Michigan s Certificate of Need Program .

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2. Government Certificate of Need Background. Dist. of Columbia and New York grew CON in 1964.Federally commanded CON projects were set up as a national medicinal services cost regulation technique. The 1974 National Health Planning and Resources Development Act ordered that states have CON projects to be qualified for certain general wellbeing funds.In 1986, the government command for CON was not renewe
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Michigan\'s Certificate of Need Program Michigan Department of Community Health

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Federal Certificate of Need Background Dist. of Columbia and New York grew CON in 1964. Governmentally commanded CON projects were built up as a national human services cost regulation system. The 1974 National Health Planning and Resources Development Act commanded that states have CON projects to be qualified for certain general wellbeing reserves. In 1986, the government command for CON was not reestablished. CON directions are organized, on a fundamental level, to enhance access to quality social insurance administrations while containing costs. Social insurance associations are required to exhibit require before putting resources into a controlled office, administration or hardware. Since the annulment of the government order, 37 states have held some type of a CON program.

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Certificate of Need Programs Range of Services Reviewed Under State CON Programs Source: 2002 National Directory of Health Planning, Policy and Regulatory Agencies , American Health Planning Association.

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Michigan CON Legislation Public Act 368 of 1978 commanded the Michigan CON program. The CON Reform Act of 1988 was passed to make a deliberate approach to create measures and lessen the quantity of administrations requiring a CON. The demonstration likewise made the CON Commission. The commission, whose enrollment is delegated by the Governor, is in charge of creating and affirming CON audit norms. Open Act 619 of 2002 adjusted a few segments the Public Health Code relating to CON including, yet not constrained to,: No CON required for non-clinical capital use ventures Redefined "country area" Expanded special cases to CON under MCL 333.22209 Expanded the CON Commission Requires audit of guidelines at regular intervals and changes strategy for creating gauges

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Michigan CON Program Requirements and Standards The accompanying activities must get a CON [M.C.L. 333.22209(1)]: Acquire a current wellbeing office or start operation of a wellbeing office at a site that is not as of now authorized for that sort Make an adjustment in the bed limit of a wellbeing office Initiate, supplant, or grow a secured clinical administration Make a secured capital consumption Capital use ventures (i.e., development, redesign) must get a CON if the activities surpasses [M.C.L. 333.22203]: $2,622,500 for clinical administration ranges, as of January 2004 Note : Thresholds are filed yearly by the division in view of the Consumer Price Index.

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Air ambulances (helicopters) Cardiac catheterization, including indicative, restorative, angioplasty, PCI, and electrophysiology Computed tomography (CT) scanners Hospital beds – general intense care Magnetic reverberation imaging (MRI) Megavoltage radiation treatment (MRT) Neonatal escalated mind units (NICU) Nursing home/healing facility long haul mind beds Open heart surgery Positron emanation tomography (PET) Psychiatric beds – intense inpatient Surgical administrations – doctor\'s facility and detached Transplantation administrations – bone marrow, including fringe immature microorganism, heart, heart-lung, lung, liver, and pancreas Urinary lithotripters Michigan CON Program Requirements and Standards proceeded… Covered Items, Clinical Services and Equipment:

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CON Review Section (CRS) Contact from Applicant (telephone, meeting, letter) LOI pkg. sent to candidate CRS gets LOI Application frames sent to candidate inside 15 days Application to CRS No Application to neighborhood survey office Additional data audit Request for extra data 30 days Recommendations to CRS ahead of time of choice date Request information. to CRS & neighborhood rev. organization 30 days (non-substantive) 90 days (substantive/near) Application regarded finish proceeded with Michigan CON Program Application Review Process

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Michigan CON Program Application Review Process proceeded…

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Michigan CON Program Application Review Process proceeded…

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Michigan CON Program Application Review Process proceeded…

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Non-substantive Review Substantive Individual Review Potential Comparative 120 days 45 days 30 days Proposed choice Proposed choice Comparative gathering 5 days Approval Denial Final choice 5 days 15 days Not similar Comparative Final choice 120 days Final choice Request for hearing Single proposed choice 15 days Waive obligatory hearing date 90 days Designated Application Dates Non-substantive audit – any workday Substantive survey – 1 st workday of month Comparative audit – 1 st workday of Feb., June, or Oct. Ask for Hearing 90 days unless postponed Reconsideration Approval Final choice Final choice Michigan CON Program Application Review Process proceeded with… Continued

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Commission, standard admonitory board, MDCH or private expert creates draft gauges. MDCH additionally gives staff help. Proposed norms are disliked by Commission. Commission affirms, dislikes, or reconsiders proposed benchmarks. Proposed models are affirmed by Commission. Proposed benchmarks might be come back to MDCH, standard counseling board, or private advisor for further work. Commission holds open hearing. Sent to joint authoritative advisory group for 30-day remark period. Commission meets to favor, object, or change proposed FINAL survey benchmarks. Benchmarks are objected by Commission. Benchmarks are affirmed by Commission. Affirmed gauges sent to joint authoritative council and Governor for 45-day survey period. Norms might be returned for further work. Models are endorsed by the joint authoritative council and the Governor. Benchmarks are disliked by the joint administrative board of trustees and the Governor. Audit guidelines get to be distinctly viable and sent to the Office of Regulatory Reform to be distributed. Benchmarks don\'t get to be distinctly compelling or come back to the Commission for further work. Michigan CON Commission Standards Development Process MDCH and the Office of the Attorney General give input (managerial attainability and lawfulness) with respect to any proposed benchmarks.

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Tools: Annual Hospital Statistical Questionnaire Hospitals, unattached surgical offices, detached MRT offices, and unsupported CT offices Annual PET scanner review MRI electronic database Michigan Inpatient Data Base (MIDB) General Measures: Measures for Select Services: Infrastructure (i.e., equipment)  Wait times Procedures  Staffing Weighted volumes  Certifications Michigan CON Program Surveillance Tools Michigan CON Authority: Act 368, P.A. 1978 – " A wellbeing office or organization should give the division information and measurements required to empower the office to do capacities required by government and state law, including tenets and directions."

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Michigan CON Program Web Site: www.michigan.gov/con Highlights Listserv Standards Laws Rules Forms Notices FQA Contact Info Updates

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Question & Answers Contact Information: Certificate of Need Program Lewis Cass Building 320 S. Walnut Street, 3 rd Floor Lansing, Michigan 48913 Phone: 517/241-3344 Web Site: www.michigan.gov/con

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