Bill Text: OR SB202 | 2011 | Regular Session | Introduced
Bill Title: Relating to health care facilities; declaring an emergency.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2011-06-30 - In committee upon adjournment. [SB202 Detail]
Download: Oregon-2011-SB202-Introduced.html
76th OREGON LEGISLATIVE ASSEMBLY--2011 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 2378
Senate Bill 202
Sponsored by Senator BATES (Presession filed.)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Requires hospital to obtain certificate of need for capital
project. Applies to capital projects beginning on or after
effective date of Act.
Declares emergency, effective on passage.
A BILL FOR AN ACT
Relating to health care facilities; creating new provisions;
amending ORS 442.015, 442.315 and 442.361; and declaring an
emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 442.015 is amended to read:
442.015. As used in ORS chapter 441 and this chapter, unless
the context requires otherwise:
(1) 'Acquire' or 'acquisition' means obtaining equipment,
supplies, components or facilities by any means, including
purchase, capital or operating lease, rental or donation, with
intention of using such equipment, supplies, components or
facilities to provide health services in Oregon. When equipment
or other materials are obtained outside of this state,
acquisition is considered to occur when the equipment or other
materials begin to be used in Oregon for the provision of health
services or when such services are offered for use in Oregon.
(2) 'Affected persons' has the same meaning as given to '
party' in ORS 183.310.
(3)(a) 'Ambulatory surgical center' means a facility or portion
of a facility that operates exclusively for the purpose of
providing surgical services to patients who do not require
hospitalization and for whom the expected duration of services
does not exceed 24 hours following admission.
(b) 'Ambulatory surgical center' does not mean:
(A) Individual or group practice offices of private physicians
or dentists that do not contain a distinct area used for
outpatient surgical treatment on a regular and organized basis,
or that only provide surgery routinely provided in a physician's
or dentist's office using local anesthesia or conscious sedation;
or
(B) A portion of a licensed hospital designated for outpatient
surgical treatment.
{ - (4) 'Budget' means the projections by the hospital for a
specified future time period of expenditures and revenues with
supporting statistical indicators. - }
{ - (5) - } { + (4) + } { - ' Develop' means to
undertake those activities that on their completion - } { +
'Development' means the undertaking of activities that, when
completed, + } will result in the offer of a new institutional
health service or the incurring of a financial obligation, as
defined under applicable state law, in relation to the offering
of such a health service.
{ - (6) - } { + (5) + } 'Expenditure' or 'capital
expenditure' means the actual expenditure, an obligation to an
expenditure, lease or similar arrangement in lieu of an
expenditure, and the reasonable value of a donation or grant in
lieu of an expenditure but not including any interest thereon.
{ - (7) - } { + (6) + } 'Freestanding birthing center'
means a facility licensed for the primary purpose of performing
low risk deliveries.
{ - (8) - } { + (7) + } 'Governmental unit' means the
state, or any county, municipality or other political
subdivision, or any related department, division, board or other
agency.
{ - (9) - } { + (8) + } 'Gross revenue' means the sum of
daily hospital service charges, ambulatory service charges,
ancillary service charges and other operating revenue. 'Gross
revenue' does not include contributions, donations, legacies or
bequests made to a hospital without restriction by the donors.
{ - (10)(a) - } { + (9)(a) + } 'Health care facility'
means:
(A) A hospital;
(B) A long term care facility;
(C) An ambulatory surgical center;
(D) A freestanding birthing center; or
(E) An outpatient renal dialysis center.
(b) 'Health care facility' does not mean:
(A) A residential facility licensed by the Department of Human
Services or the Oregon Health Authority under ORS 443.415;
(B) An establishment furnishing primarily domiciliary care as
described in ORS 443.205;
(C) A residential facility licensed or approved under the rules
of the Department of Corrections;
(D) Facilities established by ORS 430.335 for treatment of
substance abuse disorders; or
(E) Community mental health programs or community developmental
disabilities programs established under ORS 430.620.
{ - (11) - } { + (10) + } 'Health maintenance organization'
or 'HMO ' means a public organization or a private organization
organized under the laws of any state that:
(a) Is a qualified HMO under section 1310 (d) of the U.S.
Public Health Services Act; or
(b)(A) Provides or otherwise makes available to enrolled
participants health care services, including at least the
following basic health care services:
(i) Usual physician services;
(ii) Hospitalization;
(iii) Laboratory;
(iv) X-ray;
(v) Emergency and preventive services; and
(vi) Out-of-area coverage;
(B) Is compensated, except for copayments, for the provision of
the basic health care services listed in subparagraph (A) of this
paragraph to enrolled participants on a predetermined periodic
rate basis; and
(C) Provides physicians' services primarily directly through
physicians who are either employees or partners of such
organization, or through arrangements with individual physicians
or one or more groups of physicians organized on a group practice
or individual practice basis.
