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State of Vermont

House of Representatives

Montpelier, Vermont

House Resolution

H.R.  10

House resolution in opposition to the issuance of a certificate of need for a proposed ambulatory surgical center

Offered by:  Representatives LaVoie of Swanton, Perry of Richford, Allard of St. Albans Town, Branagan of Georgia, Consejo of Sheldon, Fitzgerald of St. Albans City, Gervais of Enosburg, Gilbert of Fairfax, Howrigan of Fairfield, Keenan of St. Albans City and McAllister of Highgate

Whereas, 18 V.S.A § 9431 provides that it is the policy of the state of Vermont that “all new health care projects be offered and developed in a manner which avoids unnecessary duplication and contains or reduces increases in the cost of delivering services,” and

Whereas, this law also requires that a new health care facility maintain and improve “the quality and access to health care services,” and

Whereas, a proposed ambulatory surgical center is included within the scope of this statutory directive, and therefore, the commissioner of banking, insurance, securities, and health care administration (the commissioner) is required to grant an ambulatory surgical center a certificate of need (CON) prior to the facility’s construction and offering of any medical services to the public, and

Whereas, the commissioner will grant a CON only if the public policy objectives stated in 18 V.S.A. § 9431 are satisfied, and

Whereas, a proposal is pending before the commissioner for the establishment of an ambulatory surgical center, and

Whereas, three area hospitals, Fletcher Allen Health Care in Burlington, Northwest Medical Center in St. Albans, and Porter Medical Center in Middlebury, have testified in this CON review process that they have sufficient capacity in their existing surgical suites to provide the same surgical care that the new organization is proposing, and that granting the CON would, contrary to law, be authorizing the duplication of existing medical services, and

Whereas, during a period of time when cost containment has been a major concern in the health care field, a proposed new surgical center would add in excess of $2 million in capital expenses to Vermont’s health care system, and

Whereas, the center is proposing an operating margin of 20–40 percent while, in contrast, Northwest Medical Center operates on a margin in the 6–8 percent range, and

Whereas, revenue-generating services that an ambulatory surgical center would provide are important for hospitals to offer in order that the hospitals are able to provide essential but money-losing services, including obstetrics, emergency rooms, wellness programs, and mental health support, and

Whereas, if the requested CON is granted to the proposed ambulatory surgical center, more ambulatory centers seeking to draw on hospitals’  revenue-generating medical services will emerge, and

Whereas, prospective patients should be concerned that a stand-alone ambulatory surgical center is not held to the same quality standards as a hospital, and

Whereas, the fact that health care regulations are applied less stringently to stand-alone ambulatory surgical centers than to hospitals affects both the quality of service and cost for patients, and

Whereas, as a result of this lower regulatory burden, the proposed ambulatory surgical center will have an unfair competitive advantage over a hospital, and

Whereas, the granting of the center’s application would violate fundamental Vermont public policy pertaining to construction of new health care facilities,  now therefore be it

Resolved by the House of Representatives:

That this legislative body expresses its opposition to the commissioner of banking, insurance, securities, and health care administration granting a certificate of need for the construction and operation of a proposed ambulatory surgical center, and be it further

Resolved:  That the clerk of the house be directed to send a copy of this resolution to the public oversight commission.




____________________________              Attested to:

Gaye R. Symington

Speaker of the House


                                                                      Donald G. Milne

                                                                      Clerk, House of Representatives

Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont