Green Mountain Care Board staff detail Certificate of Need process, thresholds and pending bills

Laura Bellavoe, staff attorney for the Green Mountain Care Board, described the board’s Certificate of Need (CON) process, the legal thresholds that trigger review and ongoing legislative questions about exemptions and threshold levels.

CON review matters because it governs whether health-care projects—including facility construction, major equipment purchases and some service expansions—must undergo state review intended to limit duplication, control costs and protect access to care.

Bellavoe said a project may fall under CON jurisdiction in two ways: by exceeding capital-cost thresholds or by meeting non-cost criteria. As presented to the committee, a hospital capital cost that exceeds roughly $3,800,000 and a non-hospital capital cost that exceeds roughly $1,900,000 would trigger CON review; the board also looks at projected operating expenses for the first two fiscal years (the non-hospital operating threshold discussed was about $632,000 for a given year). Non-cost triggers include changes in licensed bed counts, offering home-health services (subject to a moratorium through 2030 with exceptions), transfer of ownership…