Bill Text: MI SB1269 | 2011-2012 | 96th Legislature | Introduced

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Bill Title: Health facilities; hospitals; new hospital to be built by McLaren health system; allow. Amends secs. 22203, 22207, 22209, 22211, 22213, 22215 & 22219 of 1978 PA 368 (MCL 333.22203 et seq.) & repeals sec. 22226 of 1978 PA 368 (MCL 333.22226).

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2012-09-27 - Referred To Committee Of The Whole With Substitute S-1 [SB1269 Detail]

Download: Michigan-2011-SB1269-Introduced.html

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SENATE BILL No. 1269

 

 

September 12, 2012, Introduced by Senator KOWALL and referred to the Committee on Economic Development.

 

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 22203, 22207, 22209, 22211, 22213, 22215, and

 

22219 (MCL 333.22203, 333.22207, 333.22209, 333.22211, 333.22213,

 

333.22215, and 333.22219), sections 22203, 22207, 22209, 22211,

 

22213, and 22215 as amended and section 22219 as added by 2002 PA

 

619; and to repeal acts and parts of acts.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 22203. (1) "Addition" means adding patient rooms, beds,

 

and ancillary service areas, including, but not limited to,

 

procedure rooms or fixed equipment, surgical operating rooms,

 

therapy rooms or fixed equipment, or other accommodations to a

 

health facility.

 

     (2) "Capital expenditure" means an expenditure for a single

 

project, including cost of construction, engineering, and equipment

 

that under generally accepted accounting principles is not properly

 

chargeable as an expense of operation. Capital expenditure includes

 

a lease or comparable arrangement by or on behalf of a health

 

facility to obtain a health facility, licensed part of a health

 

facility, or equipment for a health facility, if the actual

 

purchase of a health facility, licensed part of a health facility,

 

or equipment for a health facility would have been considered a

 

capital expenditure under this part. Capital expenditure includes

 

the cost of studies, surveys, designs, plans, working drawings,

 

specifications, and other activities essential to the acquisition,

 

improvement, expansion, addition, conversion, modernization, new

 

construction, or replacement of physical plant and equipment.

 

     (3) "Certificate of need" means a certificate issued under

 

this part authorizing a new health facility, a change in bed

 

capacity, the initiation, replacement, or expansion of a covered

 

clinical service, or a covered capital expenditure that is issued

 

in accordance with this part.

 

     (4) "Certificate of need review standard" or "review standard"

 

means a standard approved by the commission.

 

     (5) "Change in bed capacity" means 1 or more of the following:

 

     (a) An increase in licensed hospital beds.

 

     (b) An increase in licensed nursing home beds or hospital beds

 

certified for long-term care.

 

     (c) An increase in licensed psychiatric beds.

 

     (d) A change from 1 licensed use to a different licensed use.

 

     (e) The physical relocation of beds from a licensed site to

 

another geographic location.

 

     (6) "Clinical" means directly pertaining to the diagnosis,

 

treatment, or rehabilitation of an individual.

 

     (7) "Clinical service area" means an area of a health

 

facility, including related corridors, equipment rooms, ancillary

 

service and support areas that house medical equipment, patient

 

rooms, patient beds, diagnostic, operating, therapy, or treatment

 

rooms or other accommodations related to the diagnosis, treatment,

 

or rehabilitation of individuals receiving services from the health

 

facility.

 

     (8) "Commission" means the certificate of need commission

 

created under section 22211.

 

     (9) "Covered capital expenditure" means a capital expenditure

 

of $2,500,000.00 or more, as adjusted annually by the department

 

under section 22221(g), by a person for a health facility for a

 

single project, excluding the cost of nonfixed medical equipment,

 

that includes or involves the acquisition, improvement, expansion,

 

addition, conversion, modernization, new construction, or

 

replacement of a clinical service area.

 

     (10) "Covered clinical service", except as modified by the

 

commission under section 22215, means 1 or more of the following:

 

     (a) Initiation or expansion of 1 or more of the following

 

services:

 

     (i) Neonatal intensive care services or special newborn nursing

 

services.

 

     (ii) Open heart surgery.

 

     (iii) Extrarenal organ transplantation.

 

     (b) Initiation, replacement, or expansion of 1 or more of the

 

following services:

 

     (i) Extracorporeal shock wave lithotripsy.

