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Comment on a pending DoN application

The public is invited to participate in the review of an Application for Determination of Need (DoN) according to the information listed below.

Table of Contents

How to comment on a DON application or request a public hearing

Individuals: Any person, and any Ten Taxpayer group, may provide written or oral comment at any time during the first 30 days following the Filing Date of an Application, or during the first ten days after a public hearing.

Groups: Any registered Ten Taxpayer Group may:

  1. Request a public hearing within 30 days of the Filing Date of an Application;
  2. Provide written comment on the Staff report no later than 20 days prior to the Department meeting at which the Application will be considered;  or
  3. Make an oral presentation to the Department at the meeting at which the Application is considered

Prior to submitting comment or requesting a public hearing, a Ten Taxpayer group must register with the Department as a “Party of Record.”  Ten Taxpayer groups may register at any time during the first 30 days following the Filing Date of an Application or during the first ten days after a public hearing. To register, the group must provide the following information on a document that is signed by each Taxpayer:

  • List each Taxpayer by name, and resident address;
  • State whether or not each Taxpayer is acting as an agent for another party. If a Taxpayer is acting as an agent for another party, the Taxpayer must list that party's full name and address;
  • Identify the Application in which the Taxpayers are interested; and
  • Specify which Taxpayer is to be the recipient of all written communications concerning the Application on behalf of the Ten Taxpayer Group.

This registration must be sent to:

Email Mail
DPH.DON@massmail.state.ma.us

Determination of Need Program
Massachusetts Department of Public Health
250 Washington Street, Boston, MA 02108

Comments must be sent to:

Email Mail
DPH.DON@massmail.state.ma.us

Determination of Need Program
Massachusetts Department of Public Health
250 Washington Street, Boston, MA 02108

Please read Ten Taxpayer Groups for more information.

How to comment on a public hearing

  • Any person may provide written or oral comment or testimony to the Department at the public hearing itself.
  • Written comments must be sent during the first ten days after a public hearing.

Comments must be sent to:

Email Mail
DPH.DON@massmail.state.ma.us

Determination of Need Program
Massachusetts Department of Public Health
250 Washington Street, Boston, MA 02108

What to comment on a DON application

Pursuant to the DoN regulation, the Department determines whether need exists for a Proposed Project, based upon whether the Applicant meets each of the relevant factors set out in those regulations. The six factors are summarized briefly below and are found at 105 CMR 100: Determination of need.

The most helpful comments for consideration in our review and analysis would be ones that address the Applicant’s ability to meet the requirements of each of the relevant factors, as described below.  

(FACTOR 1) Applicant Patient Panel Need, Public Health Value, and Operational Objectives. Here, we are looking to establish that the Applicant

(a) has demonstrated sufficient need for the Proposed Project by the Applicant's Patient Panel;

(b) has demonstrated that the Proposed Project will add measurable public health value in terms of improved health outcomes and quality of life of the Patient Panel, while providing reasonable assurances of health equity;

(c) has provided sufficient evidence that the Proposed Project will operate efficiently and effectively by furthering and improving continuity and coordination of care for the Patient Panel;

(d) has provided evidence of consultation with all Government Agencies with relevant licensure, certification, or other regulatory oversight of the Applicant or the Proposed Project;

(e) has provided evidence of sound community engagement and consultation throughout the development of the Proposed Project; and

(f) has demonstrated that the Proposed Project will compete on the basis of price, total medical expenses, provider costs, and other recognized measures of health care spending.

(FACTOR 2) Health Priorities. Here, we are looking to establish that the Applicant has demonstrated that the Proposed Project will meaningfully contribute to the Commonwealth's goals for cost containment, improved public health outcomes, and delivery system transformation; and that it meets or advances one or more of the Health Priorities set out in the Department’s Community Based Health Initiative Guideline.

(FACTOR 3) Compliance and good standing with federal, state, and local laws and regulations.

(FACTOR 4) Sufficient funds. Here, we ensure that the Applicant has provided sufficient documentation of the availability of funds for capital and ongoing operating costs necessary to support the Proposed Project.

(FACTOR 5) Relative Merit. Here, we ensure that the Applicant has provided sufficient evidence that the Proposed Project, on balance, is superior to alternative and substitute methods for meeting the Patient Panel needs identified.

(FACTOR 6) Community-based Health Initiatives. Here, we review the Applicant's proposed plans for fulfilling its responsibilities set out in the Department's Community-based Health Initiatives Guideline. The public has an opportunity to comment on the Applicant’s Community Engagement Plan and processes, Advisory Board make up and decision making structure, and Community Health Initiative Narrative.

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