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Across Virginia, Broad Community, Business Support for COPN Reforms that Preserve Vital Health Care Program

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I strongly agree with the following press release from the Virginia Hospital & Healthcare Association. Bottom line: Virginia’s General Assembly absolutely should not weaken, let alone repeal, the state’s Certificate of Public Need (COPN) program “that protects health care access, controls costs, and offsets unfunded charity care mandates on hospitals.” Also consider: “Health care is not a free market. Federal law requires hospitals to provide emergency care regardless of a patient’s ability to pay. Also, many patients who need hospital care are uninsured, underinsured, or are covered by federal or state health programs that do not cover hospitals’ full costs for delivering care.” Of course, for-profit actors would love to come in and cherry pick the profitable stuff from hospitals, leaving them with everything that loses money, sending the hospitals into a financial death spiral. The question is, why on earth would our General Assembly enable that disastrous outcome?!? – Lowell

Chambers of Commerce from Northern Virginia, Hampton Roads, Roanoke, and Bristol Favor Keeping Intact Virginia’s Certificate of Public Need Process to Protect Health Care Access, Control Costs, and Offset Charity Care Mandates

RICHMOND, VA – Chambers of Commerce, business leaders, health care advocates, and other
stakeholders are joining together to urge the Virginia General Assembly to enhance and protect Virginia’s
Certificate of Public Need (COPN) program. The groundswell of voices continues to grow as the
legislature considers proposals to alter the longstanding COPN process that protects health care access,
controls costs, and offsets unfunded charity care mandates on hospitals. Local hospitals and health
systems throughout the Commonwealth support appropriate reforms that enhance the program and
establish guidelines for future refinement. There is widespread opposition to COPN repeal among
Virginia’s local hospitals and health systems because of the serious threat that would pose to our health
care system. Support for COPN exists among many business and community organizations including the
Bristol Chamber of Commerce, the Greater Williamsburg Chamber & Tourism Alliance, the Hampton
Roads Chamber of Commerce, the Prince William Chamber of Commerce, the Roanoke Regional
Chamber of Commerce, and the Virginia Peninsula Chamber of Commerce. The Virginia Rural Health
Association and the Virginia Nurses Association also are supportive of reforms to enhance the existing
COPN process.  

The position taken by the chambers is in line with the recommendations of a state work group created last
year at the direction of the General Assembly. After spending much of 2015 thoroughly studying how
COPN works, the work group concluded that the program should be modernized but remain in place. The
Virginia Hospital & Healthcare Association similarly supports reform of the COPN program.  

Bi-partisan legislation sponsored by Delegate Chris Stolle (R-Virginia Beach) and Senator William
Stanley Jr. (R-Franklin County) embodies the recommendations of the work group. Their proposals
provide a mechanism for meaningful reforms to the COPN program now and in the future. Delegate
Stolle’s HB 1083 has many co-patrons from both sides of the aisle and both chambers of the General
Assembly, including roughly one-fourth of all House of Delegates’ members. Senator Stanley’s SB 641
likewise has gained bi-partisan support in the House of Delegates and the Virginia Senate.  


Virginia’s COPN program protects health care access, controls patient costs, and offsets unfunded charity
care mandates on hospitals. The majority of states (36) maintain COPN-like programs because they are
effective at preventing over-expansion the health care market can’t sustain. Virginia is home to 107 local
hospitals and 30 health systems which serve as economic pillars. Together, they provide 115,000 goodpaying
jobs totaling roughly $8 billion in payroll, making hospitals among the largest employers in the
state. Hospitals generate $36 billion in positive economic activity for the Commonwealth, and support
local economies by spending $17 billion on goods and services with local businesses. Those benefits are
threatened by unfunded government mandates and federal funding cuts to hospitals which are forecast to
approach $1 billion annually by 2021. They are at risk as a result of billions of dollars in uncompensated
care hospitals have absorbed in recent years. And they would be further imperiled by a repeal of COPN,
which could weaken health care across Virginia. Going that route would allow new entrants to cherry
pick only the most profitable types of care to provide, in select communities, leaving community hospitals
with the burden to provide other services a community needs even though providing those services often
represents a financial loss for hospitals. Without COPN, health care access disparities could widen in
Virginia, leaving poorer communities with fewer treatment options in comparison to more affluent areas.  

Health care is not a free market. Federal law requires hospitals to provide emergency care regardless of a
patient’s ability to pay. Also, many patients who need hospital care are uninsured, underinsured, or are
covered by federal or state health programs that do not cover hospitals’ full costs for delivering care.
Beyond mandates, Virginia hospitals deliver charitable care because it is central to their community-based
service missions. Virginia’s local hospitals, many of which are nonprofits, are committed to caring for
those who need medical attention no matter the day or time. That dedication is one reason hospitals are
economic pillars and community cornerstones in the Commonwealth. COPN functions to offset charity
care. More than $1.3 billion was provided toward Virginia charity care needs in 2013 due to COPN
conditions. And despite the fact that health care is not a free market, Virginia has comparatively low
health care costs. In fact, Virginia has lower per capita health care costs, and expenses, than the majority
of non-COPN states.  

In light of the circumstances, several chambers of commerce across the Commonwealth support efforts to
protect Virginia’s COPN process. The Bristol Chamber of Commerce, the Greater Williamsburg Chamber
& Tourism Alliance, the Prince William Chamber of Commerce, and the Virginia Peninsula Chamber of
Commerce have each endorsed resolutions that support “Virginia’s COPN program as an important
component of the Commonwealth’s health care policy,” encourage the 2016 Virginia “General Assembly
to enact COPN process reforms” consistent with the state work group recommendations, and request that
the legislature establish a process for continued COPN review to ensure the law remains effective. The
Hampton Roads Chamber of Commerce included COPN process reforms as a priority in its 2016
legislative agenda. In its Jan. 22 newsletter, the Roanoke Regional Chamber of Commerce expressed
support for the work group recommendations, noting that “the Chamber believes that any reform should
model the recommendations from the COPN work group to improve the quality and access to health care
while also eliminating waste and abuse.” The Virginia Rural Health Association and the Virginia Nurses
Association also support COPN reform.  

About VHHA: The Virginia Hospital & Healthcare Association is an alliance of 107 hospitals and 30 health
delivery systems that develops and advocates for sound health care policy in the Commonwealth. Its
vision is to achieve excellence in both health care and health