{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-102.3.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-102.3.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-102.3.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-102.3.html"}],"law_id":59668,"edition_id":1,"section_id":59668,"structure_id":14008,"section_number":"32.1-102.3","catch_line":"Demonstration of public need required; criteria for determining need","history":"1982, c. 388; 1984, c. 740; 1993, c. 704; 1999, c. 926; 2000, c. 931; 2004, cc. 71, 95; 2008, c. 292; 2009, c. 175; 2020, cc. 227, 558, 1271.","full_text":"A\n\nNo 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 Health Services 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of appropriate evidence, that the provisions of such plan are not relevant to a rural locality’s needs, inaccurate, outdated, inadequate or otherwise inapplicable, the Commissioner, consistent with such finding, may issue or approve the issuance of a certificate and shall initiate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 Health Services 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 Health Services Plan that have not been set aside and the remaining considerations in subsection B.B\n\nIn determining whether a public need for a project has been demonstrated, the Commissioner shall consider:1\n\nThe extent to which the proposed project will provide or increase access to health care services for people in the area to be served and the effects that the proposed project will have on access to health care services in areas having distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to health care;2\n\nThe extent to which the proposed project will meet the needs of people in the area to be served, as demonstrated by each of the following: (i) the level of community support for the proposed project demonstrated by people, businesses, and governmental leaders representing the area to be served; (ii) the availability of reasonable alternatives to the proposed project that would meet the needs of 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 proposed project; (v) the financial accessibility of the proposed project to people in the area to be served, including indigent people; and (vi) at the discretion of the Commissioner, any other factors as may be relevant to the determination of public need for a proposed project;3\n\nThe extent to which the proposed project is consistent with the State Health Services Plan;4\n\nThe extent to which the proposed project fosters institutional competition that benefits the area to be served while improving access to essential health care services for all people in the area to be served;5\n\nThe relationship of the proposed project to the existing health care system of the area to be served, including the utilization and efficiency of existing services or facilities;6\n\nThe feasibility of the proposed project, including the financial benefits of the proposed project to the applicant, the cost of construction, the availability of financial and human resources, and the cost of capital;7\n\nThe extent to which the proposed project provides improvements or innovations in the financing and delivery of health care 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 health care 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; and8\n\nIn 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 services for citizens of the Commonwealth, including indigent or underserved populations.","order_by":null,"text":{"0":{"id":218523,"text":"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 Health Services 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 Health Services 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 Health Services Plan that have not been set aside and the remaining considerations in subsection B.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":218524,"text":"In determining whether a public need for a project has been demonstrated, the Commissioner shall consider:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":218525,"text":"The extent to which the proposed project will provide or increase access to health care services for people in the area to be served and the effects that the proposed project will have on access to health care services in areas having distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to health care;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":218526,"text":"The extent to which the proposed project will meet the needs of people in the area to be served, as demonstrated by each of the following: (i) the level of community support for the proposed project demonstrated by people, businesses, and governmental leaders representing the area to be served; (ii) the availability of reasonable alternatives to the proposed project that would meet the needs of 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 proposed project; (v) the financial accessibility of the proposed