Current through Register 47, No. 25, June 25, 2025
(a) Subsequent
to an approval or contingent approval of an application under this Part, any
change, as set forth in paragraphs (b)(1) through (3) of this section, shall
constitute an amendment to the application, and the applicant shall submit
appropriate documentation as may be required by the commissioner pursuant to
this Part in support of such amendment. The amended application shall be
referred to the health systems agency having jurisdiction and the Public Health
and Health Planning Council for their reevaluation and recommendations. The
approval of the commissioner shall be obtained for any such amended
application.
(b) Any of the
following shall constitute an amendment:
(1)
a change in the number and/or types of beds and/or services, other than a
reduction of service which would be subject to administrative review;
(2) a change in the location of the site of
the construction if outside the facility's planning area as identified in Part
709. If the change in site, within the facility's planning area, impacts
geographic accessibility in such planning area, the commissioner may before
making any finding that such change is in the best interest of the planning
area seek the recommendation of the Public Health and Health Planning Council
and the health systems agency having geographical jurisdiction. In addition,
for applications to establish diagnostic and treatment centers which were not
reviewed competitively within a batch, a change of site within a planning area
shall not constitute an amendment pursuant to the provisions of this section
and shall require only the prior approval of the commissioner; or
(3) any change in the applicant.
(c)
(1) If the commissioner determines that
increases in total project costs or total basic costs of construction are due
to factors of an emergency nature such as labor strikes, fires, floods or other
natural disasters, or factors beyond the control of the applicant, or
modifications to the architectural aspects of the application which are made on
the recommendation of the department, the commissioner may permit review of the
application to proceed without the need for the application to be referred back
to the health systems agency and the council pursuant to this Part. However,
failure of the applicant to obtain financing or appropriate environmental and
zoning permits or approvals shall not be deemed to be beyond the control of the
applicant.
(2) If the applicant can
document by evidence acceptable to the commissioner that increases in total
project costs or total basic costs of construction were caused by delays in
obtaining zoning or planning approvals which were beyond its control, the
commissioner may permit review of the application to proceed without the need
for the application to be referred back to the health systems agency and the
council pursuant to this part. The evidence should clearly demonstrate that the
applicant had timely pursued the zoning or planning permits and in addition
that the applicant has now obtained all such required permits and approvals and
is prepared to proceed with the project.
(3) If the applicant can document, by
evidence acceptable to the commissioner, that increases in the total basic cost
of construction were caused by inflation in excess of that estimated and
approved in the application and that such inflation has affected the total
basic cost of construction as a result of delays which were beyond the
applicant's control, the commissioner may permit review of the application to
proceed without the need for the application to be referred back to the health
systems agency and the Public Health and Health Planning Council pursuant to
this Part. The evidence shall demonstrate clearly that the increase in
inflation exceeds that estimated and approved in the application, and that any
delays resulting in such inflationary cost increases were beyond the
applicant's control.
(d)
The applicant must obtain the prior approval of the commissioner for any change
relating to the program scope or functional space concept of the project, total
project costs or increase in total basic costs of construction, a change in the
ownership interest in the land, building or equipment relating to the proposal,
a change in the location of the site of the construction, or interest rates
relating to the financing of any aspect of the project, regardless of whether
such change constitutes an amendment under this section.
