Number of employees – 28

Recurring operating expenses – $ 2,305,068

Structure: Office of the Commissioner, Fiscal & Administrative Services,

Certificate of Need, Financial Analysis and Forecasting & Compliance,

Research & Planning Unit.

Agency 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 major medical equipment. 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 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 2004-2005

In order to address its statutory requirements and fulfill its mission, OHCA regulates the constantly evolving hospital and health care industry. During the 2005 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 ensuring the quality of health care services. The new Public Acts focus on enhancements to Certificate of Need (CON) regulation related to imaging equipment and affiliates of health care institutions as well as overall improvements to internal operations and efficiencies of the agency.

Public Act 05-93 - An Act Concerning the Capital Expenditure Threshold for the Regulation of Equipment Acquisitions

This public act is effective July 1, 2005 and requires CON approval, regardless of cost, for anyone acquiring, purchasing or accepting donation of a CT scanner, PET scanner, PET/CT scanner, MRI, cineangiography equipment, a linear accelerator or other similar equipment utilizing new technology that is being introduced to the state.

Prior to this new law, a $400,000 or more purchase, acquisition or accepted donation of imaging and scanning equipment triggered the CON review. In some cases this law may have provided an incentive to acquire equipment of lesser quality in order to avoid regulatory oversight. The agency believes this law will provide the citizens of Connecticut with a higher quality of imaging and scanning services.

Public Act 05-75 - An Act Concerning Certificate of Need and Public Hearing Requests

This public act is effective October 1, 2005. The public act is two-fold. First, it reestablishes the pre-1999 definition of the term affiliate within the OHCA statutes to include, “a person, entity or organization, controlling, controlled by or under common control with another person, entity or organization”, as it relates to CON review. Second, it clarifies the time frame by which one can request a public hearing.

The change in the term affiliate will require those who are not providing direct patient services, but manage, fund, or control the providers to be subject to CON review. This enables OHCA to inquire as part of the CON review about the financial solvency and managerial competency of the parent company as required by 19a-637 of the Connecticut General Statutes.

The new public hearing clarification adds a requirement that a request for a public hearing for CON be received by the agency no later than 21 days after the agency deems a CON application complete. This change still allows for a request of hearing to be open for a minimum 81 days (Letter of Intent Phase 60 days + 21 days). The agency proposed this change to give the agency, applicants and interested parties certainty as to whether a hearing will be requested.

Public Act 05-151 - An Act Concerning Revisions to the Office of Health Care Access Statutes

This act added, repealed or updated various sections of the agency’s statutes. The more significant aspects of the act are; the repeal of the mandated Graduate Medical Education reporting; deletion of outdated hospital budget requirements; and added compliance measures.

Other improvements in state fiscal year 2005 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 Pilot Planning 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. Data collection activities included an employer survey and a family health care access survey. Policy analysis and development activities conducted under the grant led to a proposal to pilot a health insurance premium 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 2005, OHCA rendered 102 final decisions, agreed settlements or modifications and 135 determinations.

Lastly, OHCA continues 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. CON decisions and CON determinations are now posted to the agency website within 24 hours of release. Additionally, responses to Freedom of Information requests are now available in electronic format on CDs.

Information Reported as Required by State Statute

· OHCA published its Fifth Annual Report on Graduate Medical Education as required under Public Act No. 99-172 in April of 2005

· In accordance with Section 19a-670, Conn. Gen. Statutes, OHCA’s Annual Report on the Financial Status of Connecticut’s Short Term Acute Care Hospitals was published in February 2005.

· OHCA continues to prepare its own Affirmative Action Plan, which was submitted to the Commission on Human Rights and Opportunities on February 4, 2005 and approved by the Commission at its April 14, 2005 meeting. This plan complies with Conn. Gen. Statutes Secs. 46a-70 through 46a-78.

· Published in March 2005, OHCA’s 2004 Annual Report to the Governor and the General Assembly more fully describes agency achievements, objectives, and initiatives.

· OHCA maintains a registry of health care facilities that have sought exemption from CON review in accordance with Sec. 19a-639a, Conn. Gen. Statutes.