HF 127

as introduced - 84th Legislature, 2005 1st Special Session (2005 - 2005) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; providing an exception to the
hospital construction moratorium; amending Minnesota
Statutes 2004, section 144.551, subdivision 1.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2004, section 144.551,
subdivision 1, is amended to read:

Subdivision 1.

Restricted construction or modification.

(a) The following construction or modification may not be
commenced:

(1) any erection, building, alteration, reconstruction,
modernization, improvement, extension, lease, or other
acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one
physical facility, complex, or site to another, or otherwise
results in an increase or redistribution of hospital beds within
the state; and

(2) the establishment of a new hospital.

(b) This section does not apply to:

(1) construction or relocation within a county by a
hospital, clinic, or other health care facility that is a
national referral center engaged in substantial programs of
patient care, medical research, and medical education meeting
state and national needs that receives more than 40 percent of
its patients from outside the state of Minnesota;

(2) a project for construction or modification for which a
health care facility held an approved certificate of need on May
1, 1984, regardless of the date of expiration of the
certificate;

(3) a project for which a certificate of need was denied
before July 1, 1990, if a timely appeal results in an order
reversing the denial;

(4) a project exempted from certificate of need
requirements by Laws 1981, chapter 200, section 2;

(5) a project involving consolidation of pediatric
specialty hospital services within the Minneapolis-St. Paul
metropolitan area that would not result in a net increase in the
number of pediatric specialty hospital beds among the hospitals
being consolidated;

(6) a project involving the temporary relocation of
pediatric-orthopedic hospital beds to an existing licensed
hospital that will allow for the reconstruction of a new
philanthropic, pediatric-orthopedic hospital on an existing site
and that will not result in a net increase in the number of
hospital beds. Upon completion of the reconstruction, the
licenses of both hospitals must be reinstated at the capacity
that existed on each site before the relocation;

(7) the relocation or redistribution of hospital beds
within a hospital building or identifiable complex of buildings
provided the relocation or redistribution does not result in:
(i) an increase in the overall bed capacity at that site; (ii)
relocation of hospital beds from one physical site or complex to
another; or (iii) redistribution of hospital beds within the
state or a region of the state;

(8) relocation or redistribution of hospital beds within a
hospital corporate system that involves the transfer of beds
from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the
capacity of the closed facility is transferred; (ii) the
capacity of the site or complex to which the beds are
transferred does not increase by more than 50 percent; (iii) the
beds are not transferred outside of a federal health systems
agency boundary in place on July 1, 1983; and (iv) the
relocation or redistribution does not involve the construction
of a new hospital building;

(9) a construction project involving up to 35 new beds in a
psychiatric hospital in Rice County that primarily serves
adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;

(10) a project to replace a hospital or hospitals with a
combined licensed capacity of 130 beds or less if: (i) the new
hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement
hospital, either at the time of construction of the initial
building or as the result of future expansion, will not exceed
70 licensed hospital beds, or the combined licensed capacity of
the hospitals, whichever is less;

(11) the relocation of licensed hospital beds from an
existing state facility operated by the commissioner of human
services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one
regional treatment center site to another; or from one building
or site to a new or existing building or site on the same
campus;

(12) the construction or relocation of hospital beds
operated by a hospital having a statutory obligation to provide
hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds;

(13) a construction project involving the addition of up to
31 new beds in an existing nonfederal hospital in Beltrami
County;

(14) a construction project involving the addition of up to
eight new beds in an existing nonfederal hospital in Otter Tail
County with 100 licensed acute care beds;

(15) a construction project involving the addition of 20
new hospital beds used for rehabilitation services in an
existing hospital in Carver County serving the southwest
suburban metropolitan area. Beds constructed under this clause
shall not be eligible for reimbursement under medical
assistance, general assistance medical care, or MinnesotaCare;

(16) a project for the construction or relocation of up to
20 hospital beds for the operation of up to two psychiatric
facilities or units for children provided that the operation of
the facilities or units have received the approval of the
commissioner of human services;

