Sec. 17b-353. Certificate of need; capital expenditure or acquisition of major medical equipment. Hearings. Regulations.
Sec. 17b-353. Certificate of need; capital expenditure or acquisition of major
medical equipment. Hearings. Regulations. (a) Any facility, as defined in subsection
(a) of section 17b-352, which proposes (1) a capital expenditure exceeding one million
dollars, which increases facility square footage by more than five thousand square feet or
five per cent of the existing square footage, whichever is greater, (2) a capital expenditure
exceeding two million dollars, or (3) the acquisition of major medical equipment requiring a capital expenditure in excess of four hundred thousand dollars, including the leasing of equipment or space, shall submit a request for approval of such expenditure, with
such information as the department requires, to the Department of Social Services. Any
such facility which proposes to acquire imaging equipment requiring a capital expenditure in excess of four hundred thousand dollars, including the leasing of such equipment,
shall obtain the approval of the Office of Health Care Access in accordance with section
19a-639, subsequent to obtaining the approval of the Commissioner of Social Services.
Prior to the facility's obtaining the imaging equipment, the Commissioner of the Office
of Health Care Access, after consultation with the Commissioner of Social Services,
may elect to perform a joint or simultaneous review with the Department of Social
Services.
(b) An applicant, prior to submitting a certificate of need application, shall request,
in writing, application forms and instructions from the department. The request shall
include: (1) The name of the applicant or applicants; (2) a statement indicating whether
the application is for (A) a new, additional, expanded or replacement facility, service
or function, (B) a termination or reduction in a presently authorized service or bed
capacity or (C) any new, additional or terminated beds and their type; (3) the estimated
capital cost; (4) the town where the project is or will be located; and (5) a brief description
of the proposed project. Such request shall be deemed a letter of intent. No certificate
of need application shall be considered submitted to the department unless a current
letter of intent, specific to the proposal and in accordance with the provisions of this
subsection, has been on file with the department for not less than ten business days. For
purposes of this subsection, "a current letter of intent" means a letter of intent on file
with the department for not more than one hundred eighty days. A certificate of need
application shall be deemed withdrawn by the department if a department completeness
letter is not responded to within one hundred eighty days.
(c) In conducting its activities pursuant to this section, section 17b-352 or both,
except as provided for in subsection (d) of this section, the Commissioner of Social
Services or said commissioner's designee may hold a public hearing on an application
or on more than one application, if such applications are of a similar nature with respect
to the request. At least two weeks' notice of the hearing shall be given to the facility
by certified mail and to the public by publication in a newspaper having a substantial
circulation in the area served by the facility. Such hearing shall be held at the discretion
of the commissioner in Hartford or in the area so served. The commissioner or the
commissioner's designee shall consider such request in relation to the community or
regional need for such capital program or purchase of land, the possible effect on the
operating costs of the facility and such other relevant factors as the commissioner or
the commissioner's designee deems necessary. In approving or modifying such request,
the commissioner or the commissioner's designee may not prescribe any condition, such
as, but not limited to, any condition or limitation on the indebtedness of the facility in
connection with a bond issued, the principal amount of any bond issued or any other
details or particulars related to the financing of such capital expenditure, not directly
related to the scope of such capital program and within the control of the facility. If the
hearing is conducted by a designee of the commissioner, the designee shall submit any
findings and recommendations to the commissioner. The commissioner shall grant,
modify or deny such request within ninety days, except as provided for in this section.
Upon the request of the applicant, the review period may be extended for an additional
fifteen days if the commissioner or the commissioner's designee has requested additional information subsequent to the commencement of the review period. The commissioner or the commissioner's designee may extend the review period for a maximum
of thirty days if the applicant has not filed in a timely manner information deemed
necessary by the commissioner or the commissioner's designee.