project to people in the area to be served, including indigent people; and (vi) at the discretion of the Commissioner, any other factors as may be relevant to the determination of public need for a proposed project;","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"4":{"id":218527,"text":"The extent to which the proposed project is consistent with the State Health Services Plan;","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"B4"},"5":{"id":218528,"text":"The extent to which the proposed project fosters institutional competition that benefits the area to be served while improving access to essential health care services for all people in the area to be served;","type":"section","prefixes":["B","4"],"prefix":"4","entire_prefix":"B4","prefix_anchor":"B4","level":2,"prior_prefix":"B3","next_prefix":"B5"},"6":{"id":218529,"text":"The relationship of the proposed project to the existing health care system of the area to be served, including the utilization and efficiency of existing services or facilities;","type":"section","prefixes":["B","5"],"prefix":"5","entire_prefix":"B5","prefix_anchor":"B5","level":2,"prior_prefix":"B4","next_prefix":"B6"},"7":{"id":218530,"text":"The feasibility of the proposed project, including the financial benefits of the proposed project to the applicant, the cost of construction, the availability of financial and human resources, and the cost of capital;","type":"section","prefixes":["B","6"],"prefix":"6","entire_prefix":"B6","prefix_anchor":"B6","level":2,"prior_prefix":"B5","next_prefix":"B7"},"8":{"id":218531,"text":"The extent to which the proposed project provides improvements or innovations in the financing and delivery of health care 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 health care 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","type":"section","prefixes":["B","7"],"prefix":"7","entire_prefix":"B7","prefix_anchor":"B7","level":2,"prior_prefix":"B6","next_prefix":"B8"},"9":{"id":218532,"text":"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 services for citizens of the Commonwealth, including indigent or underserved populations.","type":"section","prefixes":["B","8"],"prefix":"8","entire_prefix":"B8","prefix_anchor":"B8","level":2,"prior_prefix":"B7"}},"ancestry":[{"id":14008,"edition_id":1,"name":"Medical Care Facilities Certificate of Public Need","identifier":"1.1","label":"article","depth":3,"order_by":1,"parent_id":13670,"metadata":{},"date_created":"2026-06-26 03:46:36","date_modified":"2026-06-26 03:46:36","permalink":{"id":202397,"object_type":"structure","relational_id":14008,"identifier":"1.1","token":"32.1\/4\/1.1","url":"\/32.1\/4\/1.1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13670,"edition_id":1,"name":"Health Care Planning","identifier":"4","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:45:31","date_modified":"2026-06-26 03:45:31","permalink":{"id":202389,"object_type":"structure","relational_id":13670,"identifier":"4","token":"32.1\/4","url":"\/32.1\/4\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":77111,"structure_id":14008,"section_number":"32.1-102.1","catch_line":"Definitions","url":"\/32.1-102.1\/","token":"32.1\/4\/1.1\/32.1-102.1","metadata":false},{"id":75479,"structure_id":14008,"section_number":"32.1-102.10","catch_line":"Commencing project without certificate or registration grounds for refusing to issue license","url":"\/32.1-102.10\/","token":"32.1\/4\/1.1\/32.1-102.10","metadata":false},{"id":55098,"structure_id":14008,"section_number":"32.1-102.11","catch_line":"Application of article","url":"\/32.1-102.11\/","token":"32.1\/4\/1.1\/32.1-102.11","metadata":false},{"id":63051,"structure_id":14008,"section_number":"32.1-102.12","catch_line":"Repealed","url":"\/32.1-102.12\/","token":"32.1\/4\/1.1\/32.1-102.12","metadata":false},{"id":77991,"structure_id":14008,"section_number":"32.1-102.13","catch_line":"Repealed","url":"\/32.1-102.13\/","token":"32.1\/4\/1.1\/32.1-102.13","metadata":false},{"id":86983,"structure_id":14008,"section_number":"32.1-102.1:1","catch_line":"Equipment registration required","url":"\/32.1-102.1_1\/","token":"32.1\/4\/1.1\/32.1-102.1_1","metadata":false},{"id":69151,"structure_id":14008,"section_number":"32.1-102.1:2","catch_line":"Certificate of public need required; registration of certain equipment and capital projects required","url":"\/32.1-102.1_2\/","token":"32.1\/4\/1.1\/32.1-102.1_2","metadata":false},{"id":63394,"structure_id":14008,"section_number":"32.1-102.1:3","catch_line":"(Effective July 1, 2028) Medical care facilities and projects for which a certificate is required","url":"\/32.1-102.1_3\/","token":"32.1\/4\/1.1\/32.1-102.1_3","metadata":false},{"id":85729,"structure_id":14008,"section_number":"32.1-102.2","catch_line":"Regulations","url":"\/32.1-102.2\/","token":"32.1\/4\/1.1\/32.1-102.2","metadata":false},{"id":63638,"structure_id":14008,"section_number":"32.1-102.2:1","catch_line":"State Health Services Plan; Task