The Agency is proposing to amend Rule 59C-1.008, F.A.C in order to clarify the language to show that the section is not in violation of 408.037, F.S., regarding general hospital applications. In addition, language has been added to clarify sections ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Certificate of Need

RULE NO.:RULE TITLE:

59C-1.008Certificate of Need Application Procedures

PURPOSE AND EFFECT: The Agency is proposing to amend Rule 59C-1.008, F.A.C in order to clarify the language to show that the section is not in violation of 408.037, F.S., regarding general hospital applications. In addition, language has been added to clarify sections 59C-1.008(1)(g) and 59C-1.008 (2)(e) F.A.C.

SUMMARY: Rule 59C-1.008, F.A.C., outlines certificate of need application procedures. The proposed changes are pursuant to a final order (17-003108RX) invalidating 59C-1.008 (4)(c), F.A.C., in order to clarify that an audit is not required for a general hospital application. Also clarifies language in 59C-1.008 (1)(g), F.A.C., to meet statutory requirements in 408.039, F.S. as well as comparative review requirements in 59C-1.008 (2)(e).

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency prepared a checklist to determine the necessity for a SERC.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A SERC has not been prepared by the agency. The Agency prepared a checklist to determine the necessity for a SERC. Based on this information at the time of the analysis and pursuant to section 120.541, Florida Statutes, the rule will not require legislative ratification.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 408.034(3),(8) and 408.15 (8) FS.

LAW IMPLEMENTED: 408.033, 408.034, 408.036, 408.037, 408.039 and 408.042 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: May 16, 2019, 8:30 to 9:30 a.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building #3, Conference Room B, Tallahassee, FL 32308.

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 3 days before the workshop/meeting by contacting: Marisol Fitch, Bureau of Health Facility Regulation, 2727 Mahan Drive, Tallahassee, Florida, [phone] or at [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Marisol Fitch at [phone] or email at: [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59C-1.008 Certificate of Need Application Procedures.

(1) Letters of Intent and applications subject to comparative review shall be accepted in two batching cycles annually each for hospital beds and facilities and for other beds and programs, as specified in paragraph (g) of this subsection. The category “hospital beds and facilities” includes proposals for new hospital facilities, replacement hospital facilities if being replaced more than a mile away, the establishment of new neonatal level II and level III programs unless otherwise exempt pursuant to Section 408.036(3)(l), F.S., and comprehensive medical rehabilitation beds unless otherwise exempt pursuant to Section 408.036(3)(j), F.S., and except as provided in Section 408.037(2), F.S., for a general hospital. Unless otherwise directed by Section 408.037(2), F.S., general hospital applications shall conform to the schedules in this rule and will use all the applications and schedules described in paragraph (1)(f). The category “other beds and programs” includes proposals for pediatric open heart surgery, pediatric cardiac catheterization, organ transplantation, community nursing home projects unless the project meets criteria in Section 408.036(2) or Section 408.036(3), F.S., hospice programs, hospice inpatient facilities, and intermediate care facilities for the developmentally disabled.

(a) through (c) No change.

(d) Letter of Intent Deadline Extension. In order to provide for a mechanism by which applications may be filed to compete with the proposals described in filed letters of intent the following provisions apply:

1. through 3. No change.

4. The application filing due date shall not be extended for any applicant filing a letter of intent under the requirements of this paragraph unless specified under the provisions of 59C-1.008 (1)(g)1., F.A.C.

5. No change.

(e) through (f) No change.

(g) Applications Subject to Comparative Review – Batching Cycles. In order that applications pertaining to similar types of services or facilities affecting the same service district or subdistrict may be considered in relation to each other for purposes of comparative review, letters of intent and applications shall be received by the Agency no later than dates prescribed in the following schedule, unless the date is a designated state holiday then it shall be received by the Agency the next business day.

Hospital Beds and Facilities 1st Batching Cycle
Summary Need Projections Published in the F.A.R.	Third Friday in January
Letter of Intent Deadline	First Monday in February
Application Deadline	First Wednesday in March
Completeness Review Deadline	Second Wednesday in March
Application Omissions Deadline	Second Wednesday in April
Agency Initial Decision Deadline	First Friday in June

 

Hospital Beds and Facilities                                                                                           2nd Batching Cycle
Summary Need Projections Published in the F.A.R.	Third Friday in July
Letter of Intent Deadline	First Monday in August
Application Deadline	First Wednesday in September
Completeness Review Deadline	Second Wednesday in September
Application Omissions Deadline	Second Wednesday in October
Agency Initial Decision Deadline	First Friday in December

 

Other Beds and Programs 1st Batching Cycle
Summary Need Projections Published in the F.A.R.	First Friday in April
Letter of Intent Deadline	Third Monday in April
Application Deadline	Third Wednesday in May
Completeness Review Deadline	Fourth Wednesday in May
Application Omissions Deadline	Fourth Wednesday in June
Agency Initial Decision Deadline	Third Friday in August

 

Other Beds and Programs 2nd Batching Cycle
Summary Need Projections Published in the F.A.R.	First Friday in October
Letter of Intent Deadline	Third Monday in October
Application Deadline	Third Wednesday in November
Completeness Review Deadline	Fourth Wednesday in November
Application Omissions Deadline	Fourth Wednesday in December
Agency Initial Decision Deadline	Third Friday in February

 

1. Section 408.039 (2)(a),F.S. prevails in cases of conflict.  In months when the application deadline is less than thirty days from the letter of intent deadline, the application deadline, the completeness review deadline, and the application omissions deadline will be extended by one week.  The Agency initial decision deadline will remain the same.

