SCS/SB 934 - This act makes various changes to Missouri's Certificate of Need Laws.

The act removes Residential Care Facilities I and II from the Certificate of Need Process.

The expenditure minimums for intermediate and skilled nursing care facilities licensed pursuant to Chapter 198, RSMo and long term care beds in a hospital shall be $600,000 capital expenditures and $400,000 for major medical equipment. The expenditure minimums for beds or equipment used to provide 24 hours accommodations, board and basic or skilled nursing care and treatment services or beds in a long-term care hospital shall be $0 and the expenditure minimums for all other health care facilities shall be 1 million dollars for both capital expenditures and major medical equipment.

The Missouri Health Facilities Review Committee (MHFRC) is expanded to 11 members: Four members of the General Assembly, two Senators and two Representatives, divided equally as to party affiliation; and seven members appointed by the Governor with the advice and consent of the Senate. No more than 4 of the 7 publicly appointed members shall be from the same political party.

The MHFRC will be required to prepare a written report to be delivered to the General Assembly on April 1, 1998 regarding the effectiveness of the moratorium on the development of additional bed capacity of residential care facilities I and II. The report shall also have a recommendation as to whether residential care facilities should remain in the certificate of need process.

The MHFRC shall also establish a technical health care advisory council to review the committee's criteria and standards for appropriateness, accuracy, review and adequacy for information used in the review process. The advisory council will also offer recommendations regarding the expenditure minimum for capital expenditures, major medical equipment and new institutional services.

This act gives MHFRC the authority to remand certificate of need approval for failure to begin construction on any approved project within one year from the date of approval.

The act also creates a two step process for obtaining certificate of need approval for long-term acute care beds. As of the effective date of this act applicants shall submit a letter of intent to the MHFRC including the project location and a brief description of the project. The MHFRC will review all letters of intent to determine if a need exists. Within one year months of the filing of a letter of intent for a certificate of need, the MHFRC must enter its approval or denial of the certificate of need.

If there is not a need, the letter of intent shall be rejected. If need is determined, the Committee shall provide written notification that the MHFRC is accepting applications to meet the need for that service.

If the MHFRC believes that a new institutional health service is being developed or implemented for which a certificate of need is required, the Committee may refer the matter to the Attorney General's office who shall apply for an injunction to halt the development or implementation of the new institutional health service in question.
CHERYL GRAZIER