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USA Statutes : maine
Title : Title 22. HEALTH AND WELFARE
Chapter : Chapter 103-A. CERTIFICATE OF NEED (HEADING. PL 2001, c. 664, @2 (new))
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Title 22 - §326. Short title
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§326. Short title
This chapter may be known and cited as the "Maine Certificate of Need Act of 2002."
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §327. Declaration of findings and purposes
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§327. Declaration of findings and purposes
The Legislature makes the following statements of findings and purposes.
[2001, c. 664, §2 (new).]
1. Findings. The Legislature finds that unnecessary construction or modification of health care facilities and duplication of health services
are substantial factors in the cost of health care and the ability of the public to obtain necessary medical services.
[2001, c. 664, §2 (new).]
2. Purposes. The purposes of this chapter are to:
A. Support effective health planning;
[2001, c. 664, §2 (new).]
B. Support the provision of quality health care in a manner that ensures access to cost-effective services;
[2001, c. 664, §2 (new).]
C. Support reasonable choice in health care services while avoiding excessive duplication;
[2001, c. 664, §2 (new).]
D. Ensure that state funds are used prudently in the provision of health care services;
[2001, c. 664, §2 (new).]
E. Ensure public participation in the process of determining the array, distribution, quantity, quality and cost of these health
care services;
[2001, c. 664, §2 (new).]
F. Improve the availability of health care services throughout the State;
[2001, c. 664, §2 (new).]
G. Support the development and availability of health care services regardless of the consumer's ability to pay;
[2001, c. 664, §2 (new).]
H. Seek a balance, to the extent a balance assists in achieving the purposes of this subsection, between competition and regulation
in the provision of health care; and
[2001, c. 664, §2 (new).]
I. Promote the development of primary and secondary preventive health care services.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §328. Definitions
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§328. Definitions
As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.
[2001, c. 664, §2 (new).]
1. Access to care. "Access to care" means the ability to obtain in a timely manner needed personal health services to achieve the best possible
health outcomes balanced by the health system's resource limitations. Access to care may be influenced by many factors, including,
without limitation, travel, distance, waiting time, available resources, availability of a source of care and the health status
of the population served.
[2001, c. 664, §2 (new).]
2. Ambulatory surgical facility. "Ambulatory surgical facility" means a facility, not part of a hospital, that provides surgical treatment to patients not
requiring hospitalization. "Ambulatory surgical facility" does not include the offices of private physicians or dentists,
whether in individual or group practice.
[2001, c. 664, §2 (new).]
3. Capital expenditure. "Capital expenditure" means an expenditure, including a force account expenditure or predevelopment activities, that under
generally accepted accounting principles is not properly chargeable as an expense of operation and maintenance and, for the
purposes of this chapter, includes capitalized interest on borrowed funds and the fair market value of any property or equipment
that is acquired under lease or comparable arrangement or by donation.
[2001, c. 664, §2 (new).]
3-A. Capital investment fund. "Capital investment fund" means that fund established by the Governor pursuant to Title 2, section 101, subsection 1, paragraph
D.
[2003, c. 469, Pt. C, §2 (new).]
4. Construction. "Construction," when used in connection with "health care facility," means the establishment, erection, building, purchase
or other acquisition of a health care facility.
[2001, c. 664, §2 (new).]
5. Development. "Development," when used in connection with health service, means the undertaking of those activities that on their completion
will result in the offering of a new health service to the public.
[2001, c. 664, §2 (new).]
6. Expenditure minimum for annual operating costs. "Expenditure minimum for annual operating costs" means, for services commenced after October 1, 1998, $400,000 for the 3rd
fiscal year, including a partial first year.
[2001, c. 664, §2 (new).]
7. Generally accepted accounting principles. "Generally accepted accounting principles" means accounting principles approved by the American Institute of Certified Public
Accountants or a successor organization.
[2001, c. 664, §2 (new).]
8. Health care facility. "Health care facility" means a hospital, psychiatric hospital, nursing facility, kidney disease treatment center including
a freestanding hemodialysis facility, rehabilitation facility, ambulatory surgical facility, independent radiological service
center, independent cardiac catheterization center or cancer treatment center. "Health care facility" does not include the
office of a private health care practitioner, as defined in Title 24, section 2502, subsection 1-A, whether in individual
or group practice. In an ambulatory surgical facility that functions also as the office of a health care practitioner, the
following portions of the ambulatory surgical facility are considered to be a health care facility:
A. Operating rooms;
[2003, c. 469, Pt. C, §3 (new).]
B. Recovery rooms;
[2003, c. 469, Pt. C, §3 (new).]
C. Waiting areas for ambulatory surgical facility patients; and
[2003, c. 469, Pt. C, §3 (new).]
D. Any other space used primarily to support the activities of the ambulatory surgical facility.
[2003, c. 469, Pt. C, §3 (new).]
[2003, c. 469, Pt. C, §3 (amd).]
9. Health maintenance organization. "Health maintenance organization" means a public or private organization that:
A. Provides or otherwise makes available to enrolled participants health care services, including at least the following basic
health services: usual physician services, hospitalization services, laboratory services, x-ray services, emergency and preventive
health services and out-of-area coverage;
[2001, c. 664, §2 (new).]
B. Is compensated, except for copayments, for the provision of the basic health services to enrolled participants on a predetermined
periodic rate basis; and
[2001, c. 664, §2 (new).]
C. Provides physicians' services primarily through physicians who are either employees or partners of the organization or through
arrangements with individual physicians or one or more groups of physicians.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
10. Health need. "Health need" means a situation or a condition of a person, expressed in health outcome measures such as mortality, morbidity
or disability, that is considered undesirable and is likely to exist in the future.
[2001, c. 664, §2 (new).]
11. Health planning. "Health planning" means data assembly and analysis, goal determination and the formulation of action recommendations regarding
health services.
[2001, c. 664, §2 (new).]
12. Health services. "Health services" means clinically related services that are diagnostic, treatment, rehabilitative services or nursing services
provided by a nursing facility. "Health services" includes alcohol abuse, drug abuse and mental health services.
[2001, c. 664, §2 (new).]
13. Health status. "Health status" means patient or population measures, or both, of good and poor health practices, rates of death and disease,
both chronic and infectious, and the prevalence of symptoms or conditions, or both, of illness and wellness.
[2001, c. 664, §2 (new).]
14. Hospital. "Hospital" means an institution that primarily provides to inpatients, by or under the supervision of physicians, diagnostic
services and therapeutic services for medical diagnosis, treatment and care of injured, disabled or sick persons or rehabilitation
services for the rehabilitation of injured, disabled or sick persons. "Hospital" also includes psychiatric and tuberculosis
hospitals.
