Vermont 2025-2026 Regular Session

Vermont Senate Bill S0020 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	BILL AS INTRODUCED S.20
2	2	2025 Page 1 of 6
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5	5	VT LEG #379404 v.1
6	6	S.20 1
7	7	Introduced by Senators Gulick, Beck, Chittenden, Clarkson, Hart, Major, 2
8	8	Mattos, Vyhovsky, Watson, Weeks and White 3
9	9	Referred to Committee on 4
10	10	Date: 5
11	11	Subject: Health; health care facilities; Green Mountain Care Board; certificates 6
12	12	of need 7
13	13	Statement of purpose of bill as introduced: This bill proposes to increase the 8
14	14	monetary thresholds that trigger a certificate of need requirement and to 9
15	15	exempt health care services and health care facility projects that are the result 10
16	16	of a contract awarded by the State of Vermont. 11
17	17	An act relating to increasing the monetary thresholds for certificates of need 12
18	18	It is hereby enacted by the General Assembly of the State of Vermont: 13
19	19	Sec. 1. 18 V.S.A. § 9434 is amended to read: 14
20	20	§ 9434. CERTIFICATE OF NEED; GENERAL RULES 15
21	21	(a) A health care facility other than a hospital shall not develop or have 16
22	22	developed on its behalf a new health care project without issuance of a 17
23	23	certificate of need by the Board. For purposes of this subsection, a “new 18
24	24	health care project” includes the following: 19 BILL AS INTRODUCED S.20
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28	28	VT LEG #379404 v.1
29	29	(1) The construction, development, purchase, renovation, or other 1
30	30	establishment of a health care facility, or any capital expenditure by or on 2
31	31	behalf of a health care facility, for which the capital cost exceeds 3
32	32	$1,500,000.00 $10,000,000.00. 4
33	33	(2) A change from one licensing period to the next in the number of 5
34	34	licensed beds of a health care facility through addition or conversion, or 6
35	35	through relocation from one physical facility or site to another. 7
36	36	(3) The offering of any home health service, or the transfer or 8
37	37	conveyance of more than a 50 percent ownership interest in a health care 9
38	38	facility other than a hospital or nursing home. 10
39	39	(4) The purchase, lease, or other comparable arrangement of a single 11
40	40	piece of diagnostic and therapeutic equipment for which the cost, or in the case 12
41	41	of a donation the value, is in excess of $1,000,000.00 $10,000,000.00. For 13
42	42	purposes of this subdivision, the purchase or lease of one or more articles of 14
43	43	diagnostic or therapeutic equipment that are necessarily interdependent in the 15
44	44	performance of their ordinary functions or that would constitute any health 16
45	45	care facility included under subdivision 9432(8)(B) of this title, as determined 17
46	46	by the Board, shall be considered together in calculating the amount of an 18
47	47	expenditure. The Board’s determination of functional interdependence of 19
48	48	items of equipment under this subdivision shall have the effect of a final 20
49	49	decision and is subject to appeal under section 9381 of this title. 21 BILL AS INTRODUCED S.20
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54	54	(5) The offering of a health care service or technology having an annual 1
55	55	operating expense that exceeds $500,000.00 $10,000,000.00 for either of the 2
56	56	next two budgeted fiscal years, if the service or technology was not offered or 3
57	57	employed, either on a fixed or a mobile basis, by the health care facility within 4
58	58	the previous three fiscal years. 5
59	59	(6) The construction, development, purchase, lease, or other 6
60	60	establishment or expansion of an ambulatory surgical center for which the cost 7
61	61	exceeds $10,000,000.00. 8
62	62	(b) A hospital shall not develop or have developed on its behalf a new 9
63	63	health care project without issuance of a certificate of need by the Board. For 10
64	64	purposes of this subsection, a “new health care project” includes the following: 11
65	65	(1) The construction, development, purchase, renovation, or other 12
66	66	establishment of a health care facility, or any capital expenditure by or on 13
67	67	behalf of a hospital, for which the capital cost exceeds $3,000,000.00 14
68	68	$10,000,000.00. 15
69	69	(2) The purchase, lease, or other comparable arrangement of a single 16
70	70	piece of diagnostic and therapeutic equipment for which the cost, or in the case 17
71	71	of a donation the value, is in excess of $1,500,000.00 $10,000,000.00. For 18
72	72	purposes of this subdivision, the purchase or lease of one or more articles of 19
