Senate committee substitute deletes the provisions of the 2nd edition and now provides the following.

Part I.

Amends GS 131E-176, which sets outs defined terms applicable to Article 9, Certificate of Need. Changes the definition of diagnostic center to mean specified facilities in which the total cost of all the medical diagnostic equipment utilized by the facility which costs $10,000 or more exceeds $1.5 million (was, $500,000). Modifies the term major medical equipment to mean a single unit or system of use to provide medical and other health services which costs more than $2 million (was, $750,000); provides that beginning September 30, 2022, and annually thereafter, the cost threshold set forth is to be adjusted using the Medical Care Index component of the CPI as specified. Modifies the term new institutional health services to include the obligation of any person of a capital expenditure exceeding $4 million (was, $2 million) to develop or expand a health service or a health service facility or which relates to the provision of health service. Makes further technical, clarifying, and conforming changes.

Amends GS 131E-184, which provides exemptions from certificate of need review if certain conditions are met, making conforming changes to subsections (e) and (g) to reflect the now $4 million capital expenditure threshold set forth in GS 131E-176, as amended, related to new institutional health services.  Additionally, requires the Department of Health and Human Services (DHHS) to exempt from certificate of need review the replacement, renovation, or relocation of services or facilities that already have a certificate of need.

Amends GS 131E-189, deeming a certificate of need for the construction of a health service facility to expire if the holder of the certificate fails to initiate construction of the project authorized by the certificate of need within (1) four years, for projects that cost over $50 million or (2) two years, for projects that cost $50 million or less. Further, establishes that a certificate of need that has not been used at any point in the immediately previous 12 months will expire. 

Amends GS 131E-147 to require all initial applications and renewal applications for a certificate of need to state the number of procedure rooms on, and the number and type of procedures performed at, the premises named in the application.

Effective January 1, 2020.

Part II.

Further amends GS 131E-176, removing psychiatric facility and chemical dependency treatment facility from the definition of health service facility and health service facility bed. Further amends the definition of the term new institutional health services to no longer include the conversion of a specialty ambulatory surgical program to a multispecialty ambulatory surgical program or the addition of a specialty to a specialty ambulatory surgical program. 

Further amends GS 131E-184 to eliminate the conditions set forth to qualify for the exemption for the certificate of need review for any conversion of existing acute care beds to psychiatric beds, now providing for a blanket exemption. Adds new subsection (j) to require DHHS to exempt from certificate of need review the development, acquisition, construction, expansion, or replacement of a health service facility or health service that obtained certificate of need approval prior to October 1, 2019, as a psychiatric facility or a chemical dependency treatment facility. Adds new subsection (k) to require DHHS to exempt from certificate of need review the establishment of a home health agency by a licensed continuing care retirement community to provide home health care services to one or more residents of the retirement community who have entered into a contract with the retirement community to receive continuing care services with lodging. Requires the continuing care retirement community to obtain a certificate of need if developing or offering services to any individual not a resident of the retirement community under a contract to receive continuing care services with lodging. Explicitly does not exempt from the State's home health agency licensure and certification requirements a continuing care retirement community that has been exempted from certificate of need review for the provision of home health services to one or more residents pursuant to new subsection (k). Provides that new subsection (k) applies to continuing care retirement communities engaged in the direct provision of home health services 18 months after the act becomes law.

Amends Section 12F.4(b) of SL 2016-94, which requires the DHHS Secretary to select hospitals in the three State regions for institutional services to receive funds from the Dorthea Dix Hospital Property Fund for the construction or conversion of short-term, inpatient behavioral health beds in rural areas. Modifies the conditions of hospital funding, now requiring each selected hospital to reserve at least 25%, rather than 50%, of the constructed or converted beds for purchase by DHHS under the State-administered, three-way contract, and referrals by local management entities/managed care organizations for individuals who are indigent or Medicaid recipients. Maintains the remaining requirements and limitations.

Effective 18 months after the date the act becomes law. 

Part III.

Amends GS 131E-184, as amended, to require DHHS to exempt from certificate of need review the development, acquisition, construction, expansion, or replacement of a health service or health service facility that obtained certificate of need approval before October 1, 2019, as a kidney dialysis treatment center if the health service or health service facility is located in a county with a population greater than 300,000. Effective three years after this act becomes law.

Part IV.

Includes a severability clause.