Hartford Business Journal

12 HARTFORDBUSINESS.COM | FEBRUARY 10, 2025 Dr. Deidre Gifford is the commissioner of the state Office of Health Strategy, which regulates healthcare mergers and other transactions. HBJ PHOTO | STEVE LASCHEVER 'Difficult Conversations' Office of Health Strategy, legislators and hospitals seek common ground on regulatory oversight reforms would have to be "legislatively led, because there's just a lack of trust right now" in OHS from the Connecticut Hospital Association and state hospitals. Gifford deflects those comments as merely politics. "There's heated rhetoric all the time in the heat of the session," she said. "People said what they said. Some of it was probably based on inaccurate information that they had been given by other parties. But our attitude is 'head down, go to work, get back in the saddle and do the work on behalf of the people of Connecticut.' So, that's what we've been doing." Gifford said there's been "a lot of non-factual or inferential kinds of things in the press" about the CON process that OHS has been trying to correct, including what types of deals and activities it has oversight of, "and how long it takes" to make a ruling. Simply put, the certificate of need program requires certain healthcare providers to get state approval before making major changes in the health- care landscape, such as establishing a new healthcare facility, ownership transfers/mergers, significant new investments in equipment or facili- ties, and a termination of services, among other things. Gifford referred to an updated chart posted on the OHS website that shows the significant decline in the median length of time for a CON application to be processed. According to OHS data, from 2021 through the end of 2024 there has been: • A 33% reduction in the number of days between when a CON application is filed and is deemed complete; • A 68% reduction in the number of days between applications being deemed complete and the hearing date; and • A 64% reduction in the number of days between when an application was filed and when final action was taken. Gifford said the improvement came after OHS examined "every aspect" of the CON process, "streamlined it where possible within existing law," hired more staff, and targeted steps in the process that had "been prolonged in the past." Even with the 277-day reduction from the time of filing to final deci- sion, the 157-day median time means half of the applications still take longer than that. Expedited reviews Gordon, the GOP senator, believes the state should require a set timeline for the CON process. "For example, the bill that I submitted has some timelines of 180 days, because other states can do that within that time frame by law, but Connecticut, for some reason, didn't seem to be able to do that," he said. Jackson, OHS' legislation and regu- lation director, says the department doesn't disagree, and has proposed a new bill this session to speed up By David Krechevsky davidk@hartfordbusiness.com D r. Deidre Gifford, commis- sioner of the state Office of Health Strategy (OHS), keeps a square yellow note stuck to her computer monitor. The handwritten message on it states that 46% of Connecticut residents report going without or delaying health care due to the cost, a statistic that motivates her to remain focused on the department's mission. "That's not an acceptable set of circumstances," Gifford said of the 46% figure. "So, I think our biggest challenge and opportunity is to continue to work on making health care affordable, accessible and high quality for the people of Connecticut." There are those who disagree with her about what the biggest challenge is for OHS and how it conducts business. In the two years since she was appointed by Gov. Ned Lamont to lead OHS, the department's high- est-profile issue has been the fate of three hospitals owned by Califor- nia-based Prospect Medical Holdings — Waterbury, Manchester Memorial and Rockville General in Vernon. OHS and Gifford have faced criti- cism from legislators on both sides of the aisle, hospitals, and others for the amount of time it took to approve Prospect's sale of its hospitals to Yale New Haven Health (YNHH), and then for failing to help pass legislation to reform its regulatory approval process — formally known as the certificate of need (CON) application process — in the 2024 legislative session. Prospect subsequently filed for Chapter 11 bankruptcy on Jan. 11, while the sale of the three hospitals remains mired in dueling lawsuits. Sen. Jeff Gordon (R-Woodstock), a member of the legis- lature's Public Health Committee and a physi- cian, says the CON process is broken. He cited YNHH's bid to buy the Prospect hospitals, which took 16 months to be approved. "That took way, way too long and that shouldn't have happened," he said. "If the Office of Health Strategy had gotten their game together and worked on this … in a more timely manner, perhaps the Yale approval would have gone through and things would have been already taken care of, and we wouldn't be in this bankruptcy mess with Prospect." Hartford Business Journal recently sat down with Gifford and W. Boyd Jackson, director of legislation and regulation for OHS, to discuss certificate of need reform efforts, as well as some of the lessons learned about regulating the healthcare industry. 'Nonfactual' things Gifford was appointed by Lamont after serving from 2019 to 2023 as commissioner of the state Depart- ment of Social Services, and as an adviser to the governor during the COVID-19 pandemic. While Gifford, an obstetrician and gynecologist, has the demeanor of an experienced physician, she also has thick skin when it comes to her critics. As the 2024 legislative session drew to a close last June, a Lamont-supported bill that would have reformed the certificate of need process died without being brought up for a vote in either chamber, largely due to disagree- ments between the Office of Health Strategy and hospitals. That raised the level of vitriol aimed at Gifford and OHS. House Minority Leader Vincent Candelora (R-North Branford), said of OHS, "There are a lot of prob- lems with that agency," calling it "an obstacle for appropriate reform in our healthcare industry." House Speaker Matt Ritter (D-Hartford) added that any future effort to reform the CON process Sen. Jeff Gordon W. Boyd Jackson

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