73	73	diagnostic or therapeutic equipment that are necessarily interdependent in the 20
74	74	performance of their ordinary functions or that would constitute any health 21 BILL AS INTRODUCED S.20
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79	79	care facility included under subdivision 9432(8)(B) of this title, as determined 1
80	80	by the Board, shall be considered together in calculating the amount of an 2
81	81	expenditure. The Board’s determination of functional interdependence of 3
82	82	items of equipment under this subdivision shall have the effect of a final 4
83	83	decision and is subject to appeal under section 9381 of this title. 5
84	84	(3) The offering of a health care service or technology having an annual 6
85	85	operating expense that exceeds $1,000,000.00 $10,000,000.00 for either of the 7
86	86	next two budgeted fiscal years, if the service or technology was not offered or 8
87	87	employed, either on a fixed or a mobile basis, by the hospital within the 9
88	88	previous three fiscal years. 10
89	89	(4) A change from one licensing period to the next in the number of 11
90	90	licensed beds of a health care facility through addition or conversion, or 12
91	91	through relocation from one physical facility or site to another. 13
92	92	(5) The offering of any home health service. 14
93	93	(c) In the case of a project that requires a certificate of need under this 15
94	94	section, expenditures for which are anticipated to be in excess of 16
95	95	$30,000,000.00 $50,000,000.00, the applicant first shall secure a conceptual 17
96	96	development phase certificate of need, in accordance with the standards and 18
97	97	procedures established in this subchapter, that permits the applicant to make 19
98	98	expenditures for architectural services, engineering design services, or any 20
99	99	other planning services, as defined by the Board, needed in connection with the 21 BILL AS INTRODUCED S.20
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104	104	project. Upon completion of the conceptual development phase of the project, 1
105	105	and before offering or further developing the project, the applicant shall secure 2
106	106	a final certificate of need in accordance with the standards and procedures 3
107	107	established in this subchapter. Applicants shall not be subject to sanctions for 4
108	108	failure to comply with the provisions of this subsection if such failure is solely 5
109	109	the result of good faith reliance on verified project cost estimates issued by 6
110	110	qualified persons, which cost estimates would have led a reasonable person to 7
111	111	conclude the project was not anticipated to be in excess of $30,000,000.00 8
112	112	$50,000,000.00 and therefore not subject to this subsection. The provisions of 9
113	113	this subsection notwithstanding, expenditures may be made in preparation for 10
114	114	obtaining a conceptual development phase certificate of need, which 11
115	115	expenditures shall not exceed $1,500,000.00 for non-hospitals or 12
116	116	$3,000,000.00 for hospitals $10,000,000.00. 13
117	117	(d) If the Board determines that a person required to obtain a certificate of 14
118	118	need under this subchapter has separated a single project into components in 15
119	119	order to avoid cost thresholds or other requirements under this subchapter, the 16
120	120	person shall be required to submit an application for a certificate of need for 17
121	121	the entire project, and the Board may proceed under section 9445 of this title. 18
122	122	The Board’s determination under this subsection shall have the effect of a final 19
123	123	decision and is subject to appeal under section 9381 of this title. 20 BILL AS INTRODUCED S.20
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128	128	(e) The Board may periodically adjust the monetary jurisdictional 1
129	129	thresholds contained in this section. In doing so, the Board shall reflect the 2
130	130	same categories of health care facilities, services, and programs recognized in 3
131	131	this section. Any adjustment by the Board shall not exceed an amount 4
132	132	calculated using the cumulative Consumer Price Index rate of inflation. 5
133	133	Sec. 2. 18 V.S.A. § 9435 is amended to read: 6
134	134	§ 9435. EXCLUSIONS 7
135	135	* * * 8
136	136	(i) Excluded from this subchapter are the offering of a health care service, 9
137	137	or the construction, development, purchase, renovation, or other establishment 10
138	138	of a health care facility, as the result of a contract awarded by the State of 11
139	139	Vermont. 12
140	140	Sec. 3. EFFECTIVE DATE 13
141	141	This act shall take effect on July 1, 2025. 14