General Information
Proposed 2008 State Medical Facilities Plan
The Proposed 2008 State Medical Facilities Plan is now available at
/plan2008/2008proposalcomp2.pdf (pdf, 6 Mb, 343 pages).
The committee recommendations are available online for the SHCC meeting on September 26, 2007.
The Long-Term and Behavioral Health Committee is meeting on September 14, 2007 to discuss petitions and comments on the 2008 SMFP.
The Acute Care Services Committee is meeting on September 4, 2007 to discuss petitions and comments on the 2008 SMFP.
The Technology and Equipment Committee is meeting on August 29, 2007 to discuss petitions and comments on the 2008 SMFP.
There have been updates to the 2008 Proposed State Medical Facilities Plan.
You may order a printed copy of the Proposed 2008 State Medical Facilities Plan. (pdf)
Six public hearings have been set to discuss the state's health facilities needs.
The hearings will be conducted July 13 through August 1 at various locations around the state.
2007 State Medical Facilities Plan
The State Medical Facilities Plan is an annual document which contains policies and methodologies used in determining need for new health care facilities and services in North Carolina. "Need Determinations" and, where appropriate, "Certificate of Need Application Due Dates" are listed in each service area chapter. The Plan also contains background information on the N.C. State Health Coordinating Council, on the annual planning cycle, and general policies related to implementing the planning cycle.
The State Medical Facilities Plan ("Plan") is developed by the Division of Health Service Regulation, NC Department of Health and Human Services, under the direction of the North Carolina State Health Coordinating Council, (pursuant to G.S. §131E-177) and approved by the Governor. Each Plan takes effect on January 1st and expires on December 31st.
You may view the plan at
/plan2007/discplan.shtml .
If you wish to purchase a printed copy of the 2007 Plan, please click here.
Order Form (pdf).
The major objective of the Plan is to provide individuals, institutions, state and local government agencies, and community leadership with policies and projections of need to guide local planning for specific health care facilities and services. Projections of need are provided for the following types of facilities:
- acute care hospitals
- operating rooms
- inpatient rehabilitation facilities
- technology services
- nursing care facilities
- adult care home beds
- Medicare-certified home health agencies
- end-stage renal disease dialysis facilities
- hospice home care and hospice inpatient beds
- psychiatric hospital units and specialty hospitals
- substance abuse hospital units, specialty hospitals, and residential facilities
- intermediate care facilities for mentally retarded persons
Chapters dealing with specific facility/service categories contain summaries of the supply and the utilization of each type of facility or service, a description of changes in the projection method and policies from the previous planning year, a description of the projection method, and other data relevant to the projections of need.
The projections of need for the various facilities and services are used in conjunction with other statutes and rules in reviewing certificate of need applications for establishment, expansion, or conversion of health care facilities and services. All parties interested in health care facility and health services planning should consider this Plan a key resource.
Basic Principles Governing the Development of this Plan
1. Promote Cost-Effective Approaches: In these times of high and increasing costs of most health care services, North Carolina is committed to promoting cost-effective approaches to the provision and purchase of health services. The Department of Health and Human Services encourages the development and use of cost-effective alternative approaches to health care delivery by providers of care, consumers and third-party payers. The Department encourages the development of health care delivery networks, accountable health plans, accountable health carriers, community care networks, integrated delivery systems or any system which provides for more cost-effective delivery of health care services through collaborative efforts among health care providers. Other examples of cost-effective approaches include the development of prepaid health plans, appropriate uses of out-patient treatment modalities, community-based services, innovative reimbursement programs, and conversion of underutilized existing facilities to uses for which there is a demonstrated need.
2. Expand Health Care Services to the Medically Underserved:
The Department of Health and Human Services recognizes the need to ensure access to health care in as equitable a manner as possible. Individuals who are medically underserved include low-income persons, racial and ethnic minorities, and disabled persons.
It is important to recognize that a variety of public funds are used to address the needs of the medically underserved, including Medicare, Medicaid, State and local funding of public health clinics and community mental health centers, local funding of community hospitals, and some State programs that help individuals with specialized health problems (i.e., Children's Special Health Services Program, Sickle Cell Anemia Program, Sudden Infant Death Syndrome Program, etc.). In addition, many providers serve low-income persons by increasing the charges paid by insured patients, although the extent of this cost-shifting is not always known. As the health care system becomes more competitive, providers may be forced to decrease their cost-shifting practices, resulting in an increased reliance on public funds or a decrease in services available to the medically underserved.
3. Encourage Quality Health Care Services:
The Department of Health and Human Services is committed to assuring citizens of North Carolina adequate access and availability to quality health care at a reasonable cost.
The Department of Health and Human Services recognizes the practical limits of this commitment, i.e., the Department of Health and Human Services does not have resources adequate to guarantee each citizen access to every health service that could possibly benefit that person throughout her/his lifetime. Therefore, the Department, in allocating its available resources, gives priority to health services which are considered to be: a) cost-effective, and b) potentially beneficial to the majority of North Carolina's citizens. Further, the Department of Health and Human Services will attempt to influence resource allocation decisions by other public and private entities in the same direction. Trade-offs among cost
containment, access and quality complicate decisions about acceptable or desirable levels of care as well as the trend toward using complex technology, treating a greater mix of cases, and dealing with more chronic conditions. In spite of these complexities, it is important that quality of care be assured.
