The Alliance for Health is an authorized Regional Review Agency for Michigan's Certificate of Need (CON) Program in West Central Michigan.  Click here for information about current projects under review by the Alliance for Health Evaluation Board:  Project Status Report for West Central Michigan   

Click here for a schedule of PUBLIC HEARINGS for current projects under review.

Michigan’s Certificate of Need Program  

WHAT IS THE CON PROGRAM?

Certificate of Need (CON) is intended to balance cost, quality, and access issues and ensure that only needed services and facilities are developed in Michigan.  Michigan's CON program was enacted in 1972 and is administered by the Michigan Department of Community Health (MDCH) in cooperation with local communities that are designated to participate in the process. The Alliance for Health in west central Michigan is a designated Regional Review Agency. The CON program is governed by Part 222 of PA 368 of the Public Acts of 1978, as amended.

WHAT IS COVERED BY THE CON PROGRAM?

Anyone (health facility, physician, group practice, etc.) proposing any of the following types of projects must obtain a CON, regardless of the capital expenditure proposed:

• Increase in the number of licensed beds or relocate licensed beds from one site to another 

• Acquire an existing health facility.  

• Operate a new health facility.

• Initiate, replace, or expand covered clinical services. (See the list of review standards.)

In addition, covered capital expenditures above the threshold in licensed health facilities (clinical areas only) require a CON. The capital expenditure threshold is updated annually by MDCH based on the Consumer Price Index. The current threshold, effective January 3, 2006, is $2,715,000.

For purposes of CON, a health facility is defined as

• a hospital

• a psychiatric hospital or unit

• a nursing home

• a freestanding surgical outpatient facility

• an HMO (only for limited projects)

Determinations of whether a project requires CON approval, whether a project complies with applicable requirements, or whether other requirements apply must be obtained in writing from the department.

REVIEW STANDARDS

The CON Commission, a five-member independent body appointed by the Governor, has approved CON review standards for determining the need and ongoing quality assurance standards for the following:

• Air ambulances (helicopters)

• Cardiac catheterization, including diagnostic, therapeutic, angioplasty, and electrophysiology

• Computed tomography scanners

• Hospital beds: general acute care

• Magnetic resonance imaging (MRI)

• Megavoltage radiation therapy

• Neonatal intensive care units

• Nursing home/hospital long-term-care beds

• Open heart surgery PET scanners

• Psychiatric beds: acute inpatient

• Surgical services: hospital and free-standing 

• Transplantation services: bone marrow, including peripheral stem cell, heart-lung, liver, and pancreas

• Urinary lithotripters

The CON Commission is responsible for developing and approving CON review standards used by the department. The Commission is not involved in making decisions in the review of CON applications.

REVIEW TYPES

Nonsubstantive: Projects not requiring a full review, requiring less information, and processed more quickly. Examples of projects that may be reviewed on a nonsubstantive basis are equipment replacements, acquisitions of existing facilities.

Substantive: Individual projects requiring a full review.

Comparative: Applications competing for project types for which the need in a geographic area is limited: beds, PET scanners, lithotripters, and transplantation services (excluding pancreas). Comparative applications can be filed on either February 1, June 1, or October 1 of each year.

HOW DOES THE CON PROCESS WORK?

The applicant contacts the department's project review coordinator regarding a potential project.

• The department sends a Letter of Intent form (LOI) to the potential applicant.

• The applicant files the LOI with the department and Regional Review Agency, if any. Based on LOI information, the department sends relevant forms to the applicant.

• The applicant files completed application forms with the department and Regional Review Agency, if any.

• Within 15 days of receiving an application, the department, in consultation with the Regional Review Agency, reviews it for completeness and requests any necessary additional information. The applicant has 5 days to submit the requested information.

• The department deems the application complete and determines the review type.

• A proposed decision is issued within the deadlines for each review type:

  Type of Review	Regional Review	MDCH
  Nonsubstantive	30 days	45 days
  Substantive Individual	90 days	120 days
  Comparative	120 days	150 days

• If the proposed decision is an approval, a final decision is issued by the department director within five days.

• If the proposed decision is a disapproval, the applicant has '5 days to request a hearing. 

• If a hearing is not requested, a final decision to disapprove is issued by the department director. 

• If requested, the hearing must begin within 90 days, unless waived by the applicant. 

• A final decision is issued by the department director following the hearing.

WHAT ARE CON’S OBJECTIVES?

1. Help control health care cost increases resulting from the oversupply of health care services and facilities.

2. Promote access to certain health care services and facilities for all residents, particularly in rural areas and for the medically indigent.

3. Promote quality services by requiring compliance with standards developed by health experts.

4. Provide a forum for public input and community involvement prior to the development of facilities and services.

Anyone considering a health care project should contact the Regional Review Agency and the MDCH before proceeding to determine if the project requires a CON. The review of each CON application is governed by the CON law, the administrative rules, and the applicable CON review standard. Either the Regional Review Agency or the MDCH would be pleased to help a potential applicant in understanding the specific requirements.

Applicants with a CON-approved project must contact the relevant licensing or certification agencies to determine requirements applicable to the operation of the project.

If a project involves renovation or new construction, applicants must contact Health Facilities Evaluation.

FOR FURTHER INFORMATION

Updated 9/22/06