NORTH CAROLINA
REGISTER
Volume 17, Issue 14
Pages 1138 - 1224
January 15, 2003
This issue contains documents officially filed through December 19, 2002.
Office of Administrative Hearings
Rules Division
424 North Blount Street (27601)
6714 Mail Service Center
Raleigh, NC 27699-6714
(919) 733-2678
FAX (919) 733-3462
Julian Mann III, Director
Camille Winston, Deputy Director
Molly Masich, Director of APA Services
Ruby Creech, Publications Coordinator
Linda Dupree, Editorial Assistant
Dana Sholes, Editorial Assistant
Rhonda Wright, Editorial Assistant
IN THIS ISSUE
I. IN ADDITION
Voting Rights Letter................................................1138
EMC – NPDES Permit............................................1139
II. RULE-MAKING PROCEEDINGS
Building Code Council...........................................1140 - 1141
Environment and Natural Resources
Environmental Management................................1140
Wildlife Resources Commission..........................1140
III. PROPOSED RULES
Environment and Natural Resources
Environmental Management Commission...........1142
Well Contractors Certification Commission........1142 -1144
Licensing Boards
Refrigeration Examiners, Board of.......................1144 - 1146
IV. TEMPORARY RULES
Environment and Natural Resources
Wildlife Resources Commission..........................1184 - 1185
Health and Human Services
Facility Services...................................................1147 - 1180
Medical Assistance...............................................1180 - 1182
Medical Care Commission...................................1147
Insurance
Financial Evaluation Division..............................1182 - 1184
Transportation
Highways, Division of..........................................1185 - 1189
V. RULES REVIEW COMMISSION.......................1190 - 1194
VI. CONTESTED CASE DECISIONS
Index to ALJ Decisions............................................1195 - 1199
Text of Selected Decisions
02 DHR 0497.......................................................1200 - 1204
02 INS 0252.........................................................1205 - 1217
02 OSP 0103.........................................................1218 - 1224
For the CUMULATIVE INDEX to the NC Register go to:
http://oahnt.oah.state.nc.us/register/CI.pdf
North Carolina Register is published semi-monthly for $195 per year by the Office of Administrative Hearings, 424 North Blount Street, Raleigh, NC 27601. North Carolina Register (ISSN 15200604) to mail at Periodicals Rates is paid at Raleigh, NC. POSTMASTER: Send Address changes to the North Carolina Register, 6714 Mail Service Center, Raleigh, NC 27699-6714. NORTH CAROLINA ADMINISTRATIVE CODE CLASSIFICATION SYSTEM
The North Carolina Administrative Code (NCAC) has four major subdivisions of rules. Two of these, titles and chapters, are mandatory. The major subdivision of the NCAC is the title. Each major department in the North Carolina executive branch of government has been assigned a title number. Titles are further broken down into chapters which shall be numerical in order. The other two, subchapters and sections are optional subdivisions to be used by agencies when appropriate.
TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE
TITLE DEPARTMENT LICENSING BOARDS CHAPTER
1
2
3
4
5
6
7
8
9
10
11
12
13
14A
15A
16
17
18
19A
20
*21
22
23
24
25
26
27
28
Administration
Agriculture
Auditor
Commerce
Correction
Council of State
Cultural Resources
Elections
Governor
Health and Human Services
Insurance
Justice
Labor
Crime Control & Public Safety
Environment and Natural Resources
Public Education
Revenue
Secretary of State
Transportation
Treasurer
Occupational Licensing Boards
Administrative Procedures (Repealed)
Community Colleges
Independent Agencies
State Personnel
Administrative Hearings
NC State Bar
Juvenile Justice and Delinquency
Prevention
Acupuncture
Architecture
Athletic Trainer Examiners
Auctioneers
Barber Examiners
Certified Public Accountant Examiners
Chiropractic Examiners
Employee Assistance Professionals
General Contractors
Cosmetic Art Examiners
Dental Examiners
Dietetics/Nutrition
Electrical Contractors
Electrolysis
Foresters
Geologists
Hearing Aid Dealers and Fitters
Landscape Architects
Landscape Contractors
Locksmith Licensing Board
Massage & Bodywork Therapy
Marital and Family Therapy
Medical Examiners
Midwifery Joint Committee
Mortuary Science
Nursing
Nursing Home Administrators
Occupational Therapists
Opticians
Optometry
Osteopathic Examination & Reg. (Repealed)
Pastoral Counselors, Fee-Based Practicing
Pharmacy
Physical Therapy Examiners
Plumbing, Heating & Fire Sprinkler Contractors
Podiatry Examiners
Professional Counselors
Psychology Board
Professional Engineers & Land Surveyors
Real Estate Appraisal Board
Real Estate Commission
Refrigeration Examiners
Respiratory Care Board
Sanitarian Examiners
Social Work Certification
Soil Scientists
Speech & Language Pathologists & Audiologists
Substance Abuse Professionals
Therapeutic Recreation Certification
Veterinary Medical Board
1
2
3
4
6
8
10
11
12
14
16
17
18
19
20
21
22
26
28
29
30
31
32
33
34
36
37
38
40
42
44
45
46
48
50
52
53
54
56
57
58
60
61
62
63
69
64
68
65
66
Note: Title 21 contains the chapters of the various occupational licensing boards. 17:13
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NORTH CAROLINA REGISTER
