HB 715 -- CERTIFICATE OF NEED

SPONSOR:  Foley

COMMITTEE ACTION:  Voted "do pass" by the Committee on Social
Services, Medicaid and the Elderly by a vote of 8 to 4 with 1
present.

This bill makes numerous changes and additions to the Missouri
Certificate of Need Law.  The bill:

(1)  Adds the Director of the Department of Social Services and
the Director of Senior Services and Regulations in the
Department of Health to the Missouri Health Facilities Review
Committee;

(2)  Removes new hospital facilities from the list of facilities
required to obtain a certificate of need when the facility
provides for less than what was sought in the initial
application;

(3)  Requires the Health Facilities Review Committee to notify
applicants, conduct public hearings, issue written findings, and
consider certain issues in the review certification process;

(4)  Requires individuals who propose the development of an
acute care service or a first-time service to submit a letter of
intent to the committee and that an application fee be paid for
each application for review certification;

(5)  Allows applicants to file an appeal within 30 days of the
committee's decision, allows the appeal to be heard de novo by
the administrative hearing commissioner, and establishes the
venue for subsequent appeals;

(6)  Requires individuals who propose to develop or offer a new
institutional acute care service or a first-time service to
obtain a review certification from the committee prior to
offering services;

(7)  Requires that a review certification be obtained when there
is a proposal to add new beds to an existing hospital;

(8)  Requires the committee's consent to project cost increases
in excess of 10% over the initial estimate;

(9)  Requires applicants who have been granted a review
certification to provide periodic reports to the committee until
the project is completed; and

(10)  Requires acute care facilities to have a review
certification to be licensed by the state or to be granted or
appropriated funds.

FISCAL NOTE:  Estimated Income to General Revenue Fund of
$49,392 in FY 2002, FY 2003, and FY 2004.

PROPONENTS:  Supporters say that the bill simplifies the
Certificate of Need process, keeps things on a level playing
field, and streamlines regulations for routine projects.  The
Certificate of Need law holds down Medicaid costs, saves money,
ensures accountability, protects the community, and promotes
planning.

Testifying for the bill were Representative Ladd Baker; BJC
Health Care Systems; Unity Health System; Heartland Health; and
Missouri Health Facilities Review Committee.

OPPONENTS:  Those who oppose the bill say that extending the
sunset date and lowering the threshold stifles competition and
raises costs.  Small hospitals and those in rural areas will be
disadvantaged by the bill, as will hospitals in areas that
border states with fewer reviews or no Certificate of Need law.
The open market should determine the needs for facilities.

Testifying against the bill were St. Luke's Shawnee Mission
Health System; Tenet Health Care; and Missouri State Medical
Association.

Amy Woods, Legislative Analyst

Missouri House of Representatives
Last Updated November 26, 2001 at 11:45 am