(d) No facility shall be allowed to close or decrease substantially its total bed capacity until such time as a public hearing has been held in accordance with the provisions
of this subsection and the Commissioner of Social Services has approved the facility's
request unless such decrease is associated with a census reduction. The commissioner
may impose a civil penalty of not more than five thousand dollars on any facility that
fails to comply with the provisions of this subsection. Penalty payments received by
the commissioner pursuant to this subsection shall be deposited in the special fund
established by the department pursuant to subsection (c) of section 17b-357 and used for
the purposes specified in said subsection (c). The commissioner or the commissioner's
designee shall hold a public hearing upon the earliest occurrence of: (1) Receipt of any
letter of intent submitted by a facility to the department, or (2) receipt of any certificate
of need application. Such hearing shall be held at the facility for which the letter of
intent or certificate of need application was submitted not later than thirty days after
the date on which such letter or application was received by the commissioner. The
commissioner or the commissioner's designee shall provide both the facility and the
public with notice of the date of the hearing not less than fourteen days in advance of
such date. Notice to the facility shall be by certified mail and notice to the public shall
be by publication in a newspaper having a substantial circulation in the area served by
the facility.
(e) The Commissioner of Social Services shall adopt regulations, in accordance
with chapter 54, to implement the provisions of this section. The commissioner shall
implement the standards and procedures of the Office of Health Care Access concerning
certificates of need established pursuant to section 19a-643, as appropriate for the purposes of this section, until the time final regulations are adopted in accordance with said
chapter 54.
(P.A. 93-262, S. 22, 87; P.A. 94-236, S. 2, 10; P.A. 95-257, S. 39, 58; June 18 Sp. Sess. P.A. 97-2, S. 148, 165; P.A.
98-150, S. 13, 17; P.A. 02-135, S. 3; P.A. 07-209, S. 1.)
History: P.A. 93-262 effective July 1, 1993; P.A. 94-236 made technical changes and amended Subsec. (b) to provide
that a hearing shall be in accordance with Sec. 4-177 and to add "or his designee" after commissioner, effective June 7,
1994; P.A. 95-257 replaced Commission on Hospitals and Health Care with Office of Health Care Access, effective July
1, 1995; June 18 Sp. Sess. P.A. 97-2 amended Subsec. (a) by replacing a capital expenditure exceeding $1,000,000 with
a capital expenditure exceeding $1,000,000 which increases facility square footage by more than 5,000 square feet or 5%
of the existing square footage, whichever is greater, and by adding a capital expenditure exceeding $2,000,000 to those
facilities required to submit a request for approval of such expenditure, added Subsec. (b) outlining an applicant's required
procedure prior to submitting a certificate of need application and redesignated existing Subsecs. accordingly, effective
July 1, 1997; (Revisor's note: A reference in Subsec. (a) to "subsection (b) of" Sec. 19a-639, deleted by vetoed P.A. 97-204 and so reflected in June 18 Sp. Sess. P.A. 97-2, was codified since purported deletion was void); P.A. 98-150 amended
Subsec. (a) to allow joint or simultaneous review and made a technical change, effective June 5, 1998 (Revisor's note: In
Subsec. (a) a reference to "Commissioner of the Department of Social Services" was changed editorially by the Revisors
to "Commissioner of Social Services" for consistency with customary statutory language); P.A. 02-135 amended Subsec.
(c) by adding provision allowing the commissioner or a designee to hold a public hearing on one or more applications,
deleting provisions re mandatory hearing pursuant to Sec. 4-177, re waiver of hearing upon showing of emergency nature
and re ten business day time periods, and making technical changes for purposes of gender neutrality; P.A. 07-209 amended
Subsec. (c) by adding "except as provided for in subsection (d) of this section," and making technical changes, added new
Subsec. (d) re public hearing and notice requirements for facility that seeks to close or decrease substantially its total bed
capacity and re civil penalty for failure to comply with such requirements, and redesignated existing Subsec. (d) as Subsec.
(e), effective July 1, 2007.