(17) a project involving the addition of 14 new hospital
beds to be used for rehabilitation services in an existing
hospital in Itasca County; deleted text begin or
deleted text end

(18) a project to add 20 licensed beds in existing space at
a hospital in Hennepin County that closed 20 rehabilitation beds
in 2002, provided that the beds are used only for rehabilitation
in the hospital's current rehabilitation building. If the beds
are used for another purpose or moved to another location, the
hospital's licensed capacity is reduced by 20 beds deleted text begin . deleted text end new text begin ; or
new text end

new text begin (19) a project involving the establishment of a new
hospital in the city of Maple Grove that includes 250 or fewer
licensed beds and participates in the Medicare and Medicaid
programs, by an existing hospital that relocates or
redistributes the beds from its current site or adds new
licensed beds, and is owned by a nonprofit corporation that is
exempt from federal income tax under section 501(c)(3) of the
Internal Revenue Code, or has applied for an exemption. The new
hospital's initial inpatient services must include at least
medical and surgical services, obstetrical and gynecological
services, intensive care services, orthopedics, pediatrics,
noninvasive cardiac diagnostics, behavioral health, including
mental health services for children and adolescents, and
emergency room services. The project applicant must
demonstrate, to the satisfaction of the commissioner, the
ability of the project applicant to meet the criteria listed in
this clause. In making a determination, the commissioner shall
weigh each criterion on a 100-point scale according to the
points assigned in this clause:
new text end

new text begin (i) the hospital will have a significant commitment to
providing uncompensated care, including discounts for uninsured
patients, coordination with community health centers and other
providers of care to low-income uninsured persons, and
coordination with other hospitals providing uncompensated care
and serving public program participants, 16 points;
new text end

new text begin (ii) the project's initial mental health services will
include, in addition to inpatient behavioral health services,
stabilization services for children and adolescents in acute
psychiatric crisis, mental health and substance abuse
stabilization and referral services, nonovernight children and
adolescent observation services, intensive child and adolescent
outpatient services, and outpatient chemical dependency services
for persons over age 16, 16 points;
new text end

new text begin (iii) the applicant demonstrates the ability to provide and
staff sufficient new beds to meet the growing needs of the Maple
Grove service area and the surrounding communities currently
served by the applicant, 14 points;
new text end

new text begin (iv) the hospital will be a site for training for health
care related occupations and have a commitment to providing
clinical training programs for physicians and other health care
providers, including, but not limited to, obstetrics and
gynecology, pediatrics, psychiatry, and pediatric psychiatry in
coordination with other medical education training programs in
the state, ten points;
new text end

new text begin (v) the applicant has a record of providing high quality
health care services, and the proposal demonstrates a commitment
to quality care and patient safety, nine points;
new text end

new text begin (vi) the hospital will have a positive impact on the
emergency medical services system, including the coordination
and provision of trauma services and the licensed emergency
ambulance providers currently serving the area, and a positive
impact on the continuity of patient emergency medical care,
seven points;
new text end

new text begin (vii) the hospital will operate in clinical coordination
with other hospitals in Hennepin County providing additional
specialized services at volume levels conducive to the
maintenance of high quality care, six points;
new text end

new text begin (viii) the applicant or a member organization of the
nonprofit corporation owns a hospital in which an automated
patient medical records system, including physician order entry,
has been or is in the process of being implemented, six points;
new text end

new text begin (ix) the hospital will have a positive impact on the
viability of existing providers, including physicians, in the
Maple Grove service area, five points;
new text end

new text begin (x) the hospital will increase competition in the health
care marketplace and will not add to the pressure to consolidate
the provision of health care services, five points;
new text end

new text begin (xi) the project will include ambulatory care services
colocated with the hospital component of the project, including
mental health services, urgent care services, pediatrics, and
imaging services, three points; and
new text end

