07 LC 33
1846
Senate
Bill 164
By:
Senators Balfour of the 9th, Williams of the 19th, Golden of the 8th, Stoner of
the 6th, Bulloch of the 11th and others
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Title 31 of the Official Code of Georgia Annotated, relating to health, so
as to enact the "Certificate of Need Reformation Act of 2007"; to provide for
extensive revision of the certificate of need program; to revise the declaration
of policy for state health planning; to revise and add definitions; to revise
the composition and duties of the Health Strategies Council; to revise the
duties of the Department of Community Health; to provide for graduated fines for
noncompliance with notice provisions; to revise provisions relating to the scope
and validity of a certificate of need; to provide for specific conditions for
the issuance of a certificate of need; to provide for the establishment of
service-specific need methodologies in certain cases; to provide for favorable
consideration for applicants providing services in service areas of need; to
provide for a letter of intent for proposed projects; to provide for batching
and comparative review of applications; to provide for participation of opposing
parties; to provide for the imposition of a temporary moratorium on the issuance
of certificates of need for new and emerging technologies; to establish a
Certificate of Need Appeal Panel composed of independent hearing officers; to
revise provisions relating to administrative and judicial review; to add grounds
for which a certificate of need may be revoked; to provide that a portion of a
certificate of need may be revoked; to provide graduated fines for services
conducted without a required certificate of need; to add requirements relating
to the annual report prepared by the Department of Community Health; to revise
provisions relating to exemptions to certificate of need requirements; to
require provision of indigent care, participation as a Medicaid provider, and
annual reporting as a condition of exemption from certificate of need
requirements for certain entities; to require prior notice to the Department of
Community Health that certain activities are exempt from the certificate of need
requirements; to provide for transfer of some duties from the Health Strategies
Council to the Board of Community Health; to abolish the Health Planning Review
Board; to transfer pending matters of the Health Planning Review Board to the
Certificate of Need Appeal Panel; to revise a provision relating to application
of review procedures to expenditures under a federal law; to require health care
facilities and others to submit annual reports to the Department of Community
Health; to provide graduated fines for untimely and incomplete reports; to
revise a provision relating to the applicability of the article regarding the
Office of State Administrative Hearings; to transfer licensing of hospitals and
other health care facilities from the Department of Human Resources to the
Department of Community Health; to provide for transition; to amend various
other titles of the Official Code of Georgia Annotated so as to revise
provisions for purposes of conformity; to provide for related matters; to
provide for effective dates; to repeal conflicting laws; and for other
purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
PART
I
Short Title
Short Title
SECTION
1-1.
This
Act shall be known and may be cited as the "Certificate of Need Reformation Act
of 2007."
PART
II
Revisions to Certificate of Need Program
Revisions to Certificate of Need Program
SECTION
2-1.
Title
31 of the Official Code of Georgia Annotated, relating to health, is amended by
revising Chapter 6, relating to state health planning and development, as
follows:
"ARTICLE
1
31-6-1.
The
policy of this state and the purposes of this chapter are to ensure
access to
quality health care services and to ensure
that adequate health care services and facilities are developed in an orderly
and economical manner and are made available to all citizens and that only those
health care services found to be in the public interest shall be provided in
this state. To achieve
this
such
public
policy
policies
and
purpose
purposes,
it is essential that appropriate health planning activities be undertaken and
implemented and that a system of mandatory review of new institutional health
services be provided. Health care services and facilities should be provided in
a manner that avoids unnecessary duplication of services, that is cost
effective, and that is compatible with the health care needs of the various
areas and populations of the state.
31-6-2.
As
used in this chapter, the term:
(1)
'Ambulatory surgical or obstetrical facility' means a public or private
facility, not a part of a hospital, which provides surgical or obstetrical
treatment performed under general or regional anesthesia in an operating room
environment to patients not requiring hospitalization.
(2)
'Application' means a written request for a certificate of need made to the
department, containing such documentation and information as the department may
require.
(3)
'Bed capacity' means space used exclusively for inpatient care, including space
designed or remodeled for inpatient beds even though temporarily not used for
such purposes. The number of beds to be counted in any patient room shall be
the maximum number for which adequate square footage is provided as established
by rules of the
Department
of Human Resources
department,
except that single beds in single rooms shall be counted even if the room
contains inadequate square footage.
(4)
'Board' means the Board of Community Health.'
(4)(5)
'Certificate of need' means an official determination by the department,
evidenced by certification issued pursuant to an application, that the action
proposed in the application satisfies and complies with the criteria contained
in this chapter and rules promulgated pursuant hereto.
(5)(6)
'Clinical health services' means diagnostic, treatment,
therapeutic,
or rehabilitative services provided in a health care facility, or parts of the
physical plant where such services are located in a health care facility, and
includes, but is not limited to, the following: radiology and diagnostic
imaging, such as magnetic resonance imaging and positron emission tomography;
radiation therapy; biliary lithotripsy; surgery; intensive care; coronary care;
pediatrics; gynecology; obstetrics; general medical care; medical/surgical care;
inpatient nursing care, whether intermediate, skilled, or extended care; cardiac
catheterization; open-heart surgery; inpatient rehabilitation; and alcohol, drug
abuse, and mental health services.
(7)
'Commissioner' means the commissioner of community health.
(6)(8)
'Consumer' means a person who is not employed by any health care facility or
provider and who has no financial or fiduciary interest in any health care
facility or provider.
(9)
'Continuing care retirement community' means an organization which offers a
contract to provide an individual of retirement status, other than an individual
related by consanguinity or affinity to the provider furnishing the care, with
board and lodging, licensed nursing facility care, and medical or other health
related services. These services are provided for at least one year and may be
for as long as the lifetime of the resident.
(6.1)(10)
'Department' means the Department of Community Health
established
under Chapter 5A of this
title.
(7)(11)
'Develop,' with reference to a project,
means:
(A)
Constructing
constructing,
remodeling, installing, or proceeding with a project, or any part of a project,
or a capital expenditure project, the cost estimate for which exceeds
$900,000.00;
or
(B)
The expenditure or commitment of funds exceeding $500,000.00 for orders,
purchases, leases, or acquisitions through other comparable arrangements of
major medical equipment.
Notwithstanding
subparagraphs (A) and (B) of this
paragraph,
the threshold
specified in subparagraph (B) of paragraph (20) of this Code section; provided,
however, that the expenditure or
commitment or incurring an obligation for the expenditure of funds to develop
certificate of need applications, studies, reports, schematics, preliminary
plans and specifications, or working drawings or to acquire, develop, or prepare
sites shall not be considered to be the developing of a project.
