32.1-102.3 - Certificate required; criteria for determining need.
§ 32.1-102.3. Certificate required; criteria for determining need.
A. No person shall commence any project without first obtaining a certificateissued by the Commissioner. No certificate may be issued unless theCommissioner has determined that a public need for the project has beendemonstrated. If it is determined that a public need exists for only aportion of a project, a certificate may be issued for that portion and anyappeal may be limited to the part of the decision with which the appellantdisagrees without affecting the remainder of the decision. Any decision toissue or approve the issuance of a certificate shall be consistent with themost recent applicable provisions of the State Medical Facilities Plan;however, if the Commissioner finds, upon presentation of appropriateevidence, that the provisions of such plan are not relevant to a rurallocality's needs, inaccurate, outdated, inadequate or otherwise inapplicable,the Commissioner, consistent with such finding, may issue or approve theissuance of a certificate and shall initiate procedures to make appropriateamendments to such plan. In cases in which a provision of the State MedicalFacilities Plan has been previously set aside by the Commissioner andrelevant amendments to the Plan have not yet taken effect, the Commissioner'sdecision shall be consistent with the applicable portions of the StateMedical Facilities Plan that have not been set aside and the remainingconsiderations in subsection B.
B. In determining whether a public need for a project has been demonstrated,the Commissioner shall consider:
1. The extent to which the proposed service or facility will provide orincrease access to needed services for residents of the area to be served,and the effects that the proposed service or facility will have on access toneeded services in areas having distinct and unique geographic,socioeconomic, cultural, transportation, and other barriers to access to care;
2. The extent to which the project will meet the needs of the residents ofthe area to be served, as demonstrated by each of the following: (i) thelevel of community support for the project demonstrated by citizens,businesses, and governmental leaders representing the area to be served; (ii)the availability of reasonable alternatives to the proposed service orfacility that would meet the needs of the population in a less costly, moreefficient, or more effective manner; (iii) any recommendation or report ofthe regional health planning agency regarding an application for acertificate that is required to be submitted to the Commissioner pursuant tosubsection B of § 32.1-102.6; (iv) any costs and benefits of the project; (v)the financial accessibility of the project to the residents of the area to beserved, including indigent residents; and (vi) at the discretion of theCommissioner, any other factors as may be relevant to the determination ofpublic need for a project;
3. The extent to which the application is consistent with the State MedicalFacilities Plan;
4. The extent to which the proposed service or facility fosters institutionalcompetition that benefits the area to be served while improving access toessential health care services for all persons in the area to be served;
5. The relationship of the project to the existing health care system of thearea to be served, including the utilization and efficiency of existingservices or facilities;
6. The feasibility of the project, including the financial benefits of theproject to the applicant, the cost of construction, the availability offinancial and human resources, and the cost of capital;
7. The extent to which the project provides improvements or innovations inthe financing and delivery of health services, as demonstrated by: (i) theintroduction of new technology that promotes quality, cost effectiveness, orboth in the delivery of health care services; (ii) the potential forprovision of services on an outpatient basis; (iii) any cooperative effortsto meet regional health care needs; and (iv) at the discretion of theCommissioner, any other factors as may be appropriate; and
8. In the case of a project proposed by or affecting a teaching hospitalassociated with a public institution of higher education or a medical schoolin the area to be served, (i) the unique research, training, and clinicalmission of the teaching hospital or medical school, and (ii) any contributionthe teaching hospital or medical school may provide in the delivery,innovation, and improvement of health care for citizens of the Commonwealth,including indigent or underserved populations.
(1982, c. 388; 1984, c. 740; 1993, c. 704; 1999, c. 926; 2000, c. 931; 2004,cc. 71, 95; 2008, c. 292; 2009, c. 175.)