A snapshot of Georgia: Certificate of Need, a program of the Georgia Department of Community Health [Dec. 2007]

A Program Of The Georgia Department Of Community Health
A SNAPSHOT OF GEORGIA
Certificate Of Need

Overview

The Georgia Department of Community Health (DCH), Division of Health Planning (DHP) is the division of state government responsible for administering the Certificate of Need Program (CON) that evaluates proposals for new or expanded health care services, or facilities under Georgia's Health Planning
Statute, O.C.G.A. Title 31, Chapter 6.

Certificate of Need

CON is the official determination that a new or expanded health care service or facility is needed in Georgia. The purpose of the CON program is to ensure the availability of adequate health care services to meet the need of all Georgians, while safeguarding against the unnecessary duplication of services that
perpetuate the costs of health care services.

Steps for Acquiring a Certificate of Need

STEP

1

An original and one copy of an application should be submitted along with a certified check for the appropriate filing fee

STEP

2

In reviewing an application, the DHP will take into account the general considerations specified in Rule 111-2-2-.09 and the

appropriate, service-specific standards and criteria, if applicable, set

forth at Rule 111-2-2-.11

STEP

3

A project application is either approved or denied by the DHP. If the application is approved, an official CON and project evaluation

analysis is provided to the applicant. If the project is denied, a

denial letter and project evaluation analysis is provided to the

applicant

STEP 4 Following a favorable award of a CON from the DHP, the applicant
has 12 months from the date of approval to implement the proposed project. Certificates awarded for the acquisition of equipment shall be effective for 12 months, by which date the applicant must be in possession of the equipment. For projects, which require construction or renovation, the applicant has one year from the date of approval to demonstrate substantial performance

Post Approval Reporting Requirements

PROJECTS THAT REQUIRE CON
A health care professional who volunteers in a free clinic and/or his/ her own private office is protected under this legislation as long as:: n All public and private
hospitals, including general, acute-care and specialized hospitals n Nursing homes n Ambulatory surgical services or obstetrical facilities n Home health agencies, personal care homes (with 25 or more beds) n Inpatient rehabilitation facilities treating traumatic brain injury n Diagnostic, treatment and rehabilitation centers (whether for-profit or not-for-profit) n Major medical equipment purchases or leases (e.g. MRI, CT Scanners) that exceed the equipment threshold n Major hospital renovations or other capital activities by any health care facility that exceed the capital expenditure threshold n Before a health care facility can offer a health care service, which was not provided on a regular basis during the previous 12-month period, or add additional beds

All CON approved projects must comply with post-approval requirements. CON post-approval requirements and progress reporting forms are available at the DCH's Web site. An applicant may download the progress report to submit to DCH. Progress reports are required to document timely project implementation and completion, as well as
interim progress of 50 percent, completion and specific phase timetable completion.

2 Peachtree Street, Atlanta, Ga 30303 w www.dch.georgia.gov

December 2007

A Snapshot Of Certificate Of Need

Can a Certificate of Need project's approved and/or denied status be appealed?
CON decisions may be appealed by:
n The applicant; n A competing applicant; n A competing health care facility that notified the DHP in writing
about its opposition to a proposed project on or before the 60th day of the review cycle; or n The county or municipal government where the project would be located.
Sanctions for Failing to Comply with Certificate of Need Laws
The DHP may issue cease and desist mandates and/or seek court injunctions to halt violations, as well as impose maximum fines of $5,000 per day for every day a violation to the CON rules and regulations exists. The DHP may also impose monetary penalties of up to $500 per day for failure to notify of the transfer of ownership of a health care facility within 45 days of the transaction. The DHP may also require a certain percentage of the adjusted gross revenue of a facility or service to be devoted to the provision of indigent and charity care. A party may be assessed a monetary penalty of the difference between the amount of indigent and charity care that was committed to be provided and that actually provided.
Questions
If you are not sure whether a project requires a CON before implementation, correspondence should be sent to the DHP to request an official Letter of Determination. The request should be made on the "Letter of Determination" form, which is provided at DCH's Web site and should also include as much information about the project as possible. There is a filing fee of $250 for a determination request. The DHP will respond in writing. A determination about whether CON requirements apply to a specific project must be made in writing. For more information check out - http://dch.georgia.gov/con.

PROJECTS EXEMPTED FROM
CON REVIEW
n Repairs to a facility that fall below the CON review threshold
n Replacement of existing therapeutic or diagnostic equipment that received prior CON authorization
n Projects that bring facilities into compliance with licensing requirements, life safety codes or standards of the Joint Commission on Accreditation of Healthcare Organizations
n Cost overruns that represent less than 10 percent of the previously approved capital expenditure and do not exceed the CON review threshold; all cost overruns under $300,000 are exempt from review
n A hospital that maintains an occupancy rate greater than 85 percent for the preceding 12-month period may increase its capacity by 10 beds or 10 percent of its existing inventory (whichever is less) every two years without a CON unless the cost associated with the increase exceeds the capital threshold. The hospital must submit a written request for determination regarding exemption under this provision, and the request must document the facility's month-by-month occupancy
n An Ambulatory Surgery Facility that is physician owned, office-based, and single- specialty, the establishment and development of which does not exceed the statutory dollar threshold applicable to such exempted facilities