West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-24 - Exemption For Birthing Centers › Section 65-24-4 - Exemption Procedure

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. Each
				applicant seeking an exemption pursuant to this rule, must file with the board
				a letter of intent at least fifteen (15) days before the submission of the
				application. The letter of intent shall contain sufficient information to
				advise the board of the nature of the exemption sought and outline the grounds
				for the exemption.
4.2. Upon
				receipt of the letter of intent, the board shall publish a notice in the
				Saturday Charleston newspapers and the State Register. The notice shall
				identify the legal entity seeking an exemption, the type of exemption
				requested, and a description of the proposal. The notice shall also state the
				rights of affected parties to a hearing.
4.3. In order to obtain the exemption, each
				applicant must file an application with the board no sooner than the fifteenth
				(15th) day or later than the thirtieth (30th) day following the filing of the
				letter of intent. The application shall contain the following:
4.3.1. Information that demonstrates that the
				applicant meets the exemption criteria contained in subsections 3.1, 3.2, and
				3.3 of this rule. This information shall include a copy of the agreement
				between the applicant and the hospital which agrees to accept referrals from
				the applicant;
4.3.2. A copy of the
				applicant's by-laws and a list of the members of its governing board, including
				the name, occupation, address, and telephone number of each board member. The
				by-laws must fully describe the composition of the community board;
4.3.3. Appropriate documentation of the
				applicant's tax exempt non-profit status, such as a copy of the organization's
				501(c)(3) non-profit letter or a copy of the application for such designation
				or proof as a designated government entity;
4.3.4. A map detailing the geographical
				boundaries of the applicant's existing and projected service area and an
				estimate of the population within the service area, with an explanation how the
				population figure was derived. The map shall show the mileage from the site of
				the proposed birthing center to other birthing centers in the region;
4.3.5. A description of the financial
				feasibility of delivering and maintaining the proposed birthing center, the
				start-up funding involved, the applicant's budget, most recent audit and
				financial statement; and capital expenditures for the project.
4.3.6. A listing of projected physician(s),
				other practitioners, administrators, and other site staff to be employed by the
				organization, if available, identified by name, and in addition, a summary of
				what recruitment prospects exist or are being planned for vacant
				positions;
4.3.7. A timetable of
				the projected opening of the site to include source of funding, recruitment
				plans, occupancy (lease, rent, purchase, or construct), staffing, and other
				factors relevant to the opening of the site;
4.3.8. Information with respect to the
				projected annual number of users and encounters to be served at the site. In
				instances involving an existing site that is planning to add a birthing center,
				actual information regarding the operating budget, users, and encounters is to
				be provided; and
4.3.9. A
				verification signed by the chairperson of the applicant's governing board and,
				if the applicant is a hospital, chief executive officer of the
				hospital.