| 1 | | - | BILLASPASSEDBYTHEHOUSE H.96 |
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| 2 | | - | 2025 Page1of12 |
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| 3 | | - | H.96 |
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| 4 | | - | IntroducedbyRepresentativesCordesofBristol,ArsenaultofWilliston, |
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| 5 | | - | BerbecoofWinooski,BlackofEssex,ChapinofEast |
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| 6 | | - | Montpelier,CinaofBurlington,GoldmanofRockingham, |
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| 7 | | - | HarrisonofChittenden,LoganofBurlington,Marcotteof |
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| 8 | | - | Coventry,McFaunofBarreTown,OlsonofStarksboro,Pageof |
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| 9 | | - | NewportCity,andPriestleyofBradford |
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| 10 | | - | ReferredtoCommitteeon |
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| 11 | | - | Date: |
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| 12 | | - | Subject:Health;healthcarefacilities;GreenMountainCareBoard;certificates |
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| 13 | | - | ofneed |
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| 14 | | - | Statementofpurposeofbillasintroduced:Thisbillproposestoincreasethe |
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| 15 | | - | monetarythresholdsthattriggeracertificateofneedrequirementandto |
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| 16 | | - | exempthealthcareservicesandhealthcarefacilityprojectsthataretheresult |
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| 17 | | - | ofacontractawardedbytheStateofVermont. |
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| 18 | | - | Anactrelatingtoincreasingthemonetarythresholdsforcertificatesofneed |
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| 19 | | - | ItisherebyenactedbytheGeneralAssemblyoftheStateofVermont: |
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| 20 | | - | Sec.1.18V.S.A.§ 9434isamendedtoread: |
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| 21 | | - | §9434.CERTIFICATEOFNEED;GENERALRULES |
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| 40 | | - | 19 BILLASPASSEDBYTHEHOUSE H.96 |
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| 41 | | - | 2025 Page2of12 |
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| 42 | | - | (a)Ahealthcarefacilityotherthanahospitalshallnotdeveloporhave |
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| 43 | | - | developedonitsbehalfanewhealthcareprojectwithoutissuanceofa |
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| 44 | | - | certificateofneedbytheBoard.Forpurposesofthissubsection,a“new |
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| 45 | | - | healthcareproject”includesthefollowing: |
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| 46 | | - | (1)Theconstruction,development,purchase,renovation,orother |
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| 47 | | - | establishmentofahealthcarefacility,oranycapitalexpenditurebyoron |
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| 48 | | - | behalfofahealthcarefacility,forwhichthecapitalcostexceeds |
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| 49 | | - | $1,500,000.00$10,000,000.00. |
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| 50 | | - | (2)Achangefromonelicensingperiodtothenextinthenumberof |
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| 51 | | - | licensedbedsofahealthcarefacilitythroughadditionorconversion,or |
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| 52 | | - | throughrelocationfromonephysicalfacilityorsitetoanother. |
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| 53 | | - | (3)Theofferingofanyhomehealthservice,orthetransferor |
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| 54 | | - | conveyanceofmorethana50percentownershipinterestinahealthcare |
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| 55 | | - | facilityotherthanahospitalornursinghome. |
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| 56 | | - | (4)Thepurchase,lease,orothercomparablearrangementofasingle |
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| 57 | | - | pieceofdiagnosticandtherapeuticequipmentforwhichthecost,orinthecase |
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| 58 | | - | ofadonationthevalue,isinexcessof$1,000,000.00$10,000,000.00.For |
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| 59 | | - | purposesofthissubdivision,thepurchaseorleaseofoneormorearticlesof |
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| 60 | | - | diagnosticortherapeuticequipmentthatarenecessarilyinterdependentinthe |
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| 61 | | - | performanceoftheirordinaryfunctionsorthatwouldconstituteanyhealth |
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| 62 | | - | carefacilityincludedundersubdivision9432(8)(B)ofthistitle,asdetermined |
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| 83 | | - | 21 BILLASPASSEDBYTHEHOUSE H.96 |
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| 84 | | - | 2025 Page3of12 |
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| 85 | | - | bytheBoard,shallbeconsideredtogetherincalculatingtheamountofan |
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| 86 | | - | expenditure.TheBoard’sdeterminationoffunctionalinterdependenceof |
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| 87 | | - | itemsofequipmentunderthissubdivisionshallhavetheeffectofafinal |
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| 88 | | - | decisionandissubjecttoappealundersection9381ofthistitle. |
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| 89 | | - | (5)Theofferingofahealthcareserviceortechnologyhavinganannual |
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| 90 | | - | operatingexpensethatexceeds$500,000.00$10,000,000.00foreitherofthe |
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| 91 | | - | nexttwobudgetedfiscalyears,iftheserviceortechnologywasnotofferedor |
