House Moves On Certificate Of Need Repeal, Recovery Care Center Plans

Mar 7, 2017

Credit Tallahassee Memorial Hospital / TMH

Florida lawmakers are starting to put the pieces of the state’s healthcare puzzle together and the picture could involve changes for hospitals, nursing homes, hospice centers and other long-term care facilities.

The federal government rarely makes a move state lawmakers agree with. But Republicans in Florida are taking a cue from a late 80’s move by congress to repeal certificate of need rules. These laws govern where hospitals and other healthcare facilities can be built.

 “We know from studying 40 years of CON outcomes it’s not an effective mechanism for controlling costs. It’s not an effective mechanism for controlling quality outcomes. Licensure and specialty accreditation does that for us. And it’s not an effective tool for improving access," says Rep. Alexandra Miller, R-Sarasota.

Leading Age Florida President Steven Bramer is among the nursing homes and other long-term care groups opposing the repeal bill.

“The latest data I’ve got shows there are 36 states and Puerto Rico and the DC that have some sort of certificate of need program," he says.

The effort has been around for at least three years. And it’s part of the House’s efforts to generate more competition in healthcare. The idea is that more providers will drive down costs. But defenders of Certificate of Need argue the measures are necessary to make sure that there are enough providers in areas where otherwise, they wouldn’t go.

The House healthcare vision also involves expanding access by steering people out of hospitals when possible. And to that end, the chamber wants to allow patients to stay longer in out-patient facilities like recovery care centers and ambulatory care centers. Palm Coast Republican Paul Renner says it’s about getting patients to the right spot:

“So we’re not putting them in a facility where we have people who need acute hospitalization, we’re putting them in a situation where…you typically have healthy people receiving elective surgery.”  

The House has floated the idea before as an effort to give patients more choices when it comes to out-patient procedures. And it’s also targeted at costs. Hospitals tend to more expensive than other types of facilities. But Democratic Representative David Richardson is concerned the bill will eat away at the state’s hospital infrastructure.

“I understand the modernization factor but my concern is as we go down that road there has to be a balance between what work is done in hospital and what work isn’t done in a hospital. We can’t just leave a facility empty and expect the infrastructure to be there until we have the ultimate and highest level of emergency.”

Both the Certificate of Need repeal and Recovery Care Center bills come as parts of legisaltive efforts to get control of rising costs in the state's healthcare budget.