Vermont 2025 2025-2026 Regular Session

Vermont House Bill H0096 Introduced / Bill

Filed 01/27/2025

                    BILL AS INTRODUCED 	H.96 
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VT LEG #379403 v.1 
H.96 1 
Introduced by Representatives Cordes of Bristol, Arsenault of Williston, 2 
Berbeco of Winooski, Black of Essex, Chapin of East 3 
Montpelier, Cina of Burlington, Goldman of Rockingham, 4 
Harrison of Chittenden, Logan of Burlington, Marcotte of 5 
Coventry, McFaun of Barre Town, Olson of Starksboro, Page of 6 
Newport City, and Priestley of Bradford 7 
Referred to Committee on  8 
Date:  9 
Subject: Health; health care facilities; Green Mountain Care Board; certificates 10 
of need  11 
Statement of purpose of bill as introduced:  This bill proposes to increase the 12 
monetary thresholds that trigger a certificate of need requirement and to 13 
exempt health care services and health care facility projects that are the result 14 
of a contract awarded by the State of Vermont. 15 
An act relating to increasing the monetary thresholds for certificates of need 16 
It is hereby enacted by the General Assembly of the State of Vermont:  17 
Sec. 1.  18 V.S.A. § 9434 is amended to read: 18 
§ 9434.  CERTIFICATE OF NEED; GENERAL RULES 19  BILL AS INTRODUCED 	H.96 
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(a)  A health care facility other than a hospital shall not develop or have 1 
developed on its behalf a new health care project without issuance of a 2 
certificate of need by the Board.  For purposes of this subsection, a “new 3 
health care project” includes the following: 4 
(1)  The construction, development, purchase, renovation, or other 5 
establishment of a health care facility, or any capital expenditure by or on 6 
behalf of a health care facility, for which the capital cost exceeds 7 
$1,500,000.00 $10,000,000.00. 8 
(2)  A change from one licensing period to the next in the number of 9 
licensed beds of a health care facility through addition or conversion, or 10 
through relocation from one physical facility or site to another. 11 
(3)  The offering of any home health service, or the transfer or 12 
conveyance of more than a 50 percent ownership interest in a health care 13 
facility other than a hospital or nursing home. 14 
(4)  The purchase, lease, or other comparable arrangement of a single 15 
piece of diagnostic and therapeutic equipment for which the cost, or in the case 16 
of a donation the value, is in excess of $1,000,000.00 $10,000,000.00.  For 17 
purposes of this subdivision, the purchase or lease of one or more articles of 18 
diagnostic or therapeutic equipment that are necessarily interdependent in the 19 
performance of their ordinary functions or that would constitute any health 20 
care facility included under subdivision 9432(8)(B) of this title, as determined 21  BILL AS INTRODUCED 	H.96 
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by the Board, shall be considered together in calculating the amount of an 1 
expenditure.  The Board’s determination of functional interdependence of 2 
items of equipment under this subdivision shall have the effect of a final 3 
decision and is subject to appeal under section 9381 of this title. 4 
(5)  The offering of a health care service or technology having an annual 5 
operating expense that exceeds $500,000.00 $10,000,000.00 for either of the 6 
next two budgeted fiscal years, if the service or technology was not offered or 7 
employed, either on a fixed or a mobile basis, by the health care facility within 8 
the previous three fiscal years. 9 
(6)  The construction, development, purchase, lease, or other 10 
establishment or expansion of an ambulatory surgical center for which the cost 11 
exceeds $10,000,000.00. 12 
(b)  A hospital shall not develop or have developed on its behalf a new 13 
health care project without issuance of a certificate of need by the Board.  For 14 
purposes of this subsection, a “new health care project” includes the following: 15 
(1)  The construction, development, purchase, renovation, or other 16 
establishment of a health care facility, or any capital expenditure by or on 17 
behalf of a hospital, for which the capital cost exceeds $3,000,000.00 18 
$10,000,000.00. 19 
(2)  The purchase, lease, or other comparable arrangement of a single 20 
piece of diagnostic and therapeutic equipment for which the cost, or in the case 21  BILL AS INTRODUCED 	H.96 
