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What is Certificate of Need (CON)?
Kentucky’s Certificate of Need process ensures only the highest quality, most experienced healthcare providers can provide care in our communities. More than 30 states currently have CON laws.
What would healthcare in Kentucky look like without Certificate of Need?
Without Certificate of Need, out-of-state healthcare providers could swoop into our communities, cherry pick only the most profitable services with the highest reimbursement rates and offer them only to individuals with private, commercial insurance.
When this happens, as we’ve seen in states without a CON process, it creates an unlevel playing field that leads to:
Eliminating or repealing the Certificate of Need would also severely limit the ability of safety-net hospitals like St. Elizabeth to continue delivering quality care to all community members, regardless of their ability to pay.
What has happened in states that have repealed/eliminated
Certificate of Need?
Florida dropped the Certificate of Need requirement in 2019 and, as reported by USA Today, now has too many healthcare facilities popping up in the same areas, particularly in affluent communities, while people in more rural areas must travel hundreds of miles for care. This disparity impacts health care staffing and leads to higher healthcare costs. Kentucky’s Certificate of Need process helps to protect our communities against these problems.
What has happened in states that have repealed/eliminated
Certificate of Need?
Florida dropped the Certificate of Need requirement in 2019 and, as reported by USA Today, now has too many healthcare facilities popping up in the same areas, particularly in affluent communities, while people in more rural areas must travel hundreds of miles for care. This disparity impacts health care staffing and leads to higher healthcare costs. Kentucky’s Certificate of Need process helps to protect our communities against these problems.
What services are required to go through the Certificate of Need process?
Kentucky requires a CON application for 21 services: inpatient and acute care hospital beds, physical rehab beds, neonatal intensive care, open heart surgery programs, organ transplant programs, nursing home beds, home health agencies, hospice services, residential hospitals, intermediate care for people with disabilities, cardiac catheter labs, PET scans, MRI, ambulance services and ambulatory care services.
What services do not require a Certificate of Need?
In Kentucky, not all healthcare services require a Certificate of Need. Primary care offices, specialty care offices and urgent care centers are some of the services that do not have to go through the CON process.
What criteria is considered as part of the CON application process?
CON applications look at five criteria:
- Consistency with the State Health Plan, which is updated annually based on public input
- Community need
- Interrelationships and linkage with other healthcare providers
- Costs, economic feasibility and resource availability
- Quality
Who determines whether to grant a Certificate of Need?
The Kentucky Cabinet for Health and Family Services carefully reviews each CON application and makes a decision based on community need, quality and other important factors. If the application is not contested, the Cabinet can decide to approve or reject the application without a hearing. If contested, the application is presented at a hearing before an independent administrative judge with both sides present. Judges in CON hearings are employed by the Cabinet for Health and Family Services and are not elected or appointed. Appeals of CON decisions go to Franklin County Circuit Court.
Who oversees the CON process?
The Kentucky Cabinet for Health and Family Services oversees development of the State Health Plan, which independent hearing officers use when reviewing Certificate of Need applications. The State Health Plan determines which healthcare services are governed by CON and is updated annually based on public input.
Who determines whether to grant a Certificate of Need?
The Kentucky Cabinet for Health and Family Services carefully reviews each CON application and makes a decision based on community need, quality and other important factors. If the application is not contested, the Cabinet can decide to approve or reject the application without a hearing. If contested, the application is presented at a hearing before an independent administrative judge with both sides present. Judges in CON hearings are employed by the Cabinet for Health and Family Services and are not elected or appointed. Appeals of CON decisions go to Franklin County District Court.
Who oversees the CON process?
The Kentucky Cabinet for Health and Family Services oversees development of the State Health Plan, which independent hearing officers use when reviewing Certificate of Need applications. The State Health Plan determines which healthcare services are governed by CON and is updated annually based on public input.
How does Certificate of Need impact choice in healthcare?
Northern Kentuckians have many choices today when deciding where to receive their healthcare. The vast majority of care is delivered in an office or outpatient setting, and there are dozens of independent and Cincinnati hospital-affiliated physician offices, imaging services and surgery centers located throughout our region. As of April 2023, Northern Kentucky counties (Boone, Kenton and Campbell) have 109 healthcare service locations offering at least one service requiring a Certificate of Need. Just 19 of these service locations are associated with St. Elizabeth.
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What role do state legislators play in the CON process?
Legislators established the CON process to ensure quality, accessible healthcare for all Kentuckians. A special Certificate of Need Task Force was formed in May 2023 to review Kentucky’s CON program and make recommendations to further modernize the process. During the 2023 session, legislation was introduced in the Kentucky General Assembly to eliminate CON but did not pass. While many conversations around CON have been centered in Northern Kentucky, state legislation regarding CON would impact hospitals, healthcare providers and the patients they serve across the entire state.
What role do state legislators play in the CON process?
Legislators established the CON process to ensure quality, accessible healthcare for all Kentuckians. A special Certificate of Need Task Force was formed in May 2023 to review Kentucky’s CON program and make recommendations to further modernize the process. During the 2023 session, legislation was introduced in the Kentucky General Assembly to eliminate CON but did not pass. While many conversations around CON have been centered in Northern Kentucky, state legislation regarding CON would impact hospitals, healthcare providers and the patients they serve across the entire state.
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