Public Health Committee
JOINT FAVORABLE REPORT
AN ACT REQUIRING CERTIFICATE OF NEED APPROVAL FOR THE TERMINATION OF INPATIENT AND OUTPATIENT SERVICES BY A HOSPITAL.
SPONSORS OF BILL:
Public Health Committee
REASONS FOR BILL:
To require any hospital that seeks to terminate inpatient or outpatient services currently offered to file a certificate of need application with the Office of Health Care Access.
RESPONSE FROM ADMINISTRATION/AGENCY:
Rep. Christopher G. Donovan, Speaker of the House: Last session, changes were made to the Certificate of Need (CON) process that did not require a medical facility to provide any notice to the public prior to discontinuing services. The facility was required to notify the Office of Health Care Access (OHCA) 60 days before the discontinuation of services. This bill restores the CON process and will provide the public adequate notice that services could be eliminated, giving the community an opportunity to give feedback and make plans for accessing alternative services.
Rep. Claire L. Janowski: HB 5048 will restore the public transparency that existed prior to the merger of the Office of Health Care Access (OHCA) with the Department of Public Health. This bill will ensure proper oversight of any hospital that pre-dates the Certificate of Need (CON) process and are no longer subject to the same oversight protections as hospitals that operate under a Certificate of Need without introducing any new changes or restrictions.
NATURE AND SOURCES OF SUPPORT:
Natasha M. Pierre, The Permanent Commission on the Status of Women: HB 5048 would restore oversight to the Office of Health Care Access (OHCA) to require approval of the termination of essential services. This oversight was eliminated when OHCA was merged into the Department of Public Health during the last legislative session.
The Certificate of Need (CON) process ensures that if a hospital planned to eliminate services, it would have to notify the State, and hold a public hearing to get the public's reaction. Without the CON process there is no reliable mechanism to ensure a hospital's plan to eliminate a service will be made known to the community. Restoring oversight to OHCA would ensure that the process is open and accessible to the public.
Lisa D'Abrosca, President, Lawrence and Memorial Hospital RN's, AFT Local 5049:
Several years ago, Lawrence and Memorial Hospital administration attempted to close down the OB-GYN clinic. This clinic provided care to the uninsured and underprivileged individuals in the community. The CON process revealed ahead of time the hospital's intentions, and the detrimental effects it would have on the community. Through combined efforts, the clinic was saved and went on to serve its patients until just recently. With CON reform in place from last session, the hospital was able to significantly reduce services provided by the OB-GYN clinic. Now the members in the community are lacking access to important healthcare. The passage of HB 5048 would prevent similar events from happening in the future.
Mary Consoli, President, Danbury Nurses Union Unit #47: An approval process would allow the State to ensure that services a hospital plans to cut would be available to the people by another agency in that area. Without the approval process, cost cutting measures may be instituted by hospitals that would not be in the best interest of the people for whom they provide services.
NATURE AND SOURCES OF OPPOSITION:
The Stamford Hospital: HB 5048 is inconsistent with the legislation passed last session, to streamline the Certificate of Need (CON) process by reinstating the requirement that hospitals obtain a CON approval prior to terminating any inpatient or outpatient service. This requirement goes beyond the services specifically listed in Connecticut General Statute Section 19a-638 (a) (4) and (6), namely inpatient and outpatient mental health and substance abuse services and an emergency department, which require the Office of Health Care Access (OHCA) approval before a hospital terminates such services. Broadening the scope of the CON process to include the termination of any inpatient or outpatient service, HB 5048 is contradictory to the intent of the CON reform legislation to make this area of State regulation more efficient and cost-effective.
Another area of concern is that this bill is limited to hospitals only. This will place administrative and financial burdens on hospitals. HB 5048 creates an unfair and un-level playing field that adversely affects hospitals and enhances the interest of other providers that would not be subject to the same regulatory process, legal and consulting costs, and associated delays.
The following hospitals submitted testimony similar to The Stamford Hospital:
● Hospital of Saint Rapheal
● The Charlotte Hungerford Hospital
● Yale New Haven Health System
● Saint Francis Hospital and Medical Center
● Eastern Connecticut Health Network (ECHN)
● Lawrence and Memorial Hospital
● The Hospital of Central Connecticut
● Griffin Hospital, Hartford Hospital
● St. Vincent's Medical Center
● Connecticut Hospital Association
Reported by: Lori Littmann