SB236 Alabama 2024 Session

Summary

Primary Sponsor

Larry StuttsSenator

Republican

Session

Regular Session 2024

Title

Certificate of Need, exempt health care institutions and services in rural areas from requirement

Summary

SB236 would remove the certificate of need requirement for new or expanded health care facilities and services in rural Alabama, while preserving planning oversight and updating definitions.

What This Bill Does

It eliminates the certificate of need review for proposed rural health care facilities or services, but rural providers must still file reports with the State Health Planning and Development Agency (SHPDA). It defines what counts as a rural area and updates the state’s health planning framework, including fees, reporting, and the State Health Plan. It also adds exemptions and modernization allowances (such as equipment replacement and certain bed capacity changes), introduces a digital hospital concept with strict requirements and potential exemption, and repeals a previous kidney disease treatment center exemption.

Who It Affects

• Rural health care providers and hospitals in Alabama would no longer need CONeed review for new or expanded facilities or services located in rural areas, but must continue submitting health planning reports to SHPDA.
• SHPDA and the Statewide Health Coordinating Council would administer the rural CONeed framework, define rural areas, oversee reporting and the State Health Plan, manage new exemptions such as digital hospitals, and set related fees.

Key Provisions

• Eliminates certificate of need review for proposed new or expanded health care facilities or services located in rural areas.
• Defines rural area as any area in Alabama located outside a metropolitan statistical area listed in OMB Bulletin No. 20-01 (dated March 6, 2020).
• Rural health care providers must continue to submit health care reports to SHPDA; repeals the existing kidney disease treatment center exemption from CONeed review (22-21-278).
• Allows exemptions from CONeed for certain modernization and nonclinical projects on existing campuses (non-institutional buildings, parking facilities) if they do not enable new CONeed services, and for equipment replacement if specific conditions are met.
• Creates a digital hospital exemption with detailed technical and cost requirements (minimum $100 million project, fully automated digital system, integrated electronic records, and other IT/system criteria) and specifies when CONeed review may be exempt for the digital replacement hospital; the first digital hospital can be exempt under strict conditions and subject to a sunset trigger.
• Provides bed-capacity and occupancy-related exemptions for skilled nursing facilities (e.g., up to 10% increase or 10 beds with occupancy and county-wide occupancy thresholds met) and related rules for conformance with the State Health Plan.
• Imposes application and review fees (including a rural hospital discount, online filing system surcharge, and potential additional filing costs) and directs SHPDA to maintain and publish the State Health Plan and related methodologies.

AI-generated summary using openai/gpt-5-nano on Feb 22, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health