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Agenda items from canceled MHFRC near automatic approval


Committee has 100 days from time of application before applications are automatically approved

JEFFERSON CITY, Mo. – On September 7, Gov. Eric Grietens replaced four members on the Missouri Health Facilities Review Committee (MHFRC), one of which was Chairman Bill Krodinger. Three days later, the anticipated meeting – which would review 11 new applications and discuss 15 older ones – was postponed without a rescheduled date or an official statement as to why the meeting was canceled. Without such a statement, committee member Rep. Jack Bondon can only speculate that the meeting may be postponed because of a logistical issue to allow the newer members to be more familiar with Certificate of Need (CON) issues.

In addition to the inexperience of the new members, the MHFRC faces another inescapable problem in a vacant chairperson position.

According to Missouri Law,  the MHFRC has 100 days to review an application to build or expand certain health facilities before they are automatically approved. While the committee has the option to extend their review process an extra 30 days, some applications are reaching the hundred day point as early as next week.

The MHFRC is designed to act as a regulatory body to monitor health facilities from expanding without a financial need, so that smaller health facilities are not priced out of the market and to maintain costs of certain health facilities. However, the committee can only regulate health facilities by approving or denying applications in regular meetings – which can only be called by a chairperson.

There are nine members on the MHFRC, four of which are from the legislature and five are lay citizens appointed by the Governor. For the committee to appoint a new chairperson, all the members must hold a vote to appoint that person.

Jon Dalton, partner at Armstrong Teasdale, has been invested in CON issues for over 30 years. In his experience, he has noticed a loose trend of who the chair is, but it is hard to speculate who the chair might be.

“While there is no requirement or even preference in that regard what so ever… Historically, the chairperson has been a lay member of the committee, but that has not been exclusively the case,” Dalton said.

Following Greitens’ replacement of the four lay people to the MHFRC, eyes turn to Springfield accountant Derek Hunter to be the next chair. In addition to being the only lay person on the committee with substantial experience, Hunter is one of the longest-serving members on the MHFRC as a whole. He was appointed in January 2016 and his term expires in January 2018.

Dalton had high praises for Hunter, should he be a candidate to replace the former chair Bill Krodinger.

“I have seen a variety of different styles and approaches from committee members and I find Mr. Hunter to be extremely well-prepared, very thoughtful, very analytical, and very participatory in the consideration of every application,” Dalton said. “He is smart… and he is willing to listen to all sides of a particular matter.”

Another experienced candidate for the chairperson position is Sen. Kiki Curls, who is one of the senior legislators on the committee. She has served on the committee longer than any of the other legislators and is one of the most important voices on the MHFRC.

However, according to Dalton, experience on the committee does not necessarily determine the success of a chairperson. He widens the possibility for chairperson not only to longer serving members like Rep. Bondon, Rep. Kip Kendrick, or Sen. Mike Cunningham, but even to the newly appointed members.

“Experience is a relative term. If somebody has been in that capacity longer than somebody else, they have technically more experience, but a new appointee could have perspective from the health care industry or the financial industry or the development community that would make their experiences more significant than somebody who has been on the committee for a long time”

Regardless of who the MHFRC chooses, they are also under pressure to call a reschedule of their Sept. 11 meeting and avoid applications from being automatically accepted without the authority of the MHFRC. An application to build a $13.7 million retirement community will reach the 100-day deadline on Thursday of next week. The majority of the applications will reach their 100-day deadline in just over two weeks time.

For the MHFRC to ask for a 30-day extension, the committee can vote to make such a motion. Should the committee call for extensions on all the applications, the deadline will be moved as early as October 28 while most of the others will reach the deadline on November 7, the day after their next scheduled meeting. The MHFRC will hold an expedited meeting without a chairperson through an electronic paper ballot meeting that is not open to the public on October 24.