Current through Register Vol. XLI, No. 50, December 13, 2024
Section 65-7-12 - Review Criteria12.1. A certificate of need may only be issued if the proposed new institutional health service is:12.1.a. Found to be needed; and12.1.b. Except in emergency circumstances that pose a threat to public health, consistent with the State Health Plan.12.2. In the case of any proposed new institutional health service, the board shall not grant a certificate of need unless, after consideration of the appropriateness of the use of existing facilities providing services similar to those being proposed, the board makes the following findings: 12.2.a. Superior alternatives to the services in terms of cost, efficiency and appropriateness do not exist and the development of alternatives is not practicable;12.2.b. Existing facilities providing services similar to those proposed are being used in an appropriate and efficient manner;12.2.c. In the case of new construction, alternatives to new construction, such as modernization or sharing arrangements, have been considered and have been implemented to the maximum extent possible;12.2.d. Patients will experience serious problems in obtaining care of the type proposed in the absence of the proposed new service; and12.2.e. In the case of a proposal for the addition of beds for the provision of skilled nursing or intermediate care services, the addition will be consistent with the plans of other agencies of the state responsible for the provision and financing of long-term care facilities or services including home health services.12.3. The board shall, at a minimum, consider the following criteria, if applicable, when making its determination to grant or deny a certificate of need: 12.3.a. The relationship of the proposed new institutional health service to the State Health Plan and whether the proposed new institutional health service is in compliance with the State Health Plan, unless the State Health Plan is in conflict with this rule or the Act;12.3.b. The relationship of services reviewed to the long-range development plan of the applicant providing or proposing the services;12.3.c. The need that the population served or to be served by the services has for the services proposed to be offered or expanded, and the extent to which all residents of the area, and in particular low income persons, racial and ethnic minorities, women, handicapped persons, other medically underserved populations, and the elderly, are likely to have access to those services;12.3.d. The availability of less costly or more effective alternative methods of providing the service or services to be offered, expanded, reduced, relocated or eliminated;12.3.e. The immediate and long-term financial feasibility of the proposal as well as the probable impact of the proposal on the costs of and charges for providing health services by the applicant proposing the new institutional health service;12.3.f. The relationship of the services proposed to the existing health care system in the area where the services are proposed to be provided;12.3.g. In the case of health services proposed to be provided, the availability of resources, including health care providers, management personnel, and funds for capital and operating needs, for the provision of the services proposed to be provided and the need for alternative uses of these resources as identified by the State Health Plan and other applicable plans;12.3.h. The appropriate and nondiscriminatory use of existing and available health care providers;12.3.i. The relationship, including the organizational relationship, of the health services proposed to be provided to ancillary or support services;12.3.j. The special needs and circumstances of those entities which provide a substantial portion of their services or resources, or both, to individuals not residing in the health service areas in which the entities are located or in adjacent health service areas. These entities may include medical and other health professional schools, multidisciplinary clinics and specialty centers;12.3.k. In the case of a reduction or elimination of a service, including the relocation of a facility or a service, the need that the population presently served has for the service, the extent to which that need will be met adequately by the proposed relocation or by alternative arrangements, and the effect of the reduction, elimination or relocation of the service on the ability of low income persons, racial and ethnic minorities, women, handicapped persons, other medically underserved populations, and the elderly, to obtain needed health care;12.3.l. In the case of a construction project:12.3.l.1. The cost and methods of the proposed construction, including the costs and methods of energy provision; and12.3.l.2. The probable impact of the construction project reviewed on the costs of providing health services by the applicant proposing the construction project and on the costs and charges to the public of providing health services by other persons;12.3.m. In the case of health services proposed to be provided, the effect of the means proposed for the delivery of proposed health services on the clinical needs of health professional training programs in the area in which the services are to be provided;12.3.n. In the case of health services proposed to be provided, if the services are to be available in a limited number of facilities, the extent to which the schools in the area for health professions will have access to the services for training purposes;12.3.o. In the case of health services proposed to be provided, the extent to which the proposed services will be accessible to all the residents of the area to be served by the services;12.3.p. The factors influencing the effect of competition on the supply of the health services being reviewed;12.3.q. Improvements or innovations in the financing and delivery of health services which foster competition and serve to promote quality assurance and cost effectiveness;12.3.r. In the case of health services or facilities proposed to be provided, the efficiency and appropriateness of the use of existing services and facilities similar to those proposed;12.3.s. In the case of existing services or facilities, the quality of care provided by the services or facilities in the past;12.3.t. In the case where the application is by an osteopathic or allopathic facility for a certificate of need to construct, expand or modernize a health care facility, acquire major medical equipment, or add services, the need for that construction, expansion, modernization, acquisition of equipment, or addition of services shall be considered on the basis of the need for and the availability in the community of services and facilities for osteopathic and allopathic physicians and their patients. The board shall consider the application in terms of its impact on existing and proposed institutional training programs for doctors of osteopathy and medicine at the student, internship and residency training levels;12.3.u. The special circumstances of health care facilities with respect to the need for conserving energy;12.3.v. The existence of a mechanism for soliciting consumer input into the health care facility's decision-making process; and12.3.w. The accessibility of the project to the medically underserved.12.4. If the applicant proposes to provide ventilator services for a nursing facility bed which have not been previously provided, the board shall consider the application in terms of the need for the service and whether the cost exceeds the level of current medicaid services. An applicant may not provide a higher level of service for a nursing facility bed without demonstrating that the change in level of service by the provision of the additional ventilator services will result in no additional fiscal burden to the state.12.5. If the applicant proposes to provide personal care services, the board shall consider the application in terms of the need for service and whether the cost exceeds the level of the cost of current medicaid services. No applicant may provide personal care services to be billed for medicaid reimbursement without demonstrating that the provision of the personal care service will result in no additional fiscal burden to the state.12.6. The board may develop and use standards relating to any review criteria which the board finds relevant and appropriate.