Bills in the state senate aim to remove some state oversight of critical access hospitals

Jan 9, 2020

Legislation in the state senate could cut state oversight of critical access hospitals. Those are federally designated hospitals, located more than thirty-five miles away from another hospital.


The package of bills reforming Michigan’s certificate of need program was first reported on by Bridge Magazine. Those bills include SB669, 670, 671, 672, 673, 674, and 675.

The package includes one bill that would eliminate the state’s certificate of need requirements for critical access hospitals.

A certificate of need requires the hospitals to seek state approval before expanding high-cost services, such as air ambulances or neonatal intensive care. Supporters of the program say it helps keep down costs by preventing duplication of services.

Republican State Senator Curt VanderWall sponsored the legislation to remove the requirement. He said certificates of need have limited residents access to care - especially in rural areas.

“It has limited access but increased profits for some of our hospitals,” he said. “I don’t believe that is the intention of medicine and should not be the intention of medicine.”

And, according to VanderWall, when hospitals apply to expand a particular service…

“In most cases those applications can run as long as three years to be either approved or disapproved. Basically we know we have a crisis and we feel we need to move a little quicker  in making those decisions for care here in the state of Michigan.”

Michigan is one of 36 states with certificate of need laws.

A 2015 study from the University of Michigan found that Michigan had lower per capita healthcare costs than either Indiana and Wisconsin, two states without certificate of need laws.

Adam Carlson is with the Michigan Health and Hospital Association. He said eliminating certificate of need requirements could create winners and losers.

“Small and rural hospitals that have been fortunate enough to survive while providing more comprehensive services than their critical access counterparts, they might be under pressure to downsize to meet that new CA (critical access) designation.”

Carlson added that he doesn’t oppose all of the certificate of need reforms proposed by the package. One change, which would add two seats to the certificate of needs comission, he supports.