LeadingAge NY Comments on Health Equity Certificate of Need Regulations

LeadingAge NY submitted comments last week on proposed regulations implementing health equity requirements for health care facility projects subject to certificate of need (CON) approval. The comments stressed support for the health equity goals of the regulations, but raised concerns that the regulations would impede projects intended to improve the quality of life, health, or safety of nursing home residents.

The regulations arise out of legislation enacted in 2021 to address disparities in access and outcomes arising from the distribution of health care resources, as well as market competition impacts of CON projects that shift well-insured patients and lucrative services from community-based providers to larger health systems. The law and regulations, which apply to most Article 28 health care facilities (hospitals, nursing homes, and most ambulatory care facilities), require an independent health equity impact assessment (HEIA) of all major construction projects (i.e., those subject to full or administrative CON reviews), limited review projects that result in a material change in beds or services, and establishment applications that result in a material change in beds or services.

The association's comments sought additional exemptions for nursing home projects. They focused on the potential for delays and increased costs as a result of the HEIA review requirement. The comments noted that the majority of nursing home projects fall into the limited review category for minor construction and that the HEIA and associated reviews may be disproportionate to those projects. Those projects typically involve the addition of services or reconfiguration of space for the benefit of residents.

The regulations will be presented to the Public Health and Health Planning Council (PHHPC) for adoption on June 15, 2023 and will apply to CON applications submitted on or after June 22, 2023. More information about the regulations is available here.

Contact: Karen Lipson, klipson@leadingageny.org