W. Va. Code R. § 65-23-4

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 65-23-4 - Exemption Procedure

4.1. Each applicant seeking an exemption pursuant to this rule, must file with the board a letter of intent at least fifteen (15) days before the submission of the application. The letter of intent shall contain sufficient information to advise the board of the nature of the exemption sought and outline the grounds for the exemption.

4.2. Upon receipt of the letter of intent, the board shall publish a notice in the Saturday Charleston newspapers and the State Register. The notice shall identify the legal entity seeking an exemption, the type of exemption requested, and a description of the proposal. The notice shall also state the rights of affected parties to a hearing.

4.3. In order to obtain the exemption, each applicant must file an application with the board no sooner than the fifteenth day or later than the thirtieth day following the filing of the letter of intent. The application shall contain the following:

4.3.1. Information that demonstrates that the applicant meets the exemption criteria required by subsections 3.1.1, 3.1.2, and 3.1.3 of this rule;

4.3.2. A copy of the applicant's by-laws and a list of the governing board, including the name, occupation, address, and telephone number of each board member. The by-laws must fully describe the composition of the community board;

4.3.3. Appropriate documentation of the applicant's tax exempt non-profit status, such as a copy of the organization's 501(c)(3) non-profit letter or a copy of the application for such designation; or evidence that the applicant is designated a government entity;

4.3.4. A map detailing the geographical boundaries of the applicant's existing and projected service area and an estimate of the population within the service area, with an explanation of how the population figure was derived. The map shall show the mileage from the site of the proposed new services to other sites operated by community-based primary care organizations in the service area;

4.3.5. An assurance that people residing in the area to be served by the new services will receive the services without regard to ability to pay;

4.3.6. A description of the financial feasibility of delivering and maintaining the proposed new services, of the start-up funding involved, the applicant's budget, most recent audit, and financial statement and capital expenditures for the project;

4.3.7. A listing of projected physician(s), other practitioners, administrators, and other site staff to be employed by the organization, if available, identified by name, and in addition, a summary of what recruitment prospects exist or are being planned for vacant positions;

4.3.8. A timetable of the projected opening of the site to include source of funding, recruitment plans, occupancy (lease, rent, purchase, or construct), staffing, and other factors relevant to the opening of the site;

4.3.9. Information with respect to the projected annual number of users and encounters to be served at the site. In instances involving an existing provider of primary care services, actual information regarding the operating budget, users, and encounters is to be provided; and

4.3.10. A verification signed by the chairperson of the community board.

4.4. Upon receipt of the application, the board shall determine within fifteen (15) days whether or not the application is complete. If the application is not complete, the board may request additional information. Upon receipt of that additional information, the board has fifteen (15) days within which to determine if the application is complete. Failure by the applicant to provide complete information shall delay the exemption decision until all information required is provided.

4.5. Upon determining that the application is complete, the board shall send a copy of the application to the Office of Community and Rural Health Services. The Office of Community and Rural Health Services shall provide a recommendation of either exemption or non-exemption from certificate of need review to the board within thirty (30) calendar days from its receipt of the application.

4.6. The Office of Community and Rural Health Services shall review the application and advise the board whether the application proposes new primary care services as defined by this rule and whether the applicant proposes to provide services in an underserved community as defined by this rule.

4.7. Upon receipt of the recommendation from the Office of Community and Rural Health Services and after determining that the application is complete and that the date has passed in which an affected person may request a hearing, the board shall publish a notice in the Saturday Charleston newspapers and the State Register. The notice shall identify the applicant, shall describe the proposal and shall, if a hearing on the exemption is requested, state the time, place, and date of the hearing.

4.8. If a hearing has not been requested, then following the publication of the notice in the Saturday Charleston newspapers and the State Register, the board shall within ten (10) days issue a written decision on the application which decision is a final decision. The board shall publish notice of the decision in the Saturday Charleston newspapers and the State Register.

4.9. If a hearing has been requested by an affected party, the board shall follow the provisions of subsections 5.1, 5.2 and 5.3 of this legislative rule.

4.10. In order to be effective, the request for a hearing must be from an affected party and must be filed in writing with the board within ten (10) days of the publication of the notice in the Saturday Charleston newspapers as required by subsection 4.2 of this rule.

W. Va. Code R. § 65-23-4