Source: https://www.richmondsunlight.com/bill/2017/hb2458/fulltext/
Timestamp: 2020-08-07 13:04:26
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Matched Legal Cases: ['§ 2', '§ 2', '§ 32', '§ 2', '§ 2', '§ 32', '§ 32', '§ 32', '§ 32', '§ 32', '§ 32', '§ 2', '§ 2']

Richmond Sunlight » HB2458: Certificate of public need; reports.
HB2458: Certificate of public need; reports.
HOUSE BILL NO. 2458 AMENDMENT IN THE NATURE OF A SUBSTITUTE (Proposed by the House Committee on Health, Welfare and Institutions on January 31, 2017) (Patron Prior to Substitute--Delegate Stolle) A BILL to amend and reenact §§ 2.2-4006, 32.1-102.1, 32.1-102.2, 32.1-102.2:1, 32.1-102.3, and 32.1-102.6 of the Code of Virginia and to amend the Code of Virginia by adding in Article 1.1 of Chapter 4 of Title 32.1 a section numbered 32.1-102.01, by adding a section numbered 32.1-102.2:2, and by adding in Chapter 4 of Title 32.1 an article numbered 9, consisting of a section numbered 32.1-122.23, relating to Certificate of Public Need Program; reports.
1. That §§ 2.2-4006, 32.1-102.1, 32.1-102.2, 32.1-102.2:1, 32.1-102.3, and 32.1-102.6 of the Code of Virginia are amended and reenacted and that the Code of Virginia is amended by adding in Article 1.1 of Chapter 4 of Title 32.1 a section numbered 32.1-102.01, by adding a section numbered 32.1-102.2:2, and by adding in Chapter 4 of Title 32.1 an article numbered 9, consisting of a section numbered 32.1-122.23, as follows:
16. Amendments to the State Health Services Plan adopted by the Board of Health following review by the State Health Services Advisory Council pursuant to § 32.1-102.2:1 if the Board (i) provides a Notice of Intended Regulatory Action in accordance with the requirements of § 2.2-4007.01, (ii) provides notice and receives comment as provided in § 2.2-4007.03, and (iii) conducts at least one public hearing on the proposed amendments.
4. 3. Intermediate care facilities, except those intermediate care facilities established for individuals with intellectual disability (ICF/MR) that have no more than 12 beds and are in an area identified as in need of residential services for individuals with intellectual disability in any plan of the Department of Behavioral Health and Developmental Services.
7. 5. Facilities for individuals with intellectual disability.
1. Establishment of a medical care facility other than a specialized center or clinic or that portion of a physician's office developed for the provision of outpatient tor ambulatory surgery;
2. An increase in (i) the total number of beds or operating rooms in an existing medical care facility or (ii) the total number of operating rooms in an existing medical care facility when the operating room is proposed to be added to an existing medical care facility located in a health planning district in which the utilization of existing operating rooms in the health planning district does not exceed 80 percent of the maximum operating room hour availability for the health planning district when the determination of maximum operating room hour availability is based on the assumption that each operating room in the health planning district is available 40 hours per week, 50 weeks per year;
9. Conversion in an existing medical care facility of psychiatric inpatient beds approved pursuant to a Request for Applications (RFA) to nonpsychiatric inpatient beds; or
10. The establishment of any specialized center or clinic or that portion of a physician's office developed for the provision of outpatient or ambulatory surgery when such specialized center or clinic or portion of a physician's office is proposed to be established in a health planning district in which the utilization of existing operating rooms in the health planning district does not exceed 80 percent of the maximum operating room hour availability for the health planning district when the determination of maximum operating room hour availability is based on the assumption that each operating room in the health planning district is available 40 hours per week, 50 weeks per year.
1. Shall establish concise procedures for the prompt review of applications for certificates consistent with the provisions of this article which may include a structured batching process which incorporates, but is not limited to, authorization for the Commissioner to request proposals for certain projects. In any structured batching process established by the Board, applications, combined or separate, for computed tomographic (CT) scanning, magnetic resonance imaging (MRI), positron emission tomographic (PET) scanning, radiation therapy, sterotactic stereotactic radiotherapy, or proton beam therapy, or nuclear imaging shall be considered in the radiation therapy batch. A single application may be filed for a combination of (i) radiation therapy, sterotactic stereotactic radiotherapy, and proton beam therapy, and (ii) any or all of the computed tomographic (CT) scanning, magnetic resonance imaging (MRI), and positron emission tomographic (PET) scanning, and nuclear medicine imaging;
6. 5. Shall establish an expedited 45-day application and review process for any certificate for (i) projects reviewable pursuant to subdivision 8 of the definition of "project" in § 32.1-102.1 and (ii) projects identified by the Board in regulations to be generally uncontested and to present limited health planning impacts. Regulations establishing the expedited application and review procedure shall include provisions for notice and opportunity for public comment on the application for a certificate, and criteria pursuant to which an application that would normally undergo the review process would instead undergo the full certificate of public need review process set forth in § 32.1-102.6.