 

     (ii) Megavoltage radiation therapy.

 

     (iii) Positron emission tomography.

 

     (iv) Surgical services provided in a freestanding surgical

 

outpatient facility, an ambulatory surgery center certified under

 

title XVIII, or a surgical department of a hospital licensed under

 

part 215 and offering inpatient or outpatient surgical services.

 

     (v) Cardiac catheterization.

 

     (vi) Fixed and mobile magnetic resonance imager services.

 

     (vii) Fixed and mobile computerized tomography scanner

 

services.

 

     (viii) Air ambulance services.

 

     (c) Initiation or expansion of a specialized psychiatric

 

program for children and adolescent patients utilizing licensed

 

psychiatric beds.

 

     (d) Initiation, replacement, or expansion of a service not

 

listed in this subsection, but designated as a covered clinical

 

service by the commission under section 22215(1)(a).

 

     (11) "Fixed equipment" means equipment that is affixed to and

 

constitutes a structural component of a health facility, including,

 

but not limited to, mechanical or electrical systems, elevators,

 

generators, pumps, boilers, and refrigeration equipment.

 

     Sec. 22207. (1) "Medicaid" means the program for medical

 

assistance administered by the department of community health under

 

the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.

 

     (2) "Modernization" means an upgrading, alteration, or change

 

in function of a part or all of the physical plant of a health

 

facility. Modernization includes, but is not limited to, the

 

alteration, repair, remodeling, and renovation of an existing

 

building and initial fixed equipment and the replacement of

 

obsolete fixed equipment in an existing building. Modernization of

 

the physical plant does not include normal maintenance and

 

operational expenses.

 

     (3) "New construction" means construction of a health facility

 

where a health facility does not exist or construction replacing or

 

expanding an existing health facility or a part of an existing

 

health facility.

 

     (4) "Person" means a person as defined in section 1106 or a

 

governmental entity.

 

     (5) "Planning area" means the area defined in a certificate of

 

need review standard for determining the need for, and the resource

 

allocation of, a specific health facility, service, or equipment.

 

Planning area includes, but is not limited to, the state, a health

 

facility service area, or a health service area or subarea within

 

the state.

 

     (6) "Proposed project" means a proposal to acquire an existing

 

health facility or begin operation of a new health facility, make a

 

change in bed capacity, initiate, replace, or expand a covered

 

clinical service, or make a covered capital expenditure.

 

     (7) "Public member" means a member of the general public who

 

is not a licensee or registrant under this article or article 15,

 

is a resident of this state, is not less than 18 years of age, does

 

not have an ownership interest in or a contractual relationship

 

with a health facility, does not have a material financial interest

 

in the provision of health services, and has not had a material

 

financial interest in the provision of health services within the

 

12 months immediately preceding the appointment to the commission.

 

     (8) (7) "Rural county" means a county not located in a

 

metropolitan statistical area or micropolitan statistical areas as

 

those terms are defined under the "standards for defining

 

metropolitan and micropolitan statistical areas" by the statistical

 

policy office of the office of information and regulatory affairs

 

of the United States office of management and budget, 65 F.R. p.

 

82238 (December 27, 2000).

 

     (9) (8) "Stipulation" means a requirement that is germane to

 

the proposed project and has been agreed to by an applicant as a

 

condition of certificate of need approval.

 

     Sec. 22209. (1) Except as otherwise provided in this part, a

 

person shall not do any of the following without first obtaining a

 

certificate of need:

 

     (a) Acquire an existing health facility or begin operation of

 

a health facility at a site that is not currently licensed for that

 

type of health facility.

 

     (b) Make a change in the bed capacity of a health facility.

 

     (c) Initiate, replace, or expand a covered clinical service.

 

     (d) Make a covered capital expenditure.

 

     (2) A certificate of need is not required for a reduction in

 

licensed bed capacity or services at a licensed site.

 

     (3) Subject to subsection (9) and if the If a hospital bed

 

relocation does not result in an increase of licensed beds within

 

that health service area, a certificate of need is not required for

 

any of the following:

 

     (a) The physical relocation of licensed beds from a hospital

 

site licensed under part 215 to another hospital site licensed

 

under the same license as the hospital seeking to transfer the beds

 

if both hospitals are located within a 2-mile radius of each other.

