Florida Gov. Ron DeSantis could soon sign a bill that includes a significant step toward deregulation of the state's healthcare industry: the elimination of a certificate of need (CON) for general hospitals and certain other medical facilities.
Effective July 1, the new law would eliminate the CON requirement for new general acute care or long-term acute care hospitals. It would also reduce the burden for existing hospitals that want to establish a tertiary care service like comprehensive rehabilitation or neonatal intensive care units. The elimination of the CON requirement for other types of healthcare facilities — i.e. children's and women's hospitals; specialty medical, rehabilitation and psychiatric and substance abuse hospitals; and residential treatment facilities for children — will go into effect July 1, 2021.
The CON review process is a lengthy one and does not always result in the approval of a new healthcare project, so its elimination should result in more and faster development of hospital projects in Florida.
Opponents of the Florida bill argue that it will allow unfettered hospital construction and development without standard requirements like the inclusion of an emergency room, Medicaid acceptance and provisions for the treatment of uninsured patients, The News-Press reported.
Advocates of the measure claim that more hospitals will increase competition and drive down prices. In the immediate future, there at least two new hospital projects currently fighting legal challenges in southwest Florida that will be able to move forward if and when DeSantis signs the bill.
Consultants hired to navigate hospital systems through the CON process in Florida could be the losers in this new environment, but, according to Health Facilities Management, there are still plenty of costly regulatory issues facing healthcare construction projects, such as code compliance. In fact, according to a 2019 American Society for Health Care Engineering’s Hospital Construction Survey, resolving conflicting or improper code interpretation issues make up about 10% of a hospital’s construction costs.
In addition, 45% of respondents to the ASHE survey said they have incurred extra costs because of these code issues. Potential conflicts can exist between state and local authorities, as well as between building officials and the construction best practices set forth in the Facilities Guidelines Institute manual, which have been incorporated into the healthcare construction regulations of 39 states.