C. The Board shall also promulgate regulations authorizing the Commissioner to condition approval of a certificate on the agreement of the applicant to provide a level of care at a reduced rate to indigents or accept patients requiring specialized care. Such regulations shall set forth a methodology and formulas for uniform application of, active measuring and monitoring of compliance with, and approval of alternative plans for compliance in satisfaction of such conditions. In addition, the Board's licensure regulations shall direct the Commissioner to condition the issuing or renewing of any license for any applicant whose certificate was approved upon such condition on whether such applicant has complied with any agreement to provide a level of care at a reduced rate to indigents or accept patients requiring specialized care.
D. The Board shall also promulgate regulations to require the registration of a project; for introduction into an existing medical care facility of any new lithotripsy, obstetrical, or nuclear imaging services that the facility has never provided or has not provided in the previous 12 months; and for the addition by an existing medical care facility of any medical equipment for lithotripsy. Replacement of existing equipment for lithotripsy or nuclear imaging services shall not require registration. Such regulations shall include provisions for (i) establishing the agreement of the applicant to provide a level of care in services or funds that match the average percentage of indigent care provided in the appropriate health planning region and to participate in Medicaid at a reduced rate to indigents, (ii) obtaining accreditation from a nationally recognized accrediting organization approved by the Board for the purpose of quality assurance, and (iii) reporting utilization and other data required by the Board to monitor and evaluate effects on health planning and availability of health care services in the Commonwealth.
A. There is hereby established in the executive branch of state government the State Health Services Plan Advisory Council for the purpose of advising the Board on the content of the State Health Services Plan. The Advisory Council shall provide recommendations related to (i) periodic revisions to the State Health Services Plan, (ii) the appropriateness of a certificate of public need review for certain projects, (iii) whether certain projects should be subject to expedited review rather than the full review process, and (iv) improvements in the certificate of public need process. All such recommendations shall be developed in accordance with an analytical framework established by the Commissioner for such purpose.
B. The Advisory Council shall consist of the Commissioner and 13 citizen members appointed by the Commissioner as follows: two representatives each of the Virginia Hospital and Healthcare Association, the Medical Society of Virginia, the Virginia Health Care Association, and of physicians or administrators representing teaching hospitals affiliated with a public institution of higher education; one representative each of the Virginia Association of Health Plans, a company that is self-insured or full-insured for health coverage, a nonprofit organization located in the Commonwealth that engages in addressing access to health coverage for low-income individuals, and a rural locality recognized as a medically underserved area; and one individual with experience in health facilities planning. In making such appointments, the Commissioner shall, to the extent feasible, assure that the membership of the Advisory Council is broadly representative of the interests of all residents of the Commonwealth and of the various geographic regions. The Commissioner shall serve a term coincident with his term in office. All other members of the Advisory Council shall serve two-year terms and may be reappointed. Appointments to fill vacancies, other than by expiration of a term, shall be made for the unexpired term. All vacancies shall be filled in the same manner as the original appointment.
§ 32.1-102.2:2. Powers and duties of State Health Services Plan Advisory Council.
1. To develop, by November 1, 2017 or as soon as practicable thereafter, recommendations for a comprehensive State Health Services Plan for adoption by the Board that includes (i) specific formulas for projecting need for medical care facilities and services subject to the requirement to obtain a certificate of public need; (ii) current statistical information on the availability of medical care facilities and services; (iii) objective criteria and standards for review of applications for projects for medical care facilities and services; and (iv) methodologies for integrating the goals and metrics of the State Health Improvement Plan established by the Commissioner into the criteria and standards for review. Criteria and standards for review included in the State Health Services Plan shall take into account current data on drive times, utilization, availability of competing services and patient choice within and among localities included in the health planning district or region, changes and availability of new technology, and other relevant factors identified by the Advisory Council. The State Health Services Plan shall also include specific criteria for determining need in rural areas, giving due consideration to distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to care in such areas and providing for weighted calculations of need based on the barriers to health care access in such rural areas in lieu of the determinations of need used for the particular proposed project within the relevant health planning district or region as a whole.
