Connecticut General Statutes/Title 19a/Chapter 368z/Section 19a-639a

CGS § 19a-639a. Certificate of need application process. Issuance of decision. Public hearings. Retention of independent consultant. Policies, procedures and regulations.

(a) An application for a certificate of need shall be filed with the unit in accordance with the provisions of this section and any regulations adopted by the Office of Health Strategy. The application shall address the guidelines and principles set forth in (1) subsection (a) of section 19a-639, and (2) regulations adopted by the department. The applicant shall include with the application a nonrefundable application fee based on the cost of the project. The amount of the fee shall be as follows: (A) One thousand dollars for a project that will cost not greater than fifty thousand dollars; (B) two thousand dollars for a project that will cost greater than fifty thousand dollars but not greater than one hundred thousand dollars; (C) three thousand dollars for a project that will cost greater than one hundred thousand dollars but not greater than five hundred thousand dollars; (D) four thousand dollars for a project that will cost greater than five hundred thousand dollars but not greater than one million dollars; (E) five thousand dollars for a project that will cost greater than one million dollars but not greater than five million dollars; (F) eight thousand dollars for a project that will cost greater than five million dollars but not greater than ten million dollars; and (G) ten thousand dollars for a project that will cost greater than ten million dollars.

(b) Prior to the filing of a certificate of need application, the applicant shall (1) publish notice that an application is to be submitted to the unit (A) in a newspaper having a substantial circulation in the area where the project is to be located, and (B) on the applicant's Internet web site in a clear and conspicuous location that is easily accessible by members of the public, (2) request the publication of notice (A) in at least two sites within the affected community that are commonly accessed by the public, such as a town hall or library, and (B) on any existing Internet web site of the municipality or local health department, and (3) submit such notice to the unit for posting on such unit's Internet web site. Such newspaper notice shall be published for not less than three consecutive days, with the final date of consecutive publication occurring not later than twenty days prior to the date of filing of the certificate of need application, and contain a brief description of the nature of the project and the street address where the project is to be located. Postings in the affected community and on the applicant's Internet web site shall remain until the decision on the application is rendered. The unit shall not invalidate any notice due to changes or removal of the notice from a community Internet web site of which the applicant has no control. An applicant shall file the certificate of need application with the unit not later than ninety days after publishing notice of the application in a newspaper in accordance with the provisions of this subsection. The unit shall not accept the applicant's certificate of need application for filing unless the application is accompanied by the application fee prescribed in subsection (a) of this section and proof of compliance with the publication requirements prescribed in this subsection.

(c) (1) Not later than five business days after receipt of a properly filed certificate of need application, the unit shall publish notice of the application on its Internet web site. Not later than thirty days after the date of filing of the application, the unit may request such additional information as the unit determines necessary to complete the application. In addition to any information requested by the unit, if the application involves the transfer of ownership of a hospital, as defined in section 19a-639, the applicant shall submit to the unit (A) a plan demonstrating how health care services will be provided by the new hospital for the first three years following the transfer of ownership of the hospital, including any consolidation, reduction, elimination or expansion of existing services or introduction of new services, and (B) the names of persons currently holding a position with the hospital to be purchased or the purchaser, as defined in section 19a-639, as an officer, director, board member or senior manager, whether or not such person is expected to hold a position with the hospital after completion of the transfer of ownership of the hospital and any salary, severance, stock offering or any financial gain, current or deferred, such person is expected to receive as a result of, or in relation to, the transfer of ownership of the hospital.

(2) The applicant shall, not later than sixty days after the date of the unit's request, submit any requested information and any information required under this subsection to the unit. If an applicant fails to submit such information to the unit within the sixty-day period, the unit shall consider the application to have been withdrawn.

(3) The unit shall make reasonable efforts to limit the requests for additional information to two such requests and, in all cases, cease all requests for additional information not later than six months after receiving the application.

(d) Upon deeming an application complete, the unit shall provide notice of this determination to the applicant and to the public in accordance with regulations adopted by the department. In addition, the unit shall post such notice on its Internet web site and notify the applicant not later than five days after deeming the application complete. The date on which the unit posts such notice on its Internet web site shall begin the review period. Except as provided in this subsection, (1) the review period for an application deemed complete shall be ninety days from the date on which the unit posts such notice on its Internet web site; and (2) the unit shall issue a decision on an application deemed complete prior to the expiration of the ninety-day review period in matters without a public hearing. The review period for an application deemed complete that involves a transfer of a large group practice, as described in subdivision (3) of subsection (a) of section 19a-638, when the offer was made in response to a request for proposal or similar voluntary offer for sale, shall be sixty days from the date on which the unit posts notice on its Internet web site. Upon request or for good cause shown, the unit may extend the review period for a period of time not to exceed sixty days. If the review period is extended, the unit shall issue a decision on the completed application prior to the expiration of the extended review period. If the unit holds a public hearing concerning a completed application in accordance with subsection (e) or (f) of this section, the unit shall issue a decision on the completed application not later than sixty days after the date the unit closes the public hearing record.

