HB 297-AMBULATORY SURGICAL FACILITIES                                                                         
                                                                                                                                
REPRESENTATIVE  JEANETTE  JAMES, sponsor  of  HB  297, stated  the                                                              
version before  the committee [CSHB  297(STA)(title am)]  is quite                                                              
different from  the original version.   After a lot  of discussion                                                              
in  House committees,  a  solution  to  the immediate  problem  of                                                              
raising the  $1 million floor was  found.  The new  version simply                                                              
allows relocation of  a health care facility to a  new site in the                                                              
same community without  a certificate of need as  long as there is                                                              
no increase  in the services  offered.   It also disallows  use of                                                              
the  vacated  site for  another  health  care facility  without  a                                                              
certificate of need, notwithstanding the $1 million floor.                                                                      
                                                                                                                                
SENATOR  WILKEN asked  Representative  James if  the problem  that                                                              
prompted this bill originated in Fairbanks.                                                                                     
                                                                                                                                
REPRESENTATIVE JAMES replied the  real problem is in Anchorage but                                                              
there is a presumed problem in Fairbanks  as well.  This bill will                                                              
fix the  Anchorage problem but does  not address the  situation in                                                              
Fairbanks.  A facility in Anchorage  wishes to relocate two blocks                                                              
away.    The facility  size  will  remain  the same  but  doctors'                                                              
offices will  be built in the  parking lot.  Previously,  moving a                                                              
facility   was allowed without  a certificate  of need as  long as                                                              
services were  not expanded.   But, another facility  in Anchorage                                                              
moved and afterward the existing  facility was replaced by another                                                              
health care facility under the $1  million cap, therefore services                                                              
were  expanded.   DHSS could  not allow  the requested  relocation                                                              
without  a certificate  of need.   This  bill will  allow DHSS  to                                                              
permit the  new relocation  without a certificate  of need.    She                                                              
has made  a commitment  to continue  to study  this issue  further                                                              
during the next  year to find out what can be  done to solve these                                                              
problems throughout the state.                                                                                                  
                                                                                                                                
CHAIRMAN  MILLER  noted  that  Senators   Pearce  and  Kelly  were                                                              
present.  He stated it is his intent  to pass this legislation out                                                              
of committee today and that he has  always supported the repeal of                                                              
the certificate of  need however, considering the  short amount of                                                              
time available left in the session,  a repeal is not possible this                                                              
year.  He said  the legislature raised the limit  to $1 million in                                                              
1983.                                                                                                                           
                                                                                                                                
SENATOR  WILKEN  asked whether  CSHB  297(STA)(title  am) has  any                                                              
further committees of referral.                                                                                                 
                                                                                                                                
CHAIRMAN MILLER said it will go to the Rules Committee.                                                                         
                                                                                                                                
SENATOR WILKEN asked  that a representative of DHSS  comment on HB                                                              
297.                                                                                                                            
                                                                                                                                
MR. ELMER LINDSTROM,  Special Assistant to Commissioner  Perdue at                                                              
DHSS, said DHSS  has no objection to the bill  as presented today.                                                              
To his understanding, an existing  ambulatory surgical center with                                                              
a certain set of capabilities wants  to relocate with the same set                                                              
of capabilities.   This bill would  allow that to occur  without a                                                              
certificate of  need for the  replacement facility.   Commissioner                                                              
Perdue shares Representative  James' belief that  it is worthwhile                                                              
to review the underlying certificate  of need law.  Last year, the                                                              
Long Term  Care Task Force put  in place new and  very appropriate                                                              
standards  for long term  care facilities  and nursing  facilities                                                              
and review  the certificate of need.   This bill contains  the old                                                              
standards  which  apply to  acute  care  facilities.   Times  have                                                              
changed.   The old  standards contain  definitional problems  that                                                              
are worth further discussion.                                                                                                   
                                                                                                                                
SENATOR PEARCE  moved CSHB 297(STA)(title am) from  committee with                                                              
individual recommendations.  There  being no objection, the motion                                                              
carried.