As we reported last month, the draft 2024 State Medical Facilities Plan (SMFP) was released on July 3, 2023. The SMFP is North Carolina’s key health planning document in which the State publishes need determinations for healthcare services and equipment such as acute care beds, operating rooms, and MRI scanners. If a need determination is included in the SMFP, providers may then file certificate of need (CON) applications proposing to meet the need. The draft SMFP applies various methodologies that generate need determinations, but these methodologies do not always address specific needs that a particular geographic area or population may have, and in some cases, the methodology may overstate the need for certain services or equipment. Throughout the month of July, the North Carolina State Health Coordinating Council (SHCC), the governor-appointed body that oversees the development of the SMFP, held a series of public hearings in which interested parties presented petitions for special need determinations or the elimination of need determinations included in the draft 2024 SMFP. The last day to submit petitions was July 26. The list of petitions submitted is as follows:

Acute Care Services:

• Alleghany County: Three acute care beds.
• Durham/Caswell/Warren County service area: Retain the need in the draft 2024 SMFP for 38 acute care beds and potentially include a need for more than 38 beds.
• Johnston County: Twenty-four acute care beds.
• Catawba County: One operating room.
• Cumberland County: One operating room for training surgical residents.
• Health Service Area VI (Eastern North Carolina): Two specialty ambulatory surgical centers dedicated to vascular access.
• Multi-county: Liberty Healthcare filed 24 separate petitions proposing a total of 369 outpatient dialysis stations in nursing home facilities in the following North Carolina counties: Alamance, Bertie, Brunswick, Buncombe, Chatham, Columbus, Cumberland, Davie, Durham, Forsyth, Franklin, Halifax, Johnston, Lee, Mecklenburg, Moore, New Hanover, Orange, Person, Robeson, Rowan, Sampson, Wake, and Watauga.

Long Term and Behavioral Health:

• Columbus County: One Medicare-certified home health agency.
• Mecklenburg County: One hospice home care agency focused on serving historically underserved racial and ethnic minority populations.

Technology and Equipment:

• Watauga County: Convert a fixed MRI scanner to a mobile MRI scanner.
• Carteret County: One PET/CT Scanner.
• Service Area 17 (Hoke, Lee, Moore, Montgomery, Richmond, and Scotland Counties): One linear accelerator.
• Statewide: Remove the draft need determination for two additional lithotriptors.
• Statewide: Revise SMFP policy TE-2 governing interoperative MRI scanners (iMRI) to allow iMRI scanners to be used on outpatients who have a simultaneous surgical procedure or treatment. As currently written Policy TE-2 does not allow iMRI scanners to be used on outpatients.

What’s Next?

Interested parties have until August 9, 2023 at 5 pm to submit written comments on any of the aforementioned petitions. Thereafter, staff at the Division of Health Service Regulation will prepare written recommendations on the petitions. The recommendations are usually issued around Labor Day. The three SHCC Committees will then meet to review and vote upon the petitions assigned to their respective committees. The meeting schedule is as follows:

Acute Care Services:

• September 12

Technology and Equipment:

• September 13

Long Term and Behavioral Health:

• September 14

The full SHCC will meet on October 4, 2023 to vote on the final draft 2024 SMFP. The draft will then go to Governor Cooper for review and signature. The Governor has final authority to accept, reject or modify the SMFP. Typically, the Governor signs the SMFP in December, and the 2024 SMFP will take effect on January 1, 2024.

The experienced Nelson Mullins team is available to assist with your North Carolina CON and health planning needs. For further information, please contact any of the authors of this article or the Nelson Mullins attorney with whom you regularly work.