The 1997 amendments to Florida's certificate of need law.

• Author: Blank, F. Philip

After four years of trying, in the 1997 session, the legislature enacted Committee Substitute for Senate Bill 238, revising Florida's certificate-of-need law, which regulates the development and construction of health care facilities and health services. The legislation deregulates a number of projects and health services that are presently subject to review, as well as revises the list of projects which may be subject to expedited or full batch review. The new law also revises the requirements for letters of intent and applications.

Florida's Certificate of Need Program

F.S. [subsections] 408.031 through 408.045 are known as the Health Facility and Services Development Act. The act establishes the statutory basis for Florida's certificate of need (CON) program. The CON program is designed to control entry into and development within the health care market of certain health care facilities and services by requiring the Agency for Health Care Administration (AHCA) to certify that the proposed facility or service is needed. By controlling the supply of health care facilities and services, the CON program attempts to minimize the costs of excess supply, helps prevent nonprice competition, and slows the proliferation of new technology before its usefulness has been established. In addition, the CON program is designed to promote equal service and equal geographic access to quality health care, assure and reward quality care, and encourage responsiveness to community interests.

The establishment of hospitals, nursing homes, home health agencies, intermediate care facilities for the developmentally disabled, hospices, and certain institutional health services are currently subject to review under CON regulation.

The agency reviews CON applications under one of two review concepts: comparative review or expedited review. The agency also maintains an oversight function by virtue of its grant or denial of requests for exemption. Projects subject to comparative review are identified under F.S. [sections] 408.036(1). Comparative review requires that applications submitted in the same batching cycle for beds, services, or programs for the same planning area are competitively evaluated by the agency for purposes of awarding a certificate of need.

F.S. [section] 408.036(2) specifies projects that are subject to expedited review. Expedited review allows for nonbatched, noncomparative review of CON applications, resulting in a shorter review period.

F.S. [sections] 408.036(3) allows the agency to exempt a proposed project from review altogether. Prior to undertaking a project, an applicant must request that the agency evaluate its project and determine it is not subject to review. The agency must make a determination of whether the proposed project is exempt from CON review, notify the applicant in writing of its decision, provide the applicant with specific reasons if the request is denied, and publish its notice...