Eliminates requirement for prior approval of certain hospital repair and maintenance construction projects

2 Co-sponsors

• William J. Larkin Jr.
• David J. Valesky

BILL NUMBER:S4992A

Title of bill

An act to amend the public health law, in relation to hospital construction

Purpose

To ensure the state's Certificate of Need (CON) processes are updated and streamlined to promote access to high quality, cost-effective health care services

Summary of provisions

Section 1 of the bill would amend subdivision 1-a of section 2802 of the public health law to specify certain types of projects that would not require CON approval. These projects include routine repair or maintenance, including routine purchases and acquisition of minor equipment; one for one equipment replacements regardless of costs; and non-clinical infrastructure proposals regardless of cost including, but not limited to, replacement of HVAC. While these projects would not require approval, notice of a project would have to be provided to the Commissioner and, where appropriate, written certification statements that the project complies with applicable statutes, codes and regulations and also would add a. new subdivision 1-b of section 2802 to authorize the commissioner of health to waive pre-opening certifications or surveys.

Section 2 of the would make the bill effective 180 days after it becomes law.

Existing law

The public health law was amended in 2010 to provide that projects that are limited to the correction of cited deficiencies do not require approval, and to provide the Commissioner with clear authority to eliminate other unspecified categories of projects from being subject to certificate of need review.

Current law does not address the issue of pre-opening certifications or surveys; however, it is the practice of the DOH to perform these certifications and surveys.

Justification

The CON process can be an effective health planning tool to ensure a fair and cost-effective distribution of quality health care resources across New York. Unfortunately, the process is overburdened by unnecessary process steps that could be eliminated without impacting patient safety or placing undue stress on the state's finances.

As state staffing levels decrease, it is imperative to focus reviewers' energies on high-cost, complex projects that could benefit from a thorough state analysis and public debate. More routine projects that do not involve new services or the addition of capacity should not have to undergo the same level of scrutiny.

Lack of timeliness in the current review process hampers providers' ability to adjust services to respond to market changes, patient preferences, new technologies, and evolving modes of care. project delays often lead to increased project costs (e.g. labor, construction materials), a portion of which is directly borne by the state through the Medicaid capital reimbursement structure.

The types of projects that this legislation proposes to be exempt from CON approval are projects that health facilities generally must undertake to maintain their physical plants and to ensure the safety of the patients they serve. This legislation would affect projects that are almost always approved, but are subject to unnecessary delays.

This legislation would result in modest efficiencies to the current review process and would allow DOH to focus its efforts and limited resources on those more consequential projects that appropriately require more attention. Therefore, this legislation would benefit DOH, health facilities, and the patients they serve.

Legislative history

Part of S.7589-A of 2010, a more comprehensive CON bill - reported to health committee

Fiscal implications

State savings due to the need for fewer CON reviews.

Effective date

This act shall take effect on the one hundred and eightieth day after it shall become law.