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| 92 | | - | employed,eitheronafixedoramobilebasis,bythehealthcarefacilitywithin |
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| 93 | | - | thepreviousthreefiscalyears. |
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| 94 | | - | (6)Theconstruction,development,purchase,lease,orother |
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| 95 | | - | establishmentorexpansionofanambulatorysurgicalcenterforwhichthecost |
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| 96 | | - | exceeds$10,000,000.00. |
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| 97 | | - | (b)Ahospitalshallnotdeveloporhavedevelopedonitsbehalfanew |
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| 98 | | - | healthcareprojectwithoutissuanceofacertificateofneedbytheBoard.For |
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| 99 | | - | purposesofthissubsection,a“newhealthcareproject”includesthefollowing: |
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| 100 | | - | (1)Theconstruction,development,purchase,renovation,orother |
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| 101 | | - | establishmentofahealthcarefacility,oranycapitalexpenditurebyoron |
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| 102 | | - | behalfofahospital,forwhichthecapitalcostexceeds$3,000,000.00 |
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| 103 | | - | $10,000,000.00. |
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| 104 | | - | (2)Thepurchase,lease,orothercomparablearrangementofasingle |
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| 105 | | - | pieceofdiagnosticandtherapeuticequipmentforwhichthecost,orinthecase |
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| 126 | | - | 21 BILLASPASSEDBYTHEHOUSE H.96 |
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| 127 | | - | 2025 Page4of12 |
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| 128 | | - | ofadonationthevalue,isinexcessof$1,500,000.00$10,000,000.00.For |
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| 129 | | - | purposesofthissubdivision,thepurchaseorleaseofoneormorearticlesof |
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| 130 | | - | diagnosticortherapeuticequipmentthatarenecessarilyinterdependentinthe |
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| 131 | | - | performanceoftheirordinaryfunctionsorthatwouldconstituteanyhealth |
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| 132 | | - | carefacilityincludedundersubdivision9432(8)(B)ofthistitle,asdetermined |
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| 133 | | - | bytheBoard,shallbeconsideredtogetherincalculatingtheamountofan |
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| 134 | | - | expenditure.TheBoard’sdeterminationoffunctionalinterdependenceof |
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| 135 | | - | itemsofequipmentunderthissubdivisionshallhavetheeffectofafinal |
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| 136 | | - | decisionandissubjecttoappealundersection9381ofthistitle. |
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| 137 | | - | (3)Theofferingofahealthcareserviceortechnologyhavinganannual |
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| 138 | | - | operatingexpensethatexceeds$1,000,000.00$10,000,000.00foreitherofthe |
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| 139 | | - | nexttwobudgetedfiscalyears,iftheserviceortechnologywasnotofferedor |
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| 140 | | - | employed,eitheronafixedoramobilebasis,bythehospitalwithinthe |
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| 141 | | - | previousthreefiscalyears. |
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| 142 | | - | (4)Achangefromonelicensingperiodtothenextinthenumberof |
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| 143 | | - | licensedbedsofahealthcarefacilitythroughadditionorconversion,or |
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| 144 | | - | throughrelocationfromonephysicalfacilityorsitetoanother. |
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| 145 | | - | (5)Theofferingofanyhomehealthservice. |
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| 146 | | - | (c)Inthecaseofaprojectthatrequiresacertificateofneedunderthis |
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| 147 | | - | section,expendituresforwhichareanticipatedtobeinexcessof |
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| 148 | | - | $30,000,000.00$50,000,000.00,theapplicantfirstshallsecureaconceptual |
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| 169 | | - | 21 BILLASPASSEDBYTHEHOUSE H.96 |
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| 170 | | - | 2025 Page5of12 |
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| 171 | | - | developmentphasecertificateofneed,inaccordancewiththestandardsand |
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| 172 | | - | proceduresestablishedinthissubchapter,thatpermitstheapplicanttomake |
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| 173 | | - | expendituresforarchitecturalservices,engineeringdesignservices,orany |
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| 174 | | - | otherplanningservices,asdefinedbytheBoard,neededinconnectionwith |
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| 175 | | - | theproject.Uponcompletionoftheconceptualdevelopmentphaseofthe |
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| 176 | | - | project,andbeforeofferingorfurtherdevelopingtheproject,theapplicant |
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| 177 | | - | shallsecureafinalcertificateofneedinaccordancewiththestandardsand |
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| 178 | | - | proceduresestablishedinthissubchapter.Applicantsshallnotbesubjectto |
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| 179 | | - | sanctionsforfailuretocomplywiththeprovisionsofthissubsectionifsuch |
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| 180 | | - | failureissolelytheresultofgoodfaithrelianceonverifiedprojectcost |
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| 181 | | - | estimatesissuedbyqualifiedpersons,whichcostestimateswouldhaveleda |
