A proposal by the Florida Agency for Health Care Administration and Gov. Jeb Bush would soften the state's certificate-of-need process, opening the door for hospitals to expand bed counts and establish hospices without being required to win state approval.
Under the proposal, the agency seeks to amend the state CON statute by making several types of healthcare projects exempt. New hospitals and hospitals seeking to convert to specialty hospitals still would be required to go through the process before opening.
The state health agency is looking for legislative sponsors and is hoping the proposal will come up for discussion at the committee level in January 2004, said Elizabeth Dudek, deputy secretary of the health quality assurance division at the AHCA.
Florida recently has seen a spate of competing construction projects. In July, the governor signed a law exempting a handful of hospitals from undergoing the CON process in their attempts to create open-heart surgery units. The new law permits open-heart surgery and angioplasty procedures at Bethesda Memorial Hospital, Boynton Beach; Boca Raton Community Hospital; Indian River Memorial Hospital, Vero Beach; and Martin Memorial Health Systems, Stuart.
The latest proposal is aimed at "solving a systemic problem," said Alan Levine, the governor's deputy chief of staff. The proposal will preserve healthcare quality and costs, he said.
"This will make things happen a lot quicker," Dudek said. "This makes it more responsive to meeting the healthcare needs of our providers. The only thing we would regulate is new healthcare facilities and neonatal intensive-care beds."
Hospitals could establish hospices and inpatient health services while also increasing bed counts for acute-care units, specialty burn units, mental health services and comprehensive rehabilitation units, according to the proposal. Currently, these units are subject to the CON process. As a trade-off, the proposal requires hospitals to go through the CON process when converting to a specialty hospital or long-term-care hospital.
"The concern was boutique hospitals could be established," Dudek said. "They would take paying patients away from hospitals."
The Florida Hospital Association, which represents 230 hospitals, has not seen the proposal yet and has not taken a position, senior vice president Ralph Glatfelter said. "Historically, the association has opposed deregulation," Glatfelter said. The South Florida Hospital and Healthcare Association is opposed to the move because it could lead to excess hospitals and services and lower the quality of care, said association President Linda Quick.
Thomas Piper, a spokesman for the American Health Planning Association and director of the CON program at the Missouri Department of Health and Senior Services, agreed and said CON laws help control healthcare costs.
"To further abandon oversight of the healthcare industry is a terrible mistake," he said.