Certificate of Need: Environmental Scan

What defines when a CON is required in 2015?

CON state law DHEC Regulation 61-15 DHEC State Health Plan

When is a CON required in 2015:

Construction of a new healthcare facility Adding beds or a change in a license Capital expenditure for adding or expanding a

health facility or health service with standards in the State Health Plan

Capital expenditure in excess of regulation ($2 million)

Purchase of equipment in excess of regulation ($600,000)

When is a CON not required in 2015:

Equipment or service used strictly for research Physician offices Facilities operated by state or federal

government Dialysis centers Replacement of like equipment Certain medical projects & services

Urgent care centers, MOB, MRI

Certain non-medical projects HVAC, Parking garage, computer system

Specific facilities, beds, health services & equipment in DHEC State Health Plan:

Projections of need for additional healthcare facilities, beds, health services & equipment

Inpatient health facilities and beds: Acute care hospital LTAC, PLTAC Psychiatric hospitals and psychiatric beds Rehab hospitals and rehab beds Residential treatment facilities for children, adolescents Nursing homes and beds

Specific facilities, beds, health services and equipment in DHEC State Health Plan Health services connected with hospitals:

Obstetrical and neonatal Pediatric Cardiac cath labs Open heart Freestanding emergency services

Other health services and equipment: PET PET/CT PEM Linear accelerator ASC Inpatient hospice Home health agencies*

Project review criteria for each segment

CON components in state law

Definitions When CON’s required When CON’s not required Health planning committee & state health plan Use of project review criteria Public notification in newspaper Review procedure and contested cases Prohibited communication during review Use of ALC and Court of Appeals Limitations on CON

When is a CON required in July 2016:

Construction of a new healthcare facility Purchase of new & emerging technology Providing a new health service not previously

provided Expansion of an existing health service

beyond 1 mile of where it is currently located Capital expenditure greater than $5 million

Current H.3250

When is a CON not required in July 2016:

Purchase of research equipment Physician offices Replacement of like equipment Expansion of beds in acute care, rehab, psych

or nursing homes Expansion of existing services & equipment

within 1 mile of where located & for which a CON was previously awarded

Current H.3250

Other changes in July 2016:

Elimination of Health Planning Committee SHP updated annually SHP & CON application online Shortens review & appeals process Grandfather clause < $7 million Sunset in 2017

Current H.3250

Who favors CON:

Hospitals Imaging centers Oncology groups Home Health

agencies

Nursing homes Select Physician

practices Ambulatory Surgical

Centers

Who is tired of CON?

SC State House

FTC

The Governor

Allan Stalvey

The CON Environment today:

36 states have a CON program- great variability CON states have fewer hospital beds & imaging

services PA (1999) & Wisconsin (2011) were last states to

repeal Both Georgia & NC have proposed repeal Healthcare delivery is changing rapidly:

Cost & Quality Convenience Reimbursement Continuum