- Introduced -

SB 1087 - This act revises certificate of need law and enacts a review certification procedure for acute care facilities.

Current law provides definitions relating to certificate of need (CON). This act changes the definition of "health care facilities" by removing its reference to non-long term care related facilities and adding long term care beds or hospitals. The definition for and mention of "major medical equipment" is also removed (Section 197.305).

The Missouri Health Facilities Review Committee is currently established in law. This act removes the Committee's ability to hire staff and reassigns employment decisions and oversight to the Department of Health and Senior Services (Section 197.310).

Current law outlines procedures to obtain a CON. The exclusion from a CON for new medical technology is removed and relocated to the review certification Sections in 197.387.

Section 197.366 is repealed due to expiration on 12/31/2001. Section 197.367 is repealed regarding residential care facilities I or II with low occupancy levels (Section 197.315).

Sections 197.375 through 197.397, RSMo, contain new language regarding review certification and are similar to language contained in SB 235 (2001). This act provides definitions relating to review certification, such as "acute care facilities", "first-time services", and "review certification" (Section 197.375).

Duties of the Committee are outlined, including the review and approval or disapproval of all applications for review certification (Section 197.378). The procedure for application submission is also outlined. A letter of intent should be submitted thirty days before filing an application and a fee must accompany the application. The fee will be $1000 or one-tenth of one percent of the total cost of the project. Applicants have the right to appeal the Committee's decision (Sections 197.381 and 197.384).

Any person proposing a new institutional acute care service, first-time service, the addition of newly licensed beds, or renovations over a certain amount must obtain a non-transferable review certification. Certification will be granted to those meeting the health needs of the community. If costs exceed 10% of the approved amount, the Committee must consent to the increase. Applicants must submit periodic reports and the Committee may revoke certification in certain situations. A review certification may be forfeited for failure to incur any capital expenditures within twelve months. State agencies may not license, certify, or provide funds to an acute care facility without that facility first obtaining review certification, if required to do so. Review certification may not be denied based on an applicant's refusal to provide abortion services or information. Review certification may not be required for transfer of ownership in a facility's entirety. A review certification may be granted for less than requested in the original application. The purchase and use of new medical technology is exempted from review certification (Section 197.387).

A review certification will not be required for facilities run by the state, nor for nonsubstantive projects (Section 197.390).

Reimbursement for new institutional acute care service project costs over ten percent of the initial estimate will not be paid for the first three years that a facility receives payments for services through Medicaid. A review certification must be granted before payment for excess project costs will be made. The Committee is given rule authority to enforce these sections (Section 197.393 and 197.397).

Portions of this act are similar to SB 235 (2001).

ERIN MOTLEY