Scope of Jurisdiction (see also Regulations and Statutes): Under statutory authority, the Department of Public Health has jurisdiction to determine need for health care projects proposing the following:
  1. Substantial Capital Expenditure - Construction and or renovation of a health care facility which exceeds the expenditure minimum (10/1/2013) pdf format of    Informational Bulletin on Don Expenditure Minimums  doc format of Informational Bulletin on Don Expenditure Minimums . For acute care hospitals only, the acquisition of major movable equipment not otherwise defined as new technology or innovative service is excluded from the calculation of the expenditure minimum for purposes of calculating a substantial capital expenditure. Expenditures concerned solely with outpatient services (other than ambulatory surgery centers, services defined as innovative and new technology and outpatient service expenditures and acquisitions over $25,000,000) or replacement of DoN approved medical, diagnostic or therapeutic equipment are excluded from the calculation of the expenditure minimum. The expenditure minimum is adjusted annually by the inflation index established by the U.S. Department of Health and Human Services and is issued in the form of an Informational Bulletin available at this website.
  2. Substantial Change in Services - Addition or expansion of, or development of innovative services and new technology, non-acute care services, or freestanding ambulatory surgery centers. Innovative services and new technology include: Air Ambulance, Extracorporeal Membrane Oxygenation (ECMO), Extracorporeal Shock Wave Lithotripter (for gallstones), Invasive Cardiac Services (Open Heart Surgery and Left Ventricular Assist Devices), Magnetic Resonance Imager (MRI), Megavoltage Radiation Therapy, Neonatal Intensive Care Units (NICU), Organ Transplantation, Positron Emission Tomography (PET). Non-acute care services include: inpatient psychiatric, rehabilitation and chronic disease services, substance abuse treatment, and long-term care.
  3. Freestanding Ambulatory Surgery Centers - Provision of multiple specialty or single specialty surgical services, the majority of which are elective or non-urgent in a freestanding setting. Note: Applications are being accepted only for single specialty services which are approved outside the DoN guidelines need formula for multiple specialty services which show no need.
  4. Original Licensure - Establish or maintain a hospital, institution for unwed mothers, clinics only (for innovative services and new technology), freestanding ambulatory surgery center, nursing home, intermediate care facility for the mentally retarded or an alcoholism detoxification facility or treatment program.
  5. Solicitation of Funds - Funds solicited from the general public or any agreement to secure financing for substantial capital expenditure or substantial change in services. If the Department requires an application for determination of need, solicitation of funds must be delayed until such application has been acted upon by the Department.

This information is provided by the Determination of Need (DoN) program within the Department of Public Health.