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Georgia’s Obsolete CON

Sometimes, an answer to a problem is so obvious, so blatantly sitting right beneath your nose, that there might be only one conclusion: It’s not the right answer.

That seems to be the case regarding a hospital in northwest Georgia that is trying – so far, unsuccessfully – to build a new facility a few miles down the road.

CHI Memorial Hospital Georgia in Fort Oglethorpe was built in 1953 and currently staffs 36 acute-care beds. Its new owners want to build a 64-bed, $130 million facility in Ringgold, which is also in Catoosa County.

People in both communities agree it’s the right plan. Political leaders, business leaders, community leaders: All are on the same page. As usual, however, there’s one particular kind of entity that objects.

And that makes all the difference.

I’m talking about another hospital, in this case Parkridge Health System. It has appealed a decision by the Georgia Department of Community Health to award a Certificate of Need (CON) for the new facility.

Absent any interventions, the appeal could last years.

Here is where things get interesting. Parkridge, you see, is located just across the border in Tennessee.

And some people are chafing at the notion that an out-of-state hospital could influence the future of healthcare access in a Georgia community.

Remove the words “out of state” and they would have it right. There is no reason one hospital should be empowered by law to essentially veto the plans of another.

But this is where someone thinks they have found a “solution” that doesn’t address the real problem.
The DCH board is considering a rule change that would limit CON objectors to hospitals within Georgia. On its face, this seems to solve the problem of Catoosa County residents. And maybe it would solve their problem.

But they are not the only Georgians who would like more healthcare services than they have now. The people of Lee County, in southwest Georgia, have been trying for years to build a hospital. Folks in Butts County, between Atlanta and Macon, also would like to build a new, larger hospital to replace an older one and accommodate population growth.

CON regulations allow their competitors to object, and neither is close enough to the state border to be saved by this new rule.

Or what about Katie Chubb? The Augusta resident sought to open a new birth center to give women like her additional options to deliver their babies. Like the people in Catoosa County, she found agreement from state regulators about the need for expanded services. Yet, the project was scuttled anyway. Nearby hospitals, which also offer childbirth services and most likely didn’t want to lose any business to the proposed Augusta Birth Center, refused to sign the necessary direct transfer agreements (even though hospitals by federal law must accept all emergency patients).

Back to the proposed rule about out-of-state objectors. Are we to believe the Augusta community’s needs would have been radically different, or more legitimate, or more worthy of fulfilling, if the objectors simply had been located across the river in North Augusta, S.C.? Of course not. But that’s the only scenario in which a state-based policy would help Chubb and her potential patients.

CON is a statutory relic, stemming from a bygone era when the federal government largely shouldered the burden of paying for new hospitals and wanted to limit how many it funded. Those days are gone, but CON is still with us.

Although about a dozen states have repealed their CON laws for hospitals, Georgia’s lawmakers so far have been content merely to whittle away at ours. This slow, incremental approach has led to the present situation, where some objectors are seen as more distasteful than others.

Better to jettison this obsolete system and let hospitals spend their money on care for patients, not on lawyers to defend their turf.