The Department of Health and Environmental Control board on Thursday approved regulations that would make it easier for health-care facilities to make major capital improvements or buy new equipment without getting regulatory approval.
DHEC director Catherine Templeton characterized the regulations as a starting point in the debate over the proper thresholds for the state’s Certificate of Need program. “This is the beginning of the discussion in public,” she said. “I’ll admit these are arbitrary numbers. Now tell us how much, where does it make sense.”
The contentious numbers: Increasing the threshold for requiring a Certificate of Need for buying new equipment from $600,000 to $10 million, and increasing the threshold for capital improvements from $2 million to $50 million. The board approved the regulations after a long debate, but only after voting down an attempt to cut the thresholds in half.
A stakeholders group put together to guide changes in the Certificate of Need program had recommended changing the thresholds to $2 million for equipment and $5 million for capital improvements.
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Health-care facilities adding new regulated services or constructing a new facility have to go through the Certificate of Need process, regardless of the expense of the project.
The regulations approved Thursday also included changes designed to streamline the Certificate of Need process, allowing much of the paperwork-intensive procedure to be done online. There’s little debate that change is a positive.
Rep. Murrell Smith, a Sumter Republican who chairs the House Certificate of Need Ad-Hoc Committee, said at a meeting of that panel on Wednesday that DHEC officials seemed to be making the thresholds so high as to allow just about any capital expenditure or equipment purchase. He also complained that DHEC appeared to be changing the regulations to avoid having to go through the legislative process to make changes in the law.
Templeton denied that on Thursday, saying the debate is just beginning and “the thresholds are where we’re going to get the most discussion.”
The Legislature either approves the regulations or sends them back to DHEC for revisions.
Templeton also announced that the agency is ready to hit the button to put the Certificate of Need process online. For now, the process still will involve many layers of documents required under current regulations.
“It’ll be more efficient and more standardized,” she said. Also, the system is set up to be easily adapted to paperwork streamlining if changes are approved by the legislature in the coming session. Some legislators want to do away with the program completely.
The Certificate of Need program, designed to prevent duplication of expensive medical services, was put on hold in 2013 when Gov. Nikki Haley vetoed funding for it. Templeton then shut down the program’s administrative office. The S.C. Supreme Court ruled last summer that Haley couldn’t use a budget veto to kill a program required by law.