A. No certificate may be issued unless the Commissioner has determined that a public need for the project has been demonstrated. If it is determined that a public need exists for only a portion of a project, a certificate may be issued for that portion and any appeal may be limited to the part of the decision with which the appellant disagrees without affecting the remainder of the decision. Any decision to issue or approve the issuance of a certificate shall be consistent with the most recent applicable provisions of the State Health Services Plan; however, if the Commissioner finds, upon presentation of appropriate evidence, that the provisions of such plan are not relevant to a rural locality's needs, inaccurate, outdated, inadequate or otherwise inapplicable, the Commissioner, consistent with such finding, may issue or approve the issuance of a certificate and shall initiate procedures to make appropriate amendments to such plan. In cases in which a provision of the State Health Services Plan has been previously set aside by the Commissioner and relevant amendments to the Plan have not yet taken effect, the Commissioner's decision shall be consistent with the applicable portions of the State Health Services Plan that have not been set aside and the remaining considerations 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 project will provide or increase access to health care services for people in the area to be served and the effects that the proposed project will have on access to health care services in areas having distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to health care;
2. The extent to which the proposed project will meet the needs of people in the area to be served, as demonstrated by each of the following: (i) the level of community support for the proposed project demonstrated by people, businesses, and governmental leaders representing the area to be served; (ii) the availability of reasonable alternatives to the proposed project that would meet the needs of people in the area to be served in a less costly, more efficient, or more effective manner; (iii) any recommendation or report of the regional health planning agency regarding an application for a certificate that is required to be submitted to the Commissioner pursuant to subsection B of § 32.1-102.6; (iv) any costs and benefits of the proposed project; (v) the financial accessibility of the proposed project to people in the area to be served, including indigent people; and (vi) at the discretion of the Commissioner, any other factors as may be relevant to the determination of public need for a proposed project;
3. The extent to which the proposed project is consistent with the State Health Services Plan;
4. The extent to which the proposed project fosters institutional competition that benefits the area to be served while improving access to essential health care services for all people in the area to be served;
5. The relationship of the proposed project to the existing health care system of the area to be served, including the utilization and efficiency of existing services or facilities;
6. The feasibility of the proposed project, including the financial benefits of the proposed project to the applicant, the cost of construction, the availability of financial and human resources, and the cost of capital;
7. The extent to which the proposed project provides improvements or innovations in the financing and delivery of health care services, as demonstrated by (i) the introduction of new technology that promotes quality, cost effectiveness, or both in the delivery of health care services; (ii) the potential for provision of health care services on an outpatient basis; (iii) any cooperative efforts to meet regional health care needs; and (iv) at the discretion of the Commissioner, any other factors as may be appropriate; and
8. In the case of a project proposed by or affecting a teaching hospital associated with a public institution of higher education or a medical school in the area to be served, (i) the unique research, training, and clinical mission of the teaching hospital or medical school and (ii) any contribution the teaching hospital or medical school may provide in the delivery, innovation, and improvement of health care services 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; 2020, cc. 227, 558, 1271.
Structure Code of Virginia
Chapter 4 - Health Care Planning
§ 32.1-102.1:1. Equipment registration required
§ 32.1-102.1:3. Medical care facilities and projects for which a certificate is required
§ 32.1-102.2:1. State Health Services Plan; Task Force
§ 32.1-102.3. Demonstration of public need required; criteria for determining need
§ 32.1-102.3:1.1. Continuing care retirement communities accessing medical assistance
§ 32.1-102.3:7. Application for transfer of nursing facility beds
§ 32.1-102.3:8. Application for an open admission period for a continuing care retirement community
§ 32.1-102.4. Conditions of certificates; monitoring; revocation of certificates; civil penalties
§ 32.1-102.5. Certificate not transferable
§ 32.1-102.6. Administrative procedures
§ 32.1-102.6:1. Revocation of a certificate
§ 32.1-102.8. Enjoining project undertaken without certificate or registration
§ 32.1-102.9. Designation of judge
§ 32.1-102.11. Application of article
§ 32.1-111.2. Exemptions from provisions of this article
§ 32.1-111.3. Statewide Emergency Medical Services Plan; Trauma Triage Plan; Stroke Triage Plan
§ 32.1-111.4:2. Regional emergency medical services councils
§ 32.1-111.4:3. Provision of emergency medical services
§ 32.1-111.4:8. Ordinances as to emergency medical services agencies
§ 32.1-111.5:1. Emergency medical services personnel mental health awareness training
§ 32.1-111.6. Emergency medical services agency license; emergency medical services vehicle permits
§ 32.1-111.6:1. Commissioner to issue certain emergency medical services licenses or permits
§ 32.1-111.8. Revocation and suspension of licenses and permits
§ 32.1-111.9. Applications for variances or exemptions
§ 32.1-111.9:1. Out-of-state emergency medical services providers
§ 32.1-111.12. Virginia Rescue Squads Assistance Fund; disbursements
§ 32.1-111.12:01. Financial Assistance and Review Committee; appointment; terms; duties
§ 32.1-111.13. Annual financial reports
§ 32.1-111.14. Powers of governing bodies of counties, cities, and towns
§ 32.1-111.14:2. Establishment of emergency medical services zones or districts; tax levies
§ 32.1-111.14:6. Supervision and control of joint services of emergency medical services agencies
§ 32.1-111.14:8. Purchase, maintenance, etc., of equipment; donated equipment
§ 32.1-111.14:9. Entry of buildings and premises adjoining during a medical emergency
§ 32.1-111.15. Statewide poison control system established
§ 32.1-111.16. Director of Office of Emergency Medical Services annual performance evaluation
§ 32.1-116.1. Prehospital patient care reporting procedure; trauma registry; confidentiality
§ 32.1-116.1:1. Disclosure of medical records
§ 32.1-116.2. Confidential nature of information supplied; publication; liability protections
§ 32.1-116.3. Reporting of communicable diseases; definitions
§ 32.1-122.03. State Health Plan
§ 32.1-122.03:1. Statewide Telehealth Plan
§ 32.1-122.04. Responsibilities of the Department
§ 32.1-122.05. Regional health planning agencies; boards; duties and responsibilities
§ 32.1-122.06. Funds for regional health planning
§ 32.1-122.08. Continuation of regulations
§ 32.1-122.5. Criteria to identify underserved areas
§ 32.1-122.5:1. Conditional grants for certain medical students
§ 32.1-122.6. Conditional grants for certain medical students
§ 32.1-122.6:01. Board of Health to award certain scholarships and loan repayment funds
§ 32.1-122.6:02. Conditional grants for certain nurse practitioner students
§ 32.1-122.6:03. Conditional grants for certain physician assistant students
§ 32.1-122.6:04. Nurse Loan Repayment Program
§ 32.1-122.6:1. Physician Loan Repayment Program
§ 32.1-122.7. Virginia Health Workforce Development Authority; purpose
§ 32.1-122.7:1. Board of Directors of the Virginia Health Workforce Development Authority
§ 32.1-122.7:2. Powers and duties of the Virginia Health Workforce Development Authority; exemptions
§ 32.1-122.8. Board's authority to receive and expend funds
§ 32.1-122.9. Conditional grants for certain dental students
§ 32.1-122.9:1. Dentist Loan Repayment Program
§ 32.1-122.10. Conditional grants for certain dental hygiene students
§ 32.1-122.10:002. Board of directors; expenses; officers; terms of office; quorum; annual report
§ 32.1-122.10:003. Office of the authority
§ 32.1-122.10:004. Powers of the authority
§ 32.1-122.10:005. Licensed agents; liability
§ 32.1-122.20. Recruitment and retention of health care providers