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| 182 | | - | reasonablepersontoconcludetheprojectwasnotanticipatedtobeinexcessof |
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| 183 | | - | $30,000,000.00$50,000,000.00andthereforenotsubjecttothissubsection. |
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| 184 | | - | Theprovisionsofthissubsectionnotwithstanding,expendituresmaybemade |
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| 185 | | - | inpreparationforobtainingaconceptualdevelopmentphasecertificateof |
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| 186 | | - | need,whichexpendituresshallnotexceed$1,500,000.00fornon-hospitalsor |
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| 187 | | - | $3,000,000.00forhospitals$10,000,000.00. |
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| 188 | | - | (d)IftheBoarddeterminesthatapersonrequiredtoobtainacertificateof |
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| 189 | | - | needunderthissubchapterhasseparatedasingleprojectintocomponentsin |
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| 190 | | - | ordertoavoidcostthresholdsorotherrequirementsunderthissubchapter,the |
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| 191 | | - | personshallberequiredtosubmitanapplicationforacertificateofneedfor |
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| 212 | | - | 21 BILLASPASSEDBYTHEHOUSE H.96 |
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| 213 | | - | 2025 Page6of12 |
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| 214 | | - | theentireproject,andtheBoardmayproceedundersection9445ofthistitle. |
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| 215 | | - | TheBoard’sdeterminationunderthissubsectionshallhavetheeffectofafinal |
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| 216 | | - | decisionandissubjecttoappealundersection9381ofthistitle. |
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| 217 | | - | (e)TheBoardmayperiodicallyadjustthemonetaryjurisdictional |
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| 218 | | - | thresholdscontainedinthissection.Indoingso,theBoardshallreflectthe |
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| 219 | | - | samecategoriesofhealthcarefacilities,services,andprogramsrecognizedin |
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| 220 | | - | thissection.AnyadjustmentbytheBoardshallnotexceedanamount |
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| 221 | | - | calculatedusingthecumulativeConsumerPriceIndexrateofinflation. |
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| 222 | | - | Sec.2.18V.S.A.§ 9435isamendedtoread: |
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| 223 | | - | §9435.EXCLUSIONS |
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| 224 | | - | *** |
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| 225 | | - | (i)Excludedfromthissubchapteraretheofferingofahealthcareservice, |
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| 226 | | - | ortheconstruction,development,purchase,renovation,orotherestablishment |
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| 227 | | - | ofahealthcarefacility,astheresultofacontractawardedbytheStateof |
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| 228 | | - | Vermont. |
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| 229 | | - | Sec.3.EFFECTIVEDATE |
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| 230 | | - | ThisactshalltakeeffectonJuly1,2025. |
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| 231 | | - | Sec.1.18V.S.A.§ 9434isamendedtoread: |
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| 232 | | - | §9434.CERTIFICATEOFNEED;GENERALRULES |
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| 233 | | - | (a)Ahealthcarefacilityotherthanahospitalshallnotdeveloporhave |
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| 234 | | - | developedonitsbehalfanewhealthcareprojectwithoutissuanceofa |
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| 251 | | - | 17 BILLASPASSEDBYTHEHOUSE H.96 |
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| 252 | | - | 2025 Page7of12 |
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| 253 | | - | certificateofneedbytheBoard.Forpurposesofthissubsection,a“new |
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| 254 | | - | healthcareproject”includesmeansanyofthefollowing: |
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| 255 | | - | (1)Theconstruction,development,purchase,renovation,orother |
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| 256 | | - | establishmentofahealthcarefacility,oranycapitalexpenditurebyoron |
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| 257 | | - | behalfofahealthcarefacility,forwhichthecapitalcostexceeds |
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| 258 | | - | $1,500,000.00$10,000,000.00. |
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| 259 | | - | (2)Achangefromonelicensingperiodtothenextinthenumberof |
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| 260 | | - | licensedbedsofahealthcarefacilitythroughadditionorconversion,or |
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| 261 | | - | throughrelocationfromonephysicalfacilityorsitetoanother. |
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| 262 | | - | (3)Theofferingofanyhomehealthservice,orthetransferor |
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| 263 | | - | conveyanceofmorethana50percentownershipinterestinahealthcare |
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| 264 | | - | facilityotherthanahospitalornursinghome. |
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| 265 | | - | (4)Thepurchase,lease,orothercomparablearrangementofasingle |
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| 266 | | - | pieceofdiagnosticandtherapeuticequipmentforwhichthecost,orinthe |
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| 267 | | - | caseofadonationthevalue,isinexcessof$1,000,000.00$5,000,000.00.For |
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| 268 | | - | purposesofthissubdivision,thepurchaseorleaseofoneormorearticlesof |
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| 269 | | - | diagnosticortherapeuticequipmentthatarenecessarilyinterdependentinthe |
