Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-2 - HEALTH PLANNING › Subject 111-2-2 - CERTIFICATE OF NEED › Rule 111-2-2-.08 - Alternative Application and Review Procedures

Current through Rules and Regulations filed through June 27, 2024
(1)
Batching Review Process
(a) Pursuant to O.C.G.A. §
										31-6-43(e), the
				Department may limit the time periods during which it will accept applications
				for the following health care facilities and/or services: skilled nursing
				facilities; intermediate care facilities; home health agencies, open heart
				surgical services, pediatric cardiac catheterization and open heart services,
				perinatal services, freestanding birthing centers, psychiatric and substance
				abuse services, comprehensive inpatient physical rehabilitation services,
				ambulatory surgical services, positron emission tomography services, and
				megavoltage radiation therapy services. Limitation of the time periods shall be
				to only such times after the Department has determined there is an unmet need
				for such facilities and/or services, or will accept applications pursuant to
				any service- specific need standard exceptions. The Department shall make a
				determination as to whether or not there is an unmet need for each type of
				facility at least every six (6) months and shall notify those requesting such
				notification of that determination. No application for the services listed
				above will be accepted for review by the Department except as provided for
				pursuant to Ga. Comp. R. & Regs. r.
				111-2-2-.08(1). For
				purposes of batching only, the applications entered into the one hundred twenty
				(120) day review period shall be evaluated according to the data used to
				publish the unmet need, or to accept applications pursuant to any
				service-specific need standard exceptions, for the particular service at issue,
				for those services listed above, and not the latest available data at the time
				of decision, as is the case with all non-batched applications.
(b) Upon the determination of an unmet need
				for a particular facility/service in a given service area, the Department shall
				provide notice indicating which applications will be considered in that
				particular batching cycle to all interested parties requesting notice of that
				determination. It shall be the sole and exclusive responsibility of the
				interested party to notify the Department in writing of that party's desire to
				be informed of the Department's unmet need determination(s) for batching
				purposes. The Department's notice shall contain the unmet need for the type of
				facility/service in the given service area(s) and shall also contain the
				pertinent time frames and deadlines for submission of notices of intent to
				apply, for submission of applications, and the review of such
				applications.
(c) All parties
				interested in applying for the particular unmet need in a given service area
				must notify the Department of that party's intent to apply.
1. The notice must be in writing, submitted
				via the Department's web portal, and must address specifically the type of
				unmet need and service area(s) for which the applicant intends to
				apply.
2. The notice of intent must
				be received by the Department no later than the close of business on the
				thirtieth (30th) calendar day following the date that the Department publishes
				the determination of unmet need. In the event that the thirtieth (30th)
				calendar day falls on either a weekend or a legal holiday, the thirtieth (30th)
				calendar day shall become automatically the next business day that is neither a
				weekend nor a legal holiday.
3.
				Notwithstanding any other relevant provisions within this Rule, the notice of
				intent to apply must be received by the Department either before or
				simultaneously with the submission of the actual application in accordance with
				the notice of intent deadline.
4.
				In the event that the Department fails to receive the notice of intent to apply
				by the stated deadline, the interested party shall be disqualified
				automatically from applying during that batching cycle.
(d) Subject to the proper submission of a
				notice of intent to apply, any interested party shall use the Department's web
				portal to submit an application no later than 12:00 P.M. on the sixtieth (60th)
				calendar day following the date that the Department publishes the determination
				of unmet need. In the event that the sixtieth (60th) calendar day falls either
				on a weekend or a legal holiday, the sixtieth (60th) calendar day shall become
				automatically the next business day that is neither a weekend nor a legal
				holiday. For purposes of batching only, all properly submitted applications
				will be deemed received on the sixtieth (60th) day, regardless of the actual
				date of submission.
(e) For the
				purposes of batching only, an application which has been deemed received
				according to (d) above, will only be deemed properly submitted and complete if
				the following requirements, in addition to the requirements of Ga. Comp. R.
				& Regs. r.
				111-2-2-.06(5), are
				met:
1. The appropriate Certification
				Statement (an applicable service-specific related checklist) is submitted
				simultaneously with the original application; and
2. All of the items addressed in the
				Certification Statement are provided, as certified, with the original
				application.
(f) In the
				event that an application is deemed in receipt by (d) above, but is not deemed
				to be properly submitted and complete by (e) above by 12:00 PM on the sixtieth
				(60th) calendar day following the date that the Department publishes the
				determination of unmet need (in the event that the sixtieth (60th) calendar day
				falls either on a weekend or a legal holiday, the sixtieth (60th) calendar day
				shall become automatically the next business day that is neither a weekend nor
				a legal holiday), the application will be disqualified from the batching
				review.
(g) The batching review
				cycle will be conducted in the following manner:
1. The batching review cycle shall be one
				hundred and twenty (120) days in duration. As a result, no party participating
				in the batching review process, including the Department, shall either request
				or be granted an extension of time past the one hundred and twentieth (120th)
				day.
2. The first day of the
				batching review cycle shall be the day upon which all properly submitted
				applications are deemed to be received. [See Ga. Comp. R. & Regs. r.
				111-2-2-.08(1)(d)
				above.]
3. On or before the
				sixtieth (60th) day of the batching review cycle, the Department shall provide
				the applicant(s) an opportunity to meet with the Department. The Department
				will describe any issues with the application and provide an opportunity to the
				applicant(s) to amend or withdraw the application or to submit additional
				information. Any and all additional information must be submitted on or before
				the seventy-fifth (75th) day of the batching review cycle. The sixty (60) day
				meeting with the applicant(s) is restricted to the Department and the
				applicant(s). Parties opposing an application(s) may not attend or participate
				in an applicant sixty (60) day meeting.
