Connecticut

Connecticut

Connecticut requires 19 CONs within five broad healthcare categories—hospital beds, beds outside hospitals, equipment, facilities and services. In addition to Connecticut’s 19 specific CON requirements, the state maintains 26 specific exceptions including exceptions for home health agencies, Conn. Gen. Stat. § 19a-638(b)(6), and free clinics, § 19a-638(b)(11). Unlike many states, Connecticut adds confusion by allowing two separate agencies to process CON applications depending on the type of CON—the Office of Health Strategy (OHS) and the Department of Social Services.

COVID-19 Response

On March 14, 2020, Governor Lamont issued Executive Order No. 7B, which authorized OHS to waive CON provisions and enable healthcare facilities in response to COVID-19. Exec. Order 7B (Mar. 14, 2020). Thereafter, OHS issued four guidance documents allowing hospitals to temporarily increase bed capacity without obtaining CONs. OHS, Guidance Docs. 20-001 to -003b (Mar. 2020).
OHS further allowed all healthcare providers to apply for a temporary waiver of any CON requirement if necessary to respond to or manage the pandemic.

Application Process

In Connecticut, the CON application process takes anywhere from 60 days to over a year depending on the type of project. See Conn. Gen. Stat. § 19a-639a, § 17b-353. Applications can be submitted at any time. The fee for a CON application is $500. Conn. Gen. Stat. § 19a-639a(a). Competitors may request a hearing, at which they can add evidence and present arguments as to why an application should be denied. Conn. Gen. Stat. § 19a-639a(e); see generally Conn. Agencies Regs. § 19a-639a-1 to -6.

CON? Number of CONs Moratoria Temporary COVID-19 response:
Hospital Beds Yes 1 – Suspended at least some CON laws
Beds Outside Hospitals Yes 1 1 Expedited at least some CON reviews
Equipment Yes 6 – Expedited at least some CON reviews
Facilities/ Buildings Yes 10 – Expedited at least some CON reviews
Services Yes 1 – Expedited at least some CON reviews
Emergency Medical Transport No – – –

Note: these citations are accurate as of May 2020.

Connecticut CONs in Detail

Type of CON

Moratoria/Types of CONs

Conn. Gen. Stat.

Hospital Beds

1.Increase in licensed bed capacity.

§ 19a-638(a)(12)

Beds Outside Hospitals

1.Moratorium on adding new nursing home beds.

§ 17b-354(a)

1.Increase in bed capacity at health care facility.

§ 19a-638(a)(12)

Equipment

1.Computed tomography scanners.

2.Magnetic resonance imaging scanners.

3.Positron emission tomography scanners.

4.Positron emission tomography-computed tomography scanners.

§ 19a-638(a)(10)

5.Nonhospital based linear accelerators.

§ 19a-638(a)(11)

6.Equipment utilizing technology not previously used in the state.

§ 19a-638(a)(13)

Facilities/Buildings

1.Increase in two or more operating rooms within any three-year period by short-term acute care general hospital.

2.Increase of two or more operating rooms within any three-year period by outpatient surgical facility.

§ 19a-638(a)(14)

Establishment or transfer of ownership of:

3.Hospitals.

4.Specialty Hospitals.

5.Central service facilities.

6.Mental health facilities.

7.Substance abuse treatment facilities.

§§ 19a-638(a)(1), (2),

19a-630(10)

8.Transfer of ownership of large group practice.

§ 19a-638(a)(3)

9.Establishment of freestanding emergency department.

§ 19a-638(a)(4)

10.Establishment of outpatient surgical facility.

§ 19a-638(a)(6)

Services

1.Cardiac services.

§ 19a-638(a)(9)

Emergency Medical Transport

No CONs in this category.

Connecticut CON Exceptions

No CON Required For:

Conn. Gen. Stat.

1.Health care facility owned/operated by the federal government.

§ 19a-638(b)(1)

2.Establishment of offices by a licensed private practitioner.

§ 19a-638(b)(2)

3.Health care facility operated by a religious group that relies exclusively on prayer for healing.

§ 19a-638(b)(3)

4.Residential care homes.

§ 19a-638(b)(4)

5.Assisted living agencies.

§ 19a-638(b)(5)

6.Home health agencies.

§ 19a-638(b)(6)

7.Hospice services.

§ 19a-638(b)(7)

8.Outpatient rehabilitation facilities.

§ 19a-638(b)(8)

9.Outpatient chronic dialysis services.

§ 19a-638(b)(9)

10.Transplant services.

§ 19a-638(b)(10)

11.Free clinics.

§ 19a-638(b)(11)

12.School-based health centers.

§ 19a-638(b)(12)

13.A program licensed or funded by the Dep’t of Children and Families, except psychiatric residential treatment facilities.

§ 19a-638(b)(13)

14.Nonprofit facilities, institutions or providers that provide service on behalf of a state agency or department.

§ 19a-638(b)(14)

15.Nonprofit facilities operated by an educational institution for its students or faculty.

§ 19a-638(b)(15)

16.Municipal outpatient clinics.

§ 19a-638(b)(16)

17.Residential facilities for individuals with intellectual disabilities.

§ 19a-638(b)(17)

18.Replacing existing imaging equipment.

§ 19a-638(b)(18)

No CON Required For:

Conn. Gen. Stat.

19.Cone-beam dental imaging equipment used exclusively by dentists.

§ 19a-638(b)(19)

20.Partial or total elimination of certain services provided by an outpatient surgical facility.

§ 19a-638(b)(20)

21.Termination of services for which the Dep’t of Public Health has requested the facility relinquish its license.

§ 19a-638(b)(21)

22.Acquisition of equipment used exclusively for scientific research not conducted on humans.

§ 19a-638(b)(22)

23.Nursing home beds restricted for use by AIDS patients.

24.Nursing home beds restricted for use by patients requiring neurological rehabilitation.

25.Nursing home beds associated with a continuing care facility.

26.Medicaid certified beds relocated from one licensed nursing facility to another licensed nursing facility to meet a priority need identified in a strategic plan.

§ 17b-354(a)

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