Wisconsin
Wisconsin does not maintain a traditional CON program. Instead, it maintains an
approval process similar to a CON program that applies mainly to nursing homes. For this reason, some have deemed Wisconsin a “quasi-CON” state. The state maintains approvals within three broad categories—beds outside hospitals, equipment and facilities. Wisconsin also has a statewide cap on the number of hospital beds, currently set at 22,516, although the cap is unmet. See Wis. Stat. § 150.93(a).
Wisconsin’s COVID-19 Response
As of May 15, 2020, Wisconsin had not suspended any approval requirements in response to COVID-19.
Application Process
In Wisconsin, the approval process takes up to 135 days. Wis. Stat. § 150.35(3). Applications to increase beds at a facility can only be submitted within 60 days after the department publishes notice that beds are “available” in each health planning area of the state. Wis. Stat. § 150.33(3). The fee for an approval application is equal to 0.37% of the estimated project cost, but no less than $1,850 and no more than $37,000. Wis. Stat. § 150.13. Affected parties may request and offer testimony at an administrative hearing. Wis. Stat. § 150.35.
Separately, Wisconsin maintains a certificate of public advantage program, which is a voluntary program between healthcare providers to share programs, services, personnel, facilities, etc. Wis. Stat. § 150.85(1), (2). Agreements between healthcare providers, if approved by the Department of Health Services, are not subject to state antitrust law. See Wis. Stat. § 150.85.
Types of Approvals in Wisconsin
| Approval Required? | Approval required with expenditure of: | Temporary COVID-19 response: | |
| Hospital Beds | No | Any amount | – |
| Beds Outside Hospitals | Yes | Any amount | – |
| Equipment | Yes | $600,000+ | – |
| Facilities/Buildings | Yes | Any amount | – |
| Services | No | – | – |
| Emergency Medical Transport | No | – | – |
Wisconsin Approvals in Detail
| Category | Moratoria/Type of Approval | Wis. Stat. |
| Hospital Beds | Conditional moratorium on new hospital beds, if the statewide cap were met. | § 150.93 |
| Beds Outside Hospitals | Any increase in nursing home beds. | § 150.21(2) |
| Equipment | Clinical equipment for a nursing home that costs more than $600,000. | § 150.21(4) |
| Facilities/Buildings | The construction of a new nursing home regardless of cost. | § 150.21(1) |
| The partial or total conversion of a nursing home to a facility primarily serving the developmentally disabled regardless of cost. The partial or total conversion of a facility primarily serving the developmentally disabled to a nursing home. | § 150.21(5) | |
| A capital expenditure, other than a renovation or replacement, that exceeds $1 million on behalf of a nursing home. | § 150.21(3) | |
| Services | No CONs in this category. | |
| Emergency Medical Transport | No CONs in this category. |
Wisconsin Approval Exceptions
| Approval Required For: | Wis. Stat. |
| A Wisconsin veterans home including an in home hospital operated by the State Department of Veterans Affairs. | §§ 150.46(1), 150.93(5) |
| Up to four noninstitutional residential facilities run by the Department of Health Services for persons who are relocated from any center for the developmentally disabled. | §§ 150.46(2), 46.047 |