Vermont H 96: An act relating to increasing the monetary thresholds for certificates of need

Bill Text

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No. 15. An act relating to increasing the monetary thresholds for
certificates of need.
(H.96)
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 18 V.S.A. § 9434 is amended to read:
§ 9434. CERTIFICATE OF NEED; GENERAL RULES
(a) A health care facility other than a hospital shall not develop or have
developed on its behalf a new health care project without issuance of a
certificate of need by the Board. For purposes of this subsection, a “new
health care project” includes means any of the following:
(1) The construction, development, purchase, renovation, or other
establishment of a health care facility, or any capital expenditure by or on
behalf of a health care facility, for which the capital cost exceeds
$1,500,000.00 $10,000,000.00.
(2) A change from one licensing period to the next in the number of
licensed beds of a health care facility through addition or conversion, or
through relocation from one physical facility or site to another.
(3) The offering of any home health service, or the transfer or
conveyance of more than a 50 percent ownership interest in a health care
facility other than a hospital or nursing home.
(4) The purchase, lease, or other comparable arrangement of a single
piece of diagnostic and therapeutic equipment for which the cost, or in the case
of a donation the value, is in excess of $1,000,000.00 $5,000,000.00. For

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purposes of this subdivision, the purchase or lease of one or more articles of
diagnostic or therapeutic equipment that are necessarily interdependent in the
performance of their ordinary functions or that would constitute any health
care facility included under subdivision 9432(8)(B) of this title, as determined
by the Board, shall be considered together in calculating the amount of an
expenditure. The Board’s determination of functional interdependence of
items of equipment under this subdivision shall have the effect of a final
decision and is subject to appeal under section 9381 of this title.
(5) The offering of a health care service or technology having an annual
operating expense that exceeds $500,000.00 $3,000,000.00 for either of the
next two budgeted fiscal years, if the service or technology was not offered or
employed, either on a fixed or a mobile basis, by the health care facility within
the previous three fiscal years.
(6) The construction, development, purchase, lease, or other
establishment of an ambulatory surgical center. [Repealed.]
(b) A hospital shall not develop or have developed on its behalf a new
health care project without issuance of a certificate of need by the Board. For
purposes of this subsection, a “new health care project” includes the following:
(1) The construction, development, purchase, renovation, or other
establishment of a health care facility, or any capital expenditure by or on
behalf of a hospital, for which the capital cost exceeds $3,000,000.00.

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(2) The purchase, lease, or other comparable arrangement of a single
piece of diagnostic and therapeutic equipment for which the cost, or in the case
of a donation the value, is in excess of $1,500,000.00. For purposes of this
subdivision, the purchase or lease of one or more articles of diagnostic or
therapeutic equipment that are necessarily interdependent in the performance
of their ordinary functions or that would constitute any health care facility
included under subdivision 9432(8)(B) of this title, as determined by the
Board, shall be considered together in calculating the amount of an
expenditure. The Board’s determination of functional interdependence of
items of equipment under this subdivision shall have the effect of a final
decision and is subject to appeal under section 9381 of this title.
(3) The offering of a health care service or technology having an annual
operating expense that exceeds $1,000,000.00 for either of the next two
budgeted fiscal years, if the service or technology was not offered or
employed, either on a fixed or a mobile basis, by the hospital within the
previous three fiscal years.
(4) A change from one licensing period to the next in the number of
licensed beds of a health care facility through addition or conversion, or
through relocation from one physical facility or site to another.
(5) The offering of any home health service. [Repealed.]
(c) In the case of a project that requires a certificate of need under this
section, expenditures for which are anticipated to be in excess of

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$30,000,000.00 $50,000,000.00, the applicant first shall secure a conceptual
development phase certificate of need, in accordance with the standards and
procedures established in this subchapter, that permits the applicant to make
expenditures for architectural services, engineering design services, or any
other planning services, as defined by the Board, needed in co