 

     (b) Subject to subsections (7) and (8) and provided that

 

construction of the new facility commences not later than 12 months

 

after the effective date of the 2012 amendatory act that amended

 

this section, the physical relocation of licensed beds from a

 

hospital licensed under part 215 to a freestanding surgical

 

outpatient facility site licensed under part 208 if that

 

freestanding surgical outpatient facility satisfies each of the

 

following criteria: on December 2, 2002:

 

     (i) Is owned by, is under common control of, or has as a common

 

parent ownership in common with the hospital seeking to relocate

 

its licensed beds.

 

     (ii) Was licensed prior to January 1, 2002.2010.

 

     (iii) Provides 24-hour urgent or emergency care services at that

 

site.

 

     (iv) Provides at least 4 different covered clinical services at

 

that site.

 

     (v) Is located within an 8-mile radius of the hospital seeking

 

to relocate its licensed beds.

 

     (vi) Is located in a county with a population of 1,200,000 or

 

more.

 

     (c) Subject to subsections (7) and (8), the physical

 

relocation of licensed beds from a hospital licensed under part 215

 

to another hospital licensed under part 215 within the same health

 

service area if the hospital receiving the licensed beds is owned

 

by, is under common control of, or has as a common parent the

 

hospital seeking to relocate its licensed beds.

 

     (4) Subject to subsection (5), a hospital licensed under part

 

215 is not required to obtain a certificate of need to provide 1 or

 

more of the covered clinical services listed in section 22203(10)

 

in a federal veterans health care facility or to use long-term care

 

unit beds or acute care beds that are owned and located in a

 

federal veterans health care facility if the hospital satisfies

 

each of the following criteria:

 

     (a) The hospital has an active affiliation or sharing

 

agreement with the federal veterans health care facility.

 

     (b) The hospital has physicians who have faculty appointments

 

at the federal veterans health care facility or has an affiliation

 

with a medical school that is affiliated with a federal veterans

 

health care facility and has physicians who have faculty

 

appointments at the federal veterans health care facility.

 

     (c) The hospital has an active grant or agreement with the

 

state or federal government to provide 1 or more of the following

 

functions relating to bioterrorism:

 

     (i) Education.

 

     (ii) Patient care.

 

     (iii) Research.

 

     (iv) Training.

 

     (5) A hospital that provides 1 or more covered clinical

 

services in a federal veterans health care facility or uses long-

 

term care unit beds or acute care beds located in a federal

 

veterans health care facility under subsection (4) may not utilize

 

procedures performed at the federal veterans health care facility

 

to demonstrate need or to satisfy a certificate of need review

 

standard unless the covered clinical service provided at the

 

federal veterans health care facility was provided under a

 

certificate of need.

 

     (6) If a hospital licensed under part 215 had fewer than 70

 

licensed beds, on December 1, 2002, that hospital is not required

 

to satisfy the minimum volume requirements under the certificate of

 

need review standards for its existing operating rooms as long as

 

those operating rooms continue to exist at that licensed hospital

 

site.

 

     (7) Before relocating beds under subsection (3)(b), the

 

hospital seeking to relocate its beds shall provide the information

 

requested by the department of consumer and industry services

 

licensing and regulatory affairs that will allow the department of

 

consumer and industry services licensing and regulatory affairs to

 

verify the number of licensed beds that were staffed and available

 

for patient care at that hospital. as of December 2, 2002. A

 

hospital shall transfer no more than 35% of its licensed beds to

 

another hospital or freestanding surgical outpatient facility under

 

subsection (3)(b) or (c) not more than 1 time after the effective

 

date of the amendatory act that added this subsection if the

 

hospital seeking to relocate its licensed beds or another hospital

 

owned by, under common control of, or having as a common parent the

 

hospital seeking to relocate its licensed beds is located in a city

 

that has a population of 750,000 or more.

 

     (8) The licensed beds relocated under subsection (3)(b) or (c)

 

shall not be included as new beds in a hospital or as a new

 

hospital under the certificate of need review standards for

 

hospital beds. One of every 2 beds transferred under subsection

 

(3)(b) up to a maximum of 100 shall be beds that were staffed and

 

available for patient care as of December 2, 2002. A hospital

 

relocating beds under subsection (3)(b) shall not reactivate

 

licensed beds within that hospital that were unstaffed or

 

unavailable for patient care on December 2, 2002 for a period of 5

 

years after the date of the relocation of the licensed beds under

 

subsection (3)(b).Services at the new site shall not be considered

 

an initiation, replacement, or expansion of covered clinical

 

services for the purposes of subsection (1)(c) if those same

 

services are provided at the new site at the time of relocation of

 

beds and in buildings that are physically connected.