[2001, c. 664, §2 (new).]
15. Hospital swing bed. "Hospital swing bed" means an acute care bed licensed by the Bureau of Medical Services, Division of Licensing and Certification
for the use also as a nursing care bed. Swing beds may be established only in rural hospitals with fewer than 100 licensed
acute care beds.
[2001, c. 664, §2 (new).]
16. Major medical equipment. "Major medical equipment" means a single unit of medical equipment or a single system of components with related functions
used to provide medical and other health services that costs $1,200,000 or more. "Major medical equipment" does not include
medical equipment acquired by or on behalf of a clinical laboratory to provide clinical laboratory services if the clinical
laboratory is independent of a physician's office and a hospital and has been determined to meet the requirements of the United
States Social Security Act, Title XVIII, Section 1861(s), paragraphs 10 and 11. In determining whether medical equipment
costs more than the threshold provided in this subsection, the cost of studies, surveys, designs, plans, working drawings,
specifications and other activities essential to acquiring the equipment must be included. If the equipment is acquired for
less than fair market value, the term "cost" includes the fair market value. Beginning September 30, 2004 and annually thereafter,
the threshold amount for review must be updated by the commissioner to reflect the change in the Consumer Price Index, medical
index.
[2003, c. 469, Pt. C, §4 (amd).]
17. Modification. "Modification" means the alteration, improvement, expansion, extension, renovation or replacement of a health care facility
or health maintenance organization or portions thereof, including the initial equipment, and the replacement of equipment
or existing buildings.
[2001, c. 664, §2 (new).]
17-A. New health service. "New health service" means:
A. The obligation of any capital expenditures by or on behalf of a health care facility of $110,000 or more that is associated
with the addition of a health service that was not offered on a regular basis by or on behalf of the health care facility
within the 12-month period prior to the time the services would be offered;
[RR 2003, c. 1, §15 (cor).]
B. The addition of a health service that is to be offered by or on behalf of a health care facility that was not offered on
a regular basis by or on behalf of the health care facility within the 12-month period prior to the time the services would
be offered and that, for the 3rd fiscal year of operation, including a partial first year following addition of that service,
is projected to entail incremental annual operating costs directly attributable to the addition of that health service of
at least $400,000; or
[RR 2003, c. 1, §15 (cor).]
C. The addition in the private office of a health care practitioner, as defined in Title 24, section 2502, subsection 1-A,
of new technology that costs $1,200,000 or more. The department shall consult with the Maine Quality Forum Advisory Council
established pursuant to Title 24-A, section 6952, prior to determining whether a project qualifies as a new technology in
the office of a private practitioner. Beginning September 30, 2004 and annually thereafter, the threshold amount for review
must be updated by the commissioner to reflect the change in the Consumer Price Index medical index. With regard to the private
office of a health care practitioner, "new health service" does not include the location of a new practitioner in a geographic
area.
[RR 2003, c. 1, §15 (cor).]
1. Capital expenditure.
[RR 2003, c. 1, §15 (rp).]
2. Addition of health service.
[RR 2003, c. 1, §15 (rp).]
3. Addition of health care practitioner.
[RR 2003, c. 1, §15 (rp).]
"New health service" does not include a health care facility that extends a current service within the defined primary service
area of the health care facility by purchasing within a 12-month time period new equipment costing in the aggregate less than
the threshold provided in section 328, subsection 16;
[RR 2003, c. 1, §15 (cor).]
18. Nursing facility. "Nursing facility" means any facility defined under section 1812-A.
[2001, c. 664, §2 (new).]
19. Obligation. An "obligation" for a capital expenditure that is considered to be incurred by or on behalf of a health care facility:
A. When a contract, enforceable under the law of the State, is entered into by or on behalf of the health care facility for
the construction, acquisition, lease or financing of a capital asset;
[2001, c. 664, §2 (new).]
B. When the governing board of the health care facility takes formal action to commit its own funds for a construction project
undertaken by the health care facility as its own contractor; or
[2001, c. 664, §2 (new).]
C. In the case of donated property, on the date on which the gift is completed under the applicable law of the State.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
20. Offer. "Offer," when used in connection with "health services," means that the health care facility or health maintenance organization
holds itself out as capable of providing or having the means to provide a health service.
[2001, c. 664, §2 (new).]
21. Person. "Person" means an individual; trust or estate; partnership; corporation, including associations, joint stock companies and
insurance companies; the State or a political subdivision or instrumentality of the State, including a municipal corporation
of the State; or any other legal entity recognized by state law.
[2001, c. 664, §2 (new).]
22. Person directly affected by a review. "Person directly affected by a review" includes:
A. The applicant;
[2001, c. 664, §2 (new).]
B. A group of 10 persons residing or located within the health service area served or to be served by the applicant;
[2001, c. 664, §2 (new).]
C. A health care facility, a health maintenance organization or a health care practitioner that demonstrates that it provides
similar services or, by timely filing a letter of intent with the department for inclusion in the record, indicates an intention
to provide similar services in the future to patients residing in the health service area and whose services would be directly
and substantially affected by the application under review;
[2001, c. 664, §2 (new).]
D. A 3rd-party payor, including, without limitation, a health maintenance organization, that pays health care facilities for
services in the health service area in which the project is proposed to be located and whose payments would be directly and
substantially affected by the application under review; and
[2001, c. 664, §2 (new).]
E. A person who demonstrates a direct and substantial effect upon that person's health care as a result of the application
under review.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
23. Predevelopment activity. "Predevelopment activity" means any appropriately capitalized expenditure by or on behalf of a health care facility made
in preparation for the offering or development of a new health service for which a certificate of need would be required and
arrangements or commitments made for financing the offering or development of the new health service and includes site acquisitions,
surveys, studies, expenditures for architectural designs, plans, working drawings and specifications.
[2001, c. 664, §2 (new).]
24. Project. "Project" means any acquisition, capital expenditure, new health service or change in a health service, predevelopment activity
or other activity that requires a certificate of need under section 329.
[2001, c. 664, §2 (new).]
25. Rehabilitation facility. "Rehabilitation facility" means an inpatient facility that is operated for the primary purpose of assisting in the rehabilitation
of disabled persons through an integrated program of medical services and other services that are provided under competent
professional supervision.
[2001, c. 664, §2 (new).]
26. Replacement equipment. "Replacement equipment" means a piece of capital equipment that replaces another piece of capital equipment that performs
essentially the same functions as the replaced equipment.
[2001, c. 664, §2 (new).]
27. State Health Plan. "State Health Plan" means the plan developed in accordance with Title 2, chapter 5.
[2003, c. 469, Pt. C, §6 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2003,
Ch. 469,
§C2-6
(AMD).
