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DOH Hosts Webinar on New Health Equity CON Process for Article 28 Facilities

The Department of Health (DOH) hosted a webinar this week summarizing the new health equity impact assessment (HEIA) process for certain certificate of need (CON) applications filed by Article 28 facilities. The webinar provided a summary of the HEIA process, the required qualifications of an independent evaluator, a walk-through of the forms that must be submitted, and answers to questions submitted in advance and during the webinar. The slides are available here. A second webinar will be held on Thurs., Sept. 14, 2023 from 1 to 2 p.m. Registration is available here.

As previously reported, the health equity CON regulations apply to specified CON applications submitted by hospitals, nursing homes, and certain diagnostic and treatment centers (D&TCs) on or after June 22, 2023. D&TCs with a patient population that is more than 50 percent Medicaid-enrolled or uninsured are exempt from the HEIA process, unless the application includes a change in controlling person, principal stockholder, or principal member of the applicant.

The HEIA must be conducted by an independent evaluator that has experience in health equity, anti-racism, and stakeholder engagement. The independent evaluator cannot be an individual or entity that:

  • helps compile or writes any part of the CON application for this specific project, other than the HEIA;
  • has a financial interest in the outcome of this specific project’s CON application (i.e., individual is a member of the facility’s board of directors or advisory board); or
  • has accepted or will accept a financial gift or incentive from the applicant above fair market value for the cost of the HEIA.

Under the regulations, CON construction applications that require “full” or “administrative” review, and “limited review” applications that involve a “substantial change” in beds or services, are subject to HEIA requirements. A substantial change is defined as a 10 percent or greater reduction or expansion of beds or services or change in location. Establishment applications are also subject to HEIA requirements if they involve a 10 percent or greater change in services or change in location. The “10 percent” threshold is calculated based on the number of certified or authorized beds, and/or certified or authorized services, indicated on the facility’s operating certificate specific to the category of service or care.

LeadingAge NY asked DOH whether the 13 services that comprise “baseline services” on the nursing home operating certificate may be counted as 13 services or must be counted as a single service, due to the way they are portrayed on the operating certificate. In the webinar, DOH responded that nursing homes must count “baseline services” as one service, but that they are collecting input for purposes of refining options in the future.

DOH staff noted that closures are currently not subject to HEIA requirements, although closures have an impact on the community. This issue is currently under active review.

For the next webinar on Sept. 14th, attendees are strongly encouraged to submit questions and comments here at least two business days in advance.

DOH has created a webpage about the HEIA process here. Questions may be posed to the DOH HEIA team here.

More information from LeadingAge NY about the regulations is available here, here, and here.

Contact: Karen Lipson, klipson@leadingageny.org