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| 270 | | - | performanceoftheirordinaryfunctionsorthatwouldconstituteanyhealth |
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| 271 | | - | carefacilityincludedundersubdivision9432(8)(B)ofthistitle,asdetermined |
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| 272 | | - | bytheBoard,shallbeconsideredtogetherincalculatingtheamountofan |
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| 273 | | - | expenditure.TheBoard’sdeterminationoffunctionalinterdependenceofitems BILLASPASSEDBYTHEHOUSE H.96 |
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| 274 | | - | 2025 Page8of12 |
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| 275 | | - | ofequipmentunderthissubdivisionshallhavetheeffectofafinaldecisionand |
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| 276 | | - | issubjecttoappealundersection9381ofthistitle. |
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| 277 | | - | (5)Theofferingofahealthcareserviceortechnologyhavinganannual |
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| 278 | | - | operatingexpensethatexceeds$500,000.00$3,000,000.00foreitherofthe |
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| 279 | | - | nexttwobudgetedfiscalyears,iftheserviceortechnologywasnotofferedor |
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| 280 | | - | employed,eitheronafixedoramobilebasis,bythehealthcarefacilitywithin |
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| 281 | | - | thepreviousthreefiscalyears. |
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| 282 | | - | (6)Theconstruction,development,purchase,lease,orother |
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| 283 | | - | establishmentorexpansionofanambulatorysurgicalcenterforwhichthecost |
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| 284 | | - | exceeds$10,000,000.00. |
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| 285 | | - | (b)Ahospitalshallnotdeveloporhavedevelopedonitsbehalfanew |
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| 286 | | - | healthcareprojectwithoutissuanceofacertificateofneedbytheBoard.For |
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| 287 | | - | purposesofthissubsection,a“newhealthcareproject”includesmeansanyof |
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| 288 | | - | thefollowing: |
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| 289 | | - | (1)Theconstruction,development,purchase,renovation,orother |
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| 290 | | - | establishmentofahealthcarefacility,oranycapitalexpenditurebyoron |
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| 291 | | - | behalfofahospital,forwhichthecapitalcostexceeds$3,000,000.00 |
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| 292 | | - | $10,000,000.00. |
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| 293 | | - | (2)Thepurchase,lease,orothercomparablearrangementofasingle |
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| 294 | | - | pieceofdiagnosticandtherapeuticequipmentforwhichthecost,orinthe |
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| 295 | | - | caseofadonationthevalue,isinexcessof$1,500,000.00$5,000,000.00.For BILLASPASSEDBYTHEHOUSE H.96 |
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| 296 | | - | 2025 Page9of12 |
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| 297 | | - | purposesofthissubdivision,thepurchaseorleaseofoneormorearticlesof |
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| 298 | | - | diagnosticortherapeuticequipmentthatarenecessarilyinterdependentinthe |
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| 299 | | - | performanceoftheirordinaryfunctionsorthatwouldconstituteanyhealth |
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| 300 | | - | carefacilityincludedundersubdivision9432(8)(B)ofthistitle,asdetermined |
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| 301 | | - | bytheBoard,shallbeconsideredtogetherincalculatingtheamountofan |
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| 302 | | - | expenditure.TheBoard’sdeterminationoffunctionalinterdependenceofitems |
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| 303 | | - | ofequipmentunderthissubdivisionshallhavetheeffectofafinaldecisionand |
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| 304 | | - | issubjecttoappealundersection9381ofthistitle. |
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| 305 | | - | (3)Theofferingofahealthcareserviceortechnologyhavinganannual |
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| 306 | | - | operatingexpensethatexceeds$1,000,000.00$3,000,000.00foreitherofthe |
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| 307 | | - | nexttwobudgetedfiscalyears,iftheserviceortechnologywasnotofferedor |
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| 308 | | - | employed,eitheronafixedoramobilebasis,bythehospitalwithinthe |
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| 309 | | - | previousthreefiscalyears. |
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| 310 | | - | (4)Achangefromonelicensingperiodtothenextinthenumberof |
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| 311 | | - | licensedbedsofahealthcarefacilitythroughadditionorconversion,or |
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| 312 | | - | throughrelocationfromonephysicalfacilityorsitetoanother. |
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| 313 | | - | (5)Theofferingofanyhomehealthservice. |
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| 314 | | - | (c)Inthecaseofaprojectthatrequiresacertificateofneedunderthis |
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| 315 | | - | section,expendituresforwhichareanticipatedtobeinexcessof |
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| 316 | | - | $30,000,000.00$50,000,000.00,theapplicantfirstshallsecureaconceptual |
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| 317 | | - | developmentphasecertificateofneed,inaccordancewiththestandardsand BILLASPASSEDBYTHEHOUSE H.96 |
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| 318 | | - | 2025 Page10of12 |
