Current through Register Vol. 47, No. 12, March 26, 2025
(a) The factors for
determining public need for health services and medical facilities shall
include, but not be limited to:
(1) the
current and projected population characteristics of the service area, including
relevant health status indicators and socio-economic conditions of the
population;
(2) normative criteria
for age and sex specific utilization rates to correct for unnecessary
utilization for health services;
(3) standards for facility and service
utilization, comparing actual utilization to capacity, taking into
consideration fluctuation of daily census for certain services, the geography
of the service area, size of units, and specialized service networks;
(4) the patterns of in and out migration for
specific services and patient preference or origin;
(5) the need that the population served or to
be served has for the services proposed to be offered or expanded, and the
extent to which all residents in the area, and in particular low- income
persons, racial or ethnic minorities, women, handicapped persons, and other
underserved groups and the elderly, will have access to those
services;
(6) in cases involving
the reduction or elimination of a service including those involving the
relocation of a facility or service, the extent to which need will be met
adequately and the effect of the reduction, elimination, or relocation of the
service or facility on the ability of the low-income persons, racial and ethnic
minorities, women, handicapped person, and other underserved groups, and the
elderly, to obtain needed health care;
(7) the contribution of the proposed service
or facility in meeting the health needs of members of medically underserved
groups which have traditionally experienced difficulties in obtaining equal
access to health services (for example, low-income persons, racial and ethnic
minorities, women, and handicapped persons). For the purpose of determining the
extent to which the proposed service or facility will be accessible to such
persons, following shall be considered:
(i)
the extent to which medically underserved populations currently use the
applicant's services in comparison to the percentage of the population in the
applicant's service area which is medically underserved, and the extent to
which medically underserved populations are expected to use the proposed
services if approved;
(ii) the
performance of the applicant in meeting its obligation under the applicable
civil rights statutes prohibiting discrimination on the basis of race, color,
national origin, handicap, sex and age;
(iii) the extent to which Medicare, Medicaid
and medically indigent patients are served by the applicant; and
(iv) the extent to which the applicant offers
a range of means by which a person will have access to its services.
(b) The evaluative
procedure for review of public need pursuant to section
2802 of the
Public Health Law shall include, but not be limited to:
(1) description of proposal as submitted by
applicant for construction;
(2)
identification of use rates in the service area for the service or services
involved;
(3) identification of
current and projected user population of the service, area;
(4) identification of resulting estimate of
future quantitative need as projected for a period of five years from last
complete calendar year reported;
(5) identification of existing service(s)
which are the same as those proposed by the applicant available in the service
area;
(6) identification of
existing service(s) which are the same as those proposed by the applicant which
will be available to meet future need in the service area;
(7) identification of service(s) which are
the same as those proposed by the applicant and which have been approved for
construction but are not in operation in the service area;
(8) identification of resulting resource(s)
available in service area five years in future to meet need;
(9) identification of percent of need met for
proposed service(s);
(10)
description of the current utilization for all service(s) which are the same as
those proposed by applicant in the service area;
(11) description of the current utilization
for allied or alternate services in the service area;
(12) description of any migration patterns
for health care in the service area;
(13) description of any evidence of
inappropriateness of placement in the service area for the subject service(s)
and related service(s); and
(14)
description of the distribution of service(s) in relation to the population's
distribution.
(c) The
public need analysis for each proposal will include a determination of the
appropriate service area. The county in which the construction is proposed
shall be the service area, unless the commissioner, upon consideration of the
advice of the State Hospital Review and Planning Council, determines that a
service area other than the county is more appropriate. The applicant or the
health systems agency may delineate a service area other than the county
together with evidence in support of such delineation. After reviewing the
evidence, the commissioner, upon consideration of the advice of the council,
may determine that the proposed service area is not acceptable. In cases
wherein a service area other than the county is being proposed, the following
shall be considered:
(1) the patterns of
in-and-out migration for specific services which are the same as those proposed
by the applicant and patient preference or origin; and
(2) appropriateness of travel and referral
patterns.
(d) Medical
facilities shall be planned to achieve efficiency and economy of operation and
care of high quality. In addition to the other pertinent provisions of this
Part, the analysis to determine whether there is a public need for the proposed
construction shall include consideration of additional factors as appropriate,
including but not limited to the following:
(1) the condition of the facility's existing
structures and equipment and the extent to which they are in compliance with
the applicable standards of facility operation and construction under this
Title;
(2) whether the
architectural solutions proposed by the applicant to address the issues which
are the subject of the application are:
(i)
cost efficient with respect to the anticipated operational and capital cost
impact of the proposal;
(ii)
necessary to correct nonwaiverable requirements or standards of operation or
construction under this Title;
(iii) necessary to address a problem or
situation which will require corrective action within two years;
(4) whether the proposal is consistent with
the applicant's long-range capital plan;
(5) whether the applicant will take advantage
of opportunities for the efficient and economic reuse and recycling of existing
physical plant resources, where feasible and appropriate;
(6) the life cycle incremental operational
and capital cost effectiveness and efficiency of the proposal;
(7) whether the proposal could be adapted to
accommodate changes in pertinent technology;
(8) whether the applicant will take advantage
of opportunities to gain economies and improvements in the provision of
services by entering into appropriate arrangements for sharing facilities,
services or equipment with other facilities; and
(9) whether there are alternative methods or
solutions available, which are more efficient, based on capital and operating
costs, to address the subject problem or situation that will nevertheless
ensure the provision of a level and quality of care and service that is in
compliance with pertinent Federal and State statutes, rules and
regulations.
(e) Any
application for construction wherein a determination of public need is made
pursuant to this section shall be subject to the following:
(1) The commissioner may, during the
processing of an application, propose to disapprove the application solely on
the basis of a determination of public need in advance of his consideration of
the questions of the adequacy of financial resources, sources of future revenue
and the character and competence of the applicant without, however, waiving his
right to consider such criteria at a later date.
(2) In the event the commissioner upon the
recommendation of the State Hospital Review and Planning Council proposes to
disapprove an application solely on the basis of a lack of public need and the
applicant then requests a hearing, the commissioner may direct the completion
of the other required by Public Health Law, section 2802, the results of which
shall be presented to the State Hospital Review and Planning Council for
recommendations, which reviews may then be included as grounds for the proposed
disapproval to be considered at the hearing. If the commissioner directs the
completion of such reviews, a copy of the report containing the results of the
reviews shall be mailed to the applicant at least 60 days prior to the date set
for hearing.
(3) In the event the
commissioner proposes to disapprove an application solely on the basis of no
public need and the State Hospital Review and Planning Council does not concur
with such proposed disapproval, the application shall be returned to the
department without a formal recommendation. The commissioner shall then direct
the completion of the other reviews required by Public Health Law, section
2802, and shall return the application to the State Hospital Review and
Planning Council for its formal recommendation.