2. 59C-1.008 (1)(d), F.A.C., prevails in cases of conflict and summary need projections published in the Florida Administrative Register (F.A.R.) shall be published one week earlier than identified above with all other dates in the batching cycle remaining unchanged.

3. All dates shall be posted by January 1 of each calendar year on the Agency website at http://ahca.myflorida.com/MCHQ/CON_FA/Batching/index.shtml.

(h) through (i) No change.

(2) Fixed Need Pools.

(a) Publication of Fixed Need Pools.

1. The Agency shall publish in the Florida Administrative Register at least 15 days prior to the letter of intent deadline for a particular batching cycle the Fixed Need Pools for the applicable planning horizon specified for each service in applicable Agency rules contained in Rules 59C-1.031-.044, F.A.C. In cases of conflict with 59C-1.008 (1)(g), F.A.C., 59C-1.008(2)(a)1., F.A.C., prevails, and the summary need projections published in the F.A.R. shall be published one week earlier with all other dates in the batching cycle remaining as noticed in 59C-1.008(1)(g), F.A.C.

2. through 3. No change.

(b) through (d) No change.

(e) Comparative Review. Applications submitted to the Agency in the same batching cycle for the same service or beds having the same Certificate of Need methodology in the same district or subdistrict, as defined in applicable rules, shall be comparatively reviewed through final Agency action against the same Fixed Need Pools in existence at the initial review. The Fixed Need Pools and other relevant planning information shall be used by the Agency to review the application against all applicable statutory review criteria contained in Section 408.035, F.S., and applicable rules, and policies. If an Agency need methodology does not exist for the proposed project:

1. through 2. No change.

3. Regardless of need methodology, tThe existence of unmet need will not be based solely on the absence of a health service, health care facility, or beds in the district, subdistrict, region or proposed service area.

(3) No change

(4) Certificate of Need Application Contents. An application for a Certificate of Need shall contain the following items:

(a) through (b) No change.

(c) The following provision does not apply to general hospital applications pursuant to section 408.037(1), F.S. An audited financial statement of the applicant or the applicant’s parent corporation if the applicant’s audited financial statements do not exist. The following provisions apply to audited financial statements:

1. The audited financial statement of the applicant, or the applicant’s parent corporation, must be for the most current fiscal year. If the most recent fiscal year ended within 120 days prior to the application filing deadline and the audited financial statements are not yet available, then the prior fiscal year will be considered the most recent.

2. Existing health care facilities must provide audited financial statements for the two most recent consecutive fiscal years in accordance with subparagraph 1. above.

3. Only audited financial statements of the applicant, or the applicant’s parent corporation, will be accepted. Audited financial statements of any part of the applicant or the applicant’s parent corporation, including but not limited to subsidiaries, divisions, specific facilities or cost centers, will not qualify as an audit of the applicant or the applicant’s parent corporation.

(d) To comply with Section 408.037(1)(b)1., F.S., which requires a listing of all capital projects, an the applicant, for any applications other than general hospital applications, shall provide the total approximate amount of anticipated expenditures for capital projects which meet the definition in subsection 59C-1.002(7), F.A.C., at the time of initial application submission, or state that there are none. An itemized list or grouping of capital projects is not required, although an applicant may choose to itemize or group its capital projects. The applicant shall also indicate the actual or proposed financial commitment to those projects, and include an assessment of the impact of those projects on the applicant’s ability to provide the proposed project; and,

(e) No change.

(5) No change.

Rulemaking Authority 408.034(3), (8), 408.15(8) FS. Law Implemented 408.033, 408.034, 408.036, 408.037, 408.038, 408.039, 408.042 FS. History–New 1-1-77, Amended 11-1-77, 9-1-78, 6-5-79, 2-1-81, 4-1-82, 7-29-82, 9-6-84, Formerly 10-5.08, Amended 11-24-86, 3-2-87, 6-11-87, 11-17-87, 3-23-88, 5-30-90, 12-20-90, 1-31-91, 9-9-91, 5-12-92, 7-1-92, 8-9-92, Formerly 10-5.008, Amended 4-19-93, 6-23-94, 10-12-94, 10-18-95, 2-12-96, 7-18-96, 9-16-96, 11-4-97, 7-21-98, 12-12-00, 4-2-01, 1-10-02, 6-26-03, 12-13-04, 9-28-05, 10-9-07, 4-21-10, 2-13-12, 8-15-13, 10-29-15,_____.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Marisol Fitch

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Mary C. Mayhew

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: 4/5/2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: 6/19/2018