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| 319 | | - | proceduresestablishedinthissubchapter,thatpermitstheapplicanttomake |
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| 320 | | - | expendituresforarchitecturalservices,engineeringdesignservices,orany |
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| 321 | | - | otherplanningservices,asdefinedbytheBoard,neededinconnectionwith |
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| 322 | | - | theproject.Uponcompletionoftheconceptualdevelopmentphaseofthe |
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| 323 | | - | project,andbeforeofferingorfurtherdevelopingtheproject,theapplicant |
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| 324 | | - | shallsecureafinalcertificateofneedinaccordancewiththestandardsand |
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| 325 | | - | proceduresestablishedinthissubchapter.Applicantsshallnotbesubjectto |
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| 326 | | - | sanctionsforfailuretocomplywiththeprovisionsofthissubsectionifsuch |
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| 327 | | - | failureissolelytheresultofgoodfaithrelianceonverifiedprojectcost |
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| 328 | | - | estimatesissuedbyqualifiedpersons,whichcostestimateswouldhaveleda |
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| 329 | | - | reasonablepersontoconcludetheprojectwasnotanticipatedtobeinexcess |
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| 330 | | - | of$30,000,000.00$50,000,000.00andthereforenotsubjecttothissubsection. |
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| 331 | | - | Theprovisionsofthissubsectionnotwithstanding,expendituresmaybemade |
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| 332 | | - | inpreparationforobtainingaconceptualdevelopmentphasecertificateof |
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| 333 | | - | need,whichexpendituresshallnotexceed$1,500,000.00fornon-hospitalsor |
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| 334 | | - | $3,000,000.00forhospitals$10,000,000.00. |
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| 335 | | - | (d)IftheBoarddeterminesthatapersonrequiredtoobtainacertificateof |
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| 336 | | - | needunderthissubchapterhasseparatedasingleprojectintocomponentsin |
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| 337 | | - | ordertoavoidcostthresholdsorotherrequirementsunderthissubchapter,the |
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| 338 | | - | personshallberequiredtosubmitanapplicationforacertificateofneedfor |
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| 339 | | - | theentireproject,andtheBoardmayproceedundersection9445ofthistitle. BILLASPASSEDBYTHEHOUSE H.96 |
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| 340 | | - | 2025 Page11of12 |
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| 341 | | - | TheBoard’sdeterminationunderthissubsectionshallhavetheeffectofafinal |
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| 342 | | - | decisionandissubjecttoappealundersection9381ofthistitle. |
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| 343 | | - | (e)TheBoardmayperiodicallyadjustthemonetaryjurisdictional |
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| 344 | | - | thresholdscontainedinthissection.Indoingso,theBoardshallreflectthe |
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| 345 | | - | samecategoriesofhealthcarefacilities,services,andprogramsrecognizedin |
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| 346 | | - | thissection.AnyadjustmentbytheBoardshallnotexceedanamount |
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| 347 | | - | calculatedusingthecumulativeConsumerPriceIndexrateofinflation. |
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| 348 | | - | Sec.2.18V.S.A.§ 9435isamendedtoread: |
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| 349 | | - | §9435.EXCLUSIONS |
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| 350 | | - | *** |
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| 351 | | - | (f)(1)Excludedfromthissubchapterareroutinereplacementsof: |
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| 352 | | - | (A)medicalequipmentthatisfullydepreciated;and |
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| 353 | | - | (B)nonmedicalequipmentandfixtures,includingfurnaces,boilers, |
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| 354 | | - | refrigerationunits,kitchenequipment,heatingandcoolingunits,andsimilar |
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| 355 | | - | items,regardlessoftheirremainingusefullife. |
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| 356 | | - | (2)TheseThereplacementsdescribedinsubdivision(1)ofthis |
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| 357 | | - | subsectionandpurchasedbyahospitalshallbeincludedinthehospital’s |
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| 358 | | - | budgetandmaybereviewedinthebudgetprocesssetforthinsubchapter7of |
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| 359 | | - | thischapter. |
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| 360 | | - | *** BILLASPASSEDBYTHEHOUSE H.96 |
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| 361 | | - | 2025 Page12of12 |
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| 362 | | - | (i)Excludedfromthissubchapterareemergencyandnonemergency |
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| 363 | | - | groundambulanceservices,affiliatedagencies,andequipmentandsupplies |
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| 364 | | - | usedbyemergencymedicalpersonnel,asthosetermsaredefinedin24V.S.A. |
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| 365 | | - | § 2651. |
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| 366 | | - | Sec.3.EFFECTIVEDATE |
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| 367 | | - | ThisactshalltakeeffectonJuly1,2025andshallapplytoallnewhealth |
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| 368 | | - | careprojectsinitiatedonorafterthatdate.Forapplicationsforacertificate |
