The General Assembly directed the State Board of Health to “convene the State Health Services Plan Task Force (the Task Force) established by § 32.1-102.2:1 of the Code of Virginia to develop recommendations on expedited review of project types subject to certificate of public need requirements that are generally noncontested and present limited health planning impacts." The legislative mandate required the State Health Commissioner to “provide a report of these recommendations to the Secretary of Health and Human Resources, the Chairman of the Senate Committee on Education and Health, and the Chairman of the House Committee on Health and Human Services by November 1, 2024." The VDH OLC convened seven meetings throughout 2024, during which several informational presentations were given, and robust debate ensued amongst the assembled Task Force members. The Task Force developed the following recommendations, grouped by the likeliest method by which they could be accomplished, if they are adopted, and the service area the recommendation affects.

RECOMMENDATIONS

Legislative. Implementation of any of the recommendations below would require the General Assembly to amend either the Code of Virginia, or the Appropriation Act. The Task Force vote will be denoted alongside the associated recommendation below. Recommendations below all refer to including certain types of Certificate of Public Need (COPN) applications into an expedited review process.

LEGISLATIVE RECOMMENDATIONS – PSYCHIATRIC

1. Allow facilities that already provide psychiatric service to add(*2) psychiatric beds, up to 10 beds or 10% of beds, whichever is greater, in any two-year period using the expedited review process. A psychiatric bed added using the expedited COPN review process may not be converted to a non-psychiatric bed without COPN review. Unanimously adopted as a recommendation.

2. Allow facilities to relocate psychiatric beds within the same planning district through the expedited process. Unanimously adopted as a recommendation.

3. Allow facilities that already provide psychiatric services to establish(*3) a new psychiatric facility within the same planning district though the expedited review process. Adopted as a recommendation on a vote of 7-Yes, 4-No, 1-Abstain.

LEGISLATIVE RECOMMENDATIONS – HOSPITAL

The following recommendation was adopted by the Task Force as a recommendation on a vote of 10-Yes 1-No.

1. Add new hospital beds by relocation of existing hospital beds through the expedited review process.

LEGISLATIVE RECOMMENDATIONS – CARDIAC CATHETERIZATION

The following recommendation was adopted by the Task Force as a recommendation unanimously.

1. Add a cardiac catheterization lab in an existing hospital with cardiac catheterization services.

LEGISLATIVE RECOMMENDATIONS – SURGICAL

The following recommendation was adopted by the Task Force as a recommendation unanimously.

1. Add new operating rooms in an existing outpatient surgical hospital by relocating existing ORs from another hospital.

LEGISLATIVE RECOMMENDATIONS – MEDICAL REHABILITATION

The following recommendations were adopted by the Task Force as recommendations unanimously.

1. Add new medical rehabilitation beds in a hospital with existing rehabilitation services.

2. Add rehabilitation beds in a hospital with existing rehabilitation services by converting medical-surgical beds.

LEGISLATIVE RECOMMENDATIONS – RADIATION THERAPY & CANCER TREATMENT

The following recommendations were adopted by the Task Force as recommendations unanimously.

1. Add a linear accelerator by relocating an existing linear accelerator to a hospital with an existing linear accelerator.

2. Add a linear accelerator in an existing hospital with an existing linear accelerator.

3. Add a linear accelerator in an existing outpatient surgical hospital with an existing linear accelerator.

4. Add a linear accelerator in an existing radiation treatment center with a linear accelerator.

5. Add stereotactic radiosurgery (SRS) equipment in an existing radiation treatment center with existing SRS.

LEGISLATIVE RECOMMENDATIONS - OPERATIONAL

1. Allow the Commissioner to condition psychiatric projects on the acceptance of Temporary Detention Orders. Adopted as a recommendation on a vote of 10-Yes 1-No.

2. Require facilities to request a COPN in order to convert beds from psychiatric beds to non-psychiatric beds. Unanimously adopted as a recommendation.

Regulatory. Implementation of any of the recommendations below would require the State Board of Health to initiate one or more regulatory actions under the Virginia Administrative Process Act. The Task Force vote will be denoted alongside the associated recommendation below.

REGULATORY RECOMMENDATIONS – OPERATIONAL

1. Extend expedited review from 45 days to 90 days. All expedited review projects will be considered in one of four batch cycles per year specifically for expedited review projects. Adopted as a recommendation on a vote of 7-Yes 5-No.

2. Allow members of the public to request a hearing for an expedited review project. Adopted as a recommendation on a vote of 7-Yes 4-No.

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(*2) For the purposes of this report, “add" means the expansion of a service at a facility that already provides that service.
(*3) For the purposes of this report, “establish" means the establishment of a new medical care facility and the services, machines, and beds associated with such establishment.