RR 2003,
Ch. 1,
§15
(COR).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §329. Certificate of need required
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§329. Certificate of need required
A person may not enter into any commitment for financing a project that requires a certificate of need or incur an expenditure
for the project without having sought and received a certificate of need, except that this prohibition does not apply to obligations
for financing conditioned upon the receipt of a certificate of need or to obligations for predevelopment activities.
[2001, c. 664, §2 (new).]
div>
A certificate of need from the department is required for:
[2001, c. 664, §2 (new).]
1. Transfer of ownership; acquisition by lease, donation, transfer; acquisition of control. Any transfer of ownership or acquisition under lease or comparable arrangement or through donation or any acquisition of
control of a health care facility under lease, management agreement or comparable arrangement or through donation that would
have required review if the transfer or acquisition had been by purchase, except in emergencies when that acquisition of control
is at the direction of the department;
[2001, c. 664, §2 (new).]
2. Acquisitions of major medical equipment. Acquisitions of major medical equipment. The use of major medical equipment on a temporary basis in the case of a natural
disaster, major accident or equipment failure and the use of replacement equipment do not require a certificate of need.
Beginning September 30, 2004 and annually thereafter, the threshold amount for review must be updated by the commissioner
to reflect the change in the Consumer Price Index medical index;
[2003, c. 469, Pt. C, §7 (amd).]
3. Capital expenditures. Except as provided in subsection 6, the obligation by or on behalf of a health care facility of any capital expenditure
of $2,400,000 or more. Capital expenditures in the case of a natural disaster, major accident or equipment failure for replacement
equipment or for parking lots and garages, information and communications systems and physician office space do not require
a certificate of need. Beginning September 30, 2004 and annually thereafter, the threshold amount for review must be updated
by the commissioner to reflect the change in the Consumer Price Index medical index;
[2003, c. 469, Pt. C, §7 (amd).]
4. New health service. The offering or development of any new health service;
A.
[2003, c. 469, Pt. C, §7 (rp).]
B.
[2003, c. 469, Pt. C, §7 (rp).]
[2003, c. 469, Pt. C, §7 (amd).]
5. Changes in bed complement. An increase in the existing licensed bed complement or an increase in the licensed bed category of a health care facility,
other than a nursing facility, of greater than 10%;
[2001, c. 664, §2 (new).]
6. Nursing facilities. The obligation by a nursing facility, when related to nursing services provided by the nursing facility, of any capital
expenditures of $510,000 or more.
A certificate of need is not required for a nursing facility to convert beds used for the provision of nursing services to
beds to be used for the provision of residential care services. If such a conversion occurs, public funds are not obligated
for payment of services provided in the converted beds;
[2001, c. 664, §2 (new).]
7. Other circumstances. The following circumstances:
A. Any proposed use of major medical equipment to serve inpatients of a hospital, if the equipment is not located in a health
care facility and was acquired without a certificate of need, except acquisitions exempt from review under subsection 2 or
3; or
[2001, c. 664, §2 (new).]
B. If a person adds a health service not subject to review under subsection 4, paragraph A and not subject to review under
subsection 4, paragraph B at the time it was established and not reviewed and approved prior to establishment at the request
of the applicant, and its actual 3rd fiscal year operating cost exceeds the expenditure minimum for annual operating costs
in the 3rd fiscal year of operation following addition of these services; and
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
8. Related projects. Any projects that the department determines are related projects if such projects, considered in the aggregate, would otherwise
require a certificate of need under this section.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2003,
Ch. 469,
§C7
(AMD).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §330. Exceptions
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§330. Exceptions
Notwithstanding section 329, the requirements of this Act do not apply with respect to:
[2001, c. 664, §2 (new).]
1. Healing through prayer. A health care facility operated by a religious group relying solely on spiritual means through prayer for healing;
[2001, c. 664, §2 (new).]
2. Activities; acquisitions. Activities or acquisitions by or on behalf of a health maintenance organization or a health care facility controlled, directly
or indirectly, by a health maintenance organization or combination of health maintenance organizations to the extent mandated
by the National Health Policy, Planning and Resources Development Act of 1974, as amended, and its accompanying regulations;
[2001, c. 664, §2 (new).]
3. Home health care services. Home health care services offered by a home health care provider;
[2001, c. 664, §2 (new).]
4. Hospice. Hospice services and programs;
[2001, c. 664, §2 (new).]
5. Assisted living.
[2003, c. 510, Pt. B, §6 (rp).]
5-A. Assisted housing. Assisted housing programs and services regulated under chapter 1664;
[2003, c. 510, Pt. A, §15 (new).]
6. Existing capacity. The use by an ambulatory surgical facility licensed on January 1, 1998 of capacity in existence on January 1, 1998; and
[2001, c. 664, §2 (new).]
7. Critical access hospitals. Conversion by a critical access hospital or a hospital in the process of becoming a critical access hospital of licensed
acute care beds to hospital swing beds.
[2003, c. 621, §1 (amd).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2003,
Ch. 510,
§A15,B6
(AMD).
PL 2003,
Ch. 621,
§1
(AMD).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §331. Subsequent review following changes in project
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§331. Subsequent review following changes in project
When a certificate of need has been issued and changes occur as specified in this section, a subsequent review is required.
[2001, c. 664, §2 (new).]
1. Criteria for subsequent review. The following activities require subsequent review and approval if the department has previously issued a certificate of
need and one or more of the following circumstances occur within 3 years after the approved activity is undertaken:
A. There is a significant change in financing;
[2001, c. 664, §2 (new).]
B. There is a change affecting the licensed or certified bed capacity as approved in the certificate of need;
[2001, c. 664, §2 (new).]
C. There is a change involving the addition or termination of the health services proposed to be rendered;
[2001, c. 664, §2 (new).]
D. There is a change in the site or the location of the proposed health care facility; or
[2001, c. 664, §2 (new).]
E. There is a substantial change proposed in the design of the health care facility or the type of construction.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
2. Procedures for subsequent review. Any person proposing to undertake any activity requiring subsequent review and approval shall file with the department,
within 30 days of the time that person first has actual knowledge of the circumstances requiring subsequent review, a notice
setting forth the following information:
A. The nature of the proposed change;
[2001, c. 664, §2 (new).]
B. The rationale for the change including, where appropriate, an explanation of why the change was not set forth in the original
application or letter of intent; and
[2001, c. 664, §2 (new).]
C. Other pertinent detail subject to the procedures and criteria set forth in section 335.
[2001, c. 664, §2 (new).]
