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statutes  is  repealed   and   the   following  is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