(12)
'Diagnostic and other imaging services' means magnetic resonance imaging,
computed tomography (CT) scanning, positron emission tomography (PET) scanning,
positron emission tomography/computed tomography, and other advanced imaging
services as defined by the department by rule, but such term shall not include
X-rays, fluoroscopy, or ultrasound services.
(7.1)(13)
'Diagnostic, treatment, or rehabilitation center' means any professional or
business undertaking, whether for profit or not for profit, which offers or
proposes to offer any clinical health service in a setting which is not part of
a hospital;
provided, however, that any such diagnostic, treatment, or rehabilitation center
that offers or proposes to offer surgery in an operating room environment and to
allow patients to remain more than 23 hours shall be considered a hospital for
purposes of this chapter.
(8)(14)
'Health care facility' means hospitals; other special care units, including but
not limited to podiatric facilities; skilled nursing facilities; intermediate
care facilities; personal care
homes, but
only those that are certified as providers of medical assistance for Medicaid
purposes pursuant to Article 7 of Chapter 4 of Title
49; ambulatory surgical or obstetrical
facilities; health maintenance organizations; home health agencies;
and
diagnostic, treatment, or rehabilitation
centers, but only to the extent that subparagraph
(F)(G)
or (H), or both subparagraphs (G) and (H),
of paragraph
(14)(20)
of this Code section
are
is
applicable
thereto;
and facilities which are devoted to the provision of treatment and
rehabilitative care for periods continuing for 24 hours or longer for persons
who have traumatic brain injury, as defined in Code Section
37-3-1.
(9)(15)
'Health maintenance organization' means a public or private organization
organized under the laws of this state which:
(A)
Provides or otherwise makes available to enrolled participants health care
services, including at least the following basic health care services: usual
physicians´ services, hospitalization, laboratory, X-ray, emergency and
preventive services, and out-of-area coverage;
(B)
Is compensated, except for copayments, for the provision of the basic health
care services listed in subparagraph (A) of this paragraph to enrolled
participants on a predetermined periodic rate basis; and
(C)
Provides physicians´ services primarily:
(i)
Directly through physicians who are either employees or partners of such
organization; or
(ii)
Through arrangements with individual physicians organized on a group practice or
individual practice basis.
(10)(16)
'Health Strategies Council' or 'council' means the body created by this chapter
to advise the Department of Community Health
in accordance
with Code Section 31-6-20
and adopt
the state health plan.
(11)(17)
'Home health agency' means a public agency or private organization, or a
subdivision of such an agency or organization, which is primarily engaged in
providing to individuals who are under a written plan of care of a physician, on
a visiting basis in the places of residence used as such individuals´
homes, part-time or intermittent nursing care provided by or under the
supervision of a registered professional nurse, and one or more of the following
services:
(A)
Physical therapy;
(B)
Occupational therapy;
(C)
Speech therapy;
(D)
Medical social services under the direction of a physician; or
(E)
Part-time or intermittent services of a home health aide.
(12)(18)
'Hospital' means an institution which is
primarily
engaged in providing to inpatients, by or under the supervision of physicians,
diagnostic services and therapeutic services for medical diagnosis, treatment,
and care of injured, disabled, or sick persons or rehabilitation services for
the rehabilitation of injured, disabled, or sick persons. Such term includes
public, private, psychiatric, rehabilitative, geriatric, osteopathic, and other
specialty hospitals
and also
includes any diagnostic, treatment, or rehabilitation center that offers surgery
in an operating room environment and allows patients to remain more than 23
hours.
(13)(19)
'Intermediate care facility' means an institution which provides, on a regular
basis, health related care and services to individuals who do not require the
degree of care and treatment which a hospital or skilled nursing facility is
designed to provide but who, because of their mental or physical condition,
require health related care and services beyond the provision of room and
board.
(14)(20)
'New institutional health service' means:
(A)
The construction, development, or other establishment of a new health care
facility;
(B)
Any expenditure by or on behalf of a health care facility in excess of
$900,000.00
$1,750,000.00
which, under generally accepted accounting principles consistently applied, is a
capital expenditure, except expenditures for acquisition of an existing health
care facility not owned or operated by or on behalf of a political subdivision
of this state, or any combination of such political subdivisions, or by or on
behalf of a hospital authority, as defined in Article 4 of Chapter 7 of this
title or certificate of need owned by such facility in connection with its
acquisition;
(C)
Any increase in the bed capacity of a health care facility except as provided in
Code Section 31-6-47;
(D)
Clinical health services which are offered in or through a health care facility,
which were not offered on a regular basis in or through such health care
facility within the 12 month period prior to the time such services would be
offered;
(E)
Any conversion or upgrading of a facility such that it is converted from a type
of facility not covered by this chapter to any of the types of health care
facilities which are covered by this chapter;
or
(F)
The purchase or lease by or on behalf of a health care facility of diagnostic or
therapeutic equipment with a value in excess of $500,000.00. The acquisition of
one
or more
items of functionally related diagnostic or therapeutic equipment shall be
considered as one project;
(G)(F)
Clinical health services which are offered in or through a diagnostic,
treatment, or rehabilitation center which were not offered
to a
substantial number of patients on a
regular basis in or through that center within the 12 month period prior to the
time such services would be offered, but only if the clinical health services
are any of the following:
(i)
Radiation therapy;
(ii)
Biliary lithotripsy;
(iii)
Surgery in an operating room environment, including but not limited to
ambulatory surgery; provided, however, this provision shall not apply to surgery
performed in the offices of an individual private physician or single group
practice of private physicians if such surgery is performed in a facility that
is owned, operated, and utilized by such physicians who also are of a single
specialty and the capital expenditure associated with the construction,
development, or other establishment of the clinical health service does not
exceed the amount of
$1
million
$1,610,823.00;
and
(iv)
Cardiac catheterization;
or
and
(v)
Diagnostic and other imaging services.
(H)
The purchase, lease, or other use by or on behalf of a diagnostic, treatment, or
rehabilitation center of diagnostic or therapeutic equipment with a value in
excess of $500,000.00. The acquisition of one or more items of functionally
related diagnostic or therapeutic equipment shall be considered as one
project.
The
dollar amounts specified in
subparagraphs
subparagraph
(B), (F),
and (H) of this
paragraph,
and
division (iii) of
this
subparagraph
(G) of this
paragraph, and of paragraph (7) of this Code
section shall be adjusted annually by an
amount calculated by multiplying such dollar amounts (as adjusted for the
preceding year) by the annual percentage of change in the composite construction
index, or its successor or appropriate replacement index, if any, published by
the Bureau of the Census of the Department of Commerce of the United States
government for the preceding calendar year, commencing on July 1,
1991
2007,
and on each anniversary thereafter of publication of the index. The department
shall immediately institute rule-making procedures to adopt such adjusted dollar
amounts. In calculating the dollar amounts of a proposed project for purposes of
subparagraphs
subparagraph
(B), (F),
and (H) of this
paragraph,
and
division (iii) of
this
subparagraph
(G) of this
paragraph, and of paragraph (7) of this Code
section, the costs of all items subject to
review by this chapter and items not subject to review by this chapter
associated with and simultaneously developed or proposed with the project shall
be counted, except for the expenditure or commitment of or incurring an
obligation for the expenditure of funds to develop certificate of need
applications, studies, reports, schematics, preliminary plans and specifications
or working drawings, or to acquire sites.