The department shall, within 30 days of receipt of the information, advise that person in writing whether the proposed change
is approved. If not approved, the application must be treated as a new application under this Act. If approved, the department
shall amend the certificate of need as appropriate.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §332. Subsequent review following approval
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§332. Subsequent review following approval
When the commissioner approves an application unconditionally or subject to conditions pursuant to section 335, subsection
8, the commissioner may conduct a review to ensure compliance with any terms or conditions of the approval within 3 years
after the approved activity is undertaken. In this review, the commissioner may hold a public hearing and may consider any
significant changes in factors or circumstances relied upon by the commissioner in approving the application and significant
and relevant information that either is new or was withheld by the applicant at the time of the process under section 335.
If, upon review, the commissioner determines that any terms or conditions of the approval have not been met, the commissioner
may take enforcement action consistent with this Act.
[2001, c. 664, §2 (new).]
div>
This section applies to applications filed or approved on or after January 1, 1999.
[2001, c. 710, §9 (new); §10 (aff).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2001,
Ch. 710,
§10
(AFF).
PL 2001,
Ch. 710,
§9
(AMD).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §333. Procedures after voluntary nursing facility reductions
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§333. Procedures after voluntary nursing facility reductions
1. Procedures. A nursing facility that voluntarily reduces the number of its licensed beds for any reason except to create private rooms
may convert the beds back and thereby increase the number of nursing facility beds to no more than the previously licensed
number of nursing facility beds, after obtaining a certificate of need in accordance with this section, as long as the nursing
facility has been in continuous operation and has not been purchased or leased. To convert beds back to nursing facility
beds under this subsection, the nursing facility must:
A. Give notice of its intent to preserve conversion options to the department no later than 30 days after the effective date
of the license reduction; and
[2001, c. 664, §2 (new).]
B. Obtain a certificate of need to convert beds back under section 335, except that, if no construction is required for the
conversion of beds back, the application must be processed in accordance with subsection 2.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
2. Expedited review. Except as provided in subsection 1, paragraph B, an application for a certificate of need to reopen beds reserved in accordance
with this section must be processed on an expedited basis in accordance with rules adopted by the department providing for
shortened review time and for a public hearing if requested by a directly affected person. The department shall consider
and decide upon these applications as follows:
A. Review of applications that meet the requirements of this section must be based on the requirements of section 335, subsection
7, except that the determinations required by section 335, subsection 7, paragraph B must be based on the historical costs
of operating the beds and must consider whether the projected costs are consistent with the costs of the beds prior to closure,
adjusted for inflation; and
[2001, c. 664, §2 (new).]
B. Conversion of beds back under this section must be requested within 4 years of the effective date of the license reduction.
For good cause shown, the department may extend the 4-year period for conversion for one additional 4-year period.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
3. Effect on other review proceedings. Nursing facility beds that have been voluntarily reduced under this section must be counted as available nursing facility
beds for the purpose of evaluating need under section 335 as long as the nursing facility retains the ability to convert them
back to nursing facility use under the terms of this section, unless the nursing facility indicates, in response to an inquiry
from the department in connection with an ongoing project review, that it is unwilling to convert them to meet a need identified
in that project review.
[2001, c. 664, §2 (new).]
4. Rulemaking. Rules adopted pursuant to this section are major substantive rules as defined by Title 5, chapter 375, subchapter II-A.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §334. Nursing facility projects
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§334. Nursing facility projects
Nursing facility projects that propose to add new nursing facility beds to the inventory of nursing facility beds within the
State may be grouped for competitive review purposes consistent with appropriations made available for that purpose by the
Legislature. A nursing facility project that proposes renovation, replacement or other actions that will increase Medicaid
costs may be approved only if appropriations have been made by the Legislature expressly for the purpose of meeting those
costs, except that the department may approve, without a prior appropriation for the express purpose, projects to reopen beds
previously reserved by a nursing facility through a voluntary reduction pursuant to section 333, if the annual total of reopened
beds approved does not exceed 100.
[2001, c. 664, §2 (new).]
div>
Beginning with all applications pending on January 1, 2003, in evaluating whether a project will increase MaineCare expenditures
for a nursing facility for the purposes of this section, the department shall:
[2003, c. 416, §1 (new).]
1. Square footage. Allow gross square footage per licensed bed of not less than 500 square feet unless the applicant specifies a smaller allowance
for the project; and
[2003, c. 416, §1 (new).]
2. Replacement of equipment. Exclude the projected incremental cost associated with replacement of equipment.
[2003, c. 416, §1 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2003,
Ch. 416,
§1
(AMD).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §335. Approval; record
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§335. Approval; record
This section applies to determinations by the commissioner under this chapter.
[2001, c. 664, §2 (new).]
1. Basis for decision. Based solely on a review of the record maintained under subsection 6, the commissioner shall approve an application for
a certificate of need if the commissioner determines that the project:
A. Meets the conditions set forth in subsection 7;
[2003, c. 469, Pt. C, §8 (new).]
B. Is consistent with and furthers the goals of the State Health Plan;
[2005, c. 369, §7 (amd).]
C. Ensures high-quality outcomes and does not negatively affect the quality of care delivered by existing service providers;
[2003, c. 469, Pt. C, §8 (new).]
D. Does not result in inappropriate increases in service utilization, according to the principles of evidence-based medicine
adopted by the Maine Quality Forum, as established in Title 24-A, section 6951; and
[2003, c. 469, Pt. C, §8 (new).]
E. Can be funded within the capital investment fund.
[2003, c. 469, Pt. C, §8 (new).]
[2005, c. 369, §7 (amd).]
1-A. Review cycle. The commissioner shall review applications periodically on a competitive basis.
[2003, c. 469, Pt. C, §9 (new).]
2. Communications. Except as otherwise provided in this Act, only a person who is a full-time employee of the department with responsibilities
for the certificate of need program, a consultant to the project or a policy expert pursuant to section 337 may communicate
with the commissioner regarding any application for a certificate of need or any letter of intent. Nothing in this section
limits the authority or obligation of the staff of the department with responsibility for the certificate of need program
to meet with, or otherwise communicate with, any person who is not a department employee and who wants to provide information
to be considered in connection with an application for a certificate of need.
[2001, c. 664, §2 (new).]
3. Limited communications. A person who is not a department employee may not communicate with any department staff regarding the merits of a certificate
of need application except for the purpose of placing that person's views in the application record. All communications with
department staff responsible for the certificate of need program from any person who is not a department employee that the
department staff reasonably believes is intended to influence the analyses relating to or the decision regarding any application
for certificate of need must be noted by that department staff and that notation must be made part of the application record.
[2001, c. 664, §2 (new).]
4. Decision. The commissioner's decision must be in writing and must contain appropriate references to the record. If the application
is denied, the decision must specifically address comments received and made part of the record that favor granting the application.
If the application is approved, the decision must specifically address comments received and made part of the record that
favor denial of the application.