Force","url":"\/32.1-102.2_1\/","token":"32.1\/4\/1.1\/32.1-102.2_1","metadata":false},{"id":59668,"structure_id":14008,"section_number":"32.1-102.3","catch_line":"Demonstration of public need required; criteria for determining need","url":"\/32.1-102.3\/","token":"32.1\/4\/1.1\/32.1-102.3","metadata":false},{"id":73618,"structure_id":14008,"section_number":"32.1-102.3:1","catch_line":"Application for certificate not required of certain nursing facilities or nursing homes","url":"\/32.1-102.3_1\/","token":"32.1\/4\/1.1\/32.1-102.3_1","metadata":false},{"id":74212,"structure_id":14008,"section_number":"32.1-102.3:1.1","catch_line":"Continuing care retirement communities accessing medical assistance","url":"\/32.1-102.3_1.1\/","token":"32.1\/4\/1.1\/32.1-102.3_1.1","metadata":false},{"id":81863,"structure_id":14008,"section_number":"32.1-102.3:2","catch_line":"Certificates of public need; applications to be filed in response to Requests for Applications (RFAs)","url":"\/32.1-102.3_2\/","token":"32.1\/4\/1.1\/32.1-102.3_2","metadata":false},{"id":72268,"structure_id":14008,"section_number":"32.1-102.3:2.1","catch_line":"Repealed","url":"\/32.1-102.3_2.1\/","token":"32.1\/4\/1.1\/32.1-102.3_2.1","metadata":false},{"id":70992,"structure_id":14008,"section_number":"32.1-102.3:2.2","catch_line":"Expired","url":"\/32.1-102.3_2.2\/","token":"32.1\/4\/1.1\/32.1-102.3_2.2","metadata":false},{"id":81767,"structure_id":14008,"section_number":"32.1-102.3:3","catch_line":"Repealed","url":"\/32.1-102.3_3\/","token":"32.1\/4\/1.1\/32.1-102.3_3","metadata":false},{"id":85570,"structure_id":14008,"section_number":"32.1-102.3:5","catch_line":"Repealed","url":"\/32.1-102.3_5\/","token":"32.1\/4\/1.1\/32.1-102.3_5","metadata":false},{"id":58921,"structure_id":14008,"section_number":"32.1-102.3:7","catch_line":"Application for transfer of nursing facility beds","url":"\/32.1-102.3_7\/","token":"32.1\/4\/1.1\/32.1-102.3_7","metadata":false},{"id":87198,"structure_id":14008,"section_number":"32.1-102.3:8","catch_line":"Application for an open admission period for a continuing care retirement community","url":"\/32.1-102.3_8\/","token":"32.1\/4\/1.1\/32.1-102.3_8","metadata":false},{"id":84648,"structure_id":14008,"section_number":"32.1-102.4","catch_line":"Conditions of certificates; monitoring; revocation of certificates; civil penalties","url":"\/32.1-102.4\/","token":"32.1\/4\/1.1\/32.1-102.4","metadata":false},{"id":70069,"structure_id":14008,"section_number":"32.1-102.5","catch_line":"Certificate not transferable","url":"\/32.1-102.5\/","token":"32.1\/4\/1.1\/32.1-102.5","metadata":false},{"id":59090,"structure_id":14008,"section_number":"32.1-102.6","catch_line":"Administrative procedures","url":"\/32.1-102.6\/","token":"32.1\/4\/1.1\/32.1-102.6","metadata":false},{"id":73958,"structure_id":14008,"section_number":"32.1-102.6:1","catch_line":"Revocation of a certificate","url":"\/32.1-102.6_1\/","token":"32.1\/4\/1.1\/32.1-102.6_1","metadata":false},{"id":62746,"structure_id":14008,"section_number":"32.1-102.7","catch_line":"Repealed","url":"\/32.1-102.7\/","token":"32.1\/4\/1.1\/32.1-102.7","metadata":false},{"id":64703,"structure_id":14008,"section_number":"32.1-102.8","catch_line":"Enjoining project undertaken without certificate or registration","url":"\/32.1-102.8\/","token":"32.1\/4\/1.1\/32.1-102.8","metadata":false},{"id":64968,"structure_id":14008,"section_number":"32.1-102.9","catch_line":"Designation of judge","url":"\/32.1-102.9\/","token":"32.1\/4\/1.1\/32.1-102.9","metadata":false}],"previous_section":{"id":63638,"structure_id":14008,"section_number":"32.1-102.2:1","catch_line":"State Health Services Plan; Task Force","url":"\/32.1-102.2_1\/","token":"32.1\/4\/1.1\/32.1-102.2_1","metadata":false},"next_section":{"id":73618,"structure_id":14008,"section_number":"32.1-102.3:1","catch_line":"Application for certificate not required of certain nursing facilities or nursing homes","url":"\/32.1-102.3_1\/","token":"32.1\/4\/1.1\/32.1-102.3_1","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-102.3\/","history_text":"

This law was first created in 1982. The record of its establishment is cataloged in chapter 388 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1982 \u201cActs\u201d aren\u2019t available online. It has been modified 8 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1984, chapter 740; in 1993, chapter 704; in 1999, chapter 926<\/a>; in 2000, chapter 931<\/a>; in 2004, chapters 71<\/a> and 95<\/a>; in 2008, chapter 292<\/a>; in 2009, chapter 175<\/a>; in 2020, chapters 227<\/a>, 558<\/a>, and 1271<\/a>.