§ 23-15-6 - Procedures for review.
SECTION 23-15-6
§ 23-15-6 Procedures for review. –(a) The state agency, with the advice of the health services council, and inaccordance with the Administrative Procedures Act, chapter 35 of title 42,after public hearing pursuant to reasonable notice, which notice shall includeaffected persons, shall promulgate appropriate rules and regulations that maybe designated to further the accomplishment of the purposes of this chapterincluding the formulation of procedures that may be particularly necessary forthe conduct on reviews of particular types of new institutional health servicesor new health care equipment.
(b) Review procedures promulgated in accordance withsubsection (a) shall include at least the following, except that substituteprocedures for the conduct of expeditious and accelerated reviews may bepromulgated by the state agency in accordance with § 23-15-5:
(1) Provision that the state agency established a processrequiring potential applicants to file a detailed letter of intent to submit anapplication at least forty-five (45) days prior to the submission of anapplication and that the state agency shall undertake reviews in a timelyfashion no less often than twice a year and give written notification toaffected persons of the beginning of the review including the proposed schedulefor the review, the period within which a public meeting may be held, and themanner by which notification will be provided of the time and place of anypublic meeting so held.
(2) Provision that no more than one hundred and twenty (120)days shall elapse between initial notification of affected persons and thefinal decision of the state agency.
(3) Provision that, if the state agency fails to act upon anapplication within the applicable period established in subsection (b)(2), theapplicant may apply to the superior court of Providence County to require thestate agency to act upon the application.
(4) Provision for review and comment by the health servicescouncil and any affected person, including but not limited to those partiesdefined in § 23-15-2(1) and the department of business regulation, thedepartment of mental health, retardation, and hospitals, the department ofhuman services, health maintenance organizations, and the state professionalstandards review organization, on every application for the determination ofneed.
(5) Provision that a public meeting may be held during thecourse of the state agency review at which any person may have the opportunityto present testimony. Procedures for the conduct of the public meeting shall beestablished in rules and regulations promulgated by the state agency with theadvice of the health services council.
(6) Provision for issuance of a written decision by the stateagency which shall be based upon the findings and recommendations of the healthservices council unless the state agency shall afford written justification forvariance from that decision.
(ii) In the case of any proposed new institutional healthservice for the provision of health services to inpatients, a state agencyshall not make a finding that the proposed new institutional health service isneeded, unless it makes written findings as to:
(A) The efficiency and appropriateness of the use of existinginpatient facilities providing inpatient services similar to those proposed;
(B) The capital and operating costs (and their potentialimpact on patient charges), efficiency, and appropriateness of the proposed newinstitutional health services; and
(C) Makes each of the following findings in writing:
(I) That superior alternatives to inpatient services in termsof cost, efficiency, and appropriateness do not exist and that the developmentof alternatives is not practicable;
(II) That, in the case of new construction, alternatives tonew construction (e.g., modernization or sharing arrangements) have beenconsidered and implemented to the maximum extent practicable;
(III) That patients will experience serious problems in termsof costs, availability, or accessibility, or any other problems that may beidentified by the state agency, in obtaining inpatient care of the typeproposed in the absence of the proposed new service; and
(IV) That, in the case of a proposal for the addition of bedsfor the provision of skilled nursing or intermediate care, the relationship ofthe addition to the plans of other agencies of the state responsible forproviding and financing long-term care (including home health services) hasbeen considered.
(7) Provision for the distribution of the decision of thestate agency, including its findings and recommendations, to the applicant andto affected persons.
(8) Provision that the state agency may approve or disapprovein whole or in part any application as submitted, but that the parties maymutually agree to a modification of any element of an application as submitted,without requiring resubmission of the application.
(9) Provision that any person affected may request in writingreconsideration of a state agency decision if the person:
(A) Presents significant relevant information not previouslyconsidered by the state agency;
(B) Demonstrates that there have been significant changes infactors or circumstances relied upon by the state agency in reaching itsdecision;
(C) Demonstrates that the state agency has materially failedto follow its adopted procedures in reaching its decision; or
(D) Provides any other basis for reconsideration that thestate agency may have determined by regulation to constitute good cause.
(ii) Procedures for reconsideration shall be established inregulations promulgated by the state agency with the advice of the healthservices council.
(10) Provision that upon the request of any affected person,the decision of the state agency to issue, deny, or withdraw a certificate ofneed or to grant or deny an exemption shall be administratively reviewed underan appeals mechanism provided for in the rules and regulations of the stateagency, with the review to be conducted by a hearing officer appointed by thedirector of health. The procedures for judicial review shall be in accordancewith the provisions of § 42-35-15.
(c) The state agency shall publish at least annually a reportof reviews of new institutional health services and new health care equipmentconducted, together with the findings and decisions rendered in the course ofthe reviews. The reports shall be published on or about February 1 of each yearand shall contain evaluations of the prior year's statutory changes wherefeasible.
(d) All applications reviewed by the state agency and allwritten materials pertinent to state agency review, including minutes of allhealth services council meetings, shall be accessible to the public uponrequest.
(e) In the case or review of proposals by health carefacilities who by contractual agreement, chapter 19 of title 27, or otherstatute are required to adhere to an annual schedule of budget or reimbursementdetermination to which the state is a party, the state budget office, theoffice of the health insurance commissioner, and hospital service corporationsorganized under chapter 19 of title 27 shall forward to the health servicescouncil within forty-five (45) days of the initiation of the review of theproposals by the health services council under § 23-15-4(f)(1):
(1) A cost impact analysis of each proposal which analysisshall include, but not be limited to, consideration of increases in operatingexpenses, per diem rates, health care insurance premiums, and publicexpenditures; and
(2) Comments on acceptable interest rates and minimum equitycontributions and/or maximum debt to be incurred in financing needed proposals.
(f) The health services council shall not make arecommendation to the state agency that a proposal be approved unless it isfound that the proposal is affordable to the people of the state. Indetermining whether or not a proposal is affordable, the health service councilshall consider the condition of the state's economy, the statements ofauthorities and/or parties affected by the proposals, and any other factorsthat it may deem appropriate.