(21)
'New or emerging technology' means diagnostic or therapeutic equipment which has
not previously been utilized in this state and the need for which has not been
addressed in the state health plan or existing department rules.
(15)(22)
'Nonclinical health services' means services or functions provided or performed
by a health care facility, and the parts of the physical plant where they are
located in a health care facility that are not diagnostic, therapeutic, or
rehabilitative services to patients and are not clinical health services defined
in this chapter.
(16)(23)
'Offer' means that the health care facility is open for the acceptance of
patients or performance of services and has qualified personnel, equipment, and
supplies necessary to provide specified clinical health services.
(16.1)(24)
'Operating room environment' means an environment which meets the minimum
physical plant and operational standards specified
on January
1, 1991, for ambulatory surgical treatment centers in Section 290-5-33-.10
of
in
the rules of the Department of Human Resources
in effect
January 1, 2007, for purposes of obtaining a permit or license to operate or any
successor rules adopted by the
department.
(17)(25)
'Person' means any individual, trust or estate, partnership,
limited
liability company or partnership,
corporation (including associations,
joint-stock companies, and insurance companies), state, political subdivision,
hospital authority, or instrumentality (including a municipal corporation) of a
state as defined in the laws of this state.
This term
shall include all related parties, including individuals, business corporations,
general partnerships, limited partnerships, limited liability companies, limited
liability partnerships, joint ventures, nonprofit corporations, or any other for
profit or not for profit entity that owns or controls, is owned or controlled
by, or operates under common ownership or control with a person.
(18)(26)
'Personal care home' means a residential facility having at least 25 beds and
providing, for compensation, protective care and oversight of ambulatory,
nonrelated persons who need a monitored environment but who do not have injuries
or disabilities which require chronic or convalescent care, including medical,
nursing, or intermediate care. Personal care homes include those facilities
which monitor daily residents´ functioning and location, have the
capability for crisis intervention, and provide supervision in areas of
nutrition, medication, and provision of transient medical care. Such term does
not include:
(A)
Old age residences which are devoted to independent living units with kitchen
facilities in which residents have the option of preparing and serving some or
all of their own meals; or
(B)
Boarding facilities which do not provide personal care.
(19)
Reserved.
(20)(27)
'Project' means a proposal to take an action for which a certificate of need is
required under this chapter. A project or proposed project may refer to the
proposal from its earliest planning stages up through the point at which the new
institutional health service is offered.
(21)
'Review board' means the Health Planning Review Board by this
chapter.
(22)(28)
'Skilled nursing facility' means a public or private institution or a distinct
part of an institution which is primarily engaged in providing inpatient skilled
nursing care and related services for patients who require medical or nursing
care or rehabilitation services for the rehabilitation of injured, disabled, or
sick persons.
(23)(29)
'State health plan' means a comprehensive program
or
subcomponents thereof adopted by the
Health Strategies Council
or by the
board as its successor for this purpose,
approved by the Governor, and implemented by the State of Georgia for the
purpose of providing adequate health care services and facilities throughout the
state.
(30)
'Uncompensated indigent or charity care' means the dollar amount of 'net
uncompensated indigent or charity care after direct and indirect (all)
compensation' as defined by, and calculated in accordance with, the
department´s Hospital Indigent Care Survey and related
instructions.
ARTICLE
2
31-6-20.
(a)
There is created a
reconstituted
Health Strategies Council to be appointed by the
Governor,
subject to confirmation by the Senate. Any appointment made when the Senate is
not in session shall be effective until the appointment is acted upon by the
Senate. The Health Strategies Council
that
shall be the successor to the Health
Policy
Strategies
Council in
existence on June 30, 2007. Those members
of the
previously
existing Health
Policy
Strategies
Council who are serving as such on
January 1,
1991, shall continue to serve until July 1, 1991, at which
time
June 30, 2007,
shall have their terms
shall
expire on that
date and that council
as existed on
June 30, 2007, shall be abolished. On and
after that
date
July 1, 2007,
the council shall be composed of
25
15
members.
Of those members, at least one
shall be
appointed from each congressional district. The council shall be
composed as follows:
(1)
One member representing
county
governments
urban
hospitals;
(2)
One member representing
the private
insurance industry
rural
hospitals;
(3)
One member representing proprietary hospitals;
(4)
One member representing the private insurance industry;
(5)
One member who is a primary care physician;
(6)
One member who is a physician in a board certified specialty;
(7)
One member representing freestanding ambulatory surgical centers;
(8)
One member representing the nursing home/long-term care industry;
(9)
One member representing home health agencies;
(10)
One member representing health care needs of women and children;
(11)
One member representing health care needs of the disabled and
elderly;
(12)
One member representing health care needs of the indigent and
uninsured;
(13)
One member who represents populations with mental health care
needs;
(14)
One member representing health care needs as it relates to business;
and
(15)
One at-large member.
(3)
Ten members representing health care providers as follows:
(A)
One member representing rural hospitals;
(B)
One member representing urban hospitals;
(C)
One member who is a primary care physician;
(D)
One member who is a physician in a board certified specialty;
(E)
One member who is a registered professional nurse;
(F)
One member who is a registered professional nurse who is certified as a nurse
practitioner;
(G)
One member representing nursing homes;
(H)
One member representing home health agencies;
(I)
One member representing primary care centers; and
(J)
One member who is a primary care dentist;
(4)
Ten consumer representatives who are knowledgeable as to health care needs in
the fields they represent but who have no financial interest in the health care
industry as follows:
(A)
One member representing health care needs of women;
(B)
One member representing health care needs of children;
(C)
One member representing health care needs of the disabled;
(D)
One member representing health care needs of the elderly;
(E)
One member representing health care needs of low-income persons;
(F)
One member representing health care needs of small business
personnel;
(G)
One member representing health care needs of large business
personnel;
(H)
One member representing health care needs of labor organization members;
and
(I)
Two members who represent populations with special health care access problems;
and
(5)
Three at-large members.
