On January 11, 2017, the Massachusetts Public Health Council (PHC) approved a significant revision of the Determination of Need (“DoN”) Regulation (“Regulation”). The DoN regulations are promulgated pursuant to M.G.L. c.111,§§ 25B to 25G, §§ 51 through 53, 51A, and 71. The goal of DoN and the framework for analysis by the Department of Public Health (DPH or Department) is to promote population health and increased public health value. This means: improved health outcomes, increased quality of life, and increased access to care. In so doing, the Department hopes to incentivize competition with a public health focus, and to support the development of innovative health delivery methods and population health strategies.
Applicants must provide sufficient evidence that a Proposed Project, on balance, is superior to alternative and substitute methods for meeting existing patient panel needs, including alternative evidence-based strategies and public health interventions. Applicants must make a clear and convincing demonstration that the Proposed Project meets each of the applicable DoN Factors.
Applicants will use the updated DoN Application Form (“Form”). This is a multi-part form: DoN Application file size 1MB, Affiliated Parties Form , Change In Service Form and Affidavit Form . In addition, please refer to the DoN Application Instructions . The Form must be completed for all Applications for DoN. The Form is provided as a guide and may be modified from time to time to reflect changes in the DoN review process. The Form will become a part of the record through which the Applicant is required to make a clear and convincing demonstration that the Proposed Project meets all applicable DoN Factors.
The 2017 DoN regulation at 105 CMR 100.405(B) requires all applicants to pay a filing fee based on the Proposed Project’s Total Value. For the purpose of determining Total Value for a Transfer of Ownership, please see the Filing Fees Guideline .
Applicants subject to the Community Health Initiative (CHI) requirement are expected to contact the Department at DONCHI@State.MA.US at least two (2) months prior to the planned filing of the DoN Application in order to determine which of the CHI forms will be required at the time of Application. Applicants that are required to meet Community Engagement Standards will be using a combination of the following forms:
- Stakeholder Assessment
- CHNA / CHIP Self-Assessment file size 1MB
- Community Engagement Plan file size 1MB
These forms may be updated regularly and as such Applicants are encouraged to check this site for each new Application.
The Department may publish Sub-regulatory Guidelines that will inform the DoN process. Applicants are advised to review any and all Guidelines in the context of preparing their Application.
- Pending Projects
- Pending Applications
- Hearing Notices
- Guidelines and Policy Advisories
Determination of Need Program
Massachusetts Department of Public Health
250 Washington Street, 6th Floor
Boston, MA 02108