Certificate Of Need Application Costs Reach $1.5 Million in 2015

Talk about barrier to entry! In 2015, certificate of need (CON) application costs totaled just under $1.5 million. Fees for health care project proposals such as building adult care home facilities, kidney dialysis centers, or even relocating inpatient rehabilitation hospital beds range between $5,000 and $50,000. And, no, these application costs are not refundable. CON has become a high-risk regulatory game for medical professionals to navigate.

It’s time to end a law that prohibits patient choice, innovation, and access to lower cost care for North Carolina patients. For more information on the history and evolution of this law, be sure to visit restorehealthcarefreedom.com. 

NC’s sunset and periodic review of rules — reaping unexpected benefits

The news about the state’s periodic review and examination of existing administrative rules has taken an even more encouraging turn.

sunset progress March 2016

This particular reform comes from the Regulatory Reform Act of 2013. It’s one that I and my colleagues at the John Locke Foundation championed, and here’s why.

The bulk of economic literature shows that regulation is harmful to the economy. Cutting red tape and clearing out overregulation would therefore have beneficial effects for economic growth.

Sunset provisions with periodic review was found by researchers at Mercatus to have a “robustly statistically significant” effect in reducing a state’s regulatory burden — and consequentially an economically significant effect as well.

I’ve written previous updates on state rules weeded out thanks to this reform (see the graph above). Today, however, Carolina Journal has some new good news:

The Department of Health and Human Services is seeking repeal of six unnecessary certificate-of-need rules to reduce the regulatory burden on medical diagnostic centers and purchase of major medical equipment. Some health care experts welcome the reduced red tape, but say the changes don’t go far enough.

The proposal, which would be effective Dec. 1, is the latest example of the impact of regulatory reforms put in place by the Republican-led General Assembly. About 6,225 administrative rules have been reviewed throughout state government, and 690 are slated to be eliminated, while others are still under review for possible sunsetting.

“North Carolina’s Administrative Procedure Act mandates periodic review of all rules. The repeal of the CON rules is, in part, a response to that mandate,” said DHHS spokeswoman Kate Murphy. The agency has repealed 86 CON rules effective Feb. 1.

As readers here know, North Carolina’s extensive CON regulations are one of biggest remaining obstacles to the state becoming truly First in Freedom.

DHHS Proposes To Lighten The Administrative Load For Certificate of Need Applicants

In the latest edition of the North Carolina Register’s proposed rule making, the state Department of Health and Human Services (DHHS) proposes to repeal six administrative rules related to the state’s restrictive Certificate of Need law – one in which medical professionals and hospitals are required to ask the state permission (and then their competitors) to establish new health facilities or update major medical equipment.

If repeal goes into effect by the end of the year, then the CON administrative process will be a bit lighter for parties interested in applying to be licensed as a diagnostic center or to purchase medical equipment/technology inclusive of CT scanners, x-rays, mammography, ultrasound, echocardiography, or nuclear medicine.

For example, let’s say that your local urology group wants to upgrade its CT equipment. The CON application for that equipment would no longer require these physicians to find the following evidence that justifies why upgrading CT equipment is necessary for the medical community.

  • Documentation that surrounding market competitors and affiliated health facilities are using their CT equipment at 80% of operating capacity within the past year.
  • Documentation that the applicant’s current CT equipment is projected to or has reached 80% maximum operating capacity within three years of initial acquisition.
  •  Documentation that the applicant’s utilization projections are based on the experience of the provider and on epidemiological studies.

While repealing these rules would definitely reduce the time commitment to file a CON application, the larger issue at hand is that CON still leaves central planners with the final say on any diagnostic center expansions or updates that exceed $500,000 (this threshold, by the way, has not kept up with medical inflation since 1994).

The Carolina Journal has the full story here.

