State health regulators were accused Wednesday of trying to make an end run around the legislative process.
“Is this a precursor of what’s going to come from the agency?” state Rep. Murrell Smith, chairman of a special S.C. House committee studying the state’s certificate of need (CON) law, said at a short committee meeting.
It seemed to Smith as if the S.C. Department of Health and Environmental Control was saying, “Let’s find every way we can to amend the State Health Plan to do away with the CON process.”
Smith was angry when he discovered, shortly before his committee’s meeting, that regulatory changes involving the CON process were on the agenda for the health agency’s board meeting Thursday. Those proposed changes include increasing the threshold for requiring a certificate of need for building projects or major equipment purchases at health-care facilities.
Smith’s committee is considering making similar changes through the legislative process.
Smith noted the health agency and Gov. Nikki Haley already have caused plenty of anguish and court costs by trying to shut down the certificate-of-need program through a budget veto. The S.C. Supreme Court ruled last summer that move wasn’t legal.
“Let’s don’t go through something like we just went through,” Smith said.
Jonathan Yarborough, the health agency’s legislative and constituent services director, said that wasn’t the intent of the proposed regulatory changes. He also apologized for not keeping Smith’s committee up-to-date.
The proposed changes were based on testimony to Smith’s committee that the dollar thresholds that kick in the need for a certificate of need from the state hadn’t been updated in years. The certificate program is designed to prevent duplication of expensive medical services in a community.
Haley, once employed by a hospital involved in a bitter certificate-of-need fight, would like to get rid of the process altogether.
Currently, a medical facility that spends more than $2 million on capital expenditures to upgrading hospital rooms, for example, is required to go through the CON process. The proposed changes would boost that threshold to $50 million. A similar threshold to determine when a CON would be required for buying new equipment would be boosted to $10 million from $600,000.
Smith said he agreed the thresholds need to be adjusted, but he wondered if the much higher figures would mean almost no capital expenditures or equipment purchases would fall under the review process.
Even with those changes, health care facilities would have to apply for a certificate of need to expand certain areas of care, including the battle over increased capacity for open-heart surgeries that Lexington Medical Center has been fighting.