SB 387 - This act modifies several provisions relating to long-term care certificates of need (CON), including: (1) Missouri Health Facilities Review Committee membership; (2) CON applications; (3) long-term care CON need formula; and (4) ex parte communication. MISSOURI HEALTH FACILITIES REVIEW COMMITTEE MEMBERSHIP (Sections 197.310 and 197.326) Under current law, the Missouri Health Facilities Review Committee has nine members, four of whom are legislators. This act removes the legislative members from the Committee. Instead, all nine members shall be appointed by the Governor, each with knowledge and experience in the health care industry or health care accounting, insurance, financing, and banking. No more than five of the appointees shall be from the same political party. CERTIFICATE OF NEED APPLICATIONS (Section 197.315) This act requires that the operator of the facility be named in the application for a CON. No change in the named operator shall occur without the consent of the Committee. Under current law, a CON can be forfeited if no capital expenditure on an approved project is incurred within 6 months of approval. The applicant may seek an extension from the Committee. This act prohibits the granting of an extension for approved long-term care projects up to $30 million for which no substantial capital expenditure has been incurred within 3 years of the original approval date and approved projects over $30 million for which no substantial capital expenditure has been incurred within 5 years of the original approval date. LONG-TERM CARE CON NEED FORMULA (Sections 197.315, 197.318, and 197.323) This act removes the word "available" when referencing licensed long-term care beds. Under this act, the Committee shall apply the following when determining whether or not to grant a CON for any new or additional licensed long-term care beds: • No consideration shall be given to any other licensed beds located more than 15 miles from the applying facilities in all non-urban areas and 10 miles in all urban areas; • Within the 10 or 15-mile service area, the following need formula shall apply: (1) for intermediate care and skilled nursing facilities (ICF/SNF), 53 beds per 1,000 population aged 65 and older minus the current number of ICF/SNF beds; (2) for residential care and assisted living facilities (RCF/ALF), 25 beds per 1,000 population aged 65 and older minus the current number RCF/ALF beds; and (3) for long-term care hospital beds (LTCH), one-tenth of a bed per 1,000 population minus the current number of LTCH beds; and • No CON shall be granted unless the applicant can demonstrate that the average occupancy of all facilities in the same category within the service area of the project site has been equal to or greater than 85% during the four most recent quarters. EX PARTE COMMUNICATION (Sections 197.305 and 197.326) Under this act, ex parte communication, defined as any communication outside of a pending CON application and within the jurisdiction of the Committee, with any Committee member or staff member is prohibited unless such communication is made or confirmed in writing and made part of the application. This act also makes technical changes to the certificate of need statutes. SARAH HASKINS