HOUSE BILL REPORT

HB 1392

BYRepresentatives D. Sommers,  Braddock, Beck, Day, Betrozoff, Moyer, Sanders, Silver and Ferguson

Exempting type A continuing care retirement communities from certificate of need requirements.

House Committe on Health Care

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (10)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Bristow, Brooks, Bumgarner, Cantwell, Lewis, Lux, D. Sommers and Vekich.

House Staff:John Welsh (786-7133)

AS REPORTED BY COMMITTEE ON HEALTH CARE FEBRUARY 4, 1988

BACKGROUND:

For the purposes of cost containment and to assure access of the public to health resources, a certificate of need is required for the development of any new health facility or for any capital expenditure made by a health facility which substantially changes the services, or which otherwise exceeds one million dollars.

While nursing homes are considered health care facilities, "continuing care retirement communities" which may have nursing beds, are not specifically included under the certificate of need program.

SUMMARY:

SUBSTITUTE BILL:  Continuing care retirement communities are specifically included under the state certificate of need program.  A continuing care retirement community is an entity which provides shelter and services, and includes or sponsors health facilities or health services to its members, under contract, for the duration of the member's life.  The contract is conditioned upon the transfer of property, the payment of a fee or periodic charges by the member.

However, certain continuing care retirement communities are excluded from certificate of need review where they provide: 1) a restriction of services to members only; 2) a guarantee of services: 3) an assumption of costs of services; 4) evidence of operation since January 1, 1988 or otherwise having a valid certificate of need as a nursing home; 5) for holding DSHS harmless for costs; 6) a maximum ratio of one nursing home bed to four living units; and 7) a limitation on the total number of nursing home beds unless financially feasible.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  Coverage of continuing care retirement communities (CCRCs) under certificate of need is clarified.  Those conditions necessary for exemption are specified.  The definition of contracts for CCRCs is provided for.

Fiscal Note:      Requested January 21, 1988.

House Committee ‑ Testified For:    Arlene Temple, Exeter House; Daniel M. Chapman, Rockwood Manor.

House Committee - Testified Against:      Ward Miles, State Health Coordinating Council; Dan Rubin, DSHS.

House Committee - Testimony For:    An exemption from certificate of need for continuing care retirement communities reduces necessary regulation for retirement communities whose membership is closed and restricted to contracts for life care.  They are not in the nursing home business, though some services to retired persons involve long-term care.

House Committee - Testimony Against:      For consumer protection as well as health planning purposes, CCRCs should be covered under certificate of need (CON) generally, to know the availability of nursing home beds in the community and their impact on long-term care policy.  This exclusion from CON should be made only under clear conditions (as specified in the substitute), and should not be addressed until an overall licensure act has been enacted for consumer protection purposes.