Alabama Administrative Code › Title 410 - STATE HEALTH PLANNING AND DEVELOPMENT AGENCY › Chapter 410-1-4 - SCOPE OF REVIEW › Section 410-1-4-.01 - New Institutional Health Services Subject To Review

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All new
			 institutional health services which are subject to Section
			 22-21-260, et. seq..
Code of Ala. 1975
, and which are proposed to be
			 offered or developed within the state shall be subject to Certificate of Need
			 review. New institutional health services which are subject to review shall
			 include:
(a) the construction, development,
			 acquisition through lease or purchase or other establishment of a new health
			 care facility or health maintenance organization; or
(b) any expenditure by or on behalf of a
			 health care facility or health maintenance organization, which, under generally
			 accepted accounting principles consistently applied, is a capital expenditure
			 in excess of:
1. $2,000,000.00 indexed
			 annually for inflation for major medical equipment; or
2. resulting in excess of $800,000.00 for new
			 annual operating costs indexed annually for inflation; or
3. $4,000,000.00 indexed annually for
			 inflation for any other capital expenditure by or on behalf of a health care
			 facility or health maintenance organization; or
(c) any change in the existing licensed bed
			 capacity of a health care facility or health maintenance organization through
			 the:
1. addition of new beds;
2. the relocation of one or more beds from
			 one physical facility to another, (that is, one geographically separate
			 location to another); or
3.
			 reallocation among services of existing beds through the conversion of one or
			 more beds from one category to another within the following bed categories:
(i) general medical surgical
(ii) inpatient psychiatric
(iii) inpatient/residential alcohol and drug
			 abuse
(iv) inpatient
			 rehabilitation
(v) long term care
			 beds including skilled nursing care, intermediate care, transitional care, and
			 swing beds; or
(d) any health service which is proposed to
			 be offered in or through a health care facility or health maintenance
			 organization, and which was not offered on a regular basis in or through such
			 health care facility or health maintenance organization within the twelve-month
			 (12 month) period prior to the time such services would be offered, including,
			 without limitation, health services to be provided through equipment obtained
			 from vendors or lessors of equipment, provided, however, that a vendor or
			 lessor of equipment which does not materially engage in the provision of the
			 health service shall not be required to obtain a CON; or
(e) the acquisition, by any person, of major
			 medical equipment that will
1. be owned by or
			 located in a health care facility, or which will be used to provide health
			 services to persons admitted to a health care facility; provided, however, that
			 an acquisition of major medical equipment need not be reviewed if it will be
			 used to provide services to inpatients of a health care facility only on a
			 temporary basis in the case of a natural disaster, major accident, or equipment
			 failure; or
2. if a person acquires
			 major medical equipment not located in a health care facility without a
			 Certificate of Need and proposes at any time to use that equipment to serve
			 inpatients of a health care facility, then the proposed new use must be
			 reviewed unless the equipment will be used to provide services to inpatients of
			 a health care facility only on a temporary basis not to exceed six weeks in the
			 case of an emergency, a natural disaster, a major accident, or an equipment
			 failure. An extension of the six-week time period may be granted by the
			 Certificate of Need Review Board. For the purposes of this section, "temporary
			 basis" means on an occasional or irregular basis or until the applicant's
			 proposal for permanent acquisition or regular use by a health care facility is
			 reviewed under the formal review process; or
3. an acquisition made by or on behalf of a
			 health care facility under lease or comparable arrangement, or through
			 donation, which would have required a Certificate of Need if the acquisition
			 had been by purchase.
(f) For purposes of subsection (c)(3)(i)
			 above, "General Medical Surgical" shall be defined as encompassing all acute
			 care beds not otherwise included in subsections (c)(3)(ii)-(iv)
(g) Any other proposal which is related to
			 one or more of the foregoing, or any variation or combination thereof which
			 would be reviewable within the meaning of the statute.
(h) Notwithstanding all other provisions of
			 these rules to the contrary, those facilities and distinct units operated by
			 the Department of Mental Health and Mental Retardation and those facilities and
			 distinct units operating under contract or subcontract with the Department of
			 Mental Health and Mental Retardation where the contract constitutes the primary
			 source of income to the facility shall not be subject to review under this
			 article.
(i) Notwithstanding any
			 other provisions of these rules to the contrary, the definition a new
			 institutional health service shall not include any health services provided by
			 a mobile or fixed-based extra corporeal shock wave lithotripter, a mobile or
			 fixed-based magnetic resonance imaging scanner and/or a mobile or fixed-based
			 positron emission tomography scanner.
(j) Notwithstanding any other provisions of
			 these rules to the contrary, the modernization or construction of a
			 non-clinical building, parking facility or any other non-institutional health
			 services capital item on the existing campus of a health care facility shall be
			 exempt from Certificate of Need review provided the construction or
			 modernization does not allow the health care facility to provide any new
			 institutional health services subject to review and not previously provided on
			 a regular basis.
(k) Any reference
			 contained in these rules to an "index" shall be a reference to the Consumer
			 Price Index Market Basket Professional Medical Services Index as published by
			 the U. S. Department of Labor, Bureau of Labor statistics.