Letter of Intent

The first step for an applicant is to submit a letter of intent via the SHPDA's automated CON system. The purpose of the letter of intent is to inform the SHPDA that the applicant wants to obtain a CON, and to specify the key points of what is being proposed. The letter of intent should include:

• The name, address, and telephone number of the applicant
• The proposed location for the proposed health care facility or health service
• A brief description of the proposed health care facility or health service, including estimated capital expenditure and the proposed date of implementation

The Letter of Intent is considered void if an application has not been filed within 180 days of the date of submission.  An applicant may request in writing an extension of time beyond the 180 days.

A Letter of Intent should be submitted via SHPDA's automated system https://dcshpda.com/auth/login

Public Notice

An advertisement must be placed in a newspaper of general circulation in the District generally describing the proposed project, the location of the services, and stating that a letter of intent to apply for a Certificate of Need is being filed with the SHPDA.  A copy of the advertisement must be submitted with the letter of intent.

• Sample Public Notice [PDF]

A Public Notice must be submitted with the Letter of Intent via SHPDA's automated system https://dcshpda.com/auth/login

Waiting Period

The Certificate of Need regulations specify a 60-day waiting period between the submission of a letter of intent and the filing of an application. The SHPDA may waive this waiting period upon receipt of a reason demonstrating good cause.

Pre Application Conference

Applicants must consult with a designated member of the SHPDA staff prior to the submission of an application. This will allow the Applicant to review criteria, standards, procedures and timelines that will be followed during the review process.

Application Submission

The Applicant must submit the application via SHPDA's automated CON system. The fee required for an application is the greater of 3% of the proposed capital expenditure with a minimum of $5,000, and a maximum of $300,000. The Application Fee should be made payable to the DC Treasurer and mailed to:

Review periods begin on or about the 20th of the month. In order for a project to be considered, the application must be complete by the 10th of that month. In order for an application to be declared complete by the 10th, it is strongly recommended that the application be submitted at least by the 20th of the previous month. This will allow enough time for staff to review the application and request additional information.

Keep in mind that in order to submit the application on the 20th of the month, the letter of intent must have been submitted 60 days before that date. Applicants should allow six months between the time a letter of intent is submitted and the time the final decision is made by the SHPDA Director.

Once the application is declared complete, the review period begins. The SHPDA must complete the review within 90 days, barring certain conditions as outlined in regulations.

Applications for a capital expenditure to acquire an existing health care facility are reviewed within 60 days.

• Schedule of Reviews [PDF]

Completeness Review

When an application is received, the SHPDA staff reviews it for completeness within 15 workdays. In order to ensure that the completeness review proceeds expeditiously, it is recommended that the applicant work closely with the SHPDA staffer assigned to the project.

If the application is incomplete, the SHPDA will send the applicant a list of questions. When answers are received, the SHPDA will declare the application complete. The SHPDA will base its decision on the information submitted into the record.

SHPDA Staff Review

The review process is relatively straightforward. The SHPDA staff prepares an analysis of the applicant's proposal, with information on the type of service or facility proposed and a description of the applicant's plans. It also assesses those plans in relation to the DC Comprehensive Health Plan and the criteria and standards contained in DC regulations.

Public Hearings During Review

Any interested person (including the applicant) may, during the first 30 days of the review period, request that a public hearing be held. If a request is made, the SHPDA will hold a hearing. The SHPDA on its own may also decide to hold a public hearing. On the other hand, the SHPDA is required to hold an informational hearing on all applications that propose the acquisition of existing services or facilities.

If a public hearing is held, any person may present oral and/or written testimony.  Public hearings are held prior to the consideration of applications by the Project Review Committee of the Statewide Health Coordinating Council (SHCC).

SHCC Project Review Committee Consideration

The staff analysis is reviewed by the Project Review Committee of the Statewide Health Coordinating Council (SHCC). The Project Review Committee is composed of citizens (health care consumers and providers) who are appointed by the Mayor with the advice and consent of the DC City Council. The Committee will hold a meeting to consider the application, using the staff's analysis as a basic document. These meetings are generally held at 6 pm on the second Thursday of each month, and are open to the public.

The applicant may make a brief presentation of the proposed project and respond to questions raised by the Committee. Other interested people may also make brief presentations during the period reserved for public comment.

After discussion, the Project Review Committee will vote on a recommendation concerning the application. The Committee generally makes one of three types of recommendations:

• Approval by the SHCC and SHPDA
• Approval with conditions related to the review criteria
• Denial of the application.

Closure of the Review Period

Regulations require that the Project Review Committee, the full SHCC, and the SHPDA Director all consider the same information in judging applications. For this reason, the record is closed to new information two days after the Project Review Committee has considered the application. The two-day period following the meeting is designed to allow clarifying information to be placed in the record. The record is reopened solely for review, discussion, and balloting by the full SHCC. Neither the applicant nor other interested persons may participate in the SHCC deliberations.

Ex Parte Contacts

Ex parte contacts are communications with the SHPDA Director, the SHPDA staff, or members of the SHCC that concern the substance of any application and are not a part of the public record. In order to ensure fairness and openness in the review process, ex parte contacts are prohibited from the close of a public hearing held on an application (or, if no public hearing is held, from the close of the Project Review Committee meeting) until the SHPDA Director has made a decision on the application. During the period in which ex parte contacts are prohibited, applicants and other interested persons must not contact the SHPDA Director, the SHPDA staff, or members of the SHCC to discuss the project. However, any interested person may, at any time, contact the SHPDA staff to discuss non-substantive issues concerning the review, such as the review schedule.

The SHPDA Director's Consideration and Action

The SHCC's recommendation is sent to the SHPDA Director for consideration, along with the recommendation of the Project Review Committee. The SHPDA Director issues a decision within a few days of the SHCC's action. The Director can issue a Certificate of Need without conditions, award it with conditions, or deny it. The recommendations of the Project Review Committee and the SHCC are only advisory.

Reconsideration of Decisions and Appeals

Once the SHPDA Director has issued a decision, the SHPDA notifies all interested parties. Any person can appeal the Director's decision, based on the grounds for reconsideration specified in the DC Certificate of Need law and regulations. If the Director determines reconsideration is warranted, the SHPDA will hold a public hearing. After that a new decision may be issued or the original decision may be affirmed.

If a reconsideration hearing has been granted, the holders of a Certificate of Need that is under challenge are at risk if they proceed with the project before a final decision is made.

The SHPDA Director's decision on reconsideration may be further appealed to the Office of Administrative Hearings and then to the courts. Contact the Project Review Branch for additional information on the appeal process.