August 5th, 2013
ACLU Urges Department of Health to Broaden Changes to Certificate of Need Process for Hospital Transactions
Says DOH Proposal Is Too Narrow to Protect Lawful, Best Care Medical Services for Patients
The ACLU of Washington today urged the Department of Health (DOH) to broaden its proposed changes to the state’s Certificate of Need process for reviewing hospital transactions. The changes are being proposed in response to the Governor’s Directive to update the decades-old Certificate of Need process. In a letter to the Department of Health, the ACLU-WA said the proposals are too narrow to protect vital patient needs for access to health care.
“Practices in our increasingly consolidated health care marketplace should be determined by the standard of best care and patient needs or interest, not by religious doctrine,” ACLU-WA Executive Director Kathleen Taylor said in a letter to DOH. “All patients should have access in their local communities to a full range of lawful, best care medical services. No patient should be refused access to such services because of the religious doctrines of the organization controlling a hospital, clinic, or other medical facility,” said Taylor.
The ACLU pointed out that the Certificate of Need (CON) framework was developed more than 30 years ago and is being reviewed in a wholly different market environment which makes its existing rules antiquated. The consolidation of hospital ownership under fewer and fewer owners and the employment of the vast majority of physicians in a community by hospitals make a huge difference. Where health care providers restrict services based on religious doctrine, the lack of choice for consumers is a major problem, especially in rural areas. In light of these conditions, the ACLU urged that the Department of Health to:
- Spell out criteria by which CON applications might be conditionally granted – that is, where DOH imposes conditions that protect the public interest. No such clear, understandable standards currently exist.
- Ensure ongoing oversight after a merger. Currently, there is no standard mechanism for monitoring terms and conditions of a CON granted by DOH, and no clear consequences that might be invoked if entities violate promises or representations made in their CON applications.
- Make the CON process transparent and easy to understand for the general public. Currently, the CON process operates as a kind of “black box” in which there is little or no way for the public understand how DOH is making its decision.
- Review the many ways in which transactions have been structured to evade state review. Creative writing by lawyers should not determine whether the government exercises its important oversight function.
The ACLU-WA letter to the Department of Health is attached. For more information on the concerns raised by hospital mergers, see www.aclu-wa.org/myhealthcare.
--END--