<\/p>","references":false,"refers_to":[{"id":59090,"section_number":"32.1-102.6","catch_line":"Administrative procedures","order_by":null,"url":"\/32.1-102.6\/"}],"permalink":{"id":202439,"object_type":"law","relational_id":59668,"identifier":"32.1-102.3","token":"32.1\/4\/1.1\/32.1-102.3","url":"\/32.1-102.3\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-102.3\/","token":"32.1\/4\/1.1\/32.1-102.3","dublin_core":{"Title":"Demonstration of public need required; criteria for determining need","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-102.3","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> No certificate<\/span> may be issued unless the Commissioner<\/span> has determined that a public need for the project<\/span> has been demonstrated. If it is determined that a public need exists for only a portion of a project<\/span>, a certificate<\/span> may be issued for that portion and any appeal<\/span> may be limited to the part of the decision with which the appellant<\/span> disagrees without affecting the remainder of the decision. Any decision to issue<\/span> or approve the issuance of a certificate<\/span> shall be consistent with the most recent applicable provisions of the State Health Services Plan<\/span>; however, if the Commissioner<\/span> finds, upon presentation of appropriate evidence<\/span>, that the provisions of such plan are not relevant to a rural locality’s needs, inaccurate, outdated, inadequate or otherwise inapplicable, the Commissioner<\/span>, consistent with such finding<\/span>, may issue<\/span> or approve the issuance of a certificate<\/span> and shall initiate procedures to make appropriate amendments to such plan. In cases in which a provision of the State Health Services Plan<\/span> has been previously set aside by the Commissioner<\/span> and relevant amendments to the Plan have not yet taken effect, the Commissioner<\/span>’s decision shall be consistent with the applicable portions of the State Health Services Plan<\/span> that have not been set aside and the remaining considerations in subsection B. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> In determining whether a public need for a project<\/span> has been demonstrated, the Commissioner<\/span> shall consider: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> The extent to which the proposed project<\/span> will provide or increase access to health care services for people in the area to be served and the effects that the proposed project<\/span> will have on access to health care services in areas having distinct and unique geographic, socioeconomic, cultural, transportation, and other barriers to access to health care; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The extent to which the proposed project<\/span> will meet the needs of people in the area to be served, as demonstrated by each of the following: (i) the level of community support for the proposed project<\/span> demonstrated by people, businesses, and governmental leaders representing the area to be served; (ii) the availability of reasonable alternatives to the proposed project<\/span> that would meet the needs of 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<\/span> regarding an application<\/span> for a certificate<\/span> that is required to be submitted to the Commissioner<\/span> pursuant to subsection B of § 32.1-102.6<\/a>; (iv) any costs and benefits of the proposed project<\/span>; (v) the financial accessibility of the proposed project<\/span> to people in the area to be served, including indigent<\/span> people; and (vi) at the discretion of the Commissioner<\/span>, any other factors as may be relevant to the determination of public need for a proposed project<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The extent to which the proposed project<\/span> is consistent with the State Health Services Plan<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> The extent to which the proposed project<\/span> fosters institutional competition that benefits the area to be served while improving access to essential health care services for all people in the area to be served; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> The relationship of the proposed project<\/span> to the existing health care system of the area to be served, including the utilization and efficiency of existing services or facilities; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> The feasibility of the proposed project<\/span>, including the financial benefits of the proposed project<\/span> to the applicant, the cost of construction, the availability of financial and human resources, and the cost of capital; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> The extent to which the proposed project<\/span> provides improvements or innovations in the financing and delivery of health care 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 health care services on an outpatient basis; (iii) any cooperative efforts to meet regional health care needs; and (iv) at the discretion of the Commissioner<\/span>, any other factors as may be appropriate; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> In the case of a project<\/span> 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 services for citizens of the Commonwealth, including indigent<\/span> or underserved populations. