the future of CON in SC

1. the future of CON in SC

2. controversial issues last session • Loser pays • Equipment threshold • Behavioral health bed conversion • Bamberg issue • CONexemptions • Grandfathering

3. legislative attitude toward CON • CON fights are public • Why doesn’t free market apply? • Which legislator can explain a bill on the floor?

4. next session • Repeal effort? • Reform effort? • United or split?

5. CON components in state law • Definitions • When CON’s required • When CON’s not required • Health planning committee & state health plan • Use of project review criteria • Public notification in newspaper • Review procedure and contested cases • Prohibited communication during review • Use of ALC and Court of Appeals • Limitations on CON

6. what else defines when CON is required? • Regulation 61-15 • State Health Plan Regulation 61-15: • Establishes capital expenditure threshold • Establishes medical equipment expenditure threshold • Defines total project cost

7. regulation 61-15 Also provides details of the process: • Specifies when written determinations of exemptions and non-applicability are required and what is required • Creates timelines and processes for public notification • Specifies contents and format of CON application • Creates timelines for additional information • Process for relative importance project review criteria • Review time frames, notification of affected person, and public hearings • Periodic reporting requirements

8. south carolina health plan / general contents • Projections of need for additional healthcare facilities, beds, health services & equipment • Standards for distribution of healthcare facilities, beds, health services & equipment • Project review criteria

9. specific facilities, beds, health services and equipment in south carolinahealth plan • Inpatient health facilities and beds • Acute care hospital • CAH • LTAC, PLTAC • Psychiatric hospitals and psychiatric beds • Rehab hospitals and rehab beds • Residential treatment facilities for children, adolescents • Long term care facilities and beds

10. specific facilities, beds, health services and equipment in south carolina health plan • Health services connected with hospitals: obstetrical and neonatal pediatric cardiac cath open heart freestanding emergency services • Other health services and equipment: PET PET/CT PEM linear accelerator ASC inpatient hospice home health agencies

11. who responded? (n=47 respondents)

12. is it important to maintain CON? (n=47 respondents)

13. should the CON law be? (n=39 respondents)

14. limited or broad by type (n=40 respondents)

15. lf limited, when should it be required? (n=19 respondents)

16. if broad, when should it be required for facilities? (n=19 respondents)

17. if broad, when should it be required for equipment? (n=12 respondents)

18. if broad, when should it be required for services? (n=16 respondents)

19. if broad, should SC have a capital threshold? If yes, which range seems appropriate?

20. if broad, should SC have an equipment threshold? If yes, which range seems appropriate?