(b)
If the state obtains an additional member
or
members of the United States House of
Representatives as a result of reapportionment, the Governor shall
appoint,
subject to confirmation by the Senate,
from
the
each
new congressional district thus created one
additional
member representing hospitals and one additional physician member who is a
physician
health care
provider member who meets the requirements of subparagraph (a)(3)(J) of this
Code section and one consumer member who meets the requirements of subparagraph
(a)(4)(I) of this Code section as to a population specified in those
subparagraphs which is not then represented on the council. With the addition of
these two members, the council shall be composed of 27
members.
(c)
The
initial
members of the
reconstituted
council who
are appointed to succeed those members whose terms expire July 1,
1991, shall take office July 1,
1991
2007,
and
12
eight
of them shall be designated in such appointment to serve initial terms of office
of two years and
13
seven
of them shall be designated in such appointment to serve initial terms of office
of four years. If
two
additional members are appointed to the council to represent a new congressional
district as provided in subsection (b) of this Code section,
one
half of such
additional members shall be designated to
serve an initial term of office which expires when the above initial two-year
terms of office expire and
one
half of such
additional members shall be designated to
serve an initial term of office which expires when the above initial four-year
terms of office expire. After the initial terms provided in this subsection,
members of the council shall be appointed to serve for four-year terms of
office. Members of the council shall serve out their terms of office and until
their respective successors are appointed and qualified.
(d)
Members of the council shall be subject to removal by the Governor
for
incompetence, neglect of duty,
at his or her
discretion, with or without cause, or for removal by the chairperson of the
council
or
for failing to attend at least
75
50
percent of the meetings of the council in any
calendar
year or
failing to attend any three consecutive
meetings. Vacancies on the council shall
be filled by appointment by the
Governor,
subject to confirmation by the
Senate.
(e)
The Governor shall appoint the
chairman
chairperson
of the council. A majority of the members of the council shall constitute a
quorum.
(f)
The members of the council attending meetings of such council, or attending a
subcommittee meeting thereof authorized by such council, shall receive no salary
but shall be reimbursed for their expenses in attending meetings and for
transportation costs as authorized by Code Section 45-7-21, which provides for
the compensation and allowances of certain state officials.
(g)
The council shall meet no less often than bimonthly, but may meet more
frequently at the call of the chairperson as necessary to perform its
functions.
(g)(h)
The
functions
function
of the council shall be to
serve as an
advisory body to the department. The department shall be authorized to seek
input from the council on proposed changes to rules and regulations relative to
this chapter and to the state health
plan.:
(1)
Adopt the state health plan and submit it to the board for approval which shall
include all of the components of the council´s functions and be regularly
updated review;
(2)
Review, comment on, and make recommendations to the department on proposed rules
for the administration of this chapter, except emergency rules, prior to their
adoption by the department;
(3)
Conduct an ongoing evaluation of Georgia´s existing health care resources
for accessibility, including but not limited to financial, geographic, cultural,
and administrative accessibility, quality, comprehensiveness, and
cost;
(4)
Study long-term comprehensive approaches to providing health insurance coverage
to the entire population; and
(5)
Perform such other functions as may be specified for the council by the
department or its board.
(h)
The council shall prepare an annual report to the board and the General Assembly
which presents information and updates on the functions outlined in subsection
(g) of this Code section. The annual report shall include information for
Georgia´s congressional delegation which highlights issues regarding
federal laws and regulations influencing Medicaid and medicare, insurance and
related tax laws, and long-term health care. The council shall not be required
to distribute copies of the annual report to the members of the General Assembly
but shall notify the members of the availability of the annual report in the
manner which it deems to be most effective and efficient.
(i)
The council at the department´s request shall involve and coordinate
functions with such state entities as necessary.
(j)
As used in subsections (g), (h), and (i) of this Code section, the
term:
(1)
'Board' means the Board of Community Health established under Chapter 5A of this
title.
(2)
'Department' means the Department of Community Health established under Chapter
5A of this title.
31-6-21.
(a)
The Department of Community
Health,
established under Chapter 5A of this
title, is authorized to administer the
certificate of need program established under this chapter and, within the
appropriations made available to the department by the General Assembly of
Georgia and
consistently
consistent
with the laws of the State of Georgia, a state health plan adopted by the
Health
Strategies Council and approved by the
board
Board of
Community Health. The department shall
provide, by rule, for procedures to administer its functions until otherwise
provided by the Board of Community Health.
(b)
The functions of the department shall be:
(1)
To conduct the health planning activities of the state and to implement
those
parts or
components thereof of the state health
plan which relate to the government of the state;
(2)
To prepare and revise a
draft
state health plan
for
submission to the Health Strategies
Council for adoption
by the
board and submission to the
Governor;
(3)
To
assist
seek advice,
at its discretion, from the Health
Strategies Council in the performance
by the
department of its functions
pursuant to
this chapter;
(4)
With the
prior advice, comment, and recommendations of the Health Strategies Council,
except with respect to emergency rules and regulations,
to
To
adopt, promulgate, and implement rules and regulations
consistent
with this chapter sufficient to administer
the provisions of this chapter including the certificate of need
program;
(5)
To define, by rule, the form, content, schedules, and procedures for submission
of applications for certificates of need and periodic reports;
(6)
To establish time periods and procedures consistent with this chapter to hold
hearings and to obtain the viewpoints of interested persons prior to issuance or
denial of a certificate of need;
(7)
To provide, by rule, for such fees as may be necessary to cover the costs of
preparing the record for appeals before the hearing officers and
review
board
Certificate of
Need Appeal Panel of the decisions of the
department, which costs may include reasonable sharing between the department
and the parties to appeal hearings;
(8)
For the purpose of health planning and for the evaluation of certificate of need
applications, to develop and maintain a comprehensive health care data base and
to require the submission of information from health care facilities and
institutions, including ambulatory surgical centers, whether or not exempt or
excluded from obtaining a certificate of need under this chapter, which is
determined by the department, through rule, to be necessary to meet the
department´s responsibilities as established in this chapter.
(9)
To establish, by rule, uniform need methodologies for new institutional health
services and health facilities. In developing such uniform need methodologies,
the department shall, at a minimum, consider the demographic characteristics of
the population, the health status of the population, service use patterns,
standards and trends, financial and geographic accessibility, and market
economics.
(8)(10)
To provide, by rule, for a reasonable and equitable fee schedule for certificate
of need applications
and
administrative appeals;
(9)(11)
To grant, deny, or revoke a certificate of need as applied for or as amended;
and
(10)(12)
To perform powers and functions delegated
by the Governor, which delegation may include the powers to carry out the duties
and powers which have been delegated to the department under Section 1122 of the
Social Security Act of 1935, as amended.
31-6-21.1.
