SCS/SB 235 - This act revises the Certificate of Need (CON) statutes. Current CON Sections 197.300 to 197.367, RSMo, are repealed and new Sections 197.370 - 197.398 regarding "review certification" are enacted. This act is known as the "Missouri Health Facilities Review Law" and states the purpose of the Office of Health Facilities Review. Revised definitions are provided. (Sections 197.370 to 197.374).

The Missouri Health Facilities Review Committee is established, consisting of seven members and the director of the Division of Health Standards and Licensure and the Division of Aging. The Committee must meet at least twice per year. Duties of the Committee are provided, including the review and approval or disapproval of all applications for review certification. (Section 197.376 to 197.378).

Specific application procedures are outlined. A letter of intent should be submitted thirty days before filing an application and a fee must accompany the application. Applicants have the right to appeal the Committee's decision. (Sections 197.380 to 197.382).

Any person proposing a new institutional health service, first-time service, or the addition of newly licensed beds must obtain a non-transferable review certification. Certification will be granted to those meeting the health needs of the community. If costs exceed ten percent of the approved amount, the Committee must consent to the increase. Applicants must submit periodic reports and the Committee may revoke certification in certain situations. State agencies may not license, certify, or provide funds without a person or facility first obtaining review certification, if required to do so. (Section 197.384).

An application for review certification will not be required for previously certified facilities which are run by the state, facilities operated for the purpose of treating AIDS patients, and other nonreviewable projects. (Section 197.386).

After December 31, 2001, the term "health care facilities" is redefined and review certification will only be required of these entities. After December 31, 2001, a review certification will not be required for the acquisition of major medical equipment by any facility other than those listed in this section. (Section 197.387).

Review certification will not be issued until January 1, 2006, for additional intermediate care facility (ICF) or skilled nursing facility (SNF) beds, unless they are exempt from review certification requirements, or for hospital beds which are reallocated to nursing care beds. (Section 197.388)

The Department of Health must determine existing need for additional beds by county. Occupancy within a county must exceed ninety percent for at least four consecutive quarters and the Department may make other considerations, as well. (Section 197.390).

Procedures are outlined for increasing licensed bed capacity in an ICF or a SNF. This section also allows residential care facilities (RCF)to purchase licensed beds from SNFs for the purpose of continuum of care. The RCF may purchase up to ten percent of its current licensed bed capacity. Any facility that transfers or sells beds may not expand its bed capacity for five years after the transaction. This section does not prohibit a health care facility from being replaced in its entirety within fifteen miles of its existing site. (Section 197.392).

Any person paid to support or oppose a project must register with the Committee. Persons regulated by chapters 197 or 198 are prohibited from soliciting Committee members while an application is pending. (Section 197.394).

Reimbursement for new institutional health service project costs over ten percent of the initial estimate will not be paid for the first three years that a facility receives payment for services through Medicaid. A review certification must be granted before payment for excess project costs will be made. The Committee is given rule authority to enforce these sections. (Sections 197.396 to 197.398).

Portions of this act are similar to SCS/HB 949 (2001).
ERIN MOTLEY