[2001, c. 664, §2 (new).]
5. Record. The record created by the department in the course of its review of an application must contain the following:
A. The application and all other materials submitted by the applicant for the purpose of making those documents part of the
record;
[2003, c. 469, Pt. C, §10 (amd).]
B. All information generated by or for the department in the course of gathering material to assist the commissioner in determining
whether the conditions for granting an application for a certificate of need have or have not been met. This information
may include, without limitation, the report of consultants, including reports by panels of experts assembled by the department
to advise it on the application, memoranda of meetings or conversations with any person interested in commenting on the application,
letters, memoranda and documents from other interested agencies of State Government and memoranda describing officially noticed
facts;
[2003, c. 469, Pt. C, §10 (amd).]
C. Stenographic or electronic recordings of any public hearing held by the commissioner or the staff of the department at the
direction of the commissioner regarding the application;
[2001, c. 664, §2 (new).]
D. Stenographic or electronic recording of any public informational meeting held by the department pursuant to section 337,
subsection 5;
[2001, c. 664, §2 (new).]
E. Any documents submitted by any person for the purpose of making those documents part of the record regarding any application
for a certificate of need or for the purpose of influencing the outcome of any analyses or decisions regarding an application
for certificate of need, except documents that have been submitted anonymously. Such source-identified documents automatically
become part of the record upon receipt by the department;
[2003, c. 469, Pt. C, §10 (amd).]
F. Preliminary and final analyses of the record prepared by the staff; and
[2003, c. 469, Pt. C, §10 (amd).]
G. Written assessments by the Director of the Bureau of Health and the Superintendent of Insurance assessing the impact of
the application on the health care system or cost of health insurance in the State.
[2003, c. 469, Pt. C, §10 (new).]
[2003, c. 469, Pt. C, §10 (amd).]
6. Maintenance of the record. The record created pursuant to subsection 5 first opens on the day the department publishes its notice that an application
for a certificate of need has been filed. From that day, all of the record is a public record, and any person may examine
that record and purchase copies of any or all of that record during the normal business hours of the department.
The record is closed 10 days after a public notice of the closing of the record has been published in a newspaper of general
circulation in Kennebec County, in a newspaper published within the service area of the project and on the department's publicly
accessible site on the Internet, as long as the notice is not published until after the preliminary staff analysis of the
application is made part of the record.
[2001, c. 664, §2 (new).]
7. Review; approval. Except as provided in section 336, the commissioner shall issue a certificate of need if the commissioner determines and
makes specific written findings regarding that determination that:
A. The applicant is fit, willing and able to provide the proposed services at the proper standard of care as demonstrated by,
among other factors, whether the quality of any health care provided in the past by the applicant or a related party under
the applicant's control meets industry standards;
[2001, c. 664, §2 (new).]
B. The economic feasibility of the proposed services is demonstrated in terms of the:
(1) Capacity of the applicant to support the project financially over its useful life, in light of the rates the applicant
expects to be able to charge for the services to be provided by the project; and
(2) Applicant's ability to establish and operate the project in accordance with existing and reasonably anticipated future
changes in federal, state and local licensure and other applicable or potentially applicable rules;
[2001, c. 664, §2 (new).]
C. There is a public need for the proposed services as demonstrated by certain factors, including, but not limited to:
(1) Whether, and the extent to which, the project will substantially address specific health problems as measured by health
needs in the area to be served by the project;
(2) Whether the project will have a positive impact on the health status indicators of the population to be served;
(3) Whether the services affected by the project will be accessible to all residents of the area proposed to be served;
and
(4) Whether the project will provide demonstrable improvements in quality and outcome measures applicable to the services
proposed in the project;
[2003, c. 469, Pt. C, §11 (amd).]
D. The proposed services are consistent with the orderly and economic development of health facilities and health resources
for the State as demonstrated by:
(1) The impact of the project on total health care expenditures after taking into account, to the extent practical, both
the costs and benefits of the project and the competing demands in the local service area and statewide for available resources
for health care;
(2) The availability of state funds to cover any increase in state costs associated with utilization of the project's services;
and
(3) The likelihood that more effective, more accessible or less costly alternative technologies or methods of service delivery
may become available; and
[2003, c. 469, Pt. C, §11 (amd).]
E. The project meets the criteria set forth in subsection 1.
[2003, c. 469, Pt. C, §12 (new).]
In making a determination under this subsection, the commissioner shall use data available in the State Health Plan under
Title 2, section 103, including demographic, health care service and health care cost data, data from the Maine Health Data
Organization established in chapter 1683 and other information available to the commissioner. Particular weight must be given
to information that indicates that the proposed health services are innovations in high-quality health care delivery, that
the proposed health services are not reasonably available in the proposed area and that the facility proposing the new health
services is designed to provide excellent quality health care.
In making all determinations under this subsection, the commissioner must be guided by the State Health Plan as described
in Title 2, section 103.
[2005, c. 369, §8 (amd).]
8. Conditional approvals. The commissioner may grant an application subject to conditions that relate to the criteria for approval of the application.
[2001, c. 664, §2 (new).]
9. Emergency certificate of need. Upon the written or oral request of an applicant asserting that an emergency situation exists, the department shall immediately
determine whether an emergency situation exists and upon finding that an emergency situation does exist shall issue a certificate
of need for a project necessary on account of the emergency situation. The scope of the certificate of need may not exceed
that which is necessary to remedy or otherwise effectively address the emergency situation. The certificate of need may be
subject to conditions consistent with the purpose of this Act that do not interfere with the applicant's ability to respond
effectively to the emergency.
The commissioner shall find an emergency situation exists whenever the commissioner finds that an applicant has demonstrated:
A. The necessity for immediate or temporary relief due to a natural disaster, a fire, an unforeseen safety consideration, a
major accident, equipment failure, foreclosure, receivership or an action of the department or other circumstances determined
appropriate by the department;
[2001, c. 664, §2 (new).]
B. The serious adverse effect of delay on the applicant and the community that would be occasioned by compliance with the regular
requirements of this chapter and the rules adopted by the department; and
[2001, c. 664, §2 (new).]
C. The lack of substantial change in the facility or services that existed before the emergency situation.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2003,
Ch. 469,
§C8-12
(AMD).
PL 2003,
Ch. 514,
§1
(AMD).
PL 2005,
Ch. 369,
§7,8
(AMD).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §336. Simplified review and approval process
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§336. Simplified review and approval process
Notwithstanding the requirements set forth in section 335, the department shall conduct a simplified review and approval process
in accordance with this section.
[2001, c. 664, §2 (new).]
