Health care law under scrutiny
Certificate of need process faces overhaul from state legislators
For more than a year, health care workers, patients and lawmakers called on Connecticut officials to approve the sale of three hospitals to Yale New Haven Health — a deal considered crucial to the survival of the Manchester, Waterbury and Vernon facilities.
The hospitals were struggling financially and in danger of closing, many argued, leaving health care workers without jobs and patients with longer drives for emergency care.
In March, 16 months after Yale filed for a “certificate of need” that would allow the deal to go forward, the state’s Office of Health Strategy approved the sale.
But the long wait time put a spotlight on Connecticut’s decades-old certificate of need program, with lawmakers now mulling how to improve it — and questions on whether it’s even needed.
“This should be a cautionary tale,” Rep. Jason Doucette, D-manchester, said of the Yale acquisition of three hospitals owned by Prospect Medical Holdings, including one — Manchester Memorial — in his district. “We should reopen the whole certificate of need process and take a look at completely overhauling it.”
“The CON process is, I don’t want to say despicable, but it is terrible,” Rep. Lezlye Zupkus, a Republican whose district includes Waterbury, said at a recent Public Health Committee meeting. She later added: “Let’s fix the process or do away with it.”
Advocates and lawmakers point to prolonged waits for certificate of need authorization. Some say the process limits competition by denying applications for new services. Others say it creates unnecessary delays in patient care. And for those who curtail services without state approval, there is little penalty.
Legislators are considering at least four bills that would make varying degrees of change to the process, from tightening approval time frames to eliminating certificate of need authorization for the purchase of certain medical equipment.
In interviews, some have suggested wiping out the program, either wholesale or for certain transactions.
Deidre Gifford, head of the state’s Office of Health Strategy, which runs the CON program, conceded the process takes too long, but defended its merit.
“We should make sure the system is transparent, efficient and effective,” she told lawmakers at a public hearing. “But I don’t think we agree that eliminating CON altogether for some of these services is the right step.”