORE BEYOND THE ORIGINAL
AUTHORIZATION AMOUNT, OR IF THE MODIFICATION
REQUEST AGGREGATED WITH ANY OTHER PRIOR
MODIFICATION REQUESTS TOTALS ONE HUNDRED THOUSAND
DOLLARS OR MORE. The fee schedule shall be
reviewed annually and adjusted as necessary.
Sec. 10. Subsection (b) of section 17a-451b of
the general statutes, as amended by public act
97-94, is repealed and the following is
substituted in lieu thereof:
(b) Notwithstanding the provisions of the
general statutes or any special act, the
consolidation program, each project, each closure
and each contract entered into in connection with
a project shall be exempt from the provisions of
sections 4b-57, 4b-58, AS AMENDED, and 4b-91, AS
AMENDED, and from the requirements for approval of
a request or application provided for in
[subsections (a) to (d), inclusive, of] section
19a-638, AS AMENDED BY SECTION 2 OF THIS ACT, and
in subsection (a) of section 19a-639, AS AMENDED
BY SECTION 3 OF THIS ACT, provided (1) the project
begins no later than June 30, 1999; (2) the
project is completed no later than June 30, 2002;
(3) the cost of the project does not exceed
thirty-six million dollars; and (4) the
Commissioner of Mental Health and Addiction
Services certifies in writing to the Secretary of
the Office of Policy and Management that the
project meets the criteria of public act 95-257*
and upon such certification the Secretary of the
Office of Policy and Management shall authorize
the Commissioner of Public Works to implement such
project.
Sec. 11. Subsection (b) of section 17a-451c of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) Notwithstanding any provision of the
general statutes or any special act, a priority
mental health facility project and each contract
entered into in connection with a project shall be
exempt from the provisions of sections 4b-58 and
4b-91, AS AMENDED, and from the requirements for
approval of a request or application provided for
in [subsections (a) to (d), inclusive, of] section
19a-638, AS AMENDED BY SECTION 2 OF THIS ACT, and
in subsection (a) of section 19a-639, AS AMENDED
BY SECTION 3 OF THIS ACT, and sections 22a-1 to
22a-1h, inclusive, AS AMENDED, provided: (1) The
project begins no later than October 1, 1996; (2)
the project is completed no later than July 1,
1998; (3) the cost of the project does not exceed
twenty million dollars; and (4) the Commissioner
of Mental Health and Addiction Services certifies
in writing to the Secretary of the Office of
Policy and Management that the project meets the
criteria of this section and upon such
certification the Secretary of the Office of
Policy and Management authorizes the Commissioner
of Public Works to implement such project.
Sec. 12. Subsection (b) of section 17b-351 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) The General Assembly finds evidence of
insufficient need for all the nursing home beds
permitted pursuant to subsection (a) of this
section, but not licensed by the Department of
Public Health and finds allowing unnecessary beds
to be licensed will result in severely damaging
economic consequences to the state and to
consumers. An addition of beds initiated pursuant
to this section shall be licensed no later than
June 9, 1993. A facility which has initiated the
addition of beds but has not obtained licensure of
such beds, may, no later than July 15, 1993, apply
to the Office of Health Care Access for
authorization to proceed with completion of the
additional beds and application for licensure,
provided (A) plans for the additional beds have
been approved by the Department of Public Health
pursuant to section 19-13-D-8t(v)(4) of the Public
Health Code no later than June 1, 1993, and (B)
twenty-five per cent of estimated project costs
have been expended no later than June 9, 1993,
provided project costs may not exceed thirty-one
thousand two hundred eleven dollars per bed. The
office shall issue a decision on such application
within forty-five days of receipt of documentation
necessary to determine expended project costs.
Evidence of project costs expended shall be
submitted in the form of a report prepared by a
certified public accountant having no affiliation
with the owner of the facility or the developer of
the project. The owner of a facility for which
completion of additional beds is not so authorized
may apply to the Commissioner of Social Services
for compensation on or after June 29, 1993, but no
later than September 1, 1993, provided plans for
the additional beds have been approved by the
Department of Public Health no later than June 1,
1993. Such compensation shall be limited to actual
verifiable losses which directly result from the
failure to gain authorization pursuant to this
subsection and which cannot be otherwise recouped
through the mitigating efforts of the owner,
excluding consequential and incidental losses such
as lost profits. In no event may such compensation
exceed project costs. An owner aggrieved by the
amount of compensation determined by the
commissioner may request a hearing in accordance
with the provisions of sections 17b-60 and 17b-61.
This subsection shall not apply to any addition of
beds pursuant to this section which is part of a
construction project that also includes an
addition of beds authorized pursuant to
subdivision (4) of subsection [(k)] (f) of section
19a-638, AS AMENDED BY SECTION 2 OF THIS ACT.