Private school fighting back against voucherphobia

Private schools that accept voucher students need to push back against uninformed voucherphobes.  Here is a letter to the editor from Lauri Ake, principal of Fayetteville Christian School, that does just that:

Fayetteville Christian School decided to become a participating school in the N.C. Opportunity Scholarship program three years ago because we believe spiritual development as well as academic growth is what students need. We partner with families who agree that some of the most influential people in their children’s lives should share the same beliefs.

I specifically want to address the critics’ “concerns” over private schools’ lack of accountability. Keith Poston of the Public School Forum (“Opportunity on the rise,” July 23) was correct when quoted that private schools aren’t held to the same academic standard. That’s true at Fayetteville Christian School. We are dually accredited through ACSI (Association of Christian Schools International) and AdvanceED, which is the accrediting agency all public schools in North Carolina receive accreditation through. We hold ourselves to additional standards that the public schools do not. We do use licensed teachers and offer lateral entry positions for qualified personnel who are willing to get the educational training, just like the public schools.

Finally, the biggest concern voiced is that precious funding is being diverted to private schools. A scholarship recipient receives $4,200 for the year from the state. That’s a $4,096 savings based on the N.C. Department of Public Instruction’s Facts and Figures 2015-2016 per pupil expenditure. The scholarship receives no federal or local funding, so Cumberland County is actually saving money.

Obviously families in Cumberland County want alternatives to public school.

Unfortunately, the folks at the Fayetteville Observer titled the letter, “Some private schools accountable.”  The truth is that all private schools are accountable to parents, regardless if they participate in a voucher program or not.

Busing not the “best way to improve black or Hispanic achievement”

The Brown Center on Education Policy at the Brookings Institution just published “Bringing back busing: Do benefits outweigh cost?,” a must-read article on forced busing.  The author is David J. Armor, Professor Emeritus at George Mason University, who has written extensively on the subject.

The article includes a case study that compares student performance in Wake and Mecklenburg counties in 2004 and 2005.  At that time, Wake County assigned certain students based on socioeconomic status, while Charlotte-Mecklenburg had returned to a neighborhood schools assignment policy.  When adjusted for socioeconomic status, there was little difference between the performance of black and white students in the two districts.  Similarly, the black-white achievement gap was nearly identical.

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Dr. Armor concludes,

In my opinion, these advocates have not made a sufficient case that more desegregation (either racial or economic) is the best way to improve black or Hispanic achievement, and also that large-scale desegregation is a realistic goal and can be accomplished without the same controversy and resistance that occurred in the 1970s.  Indeed, the growth of predominantly minority group charter schools suggests that preference for an “own-group” school is not limited to middle class white parents.

WSFCS charter takeover?

Winston-Salem Journal ponders the possibility that a Winston-Salem-Forsyth County School could be part of new Achievement School District, in which five of the state’s lowest-performing schools will be converted to charter schools:

“Absolutely,” said Beverly Emory, superintendent of Winston-Salem/Forsyth County Schools. “I would imagine… there would be some look our way.”

Based on last year’s state performance scores, Forsyth County is home to as many as eight of North Carolina’s lowest performing elementary schools and could be looked at for inclusion in the ASD. The state will choose five elementary schools, each from a different district and each performing in the bottom five percent on the state’s grading scale — based mostly on state test scores.

The bill, signed into law last month, calls upon the State Board of Education to hire a superintendent for the new district and select five schools for the ASD pilot in 2017. Once selected, a district can either relinquish that school to the state — and, eventually, the charter management operator selected to run it — or close the school.

Note the healthy dose of skepticism over the ASD wrapping up the article. Some might say it’s unbiased journalism presenting the other side of the story. However—maybe it’s just me—other might say it reflects the mainstream media’s overall skepticism of charter schools because—horror—it “strips resources” from public school systems.

Semi-related: News & Record says schools participating in the state’s Opportunity Scholarship Program shouldn’t discriminate against gay students—-or gay parents.