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| 369 | | - | ofneedthatarealreadyinprocessonJuly1,2025forwhichoneormore |
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| 370 | | - | personshavebeengrantedinterestedpartystatus,thejurisdictionalthresholds |
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| 371 | | - | andexclusionsinplaceatthetimetheapplicationwasfiledshallcontinueto |
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| 372 | | - | applyuntilafinaldecisionismadeontheapplication.Forapplicationsfora |
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| 373 | | - | certificateofneedthatarealreadyinprocessonJuly1,2025forwhichno |
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| 374 | | - | personhasbeengrantedinterestedpartystatus,theapplicantmaywithdraw |
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| 375 | | - | theapplicationinaccordancewithBoardrules. |
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| 1 | + | BILL AS INTRODUCED H.96 |
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| 2 | + | 2025 Page 1 of 6 |
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| 3 | + | |
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| 4 | + | |
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| 5 | + | VT LEG #379403 v.1 |
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| 6 | + | H.96 1 |
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| 7 | + | Introduced by Representatives Cordes of Bristol, Arsenault of Williston, 2 |
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| 8 | + | Berbeco of Winooski, Black of Essex, Chapin of East 3 |
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| 9 | + | Montpelier, Cina of Burlington, Goldman of Rockingham, 4 |
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| 10 | + | Harrison of Chittenden, Logan of Burlington, Marcotte of 5 |
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| 11 | + | Coventry, McFaun of Barre Town, Olson of Starksboro, Page of 6 |
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| 12 | + | Newport City, and Priestley of Bradford 7 |
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| 13 | + | Referred to Committee on 8 |
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| 14 | + | Date: 9 |
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| 15 | + | Subject: Health; health care facilities; Green Mountain Care Board; certificates 10 |
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| 16 | + | of need 11 |
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| 17 | + | Statement of purpose of bill as introduced: This bill proposes to increase the 12 |
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| 18 | + | monetary thresholds that trigger a certificate of need requirement and to 13 |
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| 19 | + | exempt health care services and health care facility projects that are the result 14 |
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| 20 | + | of a contract awarded by the State of Vermont. 15 |
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| 21 | + | An act relating to increasing the monetary thresholds for certificates of need 16 |
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| 22 | + | It is hereby enacted by the General Assembly of the State of Vermont: 17 |
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| 23 | + | Sec. 1. 18 V.S.A. § 9434 is amended to read: 18 |
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| 24 | + | § 9434. CERTIFICATE OF NEED; GENERAL RULES 19 BILL AS INTRODUCED H.96 |
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| 25 | + | 2025 Page 2 of 6 |
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| 26 | + | |
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| 27 | + | |
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| 28 | + | VT LEG #379403 v.1 |
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| 29 | + | (a) A health care facility other than a hospital shall not develop or have 1 |
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| 30 | + | developed on its behalf a new health care project without issuance of a 2 |
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| 31 | + | certificate of need by the Board. For purposes of this subsection, a “new 3 |
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| 32 | + | health care project” includes the following: 4 |
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| 33 | + | (1) The construction, development, purchase, renovation, or other 5 |
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| 34 | + | establishment of a health care facility, or any capital expenditure by or on 6 |
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| 35 | + | behalf of a health care facility, for which the capital cost exceeds 7 |
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| 36 | + | $1,500,000.00 $10,000,000.00. 8 |
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| 37 | + | (2) A change from one licensing period to the next in the number of 9 |
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| 38 | + | licensed beds of a health care facility through addition or conversion, or 10 |
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| 39 | + | through relocation from one physical facility or site to another. 11 |
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| 40 | + | (3) The offering of any home health service, or the transfer or 12 |
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| 41 | + | conveyance of more than a 50 percent ownership interest in a health care 13 |
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| 42 | + | facility other than a hospital or nursing home. 14 |
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| 43 | + | (4) The purchase, lease, or other comparable arrangement of a single 15 |
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| 44 | + | piece of diagnostic and therapeutic equipment for which the cost, or in the case 16 |
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| 45 | + | of a donation the value, is in excess of $1,000,000.00 $10,000,000.00. For 17 |
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| 46 | + | purposes of this subdivision, the purchase or lease of one or more articles of 18 |
