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Constitution Revision Commission Drops Certificate Of Need Revamp

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Mary Shedden/WUSF
The Florida Channel
People attending a Constitution Revision Commission hearing in St. Petersburg were asked to wave green signs to support an issue, red to oppose.

Gov. Rick Scott’s long-standing priority to eliminate Florida’s certificate of need program for Florida hospitals came to a halt Monday, after a member of a powerful panel withdrew a proposal that would have overhauled the current hospital-approval system.

Constitution Revision Commission member Frank Kruppenbacher on Monday withdrew Proposal 54, which would have tied new hospital growth in the state to hospital-acquired infection rates at existing facilities.

Lindy Kennedy, executive vice president of the Safety Net Hospital Alliance of Florida, praised the removal of the proposal.

“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,” Kennedy said 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.’’

Though the proposal didn’t mention the words “certificate of need,” it would have the effect of circumventing the regulatory process that has required hospitals to get state approval before adding facilities or offering expanded services.

The measure only would have had an impact on so-called CONs for hospitals and wouldn’t have affected regulations for nursing homes or hospices.

“The governor looks forward to reviewing every proposal the CRC puts forth,” Scott spokesman McKinley Lewis said in a statement.

While Scott --- who appointed Kruppenbacher to the commission --- may review the proposals, the governor doesn't have any authority over which measures make it to the ballot.

Kruppenbacher in March told members of the commission that the proposed constitutional amendment was necessary because it would be the only way the state would ever be able to scrap the certificate of need system.  

“It’s not going to get fixed in this building,” Kruppenbacher said at the time, referring to the Capitol where the Constitution Revision Commission had been meeting. “It’s just not. The history and the record of the lobbying and the hold on the Legislature that health care has is going to prevent it.”

A former hospital executive, Scott has long tried to eliminate the certificate of need program for Florida hospitals.

In 2015, Scott appointed a hospital and health care commission, which issued a final report supporting a “thorough re-examination of the CON program to measure its current impact on competition, quality, and cost in Florida.” The 2015 commission also supported a repeal of the process, if appropriate.

The Constitution Revision Commission meets every 20 years and has the power to place proposed constitutional amendments directly on the November ballot. Ultimately, 60 percent of voters would have to approve any constitutional amendments.

Kruppenbacher’s was the third health care-related proposal pulled from consideration in recent weeks.  

CRC member Jeanette Nunez withdrew her proposal to eliminate a constitutional requirement that the state set aside 30 percent of overall tobacco-education and prevention funding for an edgy advertising and marketing campaign.

And CRC member Brecht Heuchen withdrew his proposed amendment that would have added a “residents’ bill of rights”: to the constitution for those who living in nursing homes and assisted living facilities.