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Proposal to end hospitals' certificate of need system pulled from CRC

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A proposal that would have ended the state's certificate-of-need process for approving hospitals was withdrawn Monday, just before it was set to move into the next stage of consideration for the November ballot as a constitutional amendment.

Proposal 54, which was sponsored by Constitution Revision Commission member Frank Kruppenbacher, would have linked the approval process for new hospitals to infection rates at other hospitals in the area. By doing so, it would have no longer allowed to state to limit hospital growth through the current certificate of need process. The CON process currently requires the state to approve hospitals and other health care providers like nursing homes to add more sites or services.

The proposed amendment did not reference the long-running certificates of need process directly, but it would have prohibited limiting hospital growth in any counties with at least one hospital with an infection rate above the state average. Deregulating the hospital industry by restricting or removing the program has long been a priority for some leaders in the Republican-dominated Legislature and for Gov. Rick Scott, a past hospital executive.

When the proposal moved forward last month, Kruppenbacher — who Scott appointed to the seat — dismissed the possibility that such a measure might advance in the Legislature, saying overhauling the system had to happen through the CRC. The powerful 37-member committee meets once every 20 years to choose proposals to put directly before voters, which voters can then pass by a 60 percent majority.

He did not respond to requests for comment Monday on why the proposal was pulled before the commission meets this week to refine the language of the remaining proposed amendments.

The Safety Net Hospital Alliance of Florida, which represents public, nonprofit and teaching hospitals in the state, objected to the proposal and lauded its withdrawal Monday.

“Preserving Florida’s health care strategic planning process is vital for a strong safety net hospital system which provides the most highly specialized medical care regardless of a patient’s ability to pay,” said Lindy Kennedy, the group's executive vice president, in a statement. “With fewer commercially insured patients to help cover the costs of caring for the poor and uninsured, safety net hospitals would have been forced to cut vital services that benefit all Floridians, such as neonatal care, trauma, burn, and transplants."

The withdrawal is part of the further culling of dozens of proposal from the commission's consideration: Another health care proposal, which would have added a "bill of rights" for residents in long-term care facilities, was withdrawn last month after sponsor Brecht Heuchan conceded it was unlikely to have the votes in its current form.

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