 

     (9) No licensed beds shall be physically relocated under

 

subsection (3) if 7 or more members of the commission, after the

 

appointment and confirmation of the 6 additional commission members

 

under section 22211 but before June 15, 2003, determine that

 

relocation of licensed beds under subsection (3) may cause great

 

harm and detriment to the access and delivery of health care to the

 

public and the relocation of beds should not occur without a

 

certificate of need.

 

     (9) (10) An applicant seeking a certificate of need for the

 

acquisition of an existing health facility may file a single,

 

consolidated application for the certificate of need if the project

 

results in the acquisition of an existing health facility but does

 

not result in an increase or relocation of licensed beds or the

 

initiation, expansion, or replacement of a covered clinical

 

service. Except as otherwise provided in this subsection, a person

 

acquiring an existing health facility is subject to the applicable

 

certificate of need review standards in effect on the date of the

 

transfer for the covered clinical services provided by the acquired

 

health facility. The department may except 1 or more of the covered

 

clinical services listed in section 22203(10)(b), except the

 

covered clinical service listed in section 22203(10)(b)(iv), from

 

the minimum volume requirements in the applicable certificate of

 

need review standards in effect on the date of the transfer, if the

 

equipment used in the covered clinical service is unable to meet

 

the minimum volume requirements due to the technological incapacity

 

of the equipment. A covered clinical service excepted by the

 

department under this subsection is subject to all the other

 

provisions in the applicable certificate of need review standards

 

in effect on the date of the transfer, except minimum volume

 

requirements.

 

     (10) (11) An applicant seeking a certificate of need for the

 

relocation or replacement of an existing health facility may file a

 

single, consolidated application for the certificate of need if the

 

project does not result in an increase of licensed beds or the

 

initiation, expansion, or replacement of a covered clinical

 

service. A person relocating or replacing an existing health

 

facility is subject to the applicable certificate of need review

 

standards in effect on the date of the relocation or replacement of

 

the health facility.

 

     (11) (12) As used in this section, "sharing agreement" means a

 

written agreement between a federal veterans health care facility

 

and a hospital licensed under part 215 for the use of the federal

 

veterans health care facility's beds or equipment, or both, to

 

provide covered clinical services.

 

     Sec. 22211. (1) The certificate of need commission is created

 

in the department. The commission shall consist of 11 13 members

 

appointed by the governor with the advice and consent of the

 

senate. The governor shall not appoint more than 6 members from the

 

same major political party and shall appoint 5 members from another

 

other major political party. The members constituting the

 

commission on the day before the effective date of the amendatory

 

act that added subdivision (a) shall serve on the commission for

 

the remainder of their terms. On the expiration of the term of each

 

member constituting the commission on the day before the effective

 

date of the amendatory act that added subdivision (a), the governor

 

shall appoint a successor as required under this section in

 

accordance with subdivisions (f), (g), (h), (i), and (j) and in

 

that order. Of the additional members, the governor, within 30 days

 

after the effective date of the amendatory act that added

 

subdivision (a), shall appoint 6 additional members to the

 

commission as required under subdivisions (a), (b), (c), (d), and

 

(e). parties. The commission shall consist of the following 11 13

 

members:

 

     (a) Two individuals representing hospitals.

 

     (b) One individual representing physicians licensed under part

 

170 to engage in the practice of medicine.

 

     (c) One individual representing physicians licensed under part

 

175 to engage in the practice of osteopathic medicine and surgery.

 

     (d) One individual who is a physician licensed under part 170

 

or 175 representing a school of medicine or osteopathic medicine.

 

     (e) One individual representing nursing homes.

 

     (f) One individual representing nurses.

 

     (g) One individual representing a company that is self-insured

 

for health coverage.

 

     (h) One individual representing a company that is not self-

 

insured for health coverage.

 

     (i) One individual representing a nonprofit health care

 

corporation operating pursuant to under the nonprofit health care

 

corporation reform act, 1980 PA 350, MCL 550.1101 to 550.1703

 

550.1704.