(a)
Rules of the department shall be adopted, promulgated, and implemented as
provided in this Code section and in Chapter 13 of Title 50, the 'Georgia
Administrative Procedure Act,' except that the department shall not be required
to comply with subsections (c) through (g) of Code Section 50-13-4.
(b)
The department shall transmit three copies of the notice provided for in
paragraph (1) of subsection (a) of Code Section 50-13-4 to the legislative
counsel. The copies shall be transmitted at least 30 days prior to
that
the
department´s intended action. Within
five days after receipt of the copies, if possible, the legislative counsel
shall furnish the presiding officer of each house with a copy of the notice and
mail a copy of the notice to each member of the Health and Human Services
Committee of the Senate and each member of the Health and Human Services
Committee of the House of Representatives. Each such rule and any part thereof
shall be subject to the making of an objection by either such committee. Any
rule or part thereof to which no objection is made by both such committees may
become adopted by the department at the end of such 30 day period. The
department may not adopt any such rule or part thereof which has been changed
since having been submitted to those committees unless:
(1)
That change is to correct only typographical errors;
(2)
That change is approved in writing by both committees and that approval
expressly exempts that change from being subject to the public notice and
hearing requirements of subsection (a) of Code Section 50-13-4;
(3)
That change is approved in writing by both committees and is again subject to
the public notice and hearing requirements of subsection (a) of Code Section
50-13-4; or
(4)
That change is again subject to the public notice and hearing requirements of
subsection (a) of Code Section 50-13-4 and the change is submitted and again
subject to committee objection as provided in this subsection.
Nothing
in this subsection shall prohibit the department from adopting any rule or part
thereof without adopting all of the rules submitted to the committees if the
rule or part so adopted has not been changed since having been submitted to the
committees and objection thereto was not made by both committees.
(c)
Any rule or part thereof to which an objection is made by both committees within
the 30 day objection period under subsection (b) of this Code section shall not
be adopted by the department and shall be invalid if so adopted. A rule or part
thereof thus prohibited from being adopted shall be deemed to have been
withdrawn by the department unless the department, within the first 15 days of
the next regular session of the General Assembly, transmits written notification
to each member of the objecting committees that the department does not intend
to withdraw that rule or part thereof but intends to adopt the specified rule or
part effective the day following adjournment sine die of that regular session. A
resolution objecting to such intended adoption may be introduced in either
branch of the General Assembly after the fifteenth day but before the thirtieth
day of the session in which occurs the notification of intent not to withdraw a
rule or part thereof. In the event the resolution is adopted by the branch of
the General Assembly in which the resolution was introduced, it shall be
immediately transmitted to the other branch of the General Assembly. It shall
be the duty of the presiding officer of the other branch to have that branch,
within five days after receipt of the resolution, consider the resolution for
purposes of objecting to the intended adoption of the rule or part thereof.
Upon such resolution being adopted by two-thirds of the vote of each branch of
the General Assembly, the rule or part thereof objected to in that resolution
shall be disapproved and not adopted by the department. If the resolution is
adopted by a majority but by less than two-thirds of the vote of each such
branch, the resolution shall be submitted to the Governor for his
or
her approval or veto. In the event of
his
a
veto, or if no resolution is introduced objecting to the rule, or if the
resolution introduced is not approved by at least a majority of the vote of each
such branch, the rule shall automatically become adopted the day following
adjournment sine die of that regular session. In the event of the
Governor´s approval of the resolution, the rule shall be disapproved and
not adopted by the department.
(d)
Any rule or part thereof which is objected to by only one committee under
subsection (b) of this Code section and which is adopted by the department may
be considered by the branch of the General Assembly whose committee objected to
its adoption by the introduction of a resolution for the purpose of overriding
the rule at any time within the first 30 days of the next regular session of the
General Assembly. It shall be the duty of the department in adopting a proposed
rule over such objection so to notify the
chairmen
chairpersons
of the Health and Human Services Committee of the Senate and the Health and
Human Services Committee of the House within ten days after the adoption of the
rule. In the event the resolution is adopted by such branch of the General
Assembly, it shall be immediately transmitted to the other branch of the General
Assembly. It shall be the duty of the presiding officer of the other branch of
the General Assembly to have such branch, within five days after the receipt of
the resolution, consider the resolution for the purpose of overriding the rule.
In the event the resolution is adopted by two-thirds of the votes of each branch
of the General Assembly, the rule shall be void on the day after the adoption of
the resolution by the second branch of the General Assembly. In the event the
resolution is ratified by a majority but by less than two-thirds of the votes of
either branch, the resolution shall be submitted to the Governor for his
or
her approval or veto. In the event of
his
a
veto, the rule shall remain in effect. In the event of
his
the
Governor´s approval, the rule shall
be void on the day after the date of
his
such
approval.
(e)
Except for emergency rules, no rule or part thereof adopted by the department
after April 3, 1985, shall be valid unless adopted in compliance with
subsections (b), (c), and (d) of this Code section and subsection (a) of Code
Section 50-13-4.
(f)
Emergency rules shall not be subject to the requirements of subsection (b), (c),
or (d) of this Code section but shall be subject to the requirements of
subsection (b) of Code Section 50-13-4. Upon the first expiration of any
department emergency rules, where those emergency rules are intended to cover
matters which had been dealt with by the department´s nonemergency rules
but such nonemergency rules have been objected to by both legislative committees
under this Code section, the emergency rules concerning those matters may not
again be adopted except for one 120 day period. No emergency rule or part
thereof which is adopted by the department shall be valid unless adopted in
compliance with this subsection.
(g)
Any proceeding to contest any rule on the ground of noncompliance with this Code
section must be commenced within two years from the effective date of the
rule.
(h)
For purposes of this Code section, 'rules' shall mean rules and
regulations.
(i)
The state health plan or the rules establishing considerations, standards, or
similar criteria for the grant or denial of a certificate of need pursuant to
Code Section 31-6-42 shall not apply to any application for a certificate of
need as to which, prior to the effective date of such plan or rules,
respectively, the evidence has been closed following a full evidentiary hearing
before a hearing officer.
31-6-22.
The
department shall be directed by the commissioner of community
health.
ARTICLE
3
31-6-40.
(a)
From and after July 1,
1999
2007,
only such new institutional health services
or
and
health care facilities as are found by the
department to be needed shall be offered in the state. Prior to that date, only
such new institutional health services
or
and
health care facilities which had been found to be needed by
department or
its predecessor, the Health Planning
Agency,
under any prior provisions of this chapter and the regulations issued thereunder
shall have been offered in the state, unless otherwise exempt from the
requirements of the law or unless that law was not applicable. It is the intent
of this provision to assure that no new institutional health services or health
care facilities, as defined prior to July 1,
1999
2007,
are allowed to avoid the requirements of any prior provisions of this
chapter,
and applicable regulations, if those laws and regulations were applicable to
them.
