The governor’s task force charged with finding ways to streamline consideration of mergers and acquisitions of health care facilities while also improving quality of care and access has completed its draft report and recommendations that will be submitted to the governor’s office Friday.
After nearly a year of work, the Certificate of Need Task Force has adopted 18 recommendations and subsections on ways to improve the regulatory process on a wide range of things, including purchase and conversion of hospitals; opening and closure of nursing homes, radiology or imaging sites, freestanding clinics, and emergency rooms; acquiring equipment; and reducing or relocating services.
Gov. Dannel P. Malloy issued an executive order last February that not only created the task force, but also imposed a moratorium on decisions by the Department of Public Health and the Department of Social Services on some hospital acquisitions and mergers that results in two parties owning at least 20 percent of Connecticut’s hospital market.
Headed by Lt. Gov. Nancy Wyman, the task force was initially given a Dec. 1 deadline to recommend how to improve the existing certificate-of-need program — now run primarily by the Office of Healthcare Access and, when charitable foundations are involved, the attorney general’s office.
But the 16-member panel of experts that includes government agency heads, nonprofit advocates, and industry officials, was given an extension as the group haggled up until its last meeting Monday on the wording of some recommendations.
Some of the major issues of debate surrounded recommendations that could extend the review process, strengthen OHCA’s regulatory powers, and create better transparency and public input into the process.
Others involved increased costs for such things as added staff to carry out the recommendations — something that Malloy’s budget office says it can’t support during the current fiscal crisis.
Some of the recommendations include:
• Applying Certificate of Need Task Force review when terminating hospital emergency departments, select inpatient or outpatient services, and mental health/substance abuse treatment services of hospitals and other entities. The need to review termination of outpatient surgical facilities was dropped.
• Revising OHCA’s current 12 guidelines on acquiring equipment to focus on protecting access to under-served areas; ensuring services are provided to Medicaid patients; increasing the role of state health planning; and limiting actions that adversely impact the health care market by removing barriers and fostering a competitive environment.
• Applying expanded CON review to all hospital mergers and acquisitions — and not only those involving for-profit entities and larger hospital systems as current law requires — and including a financial analysis of a buyer’s entire organization and its holdings in other states.
Monday was the commission’s final meeting to vote on recommendations that should be submitted to the governor before the moratorium expires.
The draft document will now go to the governor and the General Assembly for consideration and possible legislation.
The temporary halt in the CON process didn’t affect Prospect Medical Holdings’ $105 million acquisition of Eastern Connecticut Health Network, the parent company of Manchester Memorial and Rockville General hospitals, which was completed Oct. 1.
Malloy’s directive did, however, affect applications from Yale New Haven Health System, which accounted for nearly a third of the state’s hospital revenue in 2014, as it attempts to acquire Lawrence & Memorial Hospital in New London.
Hartford HealthCare, with the second largest share of the state’s overall hospital revenue at roughly 23 percent, also was affected by the cessation.