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of a donation the value, is in excess of $1,500,000.00 $10,000,000.00.  For 1 
purposes of this subdivision, the purchase or lease of one or more articles of 2 
diagnostic or therapeutic equipment that are necessarily interdependent in the 3 
performance of their ordinary functions or that would constitute any health 4 
care facility included under subdivision 9432(8)(B) of this title, as determined 5 
by the Board, shall be considered together in calculating the amount of an 6 
expenditure.  The Board’s determination of functional interdependence of 7 
items of equipment under this subdivision shall have the effect of a final 8 
decision and is subject to appeal under section 9381 of this title. 9 
(3)  The offering of a health care service or technology having an annual 10 
operating expense that exceeds $1,000,000.00 $10,000,000.00 for either of the 11 
next two budgeted fiscal years, if the service or technology was not offered or 12 
employed, either on a fixed or a mobile basis, by the hospital within the 13 
previous three fiscal years. 14 
(4)  A change from one licensing period to the next in the number of 15 
licensed beds of a health care facility through addition or conversion, or 16 
through relocation from one physical facility or site to another. 17 
(5)  The offering of any home health service. 18 
(c)  In the case of a project that requires a certificate of need under this 19 
section, expenditures for which are anticipated to be in excess of 20 
$30,000,000.00 $50,000,000.00, the applicant first shall secure a conceptual 21  BILL AS INTRODUCED 	H.96 
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development phase certificate of need, in accordance with the standards and 1 
procedures established in this subchapter, that permits the applicant to make 2 
expenditures for architectural services, engineering design services, or any 3 
other planning services, as defined by the Board, needed in connection with the 4 
project.  Upon completion of the conceptual development phase of the project, 5 
and before offering or further developing the project, the applicant shall secure 6 
a final certificate of need in accordance with the standards and procedures 7 
established in this subchapter.  Applicants shall not be subject to sanctions for 8 
failure to comply with the provisions of this subsection if such failure is solely 9 
the result of good faith reliance on verified project cost estimates issued by 10 
qualified persons, which cost estimates would have led a reasonable person to 11 
conclude the project was not anticipated to be in excess of $30,000,000.00 12 
$50,000,000.00 and therefore not subject to this subsection.  The provisions of 13 
this subsection notwithstanding, expenditures may be made in preparation for 14 
obtaining a conceptual development phase certificate of need, which 15 
expenditures shall not exceed $1,500,000.00 for non-hospitals or 16 
$3,000,000.00 for hospitals $10,000,000.00. 17 
(d)  If the Board determines that a person required to obtain a certificate of 18 
need under this subchapter has separated a single project into components in 19 
order to avoid cost thresholds or other requirements under this subchapter, the 20 
person shall be required to submit an application for a certificate of need for 21  BILL AS INTRODUCED 	H.96 
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the entire project, and the Board may proceed under section 9445 of this title.  1 
The Board’s determination under this subsection shall have the effect of a final 2 
decision and is subject to appeal under section 9381 of this title. 3 
(e)  The Board may periodically adjust the monetary jurisdictional 4 
thresholds contained in this section.  In doing so, the Board shall reflect the 5 
same categories of health care facilities, services, and programs recognized in 6 
this section.  Any adjustment by the Board shall not exceed an amount 7 
calculated using the cumulative Consumer Price Index rate of inflation. 8 
Sec. 2.  18 V.S.A. § 9435 is amended to read: 9 
§ 9435.  EXCLUSIONS 10 
* * * 11 
(i)  Excluded from this subchapter are the offering of a health care service, 12 
or the construction, development, purchase, renovation, or other establishment 13 
of a health care facility, as the result of a contract awarded by the State of 14 
Vermont.  15 
Sec. 3.  EFFECTIVE DATE 16 
This act shall take effect on July 1, 2025. 17