Number of employees – 28

Recurring operating expenses – $2,588,398

Organizational structure - Office of the Commissioner, Certificate of Need, Financial Analysis and Forecasting and Compliance Unit, Research and Planning Unit.

Mission

The mission of the Office of Health Care Access (OHCA) 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 Authority

OHCA oversees the state’s health care delivery system to ensure that access to affordable, quality care is available to the citizens of the state. The agency’s major functions are administration of the certificate of need (CON) program; health care data collection, analysis and reporting; and hospital financial review and reporting.

The agency is responsible for managing the CON program in order to promote appropriate health facility and service development and access to health care. The CON process ensures that a proposed project meets public need while preventing excessive, unnecessary, or duplicative development of facilities or services and that no reduction or termination of service will have an adverse effect on health care access. The process also allows for public opportunity to comment during health facility/service project development.

State statute also empowers OHCA with the ability to initiate a formal investigation or inquiry into or hearing on matters under agency jurisdiction, if necessary, with the authority by law to subpoena witnesses and require the production of pertinent records, papers and documents.

In addition, the Office of Health Care Access has statutory authority to gather and analyze significant amounts of hospital financial data and hospital billing and discharge data. Information collected, verified, analyzed and reported on includes hospital expenses and revenues, uncompensated care volumes, and other financial data as well as hospital utilization, demographic, clinical, charge, payer and provider statistics.

Public Service

The Office of Health Care Access’ CON program, data collection, research, analysis and planning activities and related initiatives have a significant impact on the health care delivery system within Connecticut.

OHCA guides health system development by overseeing and coordinating statewide health system planning and by administering the CON program for hospitals, other types of health care facilities and for all acquisition of CT scanners, MRI scanners, PET and PET/CT scanners, linear accelerators, cineangiography equipment, new technology being introduced to the state and major medical equipment. The CON program is designed to promote cost containment, prevent unnecessary duplication of health care facilities and services, guide the establishment of health facilities and services and ensure that high quality health services are provided. The process ensures that capital and technology investments in the health care industry are in the best interest of the citizens of Connecticut. In addition, 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.

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. Hospitals and other health care facilities must be financially viable in order to deliver quality, cost-effective health care. By collecting and analyzing numerous financial data, OHCA is able to provide a picture of the financial well-being of Connecticut’s hospitals.

OHCA’s data collection, analysis and public release of health care utilization information is a cornerstone of the agency, and allows the agency to function as both policy advisor and information resource to a variety of organizations and individuals. OHCA regularly provides legislators, health care policy makers, the health care industry and members of the general public with detailed analyses of health care trends and health care topics relevant to public policy and public interest.

In addition, the agency continues to plan for providing access to affordable health insurance for all state residents. OHCA has focused on educating policy makers regarding access to health care coverage through data collection, the synthesis of information and the preparation of briefings and presentations.

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, agency forms, and links to relevant national, federal, state, and organizational health care-related websites. The address is: www.ct.gov/ohca.

Improvements/Achievements 2006-07

In order to address its statutory requirements and fulfill its mission, OHCA regulates the constantly evolving hospital and health care industry. The agency maintains a focus on issues related to hospital finance, hospital utilization and access to health care coverage. Some key agency accomplishments are described below.

In 2006, OHCA issued 55 CON decisions, 87 CON determinations and 39 CON modifications. Also in 2006, OHCA invoked its investigatory powers, pursuant to Section 19a-633, CGS, on two occasions. First, in May 2006, OHCA initiated an investigation to review utilization and capacity of acute care services provided in the Waterbury area by Waterbury and St. Mary’s Hospitals. Second, in November 2006, OHCA initiated an investigation into the acquisition, without necessary CON authorization, of a PET-CT scanner by a physician practice group. OHCA conducted these investigations in an effort to ensure citizens of Connecticut have adequate access to care and that care is delivered appropriately.

OHCA continued its ongoing examination of access to health insurance coverage, fielding separate telephone surveys of Connecticut households, employers, and two groups that the agency’s prior research had shown are at high risk for being uninsured -- Hispanic adults and young adults (ages 19 to 29). From 2001 through 2006, OHCA’s survey research was supported by State Planning Grants (SPG) competitively awarded by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA). The SPG program helped states design policies to expand access to affordable health insurance coverage. Information from OHCA’s surveys was used by legislators, state agencies, healthcare advocates, municipal governments, health care providers and other stakeholders to inform planning and policy making efforts.

During the 2007 session of the General Assembly, OHCA successfully supported the passage of Public Act 07-149 -- An Act Concerning Revisions to Office of Health Care Access Statutes. This act redefines several terms OHCA uses in calculating uncompensated care for the disproportionate share hospital program and helps the agency’s financial unit fulfill its statutory obligations. It also removes obsolete references and makes minor technical changes to statutory language.

In addition, PA 07-2 -- An Act Implementing the Provisions of the Budget Concerning Human Services and Public Health, requires the Department of Public Health, in consultation with OHCA, to contract for the development of a statewide health information technology plan. The plan must include general standards and protocols for health information exchange, electronic data standards for the development of an integrated electronic health information system and pilot programs for health information exchange.

Information Reported as Required by State Statute

· In accordance with CGS Sec. 19a-670, OHCA’s Annual Report on the Financial Status of Connecticut’s Short Term Acute Care Hospitals was published in December 2006.

· OHCA’s Affirmative Action Plan was submitted to the Commission on Human Rights and Opportunities on February 15, 2007 and approved by the Commission at its May 10, 2007 meeting. This plan complies with CGS Secs. 46a-70 through 46a-78.

· OHCA’s 2006 Annual Report to the Governor and the General Assembly, published in April 2007 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 CGS Sec. 19a-639a.