JEFFERSON CITY, Mo. – Appointed in 2010, William Krodinger is the current chairman of the Missouri Health Services Review Committee, which oversees the bi-monthly Certificate of Need meetings.
Certificates of Need (CON) are an effort to contain costs, improve quality and increase access for many of Missouri’s major health care services. This effort was established in Missouri in 1980, motivated by federal Public Law 93-641 as part of the Health Planning and Resource Development Act of 1974.
The committee’s mission is to achieve the highest level of health for Missourians through cost containment, reasonable access, and public accountability.
“I think this way, it is a way for the government to kind of use private entrepreneurs and force them to put nursing homes in areas that may not have received them if we didn’t have this system,” Krodinger told The Missouri Times.
The goals of the committee are to review proposed health care services, contain health costs, promote economic value, evaluate competing interests, prevent unnecessary duplications, and disseminate health-related information to affected parties.
Krodinger applied to serve on a board or commission in 2010. As a successful small-business owner in Kirkwood, he wanted to give back.
“I started into the real estate business,” Krodinger said. “Appraising became a larger part of it as time went on. It got to a point that I wanted to do a little something back for the community and I applied to the committees down there and saw there was an opening on the Medical Health Facilities Review Committee, which they thought may be something that my expertise might be helpful in, as far as construction and venues and where sites will be located. I applied for it and I was picked by the governor.”
“I didn’t know if it was going to be good for the community, but I thought it would be some public service,” Krodinger said.
The committee has 6 CON meetings annually and 1 administrative workshop in Jefferson City. Each meeting can last up to 4 hours.
Krodinger and his committee colleagues were appointed by the governor and confirmed by the senate. Committees are not allowed to have an unbalanced political presence, which led Krodinger’s confirmation as an independent to be rougher than most.
“I started getting scrutiny from both sides of the aisle, thinking some Mickey Mouse stuff was going on and I was kind of blindsided by it,” Krodinger said. “Republicans had weirdest questions, thinking the governor was stacking the committee with Democrats by saying I’m an independent.”
His term was kicked off with a weird case regarding a small facility in Washington, Missouri. The case led to a legal and political struggle and the fighting surprised Krodinger upon arrival.
“As I’ve spent time on the committee, I see a lot of people say that we shouldn’t have a Certificate of Need committee and say, ‘if you have the money and you want to have a nursing home, build it; you should be that entrepreneur,’” Krodinger said. “I look at it after I got on there as, if that were really true, then there would have a lot more disparity than there already is as far as rural areas and smaller towns getting nursing homes instead of the Kirkwoods and the Ladues of the area. Everybody wants to go to private pay. Everybody wants to get the biggest rent for their room.”
One case that stands out to Krodinger is a small facility in Maryville that may never have developed without a CON.
“Would it have happened without a certificate of need? I don’t know. Yes? No? Maybe,” Krodinger said. “But, at least it has a circle now and some data in the circle. Sometimes you have to have a small safety net for an operation otherwise it cannot survive.”
Krodinger is in his first year as chairman of the committee and is the third chairman since the start of his term. As chairman, he oversees the Certificate of Need meetings.
“It’s been an experience,” he said. “Overall, it has been enjoyable. Some of the process of government is tedious. I can see places where we could streamline it, but it always comes back to the decision of the Assembly, rather than just rulemaking by the committee. We would have to go back to square one with basic changes.”
Since the beginning of Krodinger’s term, meetings have become more efficient through rule adherence. Just years ago, CON meetings would go on for hours despite there being time limit-oriented rules on the books. Since his chairmanship started, rules have continued to be adhered to, streamlining meetings.
“I enjoy controlling the meetings so that they don’t go on forever,” Krodinger said.
Despite regular criticisms of the committee, the chairman stands by the purpose of it and he views CONs to be a continual need in Missouri.
“The baby boomers are coming up the track,” he said. “Nursing homes, independent living is going to continue to be huge and it is getting bigger all the time. I think the statistic is that 10,000 baby boomers are retiring every day. Those in their fifties and sixties are 10 more years away from nursing home eligibility.”
The committee has one vacant seat. The governor appoints five of the 9 seats, with four being consisted of two from each Assembly chamber. Krodinger joins Reps. Penny Hubbard (D-St. Louis) and Caleb Jones (R-California), Sens. Mike Parson (R-Boliver) and Paul LeVota (D-Independence), Dr. Marty Vollmar (R), and the former representatives Marsha Campbell (D-St. Louis, 1996-2000) and Judith Grace O’Connor (D-St. Louis, 1971-1990).
Featured image from July 2015 meeting.
Rachael Herndon was the editor at The Missouri Times and also produced This Week in Missouri Politics, published Missouri Times Magazine, and co-hosted the #MoLeg podcast. She joined The Missouri Times in 2014, returning to political reporting after working as a campaign and legislative staffer.
Rachael studied at the University of Missouri – Columbia. She lives in Jefferson City with her husband, Brandon, and their two children.