1. Maintenance projects. The commissioner shall issue a certificate of need for a project that primarily involves the maintenance of a health facility
if the commissioner determines that the project:
A. Will result in no or a minimal additional expense to the public or to the health care facility's clients;
[2001, c. 664, §2 (new).]
B. Will be in compliance with other applicable state and local laws and regulations; and
[2001, c. 664, §2 (new).]
C. Will significantly improve or, in the alternative, not significantly adversely affect the health and welfare of any person
currently being served by the health care facility.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
2. Life safety codes; previous certificate of need. The commissioner shall issue a certificate of need for a project that is required solely to meet federal, state or local
life safety codes if the project involves a health facility, major medical equipment or a new health service that has previously
received a certificate of need.
[2001, c. 664, §2 (new).]
3. Acquisition of control. The commissioner shall issue a certificate of need for a project that involves the acquisition of control of a health facility
when the acquisition consists of a management agreement or similar arrangement and primarily involves the day-to-day operation
of the facility in its current form if the commissioner determines that the project meets the requirements of section 335,
subsection 7, paragraph B and that the project is economically feasible in light of its impact on:
A. The operating budget of the facility and the applicant; and
[2001, c. 664, §2 (new).]
B. The applicant's ability to operate the facility without increases in the facility's rates beyond those that would otherwise
occur absent the acquisition.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
4. Capital expenditures. The commissioner shall issue a certificate of need for a proposed capital expenditure upon determining that:
A. The capital expenditure is required to eliminate or prevent imminent safety hazards, as defined by applicable fire, building
or life safety codes and regulations; to comply with state licensure standards; or to comply with accreditation or certification
standards that must be met to receive reimbursement under the United States Social Security Act, Title XVIII or payments under
a state plan for medical assistance approved under Title XIX of that Act;
[2001, c. 664, §2 (new).]
B. The economic feasibility of the project is demonstrated in terms of its effects on the operating budget of the applicant,
including its existing rate structure;
[2001, c. 664, §2 (new).]
C. There remains a public need for the service to be provided; and
[2001, c. 664, §2 (new).]
D. The corrective action proposed by the applicant is the most cost-effective alternative available under the circumstances.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §337. Application process for certificate of need
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§337. Application process for certificate of need
1. Letter of intent. Prior to filing an application for a certificate of need, an applicant shall file a letter of intent with the department.
The letter of intent forms the basis for determining the applicability of this chapter to the proposed expenditure or action.
A letter of intent is deemed withdrawn one year after receipt by the department, unless sooner superseded by an application,
except that the applicant is not precluded from resubmitting the same letter of intent.
[2001, c. 664, §2 (new).]
2. Application filed. Paragraphs A to C apply in the given order to the application process for certificate of need.
A. After receiving the letter of intent, the department shall issue a letter or checklist, or both, to an applicant that stipulates
and clarifies what will be required in the application.
[2001, c. 664, §2 (new).]
B. Within 30 days of filing the letter of intent, the applicant shall meet with the department staff in order to assist the
department in understanding the application and to receive technical assistance concerning the nature, extent and format of
the documentary evidence, statistical data and financial data required for the department to evaluate the proposal. The department
may not accept an application for review until the applicant has satisfied this technical assistance requirement.
[2001, c. 664, §2 (new).]
C. After receiving notice from the department that a certificate of need is required for a proposed expenditure or action,
if the applicant wishes to proceed with the project, the applicant must file an application for a certificate of need.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
3. Application content. An application for a certificate of need must describe with specificity how the proposed project meets each of the conditions
for granting a certificate of need required by this chapter. A statement or statements that the project will meet the conditions
without supporting facts backed by relevant documentation and analysis constitute sufficient cause to deny the application.
An application subject to full review must contain, if available and relevant to the particular service or technology, information
on health status, public health need for the service or technology, quality assurance processes and prevention programs.
[2001, c. 664, §2 (new).]
4. Application complete. An application is certified as complete when the applicant delivers to the department a certification in writing that states
that the application should be considered complete by the department. Subsequent to the applicant's certification under this
subsection, the applicant may submit information that is responsive to any concern, issue, question or allegation of facts
contrary to those in the application made by the department or any other person.
[2001, c. 664, §2 (new).]
5. Public notice; public informational meeting. Within 5 business days of the filing of a certificate by an applicant that a complete certificate of need application is
on file with the department, public notice that the application has been filed and that a public informational meeting must
be held regarding the application must be given by publication in a newspaper of general circulation in Kennebec County and
in a newspaper published within the service area in which the proposed expenditure will occur. The notice must also be provided
to all persons who have requested notification by means of asking that their names be placed on a mailing list maintained
by the department for this purpose. This notice must include:
A. A brief description of the proposed expenditure or other action;
[2001, c. 664, §2 (new).]
B. A description of the review process and schedule;
[2001, c. 664, §2 (new).]
C. A statement that any person may examine the application, submit comments in writing to the department regarding the application
and examine the entire record assembled by the department at any time from the date of publication of the notice until the
application process is closed for comment; and
[2001, c. 664, §2 (new).]
D. The time and location of the public informational meeting and a statement that any person may appear at the meeting to question
the applicant regarding the project or the department regarding the conditions that the applicant must satisfy in order to
receive a certificate of need for the project.
[2001, c. 664, §2 (new).]
The department shall make an electronic or stenographic record of the public informational meeting.
[2001, c. 664, §2 (new).]
6. Voluntary withdrawal of application. During the review period, prior to the date that department staff submits a final report to the commissioner, an applicant
may withdraw an application without prejudice by filing written notice of the withdrawal with the department. A withdrawn
application may be resubmitted and will be processed as an entirely new application under this chapter.
[2001, c. 664, §2 (new).]
7. Filing fee. The department shall adopt rules setting minimum and maximum filing fees under this chapter. A nonrefundable filing fee
must be paid at the time an application is filed with the department. If the approved capital expenditure or operating cost
upon which the fees were based is higher than the initially proposed capital expenditure, then the filing fee must be recalculated
and the difference in fees, if any, must be paid before the certificate of need may be issued.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §338. Consultation
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§338. Consultation
1. Consultation on new technologies and needs. In connection with the development of policies and procedures to implement this Act, the commissioner may, from time to
time, consult with persons with relevant skills and experience regarding:
A. New medical technologies and the impact of those technologies on the health care delivery system in the State;
[2003, c. 469, Pt. C, §13 (amd).]
B. Unmet need for health care services in the State; and
[2003, c. 469, Pt. C, §13 (amd).]
C. The quality of health care.
[2003, c. 469, Pt. C, §14 (new).]
[2003, c. 469, Pt. C, §§13, 14 (amd).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
PL 2003,
Ch. 469,
§C13,14
(AMD).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §339. Review process; public hearing
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§339. Review process; public hearing
1. Review process. The review process consists of an evaluation of the project application for a certificate of need by the department in light
of:
A. The application itself;
[2001, c. 664, §2 (new).]
