SSB 1117

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. The bill amends the definition of “new institutional health service” or “changed institutional health service” by striking many of the services included in current Code and only including: the construction, development, or other establishment of a new institutional health facility regardless of ownership; relocation of an institutional health facility; any capital expenditure, lease, or donation by or on behalf of an institutional health facility in excess of $5 million 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 under the Code chapter that are no longer necessary due to provisions of the bill including the definitions of “birth center” and “mobile health service”. _____ The bill amends the qualifications for members of the HFC by retaining the requirement that members of the council be chosen so that the council as a whole is broadly representative of various geographical areas of the state, but eliminating the requirements that no more than three members are affiliated with the same political party and that each council member be a person who has demonstrated by prior activities an informed concern for the planning and delivery of health services.16 requires that all appointive bodies if not otherwise provided by law shall be bipartisan in their composition. The bill amends HFC member appointment provisions to provide that terms of council members shall be three rather than six years, and by eliminating the requirements that a member shall be appointed in each odd-numbered year to succeed each member whose term expires in that year, that vacancies shall be filled by the governor for the balance of the unexpired term, and that each appointment to the council is subject to confirmation by the senate. The bill also removes the provision that a council member is ineligible for appointment to a second consecutive term, unless first appointed to an unexpired term of three years or less. With regard to the chairperson of the HFC, the bill provides that the council, rather than the governor, shall designate one of the council members as chairperson. The bill amends the fee requirements relating to the application for a CON to provide that instead of a fee equivalent to three-tenths of percent of the anticipated cost of the project with a minimum fee of $600 and a maximum fee of $21,000, the fee is $1,000. The bill retains the provision that provides that if an application is voluntarily withdrawn within calendar days after submission, percent of the application fee shall be refunded, but eliminates the proportionate refund of any portion of the fee if the application is voluntarily withdrawn beyond that 30-day period. _____ The bill requires that an application 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 the department of health and human services (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. _____ 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 amends the time frames related to the HFC’s review of CON applications. The bill requires that HHS shall complete its formal review of the application within days, rather than the current days, after acceptance of the application. The bill also provides that failure by the council 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 the HFC’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 the department agree to a longer deferment.