Sec. 13. Subsection (a) of section 17b-353 of
the general statutes, as amended by section 148 of
public act 97-2 of the June 18 special session, is
repealed and the following is substituted in lieu
thereof:
(a) Any facility, as defined in subsection (a)
of section 17b-352, AS AMENDED, which proposes (1)
a capital expenditure exceeding one million
dollars, which increases facility square footage
by more than five thousand square feet or five per
cent of the existing square footage, whichever is
greater, (2) a capital expenditure exceeding two
million dollars, or (3) the acquisition of major
medical equipment requiring a capital expenditure
in excess of four hundred thousand dollars,
including the leasing of equipment or space, shall
submit a request for approval of such expenditure,
with such information as the department requires,
to the Department of Social Services. Any such
facility which proposes to acquire imaging
equipment requiring a capital expenditure in
excess of four hundred thousand dollars, including
the leasing of such equipment, shall obtain the
approval of the Office of Health Care Access in
accordance with [subsection (b) of] section
19a-639, AS AMENDED BY SECTION 3 OF THIS ACT,
subsequent to obtaining the approval of the
Commissioner of Social Services. PRIOR TO THE
FACILITY'S OBTAINING THE IMAGING EQUIPMENT, THE
COMMISSIONER OF THE OFFICE OF HEALTH CARE ACCESS,
AFTER CONSULTATION WITH THE COMMISSIONER OF THE
DEPARTMENT OF SOCIAL SERVICES, MAY ELECT TO
PERFORM A JOINT OR SIMULTANEOUS REVIEW WITH THE
DEPARTMENT OF SOCIAL SERVICES.
Sec. 14. Subsection (c) of section 19a-612b of
the general statutes is repealed and the following
is substituted in lieu thereof:
(c) Any order, decision, agreed settlement, or
regulation of the Commission on Hospitals and
Health Care which is in force on June 30, 1995,
shall continue in force and effect as an order or
regulation of the Office of Health Care Access
until amended, repealed or superseded pursuant to
law. The Commissioner of Health Care Access may
implement policies and procedures consistent with
the provisions of section 4-5, sections 19a-612 to
19a-614, inclusive, AS AMENDED BY THIS ACT,
[subsection (a) of] section 19a-630, AS AMENDED BY
SECTION 1 OF THIS ACT, subsection (b) of section
19a-631, sections 19a-632 [, 19a-633 and 19a-634,
subsection (b) of section 19a-638 and subsection
(a) of section 19a-639] TO 19a-634, INCLUSIVE,
19a-638 AND 19a-639, AS AMENDED BY THIS ACT, while
in the process of adopting the policy or procedure
in regulation form, provided notice of intention
to adopt the regulations is printed in the
Connecticut Law Journal within twenty days of
implementation. The policy or procedure shall be
valid until the time final regulations are
effective.
Sec. 15. Section 19a-644 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) On or before February twenty-eighth
annually, each health care facility and
institution for which a budget was approved or
revenue limits were established under the
provisions of section 19a-640 or section 19a-674,
for the fiscal year ending on September thirtieth
of the immediately preceding year, shall report to
the office with respect to its operations in such
fiscal year, in such form as the office may by
regulation require. Said report shall include: (1)
Average salaries in each department of
administrative personnel, supervisory personnel,
and direct service personnel by job
classification; (2) salaries and fringe benefits
for the ten highest paid positions; (3) the name
of each joint venture, partnership, subsidiary and
corporation related to the hospital; (4) the
salaries paid to hospital employees by each such
joint venture, partnership, subsidiary and related
corporation and by the hospital to the employees
of related corporations; and (5) a breakdown of
hospital and department budgets by administrative,
supervisory and direct service categories, by
total dollars and by full-time equivalent staff.
(b) THE OFFICE SHALL ADOPT REGULATIONS IN
ACCORDANCE WITH CHAPTER 54 TO PROVIDE FOR THE
COLLECTION OF DATA AND INFORMATION IN ADDITION TO
THE ANNUAL REPORT REQUIRED IN SUBSECTION (a) OF
THIS SECTION. SUCH REGULATIONS SHALL PROVIDE FOR
THE SUBMISSION OF INFORMATION ABOUT THE OPERATIONS
OF THE FOLLOWING ENTITIES: PARENT CORPORATIONS
THAT OWN OR CONTROL THE HEALTH CARE FACILITY,
INSTITUTION OR PROVIDER; CORPORATIONS, INCLUDING
LIMITED LIABILITY CORPORATIONS, IN WHICH THE
HEALTH CARE FACILITY, INSTITUTION, PROVIDER, ITS
PARENT, AN AFFILIATE OR ANY COMBINATION THEREOF,
OWNS MORE THAN FIFTY PER CENT OF THE STOCK OR, IN
THE CASE OF NONSTOCK CORPORATIONS, IS THE SOLE
MEMBER; AND ANY PARTNERSHIPS IN WHICH THE HEALTH
CARE FACILITY, INSTITUTION, ITS PARENT OR AN
AFFILIATE OR ANY COMBINATION THEREOF, OWNS A
GREATER THAN FIFTY PER CENT INTEREST.
Sec. 16. Section 17a-678 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Notwithstanding the provisions of sections
19a-638 and 19a-639, (1) a community agency
operating a program in a state institution or
facility, (2) a nonprofit community agency
operating a program, identified as closing a
service delivery system gap in the state-wide
service delivery plan, in a state institution or
facility, and receiving funds from the Department
of Mental Health and Addiction Services, or (3) a
nonprofit substance abuse treatment facility,
identified as closing a service delivery system
gap in the state-wide service delivery plan and
receiving funds from the department, shall not be
required to obtain a certificate of need from the
Office of Health Care Access.
(b) NOTHING IN SUBSECTION (a) OF THIS SECTION
SHALL BE CONSTRUED AS CREATING A CERTIFICATE OF
NEED EXEMPTION FOR THE RELOCATION OR TERMINATION
OF SERVICES.
Sec. 17. This act shall take effect from its
passage.
Approved June 5, 1998