2. To engage the services of private consultants or request the Department to contract with any private organization for professional and technical assistance and advice or other services to assist the Advisory Council in carrying out its duties and functions pursuant to this section. The Advisory Council may also solicit the input of experts with professional competence in the subject matter of the State Health Services Plan, including representatives of licensed health care providers or health care provider organizations owning or operating licensed health facilities, and representatives of organizations concerned with health care consumers and the purchasers and payers of health care services; and
3. To review annually and, if necessary, develop recommendations for revisions to each section of the State Health Services Plan on a rotating schedule defined by the Advisory Council at least every two years following the last date of adoption by the Board.
C. Not less than 30 days prior to final action on any recommendation of the Advisory Council, the Advisory Council shall (i) submit the proposed action and a concise summary of the expected impact of the proposed action for comment to each member of the Board for review and comment and (ii) solicit public comment on such recommendation. All comments received by the Advisory Council shall be submitted to and reviewed by the Commissioner. If the Commissioner determines that a public hearing is necessary or appropriate to seek further input on a recommendation, the Commissioner may hold one public hearing. Any public hearing shall be conducted no more than 30 days after the close of the public comment period. Prior to such public hearing, the Commissioner shall notify the Board and shall cause notice of the public hearing to be published on the Department's website. Following completion of the public comment period, and if applicable, the public hearing, the Advisory Council shall either approve or disapprove of the proposed recommendation. All final recommendations shall be communicated to the Board for consideration at its next regularly scheduled meeting. No recommendation of the Advisory Council shall become effective until such time as it is approved by the Board.
3. The extent to which the application is consistent with the State Medical Facilities Health Services Plan;
A. To obtain a certificate for a project, the applicant shall file a completed application for a certificate with the Department and the appropriate regional health planning agency if a regional health planning agency has been designated for that region. An application submitted for review shall be considered complete when all relevant sections of the application form have responses. The applicant shall provide sufficient information to prove public need for the requested project exists without the addition of supplemental or supporting material at a later date. The Department shall ensure that only data necessary for review of an application is required to be submitted and that the application reflects statutory requirements. Nothing in this section shall prevent the Department from seeking, at its discretion, additional information from the applicant or other sources.
In order to verify the date of the Department's and the appropriate regional health planning agency's receipt of the application, the applicant shall transmit the document electronically, by certified mail or a delivery service, return receipt requested, or shall deliver the document by hand, with signed receipt to be provided.
B. For projects proposed in health planning regions with regional planning agencies, the appropriate regional health planning agency shall (i) review each completed application for a certificate within 60 calendar days of the day which begins the appropriate batch review cycle as established by the Board by regulation pursuant to subdivision A 1 of § 32.1-102.2, such cycle not to exceed 190 days in duration, and (ii) (i) within 10 calendar days following receipt of the completed application, solicit public comment on such application by posting notice of such application and a summary of the proposed project on a website maintained by the Department; such notice shall include information about how comments may be submitted to the regional health planning agency and the date on which the public comment period shall expire, which shall be no later than 45 calendar days following the date of the public notice, and (ii) in the case of competing applications or in response to a written request by an elected local government representative, member of the General Assembly, the Commissioner, the applicant, or a member of the public, hold one public hearing on each application in a location in the county or city in which the project is proposed or a contiguous county or city. Prior to the any required public hearing, the regional health planning agency shall notify the local governing bodies in the planning district. At least nine days prior to the public hearing, the regional health planning agency shall cause notice of the public hearing to be published in a newspaper of general circulation in the county or city where the project is proposed to be located. The regional health planning agency shall consider the comments of the local governing bodies in the planning district and all other public comments in making its decision. Such comments shall be part of the record. In no case shall a regional health planning agency hold more than two meetings on any application, one of which shall be the public hearing required pursuant to clause (ii), if any, conducted by the board of the regional health planning agency or a subcommittee of the board. The applicant shall be given the opportunity, prior to the vote by the board of the regional health planning agency or a committee of the agency, if acting for the board, on its recommendation, to respond to any comments made about the project by the regional health planning agency staff, any information in a regional health planning agency staff report, or comments by those voting members of the regional health planning agency board; however, such opportunity shall not increase the 60-calendar-day period designated herein for the regional health planning agency's review unless the applicant or applicants request a specific extension of the regional health planning agency's review period.