new text begin (xii) the project will provide a broad range of senior
services to enable seniors to remain living in the community,
three points. The exception under clause (19) is available for
the establishment of only one new hospital. Between June 30 and
August 1, 2005, any entity that has a plan for a hospital that
has been previously determined by the commissioner to be in the
public interest according to section 144.552 and desires to
establish a new hospital must submit to the commissioner an
application for an exception under clause (19). The application
must contain the plan, a true copy of the commissioner's
determination, any additional relevant evidence not contained in
the plan that is supportive of the application, and evidence of
compliance with the criteria specified in clause (19). The
commissioner may request information from an applicant that the
commissioner deems necessary and relevant to review an
application under clause (19). An applicant shall pay the
commissioner for the commissioner's cost of reviewing the plan,
as determined by the commissioner and notwithstanding section
16A.1283. Money received by the commissioner under clause (19)
shall be used by the commissioner for the purpose of
administering clause (19).
new text end

new text begin (c) If there is only one applicant under paragraph (b),
clause (19), the commissioner shall review the application to
determine its compliance with the criteria. If the commissioner
determines that the application complies with the criteria, the
commissioner shall issue an order approving the application.
new text end

new text begin (d) If there is more than one applicant under paragraph
(b), clause (19), between June 30 and August 1, 2005, the
commissioner shall determine which plan or plans continue to be
in the public interest and the applicant's compliance with the
criteria. If more than one applicant would meet the criteria,
the commissioner shall determine which applicant has
demonstrated that it is best able to provide services consistent
with the criteria in paragraph (b), clause (19).
new text end

new text begin (e)(1) The commissioner shall make the determination in
paragraph (d) by order following a hearing according to this
paragraph. The hearing shall not constitute or be considered to
be a contested case hearing under chapter 14 and shall be
conducted solely under the procedures specified in this
paragraph. The hearing shall commence upon at least 30 days'
notice to the applicants by the commissioner, but no later than
October 15. The hearing may be conducted by the commissioner or
by a person designated by the commissioner. The designee may be
an administrative law judge. The purpose of the hearing shall
be to receive evidence to assist the commissioner in determining
which applicant has demonstrated that it best meets the criteria
in paragraph (b), clause (19).
new text end

new text begin (2) The parties to the hearing shall consist only of those
applicants under paragraph (b), clause (19), who have submitted
a completed application that the commissioner has determined
would be in the public interest. Each applicant shall have the
right to be represented by counsel, to present evidence deemed
relevant by the commissioner, and to examine and cross-examine
witnesses. Persons who are not parties to the proceeding but
who wish to present comments or submit information may do so in
the manner determined by the commissioner or the commissioner's
designee. Any person who is not a party shall have no right to
examine or cross-examine witnesses. The commissioner may
participate as an active finder of fact in the hearing and may
ask questions to elicit information or clarify answers or
responses.
new text end

new text begin (3) Notwithstanding section 16A.1283, applicants who are a
party to the hearing shall pay the cost of the hearing, as
determined by the commissioner. The cost of the hearing shall
be divided equally among the applicants. Money received by the
commissioner under this clause is appropriated to the
commissioner for the purpose of administering this paragraph.
new text end

new text begin (4) The commissioner shall issue an order approving an
application under paragraph (b), clause (19), within 90 days
following the closing of the record of the hearing as determined
by the hearing officer. The hearing officer must close the
record by November 15. The commissioner's order shall include a
statement of the reasons the application best meets the criteria
of this paragraph. Prior to making a determination approving an
application under paragraph (b), clause (19), the commissioner
shall, through a process announced by the commissioner, accept
comments from members of the public in the service area for the
new hospital specified in paragraph (b), clause (19). The
commissioner shall take this information into consideration in
making the determination. The commissioner must also consider
the input and preferences of legislators and local elected
officials who represent the service area regarding the selection
of the hospital provider specified in paragraph (b), clause (19).
new text end

new text begin (5) Any applicant aggrieved by the commissioner's order is
entitled to judicial review by the Court of Appeals according to
sections 14.63 to 14.69. Review by the Court of Appeals must be
based on the administrative record and expedited.
new text end