PA 10-104—sHB 5027

Higher Education and Employment Advancement Committee

Finance, Revenue and Bonding Committee

AN ACT ESTABLISHING THE UNIVERSITY OF CONNECTICUT HEALTH NETWORK AND CONNECTICUT BIOSCIENCE INITIATIVE

SUMMARY: This act provides funding, under certain conditions, for (1) the construction of a new bed tower and renovations of academic, clinical, and research space at UConn's John Dempsey Hospital (JDH) and (2) the development of regional health network initiatives.

The total cost is $362 million. The act authorizes the issuance of $237 million in new state bonds of which $207 million will be issued under the UConn 2000 infrastructure improvement program, which the act extends from 2016 to 2018. It also reallocates $25 million in existing UConn 2000 funds to pay for planning and design costs of the new JDH bed tower and requires a contribution of $100 million in federal, private, or other nonstate money. The act prohibits the $237 million in new bonds from being issued and construction of the bed tower from commencing until the $100 million is received. It establishes June 30, 2015 as the deadline for receiving the $100 million.

The act also establishes provisions for transferring, from JDH to Connecticut Children's Medical Center (CCMC), licensure and control of 40 neonatal intensive care unit (NICU) beds. It confers the benefits of an enterprise zone on certain businesses in Hartford and parts of Farmington, New Britain, and Bristol, and it requires UConn to report biennially on the progress of the health network initiative and the JDH construction and renovation.

EFFECTIVE DATE: Upon passage, except for the section on enterprise zones, which is effective July 1, 2010.

COSTS AND FUNDING SOURCES

Table 1 summarizes the cost of each project in the act, the sources of funds, and the conditions for their use.

Table 1: Costs, Funding Sources, and Conditions on Use

Project

Amount

(in millions)

Description of funds

Conditions

Planning and Design

$25

Funds shifted from an existing UConn 2000 project

None

New Construction and Renovation at UConn Health Center

207

New UConn 2000 bonds

May not be issued unless $100 million in nonstate money is received.

100

Federal, private, or other nonstate money

Must be received by June 30, 2015

UConn health network initiative

30

State GO bonds, outside of UConn 2000

May not be issued unless $100 million in nonstate money is received.

TOTAL

$362

$237 million in new state bonding

 

RENOVATIONS AND NEW BED TOWER AT JDH

Under the act, “University of Connecticut Health Center (UCHC) new construction and renovation” means the planning, design, development, financing, construction, renovation, furnishing, equipping, and completion of clinical, academic, and research space at JDH. It specifically includes the construction of a new bed tower, increasing the number of licensed beds from 224 to a maximum of 234, including newborn bassinettes.

The act adds the UCHC construction and renovation to the list of enumerated UConn 2000 infrastructure improvement projects and authorizes $207 million in new bonding. The issuance of these bonds is contingent on the receipt of $100 million in nonstate money.

The act also reallocates $25 million from existing UConn 2000 authorizations for main building renovations for the planning and design costs associated with the JDH construction and renovation. This reallocation is not contingent on the receipt of the $100 million in nonstate money.

UCONN HEALTH NETWORK INITIATIVE

The act authorizes the issuance of up to $30 million in state general obligation (GO) bonds to fund the UConn health network initiatives (see Table 2). The issuance of these bonds is contingent on the receipt of the $100 million in nonstate money.

Under the act, the UConn health network initiatives include:

1. a simulation and conference center on the Hartford Hospital campus that uses new technologies and simulated care settings to educate and train healthcare professionals;

2. a Connecticut Institute for Primary Care at the Saint Francis Hospital and Medical Center campus that is intended to increase the number of primary care providers in the state;

3. an institute for clinical and translational science (for the translation of scientific discoveries into practical applications) at UCHC;

4. a comprehensive cancer center to expand clinical trials and advance patient care in the Hartford region;

5. a UConn-sponsored health disparities institute intended to enhance research and the delivery of care to minority and medically underserved people;

6. the Connecticut Institute for Nursing Excellence at the UConn School of Nursing that will explore ways to enhance the recruitment, education, and retention of nurses and nursing faculty;

7. improvements at the Hospital of Central Connecticut, to include (a) the planning, design, land acquisition, development, and construction of a cancer treatment center constructed by, or in partnership with, the hospital and located entirely within the city of New Britain, (b) renovations and upgrades to the hospital's oncology unit, and (c) a permanent regional phase one clinical trials unit at the hospital, provided that a certificate of need is approved for this purpose; and

8. patient room renovations at Bristol Hospital.

