ANALYSIS OF HOUSE BILL 3005

   Allowing for greater coronary health care in certain rural areas.

Health Care Committee                          February 2, 2000

Washington State House of Representatives

SPONSORS:  Representatives Grant and Mastin.

BACKGROUND:  The Certificate of Need (CON) program, within the Department of Health,  reviews and authorizes a variety of new health care facilities such as hospitals, nursing homes, End Stage Renal Disease treatment centers, Medicare certified home health and hospice agencies.  The program also reviews and authorizes bed additions to hospitals and nursing homes, additions of kidney dialysis stations, new tertiary services in hospitals, and nursing home capital expenditures.  The program staff develop service specific planning and review criteria; coordinate planning, and review activities with public and community organizations; provide technical information and assistance to applicants, and conduct public hearings as requested.

Construction/Development of new health care facilities:

�Ambulatory Surgical Facilities

� Continuing Care Retirement Communities

� Home Health Agencies

� Hospices

� Hospitals

� Kidney Disease Treatment Centers

� Nursing Homes

� Psychiatric Hospitals

Sale, purchase or lease of all or part of:

� Hospitals

� Psychiatric Hospitals

� Capital expenditure for construction, renovation or alteration of a nursing home which substantially changes services, as specified in WAC

� Capital expenditure over expenditure minimum (currently $1,202,000) for construction, renovation, or alteration of a nursing home (with certain exceptions)

� Increase in health care facility licensed bed capacity or redistribution of existing bed capacity between acute care, nursing home care and boarding home.

� Increase in number of dialysis stations in a kidney disease treatment center

New Atertiary health services@ offered in or through a health care facility:

� Elective Therapeutic Cardiac Catheterization

� Intermediate Care Nursery

� Obstetric Services Level 2

� Obstetric Services Level 3

� Open Heart Surgery

� Rehabilitation Services Level 3

� Solid Organ Transplantation (organ-specific)

� Specialized Inpatient Pediatric Services

� Specialty Burn Services

The Department of Health=s CON program has begun a new review of the methodologies used to evaluate applications for a number of projects and services.

SUMMARY:  The Department of Health is directed to review, revise, and develop a new methodology for the methodology to be applied to CON applications for the tertiary health services of:  1) open heart surgery; 2) therapeutic cardiac catheterization; and 3) percutaneous translumenal coronary angioplasty.  The new methodology must be adopted in rules, and be applied to new applications, replacing the current methodology

The review and development of new methodologies for the cardiac services will be scheduled for immediate review and revision, and incorporation into rule. The department=s review and rulemaking process must involve a wide variety of stakeholders.  These may include cardiac surgery programs, cardiac surgeons not directly affiliated with existing hospital programs, and representatives of medical education.