(e) Except as provided in this subsection, the unit shall hold a public hearing on a properly filed and completed certificate of need application if three or more individuals or an individual representing an entity with five or more people submits a request, in writing, that a public hearing be held on the application. For a properly filed and completed certificate of need application involving a transfer of ownership of a large group practice, as described in subdivision (3) of subsection (a) of section 19a-638, when an offer was made in response to a request for proposal or similar voluntary offer for sale, a public hearing shall be held if twenty-five or more individuals or an individual representing twenty-five or more people submits a request, in writing, that a public hearing be held on the application. Any request for a public hearing shall be made to the unit not later than thirty days after the date the unit deems the application to be complete.

(f) (1) The unit shall hold a public hearing with respect to each certificate of need application filed pursuant to section 19a-638, after December 1, 2015, that concerns any transfer of ownership involving a hospital. Such hearing shall be held in the municipality in which the hospital that is the subject of the application is located.

(2) The unit may hold a public hearing with respect to any certificate of need application submitted under this chapter. The unit shall provide not less than two weeks' advance notice to the applicant, in writing, and to the public by publication in a newspaper having a substantial circulation in the area served by the health care facility or provider. In conducting its activities under this chapter, the unit may hold hearings with respect to applications of a similar nature at the same time. The applicant shall post a copy of the unit's hearing notice on the applicant's Internet web site in a clear and conspicuous location that is easily accessible by members of the public. Such applicant shall request the publication of notice in at least two sites within the affected community that are commonly accessed by the public, such as a town hall or library, as well as on any existing Internet web site of the municipality or local health department. The unit shall not invalidate any notice due to changes or removal of the notice from a community Internet web site of which the applicant has no control.

(g) For applications submitted on or after October 1, 2023, the unit may retain an independent consultant with expertise in the specific area of health care that is the subject of the application filed by an applicant if the review and analysis of an application cannot reasonably be conducted by the unit without the expertise of an industry analyst or other actuarial consultant. The unit shall submit bills for independent consultant services to the applicant. Such applicant shall pay such bills not later than thirty days after receipt of such bills. Such bills shall be a reasonable amount per application. The provisions of chapter 57 and sections 4-212 to 4-219, inclusive, and 4e-19 shall not apply to any retainer agreement executed pursuant to this subsection.

(h) The Commissioner of Health Strategy may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the commissioner holds a public hearing prior to implementing the policies and procedures and posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.

Short History

(P.A. 98-150, S. 4, 17; June 30 Sp. Sess. P.A. 03-3, S. 90; P.A. 05-93, S. 5; 05-151, S. 5; 05-168, S. 4; P.A. 06-28, S. 3; P.A. 07-217, S. 84; P.A. 08-14, S. 2; P.A. 09-232, S. 94; P.A. 10-179, S. 89; P.A. 11-242, S. 25; P.A. 12-170, S. 2; P.A. 14-168, S. 8; P.A. 15-146, S. 30; 15-242, S. 42; P.A. 18-91, S. 27; P.A. 19-56, S. 9; P.A. 22-118, S. 225; P.A. 23-171, S. 12; P.A. 24-81, S. 208.)

