05/15/1999 09:42 AM Senate FIN

                                                                                                                                
HOUSE BILL NO. 187                                                                                                              
"An Act relating to the certificate of need program                                                                             
for nursing care facilities and other facilities; and                                                                           
providing for an effective date."                                                                                               
                                                                                                                                
                                                                                                                                
This was the first hearing for this bill in the Senate                                                                          
Finance Committee.                                                                                                              
                                                                                                                                
Senator Wilken presented the bill noting that the sponsors,                                                                     
the House Health Education and Social Services Committee,                                                                       
were unable to attend the meeting. He indicated that this                                                                       
bill is identical to SB 59 that the Committee heard                                                                             
previously.                                                                                                                     
                                                                                                                                
Senator Gary Wilken reminded members that the legislation                                                                       
is a result of the Long Term Care Task Force's                                                                                  
Recommendation #21. He stated that one of the goals of the                                                                      
task force is to keep people in home settings rather than                                                                       
institutions, because it is less expensive and in many                                                                          
cases, the care is better.                                                                                                      
                                                                                                                                
Senator Gary Wilken warned that there would be a financial                                                                      
risk if a "certificate of need" process is not implemented.                                                                     
He referred to the ability to build nursing homes using                                                                         
Medicaid funds, and cautioned that there could be a                                                                             
proliferation of new homes, which would cost the state. In                                                                      
response to this concern, this bill adds a third level of                                                                       
consideration before new nursing homes can be constructed,                                                                      
he stated. The original two criteria for new nursing home                                                                       
approval are accessibility and quality, and he noted that                                                                       
the new criteria would require consideration of cost-                                                                           
effectiveness and appropriateness.                                                                                              
                                                                                                                                
                                                                                                                                
Tape: SFC - 99 #141, Side B                                                                                                     
                                                                                                                                
                                                                                                                                
ELMER LINDSTROM, Special Assistant, Office of the                                                                               
Commissioner, Department of Health and Social Services                                                                          
testified that the Department of Administration also                                                                            
contributed to the recommendations of the Long Term Care                                                                        
Task Force. He stated that the Department of Health and                                                                         
Social Services supports the bill. He had heard the bill                                                                        
described as a moratorium, but he assured the Committee                                                                         
that the department does not view this bill as such.  He                                                                        
stressed that the bill actually gives the commissioner some                                                                     
additional standards, which the department feels are                                                                            
appropriate, when a certificate of need application is                                                                          
being reviewed. He predicted that in the future, the need                                                                       
for new nursing home beds will be demonstrated and will                                                                         
meet all the criteria.                                                                                                          
                                                                                                                                
Elmer Lindstrom pointed out that the bill has a fiscal                                                                          
note, which reflects a one-time cost.  He explained that                                                                        
the certificate of need program is administered by one                                                                          
staff member and because that staff already has several                                                                         
applications pending relating to acute-care programs,                                                                           
additional funds are necessary to contract out the task of                                                                      
setting up the new standards.  He suggested that since                                                                          
there currently are no pending nursing home applications on                                                                     
file, this is an ideal time to implement the new criteria.                                                                      
                                                                                                                                
Senator Gary Wilken commented that after the Committee had                                                                      
considered the companion SB 59, day-surgery and imaging                                                                         
center facilities were added to that bill.  He noted that                                                                       
the conflicts regarding the additional facilities were                                                                          
since settled and this bill only addresses nursing homes.                                                                       
                                                                                                                                
Senator Loren Leman pointed out a technical discrepancy                                                                         
with language page 4, lines 1 and 9, saying that "relating"                                                                     
should actually be "related".  He felt the matter should be                                                                     
pointed out to the legal drafter.                                                                                               
                                                                                                                                
Senator Phillips wanted it put on the record that he has a                                                                      
possible conflict of interest with this legislation due to                                                                      
his employment with an organization that operates several                                                                       
nursing homes.  Senator Adams objected to allowing Senator                                                                      
Randy Phillips abstain from voting on the bill.                                                                                 
                                                                                                                                
Senator Wilken offered a motion to report from Committee,                                                                       
CSHB 187(FIN) with individual recommendations and                                                                               
accompanying fiscal note from the Department of Health and                                                                      
Social Services in the amount of $26.5. Without objection,                                                                      
the bill was REPORTED OUT.                                                                                                      
                                                                                                                                
                                                                                                                                
ADJOURNMENT                                                                                                                     
                                                                                                                                
Assistant Co-Chair Alexis Grundman adjourned the Committee                                                                      
on behalf of Co-Chair John Torgerson until tomorrow at                                                                          
2:00PM.                                                                                                                         
SFC-99 (15) 5/15/99