{ - (12) - } { + (11) + } 'Health services' means
clinically related diagnostic, treatment or rehabilitative
services, and includes alcohol, drug or controlled substance
abuse and mental health services that may be provided either
directly or indirectly on an inpatient or ambulatory patient
basis.
{ - (13) - } { + (12) + } 'Hospital' means:
(a) A facility with an organized medical staff and a permanent
building that is capable of providing 24-hour inpatient care to
two or more individuals who have an illness or injury and that
provides at least the following health services:
(A) Medical;
(B) Nursing;
(C) Laboratory;
(D) Pharmacy; and
(E) Dietary; or
(b) A special inpatient care facility as that term is defined
by the Oregon Health Authority by rule.
{ - (14) - } { + (13) + } 'Institutional health services'
means health services provided in or through health care
facilities and includes the entities in or through which such
services are provided.
{ - (15) - } { + (14) + } 'Intermediate care facility'
means a facility that provides, on a regular basis,
health-related care and services to individuals who do not
require the degree of care and treatment that a hospital or
skilled nursing facility is designed to provide, but who because
of their mental or physical condition require care and services
above the level of room and board that can be made available to
them only through institutional facilities.
{ - (16) - } { + (15) + } 'Long term care facility' means a
facility with permanent facilities that include inpatient beds,
providing medical services, including nursing services but
excluding surgical procedures except as may be permitted by the
rules of the Director of Human Services, to provide treatment for
two or more unrelated patients. 'Long term care facility'
includes skilled nursing facilities and intermediate care
facilities but may not be construed to include facilities
licensed and operated pursuant to ORS 443.400 to 443.455.
{ - (17) - } { + (16) + } 'New hospital' means a facility
that did not offer hospital services on a regular basis within
its service area within the prior 12-month period and is
initiating or proposing to initiate such services. 'New hospital'
also includes any replacement of an existing hospital that
involves a substantial increase or change in the services
offered.
{ - (18) - } { + (17) + } 'New skilled nursing or
intermediate care service or facility' means a service or
facility that did not offer long term care services on a regular
basis by or through the facility within the prior 12-month period
and is initiating or proposing to initiate such services. 'New
skilled nursing or intermediate care service or facility' also
includes the rebuilding of a long term care facility, the
relocation of buildings that are a part of a long term care
facility, the relocation of long term care beds from one facility
to another or an increase in the number of beds of more than 10
or 10 percent of the bed capacity, whichever is the lesser,
within a two-year period.
{ - (19) - } { + (18) + } { - ' Offer' means that the
health care facility holds itself out as capable of providing, or
as having the means for the provision of, - } { + ' Offering'
means + } specified health services { + that a health care
facility holds itself out as capable of providing + }.
{ - (20) - } { + (19) + } 'Outpatient renal dialysis
facility' means a facility that provides renal dialysis services
directly to outpatients.
{ - (21) - } { + (20) + } 'Person' means an individual, a
trust or estate, a partnership, a corporation (including
associations, joint stock companies and insurance companies), a
state, or a political subdivision or instrumentality, including a
municipal corporation, of a state.
{ - (22) - } { + (21) + } 'Skilled nursing facility' means
a facility or a distinct part of a facility, that is primarily
engaged in providing to inpatients skilled nursing care and
related services for patients who require medical or nursing
care, or an institution that provides rehabilitation services for
the rehabilitation of individuals who are injured or sick or who
have disabilities.
SECTION 2. ORS 442.315 is amended to read:
442.315. (1) { + (a) + } { - Any - } { + A + } new hospital
or new skilled nursing or intermediate care service or facility
not excluded pursuant to ORS 441.065 shall obtain a certificate
of need from the Oregon Health Authority prior to an offering or
development.
{ + (b) A hospital shall obtain a certificate of need from
the Oregon Health Authority prior to beginning a capital
project. + }
(2) The authority shall adopt rules specifying criteria and
procedures for making decisions as to the need for the new
services or facilities.
(3)(a) An applicant for a certificate of need shall apply to
the authority on forms provided for this purpose by authority
rule.
(b) An applicant shall pay a fee prescribed as provided in this
section. Subject to the approval of the Oregon Department of
Administrative Services, the authority shall prescribe
application fees, based on the complexity and scope of the
proposed project.
(4) The authority shall be the decision-making authority for
the purpose of certificates of need.