Long History

History: P.A. 98-150 effective June 5, 1998 (Revisor's note: In codifying this section the Revisors editorially changed a reference in Subsec. (b) to “... September thirty.” to “... September thirtieth.”); June 30 Sp. Sess. P.A. 03-3 amended Subsec. (a) to delete references to residential care home and make a technical change, effective August 20, 2003; P.A. 05-93 amended Subsec. (a) by adding exception re Sec. 19a-639(c) and making a technical change, and added Subsec. (c), exempting health care facilities, institutions and providers that purchase, lease or accept donation of certain scanning equipment or linear accelerators on or before July 1, 2005, or that obtain certificate of need approval or a determination that a certificate of need is not required on or before said date, effective July 1, 2005; P.A. 05-151 amended Subsec. (b) by requiring biennial, rather than annual, registration of exempt institutions; P.A. 05-168 added new Subsec. (d) exempting from certificate of need review, at office's discretion, proposals involving the purchase or operation of an electronic medical records system on or after October 1, 2005; P.A. 06-28 amended Subsec. (c)(1) by restricting exemption from certificate of need review to proposals involving certain equipment in operation on or before July 1, 2006, effective May 8, 2006; P.A. 07-217 made a technical change in Subsec. (c), effective July 12, 2007; P.A. 08-14 amended Subsec. (b) by substituting 14 days for 10 business days and making a technical change and added Subsec. (e) re additional capital expenditures that are exempt from certificate of need review, effective April 29, 2008; P.A. 09-232 added Subsec. (a)(12) re program licensed or funded by Department of Children and Families, amended Subsec. (c) by eliminating “cineangiography equipment” and added Subsec. (f) re exemption for outpatient services provided at alternative location within primary service area, effective July 1, 2009; P.A. 10-179 replaced former Subsecs. (a) to (f) with new Subsecs. (a) to (g) re certificate of need application process, time frames for review and issuance of decision by office, public hearing process and authority of Commissioner of Public Health to implement policies and procedures while in process of adopting regulations; P.A. 11-242 amended Subsec. (b) by restructuring existing provisions and adding Subdiv. and Subpara. designators, by requiring applicant to file certificate of need application with office not later than 90 days after publishing notice of application and by making technical changes, and amended Subsec. (c) by eliminating requirement that certificate of need application be filed with Office of the Secretary of the State; P.A. 12-170 amended Subsecs. (a) and (d) by replacing references to office with references to Department of Public Health re regulations and amended Subsec. (d) by replacing provision requiring office to issue a decision not later than 60 days after date of public hearing with provision requiring office to issue a decision not later than 60 days after date the office closes the public hearing record; P.A. 14-168 amended Subsec. (d) by adding provision re review period for transfer of a group practice and amended Subsec. (e) by adding provisions re application involving transfer of ownership of a group practice, effective July 1, 2014; P.A. 15-146 amended Subsec. (c) by designating existing provisions re notice of application and request for information as Subdiv. (1) and amending same by adding provisions re application involving transfer of ownership of a hospital, designating existing provisions re submission of requested information as Subdiv. (2) and amending same by adding reference to information required and making technical changes, amended Subsecs. (d) and (e) by replacing “group practice” with “large group practice”, amended Subsec. (f) by adding Subdiv. (1) re public hearing for application involving transfer of ownership of a hospital and designating existing provisions re public hearing as Subdiv. (2), amended Subsec. (g) by replacing reference to Connecticut Law Journal with reference to department's Internet web site and the eRegulations System and deleting provision re date for adoption of final regulations, effective July 1, 2015; P.A. 15-242 amended Subsecs. (c) and (d) by adding “Internet” re web site and making a technical change; P.A. 18-91 replaced references to office with references to unit, amended Subsec. (a) to replace “Department of Public Health” with “Office of Health Strategy”, and amended Subsec. (g) to replace references to Commissioner of Public Health with references to executive director of the Office of Health Strategy, replace “prints notice” with “posts notice”, and replace “department's” with “office's”, effective May 14, 2018; P.A. 19-56 replaced “hearing on” with “hearings with respect to” in Subsec. (f)(2), effective June 28, 2019; P.A. 22-118 amended Subsec. (a) by removing the $500 application fee and adding an application fee scale based on the cost of the project, effective May 7, 2022; P.A. 23-171 amended Subsec. (b) by inserting new Subdiv. (1) and Subpara. (A) designators, adding new Subdiv. (2) re requesting publication of notice, adding new Subdiv. (3) re submission of notice to the unit, deleting existing Subdiv. (1) and (2) designators, deleting existing Subdiv. (1)(A), requiring newspaper notice for not less than 3 consecutive days, with final date of consecutive publication occurring not later than 20 days prior to the date of filing of the application, and requiring postings to remain until a decision is rendered, amended Subsec. (c) by adding Subdiv. (3) re reasonable efforts by unit to limit requests for additional information, amended Subsec. (d) by requiring unit to notify the applicant not later than 5 days after deeming the application complete and making technical changes, amended Subsec. (e) by making a technical change, amended Subsec. (f)(2) by requiring applicant to post a copy of unit's hearing notice on applicant's Internet web site and to request publication of a notice in at least 2 sites within the affected community, added new Subsec. (g) re retention of independent consultant, and redesignated existing Subsec. (g) as Subsec. (h); P.A. 24-81 amended Subsec. (h) by replacing references to executive director of the Office of Health Strategy with references to Commissioner of Health Strategy, effective May 30, 2024.

Citations

Subsec. (f)(2): Use of the term “may” in Subdiv. confers discretion on Office of Health Care Access as to whether to hold a public hearing for a certificate of need application, thus, any such hearing is not a contested case for purposes of triggering judicial review; Subsec. (e): a request to intervene, without additional language also indicating a request for a hearing, cannot be deemed to meet the requirements of Subsec. 207 CA 397.

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