Or. Admin. R. 333-580-0050 - Availability of Resources and Alternative Uses of Those Resources
Applicants must provide a narrative discussion of each of the following:
(1) Criterion: Does the
proposed project represent the most effective and least costly alternative,
considering all appropriate and adequate ways of meeting the identified needs?
(a) The applicant must demonstrate that the
best price for the proposal has been sought and selected;
(b) The applicant must demonstrate that
proposed solutions to identified needs represent the best solution from among
reasonable alternatives:
(A) Internal
alternatives:
(i) The applicant must list the
major internal operational adjustments considered which could lower the cost
and improve the efficiencies of offering the beds, equipment or
service;
(ii) The applicant must
demonstrate that the alternative considered represents the best solution for
the patients, and discuss why other alternatives were rejected;
(iii) If the proposal is for an inpatient
service, whether new or expanded, applicant must demonstrate this method of
delivery is less costly than if done on an outpatient basis;
(iv) The applicant must demonstrate that the
selected architectural solution represents the most cost effective and
efficient alternative to solving the identified needs.
(B) External alternatives:
(i) If the proposed beds, equipment or
services are currently being offered in the service area, applicant must
demonstrate:
(I) Why approval of the
application will not constitute unnecessary duplication of services;
(II) Why the proposal is an efficient
solution to identified needs;
(III)
Why the proposal represents the most effective method of providing the
proposal; and
(IV) That the
applicant can provide this proposal at the same or lower cost to the patient
than is currently available.
(ii) If paragraphs (A)(i) to (A)(iv) of this
subsection cannot be demonstrated, the applicant must show that without the
proposal, the health of the service area population will be seriously
compromised.
(C) Less
costly alternatives of adequate quality:
(i)
If a less costly and adequately effective alternative for the proposal is
currently available in the area, the applicant must demonstrate why its
proposal is:
(I) Not an unnecessary
duplication; or
(II) A more
efficient solution to the identified needs.
(ii) Applicants must demonstrate that the
identified needs of the population to be served cannot be reasonably served
under current conditions, or by alternative types of service or equipment or
equal quality to the proposal. "Alternatives of adequate quality" does not
imply that they need be exactly like those being proposed, but only that they
meet identified needs at state approved levels.
(D) If there are competing applications for
the proposal, each applicant must demonstrate why theirs is the best solution,
and why a certificate of need should be granted them.
(2) Criterion: Will sufficient
qualified personnel , adequate land, and adequate financing be available to
develop and support the proposed project? The applicant must demonstrate that
there are, or will be sufficient physicians in the area to support the
proposal; sufficient nurses available to support the proposal; sufficient
technicians available to support the proposal; adequate land available to
develop the proposal and accommodate future expansion; and the source(s) and
availability of funds for the project.
(3) Criterion: Will the proposed project have
an appropriate relationship to its service area, including limiting any
unnecessary duplication of services and any negative financial impact on other
providers?
(a) The applicant must identify
the extent to which the proposal and its alternatives are currently being
offered to the identified service area population, or, in the case of acute
inpatient beds, could be offered on the basis of an analysis under Division 590
of this Chapter;
(b) The applicant
will discuss to the best of his or her knowledge, any negative impact the
proposal will have on those presently offering or reimbursing for similar or
alternative services. Areas to be discussed are utilization, quality of care,
and cost of care;
(c) The applicant
must demonstrate that jointly operated or shared services between the applicant
and other providers have been considered and the extent to which they are
feasible or not;
(d) The applicant
must demonstrate that all necessary support services and ancillary services for
the proposal are available at acceptable levels to insure that patients will
have the necessary continuity in their health care.
(4) Criterion: Does the proposed project
conform to relevant state physical plant standards, and will it represent any
improvement in regard to conformity to such standards, compared to other
similar services in the area?
(a) The
proposed project must comply with state licensing, architectural and fire code
standards;
(b) If the proposal is
already being offered in the defined service area, the applicant must describe,
to the best of his or her knowledge, to what degree the existing service
complies with state licensing, architectural and fire code standards.
Notes
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) & 442.315
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