The goal is to reduce costs and ensure that communities have access to health care. This is called a certificate of necessity.
Hospitals must apply to the state before suspending services such as labor and delivery that could put them in the red or make other major decisions that could affect public health.
But some hospital chains and some lawmakers say it's time to revise the certificate requirements regulations or eliminate them altogether.
Senator Saud Anwar chairs the Public Health Committee. He sheds some light on this discussion.
Mike Heidek:Thank you for your participation. First, his three hospitals in Waterbury, Rockville, and Manchester were saddled with mountains of debt. They were being sold to Yale New Haven Health. The state had to approve the deal, which took nearly two years. Is it too long if the debt keeps increasing? And what should we do?
saud anwar: Mike, thank you so much for having me to talk about this important topic. It obviously took a while. And there were multiple reasons why it took so long. But it was a three-way deal. And there was a conversation going on between the two sides, and the state was part of that conversation. And when you add up all these timelines from the time the application is made to the time the application is completed for some of the research required to look at how it will impact the health and well-being of the community, it took time. It takes a long time to reach at least the first stage.
Mike Heidek：So, you are a doctor, a doctor of medicine, and you are also active on the front lines. So you will know when the necessary actions can be taken and that they may affect the patient. How can this particular process be sped up? Or do you think it should be sped up?
saud anwar: Definitely needs to be faster. And I think this is what we're talking about openly with the Office of Health Care Strategy, the Connecticut Hospital Association, the governor's office, all of our legislators. Four bills have been introduced so far, with more on other components. But there was a bill dedicated to looking at how this process could be streamlined. What can be done to improve this process and eliminate barriers for individuals to enter Connecticut's health care market? And it's safe for patients. When someone does an acquisition or a merger, the process should go a little more smoothly and efficiently. So we are currently having discussions in the Bill to improve that process.
Mike Heidek: In terms of the process improvements you mentioned earlier, this was a three-way agreement to begin with. It must be an arduous process to research the financials of so many different organizations, but it must be done in such a way that it is a fair deal overall. So how can you speed up your financial paperwork? It seems as complicated as it can be.
saud anwar: I think that's part of the detail of this whole long process because the Health Strategy Office was taking its time, but the fact is that the application was not completed by the various parties. And they also used this as a bargaining tool to try to reduce the value of the entire deal. So during all these conversations that were happening on multiple levels, the process slowed down because of the applications and new information that we're getting and that you're listening to. And I think it's important here that at least the Department of Health Strategy has a process where they can set timelines and guidelines and make sure that if people are going to delay it, there's a good reason.
Mike Heidek: You're a privileged physician in Rockville and Manchester, so you know what it's like to have the equipment you need to do your job. One of the things that has to do with this certificate of need is that if the hospital wants to buy large equipment that is very expensive, like his PET scan or his MRI machine, they also have to go through this certificate of need process. about it. . Does that equipment need to be handled differently? Or should it still be on the certificate of need?
saud anwar: Mike, you're right. This is another conversation we're having. This should be a quick process. This should be your fast lane for some simple things. Obviously, due diligence needs to be done in many areas, but for some common sense matters it should be a quick process. And the Health Strategy Office is also open to this conversation and is ready to look at ways that some of these processes can be expedited.
Mike Heidek:So some members of Congress say, “Look, let's get rid of it.'' New Hampshire got rid of theirs. Judging by the numbers, they seem to be doing well. Where do you stand: fix it or remove it?
saud anwar: Please fix it and I'll tell you why. Over the years, we have noticed that many medical centers in the state have become disconnected from some of their communities. As a result, women's health in our state has become dangerous and unacceptable, maternity wards have been closed, and hospitals have closed down and relocated their departments. It would be beneficial to have a Health Strategy Office working on CON with a focus on ensuring that some of the most underserved populations are protected. This can actually improve this entire process. And I know there's an appetite from everyone for this, between the governor's office, the Office of Health Strategy, legislators, and hospital associations. We will work together to craft the bill. Take us to a much better place than where we are now.
Mike Heidek: Last question. It lasts about 30 seconds. One last thing: When we tried to close down labor and delivery, many people protested against the particular hospitals that tried to do this. Will I need to go through the appeal process regarding this certificate of necessity in the future?
saud anwar: absolutely. I think there's already an appeals process going on, but public hearings are being held to allow people to have a say in what happens to their health if the health care system is abolished or abolished. I think local community involvement will be important as we move forward. Shut down all kinds of services in the community. Rural areas in our state in particular are suffering in several ways. Therefore, its protection is necessary.