The act also requires the Hospital of Central Connecticut to repay its share of the proceeds from the bond sale in the event the cancer treatment center is built in whole or in part outside the legal boundaries of the city of New Britain. Further, PA 10-179 specifies that the simulation and conference center is to be run exclusively by Hartford Hospital.

Table 2: UConn Health Network Initiative Projects

Project

Location

Bond Authorization (in millions)

Simulation and conference center

Hartford Hospital

$20

Primary care institute

Saint Francis Hospital and Medical Center

Institute for clinical and translational science

UCHC

Comprehensive cancer center

Hartford region

Health disparities institute

Not specified

Hospital of Central Connecticut

New Britain

5

Institute for nursing excellence

UConn School of Nursing

3

Bristol Hospital

Bristol

2

TOTAL

 

30

Twenty million dollars of the $30 million bond authorizations were revised by PA 10-179, which authorized $5 million apiece for the simulation and conference center and the primary care institute and $10 million to be shared among the (1) institute for clinical and translational science, (2) comprehensive cancer center, and (3) health disparities institute. It left unchanged the authorizations for the Hospital of Central Connecticut, institute for nursing excellence, and Bristol Hospital.

Institute for Primary Care Innovation

The act establishes the Connecticut Institute for Primary Care Innovation as a collaborative enterprise between the UConn School of Medicine and Saint Francis Hospital and Medical Center. The institute will be located on the St. Francis campus and focus on research and training relevant to primary care. The act prohibits the institute from engaging in or managing the delivery of healthcare services, and it requires the UConn School of Medicine and St. Francis to enter into an affiliation agreement under which the institute will not be constrained by the Ethical and Religious Directives for Catholic Health Care Services with regard to (1) research and training pertaining to primary care or (2) any report or recommendation generated from such research.

The act also requires the institute to (1) operate in accordance with the requirements and policies of the UConn School of Medicine, the Liaison Committee on Medical Education, and the Accreditation Council for Graduate Medical Education, and (2) disclose any research findings or results concerning medically accepted best practices.

Connecticut Institute for Nursing Excellence

The act establishes the Connecticut Institute for Nursing Excellence at the UConn School of Nursing. The institute's oversight board is chaired by a representative from the UConn School of Nursing, who is appointed by the school's dean. The board also comprises one representative each from:

1. UCHC, appointed by its board of directors;

2. Saint Joseph College, appointed by its president;

3. Yale University School of Nursing, appointed by its dean;

4. Yale-New Haven Hospital, appointed by its president;

5. the regional community-technical college system, appointed by its board of trustees;

6. Connecticut Hospital Association (CHA), appointed by its board of trustees;

7. Hartford Hospital, appointed by its president;

8. Saint Francis Hospital and Medical Center, appointed by its president;

9. a nursing student, appointed by the governor; and

10. a member of the public, appointed by the governor.

The board members must be appointed within 30 days of the issuance of the GO bonds for the institute, and the chairperson may appoint additional members as needed. Board members serve four-year terms, with the exception that the initial terms of the nursing student, member of the public, and the representatives from CHA, Hartford Hospital, and Saint Francis Hospital and Medical Center are two years. Members may not serve more than two consecutive four-year terms.

The act requires the institute to:

1. evaluate and formulate strategies for increasing the retention of nurses and enhancing the education, recruitment, and retention of nursing faculty in Connecticut;

2. help hospitals establish and evaluate a pilot nursing residency program to provide mentoring to first-year, hospital-based nurses;

3. establish and promote master's- and doctorate-level programs to prepare nurses to serve as educators in nursing schools, including providing (a) eligibility for loan forgiveness programs for those nurses who successfully complete such master's-level programs and have been members of a nursing faculty in this state for at least four years, and (b) methods to increase compensation for nurse educators, including scholarships for service;

4. establish an evidence-based research center that reflects the current best science, experiential learning, and clinical knowledge development; and

5. pursue grant funding and philanthropic support for nursing projects.

BONDING

The act (1) authorizes $207 million in new bonding under UConn 2000, (2) extends the bonding for UConn 2000 from 2016 to 2018 and adjusts the annual caps, and (3) extends UConn's control of UConn 2000 projects from June 30, 2016 until June 30, 2018 or until the program is completed, whichever is later.

The act cancels UConn's bond authorization for FY 10, reduces the cap for FY 11, increases the caps for FY 12 through FY 16, and extends the program through 2018 as shown in Table 3. Under existing law and the act, any difference between the amount actually issued in any year and the cap can be carried forward to any succeeding fiscal year. Financing transaction costs can be added to the caps.