If no regional health planning agency has been designated for a region, the Department shall (i) solicit public comment on such application by posting notice of such application and a summary of the proposed project on a website maintained by the Department, together with information about how comments may be submitted to the Department and the date on which the public comment period shall expire, and (ii) in the case of competing applications or in response to a written request by an elected local government representative, member of the General Assembly, the Commissioner, the applicant, or a member of the public, hold one hearing on each application in a location in the county or city in which the project is proposed or a contiguous county or city. Prior to the any required hearing, the Department shall notify the local governing bodies in the planning district in which the project is proposed. At least nine days prior to the any required public hearing, the Department shall cause notice of the public hearing to be published in a newspaper of general circulation in the county or city where the project is proposed to be located. The Department shall consider the comments of the local governing bodies in the planning district and all other public comments in making its decision. Such comments shall be part of the record.
3. Any person seeking to be made a party to the case for good cause shall notify the Department of his request and the basis therefor on or before the eightieth calendar day following the day which begins the appropriate batch review cycle, no later than four days after the Department has completed its review and submitted its recommendation on an application and has transmitted the same to the applicants and to persons who have, prior to the issuance of the report, requested a copy in writing, notify the Commissioner, all applicants, and the regional health planning agency, in writing and under oath, stating the grounds for good cause and providing the factual basis therefor.
Article 9. Permits for Certain Medical Care Facility Projects.
§ 32.1-122.23. Permit required; conditions on permits.
A. No person shall (i) add any operating room at any medical care facility as defined in § 32.1-102.1 in a health planning district in which the utilization of existing operating rooms in the health planning district exceeds 80 percent of the maximum operating room hour availability for the health planning district when the determination of maximum operating room hour availability is based on the assumption that each operating room in the health planning district is available 40 hours per week, 50 weeks per year, or (ii) establish any specialized center or clinic or portion of a physician's office for the provision of outpatient or ambulatory surgery in a health planning district in which the utilization of existing operating rooms in the health planning district exceeds 80 percent of the maximum operating room hour availability for the health planning district when the determination of maximum operating room hour availability is based on the assumption that each operating room in the health planning district is available 40 hours per week, 50 weeks per year without first obtaining a permit from the Commissioner.
B. At least 90 days prior to adding an operating room at an existing medical care facility or establishing any specialized center or clinic or portion of a physician's office for the provision of outpatient or ambulatory surgery in a health planning district described in subsection A, a person shall file with the Department an application for a permit, together with a fee determined by the Board. The Commissioner shall issue the permit within 30 days of receipt of the application.
C. The Commissioner shall condition the issuance of a permit upon the agreement of the applicant to (i) provide a specified level of care at a reduced rate to indigents in an amount that matches the average amount of indigent care provided by holders of certificates of public need in the applicant's health planning region, (ii) accept patients requiring specialized care, or (iii) establish charity care policies governing the provision of the permitted services to patients free of charge or at a reduced rate due to the indigence or medical indigence of the patient. Such policies shall include eligibility criteria for charity care and a process whereby a patient may apply for charity care. Such information shall be conspicuously posted in public areas of the applicant's place of practice and shall be (a) provided, in writing, to a patient at the time services are provided; (b) included with any billing statements sent to uninsured patients; and (c) included on any website maintained by the applicant.
The holder of a permit that is subject to conditions pursuant to this subsection shall provide such documentation as may be required by the Commissioner to demonstrate compliance with the conditions imposed.
The Commissioner shall monitor compliance with permit conditions pursuant to this subsection and may impose penalties on a permit holder that fails to comply with such permit conditions. If the permit holder is unable or fails to comply with the conditions imposed by the Commissioner, the Commissioner may, upon request of the permit holder, approve a plan of compliance with alternate methods to satisfy the permit conditions. Such alternate methods may include such other methods for the provision of primary or specialized care to indigent patients or patients requiring specialized care as may be approved by the Commissioner. Any permit holder that fails or refuses to comply with the requirements of a plan of compliance entered into in accordance with this subsection is subject to a civil penalty of up to $100 per violation per day until the date of compliance.
The Commissioner may, pursuant to regulations of the Board, accept requests for and approve amendments to permit conditions pursuant to this subsection upon request of the permit holder.
The Board shall adopt regulations governing the issuance and revocation of permits in accordance with the provisions of this subsection.
D. The Commissioner shall condition the issuance of a permit upon the compliance of the applicant with quality of care standards established by the Board and may revoke a permit issued in accordance with this section in any case in which the permit holder fails to maintain compliance with such standards.