(b)
Any person proposing to develop or offer a new institutional health service or
health care facility shall, before commencing such activity, submit an
application to the department and obtain a certificate of need in the manner
provided in this chapter unless such activity is excluded from the scope of this
chapter.
(c)(1)
Any person who offered new institutional health services, as defined only in
subparagraphs (G) and (H) of paragraph (14) of Code Section 31-6-2, within the
12 month period prior to July 1, 1999, and for which services a certificate of
need was not required under the provisions of this chapter as they existed prior
to July 1, 1999, shall not be required to obtain a certificate of need in order
to continue to offer those previously offered services after that date if that
person obtains an exemption therefor as provided in this
subsection.
(1.1)
Any person who, on July 1, 1999:
(A)
Has in place a valid written contract of purchase, construction, or assembly for
purposes of offering new institutional health services, as defined only in
subparagraphs (G) and (H) of paragraph (14) of Code Section 31-6-2;
(B)
Has prior to said date paid in cash or made an irrevocable and secured
commitment or obligation of a minimum of 30 percent of the price called for
under said contract;
(C)
Has taken delivery and has in operation such new institutional health services
on or before January 1, 1992; and
(D)
Has notified the Health Planning Agency no later than July 1, 1991, of that
person´s intent to apply for an exemption under this paragraph
shall
not be required to obtain a certificate of need in order to offer those services
if that person obtains an exemption therefor as provided in this
subsection.
(2)
A person claiming an exemption under paragraph (1) or (1.1) of this subsection
shall apply to the Health Planning Agency for that exemption no later than July
1, 1992. The application shall be in such form and manner as established by the
Health Planning Agency to provide sufficient proof that the applicant qualifies
for the exemption claimed. The Health Planning Agency shall notify the applicant
within 90 days after the required application and proof have been properly
submitted that the application for exemption is denied; otherwise, the
application shall be deemed granted by operation of law upon the ninety-first
day. Such a grant of the exemption shall be final and no appeal therefrom shall
be authorized. A denial of such application for exemption shall constitute a
contested case under Chapter 13 of Title 50, the 'Georgia Administrative
Procedure Act.' Any person having a certificate of need or authorization to
offer the services for which an application for exemption has been denied may
intervene in the contested case if such person offers those services within the
same service area as the service area in which were to be offered the services
for which the application for exemption was denied.
(3)
A person who claims an exemption pursuant to this subsection may continue to
offer the services for which the exemption may be claimed without applying for
the exemption, but those services may not be offered after October 1, 1992, or
any date prior thereto upon which a decision denying the exemption has become
final unless:
(A)
The person applied for the exemption as provided in paragraph (2) of this
subsection but on October 1, 1992, there has either been no decision made
denying the exemption or a decision denying the exemption has not become final,
in either of which events the services for which the application for exemption
was made may be offered until there is a final decision denying the
exemption;
(B)
The person is granted the exemption; or
(C)
The person obtains a certificate of need for the services.
For
purposes of this subsection, a decision denying an application for an exemption
shall become final when the time for appealing that decision expires without an
appeal of such decision having been properly made.
(4)
An exemption obtained pursuant to this subsection may be transferred to another
person if the department is notified thereof within 45 days after the transfer
occurs.
(5)
The Health Planning Agency shall establish procedures for obtaining exemptions
under this subsection and shall publish a list not later than October 1, 1992,
of all such applications granted or pending on that date.
(d)(c)
Any person that had formally requested, prior to
February 1,
1991
July 1,
2007, a determination from the
Health
Planning Agency
department
of the applicability of the certificate of need requirements for a specific
project that is subsequently approved by the
Health
Planning Agency
department
or by appeal of the
Health
Planning Agency´s
department´s
denial shall be exempt under the provisions of this chapter from the requirement
of obtaining a certificate of need for that project.
31-6-40.1.
(a)
Any person who acquires a health care facility by stock or asset purchase,
merger, consolidation, or other lawful means shall notify the department of such
acquisition, the date thereof, and the name and address of the acquiring person.
Such notification shall be made in writing to the department within 45 days
following the acquisition and the acquiring person may be fined by the
department
in the
amount of $500.00
up to
$1,000.00 per day for each day that such
notification is late.
The fine
imposed pursuant to this subsection shall increase to $5,000.00 per day upon the
seventy-fifth day following the acquisition for each day thereafter that
notification has not been made. Such fine
or
fines shall be paid into the state
treasury.
(b)
The department may limit the time periods during which it will accept
applications for the following health care facilities:
(1)
Skilled nursing facilities;
(2)
Intermediate care facilities;
and
(3)
Home health
agencies;
and
(4)
New and emerging
technologies,
to
only such times after the department has determined there is an unmet need for
such facilities. The department shall make a determination as to whether or not
there is an unmet need for each type of facility at least every six months and
shall notify those requesting such notification of that
determination.
(c)
The department may require that any applicant for a certificate of need agree to
provide a specified amount of clinical health services to indigent patients as a
condition for the grant of a certificate of need. A grantee or successor in
interest of a certificate of need or an authorization to operate under this
chapter which violates such an agreement, whether made before or after
July 1,
1991
July 1,
2007, shall be liable to the department
for a monetary penalty in the amount of the difference between the amount of
services so agreed to be provided and the amount actually provided. Any penalty
so recovered shall be paid into the state treasury.
(d)
Penalties authorized under this Code section shall be subject to the same
notices and hearing for the levy of fines under Code Section
31-6-45.
31-6-40.2.
(a)
As used in this Code section only, the term:
(1)
'Certificate of need application' means an application for a certificate of need
filed with the department, any amendments thereto, and any other written
material relating to the application and filed by the applicant with the
department.
(2)
'First three years of operation' means the first three consecutive 12 month
periods beginning on the first day of a new perinatal service´s first full
calendar month of operation.
(3)
'First year of operation' means the first consecutive 12 month period beginning
on the first day of a new perinatal service´s first full calendar month of
operation.
(4)
'New perinatal service' means a perinatal service whose first year of operation
ends after April 6, 1992.
(5)
'Perinatal service' means obstetric and neonatal services.
(6)
'Uncompensated indigent or charity care' means the dollar amount of 'net
uncompensated indigent or charity care after direct and indirect (all)
compensation' as defined by, and calculated in accordance with, the
department´s Hospital Indigent Care Survey and related
instructions.
(7)
'Year' means one of the three consecutive 12 month periods in a new perinatal
service´s first 36 months of operation.