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nDEMONSTRATION OF PUBLIC NEED REQUIRED; CRITERIA FOR DETERMINING NEED (\u00a7\n32.1-102.3)\n\nA. No certificate may be issued unless the Commissioner has determined that a\npublic need for the project has been demonstrated. If it is determined that a\npublic need exists for only a portion of a project, a certificate may be issued\nfor that portion and any appeal may be limited to the part of the decision with\nwhich the appellant disagrees without affecting the remainder of the decision.\nAny decision to issue or approve the issuance of a certificate shall be\nconsistent with the most recent applicable provisions of the State Health\nServices Plan; however, if the Commissioner finds, upon presentation of\nappropriate evidence, that the provisions of such plan are not relevant to a\nrural locality’s needs, inaccurate, outdated, inadequate or otherwise\ninapplicable, the Commissioner, consistent with such finding, may issue or\napprove the issuance of a certificate and shall initiate procedures to make\nappropriate amendments to such plan. In cases in which a provision of the State\nHealth Services Plan has been previously set aside by the Commissioner and\nrelevant amendments to the Plan have not yet taken effect, the\nCommissioner’s decision shall be consistent with the applicable portions\nof the State Health Services Plan that have not been set aside and the remaining\nconsiderations in subsection B.\n\nB. In determining whether a public need for a project has been demonstrated, the\nCommissioner shall consider:\n\n 1. The extent to which the proposed project will provide or increase access to\n health care services for people in the area to be served and the effects that\n the proposed project will have on access to health care services in areas\n having distinct and unique geographic, socioeconomic, cultural,\n transportation, and other barriers to access to health care;\n\n 2. The extent to which the proposed project will meet the needs of people in\n the area to be served, as demonstrated by each of the following: (i) the level\n of community support for the proposed project demonstrated by people,\n businesses, and governmental leaders representing the area to be served; (ii)\n the availability of reasonable alternatives to the proposed project that would\n meet the needs of people in the area to be served in a less costly, more\n efficient, or more effective manner; (iii) any recommendation or report of the\n regional health planning agency regarding an application for a certificate\n that is required to be submitted to the Commissioner pursuant to subsection B\n of § 32.1-102.6; (iv) any costs and benefits of the proposed project; (v)\n the financial accessibility of the proposed project to people in the area to\n be served, including indigent people; and (vi) at the discretion of the\n Commissioner, any other factors as may be relevant to the determination of\n public need for a proposed project;\n\n 3. The extent to which the proposed project is consistent with the State\n Health Services Plan;\n\n 4. The extent to which the proposed project fosters institutional competition\n that benefits the area to be served while improving access to essential health\n care services for all people in the area to be served;\n\n 5. The relationship of the proposed project to the existing health care system\n of the area to be served, including the utilization and efficiency of existing\n services or facilities;\n\n 6. The feasibility of the proposed project, including the financial benefits\n of the proposed project to the applicant, the cost of construction, the\n availability of financial and human resources, and the cost of capital;\n\n 7. The extent to which the proposed project provides improvements or\n innovations in the financing and delivery of health care services, as\n demonstrated by (i) the introduction of new technology that promotes quality,\n cost effectiveness, or both in the delivery of health care services; (ii) the\n potential for provision of health care services on an outpatient basis; (iii)\n any cooperative efforts to meet regional health care needs; and (iv) at the\n discretion of the Commissioner, any other factors as may be appropriate; and\n\n 8. In the case of a project proposed by or affecting a teaching hospital\n associated with a public institution of higher education or a medical school\n in the area to be served, (i) the unique research, training, and clinical\n mission of the teaching hospital or medical school and (ii) any contribution\n the teaching hospital or medical school may provide in the delivery,\n innovation, and improvement of health care services for citizens of the\n Commonwealth, including indigent or underserved populations.\n\nHISTORY: 1982, c. 388; 1984, c. 740; 1993, c. 704; 1999, c. 926; 2000, c. 931;\n2004, cc. 71, 95; 2008, c. 292; 2009, c. 175; 2020, cc. 227, 558, 1271.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}