In re the Review of the Decision of the Kansas Corporation Commission Granting a Certificate of Need to Providence-St. Margaret Health Center

659 P.2d 199, 232 Kan. 787, 1983 Kan. LEXIS 257
CourtSupreme Court of Kansas
DecidedFebruary 19, 1983
DocketNo. 54,539
StatusPublished
Cited by2 cases

This text of 659 P.2d 199 (In re the Review of the Decision of the Kansas Corporation Commission Granting a Certificate of Need to Providence-St. Margaret Health Center) is published on Counsel Stack Legal Research, covering Supreme Court of Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re the Review of the Decision of the Kansas Corporation Commission Granting a Certificate of Need to Providence-St. Margaret Health Center, 659 P.2d 199, 232 Kan. 787, 1983 Kan. LEXIS 257 (kan 1983).

Opinion

The opinion of the court was delivered by

Floyd H. Coffman, District Judge, Assigned;

This is an appeal from the order of the trial court sustaining the order of the Kansas Corporation Commission (KCC) which reversed the Secretary of the Kansas Department of Health and Environment’s (KDHE or Secretary) Order Denying Certificate of Need on the application of Providence-St. Margaret Health Center (applicant) for a 6 megavolt linear accelerator (6 MeV). The principal respondent through these proceedings has been the Bethany Medical Center (Bethany). There was no appearance in the district court or before the supreme court by either of the administrative agencies. The Secretary participated by oral argument in the proceedings before KCC but did not file a brief or argue in the trial [788]*788court, nor in the appellate courts prior to filing an amicus curiae brief on January 11, at 4:01 p.m., the afternoon before oral argument before this court.

A review of the factual situation will be helpful. A 6 megavoltage linear accelerator is a machine designed for the treatment of cancer by radiation. There are three recognized methods of treating cancer: surgery, chemotherapy and radiation therapy. Radiation therapy is often prescribed for a number of reasons. It may cure the patient, it may alleviate the pain or it may cause remission of the disease. Frequently two or all three methods of treatment are required for the same individual suffering from cancer. The applicant is a general purpose hospital located on the western edge of Kansas City, Kansas, in Wyandotte County, which treats an extensive number of cancer patients. The applicant, Providence-St. Margaret, is now capable of providing only two of the three recognized, and often essential, methods of treatment; that is, surgery and chemotherapy. Patients requiring radiation therapy are treated at the University of Kansas Medical Center (UKMC) or at other hospitals equipped to do so. The project would involve approximately 6,000 square feet of new construction and the purchase of a 6 MeV linear accelerator at a total cost of approximately 1.75 million dollars. Patients who require radiation therapy must now be treated at UKMC or other facilities within the area depending on the desires of the patient and the attending physician by 6 MeV or other similar units, including, when installed, the unit authorized for Rethany in In re Bethany Medical Center, 230 Kan. 201, 630 P.2d 1136 (1981). The applicant hospital is located some ten miles from Bethany and eighteen miles from UKMC through the urban and inner-city areas.

It is the applicant’s position that the acquisition of the 6 MeV linear accelerator would not only be beneficial to Providence-St. Margaret and its patients but is necessary for proper treatment and care of other cancer patients in the service area defined by the application.

With that brief background we now turn to the procedures involved with the application. On December 24, 1980, applicant filed with KDHE, pursuant to K.S.A. 65-4806, for a Certificate of Need (CON) for a 6 MeV. As required by statute a copy of the [789]*789application was next submitted to Mid-America Health Service Agency (MAHSA). Various committees of MAHSA proceeded to study and process the application. An evidentiary hearing on this application was held before the MAHSA special committee of three persons on March 23, 1981, following which it was disapproved by a vote of one to two. The vote for approval was by Dr. Ben Throne, chief of radiation therapy at Research Hospital, Kansas City, Missouri. At a hearing scheduled for April 9, 1981, the Resources Development Committee of MAHSA, meeting without a quorum (4 of 15 members being present), approved, by consensus, the recommendation of the special committee to deny the issuance of a CON. On April 23, 1981, after considering information and evidence heard by the special committee on March 23, and other information accumulated by the staff in accordance with the regulations of MAHSA, and the thorough 10-page report of the staff recommending disapproval, the MAHSA board of directors in its final action voted to approve the application, with a variance, by a vote of 12 to 5 with 1 abstention and the chair not voting. An April 24, 1981, letter from the Executive Director of MASHA to the Secretary of KDHE included the following explanation:

“The motion of the Board of Directors to recommend approval included the granting of a variance to the Health Systems Plan based on the applicant’s use of a retreatment factor in determining utilization rates which indicated one additional radiation therapy unit could be needed in the MAHSA area." (Emphasis supplied.)

In accordance with health agency procedures, the application was next referred to the Secretary of KDHE. Then Bethany filed a request for a public hearing for the purpose of admitting additional evidence and adding to the record which would be used on any appeal. After a show-cause hearing on May 18, 1981, the hearing officer, by order dated May 20, found that good cause for another public hearing had not been shown by Bethany.

Two days later on May 22, the Secretary of KDHE, in his Order Denying Certificate of Need, made extensive findings summarized in part as follows:

“1. Community Need — The Secretary finds that the project is not needed to continue the satisfactory provision of radiation therapy services in the defined service area, for the reasons set forth below.

“A. Service Area”— The “service area of the proposed project is appropriately defined” as follows:

[790]*7901. The primary service area of the project consists of Wyandotte, Leavenworth, Atchison, Douglas, Franklin, Jefferson, and Miami Counties and 31% of Johnson County with a projected population of 462,340 in 1985.

2. The secondary service area is defined as the balance of Johnson County plus Buchanan and Platte Counties in Missouri with population by 1985 of 337,784.

“B. Health Problem and C. Health Care System The . . . existing radiation therapy services are adequate to assure the availability and efficiency of radiation therapy services in the defined service area, for the following reasons.”

1. Applicant claimed there would be 1658 new cancer cases in the primary area by 1985. Assuming 50 to 60% of new cancer cases need radiation therapy and 25% need retreatment later, the sponsor estimated 998 to 1,198 patients would require therapy by 1983. A recent study by National Cancer Institute (NCI) estimated the retreatment factor to be 33%, which applicant maintained is proper.

2. The 1985 projected population of462,340 at 150,000 persons per unit would by that standard require slightly over three radiation therapy units.

3. Using 1658 new cancer cases estimated for 1985 and a conservative 50% assumed to benefit from radiation, there will be 829 new cases requiring radiation therapy by 1985. Just under three units would be needed to meet the standard of 300 cases per unit per year.

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Related

Coonce v. Garner
167 P.3d 801 (Court of Appeals of Kansas, 2007)
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75 P.3d 226 (Supreme Court of Kansas, 2003)

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Bluebook (online)
659 P.2d 199, 232 Kan. 787, 1983 Kan. LEXIS 257, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-the-review-of-the-decision-of-the-kansas-corporation-commission-kan-1983.