Relating to health facilities and health services including licensing and the certificate of need process, and including effective date provisions

The bill amends the definition of “institutional health facility” by removing a “community mental health facility” and a “birth center” from inclusion in the definition, thereby making these facilities and centers exempt from CON requirements.5 million on January 1, 2023, and increasing to $5 million beginning January 1, 2038, within a 12-month period, and a permanent change (effective for one year or more) in the bed capacity of an institutional health facility. Under the bill, only these services included in the definition are subject to CON requirements. The bill eliminates terms defined and references to these terms in current Code that are no longer necessary due to provisions of the bill including the definitions of “birth center” and “mobile health service”. The bill requires that an application for CON be accompanied by an economic impact statement that includes information required by rule to assist in evaluation of the application. Due to the combining of the department of human services (DHS) and the department of public health (DPH) into HHS, the bill eliminates the requirement that a copy of the application for CON be sent to DHS at the time the application is submitted to DPH. Current law provides that within business days after receipt of an application for a CON, HHS shall examine the application and accept or reject it, and that HHS shall promptly return to the applicant any rejected application, with an explanation of the reasons for its rejection. The bill adds a provision that within days after notifying the applicant of rejection of the application, the applicant may resubmit a revised application for review and shall not be subject to payment of another required application fee. Further, if a subsequent rejection is issued, the applicant shall resubmit the application in accordance with and shall be subject to the procedure and requirements for an initial application. Current law provides that upon acceptance of an application for a CON, HHS shall promptly notify all affected persons in writing that formal review of the application has been initiated, and that notification to those affected persons who are consumers or third-party payers or other payers for health services may be provided notification by distribution of the pertinent information to the news media. The bill amends this provision to eliminate the reference to third-party payers or other payers as they are no longer included in the definition of affected persons, and provides that notification to affected persons who are consumers may be provided by an electronic distribution method available to HHS. The bill also provides that any affected person or that person’s representative may submit written testimony as prescribed by HHS beginning the day the notice of the hearing is given until the day prior to the date of the hearing. The bill eliminates the letter of intent procedure requiring that before applying for a CON, the sponsor of a proposed new institutional health service or changed institutional health service submit to HHS a letter of intent to offer or develop a service requiring a CON, as soon as possible after initiation of the applicant’s planning process and not less than days before applying for a CON and before substantial expenditures to offer or develop the service are made. Under this provision, the letter must include a brief description of the proposed new or changed service, its location, and its estimated cost. If requested by the sponsor, HHS was required to make a preliminary review of the letter and inform the sponsor of any factors likely to result in denial of a CON. The bill also makes a conforming change to eliminate a reference to the letter of intent procedure. The bill provides that failure by HHS to issue a written decision on a CON application within the time required shall constitute approval rather than the current denial of and final administrative action on the application. The bill provides that any administrative rule adopted for determining when it is not feasible to complete formal review of an application for a CON within the time limits specified for HHS’s final decision shall not permit a deferral of more than days, rather than the current days, beyond the time specified for a decision on the final decision, unless both the applicant and HHS agree to a longer deferment. The bill provides for a moratorium on applications for new construction or a permanent change in bed capacity of a nursing facility for an initial period of months, and provides for 6-month extensions of the moratorium. The department may waive the moratorium if the department determines there is a need for specialized needs beds. The department shall make a recommendation to the general assembly regarding continuation of the moratorium by February 1, 2027. DIVISION II —— BIRTH CENTERS. This division of the bill provides for provisional licensing of birth centers and requires the department of inspections and appeals to propose legislation for state licensure of birth centers to be considered by the 2024 session of the general assembly. The division takes effect upon enactment.