 

     (j) One individual representing organized labor unions in this

 

state.

 

     (k) Two public members, 1 of whom shall be the chairperson.

 

     (2) In making appointments, the governor shall, to the extent

 

feasible, assure that the membership of the commission is broadly

 

representative of the interests of all of the people of this state

 

and of the various geographic regions.

 

     (3) A member of the commission shall serve for a term of 3

 

years or until a successor is appointed. Of the 6 members appointed

 

within 30 days after the effective date of the amendatory act that

 

added subsection (1)(a), 2 of the members shall be appointed for a

 

term of 1 year, 2 of the members shall be appointed for a term of 2

 

years, and 2 of the members shall be appointed for a term of 3

 

years. A vacancy on the commission shall be filled for the

 

remainder of the unexpired term in the same manner as the original

 

appointment.

 

     (4) Commission members are subject to the following:

 

     (a) 1968 PA 317, MCL 15.321 to 15.330.

 

     (b) 1973 PA 196, MCL 15.341 to 15.348.

 

     (c) 1978 PA 472, MCL 4.411 to 4.431.

 

     Sec. 22213. (1) The commission shall, within 2 months after

 

appointment and confirmation of all members, adopt bylaws for the

 

operation of the commission. The bylaws shall include, at a

 

minimum, voting procedures that protect against conflict of

 

interest and minimum requirements for attendance at meetings.

 

     (2) The governor may remove a commission member from office

 

for failure to attend 3 consecutive meetings in a 1-year period.

 

     (3) The commission annually shall elect a chairperson, who

 

shall be a public member, and a vice-chairperson.

 

     (4) If the commission's agenda includes a conflict of interest

 

for the chairperson, the vice-chairperson shall lead the

 

discussion.

 

     (5) (4) The commission shall hold regular quarterly meetings

 

at places and on dates fixed by the commission. Special meetings

 

may be called by the chairperson, by not less than 3 commission

 

members, or by the department.

 

     (6) (5) A majority of the commission members appointed and

 

serving constitutes a quorum. Final action by the commission shall

 

be only by affirmative vote of a majority of the commission members

 

appointed and serving. A commission member shall not vote by proxy.

 

     (7) (6) The legislature annually shall fix the per diem

 

compensation of members of the commission. Expenses of members

 

incurred in the performance of official duties shall be reimbursed

 

as provided in section 1216.

 

     (8) (7) The department shall furnish administrative services

 

to the commission, shall have charge of the commission's offices,

 

records, and accounts, and shall provide at least 2 full-time

 

administrative employees, secretarial staff, and other staff

 

necessary to allow the proper exercise of the powers and duties of

 

the commission. sufficient staff to support the work of the

 

commission. The department shall make available the times and

 

places of commission meetings and keep minutes of the meetings and

 

a record of the actions of the commission. The department shall

 

make available a brief summary of the actions taken by the

 

commission.

 

     (9) (8) The department shall assign at least 2 full-time

 

professional employees to staff the commission to assist the

 

commission in the performance of its substantive responsibilities

 

under this part.

 

     Sec. 22215. (1) The commission shall do all of the following:

 

     (a) If determined necessary by the commission, revise, add to,

 

or delete 1 or more of the covered clinical services listed in

 

section 22203. If the commission proposes to add to the covered

 

clinical services listed in section 22203, the commission shall

 

develop proposed review standards and make the review standards

 

available to the public not less than 30 days before conducting a

 

hearing under subsection (3).

 

     (b) Develop, approve, disapprove, or revise certificate of

 

need review standards that establish for purposes of section 22225

 

the need, if any, for the initiation, replacement, or expansion of

 

covered clinical services, the acquisition or beginning the

 

operation of a health facility, making changes in bed capacity, or

 

making covered capital expenditures, including conditions,

 

standards, assurances, or information that must be met,

 

demonstrated, or provided by a person who applies for a certificate

 

of need. A certificate of need review standard may also establish

 

ongoing quality assurance requirements including any or all of the

 

requirements specified in section 22225(2)(c). Except for nursing

 

home and hospital long-term care unit bed review standards, by

 

January 1, 2004, the commission shall revise all certificate of

 

need review standards to include a requirement that each applicant

 

participate in title XIX of the social security act, chapter 531,

 

49 Stat. 620, 1396r-6 and 1396r-8 to 1396v.42 USC 1396 to 1396w-5.

 

     (c) Direct the department to prepare and submit

 

recommendations regarding commission duties and functions that are

 

of interest to the commission including, but not limited to,

 

specific modifications of proposed actions considered under this

 

section.