Table 3: Annual Bond Limits for UConn 2000

FY

Prior Limit

(in millions)

New Limit

(in millions)

Change

(in millions)

2010

$140. 5

$0. 0

($140. 5)

11

146. 5

138. 8

(7. 7)

12

123. 1

157. 2

34. 1

13

114. 5

143. 0

28. 5

14

111. 5

140. 0

28. 5

15

100. 0

128. 5

28. 5

16

90. 9

119. 5

28. 6

17

N. A.

116. 0

116. 0

18

N. A.

91. 0

91. 0

Total

827. 0

1034. 0

207. 0

Bonding Conditions

The issuance of the $237 million in new state bonding is contingent on securing $100 million in nonstate money. The act requires the UConn president and the governor's designee, by June 30, 2011, to notify the Office of Policy and Management (OPM) secretary of the status of the $100 million, and it prohibits any construction on the hospital until that money is received.

The act sets June 30, 2015 as the deadline for receiving the $100 million in nonstate money. If the money is not obtained by that date, all projects under the bill terminate, and the UConn 2000 bonding caps revert to their previous totals.

NICU TRANSFER

The act defines the NICU transfer as the transfer, from JDH to CCMC, of the licensure and control of 40 NICU beds, which remain at JDH. It increases CCMC's licensed bed capacity by 40 while leaving JDH's licensed bed capacity unchanged.

By December 31, 2010, CCMC and JDH must notify the OPM secretary (1) jointly, of their intent to proceed with the NICU transfer or (2) jointly or individually, that they will not pursue it.

By law, the NICU transfer and JDH bed capacity expansion require the issuance of a certificate of need (CON) from the Office of Healthcare Access (OHCA). The act requires OHCA to (1) expedite the CON application process for the NICU transfer, UCHC new construction and renovation, and UConn health network initiatives, specifically by prohibiting any extensions to its 90-day review period for completed CON applications; and (2) treat the NICU transfer and JDH bed capacity expansion as a single project for CON purposes, thus prohibiting the NICU transfer from occurring unless JDH's expansion plans are also approved. Unlike other aspects of the act, the NICU transfer is not contingent on the receipt of $100 million in nonstate money.

The act also maintains the ability of state employees who provide (1) services in the NICU and (2) transport services to JDH to continue to negotiate wages, hours, and other conditions of employment through their bargaining agents. It prohibits any change in the licensure and ownership of the transport services as a result of the NICU transfer.

The act requires the NICU transfer and bed capacity increase to be treated as one project, but if the NICU transfer does not occur, the bill appears to allow UConn to file a CON application solely for the UCHC construction and renovation. In the event this new CON is approved and the $100 million in nonstate money is secured, it appears UConn could proceed with the construction and renovation without undertaking the NICU transfer.

ENTERPRISE ZONE

The act extends the benefits of an enterprise zone to certain businesses and commercial properties in (1) Hartford; (2) certain census blocks and block groups in Farmington; (3) certain census blocks, block groups, and tracts in New Britain; and (4) certain census tracts in Bristol. Generally, these areas are located near JDH, the Hospital of Central Connecticut, or Bristol Hospital. It appears that these blocks, block groups, and tracts are based on the 2000 Census and could change if the boundaries are redrawn after the 2010 Census.

By law, enterprise zone benefits include property tax exemptions, business tax credits, and sales tax exemptions. Under prior law, an eligible business is one that has had fewer than 300 employees at all times during the previous 12 months and is engaged in biotechnology, pharmaceutical, or photonics research, development, or production in the state. The act extends this definition to include businesses engaged in bioscience, which it defines as the study of genes, cells, tissues, and chemical and physical structures of living organisms.

An eligible commercial property is one that an eligible business has owned or leased and used at all times during the preceding 12 months or real property that the Department of Economic and Community Development commissioner or Connecticut Innovations, Incorporated has certified as newly constructed or substantially renovated and expanded primarily for occupancy by one or more eligible businesses.

The act also extends enterprise zone benefits to eligible businesses and commercial properties in any municipality that has a major research university with a bioscience program. Under existing law these benefits apply if the university has programs in biotechnology, pharmaceuticals, or photonics.

REPORTING

The act requires UConn, beginning January 1, 2011 and until the health network initiatives and UCHC construction and renovation are completed, to submit a biennial progress report on these projects. The report must be submitted to the Higher Education, Public Health, Finance, and Appropriations committees.

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