B. Material collected or developed by or for the department staff to test the assertions in the application;
[2001, c. 664, §2 (new).]
C. All comments received by any person regarding the project; and
[2001, c. 664, §2 (new).]
D. Any other material made part of the record.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
2. Public hearing. The following provisions apply to a public hearing under this chapter.
A. The commissioner or the commissioner's designee may hold a public hearing regarding the application.
[2001, c. 664, §2 (new).]
B. The commissioner, or the commissioner's designee, shall hold a public hearing if 5 persons residing or located within the
health service area to be served by the applicant request, in writing, that such a public hearing be held and the request
is received by the commissioner no later than 30 days following the informational hearing on the application conducted pursuant
to section 337, subsection 5.
[2001, c. 664, §2 (new).]
C. An electronic or stenographic record of the public hearing must be made part of the record.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
3. Preliminary staff analyses. As soon as practicable, the department staff shall provide the preliminary analyses of the application and the record to
the applicant, the commissioner and any person who requests the analyses and record. Notice of the availability of the analyses
must be published in a newspaper in general circulation in Kennebec County and a newspaper of general circulation serving
the area in which the project is to be located and on the department's publicly accessible site on the Internet.
[2001, c. 664, §2 (new).]
4. Final department staff analysis. A final department staff analysis must be submitted to the commissioner, together with the documentary record described in
section 335, subsection 2, as soon as practicable after the closing of the record.
[2001, c. 664, §2 (new).]
5. Reviews. To the extent practicable, a review must be completed and the commissioner shall make a decision within 90 days after the
application has been certified as complete by the applicant. The department shall establish criteria for determining when
it is not practicable to complete a review within 90 days. Whenever it is not practicable to complete a review within 90
days, the department may extend the review period for up to an additional 60 days.
[2001, c. 664, §2 (new).]
6. Public necessity. The department may delay action on an otherwise complete application for up to 180 days from the time the application has
been certified as complete by the applicant if the department finds that a public necessity exists. The department shall
provide written notice of the delay to the applicant and any other person who has requested in writing information regarding
the application. For purposes of this subsection, the department shall find that a public necessity exists if:
A. The application represents a new service or technology not previously provided within the State;
[2001, c. 664, §2 (new).]
B. The application represents a potential significant impact on health care system costs;
[2001, c. 664, §2 (new).]
C. The application represents a new service or technology for which a health care system need has not been previously established;
or
[2001, c. 664, §2 (new).]
D. There are several applications for the same or similar projects before the department.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §340. Reconsideration
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§340. Reconsideration
Any person directly affected by a review under this chapter may, for good cause shown, request in writing a hearing for the
purpose of reconsideration of the decision of the department to issue or to deny a certificate of need.
[2001, c. 664, §2 (new).]
1. Timing for request. A request for hearing for reconsideration under this section must be received within 30 days of the department's decision.
[2001, c. 664, §2 (new).]
2. Hearing. If the department determines that good cause for a hearing under this section has been demonstrated, the department shall
commence a hearing within 30 days of receipt of the request. For purposes of this section, a request for a hearing is considered
to show good cause if it:
A. Presents significant, relevant information not previously considered by the department;
[2001, c. 664, §2 (new).]
B. Demonstrates that there have been significant changes in factors or circumstances relied upon by the department in reaching
its decision;
[2001, c. 664, §2 (new).]
C. Demonstrates that the department has materially failed to follow its adopted procedures in reaching its decision; or
[2001, c. 664, §2 (new).]
D. Provides other bases for a hearing that the department has determined constitute good cause.
[2001, c. 664, §2 (new).]
[2001, c. 664, §2 (new).]
3. Decision. A decision must be rendered within 60 days of the commencement of a hearing under this section, except that the parties
may agree to a longer time period.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §341. Remedy
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§341. Remedy
Any person aggrieved by a final decision of the department made under the provisions of this Act is entitled to review in
accordance with this chapter and with Title 5, chapter 375, subchapter VII.
[2001, c. 664, §2 (new).]
1. Finality. A decision of the department to issue a certificate of need or to deny an application for a certificate of need is not considered
final until the department has taken final action on a request for reconsideration under section 340. A decision by the department
is not final when opportunity for reconsideration exists with respect to matters involving new information or changes in circumstances
pursuant to section 340, subsection 2, paragraphs A and B.
[2001, c. 664, §2 (new).]
2. Competitive reviews. If a person or persons file for review under Title 5, chapter 375, regarding competitive reviews of proposals to construct
new nursing facility beds, the court shall require the party seeking judicial review to give security in such sums as the
court determines proper for the payment of costs and damages that may be incurred or suffered by any other party who is found
to have been wrongfully delayed or restrained from proceeding to implement the certificate of need, except that, for good
cause shown and recited in the order, the court may waive the giving of security. A surety upon a bond or undertaking under
this subsection submits the surety to the jurisdiction of the court and irrevocably appoints the clerk of the court as the
agent for the surety upon whom any papers affecting liability on the bond or undertaking may be served. The liability of the
surety may be enforced on motion without the necessity of an independent action. The motion and such notice of the motion
as the court prescribes may be served on the clerk of the court, who shall mail copies to the persons giving the security
if their addresses are known.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §342. Rules
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§342. Rules
The department shall adopt any rules, standards, criteria, plans or procedures that may be necessary to carry out the provisions
and purposes of this Act. The department shall provide for public notice and hearing on all proposed rules, standards, criteria,
plans, procedures or schedules pursuant to Title 5, chapter 375. Unless otherwise provided by this chapter, rules adopted
pursuant to this chapter are routine technical rules as defined by Title 5, chapter 375, subchapter II-A.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §343. Public information
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§343. Public information
The department shall prepare and publish at least annually a report on its activities conducted pursuant to this Act. The
annual report must include information on all certificates of need granted and denied. With regard to all certificates granted
on a conditional basis, the report must include a summary of information reported pursuant to section 332 and any accompanying
statements by the commissioner or department staff submitted regarding the reports.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §344. Conflict of interest
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§344. Conflict of interest
In addition to the limitations of Title 5, section 18, a member or employee of the department who has a substantial economic
or fiduciary interest that would be affected by a recommendation or decision to issue or deny a certificate of need or who
has a close relative or economic associate whose interest would be so affected is ineligible to participate in the review,
recommendation or decision-making process with respect to any application for which the conflict of interest exists.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §345. Division of project to evade cost limitation prohibited
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§345. Division of project to evade cost limitation prohibited
A health care facility or other party required to obtain a certificate of need may not separate portions of a single project
into components, including, but not limited to, site facility and equipment, to evade the cost limitations or other requirements
of section 329.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §346. Scope of certificate of need
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§346. Scope of certificate of need
1. Application determinative. A certificate of need is valid only for the defined scope, premises and facility or person named in the application and
is not transferable or assignable.
