Sen. Saud Anwar (D- South Windsor) joins Mike to discuss what’s next for the state’s certificate of need program. Hospitals are required to get a certificate of need before discontinuing services, mergers, or even making a major purchase. Lawmakers hoped to make changes to the lengthy process during the short session, but ran out of time.
Mike Hydeck: It is called a certificate of need. It is something hospitals need from the state so they can do things like possibly discontinue a service like labor and delivery, like we've seen in some of our hospitals or buy a piece of equipment. They need it for that, too. Or enter into a merger. Health care companies have been complaining now for years that this process is too slow. Sometimes one of these things can take more than a year to decide and get that certificate of need. Lawmakers in both parties say it's time to fix that. It did not, however, get done in this latest short session. So now what? Joining me now is Senator Saud Anwar, co-chair of the Public Health Committee. The South Windsor Democrat, also a pulmonologist by trade, understands the issue from the health care side and the legislative side. Senator, welcome back. First up, getting a decision from the state on a merger can take longer than a year, sometimes up to a year-and-a-half. Is that too long?
Saud Anwar: Absolutely, it's too long. We can do better as a state, and I think that's one of the responsibilities with the legislation we should have. And it's good to be here with you, Mike, again.
Mike Hydeck: Thanks for joining us on vacation. We really appreciate it. So Yale New Haven Hospital is trying to buy several small facilities. It was approved, even through this process, but it's still not a done deal. Why is that? Is that certificate of need related or not?
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Saud Anwar: This is not certificate of need related anymore because the Office of Health Strategies has granted that permission. And again, the responsibility of the government, of the state government, is to make sure that the vulnerable people are protected. And this is a transaction that is going to make sure that nobody is put in danger and the communities will not be left behind. They looked at all of those aspects. They made sure that things were going to be on the right track from that perspective, now it's between the two parties. It's Yale New Haven and Prospect who have not been able to come together in an agreement, and the hope is that they will come together because this is critical for our communities in all of these hospital service areas.
Mike Hydeck: So some of your colleagues across the aisle on the Republican side say, 'look, we've looked at certificate of need programs in other states, and they've proven inefficient, and they did not prove to save very much money for the state.' Is that a fair criticism? And if so, how can we and how should we change the certificate of need moving forward?
Saud Anwar: Sure, and I don't think this is a bipartisan issue. If you look at the legislation that have been proposed, they have been bipartisan on this issue. They have worked very closely with both parties to look at this, because healthcare is really an impact on each and every individual in our state. So I look at the process itself being more efficient and I know that that's going to be one of the priorities to look at, but also what kind of financial transaction around health care systems need to be considered in that option. I think that's something that needs more discussion. And also, if somebody is going to leave a community, we want to make sure that nobody's going to be left without health care if that is to happen. So these are the areas that we need to focus on. And I think the reason we weren't able to do this was that the time was our enemy. We had been negotiating and coming as close as we could, but in the short session, it was almost impossible to get this done.
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Mike Hydeck: So let's talk about some of the things that could or could still be under the certificate of need purview. Like, you and I have talked about this before, if a hospital needs to buy a multi-million dollar MRI piece of equipment, should that be mutually exclusive from certificate of need, or should that be included, would you say?
Saud Anwar: Well, if it's a hospital that already has one, absolutely it should not go through it again because they've already been through a process, they're upgrading their their equipment, and that is already excluded. But if a hospital is going to get new machinery, they should be able to get it without that process, as long as it's not standalone in other community, because then it encroaches into the territory of some of the standalone businesses. And we don't want to be anti-business in the process either.
Mike Hydeck: Wondering why that was connected to certificate of need. If I own a business, I want to be, I want to buy a new mixer because I work in a pizza place, I shouldn't have to ask anybody. It's different, though, if you're hampering competition, I guess that's why it's under that.
Saud Anwar: I think the arguments that have been looked at in some of the other states is that sometimes the number of procedures and tests are increased when there are too many of the competitors in the same area. And also the communication is not as efficient between one hospital system with the other, and that results in not getting the timely information on the patient's well being. So they want to make sure that there is a right amount of procedures or tests that are going to be performed, but also there's a communication system, so there are multiple factors to that.
Mike Hydeck: Got it. Okay, I have less than a minute, one last question. Some of some of your colleagues have been blaming the Office of Health Strategy for being too slow in trying to come up with some changes moving forward to make this more efficient. Is that fair?
Saud Anwar: I think a little bit of that is fair because we have almost the leadership of the Office of Health Strategies has been there for a year-and-a-half. They've not been there for the 10, 15, 20 years of baggage that people have emotionally with them. So I know that there's a new team in place. They've already reduced the time. But I do know that there's more that needs to be done and we are going to have very frank conversations to see how we can do better collectively as a state, around the timeline and the processes for the Office of Health Strategies work.
Mike Hydeck: Senator Saud Anwar, thank you so much for joining us once again from vacation and joining us on Face the Facts this morning.
Saud Anwar: Thank you so much for having me.