(5)(a) An applicant or any affected person who is dissatisfied
with the proposed decision of the authority is entitled to an
informal hearing in the course of review and before a final
decision is rendered.
(b) Following a final decision being rendered by the authority,
an applicant or any affected person may request a reconsideration
hearing pursuant to ORS chapter 183.
(c) In any proceeding brought by an affected person or an
applicant challenging an authority decision under this
subsection, the authority shall follow procedures consistent with
the provisions of ORS chapter 183 relating to a contested case.
(6) Once a certificate of need has been issued, it may not be
revoked or rescinded unless it was acquired by fraud or deceit.
However, if the authority finds that { - a person is offering
or developing a project that - } { + an offering, development
or capital project + } is not within the scope of the certificate
of need, the authority may limit the { - project - } { +
offering, development or capital project + } as specified in the
issued certificate of need or reconsider the application. A
certificate of need is not transferable.
(7) Nothing in this section applies to any hospital, skilled
nursing or intermediate care service or facility that seeks to
replace equipment with equipment of similar basic technological
function or an upgrade that improves the quality or
cost-effectiveness of the service provided. Any person acquiring
such replacement or upgrade shall file a letter of intent for the
project in accordance with the rules of the authority if the
price of the replacement equipment or upgrade exceeds $1 million.
(8) Except as required in subsection (1) of this section for a
new hospital or new skilled nursing or intermediate care service
or facility not operating as a Medicare swing bed program,
nothing in this section requires a rural hospital as defined in
ORS 442.470 (5)(a)(A) and (B) to obtain a certificate of need.
(9) Nothing in this section applies to basic health services,
but basic health services do not include:
(a) Magnetic resonance imaging scanners;
(b) Positron emission tomography scanners;
(c) Cardiac catheterization equipment;
(d) Megavoltage radiation therapy equipment;
(e) Extracorporeal shock wave lithotriptors;
(f) Neonatal intensive care;
(g) Burn care;
(h) Trauma care;
(i) Inpatient psychiatric services;
(j) Inpatient chemical dependency services;
(k) Inpatient rehabilitation services;
(L) Open heart surgery; { - or - }
(m) Organ transplant services { + ; or
(n) Skilled nursing or intermediate care nursing facilities or
services + }.
(10) In addition to any other remedy provided by law, whenever
it appears that any person is engaged in, or is about to engage
in, any acts that constitute a violation of this section, or any
rule or order issued by the authority under this section, the
authority may institute proceedings in the circuit courts to
enforce obedience to such statute, rule or order by injunction or
by other processes, mandatory or otherwise.
(11) As used in this section, 'basic health services' means
health services offered in or through a hospital licensed under
ORS chapter 441 { - , except skilled nursing or intermediate
care nursing facilities or services and those services specified
in subsection (9) of this section - } .
SECTION 3. ORS 442.361 is amended to read:
442.361. As used in this section and ORS { + 442.315, + }
442.362 and 442.991:
(1)(a) 'Capital project' means:
(A) The construction, development, purchase, renovation or any
construction expenditure by or on behalf of a reporting entity,
for which the cost:
(i) For type A hospitals, exceeds five percent of gross
revenue.
(ii) For type B hospitals, exceeds five percent of gross
revenue.
(iii) For DRG hospitals, exceeds 1.75 percent of gross revenue.
(iv) For ambulatory surgery centers, exceeds $2 million.
(B) The purchase or lease of, or other comparable arrangement
for, a single piece of diagnostic or therapeutic equipment for
which the cost or, in the case of a donation, the value exceeds
$1 million. The acquisition of two or more pieces of diagnostic
or therapeutic equipment that are necessarily interdependent in
the performance of ordinary functions shall be combined in
calculating the cost or value of the transaction.
(b) 'Capital project' does not include a project financed
entirely through charitable fundraising.
(2) 'DRG hospital' means a hospital that is not a type A or
type B hospital and that receives Medicare reimbursement based
upon diagnostic related groups.
(3) 'Gross revenue' has the meaning given that term in ORS
442.015.
(4) 'Reporting entity' includes the following if licensed
pursuant to ORS 441.015:
(a) A type A hospital as described in ORS 442.470.
(b) A type B hospital as described in ORS 442.470.
(c) A DRG hospital.
(d) An ambulatory surgical center as defined in ORS 442.015.
SECTION 4. { + The amendments to ORS 442.315 by section 2 of
this 2011 Act apply to capital projects for which the
construction, development, purchase or construction expenditure
begins or occurs on or after the effective date of this 2011
Act. + }
SECTION 5. { + This 2011 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2011 Act takes effect on its
passage. + }
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