Introduced
by
To transfer oversight of the Certificate of Need (CON) commission from the Department of Community Health to the Department of Consumer and Industry Services, and raise the threshold of health provider capital expenditure that requires CON approval. It would also remove from CON oversight Magnetic Resonance Image machines (MRIs), air ambulances, and lithotriptors (which remove kidney stones by focusing shock waves that pulverize them). The state “Certificate of Need” program limits the availability of health care facilities and technology by requiring health care providers to seek permission from a state commission for new or expanded facilities, or to add certain pieces of capital-intensive equipment (such as MRIs).
Referred to the Committee on Health Policy
Substitute offered
To replace the previous version of the bill with one which leaves certification of Magnetic Resonance Image machines (MRIs), lithotriptors and air ambulances under the Certificate of Need (CON) process, provides for a permanent commission staff, and allows it to contract with expert consultants to research issues before the body, rather than appointing ad-hoc committees (which supporters contend takes too much time). The substitute expands the CON board from five to nine members, representing hospitals, HMOs, medical schools, physicians, large employers, small employers, Blue Cross/Blue Shield, labor unions and nursing homes. It leaves the CON process under the Department of Community Health, rather than transferring it to the Department of Consumer and Industry Services. The substitute was amended to require that at least two MRIs be allowed in all counties with a population of 150,000 or greater, and giving the Senate advise and consent power over all gubernatorial appointments to the commission.
The substitute passed by voice vote
Amendment offered
by
To remove the provision which expands the CON commission from five to nine members representing various interest groups, instead leaving in place the current five-member commission, to be appointed with consideration given to geographic representation. The amendment would also remove the provision which allows the commission to contract with expert consultants to research issues before it, and retain the current practice of appointing ad-hoc committees, which supporters of the amendment contend ensures more deliberative and balanced decisions.
The amendment failed 13 to 22 (details)
Passed in the Senate 24 to 11 (details)
To raise the threshold of health provider capital expenditures that require “Certificate of Need” (CON) commission approval; allow the commission to contract with expert consultants to research issues before the body, rather than appointing ad-hoc committees; expand the CON board from five to nine members, representing hospitals, HMOs, medical schools, physicians, large employers, small employers, Blue Cross/Blue Shield, labor unions and nursing homes; and require that at least two Magnetic Resonance Image machines (MRIs) be allowed in all counties with a population of 150,000 or greater. The state CON program limits the availability of health care facilities and technology by requiring health care providers to seek permission from a state commission for new or expanded facilities, or to add certain pieces of capital-intensive equipment (such as MRIs).
Referred to the Committee on Health Policy
Substitute offered
To replace the previous version of the bill with one which would retain the “ad hoc” committee procedures with new regulations to expedite the process, increase the CON board to 11 members from various named interest groups, increase the fees hospitals pay to support the CON, revise the minimum MRI per-county to one MRI per-county rather than two, and provide an exemption to the process which will allow the Detroit Medical Center, the Henry Ford Health System, and the Providence/St. Johns Health System to transfer beds from their Detroit to their Oakland County hospitals.
The substitute passed by voice vote
Amendment offered
by
To limit to 200 each the number of beds the Detroit Medical Center, the Henry Ford Health System, and the Providence/St. Johns Health System will be allowed to transfer from their Detroit to their Oakland County hospitals.
The amendment failed 44 to 60 (details)
Amendment offered
by
To limit to 20 percent rather than 35 percent the number of beds the Detroit Medical Center, the Henry Ford Health System, and the Providence/St. Johns Health System will be allowed to transfer from their Detroit to their Oakland County hospitals.
The amendment failed 37 to 63 (details)
Amendment offered
by
To strip out a provision that will allow the Henry Ford Health System, and the Providence/St. Johns Health System to transfer beds from their Detroit to their Oakland County hospitals.
The amendment passed 90 to 11 (details)
Amendment offered
by
To strip out a provision which will, without going through the CON process, allow more than one MRI in counties with a population of at least 160,000.
The amendment failed 17 to 82 (details)
Amendment offered
by
To clarify a provision related to requirements for veterans hospitals to demonstrate a need under the CON process.
The amendment passed by voice vote
Amendment offered
by
To require as a condition of the bed transfers authorized by the bill that the Detroit Medical Center, the Henry Ford Health System, and the Providence/St. Johns Health System Oakland County hospitals be bound by the work rules, benefit, and pension provisions that apply to employees at their Detroit facilities.
The amendment failed 49 to 54 (details)
Amendment offered
by
To clarify and limit the bed transfer exceptions authorized by the House substitute.
The amendment passed by voice vote
Amendment offered
by
The amendment failed by voice vote
Passed in the House 76 to 29 (details)
To raise the threshold of health provider capital expenditures that require “Certificate of Need” (CON) commission approval; retain the “ad hoc” committee procedures to research issues before the body, with new regulations to expedite the process; expand the CON board from five to 11 members, representing 11 members from various named interest groups; require that at least one Magnetic Resonance Image machine (MRIs) be allowed in all counties with a population of 160,000 or greater; and increase the fees hospitals pay to support the CON. The bill would also provide an exemption to the process to allow the Detroit Medical Center, the Henry Ford Health System, and the Providence/St. Johns Health System to transfer beds from their Detroit to their Oakland County facilities. The state CON program limits the availability of health care facilities and technology by requiring health care providers to seek permission from a state commission for new or expanded facilities, or to add certain pieces of capital-intensive equipment (such as MRIs).
Failed in the Senate 1 to 34 (details)
To concur with a House-passed version of the bill. The vote sends the bill to a House-Senate conference committee to work out the differences.
Passed in the House 61 to 38 (details)
To adopt a House-Senate compromise version which retains most of the provisions of the House-passed bill. Among the important differences are: The new CON commission must not have more than six (of 11) members from the same party, and with a majority of at least seven could override the Detroit-to-Oakland bed transfers. Counties with a population of 160,000 or more would be authorized to have a minimum of two MRI machines.
Failed in the Senate 19 to 12 (details)
To adopt a House-Senate compromise version. See below.
Received
Motion to reconsider
To reconsider the vote by which the conference report was not adopted.
The motion passed by voice vote
Passed in the Senate 20 to 12 (details)
To adopt a House-Senate compromise version which retains most of the provisions of the House-passed bill. Among the important differences are: The new CON commission must not have more than six (of 11) members from the same party, and with a majority of at least seven could override the Detroit-to-Oakland bed transfers. Counties with a population of 160,000 or more would be authorized to have a minimum of two MRI machines.
