Invitation to July 23, 2008 Meeting on Proposed CON Process Reforms

June 19, 2008

Dear [stakeholder name]:

We are writing to invite your organization to make a presentation to the Planning Committee of the State Hospital Review and Planning Council (SHRPC) concerning your organization's proposed reforms to the certificate of need (CON) process. Members of the other SHRPC committees, as well as members of the Public Health Council have also been invited to participate. The meeting will take place on July 23 between 1:00 and 4:30 p.m. in Meeting Room 6 on the Concourse of the Empire State Plaza in Albany. As the date approaches, and the list of presenters is finalized, we will try to provide you with the approximate time of your presentation.

The Department of Health is currently evaluating the CON process in an effort to ensure that our process facilitates the appropriate alignment of health care resources with community needs and avoids another forced downsizing of the delivery system. Our goal is the development of a patient-centered, high performing health care delivery system – in other words, a system that offers accessible, affordable, high-quality and cost-effective care in settings that are appropriate to the needs and preferences of health care consumers. Further, a high performing health care delivery system contributes not only to individual health, but also the health of the community as a whole.

This meeting provides stakeholders with an opportunity to present focused and substantive recommendations regarding CON reform and Council members with an opportunity to hear ideas and recommendations from a variety of stakeholders. Presentations are by invitation only and will be limited to 10 minutes in duration, including responses to questions from Council members. Presenters should bring with them at least 35 copies of any written remarks for distribution to Council members and Department staff. Presentations should provide concrete recommendations that will improve the certificate of need process. Please focus your presentation on one or more of the following issues:

1. Projects, Services and Equipment Subject to Review

  1. How can the CON process be improved to respond to changes in the health care marketplace?
  2. Are there types of construction projects, medical services, or equipment that should no longer be subject to certificate of need review?
  3. Are there projects, services and equipment that are currently not regulated, but should be?
  4. Are there types of facilities or services that should be licensed, but not subject to a need test? Are there other regulatory mechanisms or controls that might make more sense?

2. Local Planning and Public Notice

  1. What are effective ways to notify interested stakeholders about pending certificate of need applications that are actively under review?
  2. How can the Department support the development of collaborative efforts to assess community health needs and make recommendations to develop and/or deploy efficiently and effectively the health care system resources needed to address those needs?
  3. Are there effective local health planning models the Department should consider?

3. Migration of Services

  1. Due to technological advances, surgical procedures and complex diagnostic services are increasingly migrating from inpatient to ambulatory settings. How should the CON process respond?
  2. In addition, tertiary care facilities are increasing their market share at the expense of community hospitals. What role, if any, should the CON process play in preserving community hospitals? How should consumer preferences be weighed in this process?
  3. How can the Department encourage more collaboration among health care providers in order to achieve economies of scale, avoid duplicative services, and improve access to care and quality?
  4. In order to facilitate collaboration, should the Department exercise "active supervision" in connection with CON applications as a means of avoiding antitrust concerns?
  5. In order to encourage collaboration, should there be changes in the Department's approach to "active" vs. "passive" parent models?

4. CON Submission and Review Process

  1. Are there ways in which the CON review process could be streamlined and to what effect?
  2. Are there aspects of the process that are duplicative, unnecessary or provide minimal marginal benefit?
  3. How should the CON process weigh the financial impact of a project or service on Medicaid and other payors (and ultimately consumers and taxpayers)?
  4. Should need methodologies be modified to reflect more accurately the unique needs of rural areas, increased utilization of community-based long-term care, health disparities, and other similar factors?

Please complete the attached reply form and e-mail it to Lisa Thomson at lat02@health.state.ny.us or mail it to her at:

NYS Department of Health
Office of Health Systems Management
433 River Street, suit 303
Troy, NY 12180

If you have any questions about administrative arrangements please call Ms. Thomson at (518) 402-0964. Thank you in advance for your time. We look forward to hearing from you.

Sincerely yours,

  • James Kennedy
    Chair, SHRPC Planning Committee
  • Howard Berliner
    Vice-Chair, SHRPC Planning Committee