The State Health Planning Process
Throughout the development of the State Medical Facilities Plan there are opportunities for public review and comment. Sections of the Plan, including the policies and methods for projecting need, are developed with the assistance of committees of the North Carolina State Health Coordinating Council (Table 1A). The committees submit their recommendations to the Council for approval. A Proposed Plan is assembled and made available to the public. Public hearings
on the Proposed Plan are held throughout the State in early summer. Comments and petitions received during this period are considered by the Council and, upon incorporation of all changes approved by the Council, a final draft of the Plan is presented to the Governor for his review and approval. With the Governor's approval, the State Medical Facilities Plan becomes the official document for health facility and health service planning in North Carolina for the specified calendar year.
Other Publications
Information concerning publications or the availability of other data related to the health planning process may be obtained by writing or calling the Medical Facilities Planning Section, Division of Health Service Regulation, 2714 Mail Service Center, Raleigh, North Carolina 27699-2714, Telephone Number: (919) 855-3865, FAX Number (919) 715-4413.
Note
Determinations of need for services and facilities in the State Medical Facilities Plan do not imply an intent on the part of the Division of Medical Assistance of the N. C. Department of Health and Human Services to participate in the reimbursement of the cost of care of patients using services and facilities developed in response to this need.
North Carolina State Health Coordinating Council Members
Committee Membership, and Staff
| Members |
Representing |
From |
| Dan A. Myers, M.D., Chairman | At-Large | Kinston |
| Donald C. Beaver | Health Care Facilities Association | Hickory |
| Bill Bedsole | At-Large | Washington |
| Greg Beier | At-Large | Winston-Salem |
| Richard F. Bruch, M.D. | Medical Society | Durham |
| Dennis A. Clements, III, M.D. | Academic Medical Centers | Durham |
| Dana D. Copeland, M.D. | At-Large | Raleigh |
| Dr. Lawrence Cutchin | At-Large | Tarboro |
| Sandra B. Greene, Dr. P.H. | Health Insurance Industry | Chapel Hill |
| Ted Griffin | Business & Industry | Durham |
| Charles Hauser | At-Large | Winston-Salem |
| Laurence C. Hinsdale | At-Large | Concord |
| Ken Hodges | Long-Term and Behavioral Health | Henderson |
| Frances D. Mauney | At-Large | Durham |
| Mac McCrary | Business & Industry | Morganton |
| William O. McMillan, Jr., M.D. | Area Health Education Centers | Wilmington |
| M. Jackson Nichols | County Commissioners Association | Wilmington |
| Stephen W. Nuckolls | At-Large | New Bern |
| Jerry Parks | Association of Local Health Directors | Edenton |
| Thomas J. Pulliam, M.D. | At-Large | Winston-Salem |
| Timothy R. Rogers | Home Care Association | Raleigh |
| Michael C. Tarwater | Hospital Association | Charlotte |
| Christopher G. Ullrich, M.D. | At-Large | Charlotte |
| Rep. William L. Wainwright | N.C. House of Representatives | Havelock |
| Zane Walsh, M.D. | At-Large | Fayetteville |
| Acute Care Services Committee (planning for acute care beds, operating rooms,
open heart surgery services, heart-lung bypass machines, burn intensive care services, transplantation services [bone marrow transplants and solid organ transplants], and inpatient rehabilitation services):
|
| Michael C. Tarwater (Chair); Sandra B. Greene, Dr.P.H.; (Vice Chair), Bill Bedsole; Dr. Dana D. Copeland; Dr. Lawrence M. Cutchin; Laurence C. Hinsdale; Jack Nichols; Dr. Zane Walsh. |
| Staffed by: Victoria McClanahan |
|
Long-Term and Behavioral Health Committee (planning for nursing care facilities; adult care homes; home health services; hospice services; end-stage renal disease dialysis facilities; psychiatric inpatient facilities; substance abuse inpatient and residential services; and intermediate care facilities for the mentally retarded):
|
|
Dr. Thomas J. Pulliam (Chair); Jerry Parks (Vice Chair); Donald C. Beaver;
Doug Copeland; Ted Griffin; Ken Hodges; Frances D. Mauney; Timothy R. Rogers.
|
| Staffed by: Floyd Cogley, Tom Elkins and Victoria McClanhan |
|
Technology and Equipment Committee (planning for lithotripsy, gamma knife, radiation oncology services – linear accelerators, positron emission tomography scanners, magnetic resonance imaging scanners, and cardiac catheterization/angioplasty equipment):
|
| Dr. Christopher G. Ullrich (Chair); Dr. William O. McMillan, Jr. (Vice Chair);
Greg Beier; Dr. Richard F. Bruch; Dr. Dennis A. Clements III; Charles Hauser; Mac McCrary;
Stephen W. Nuckolls; Rep. William L. Wainwright.
|
| Staffed by: Tom Elkins |
NOTE: The SHCC Chairperson, Dr. Dan A. Myers, serves as an ex officio member of all standing committees. Each committee chairperson also serves as an ex officio member on the other standing committees.
Medical Facilities Planning Section Staff
Floyd Cogley, Planner
Tom Elkins, Planner
Victoria McClanahan, Planner
Kelli Fisk, Secretary
Division of Health Service Regulation
Robert J. Fitzgerald, Director
Elizabeth K. Brown, Chief, Budget and Planning