Free market best decides facility needs

By Denise Clemonds

JEFFERSON CITY, Mo. -- The Southeast Missourian's July 2 editorial, "Certificate-of-need law too full of loopholes," pointed out the problems of Missouri's law, which favors those who have the means to force an exception to the law.

The Missouri Association of Homes for the Aging, representing not-for-profit long-term care providers, agrees that the best way to achieve quality patient care for Missouri's elderly citizens is through a free market.

In a free market, the public is given the opportunity to demand better services of nursing and residential care facilities. If quality services are not provided in a free market, the public has the option of going elsewhere -- to a facility that does provide the type and quality patient care they're looking for.

The certificate-of-need law impedes competition and does not allow the marketplace to decide. If the certificate of need law is followed, then the needs of Missouri's elderly are not in the forefront.

Under current law, a facility meeting the needs of today's seniors would not be allowed to exist or to expand -- only because other facilities who cannot or will not meet the needs of seniors have low occupancy, and that alone keeps other providers out of town. The current law requires a certain occupancy level in order for facilities to build or expand. Quality facilities are often prevented from doing this solely because low occupancy facilities are nearby.

Is this the best way to treat Missouri's elderly citizens?

Is it best to force them to go to a facility of lesser quality simply because the "good" facility is at full occupancy and cannot expand because of a formula in the law?

As of Jan. 1, the state's certificate-of-need committee can no longer apply such stringent occupancy requirements. At that time, a moratorium expired on the expansion of long-term care beds in a facility.

While this is a step in the right direction, new regulations must be developed in light of the moratorium expiration. There are efforts to impose another percentage in the occupancy requirements. The committee attempted to enact new regulations during the spring. However, a legislative committee that looks at administrative rules did not allow the rules. Thus, the process must begin again and, while we wait for rules to be approved, the occupancy percentages still exist in the regulations.

The time has come to stop this cycle of prohibiting competition. We should allow those who need the services most decide what services will be offered. The Missouri Association of Homes for the Aging supports this position. We congratulate the Southeast Missourian for voicing concern about the certificate-of-need law.

Denise Clemonds is the executive director of the Missouri Association of Homes for the Aging.