NY Post columnist warns of journalism’s collapse

Michael Goodwin of the New York Post has detected one clear lesson from this year’s presidential campaign.

Donald Trump may or may not fix his campaign, and Hillary Clinton may or may not become the first female president. But something else happening before our eyes is almost as important: the complete collapse of American journalism as we know it.

The frenzy to bury Trump is not limited to the Clinton campaign and the Obama White House. They are working hand-in-hand with what was considered the cream of the nation’s news organizations.

The shameful display of naked partisanship by the elite media is unlike anything seen in modern America.

The largest broadcast networks — CBS, NBC and ABC — and major newspapers like The New York Times and Washington Post have jettisoned all pretense of fair play. Their fierce determination to keep Trump out of the Oval Office has no precedent.

Indeed, no foreign enemy, no terror group, no native criminal gang, suffers the daily beating that Trump does. The mad mullahs of Iran, who call America the Great Satan and vow to wipe Israel off the map, are treated gently by comparison.

By torching its remaining credibility in service of Clinton, the mainstream media’s reputations will likely never recover, nor will the standards. No future producer, editor, reporter or anchor can be expected to meet a test of fairness when that standard has been trashed in such willful and blatant fashion. …

… The Times now is so out of the closet as a Clinton shill that it is giving itself permission to violate any semblance of evenhandedness in its news pages as well as its opinion pages.

A recent article by its media reporter, Jim Rutenberg, whom I know and like, began this way: “If you’re a working journalist and you believe that Donald J. Trump is a demagogue playing to the nation’s worst racist and nationalistic tendencies, that he cozies up to anti-American dictators and that he would be dangerous with control of the United States nuclear codes, how the heck are you supposed to cover him?”

Whoa, Nellie. The clear assumption is that many reporters see Trump that way, and it is note­worthy that no similar question is raised about Clinton, whose scandals are deserving only of “scrutiny.” Rutenberg approvingly cites a leftist journalist who calls one candidate “normal” and the other ­“abnormal.”

Clinton is hardly “normal” to the 68 percent of Americans who find her dishonest and untrustworthy, though apparently not a single one of those people writes for the Times. Statistically, that makes the Times “abnormal.”

Welfare reform’s positive impact defended

Joseph Lawler of the Washington Examiner reports on a new study that defends the 1996 federal welfare reform law against its present-day left-of-center critics.

A new analysis has rejected one of the popular criticisms of the 1996 welfare reform, namely that it led to an increase in deep poverty by preventing some single-mother households from receiving government help.

Instead, government data indicates that poverty fell overall, without any increase in deep poverty, when government benefits and tax credits are taken into account and inflation is properly accounted for, according to new research from the conservative Manhattan Institute.

Lawmakers “should reject the increasingly conventional view that extreme poverty has dramatically increased and the view that welfare reform did more harm than good,” concludes the report, published Monday to mark the 20th anniversary of President Bill Clinton signing the reform legislation.

Scott Winship, the report’s author, said in an interview with the Washington Examiner that he was motivated to study trends in deep poverty because he has been “appalled” by recent efforts to recast the 1996 reform, which instituted time limits and work requirements on cash welfare, as a disaster.

Much of the criticism of the law has been spurred by the publication of a new book, $2.00 a Day: Living on Almost Nothing in America, written by prominent Johns Hopkins sociologist Kathryn Edin, with Michigan professor Luke Shaefer. The book suggests millions of children live in families getting by on less than $2 a day and that the welfare reform law is to blame for forcing more people into such terrible situations.

Winship, however, finds in his study of the data that there were practically no children of single mothers in extreme poverty at the time welfare reform was signed in 1996, and that the same was true in 2012, the last year for which data was available.

The problem with the claim that extreme, $2-a-day poverty has risen, Winship claims, is that it fails to take into account the non-cash government benefits that have replaced cash welfare, it ignores the growth of low-income tax credits and it improperly accounts for inflation.