4. Any party who is opposed to one or more
				applications submitted during a batching cycle must submit a notice of
				opposition via the Department's web portal, on the form provided by the
				Department, no later than the sixtieth (60th) day of the batching review cycle.
				The notice must contain the information specified by the form. The notice of
				opposition form submission shall also include one signed original of the
				written vendor lobbyist certification required by Ga. Comp. R. & Regs. r.
				111-1-2-.03(2). The
				notice of opposition must not contain the substantive arguments against a
				particular application.
Those parties who are opposed to an application will be given
				  an opportunity to meet with the Department at a time and place specified by the
				  Department after a review of the opposition notices. The opposition meeting,
				  provided for by O.C.G.A. §
												31-6-43(h), shall
				  be held no earlier than the ninetieth (90th) day of the batching review cycle.
				  The applicant(s) shall be entitled to attend the opposition meeting. Only one
				  designated person on behalf of each party opposed to a particular application
				  will be allowed to speak on behalf of the opposition to said application at the
				  opposition meeting. The time period provided for that opposition spokesperson
				  shall be determined in the sole discretion of the Department. The applicant(s)
				  will not be allowed to speak in rebuttal of the opposition remarks at the
				  opposition meeting. The Department shall make no formal substantive comments
				  regarding the review of the application(s) at the opposition meeting. The
				  opposition parties shall submit via the Department's web portal, substantive
				  written comments and arguments regarding the nature of their opposition to the
				  particular project. The opposition parties must provide one copy of the
				  substantive opposition comments to the applicant at the opposition meeting. In
				  order for an opposing party to have standing to appeal an adverse decision
				  pursuant to O.C.G.A. §
												31-6-44, such party must attend
				  and participate in an opposition meeting. Substantive opposition comments must
				  pertain to only one application and one applicant. In no case shall the
				  Department accept substantive opposition comments that concerns multiple
				  applicants or applications.
Letters of support for a particular application must be
				  submitted pursuant to and in compliance with Ga. Comp. R. & Regs. r.
				  111-2-2-.06(6) via
				  the Department's web portal and can be submitted no later than the one
				  hundredth (100th) day of the batching review cycle.
5. Applicants shall be given the opportunity
				to respond to the substantive opposition comments made orally and submitted in
				writing at the opposition meeting. The last day for the applicant(s) to submit
				final amendments to the application and/or to respond to the opposition meeting
				comments, shall be the one hundred and tenth (110th) day of the batching review
				cycle. The Department reserves the right, but is not required to, ask the
				applicant(s) for information in response to the substantive opposition
				comments. If the Department asks the applicant for information as a result of
				the comments provided at the opposition meeting, the applicant must submit the
				information requested no later than the one hundred and tenth (110th) day of
				the batching review cycle.
6. No
				later than the one hundred and twentieth (120th) day of the batching review
				cycle, the Department shall provide written notification of its decision to
				issue or deny a Certificate of Need to the pertinent applicant(s).
(h) In evaluating batched
				applications, if any or all of the batched applications equally meet the
				statutory considerations, priority consideration will be given to a comparison
				of the applications with regard to:
1. The
				past and present records of the facility, and other existing facilities in
				Georgia, if any, owned by the same parent organization, regarding the provision
				of service to all segments of the population, particularly including Medicare,
				Medicaid, minority patients and those patients with limited or no ability to
				pay;
2. Specific services to be
				offered;
3. Appropriateness of the
				site, i.e., the accessibility to the population to be served, availability of
				utilities, transportation systems, adequacy of size, cost of acquisition, and
				cost to develop;
4. Demonstrated
				readiness to implement the project, including commitment of
				financing;
5. Patterns of past
				performance, if any, of the applicants in implementing previously approved
				projects in a timely fashion;
6.
				Past record, if any, of the applicant facility, and other existing facilities
				owned by the same parent organization, if any, in meeting licensure
				requirements and factors relevant to providing accessible, quality health
				care;
7. Evidence of attention to
				factors of cost containment, which do not diminish the quality of care or
				safety of the patient, but which demonstrate sincere efforts to avoid
				significant costs unrelated to patient care; and
8. Past compliance, if any, with survey and
				post-approval reporting requirements and indigent and charity care
				commitments.
(i) In the
				event of a favorable decision, the Department's notification letter shall serve
				as the Certificate of Need. The date of the decision shall be the date on the
				notification letter of the Department. The decision shall be to approve or deny
				the application(s) as submitted or as amended by the applicant(s) during the
				course of the batching review cycle, whichever is applicable. The effective
				date of the Certificate shall be the decision or approval date if not appealed.
				If administratively appealed in a timely fashion, the effective date of the
				Certificate shall be the date of final resolution of any administrative
				hearing. The Department may stay the effective date of a project appealed
				through judicial process at the request of any party to such appeal or upon the
				Department's own initiative. Any determination by the Department to stay the
				effective date will be based upon sound health planning principles. If the
				Department stays the effective date of a project appealed through judicial
				process, the effective date shall be the date of final resolution of any
				judicial appeal.
(j) The decision
				letter shall contain at least the following:
1. A detailed statement of the findings
				related to each applicable consideration and standard relevant to the decision
				to issue or deny a Certificate of Need; and
2. Information pertaining to the availability
				of an appeal hearing.
(k)
				A copy of the notification letter shall be sent to the applicant(s), to the
				appropriate Regional Development Center and to the chief elected official of
				the applicable county and municipal government, if any. The Department's
				decision shall be subject to the provisions of the Open Records Act.
(l) Appeals of the Decision of the Department
				shall be in accordance with the Rules promulgated by the Certificate of Need
				Appeal Panel found in Ga. Comp. R. & Regs. Chapter 274.