(b)(1)
A new perinatal service shall provide uncompensated indigent or charity care in
an amount which meets or exceeds the department´s established minimum at
the time the department issued the certificate of need approval for such service
for each of the service´s first three years of operation; provided,
however, that if the certificate of need application under which a new perinatal
service was approved included a commitment that uncompensated indigent or
charity care would be provided in an amount greater than the established minimum
for any time period described in the certificate of need application that falls
completely within such new perinatal service´s first three years of
operation, such new perinatal service shall provide indigent or charity care in
an amount which meets or exceeds the amount committed in the certificate of need
application for each time period described in the certificate of need
application that falls completely within the service´s first three years of
operation.
(2)
The department shall revoke the certificate of need and authority to operate of
a new perinatal service if after notice to the grantee of the certificate or
such grantee´s successors, and after opportunity for a fair hearing
pursuant to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,'
the department determines that such new perinatal service has failed to provide
indigent or charity care in accordance with the requirements of paragraph (1) of
this subsection and such failure is determined by the department to be for
reasons substantially within the perinatal service provider´s control. The
department shall provide the requisite notice, conduct the fair hearing, if
requested, and render its determination within 90 days after the end of the
first year, or, if applicable, the first time period described in paragraph (1)
of this subsection during which the new perinatal service fails to provide
indigent or charity care in accordance with the requirements of paragraph (1) of
this subsection. Revocation shall be effective 30 days after the date of the
determination by the department that the requirements of paragraph (1) of this
subsection have not been met.
(c)(1)
A new perinatal service shall achieve the standard number of births specified in
the state health plan in effect at the time of the issuance of the certificate
of need approval by the department in at least one year during its first three
years of operation.
(2)
The department shall revoke the certificate of need and authority to operate of
a new perinatal service if after notice to the grantee of the certificate of
need or such grantee´s successors, and after opportunity for a fair hearing
pursuant to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,'
the department determines that such new perinatal service has failed to comply
with the applicable requirements of paragraph (1) of this subsection and such
failure is determined by the department to be for reasons substantially within
the perinatal service provider´s control. The department shall provide the
requisite notice, conduct the fair hearing, if requested, and render its
determination within 90 days after the end of the new perinatal service´s
first three years of operation. Revocation shall be effective 30 days after the
date of the determination by the department that the requirements of this
paragraph or paragraph (1) of this subsection have not been met.
(d)
Nothing contained in this Code section shall limit the department´s
authority to regulate perinatal services in ways or for time periods not
addressed by the provisions of this Code section.
31-6-41.
(a)
A certificate of need shall be valid only for the defined scope, location, cost,
service area, and person named in an application, as it may be amended, and as
such scope, location, area, cost, and person are approved by the department,
unless such certificate of need owned by an existing health care facility is
transferred to a person who acquires such existing
facility;
provided, however, that a certificate holder may relocate pursuant to paragraph
(17) of subsection (a) of Code Section
31-6-47. In such case, the certificate of
need shall be valid for the person who acquires such a facility and for the
scope, location, cost, and service area approved by the
department;
provided, however, that a certificate holder may relocate pursuant to paragraph
(17) of subsection (a) of Code Section
31-6-47.
(b)
A certificate of need shall be valid and effective for a period of 12 months
after it is issued, or such greater period of time as may be specified by the
department at the time the certificate of need is issued. Within the effective
period after the grant of a certificate of need, the applicant of a proposed
project shall fulfill reasonable performance and scheduling requirements
specified by the department, by rule, to assure reasonable progress toward
timely completion of a project.
The license or
permit of any health care facility or institutional health services provider
subject to the provisions of this chapter shall specify the number of beds and
identify the clinical health services authorized or exempted by the department
pursuant to this chapter.
(c)
By rule, the department may provide for extension of the effective period of a
certificate of need when an applicant, by petition, makes a good faith showing
that the conditions to be specified according to subsection (b) of this Code
section will be performed within the extended period and that the reasons for
the extension are beyond the control of the applicant.
31-6-41.1.
(a)
The department may require that an applicant agree to meet certain specified
conditions, either prescribed by applicable rule or based upon representations
of intent by the applicant in the application, in order to obtain a certificate
of need and may issue a certificate of need predicated upon the applicant´s
compliance with those conditions. Such conditions may include requiring a
minimum amount of uncompensated indigent or charity care, requiring
participation as a provider of medical assistance for Medicaid purposes, or any
other condition relating to the considerations in Code Section 31-6-42. Any
such conditions imposed on a certificate of need specified by the department
shall be stated by the department in its decision to grant the certificate and
on the face of the certificate of need issued to the applicant.
(b)
The department may revoke the certificate of need, assess a monetary penalty
against the certificate holders, or both, if the holder of a certificate of need
fails to comply substantially with a condition imposed pursuant to subsection
(a) of this Code section. The maximum amount of the fine imposed shall not
exceed $5,000.00 per failure per day of noncompliance. The department shall
promulgate rules for reporting compliance with conditions imposed on a
certificate of need. Failure by the certificate holder to report compliance
with any condition upon which the issuance of the certificate was granted shall
constitute noncompliance. In assessing the appropriate penalty, the department
shall take into account as mitigation the degree of noncompliance and good cause
demonstrated by the certificate holder.
31-6-42.
(a)
The written findings of fact and decision, with respect to the department´s
grant or denial of a certificate of need, shall be based on the applicable
considerations specified in this Code section and reasonable rules promulgated
by the department interpretive thereof. The department shall issue a
certificate of need to each applicant whose application is consistent with the
following considerations and such rules deemed applicable to a project, except
as specified in subsection
(d)(f)
of Code Section 31-6-43:
(1)
The proposed new institutional health services are reasonably consistent with
the relevant general goals and objectives of the state health plan;
(2)
The population residing in the area served, or to be served, by the new
institutional health service has a need for such services;
(3)
Existing alternatives for providing services in the service area the same as the
new institutional health service proposed are neither currently available,
implemented, similarly utilized, nor capable of providing a less costly
alternative, or no certificate of need to provide such alternative services has
been issued by the department and is currently valid;
(4)
The project can be adequately financed and is, in the immediate and long term,
financially feasible;
(5)
The effects of new institutional health service on payors for health services,
including governmental payors, are not unreasonable;
(6)
The costs and methods of a proposed construction project, including the costs
and methods of energy provision and conservation, are reasonable and adequate
for quality health care;
(7)
The new institutional health service proposed is reasonably financially and
physically accessible to the residents of the proposed service
area;
(8)
The proposed new institutional health service has a positive relationship to the
existing health care delivery system in the service area;
(9)
Any adverse effects of the proposed new institutional health service on existing
providers have been assessed and will not unreasonably impact the quality,
efficiency, or financial viability of such existing providers;
(9)(10)
The proposed new institutional health service encourages more efficient
utilization of the health care facility proposing such service;
(10)(11)
The proposed new institutional health service provides, or would provide, a
substantial portion of its services to individuals not residing in its defined
service area or the adjacent service area;
(11)(12)
The proposed new institutional health service conducts biomedical or behavioral
research projects or new service development which is designed to meet a
national, regional, or state-wide need;
(12)(13)
The proposed new institutional health service meets the clinical needs of health
professional training programs which request assistance;
(13)(14)
The proposed new institutional health service fosters improvements or
innovations in the financing or delivery of health services, promotes health
care quality assurance or cost effectiveness, or fosters competition that is
shown to result in lower patient costs without a loss of the quality of care;
and
(15)
The applicant for the proposed new institutional health service:
(A)
If an existing health care facility, demonstrates that it provides high quality
care and complies fully with relevant licensure and accreditation standards;
or
(B)
If not an existing provider, demonstrates that it will provide quality care and
will comply fully with relevant licensure and accreditation standards;
and
(14)(16)
The proposed new institutional health service fosters the special needs and
circumstances of health maintenance organizations.
