After six months of study, Kentucky certificate of need task force says more study needed

By: - December 14, 2023 11:18 am

Donald Douglas (LRC Public Information)

Lawmakers wrapped up a six-month study of Kentucky’s certificate of need law Thursday by saying more study is needed before they can make solid recommendations for reform.

The task force unanimously approved a Findings and Recommendations Memo Thursday morning that laid out the opposing views on certificate of need (CON) in Kentucky:

  • “One position is that certificate of need laws limit competition by protecting incumbent providers and creating a burdensome approval process for establishing new or expanding health services and facilities, and that there is little evidence that certificate of need laws control costs, improve quality, or ensure access to healthcare.”
  • “A second position is that health-care service delivery does not operate in a free market, thus certificate of need laws are necessary to control costs, improve quality, and ensure access to health care for all people in all geographic areas. The existing certificate of need program may be improved with modifications for some healthcare facilities and services.” 

Monthly meetings with the 10 senators and representatives featured testimony about the impact of certificate of need (CON) on Kentucky’s long-term care sector, hospitals, freestanding birth centers and more. 

The final recommendation states: “Further study may provide additional information to guide statutory and regulatory changes” to the law.  

CON task force co-chair Sen. Donald Douglas, R-Nicholasville, also recommended that a “a similar or a new” task force be convened next year to study the topic more in depth. 

“This particular task force,” he said, “took a lot of time just understanding what certificate of need was.” 

The certificate of need requirement mandates regulatory mechanisms for approving major capital expenditures and projects for certain health care facilities, according to the National Conference of State Legislatures. 

Sometimes called the “competitor’s veto,” certificate of need laws were in effect in 35 states and Washington D.C. as of December 2021. 

“This is a very, very broad area and really affects the entire business of medicine and health care,” said Douglas, a physician, on Thursday. “I think the recommendations can be made by listening to more information or at least taking the information and taking a deeper look at…how it’s going to affect people.” 

Task force member Sen. John Schickel, R-Union, said the past six months have highlighted the divide between Kentucky’s urban and rural communities and that “the solutions may be…very different for urban and rural” areas. 

“I believe now more than ever, that we need certificate of need reform,” he said. “I’m going to continue to be an advocate for this issue in the future.”  

This story may update. 


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Sarah Ladd
Sarah Ladd

Sarah Ladd is a Louisville-based journalist from West Kentucky who's covered everything from crime to higher education. She spent nearly two years on the metro breaking news desk at The Courier Journal. In 2020, she started reporting on the COVID-19 pandemic and has covered health ever since. As the Kentucky Lantern's health reporter, she focuses on mental health, LGBTQ+ issues, children's welfare, COVID-19 and more.