Hartford Business Journal

6 HARTFORDBUSINESS.COM | JULY 27, 2026 Politics & Policy Department of Public Health Commissioner Dr. Manisha Juthani said maintaining continuity will be the agency's top priority as it assumes oversight of the state's Certificate of Need program, which governs many major healthcare investments and transactions. Contributed Photo New Gatekeeper CT revamps approval process for major healthcare investments, deals Transition year Although OHS oversaw Connecti- cut's healthcare planning functions beginning in 2018, the Certificate of Need program had previously been housed within DPH. Juthani said the department did not object when Gov. Ned Lamont proposed returning the program to her agency. "It certainly is something that is within the description of health depart- ments around the country," she said, adding that DPH supported the move, provided it received the experienced staff needed to continue the work. The department had about 750 employees before the reorganiza- tion and has absorbed 22 former OHS employees. That transition also reunites func- tions that, behind the scenes, never really left. Juthani noted that DPH already handled many administrative services for OHS — including human resources, information technology and some fiscal functions — because the smaller agency lacked the staff needed to operate independently. She described the transition as, in many ways, bringing those functions "home." DPH Deputy Commis- sioner Adelita Orefice, who now oversees the Certificate of Need program, said the biggest challenge has been untangling OHS' various responsibilities. "Because OHS was such a small agency, people worked on a number of different activities," which means individuals had pieces of projects that are now being divided among DPH and OPM, she said. "So there's been a little detangling, and the same is true for the money." According to state officials, DPH assumed more than $2.6 million from the former OHS budget, including about $2.4 million in personnel costs and $213,000 in other expenses. Orefice said it will take time to fully separate OHS' responsibilities. "You're going to take this year to figure out, 'OK, did things land in the right place,'" she said. No immediate changes While lawmakers substantially reshaped Connecticut's healthcare regulatory system, providers plan- ning projects shouldn't expect any immediate procedural changes, Juthani said. Instead, the next year will focus on understanding the existing process, maintaining current operations and preparing for reforms scheduled to begin next July. Among the changes taking effect next year are revised application requirements, broader use of expe- dited reviews for certain projects and a new decision-making structure. Under the revised law, some applica- tions — including requests to acquire advanced imaging equipment, expand hospital bed capacity or add operating By David Krechevsky davidk@hartfordbusiness.com W hether it's expanding a hospital, opening an outpatient surgery center, buying an MRI scanner or selling a large physician practice, many of Connecticut's most significant healthcare projects and deals can't move forward without state approval. Beginning this month, those deci- sions have a new gatekeeper. A major state government reorga- nization approved by lawmakers this year shifted responsibility for deciding which major healthcare transactions receive state approval, marking the biggest change to Connecticut's regulatory system since 2018. For hospitals, physician groups and other providers planning major investments, the immediate question isn't simply who now oversees the approval process. It's whether a system long criticized as slow and inefficient will improve. State officials say the answer, for now, is continuity. The shift follows the legislature's decision to eliminate the Office of Health Strategy and transfer over- sight of the state's Certificate of Need program — the review process governing many major healthcare investments — to the Department of Public Health. In an interview with Hartford Business Journal, DPH Commis- sioner Dr. Manisha Juthani said the first message she wants healthcare organizations filing Certificate of Need applications to hear is that projects will continue moving through the system. "The wheels are still turning and the trains are on time," Juthani said. That focus on continuity, rather than immediate reforms, is expected to define the next year as DPH absorbs former OHS staff and prepares to implement sweeping changes to the Certificate of Need process that don't take effect until July 1, 2027. Under the state reorganization, OHS' 42 employees and roughly $18 million budget were divided among several agencies. DPH assumed responsibility for the Certificate of Need program and health system planning, while healthcare cost benchmarking — the state's program for tracking and setting spending targets for hospi- tals and other providers — and other policy functions shifted to the Office of Policy and Management. Certificate of Need approval is required for many major healthcare investments, including: • Hospital expansions • Outpatient surgery centers • MRI, CT and other advanced imaging equipment purchases • Hospital mergers and acquisitions • Sales of large physician practices • New cardiac services Adelita Orefice

• Cover