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May 9, 2024

CT lawmakers criticize OHS for CT health care reform bill failure

SHAHRZAD RASEKH / CT MIRROR Office of Health Strategy Executive Director Deidre Gifford addresses the press as Gov. Ned Lamont watches.

Legislative leaders took aim at the state’s Office of Health Strategy and its director, Deidre Gifford, Wednesday morning as the midnight session deadline loomed and it became clear some hospital oversight reforms raised by the executive branch would not get a vote.

In particular, House leaders blamed OHS and Gifford for their inability to pass changes this year to the certificate of need program, a controversial process that came under intense scrutiny during Yale New Haven Health’s attempt to buy Prospect Medical Holdings’ hospitals in Connecticut.

They also criticized OHS for the lack of agreement on cost growth benchmarking — annual targets set by the state meant to limit the increasing cost of health care — and said negotiations around hospital-related bills should be “legislatively led” in the future, meaning lawmakers would spearhead the talks.

Senate Bill 9, a key hospital oversight measure that would have made changes to the certificate of need program and required more hospital reporting on finances, was introduced by the executive branch.

Hospital reforms “need to be legislatively led, because there’s just a lack of trust right now in the executive branch from [the Connecticut Hospital Association] and the hospitals,” House Speaker Matthew Ritter, D-Hartford, said. “Sometimes the executive branch has a good lead on an issue given expertise from different departments. But I think this [topic] has to be legislatively led.

“I can just tell you that every meeting I have with a hospital … it starts with, ‘We disagree with OHS.’ Then you meet with OHS and they say, ‘It’s not a big deal.’ It’s been like this the last two years.”

Spokespeople for the Office of Health Strategy and Gov. Ned Lamont’s office declined to comment Wednesday.

House Minority Leader Vincent Candelora, R-North Branford, also expressed frustration with OHS.

“What we’re seeing is, bills are coming out, and there’s a complete disconnect between the [health care] industry, the legislature and the Office of Health Strategy,” he said. “We tried to get [the certificate of need program] revised and it all fell apart. There are a lot of problems with that agency.

“It’s pretty sad when the only success coming out of OHS is they reformed the agency to make the director the commissioner now. It doesn’t change the fact that they are an obstacle for appropriate reform in our health care industry.”

Ritter and House Majority Leader Jason Rojas, D-East Hartford, said OHS and the hospitals couldn’t agree on reporting data that inform cost growth benchmarking efforts.

“They can’t even agree on reporting requirements,” Ritter said.

Rojas added: “Data collection is a big issue when we’re talking about the health care benchmarks.”

The failure of the General Assembly to make substantive changes in how Connecticut regulates and oversees hospitals, a sensitive issue given the precarious finances of the three Prospect Medical-owned hospitals, prompted legislative leaders Wednesday to question whether the Lamont administration was adequately engaged.

The session will end at midnight Wednesday without the passage of Senate Bill 9, an administration bill that would have mandated greater financial oversight of hospitals and revised the state’s much-maligned program for assessing health care needs, the certificate of need program.

The legislature had also considered three other bills that would have made various changes to the CON program, including reducing the timeframes for a decision on an application. In the waning weeks of the session, elements of those proposals were going to be included in Senate Bill 9, legislators have said.

The bond package includes one provision on hospital financial reporting.

The Democratic co-chairs and ranking Republicans on the legislature’s Public Health Committee said the failure was frustrating, coming on the heels of Yale New Haven Hospital suing to get out of a deal to purchase the three hospitals, but not solely the fault of the administration.

They disagreed with suggestions by legislative leadership that the failure was due to a lack of effort or engagement by the administration’s Office of Health Strategy.

“It’s the last day of session, and everyone’s frustrated because a lot of things that people try to do and want to do to help protect access to health care, costs of health care, and safety of patients aren’t going to happen today,” said Rep. Cristin McCarthy Vahey, D-Fairfield, co-chair of the Public Health Committee.

She attributed the failure to its ambition, complexity and lingering mistrust by the hospitals toward state government due to a protracted fight over taxation by the previous administration of Gov. Dannel P. Malloy.

“There’s plenty of blame to go around,” said Rep. Nicole Klarides-Ditria, R-Seymour, the ranking House Republican. “Everybody wants what they want. OHS wants theirs. CHA wants theirs. Everybody thinks what they want is best. So, it’s our job as legislators to literally pick and choose the things that we think are best. That’s our job.”

Sen. Saud Anwar, D-South Windsor, co-chair of the Public Health Committee, said the failure to reach a deal is set against “the backdrop of a historically poor relationship between the Office of Health Strategy and [the hospital association] for a long, long time.

“We have a completely new team at the Office of Health Strategy that is about a year and a half old. So what may have happened five years ago, two years ago, three years ago, is not the actual situation.”

Paul Kidwell, senior vice president for policy at the Connecticut Hospital Association, did not comment directly on the remarks made Wednesday, but said the association continues to work with lawmakers and Lamont’s administration.

“Connecticut hospitals and health systems are committed to exceptional patient care, preserving and expanding access, improving affordability, helping our communities, and advancing world-class healthcare here in Connecticut,” he said. “We work with our communities, legislative partners, and the governor and his administration to advance these goals. This work does not end at the close of the legislative session, and we look forward to continuing to collaborate for the benefit of patients across the state.”

Sen. Heather Somers, R-Groton, said OHS was engaged, if inflexible at times.

“There was some compromise, but not to a point that we would have buy-in from the legislators to be able to get that passed,” she said. “And it was a complex bill. It’s hard to explain. It’s in the weeds. You almost need a PhD in CON.”

Of course, she added, there was no consensus on how to fix CON, since some lawmakers want it eliminated.

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