Alaska health department seeks input to update its 2005 health project review standards

The Alaska Department of Health's Office of Rate Review began gathering input Thursday on updating the standards it uses to decide whether major health care projects are needed. A stakeholder survey runs Oct. 30 through Nov. 13.

The Certificate of Need program is a state planning and regulatory program that governs whether hospitals, clinics and nursing homes may build or expand. It generally covers projects of $1.5 million or more for construction, renovation or expansion, changes in bed capacity or a new category of health services.

The program looks at proposed projects in the context of community need, including access to care and existing services, Certificate of Need Program Manager Mattie Dawson said at the online kickoff. She said that planning matters in Alaska, where many small communities are spread across a large area and getting care can involve significant travel.

The department adopted its current review standards and methodologies, the criteria and calculations used to evaluate a project, in December 2005. "A lot has changed in how healthcare is delivered since then," Dawson said.

"The number of beds a facility has doesn't necessarily tell us how many patients it can care for," she said, adding that current methods have limited ways to account for staffing and operating capacity.

The consulting firm Myers and Stauffer will review Alaska's methods and how other states handle these reviews. Candice McDaniel, a senior manager with the firm, said a Zoom listening session is tentatively set for Dec. 10, before recommendations are finalized in June.

McDaniel said the team wants to hear whether requirements led providers to delay, change or drop projects, where the process could be less burdensome and what should be preserved.

Jared Kosin, president and CEO of the Alaska Hospital & Healthcare Association, relayed a question someone had asked him: why do this at the tail end of an administration? Office of Rate Review Executive Director Nicole Lebo said she didn't think "rush" described the work, since regulatory proposals aren't expected before state fiscal year 2028, and "this one is long overdue."

A draft of updated standards will get another round of input before a regulation package with formal public comment.