 

     (d) Approve, disapprove, or revise proposed criteria for

 

determining health facility viability under section 22225.

 

     (e) Annually assess the operations and effectiveness of the

 

certificate of need program based on periodic reports from the

 

department and other information available to the commission.

 

     (f) By January 1, 2005, and every 2 years thereafter, after

 

that, make recommendations to the joint committee regarding

 

statutory changes to improve or eliminate the certificate of need

 

program.

 

     (g) Upon submission by the department approve, disapprove, or

 

revise standards to be used by the department in designating a

 

regional certificate of need review agency. , pursuant to section

 

22226.

 

     (h) Develop, approve, disapprove, or revise certificate of

 

need review standards governing the acquisition of new technology.

 

     (i) In accordance with section 22255, approve, disapprove, or

 

revise proposed procedural rules for the certificate of need

 

program.

 

     (j) Consider the recommendations of the department and the

 

department of attorney general as to the administrative feasibility

 

and legality of proposed actions under subdivisions (a), (b), and

 

(c).

 

     (k) Consider the impact of a proposed restriction on the

 

acquisition of or availability of covered clinical services on the

 

quality, availability, and cost of health services in this state.

 

The commission shall also evaluate all certificate of need review

 

standards to determine if the language allows for actual approval

 

of an application. If the commission determines that a service will

 

be capped at a specific number of providers, the commission shall

 

express that determination plainly in the review standards.

 

     (l) If the commission determines it necessary, appoint standard

 

advisory committees to assist in the development of proposed

 

certificate of need review standards. A standard advisory committee

 

shall complete its duties under this subdivision and submit its

 

recommendations to the commission within 6 months unless a shorter

 

period of time is specified by the commission when the standard

 

advisory committee is appointed. Voting on all motions before the

 

committees shall be documented by a roll call vote and shall be

 

recorded in the minutes. An individual shall serve on no more than

 

2 standard advisory committees in any 2-year period. The

 

composition of a standard advisory committee shall not include a

 

lobbyist registered under 1978 PA 472, MCL 4.411 to 4.431, but

 

shall include all of the following:

 

     (i) Experts with professional competence in the subject matter

 

of the proposed standard, who shall constitute a 2/3 majority of

 

the standard advisory committee.

 

     (ii) Representatives of health care provider organizations

 

concerned with licensed health facilities or licensed health

 

professions.

 

     (iii) Representatives of organizations concerned with health

 

care consumers and the purchasers and payers of health care

 

services.

 

     (m) In addition to subdivision (b), review and, if necessary,

 

revise each set of certificate of need review standards at least

 

every 3 years.

 

     (n) If a standard advisory committee is not appointed by the

 

commission and the commission determines it necessary, submit a

 

request to the department to engage the services of private

 

consultants or request the department to contract with any private

 

organization for professional and technical assistance and advice

 

or other services to assist the commission in carrying out its

 

duties and functions under this part.

 

     (o) Within 6 months after the appointment and confirmation of

 

the 6 additional commission members under section 22211, develop,

 

approve, or revise certificate of need review standards governing

 

the increase of licensed beds in a hospital licensed under part

 

215, the physical relocation of hospital beds from 1 licensed site

 

to another geographic location, and the replacement of beds in a

 

hospital licensed under part 215.

 

     (2) The commission shall exercise its duties under this part

 

to promote and assure all of the following:

 

     (a) The availability and accessibility of quality health

 

services at a reasonable cost and within a reasonable geographic

 

proximity for all people in this state.

 

     (b) Appropriate differential consideration of the health care

 

needs of residents in rural counties in ways that do not compromise

 

the quality and affordability of health care services for those

 

residents.

 

     (3) Not less than 30 days before final action is taken by the

 

commission under subsection (1)(a), (b), (d), (h), or (o), the

 

commission shall conduct a public hearing on its proposed action.

 

In addition, not less than 30 days before final action is taken by

 

the commission under subsection (1)(a), (b), (d), (h), or (o), the

 

commission chairperson shall submit the proposed action and a

 

concise summary of the expected impact of the proposed action for

 

comment to each member of the joint committee. The commission shall

 

inform the joint committee of the date, time, and location of the

 

next meeting regarding the proposed action. The joint committee

 

shall promptly review the proposed action and submit its

 

recommendations and concerns to the commission.

 

     (4) The commission chairperson shall submit the proposed final

 

action including a concise summary of the expected impact of the

 

proposed final action to the governor and each member of the joint

 

committee. The governor or the legislature may disapprove the

 

proposed final action within 45 days after the date of submission.

 

If the proposed final action is not submitted on a legislative

 

session day, the 45 days commence on the first legislative session

 

day after the proposed final action is submitted. The 45 days shall

 

include not less than 9 legislative session days. Legislative

 

disapproval shall be expressed by concurrent resolution which that

 

shall be adopted by each house of the legislature. The concurrent

 

resolution shall state specific objections to the proposed final

 

action. A proposed final action by the commission under subsection

 

(1)(a), (b), (d), (h), or (o) is not effective if it has been

 

disapproved under this subsection. If the proposed final action is

 

not disapproved under this subsection, it is effective and binding

 

on all persons affected by this part upon the expiration of the 45-

 

day period or on a later date specified in the proposed final

 

action. As used in this subsection, "legislative session day" means

 

each day in which a quorum of either the house of representatives

 

or the senate, following a call to order, officially convenes in

 

Lansing to conduct legislative business.

 

     (5) The commission shall not develop, approve, or revise a

 

certificate of need review standard that requires the payment of

 

money or goods or the provision of services unrelated to the

 

proposed project as a condition that must be satisfied by a person

 

seeking a certificate of need for the initiation, replacement, or

 

expansion of covered clinical services, the acquisition or

 

beginning the operation of a health facility, making changes in bed

 

capacity, or making covered capital expenditures. This subsection

 

does not preclude a requirement that each applicant participate in

 

title XIX of the social security act, chapter 531, 49 Stat. 620,

 

1396r-6 and 1396r-8 to 1396v 42 USC 1396 to 1396w-5, or a

 

requirement that each applicant provide covered clinical services

 

to all patients regardless of his or her ability to pay.

 

     (6) If the reports received under section 22221(f) indicate

 

that the certificate of need application fees collected under

 

section 20161 have not been within 10% of 3/4 the cost to the

 

department of implementing this part, the commission shall make

 

recommendations regarding the revision of those fees so that the

 

certificate of need application fees collected equal approximately

 

3/4 of the cost to the department of implementing this part.

 

     (6) (7) As used in this section, "joint committee" means the

 

joint committee created under section 22219.

 

     Sec. 22219. (1) A joint legislative committee to focus on

 

proposed actions of the commission regarding the certificate of

 

need program and certificate of need standards and to review other

 

certificate of need issues is created. The joint committee shall

 

consist of 6 members as follows:

 

     (a) The chairperson of the senate committee on health policy.

 

     (b) The vice-chairperson of the senate committee on health

 

policy.

 

     (c) The minority vice-chairperson of the senate committee on

 

health policy.

 

     (d) The chairperson of the house of representatives committee

 

on health policy.

 

     (e) The vice-chairperson of the house of representatives

 

committee on health policy.

 

     (f) The minority vice-chairperson of the house of

 

representatives committee on health policy.

 

     (2) The joint committee shall be co-chaired by the chairperson

 

of the senate committee on health policy and the chairperson of the

 

house committee on health policy.

 

     (3) The joint committee may administer oaths, subpoena

 

witnesses, and examine the application, documentation, or other

 

reports and papers of an applicant or any other person involved in

 

a matter properly before the committee.

 

     (4) The joint committee shall meet quarterly to review the

 

recommendations made by the commission under section 22215(6)

 

regarding the revision of the certificate of need application fees

 

and submit a written report to the legislature outlining the costs

 

to the department to implement the program, the amount of fees

 

collected, and its recommendation regarding the revision of those

 

fees.

 

     (5) The joint committee may develop a plan for the revision of

 

the certificate of need program. If a plan is developed by the

 

joint committee, the joint committee shall recommend to the

 

legislature the appropriate statutory changes to implement the

 

plan.

 

     Enacting section 1. Section 22226 of the public health code,

 

1978 PA 368, MCL 333.22226, is repealed.