Connecticut rewrites its CON program: OHS's review power moves to DPH, with a new 3-member panel

Connecticut has rebuilt its certificate-of-need program inside its state budget. Public Act 26-68 — Substitute Senate Bill No. 1, the act adjusting the state budget for the biennium ending June 30, 2027 — was approved by the Governor on May 26, 2026, per the act’s final page, and moves CON review out of the independent Office of Health Strategy and back to the Department of Public Health under a new three-member panel.

The transfer is structural, not cosmetic. Section 152 of the act makes DPH the “successor agency” to the Office of Health Strategy for both the Health Systems Planning Unit and the certificate-of-need process in sections 19a-638 to 19a-641 of the general statutes, effective July 1, 2026; a parallel section moves the office’s cost-growth-benchmark, all-payer-claims-database, and health-information-exchange functions to the Office of Policy and Management. Two firms tracking the change — Robinson+Cole’s Health Law Diagnosis and a National Law Review analysis — describe it as eliminating the Office of Health Strategy, which had overseen CONs since 2018, and report the legislature approved the package on May 2 as part of the budget.

The new machinery is dated. Sections 226 through 232 — the CON definitions, the program, and the panel — take effect October 1, 2026, and the operative application process applies “on and after July 1, 2027.” Under Section 227, the panel that decides every CON application has three members: the Commissioner of Public Health as chairperson, the Secretary of the Office of Policy and Management, and the Commissioner of Social Services (or their designees).

For surgery-center operators, two provisions cut in opposite directions. The act’s definition of “health care facility” in Section 226 now expressly reaches “a hospital, including any satellite location” and an outpatient surgical facility “as established by a short-term acute care general hospital” — language that pulls hospital-affiliated outpatient surgery sites under CON as facilities in their own right. On the independent side, Section 229 exempts from CON “the relocation of a health care facility within the same town or within ten miles of the existing facility location, provided such relocation will not result in a substantial change to the payer mix or patient population served by the facility.”

On operating rooms, the standard threshold is unchanged: Section 229 still requires a CON for “an increase of two or more operating rooms within any three-year period” by an outpatient surgical facility or short-term acute care general hospital. What is new is a faster lane for the smaller adds. Section 232 directs the panel to create an expedited-review pathway by January 1, 2028; on and after that date, an applicant may request expedited review for, among other categories, “an increase of two or three operating rooms, within any three-year period.” Expedited applications are not entitled to a hearing before a hearing officer, though the panel may pull one back to the standard track.