| 47 | | - | SECTION 1. The legislature finds that certificate of need regulations have become an increasing burden on health care access in Hawaii. According to multiple national studies, certificate of need requirements are associated with higher health care costs and fewer facilities, especially in rural areas. Under existing state law, twenty-eight health care services require a certificate of need, making Hawaii's certificate of need regime the most restrictive in the country. The legislature further finds that health care shortages caused by the coronavirus disease 2019 pandemic have been exacerbated by the State's onerous certificate of need requirements. Reforming the State's certificate of need laws will help improve access and remove barriers to the expansion and construction of certain much-needed facilities, especially those concerned with mental health and substance abuse. Therefore, the purpose of this Act is to remove unnecessary restrictions that hamper health care access in the State by exempting substance abuse treatment facilities, psychiatric facilities, and certain bed change services from statutory certificate of need requirements. SECTION 2. Section 323D-54, Hawaii Revised Statutes, is amended to read as follows: "§323D-54 Exemptions from certificate of need requirements. Nothing in this part or rules with respect to the requirement for certificates of need applies to: (1) Offices of physicians, dentists, or other practitioners of the healing arts in private practice as distinguished from organized ambulatory health care facilities, except in any case of purchase or acquisition of equipment attendant to the delivery of health care service and the instruction or supervision for any private office or clinic involving a total expenditure in excess of the expenditure minimum; (2) Laboratories, as defined in section 321-11(12), except in any case of purchase or acquisition of equipment attendant to the delivery of health care service and the instruction or supervision for any laboratory involving a total expenditure in excess of the expenditure minimum; (3) Dispensaries and first aid stations located within business or industrial establishments and maintained solely for the use of employees; provided such facilities do not regularly provide inpatient or resident beds for patients or employees on a daily twenty-four-hour basis; (4) Dispensaries or infirmaries in correctional or educational facilities; (5) Dwelling establishments, such as hotels, motels, and rooming or boarding houses that do not regularly provide health care facilities or health care services; (6) Any home or institution conducted only for those who, pursuant to the teachings, faith, or belief of any group, depend for healing upon prayer or other spiritual means; (7) Dental clinics; (8) Nonpatient areas of care facilities such as parking garages and administrative offices; (9) Bed changes that involve [ten] up to thirty per cent or [ten] beds of existing licensed bed types, whichever is less, of a facility's total existing licensed beds within a two-year period; (10) Projects that are wholly dedicated to meeting the State's obligations under court orders, including consent decrees, that have already determined that need for the projects exists; (11) Replacement of existing equipment with its modern-day equivalent; (12) Primary care clinics under the expenditure thresholds referenced in section 323D-2; (13) Equipment and services related to that equipment, that are primarily invented and used for research purposes as opposed to usual and customary diagnostic and therapeutic care; (14) Capital expenditures that are required: (A) To eliminate or prevent imminent safety hazards as defined by federal, state, or county fire, building, or life safety codes or regulations; (B) To comply with state licensure standards; (C) To comply with accreditation standards, compliance with which is required to receive reimbursements under Title XVIII of the Social Security Act or payments under a state plan for medical assistance approved under Title XIX of such Act; (15) Extended care adult residential care homes and assisted living facilities; [or] (16) Psychiatric facilities; (17) Substance abuse treatment facilities; or [(16)] (18) Other facilities or services that the agency through the statewide council chooses to exempt, by rules pursuant to section 323D-62." SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 4. This Act shall take effect on July 1, 3000. |
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| 47 | + | SECTION 1. The legislature finds that certificate of need regulations have become an increasing burden on health care access in Hawaii. According to multiple national studies, certificate of need requirements are associated with higher health care costs and fewer facilities, especially in rural areas. Under existing state law, twenty-eight health care services require a certificate of need, making Hawaii's certificate of need regime the most restrictive in the country. The legislature further finds that health care shortages caused by the coronavirus disease 2019 pandemic have been exacerbated by the State's onerous certificate of need requirements. Reforming the State's certificate of need laws will help improve access and remove barriers to the expansion and construction of certain much-needed facilities, especially those concerned with mental health, substance abuse, and dialysis. Therefore, the purpose of this Act is to remove unnecessary restrictions that hamper health care access in the State by exempting dialysis centers, substance abuse facilities, psychiatric facilities, and certain bed change services from statutory certificate of need requirements. SECTION 2. Section 323D-54, Hawaii Revised Statutes, is amended to read as follows: "§323D-54 Exemptions from certificate of need requirements. Nothing in this part or rules with respect to the requirement for certificates of need applies to: (1) Offices of physicians, dentists, or other practitioners of the healing arts in private practice as distinguished from organized ambulatory health care facilities, except in any case of purchase or acquisition of equipment attendant to the delivery of health care service and the instruction or supervision for any private office or clinic involving a total expenditure in excess of the expenditure minimum; (2) Laboratories, as defined in section 321-11(12), except in any case of purchase or acquisition of equipment attendant to the delivery of health care service and the instruction or supervision for any laboratory involving a total expenditure in excess of the expenditure minimum; (3) Dispensaries and first aid stations located within business or industrial establishments and maintained solely for the use of employees; provided such facilities do not regularly provide inpatient or resident beds for patients or employees on a daily twenty-four-hour basis; (4) Dispensaries or infirmaries in correctional or educational facilities; (5) Dwelling establishments, such as hotels, motels, and rooming or boarding houses that do not regularly provide health care facilities or health care services; (6) Any home or institution conducted only for those who, pursuant to the teachings, faith, or belief of any group, depend for healing upon prayer or other spiritual means; (7) Dental clinics; (8) Nonpatient areas of care facilities such as parking garages and administrative offices; (9) Bed changes that involve [ten] up to thirty per cent [or ten beds of existing licensed bed types, whichever is less,] of a facility's total existing licensed beds within a two-year period; (10) Projects that are wholly dedicated to meeting the State's obligations under court orders, including consent decrees, that have already determined that need for the projects exists; (11) Replacement of existing equipment with its modern-day equivalent; (12) Primary care clinics under the expenditure thresholds referenced in section 323D-2; (13) Equipment and services related to that equipment, that are primarily invented and used for research purposes as opposed to usual and customary diagnostic and therapeutic care; (14) Capital expenditures that are required: (A) To eliminate or prevent imminent safety hazards as defined by federal, state, or county fire, building, or life safety codes or regulations; (B) To comply with state licensure standards; (C) To comply with accreditation standards, compliance with which is required to receive reimbursements under Title XVIII of the Social Security Act or payments under a state plan for medical assistance approved under Title XIX of such Act; (15) Extended care adult residential care homes and assisted living facilities; [or] (16) Hospice homes and other hospice facilities; (17) Psychiatric facilities; (18) Substance abuse facilities; (19) Dialysis centers; or [(16)] (20) Other facilities or services that the agency through the statewide council chooses to exempt, by rules pursuant to section 323D-62." SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 4. This Act shall take effect upon its approval. INTRODUCED BY: _____________________________ |
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