CSHB 187(FIN): "An Act removing a requirement that a certificate of need is needed before elimination of a category of health services provided by a health care facility; prohibiting a person from converting a building or part of a building to a nursing home that requires licensure unless authorized by a certificate of need; setting a standard of review for applications for certificates of need relating to nursing homes and nursing home beds and relating to that standard of review; providing that the standard of review for applications for certificates of need for beds other than nursing home beds or for a health care facility other than a nursing home is the availability and quality of existing health care resources or the accessibility to those resources compared to the current or projected requirement for health services required to maintain the good health of citizens of this state; defining the term 'nursing home bed'; eliminating statutory references to the office of planning and research in the Department of Health and Social Services; and providing for an effective date."
00CS FOR HOUSE BILL NO. 187(FIN) 01 "An Act removing a requirement that a certificate of need is needed before 02 elimination of a category of health services provided by a health care facility; 03 prohibiting a person from converting a building or part of a building to a 04 nursing home that requires licensure unless authorized by a certificate of need; 05 setting a standard of review for applications for certificates of need relating to 06 nursing homes and nursing home beds and relating to that standard of review; 07 providing that the standard of review for applications for certificates of need 08 for beds other than nursing home beds or for a health care facility other than 09 a nursing home is the availability and quality of existing health care resources 10 or the accessibility to those resources compared to the current or projected 11 requirement for health services required to maintain the good health of citizens 12 of this state; defining the term 'nursing home bed'; eliminating statutory 13 references to the office of planning and research in the Department of Health 14 and Social Services; and providing for an effective date."
01 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 02 * Section 1. FINDINGS. The legislature finds that 03 (1) ch. 84, SLA 1996, placed a two-year moratorium on the issuance or 04 modification of certificates of need under AS 18.07 for nursing beds and created a working 05 group to analyze issues relating to long-term care and the certificate of need program; 06 (2) it is anticipated that the long-term care system in Alaska will face a crisis 07 in its ability to provide services to a growing and increasingly aging population by the twenty- 08 first century unless the system can provide services in a more efficient and appropriate 09 manner; 10 (3) in 1996, the state spent $120,000,000 in long-term care services for 11 approximately 5,000 Alaskans; approximately two-thirds of these expenditures, $80,000,000, 12 were made from the state general fund; 13 (4) moderate assumptions about population and inflation would project that 14 more than $545,000,000 will be needed to pay for long-term care services in Alaska by the 15 year 2015; 16 (5) a shift from the current significant reliance on costly institutional care to 17 a more balanced continuum of home-based and community-based services is needed; 18 (6) a two-year moratorium on the issuance or modification of a certificate of 19 need for the addition of nursing home beds was enacted into law in 1996 to 20 (A) encourage the development of home-based and community-based 21 services; 22 (B) direct the state's resources toward the services that can best meet 23 the needs of the clients; and 24 (C) facilitate actions to provide a more balanced system of care and 25 more appropriate placement of clients, enlarge client choice, and avoid unnecessary 26 new long-term care costs; 27 (7) appropriate planning is necessary to ensure that a certificate of need for 28 new or replacement nursing home beds is not approved without a 29 (A) demonstrated long-term need for those beds on a regional basis; 30 (B) demonstration that the project is financially feasible and fosters the 31 least reliance on the state general fund for provision of the most appropriate service;
