The Illinois Hospital Association is actively working with state legislators to extend the Certificate of Need (CON) program from May 31 through August 2008. Why is that important to all of us in healthcare here in the greater Peoria area? To better understand the importance, it is incumbent upon me to provide you with some pertinent background information about the CON program.
Many years ago the Illinois legislature passed the Health Facilities Planning Act (20 ILCS 3960), establishing Illinois’ Certificate of Need (CON) program. According to the description available on the Illinois Department of Public Health website, www.idph.state.il.us, “CON is designed to restrain rising healthcare costs by preventing unnecessary construction or modification of healthcare facilities. The Act promotes the development of a comprehensive healthcare delivery system that assures the availability of quality facilities, related services and equipment to the public, while simultaneously addressing the issues of community need, accessibility and financing. In addition, CON promotes cost containment, better management and improved planning by healthcare providers.”
“Entities subject to the Act include licensed and state-operated hospitals; long-term care facilities; dialysis centers; ambulatory surgery centers and alternative healthcare delivery models. Transactions requiring a permit include: any construction or modification by or on behalf of a healthcare facility exceeding the expenditure minimum ($7,167,063); substantial increase in a facility’s bed capacity; substantial change in the scope or functional operation of a facility; and, proposed establishment or discontinuation of a facility or category of service. In addition, the acquisition of major medical equipment (valued at more than $6,573,026) or health and fitness centers (valued at more than $3,267,766) must obtain a permit or exemption.”
Assuming the CON program is extended through August 2008, the IHA has suggested establishing a task force to consider potential reforms and modifications of the program as well as a longer-term extension of the program, say three to five years. We firmly support the efforts of IHA as they contend:
- CON prevents unnecessary duplication of healthcare facilities and services. It prevents unnecessary capital expenditures and prevents unchecked proliferation of healthcare services, particularly by those who don’t provide the full range of essential community services. The free market doesn’t control the growth of healthcare facilities and services.
- CON enables hospitals across the state to continue to provide essential safety net services to their communities. Among those are 24/7 emergency services, trauma care and perinatal services—which lose money because of the resources, both human and financial, required to support them. Yet they are vitally important to Illinoisans who need them. Community education, vaccination and health screening programs may also be harmed.
- CON helps promote quality by ensuring that if a facility or service is approved, the professionals who are needed will be available without exacerbating already challenging workforce shortages faced by hospitals.
- Efficient stewardship of healthcare resources calls for a CON program that does not impose unnecessary costs on providers without adding value, and calls for a regulatory program that is cost-effective and accountable to the public.
We believe this CON program serves as a very appropriate barrier to entry into various healthcare services and consequently serves the overall good of our patients, their families and those providing care. IBI