The Board shall adopt regulations governing the issuance and revocation of permits in accordance with the provisions of this subsection, which shall include:
1. Quality of care standards for the specific specialty service that are consistent with nationally recognized standards for such specialty service;
2. A list of those national accrediting organizations having quality of care standards, compliance with which shall be deemed satisfactory to comply with quality of care standards adopted by the Board;
3. Equipment standards and standards for appropriate utilization of equipment and services;
4. Requirements for monitoring compliance with quality of care standards, including data reporting and periodic inspections; and
5. Procedures for the issuance and revocation of permits pursuant to this subsection.
2. That the Secretary of Health and Human Resources shall review charity care services delivered throughout the Commonwealth and shall recommend changes to the definition of charity care and the types of charity care requirements imposed upon various providers of health care services. The Secretary shall report his findings to the Governor and the General Assembly by December 1, 2017.
3. That the Secretary of Health and Human Resources shall implement a system by January 1, 2018, or as soon as possible thereafter to ensure that data needed to evaluate whether an application for a certificate of public need is consistent with the State Health Services Plan requirements are timely and reliable, with such funds as are available.
4. That the Secretary of Health and Human Resources implement a system by January 1, 2018, or as soon as possible thereafter to make all public records pertaining to certificate of public need applications and review process, including letters of intent, available in real time in a searchable, digital format online, with such funds as are available.
5. That the Secretary of Health and Human Resources implement a system by January 1, 2018, or as soon as possible thereafter to make an inventory of capacity authorized by certificates of public need, both operational and not yet operational, available in a digital format online, with such funds as are available.
6. That the Secretary of Health and Human Resources implement a system by January 1, 2018, or as soon as possible thereafter to make charity care conditions, charity care compliance reporting status, details on the exact amount of charity care provided or contributed, and to whom it was provided or contributed available in a digital format online, with such funds as are available.
7. That the Commissioner of Health shall develop and implement, by November 1, 2017, an analytical framework that incorporates review of the State Health Services Plan to support the State Health Services Plan Advisory Council in developing recommendations concerning the appropriateness of certificate of public need for specific medical care facilities and projects, or whether such projects should be subject to expedited review, and improvements in the certificate of public need process. The analytical framework shall include a specific evaluation of whether certificate of public need review is consistent with the goals of (i) meeting the health care needs of the indigent and uninsured citizens of the Commonwealth, (ii) protecting the public health and safety of the citizens of the Commonwealth, (iii) promoting the teaching missions of academic medical centers and private teaching hospitals, and (iv) ensuring the availability of essential health care services in the Commonwealth, and should be aligned with the goals and metrics of the Commonwealth's State Health Improvement Plan. The analytical framework shall also (a) take into consideration components of the approach utilized prior to 2012 in development of the Certificate of Public Need Annual Report; (b) include a recurrent three-year schedule for analysis of all project categories, with procedures for analysis of at least three project categories per year, which shall be developed in such a manner as to ensure that projects that are of relatively low complexity and low cost are analyzed first, and projects that are of relatively high complexity and high cost are analyzed subsequently; (c) include appropriate metrics to evaluate the impact of introducing a more competitive health care framework that could reduce costs and increase access to health care services; and (d) include a process for stakeholder involvement in review and public comment on any recommendations.
8. That the Joint Commission on Health Care shall review the current role of regional health planning agencies in the process for issuance of certificates of public need and shall develop recommendations for methods of eliminating differences in the certificate of public need review process from one region to another, including developing mechanisms to include region-specific analysis and encourage more local input in the certificate of public need review process for all regions, including those that do not have regional health planning agencies. The Joint Commission on Health Care shall develop specific recommendations for eliminating differences in the certificate of public need review process from one region to another and report on the recommendations to the Chairmen of the House Health, Welfare and Institutions and Senate Education and Health Committees by December 1, 2017.
9. That the State Health Services Plan Advisory Council shall review the appropriateness of requiring a certificate of public need for certain projects and make recommendations for the continued requirement of a certificate for those projects reviewed. The first category of projects to be reviewed shall include the addition of any new medical care facility for the provision of computed tomographic (CT) scanning or magnetic resonance imaging (MRI), the addition by any existing medical care facility of any new computed tomographic (CT) scanning or magnetic resonance imaging (MRI) service, and the addition by any existing medical care facility of any new equipment for computed tomographic (CT) scanning or magnetic resonance imaging (MRI).