01 (C) demonstration of public participation in the planning process and 02 support by affected groups; and 03 (D) showing that the approval or modification of the certificate of need 04 is consistent with existing state plans for delivery of care in Alaska; and 05 (8) this Act provides a minimum framework to ensure that the approval of new 06 or replacement nursing home beds enhances access to the appropriate level of care to meet 07 the needs of Alaskans and does not foster reliance on the state general fund to finance the 08 operating and capital costs. 09 * Sec. 2. AS 18.07.021 is amended to read: 10 Sec. 18.07.021. Administration [OFFICE OF PLANNING AND 11 RESEARCH]. The [OFFICE OF PLANNING AND RESEARCH IN THE] 12 department shall administer the certificate of need program under this chapter and 13 perform other functions prescribed in this chapter. 14 * Sec. 3. AS 18.07.031 is amended to read: 15 Sec. 18.07.031. Certificate of need required. (a) A person may not make 16 an expenditure of $1,000,000 or more for any of the following unless authorized under 17 the terms of a certificate of need issued by the department [OFFICE]: 18 (1) construction of a health care facility; 19 (2) alteration of the bed capacity of a health care facility; or 20 (3) addition [OR ELIMINATION] of a category of health services 21 provided by a health care facility. 22 (b) Notwithstanding the expenditure threshold in (a) of this section, a person 23 may not convert a building or part of a building [THAT IS LICENSED AS AN 24 ASSISTED LIVING FACILITY UNDER AS 47.33] to a nursing home that requires 25 licensure under AS 18.20.020 unless authorized under the terms of a certificate of need 26 issued by the department [OFFICE]. 27 * Sec. 4. AS 18.07.041 is amended to read: 28 Sec. 18.07.041. Standard of review for applications for certificates of need 29 relating to non-nursing home beds and services . The department [OFFICE] shall 30 grant a sponsor a certificate of need or modify a certificate of need that authorizes 31 beds other than nursing home beds or that is for a health care facility other than
01 a nursing home if the availability and quality of existing health care resources or the 02 accessibility to those resources is less than the current or projected requirement for 03 health services required to maintain the good health of citizens of this state. 04 * Sec. 5. AS 18.07 is amended by adding a new section to read: 05 Sec. 18.07.043. Standard of review for applications for certificates of need 06 relating to nursing homes and nursing home beds. (a) The department shall 07 develop review standards for an application for a certificate of need, or for a 08 modification of a certificate of need, issued under this chapter for a health care facility 09 that is a nursing home or has nursing home beds. 10 (b) In developing the review standards under (a) of this section, the department 11 shall consider whether 12 (1) a public process and existing appropriate statewide, regional, and 13 local plans were included in planning and designing the additional nursing home beds 14 or the health care facility; 15 (2) the additional nursing home beds or the health care facility meets 16 minimum required use rates for new nursing beds, and the effect on use rates for 17 existing nursing home beds; 18 (3) the additional nursing home beds or the health care facility 19 demonstrates consideration of the community, regional, and statewide needs for new 20 nursing home beds; 21 (4) the additional nursing home beds or the health care facility meets 22 the minimum number of new nursing beds that should be required in a facility to 23 ensure efficiency and economies of scale; 24 (5) the additional nursing home beds or the health care facility 25 demonstrates the proposed service will provide a quality of care equivalent to existing 26 community, regional, or statewide services; 27 (6) the additional nursing home beds or the health care facility 28 demonstrates financial feasibility, including long-term viability, and what the financial 29 effect will be on consumers and the state; and 30 (7) the sponsor has demonstrated cost effectiveness through considering 31 the availability of appropriate, less costly alternatives of providing the services
01 planned. 02 (c) The department shall grant a sponsor a certificate of need or modify a 03 certificate of need that authorizes nursing home beds or that is for a health care facility 04 that is a nursing home if the department finds that the sponsor meets the standards 05 established in or under this chapter. 06 * Sec. 6. AS 18.07.061 is amended to read: 07 Sec. 18.07.061. Modification and termination of activities. The certificate 08 holder shall apply to the department [OFFICE] for a modification of the certificate 09 before terminating part of the activities authorized by the terms of issuance, but the 10 certificate holder is not required to obtain the acquiescence of the department 11 [OFFICE] before terminating all the activities authorized by the certificate. If a 12 certificate holder terminates all of the activities authorized by a certificate, the 13 certificate holder is required to notify the department [OFFICE] 60 days before 14 termination and to surrender the certificate to the department [OFFICE] within 30 15 days of termination. 16 * Sec. 7. AS 18.07.071 is amended to read: 17 Sec. 18.07.071. Temporary and emergency certificates. (a) The 18 department [OFFICE] shall grant a sponsor an emergency certificate for the 19 construction of a health care facility for which a certificate is required under 20 AS 18.07.031 if the sponsor shows, by affidavit or formal hearing, that the act of 21 construction consists of effecting emergency repairs. 