[2001, c. 664, §2 (new).]
2. Maximum expenditure. In issuing a certificate of need, the department shall specify the maximum capital expenditures that may be obligated under
this certificate. The department shall adopt rules regarding the determination of capital expenditure maximums, procedures
to monitor capital expenditures obligated under certificates and procedures to review projects for which the capital expenditure
maximum is exceeded or expected to be exceeded.
[2001, c. 664, §2 (new).]
3. Periodic review. After the issuance of a certificate of need, the department shall periodically review the progress of the holder of the
certificate in meeting the timetable for making the service or equipment available or for completing the project specified
in the approved application. A certificate of need expires if the project for which the certificate has been issued is not
commenced within 12 months following the issuance of the certificate. The department may grant an extension of a certificate
for an additional specified time not to exceed 12 months if good cause is shown why the project has not commenced. The department
may require evidence of the continuing feasibility and availability of financing for a project as a condition for extending
the life of the certificate. In addition, if on the basis of its periodic review of progress under the certificate the department
determines that the holder of a certificate is not otherwise meeting the timetable and is not making a good faith effort to
meet it, the department may, after a hearing, withdraw the certificate of need. The applicant shall issue to the department
periodic reports as designated in the certificate of need approval notification on the impact of the service on the health
status, quality of care and health outcomes of the population served. These reports may not be in less than 12-month intervals
following the start of service approved in the certificate of need. The department shall adopt rules for the withdrawal of
certificates of need.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §347. Withholding of license
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§347. Withholding of license
A new health care facility, as defined in section 328, is eligible to obtain a license under the applicable state law if the
facility has obtained a certificate of need as required by this chapter. The license of any facility does not extend to include
and may not otherwise be deemed to allow the delivery of any services, the use of any equipment that has been acquired, the
use of any portion of a facility or any other change for which a certificate of need as required by this chapter has not been
obtained. Any unauthorized delivery of services, use of equipment or a portion of a facility or other change is in violation
of the respective chapter under which the facility is licensed.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §348. Withholding of funds
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§348. Withholding of funds
A health care facility or other provider may be eligible to apply for or receive any reimbursement, payment or other financial
assistance from any state agency or other 3rd-party payor, either directly or indirectly, for any capital expenditure or operating
costs attributable to any project for which a certificate of need is required by this chapter only if the certificate of need
has been obtained. For the purposes of this section, the department shall determine the eligibility of a facility to receive
reimbursement for all projects subject to the provisions of this chapter.
[RR 2001, c. 2, Pt. A, §29 (cor).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
RR 2001,
Ch. 2,
§A29
(COR).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §349. Injunction
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§349. Injunction
The Attorney General, upon the request of the department, shall seek to enjoin any project for which a certificate of need
as required by this chapter has not been obtained and shall take any other action as may be appropriate to enforce this chapter.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §350-A. Cost-of-living adjustment (REALLOCATED FROM TITLE 22, SECTION 351)
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§350-A. Cost-of-living adjustment (REALLOCATED FROM TITLE 22, SECTION 351)
Every 2 years, beginning January 1, 2005, the department shall review the monetary figures contained in this chapter. The
department shall revise those figures to correspond to changes in the Consumer Price Index medical index by adopting rules
setting the new figures.
[RR 2001, c. 2, Pt. A, §30 (ral).]
Section History:
RR 2001,
Ch. 2,
§A30
(RAL).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §350-B. Federal funding (REALLOCATED FROM TITLE 22, SECTION 352)
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§350-B. Federal funding (REALLOCATED FROM TITLE 22, SECTION 352)
The department is authorized to accept any federal funds to be used for the purposes of carrying out this chapter.
[RR 2001, c. 2, Pt. A, §31 (ral).]
Section History:
RR 2001,
Ch. 2,
§A31
(RAL).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §350-C. Implementation reports (REALLOCATED FROM TITLE 22, SECTION 353)
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§350-C. Implementation reports (REALLOCATED FROM TITLE 22, SECTION 353)
The holder of a certificate of need shall make written reports as provided in this section and as required by rule adopted
by the department.
[RR 2001, c. 2, Pt. A, §32 (ral).]
1. Final plans and specifications. A holder of a certificate of need that has been issued for the construction or modification of a facility or portion of
a facility shall file final plans and specifications for the project as required by the department to determine that the plans
and specifications are in compliance with the certificate of need and with applicable licensure, life safety code and accreditation
standards.
[RR 2001, c. 2, Pt. A, §32 (ral).]
2. Periodic reports. Periodic reports must be filed at the end of each 6-month period following the issuance of a certificate of need under section
335, subsection 7 or section 336 regarding implementation activities, obligations incurred and expenditures made and any other
matters as the department may require.
[RR 2001, c. 2, Pt. A, §32 (ral).]
3. Summary report. A summary report must be made when the service or services for which a certificate of need was issued become operational.
[RR 2001, c. 2, Pt. A, §32 (ral).]
4. Cost and utilization reports. For a period of one year following the implementation of the service or services for which a certificate of need was granted,
the holder of the certificate of need shall file, at 6-month intervals, reports concerning the costs and utilization.
[RR 2001, c. 2, Pt. A, §32 (ral).]
5. Department action. The department may revoke any certificate of need the department has issued when the person to whom it has been issued fails
to file reports or plans and specifications required by this section on a timely basis. The department shall review services
that fall below the required volume and quality standards of a certificate of need.
[RR 2001, c. 2, Pt. A, §32 (ral).]
Section History:
RR 2001,
Ch. 2,
§A32
(RAL).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
Title 22 - §350. Penalty
Title 22: HEALTH AND WELFARE
Subtitle 2: HEALTH
Part 1: ADMINISTRATION
Chapter 103-A: CERTIFICATE OF NEED (HEADING: PL 2001, c. 664, @2 (new))
§350. Penalty
Whoever violates any provision of this chapter or any rate, rule or regulation pursuant to this chapter is subject to a civil
penalty payable to the State of not more than $5,000 to be recovered in a civil action. The department may hold these funds
in a special revenue account that may be used only to support certificate of need reviews, such as for hiring expert analysts
on a short-term consulting basis.
[2001, c. 664, §2 (new).]
Section History:
PL 2001,
Ch. 664,
§2
(NEW).
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.
Office of the Revisor of Statutes
7 State House Station
State House Room 108
Augusta, Maine 04333-0007
This page created on: 2005-10-01
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