Be it enacted by the General Assembly of Virginia:
1. That §32.1-102.3 of the Code of Virginia is amended and reenacted as follows:
§32.1-102.3. Certificate required; criteria for determining need.
A. No person shall commence any project without first obtaining a certificate issued by the Commissioner. No certificate may be issued unless the Commissioner has determined that a public need for the project has been demonstrated. If it is determined that a public need exists for only a portion of a project, a certificate may be issued for that portion and any appeal may be limited to the part of the decision with which the appellant disagrees without affecting the remainder of the decision. Any decision to issue or approve the issuance of a certificate shall be consistent with the most recent applicable provisions of the State Medical Facilities Plan; however, if the Commissioner finds, upon presentation of appropriate evidence, that the provisions of such plan are not relevant to a rural locality's needs, inaccurate, outdated, inadequate or otherwise inapplicable, the Commissioner, consistent with such finding, may issue or approve the issuance of a certificate and shall initiate procedures to make appropriate amendments to such plan. In cases in which a provision of the State Medical Facilities Plan has been previously set aside by the Commissioner and relevant amendments to the Plan have not yet taken effect, the Commissioner's decision shall be consistent with the applicable portions of the State Medical Facilities Plan that have not been set aside and the remaining considerations in subsection B.
B. In determining whether a public need for a project has been demonstrated, the Commissioner shall consider:
1. The extent to which the proposed service or facility will
provide or increase access to needed services for residents of people
in the area to be served, and the effects that the proposed service or
facility will have on access to needed services in areas having distinct and
unique geographic, socioeconomic, cultural, transportation, and other barriers
to access to care;
2. The extent to which the project will meet the needs of
the residents of people in the area to be served, as demonstrated by
each of the following: (i) the level of community support for the project
demonstrated by citizens people, businesses, and governmental
leaders representing the area to be served; (ii) the availability of reasonable
alternatives to the proposed service or facility that would meet the needs of
the population people in the area to be served in a less costly,
more efficient, or more effective manner; (iii) any recommendation or report of
the regional health planning agency regarding an application for a certificate
that is required to be submitted to the Commissioner pursuant to subsection B
of §32.1-102.6; (iv) any costs and benefits of the project; (v) the financial
accessibility of the project to the residents of people in the
area to be served, including indigent residents people; and (vi)
at the discretion of the Commissioner, any other factors as may be relevant to
the determination of public need for a project;
3. The extent to which the application is consistent with the State Medical Facilities Plan;
4. The extent to which the proposed service or facility
fosters institutional competition that benefits the area to be served while
improving access to essential health care services for all persons
people in the area to be served;
5. The relationship of the project to the existing health care system of the area to be served, including the utilization and efficiency of existing services or facilities;
6. The feasibility of the project, including the financial benefits of the project to the applicant, the cost of construction, the availability of financial and human resources, and the cost of capital;
7. The extent to which the project provides improvements or
innovations in the financing and delivery of health services, as demonstrated
by: (i) the introduction of new technology that promotes quality, cost
effectiveness, or both in the delivery of health care services; (ii) the
potential for provision of services on an outpatient basis; (iii) any
cooperative efforts to meet regional health care needs; and (iv) at the
discretion of the Commissioner, any other factors as may be appropriate; and
8. In the case of a project proposed by or affecting a
teaching hospital associated with a public institution of higher education or a
medical school in the area to be served, (i) the unique research, training, and
clinical mission of the teaching hospital or medical school, and (ii)
any contribution the teaching hospital or medical school may provide in the
delivery, innovation, and improvement of health care for citizens of the
Commonwealth, including indigent or underserved populations.