HOUSE BILL NO. 2458 Offered January 20, 2017 A BILL to amend and reenact §§ 2.2-4006, 32.1-102.1, 32.1-102.2, 32.1-102.2:1, 32.1-102.3, and 32.1-102.6 of the Code of Virginia and to amend the Code of Virginia by adding in Article 1.1 of Chapter 4 of Title 32.1 a section numbered 32.1-102.01 and by adding a section numbered 32.1-102.2:2, relating to Certificate of Public Need program; reports.
1. That §§ 2.2-4006, 32.1-102.1, 32.1-102.2, 32.1-102.2:1, 32.1-102.3, and 32.1-102.6 of the Code of Virginia are amended and reenacted and that the Code of Virginia is amended by adding in Article 1.1 of Chapter 4 of Title 32.1 a section numbered 32.1-102.01 and by adding a section numbered 32.1-102.2:2 as follows:
6. 5. Mental hospitals.
7. 6. Facilities for individuals with intellectual disability.
8. 7. Psychiatric hospitals and intermediate care facilities established primarily for the medical, psychiatric or psychological treatment and rehabilitation of individuals with substance abuse.
9. 8. Specialized centers or clinics or that portion of a physician's office developed for the provision of outpatient or ambulatory surgery, cardiac catheterization, computed tomographic (CT) scanning, stereotactic radiosurgery, lithotripsy, magnetic resonance imaging (MRI), magnetic source imaging (MSI), positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy, proton beam therapy, nuclear medicine imaging, except for the purpose of nuclear cardiac imaging, or such other specialty services as may be designated by the Board by regulation.
10. 9. Rehabilitation hospitals.
11. 10. Any facility licensed as a hospital.
1. To develop, by November 1, 2016, recommendations for a comprehensive State Health Services Plan for adoption by the Board that includes (i) specific formulas for projecting need for medical care facilities and services subject to the requirement to obtain a certificate of public need; (ii) current statistical information on the availability of medical care facilities and services; (iii) objective criteria and standards for review of applications for projects for medical care facilities and services; and (iv) methodologies for integrating the goals and metrics of the State Health Improvement Plan established by the Commissioner into the criteria and standards for review. Criteria and standards for review included in the State Health Services Plan shall take into account current data on drive times, utilization, availability of competing services and patient choice within and among localities included in the health planning district or region, changes and availability of new technology, and other relevant factors identified by the Advisory Council. The State Health Services Plan shall also include specific criteria for determining need in rural areas, giving due consideration to distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to care in such areas and providing for weighted calculations of need based on the barriers to health care access in such rural areas in lieu of the determinations of need used for the particular proposed project within the relevant health planning district or region as a whole.
If no regional health planning agency has been designated for a region, the Department shall (i) solicit public comment on such application by posting notice of such application and a summary of the proposed project on a website maintained by the Department, together with information about how comments may be submitted to the Department and the date on which the public comment period shall expire and (ii) in the case of competing applications or in response to a written request by an elected local government representative, member of the General Assembly, the Commissioner, the applicant, or a member of the public, hold one hearing on each application in a location in the county or city in which the project is proposed or a contiguous county or city. Prior to the any required hearing, the Department shall notify the local governing bodies in the planning district in which the project is proposed. At least nine days prior to the any required public hearing, the Department shall cause notice of the public hearing to be published in a newspaper of general circulation in the county or city where the project is proposed to be located. The Department shall consider the comments of the local governing bodies in the planning district and all other public comments in making its decision. Such comments shall be part of the record.
2. The Secretary of Health and Human Resources shall review charity care services delivered throughout the Commonwealth and shall recommend changes to the definition of charity care and the types of charity care requirements imposed upon various providers of health care services. The Secretary shall report his findings to the Governor and the General Assembly by December 1, 2017.
3. That the Secretary of Health and Human Resources implement a system by January 1, 2018, or as soon as possible thereafter to ensure that data needed to evaluate whether an application for a certificate of public need is consistent with the State Health Services Plan requirements are timely and reliable, with such funds as are available.
8. That the Joint Commission on Health Care shall review the current role of regional health planning agencies in the process for issuance of certificates of public need and shall develop recommendations for methods of eliminating differences in the certificate of public need review process from one region to another, including evaluating possible funding mechanisms to support regional health planning agencies and developing mechanisms to include region-specific analysis and encourage more local input in the certificate of public need review process for all regions including those that do not have regional health planning agencies. The Joint Commission on Health Care shall develop specific recommendations for eliminating differences in the certificate of public need review process from one region to another and report on the recommendations to the Chairmen of the House Health, Welfare and Institutions and Senate Education and Health Committees by December 1, 2017.