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| 47 | + | diagnostic or therapeutic equipment that are necessarily interdependent in the 19 |
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| 48 | + | performance of their ordinary functions or that would constitute any health 20 |
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| 49 | + | care facility included under subdivision 9432(8)(B) of this title, as determined 21 BILL AS INTRODUCED H.96 |
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| 50 | + | 2025 Page 3 of 6 |
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| 51 | + | |
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| 52 | + | |
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| 53 | + | VT LEG #379403 v.1 |
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| 54 | + | by the Board, shall be considered together in calculating the amount of an 1 |
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| 55 | + | expenditure. The Board’s determination of functional interdependence of 2 |
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| 56 | + | items of equipment under this subdivision shall have the effect of a final 3 |
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| 57 | + | decision and is subject to appeal under section 9381 of this title. 4 |
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| 58 | + | (5) The offering of a health care service or technology having an annual 5 |
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| 59 | + | operating expense that exceeds $500,000.00 $10,000,000.00 for either of the 6 |
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| 60 | + | next two budgeted fiscal years, if the service or technology was not offered or 7 |
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| 61 | + | employed, either on a fixed or a mobile basis, by the health care facility within 8 |
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| 62 | + | the previous three fiscal years. 9 |
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| 63 | + | (6) The construction, development, purchase, lease, or other 10 |
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| 64 | + | establishment or expansion of an ambulatory surgical center for which the cost 11 |
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| 65 | + | exceeds $10,000,000.00. 12 |
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| 66 | + | (b) A hospital shall not develop or have developed on its behalf a new 13 |
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| 67 | + | health care project without issuance of a certificate of need by the Board. For 14 |
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| 68 | + | purposes of this subsection, a “new health care project” includes the following: 15 |
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| 69 | + | (1) The construction, development, purchase, renovation, or other 16 |
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| 70 | + | establishment of a health care facility, or any capital expenditure by or on 17 |
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| 71 | + | behalf of a hospital, for which the capital cost exceeds $3,000,000.00 18 |
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| 72 | + | $10,000,000.00. 19 |
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| 73 | + | (2) The purchase, lease, or other comparable arrangement of a single 20 |
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| 74 | + | piece of diagnostic and therapeutic equipment for which the cost, or in the case 21 BILL AS INTRODUCED H.96 |
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| 75 | + | 2025 Page 4 of 6 |
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| 76 | + | |
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| 77 | + | |
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| 78 | + | VT LEG #379403 v.1 |
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| 79 | + | of a donation the value, is in excess of $1,500,000.00 $10,000,000.00. For 1 |
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| 80 | + | purposes of this subdivision, the purchase or lease of one or more articles of 2 |
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| 81 | + | diagnostic or therapeutic equipment that are necessarily interdependent in the 3 |
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| 82 | + | performance of their ordinary functions or that would constitute any health 4 |
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| 83 | + | care facility included under subdivision 9432(8)(B) of this title, as determined 5 |
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| 84 | + | by the Board, shall be considered together in calculating the amount of an 6 |
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| 85 | + | expenditure. The Board’s determination of functional interdependence of 7 |
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| 86 | + | items of equipment under this subdivision shall have the effect of a final 8 |
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| 87 | + | decision and is subject to appeal under section 9381 of this title. 9 |
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| 88 | + | (3) The offering of a health care service or technology having an annual 10 |
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| 89 | + | operating expense that exceeds $1,000,000.00 $10,000,000.00 for either of the 11 |
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| 90 | + | next two budgeted fiscal years, if the service or technology was not offered or 12 |
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| 91 | + | employed, either on a fixed or a mobile basis, by the hospital within the 13 |
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| 92 | + | previous three fiscal years. 14 |
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| 93 | + | (4) A change from one licensing period to the next in the number of 15 |
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| 94 | + | licensed beds of a health care facility through addition or conversion, or 16 |
