Number of employees – 28

Recurring operating expenses – $ 2,047,655

Organizational structure - Office of the Commissioner, Fiscal and Administrative Services, and Certificate of Need and Compliance, Research and Planning Unit.

Mission

The mission of the Office of Health Care Access is to ensure that the citizens of Connecticut have access to a quality health care delivery system. The agency fulfills its mission by advising policy makers of health care issues, informing the public and the industry of statewide and national trends, and designing and directing health care system development.

Statutory Responsibility

State statutes empower the Office of Health Care Access (OHCA) to gather and analyze significant amounts of health care data, thus positioning the agency as an informed contributor to State health care policy deliberations. OHCA’s role as policy advisor and information resource permits the agency to assess and report on health care access, cost and delivery within the state and to assist policy makers and the industry in crafting and sustaining a superior health care system for all Connecticut residents.

Public Service

OHCA contributes to the overall financial well being of the state’s health care delivery system by analyzing acute care hospitals’ financial condition and by assisting the Department of Social Services in administering the Disproportionate Share Payments to Hospitals (DSH) Program. The DSH Program protects access to hospital care for the uninsured and underinsured by providing financial assistance to hospitals that provide a disproportionate amount of such care.

OHCA encourages health system development by overseeing and coordinating statewide health system planning and by administering the Certificate of Need (CON) program for hospitals, other types of health care facilities and for all imaging equipment and linear accelerators costing over $400,000. The CON program encourages health care industry leaders to consider collaborative efforts and multiple perspectives in developing an effective, responsive health care system. The program also provides an opportunity for consumer, provider and payer participation during the application process. The CON process also helps limit excess costs to the evolving health care system by preventing unnecessary duplication of health care technology, services, and programs.

The State continues to be the largest purchaser of health care in connecticut, spending close to $4 billion each year. Under OHCA’s ACHIEVE initiative, the agency developed a results management database, a financial reporting tool that uses data readily available from the State’s health plan vendors, to track and evaluate monthly claims data. OHCA is providing this information to the Office of Policy and Management to support ongoing development and assessment of the budget for State employee/retiree health benefit costs.

The functions administered by OHCA enable State policy makers to monitor the health care system, identify areas of potential need, coordinate State policy and actions, formulate solutions for meeting identified needs, and fully leverage the State’s significant buying power in a coordinated manner to control cost and increase quality.

OHCA uses numerous vehicles to inform the public, legislators and the health care industry of important health care issues and trends. OHCA’s website offers current information about the agency and its activities, access to complete OHCA reports and publications, Certificate of Need decisions, and hospital budget and utilization data. The site also includes statutes, regulations, legal notices, relevant forms, and links to relevant national, federal, state, and organizational health care-related websites. The address is: www.ct.gov/ohca.

Improvements/Achievements 2003-04

In order to address its statutory requirements and fulfill its mission, OHCA regulates the constantly evolving hospital and health care industry. During the 2004 session of the General Assembly, OHCA successfully supported the passage of laws that will make a significant positive impact upon the State’s ability to remain responsive and flexible in regulating the rapidly changing health care environment, while reducing time-consuming and costly burdens on the industry and in many cases, the State.

Public Act 04-249, AN ACT CONCERNING THE REGULATION OF OUPATIENT SURGICAL FACILITIES, makes permanent certain provisions of Public Act 03-274, AN ACT CONCERNING OUTPATIENT SURGICAL FACILITIES, requiring outpatient surgical facilities to comply with certificate of need and licensing laws applicable to institutional care providers. The public act removes expired and obsolete exceptions to compliance with OHCA’s certificate of need requirements and Department of Public Health’s licensure and regulatory requirements. This public act revises the law regarding outpatient surgical facilities by amending the definition of "outpatient surgical facility" to eliminate the term "free standing”, includes facilities performing diagnostic procedures under certain conditions, and excludes certain medical offices owned and operated exclusively by physicians. The public act also includes the provision that OHCA study the feasibility of an expedited CON process for certain outpatient surgical facilities and establish a task force to study other outpatient surgical facility-related issues.

Other improvements in state fiscal year 2004 include $63.7 million in enhanced Medicaid or Disproportionate Share Payments to Hospitals (DSH) program payments made to acute care hospitals, resulting in over $31.9 million in federal matching funds coming to Connecticut.

OHCA also continued its planning activities under its U.S. Health Resources and Services Administration grant. This State Planning Grant provides the agency with an opportunity to develop a realistic plan to increase access to health insurance coverage in Connecticut. Policy analysis and development activities conducted under the grant led to a proposal to pilot a small employer health insurance subsidy initiative.

The Certificate of Need (CON) regulatory process is a review of certain proposed capital expenditures by heath care facilities, acquisition of major medical equipment, institution of new services or functions, termination of services, transfer of ownership, and decreases in total bed capacity. A CON is a formal OHCA statement that a health care facility’s CON application request is needed. The CON program continues to protect the health care system and provide savings in system costs while significantly simplifying procedures and reducing time and paperwork for applicants and the agency. During state fiscal year 2004, OHCA rendered 87 final decisions or modifications and 101 determinations.

Lastly, OHCA has continued to expand and improve its information technology capabilities. Much of this work has been done in response to requests for increased accessibility to information retained by the Agency. All CON decisions and CON determinations are now posted to the agency website within 24 h ours of release. Additionally, responses to Freedom of Information requests are now available in electronic format on CDs. One example is that the certificate of need decisions made by the Agency are being scanned and posted to our website within 24 hours of them being made.

Information Reported as Required by State Statute

· OHCA will soon publish its Fourth Annual Report on Graduate Medical Education as required under Public Act No. 99-172.

· In accordance with Section 19a-670, Connecticut General Statutes, OHCA’s Annual Report on the Financial Status of Connecticut’s Short Term Acute Care Hospitals was published in February 2004.

· OHCA continues to prepare its own Affirmative Action Plan, which was submitted in February 2004, and approved in April 2004. This plan complies with Connecticut General Statutes Secs. 46a-70 through 46a-78.

· Published in April 2004, OHCA’s 2003 Annual Report to the Governor and the General Assembly more fully describes agency achievements, objectives, and initiatives.

· OHCA continues to maintain a registry of health care facilities that have sought exemption from CON review in accordance with Sec. 19a-639a, Connecticut General Statutes.