(b)
No later than January 1, 2008, the department shall develop and adopt a
service-specific need methodology for each clinical health service and for all
diagnostic and other imaging services; diagnostic, treatment, or rehabilitation
centers; and diagnostic imaging and therapeutic equipment subject to review
under this chapter.
(b)(c)
In the case of applications for the development or offering of a new
institutional health service or health care facility for osteopathic medicine,
the need for such service or facility shall be determined on the basis of the
need and availability in the community for osteopathic services and facilities
in addition to the considerations in subsection (a) of this Code section.
Nothing in this chapter shall, however, be construed as otherwise recognizing
any distinction between allopathic and osteopathic medicine.
(d)
In the case of applications that are joined for comparative review pursuant to
subsection (b) of Code Section 31-6-40.1 or subsection (f) of Code Section
31-6-43, the department may give favorable consideration to projects and
applicants where the applicant agrees to provide a clinical health service that
is needed in the service area of the proposed project, and the department shall
condition the award of a certificate upon the applicant´s providing such
needed clinical health service. Such favorable consideration shall only be
available where each applicant competing in the comparative review may provide
such needed clinical health services.
(c)(e)
If the denial of an application for a certificate of need for a new
institutional health service proposed to be offered or developed by
a:
(1)
Minority administered hospital facility serving a socially and economically
disadvantaged minority population in an urban setting; or
(2)
Minority administered hospital facility utilized for the training of minority
medical practitioners
would
adversely impact upon the facility and population served by said facility, the
special needs of such hospital facility and the population served by said
facility for the new institutional health service shall be given
extraordinary
favorable
consideration by the department in making its determination of need as required
by this Code section. The department shall have the authority to vary or modify
strict adherence to the provisions of this chapter and the rules enacted
pursuant hereto in considering the special needs of such facility and its
population served and to avoid an adverse impact on the facility and the
population served thereby. For purposes of this subsection, the term 'minority
administered hospital facility' means a hospital controlled or operated by a
governing body or administrative staff composed predominantly of members of a
minority race.
(d)(f)
For the purposes of the considerations contained in this Code section and in the
department´s applicable rules, relevant data which were unavailable or
omitted when the state health plan or rules were prepared or revised may be
considered in the evaluation of a project.
(e)(g)
The department shall specify in its written findings of fact and decision which
of the considerations contained in this Code section and
in
the department´s applicable rules are applicable to an application and its
reasoning as to
and
any
evidentiary support for its evaluation of each such applicable consideration and
rule.
31-6-43.
(a)
Each application for a certificate of need shall be reviewed by the department
and within ten working days after the date of its receipt a determination shall
be made as to whether the application complies with the rules governing the
preparation and submission of applications. If the application complies with the
rules governing the preparation and submission of applications, the department
shall declare the application complete for review, shall accept and date the
application, and shall notify the applicant of the timetable for its review. The
department shall also notify a newspaper of general circulation in the county in
which the project
shall
will
be developed that the application has been deemed complete
and shall
publish notice of the application in a department tracking report established
for these purposes. The department shall
also notify the appropriate regional development center and the chief elected
official of the county and municipal governments, if any, in whose boundaries
the proposed project will be located that the application is complete for
review. If the application does not comply with the rules governing the
preparation and submission of applications, the department shall notify the
applicant in writing and provide a list of all deficiencies.
If the
requested information is not filed with the department within 14 days of the
date of the notice, the application shall be deemed incomplete and deemed
withdrawn from consideration.
The
applicant shall be afforded an opportunity to correct such deficiencies, and
upon such correction
If the
applicant corrects such deficiencies, the
application shall then be declared complete for review
within ten
days of the correction of such
deficiencies, and notice given to a
newspaper of general circulation in the county in which the project
shall
will
be developed that the application has been so declared
and notice
published in the department tracking
report. The department shall also notify
the appropriate regional development center and the chief elected official of
the county and municipal governments, if any, in whose boundaries the proposed
project will be located that the application is complete for review or when in
the determination of the department a significant amendment is
filed.
(b)
At least 45 days prior to filing an application, the applicant shall file a
letter of intent with the department respecting the development of a project
subject to review. The department shall provide by rule a process for filing
letters of intent and a mechanism by which applications may be filed to compete
with and be reviewed comparatively with proposals described in filed letters of
intent. Letters of intent must describe the proposal; specify the number of
beds sought, if any; identify the services to be provided and the specific
location and service area; and identify the applicant. Within 14 days after
receipt of a letter of intent, the department shall publish notice of the letter
of intent in the department tracking report.
(b)(c)
An
The department
shall specify by rule the time within which
an applicant may amend its
application,
but no amendment shall be allowed at any
time no
later than ten days prior to the end
within 30
days of the end of the review period, and
the department may request an applicant to make
amendments
an
amendment. The department decision shall
be made on an application as amended, if at all, by the applicant.
(c)(d)
Except as
provided in subsection (d) of this Code section, there
There
shall be a time limit of
90
120
days for review of a project, beginning on the day the department declares the
application complete for
review or, in
the case of applications joined for comparative review, beginning on the day the
department declares the final application
complete.
The
department may adopt rules for determining when it is not practicable to
complete a review in 90 days and may extend the review period upon written
notice to the applicant but only for an extended period of not longer than an
additional 30 days.
The department
shall adopt rules governing the submission of additional information by the
applicant and for opposing an application.
(e)
To allow the opportunity for comparative review of applications, the department
shall provide by rule for applications for a certificate of need to be submitted
on a timetable or batching cycle basis no less often than two times per calendar
year for each clinical health service. Applications for services, facilities,
or expenditures for which there is no specified batching cycle may be filed at
any time.
(d)(f)
The department