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| 95 | + | through relocation from one physical facility or site to another. 17 |
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| 96 | + | (5) The offering of any home health service. 18 |
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| 97 | + | (c) In the case of a project that requires a certificate of need under this 19 |
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| 98 | + | section, expenditures for which are anticipated to be in excess of 20 |
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| 99 | + | $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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| 100 | + | 2025 Page 5 of 6 |
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| 101 | + | |
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| 102 | + | |
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| 103 | + | VT LEG #379403 v.1 |
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| 104 | + | development phase certificate of need, in accordance with the standards and 1 |
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| 105 | + | procedures established in this subchapter, that permits the applicant to make 2 |
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| 106 | + | expenditures for architectural services, engineering design services, or any 3 |
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| 107 | + | other planning services, as defined by the Board, needed in connection with the 4 |
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| 108 | + | project. Upon completion of the conceptual development phase of the project, 5 |
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| 109 | + | and before offering or further developing the project, the applicant shall secure 6 |
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| 110 | + | a final certificate of need in accordance with the standards and procedures 7 |
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| 111 | + | established in this subchapter. Applicants shall not be subject to sanctions for 8 |
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| 112 | + | failure to comply with the provisions of this subsection if such failure is solely 9 |
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| 113 | + | the result of good faith reliance on verified project cost estimates issued by 10 |
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| 114 | + | qualified persons, which cost estimates would have led a reasonable person to 11 |
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| 115 | + | conclude the project was not anticipated to be in excess of $30,000,000.00 12 |
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| 116 | + | $50,000,000.00 and therefore not subject to this subsection. The provisions of 13 |
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| 117 | + | this subsection notwithstanding, expenditures may be made in preparation for 14 |
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| 118 | + | obtaining a conceptual development phase certificate of need, which 15 |
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| 119 | + | expenditures shall not exceed $1,500,000.00 for non-hospitals or 16 |
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| 120 | + | $3,000,000.00 for hospitals $10,000,000.00. 17 |
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| 121 | + | (d) If the Board determines that a person required to obtain a certificate of 18 |
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| 122 | + | need under this subchapter has separated a single project into components in 19 |
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| 123 | + | order to avoid cost thresholds or other requirements under this subchapter, the 20 |
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| 124 | + | person shall be required to submit an application for a certificate of need for 21 BILL AS INTRODUCED H.96 |
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| 125 | + | 2025 Page 6 of 6 |
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| 126 | + | |
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| 127 | + | |
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| 128 | + | VT LEG #379403 v.1 |
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| 129 | + | the entire project, and the Board may proceed under section 9445 of this title. 1 |
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| 130 | + | The Board’s determination under this subsection shall have the effect of a final 2 |
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| 131 | + | decision and is subject to appeal under section 9381 of this title. 3 |
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| 132 | + | (e) The Board may periodically adjust the monetary jurisdictional 4 |
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| 133 | + | thresholds contained in this section. In doing so, the Board shall reflect the 5 |
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| 134 | + | same categories of health care facilities, services, and programs recognized in 6 |
|---|
| 135 | + | this section. Any adjustment by the Board shall not exceed an amount 7 |
|---|
| 136 | + | calculated using the cumulative Consumer Price Index rate of inflation. 8 |
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| 137 | + | Sec. 2. 18 V.S.A. § 9435 is amended to read: 9 |
|---|
| 138 | + | § 9435. EXCLUSIONS 10 |
|---|
| 139 | + | * * * 11 |
|---|
| 140 | + | (i) Excluded from this subchapter are the offering of a health care service, 12 |
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| 141 | + | or the construction, development, purchase, renovation, or other establishment 13 |
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| 142 | + | of a health care facility, as the result of a contract awarded by the State of 14 |
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| 143 | + | Vermont. 15 |
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| 144 | + | Sec. 3. EFFECTIVE DATE 16 |
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| 145 | + | This act shall take effect on July 1, 2025. 17 |
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