A Publication of WTVP

A significant topic that will emerge within the first half of 2003—and one that may impact the City of Peoria and its plans for the future—involves the sunset legislation regarding the State of Illinois Certificate of Need (CON) program. The current legislation regarding CON sunsets December 31. A decision about whether or not to continue the CON program must be made by June 30.

CON is a concept developed in the early 1970s. At that time there was a strong belief at both the federal and state levels that health planning would be the most appropriate way to reduce health care costs while meeting the needs of the entire community, especially the indigent and uninsured. CON was based on a theory that unnecessary duplication of technology and services was the cause of medical inflation. By controlling supply, the government thought they could reduce health care costs. CON was federally mandated with the passage of Public Law 93-641 in 1974. All states were forced to comply.

Typically, the process involves projects being approved for a certain amount of money and services prior to implementation. All states did have CONs, but as the model of health care changed to a more competitive model and as technologies have evolved, it’s been very difficult for health planning agencies to keep up with the pace of change in health care. Health planning prohibits current technology being implemented in a timely fashion, thereby denying patients the most current treatment available. Federal support of CON vanished when Medicare and Medicaid moved from cost-based to prospective reimbursement in 1982.

From the larger community perspective, the issue of CON may have tremendous impact on the future of our tri-county area. For example, the planning efforts and goals for Peoria Next revolve around the collaboration and coordination of its anchor organizations. Dr. Richard Lister has done more than 100 presentations emphasizing how strengthening our medical community through Peoria Next could enable us to compete in the knowledge economy of the 21st century.

The elimination of CON would mean all medical providers would be free to perform whatever services they wish and provide that service at whatever location they wish. More and more services could leave the City of Peoria, and it could further encourage physicians to leave the downtown area. The hundreds of thousands of patients who come to the downtown area now could see a slow transition to outlying areas, resulting in more fragmentation of care. In addition, out-of-state for-profit hospital systems could build a new hospital anywhere. A specialty hospital, such as a heart hospital, could be built anywhere.

The present position of the Illinois Hospital Association is to support continuation of the CON with some modifications. It’s unclear what the position of the new Blagojevich administration is. Typically, Democratic administrations have supported CON. Given the current budget crisis and other issues, it will be interesting to see what our new governor’s position will be. IBI