Senate Bill S4992

                                BILL NUMBER:S4992

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 state that pre-opening certifications or surveys would not be
required before approved CON projects can be operationalized.
              

Instead, the provider would submit an appropriate certification
statement of compliance. In addition, the DOH would assess compliance
during DOH's next survey of the hospital.

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.