Applying for a certificate of need for unit dose and i.v. admixture services in a Connecticut hospital.

The process of obtaining regulatory-agency review of a proposal for unit dose and i.v. admixture services is described. In a 901-bed community hospital in Connecticut, a pharmacy department proposal for instituting unit dose distribution and expanding the i.v. admixture service was supported by the hospital administration and included in hospital budget projections. A state body that regulates hospital revenues, the Commission on Hospitals and Health Care (CHHC), rejected the proposal for these changes in pharmaceutical services. The pharmacy and hospital administration subsequently petitioned the Health Systems Agency in that jurisdiction for a certificate of need (CON); the procedure required that the application also be simultaneously submitted to CHHC. Implementation of the program over a three-year period was proposed. The CON application was submitted in July 1981; it required detailed information from pharmacy, nursing services, and hospital administration. During the nine months following application for the CON, further questions were asked and five hearings were held. In April 1982, CHHC approved the program and the capital expenditures but did not approve the proposed 10% increase in drug revenue needed to support the services. The hospital ultimately committed funding for implementation of the program over three years. The net result of the application procedure was a delay in implementation of expanded pharmaceutical services.