22 (b) The department [OFFICE] may grant a sponsor a temporary certificate for 23 the temporary operation of a category of health service [,] if the sponsor shows by 24 affidavit or formal hearing 25 (1) the necessity for early, immediate, or temporary relief ; [,] and 26 (2) adverse effect to the public interest by reason of delay occasioned 27 by compliance with the requirements of AS 18.07.041 , 18.07.043, and application 28 procedures prescribed by regulations under this chapter. 29 (c) A temporary certificate granted under (b) of this section does not confer 30 vested rights on behalf of the applicant. The department [OFFICE] shall impose 31 those special limitations and restrictions concerning duration and right of extension that
01 the department [OFFICE] considers appropriate. A temporary certificate may not be 02 granted for a period longer than necessary for the sponsor to obtain review of the 03 action certified by the temporary certificate under AS 18.07.051. Application for a 04 certificate of need under AS 18.07.041 or 18.07.043 must commence within 60 days 05 of the date of issuance of the temporary certificate. 06 * Sec. 8. AS 18.07.081(a) is amended to read: 07 (a) The department [OFFICE], a member of the public who is substantially 08 affected by activities authorized by the certificate, or another applicant for a certificate 09 of need may initiate a hearing to obtain modification, suspension, or revocation of an 10 existing certificate of need by filing an accusation with the commissioner as prescribed 11 under AS 44.62.360. A revocation, modification, or suspension of an outstanding 12 certificate may not be undertaken unless it is in accordance with AS 44.62.330 - 13 44.62.630. 14 * Sec. 9. AS 18.07.081(c) is amended to read: 15 (c) A certificate of need shall be suspended if an accusation is filed before the 16 commencement of activities authorized under AS 18.07.041 or 18.07.043 that charges 17 that factors upon which the certificate of need was issued have changed [,] or new 18 factors have been discovered that significantly alter the need for the activity 19 authorized. A suspension of a certificate may not exceed 60 days. At the end of this 20 period or sooner, the department [OFFICE] shall revoke or reinstate the certificate. 21 * Sec. 10. AS 18.07.081(d) is amended to read: 22 (d) A certificate of need may be revoked if 23 (1) the sponsor has not shown continuing progress toward 24 commencement of the activities authorized under AS 18.07.041 or 18.07.043 after six 25 months of issuance; 26 (2) the applicant fails, without good cause, to complete activities 27 authorized by the certificate; 28 (3) the sponsor fails to comply with the provisions of this chapter or 29 regulations adopted under this chapter; 30 (4) the sponsor knowingly misrepresents a material fact in obtaining the 31 certificate;
01 (5) the facts charged in an accusation filed under (c) of this section are 02 established; or 03 (6) the sponsor fails to provide services authorized by the terms of the 04 certificate. 05 * Sec. 11. AS 18.07.101 is amended to read: 06 Sec. 18.07.101. Regulations. The commissioner shall adopt, in accordance 07 with AS 44.62 (Administrative Procedure Act), regulations that establish procedures 08 under which sponsors may make application for certificates of need required by this 09 chapter and that govern the review of those applications by the department [OFFICE], 10 establish requirements for a uniform statewide system of reporting financial and other 11 operating data, and otherwise carry out the purposes of this chapter. 12 * Sec. 12. AS 18.07.111(2) is amended to read: 13 (2) "certificate" means a certificate of need issued by the department 14 [OFFICE] under AS 18.07.041 , 18.07.043, or 18.07.071 [AS 18.07.071]; 15 * Sec. 13. AS 18.07.111 is amended by adding a new paragraph to read: 16 (13) "nursing home bed" means a bed not used for acute care in which 17 nursing care and related medical services are provided over a period of 24 hours a day 18 to individuals admitted to the health care facility because of illness, disease, or 19 physical infirmity. 20 * Sec. 14. AS 18.07.111(11) is repealed. 21 * Sec. 15. TRANSITION. (a) A matter described in former AS 18.07.031 that is 22 authorized under a certificate of need issued before the effective date of this Act shall be 23 reviewed and completed in accordance with the applicable statutes and regulations as they 24 existed on the day before the effective date of this Act. 25 (b) Except as provided in (a) of this section, pending applications and any other 26 matters described in former AS 18.07.031 or in AS 18.07.031, as amended by this Act, shall 27 be reviewed and completed in accordance with the provisions of this Act. 28 * Sec. 16. This Act takes effect immediately under AS 01.10.070(c).