Publication Schedule for January 2003 – December 2003
Filing Deadlines
Notice of
Rule-Making Proceedings
Notice of Text
Temporary Rule
volume & issue number
issue date
last day for filing
earliest register issue for publication of text
earliest date for public hearing
end of
required comment period
deadline to
submit to RRC
for review at
next meeting
first legislative
day of the next
regular session
end of
required
comment
period
deadline to submit to RRC
for review at
next meeting
first legislative
day of the next
regular session
270th day from issue date
17:16
02/17/03
01/27/03
05/01/03
03/04/03
03/19/03
03/20/03
05/00/04
04/21/03
04/21/03
05/00/04
11/14/03
17:17
03/03/03
02/10/03
05/15/03
03/18/03
04/02/03
04/21/03
05/00/04
05/02/03
05/20/03
05/00/04
11/28/03
17:18
03/17/03
02/24/03
06/02/03
04/01/03
04/16/03
04/21/03
05/00/04
05/16/03
05/20/03
05/00/04
12/12/03
17:19
04/01/03
03/11/03
06/02/03
04/16/03
05/01/03
05/20/03
05/00/04
06/02/03
06/20/03
05/00/04
12/27/03
17:20
04/15/03
03/25/03
06/16/03
04/30/03
05/15/03
05/20/03
05/00/04
06/16/03
06/20/03
05/00/04
01/10/04
17:21
05/01/03
04/09/03
07/01/03
05/16/03
06/02/03
06/20/03
05/00/04
06/30/03
07/21/03
05/00/04
01/26/04
17:22
05/15/03
04/24/03
07/15/03
05/30/03
06/16/03
06/20/03
05/00/04
07/14/03
07/21/03
05/00/04
02/09/04
17:23
06/02/03
05/09/03
08/01/03
06/17/03
07/02/03
07/21/03
05/00/04
08/01/03
08/20/03
05/00/04
02/27/04
17:24
06/16/03
05/23/03
08/15/03
07/01/03
07/16/03
07/21/03
05/00/04
08/15/03
08/20/03
05/00/04
03/12/04
18:01
07/01/03
06/10/03
09/02/03
07/16/03
07/31/03
08/20/03
05/00/04
09/02/03
09/22/03
05/00/04
03/27/04
18:02
07/15/03
06/23/03
09/15/03
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04/10/04
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10/20/03
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04/27/04
18:04
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07/25/03
10/15/03
08/30/03
09/15/03
09/22/03
05/00/04
10/14/03
10/20/03
05/00/04
05/11/04
18:05
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08/11/03
11/03/03
09/17/03
10/02/03
10/20/03
05/00/04
11/03/03
11/20/03
05/00/04
05/29/04
18:06
09/15/03
08/22/03
11/17/03
09/30/03
10/15/03
10/20/03
05/00/04
11/14/03
11/20/03
05/00/04
06/11/04
18:07
10/01/03
09/10/03
12/01/03
10/16/03
10/31/03
11/20/03
05/00/04
12/01/03
12/22/03
05/00/04
06/27/04
18:08
10/15/03
09/24/03
12/15/03
10/30/03
11/14/03
11/20/03
05/00/04
12/15/03
12/22/03
05/00/04
07/11/04
18:09
11/03/03
10/13/03
01/02/04
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12/03/03
12/22/03
05/00/04
01/02/04
01/20/04
05/00/04
07/30/04
18:10
11/17/03
10/24/03
02/02/04
12/02/03
12/17/03
12/22/03
05/00/04
01/16/04
01/20/04
05/00/04
08/13/04
18:11
12/01/03
11/05/03
02/02/04
12/16/03
12/31/03
01/20/04
05/00/04
01/30/04
02/20/04
05/00/04
08/27/04
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12/15/03
11/20/03
02/16/04
12/30/03
01/14/04
01/20/04
05/00/04
02/13/04
02/20/04
05/00/04
09/10/04
non-substantial economic impact
substantial economic impact
EXPLANATION OF THE PUBLICATION SCHEDULE
This Publication Schedule is prepared by the Office of Administrative Hearings as a public service and the computation of time periods are not to be deemed binding or controlling. Time is computed according to 26 NCAC 2C .0302 and the Rules of Civil Procedure, Rule 6.
GENERAL
The North Carolina Register shall be published twice a month and contains the following information submitted for publication by a state agency:
(1) temporary rules;
(2) notices of rule-making proceedings;
(3) text of proposed rules;
(4) text of permanent rules approved by the Rules Review Commission;
(5) notices of receipt of a petition for municipal incorporation, as required by G.S. 120-165;
(6) Executive Orders of the Governor;
(7) final decision letters from the U.S. Attorney General concerning changes in laws affecting voting in a jurisdiction subject of Section 5 of the Voting Rights Act of 1965, as required by G.S. 120-30.9H;
(8) orders of the Tax Review Board issued under G.S. 105-241.2; and
(9) other information the Codifier of Rules determines to be helpful to the public.
COMPUTING TIME: In computing time in the schedule, the day of publication of the North Carolina Register is not included. The last day of the period so computed is included, unless it is a Saturday, Sunday, or State holiday, in which event the period runs until the preceding day which is not a Saturday, Sunday, or State holiday.
FILING DEADLINES
ISSUE DATE: The Register is published on the first and fifteen of each month if the first or fifteenth of the month is not a Saturday, Sunday, or State holiday for employees mandated by the State Personnel Commission. If the first or fifteenth of any month is a Saturday, Sunday, or a holiday for State employees, the North Carolina Register issue for that day will be published on the day of that month after the first or fifteenth that is not a Saturday, Sunday, or holiday for State employees.
LAST DAY FOR FILING: The last day for filing for any issue is 15 days before the issue date excluding Saturdays, Sundays, and holidays for State employees.
NOTICE OF RULE-MAKING PROCEEDINGS
END OF COMMENT PERIOD TO A NOTICE OF RULE-MAKING PROCEEDINGS: This date is 60 days from the issue date. An agency shall accept comments on the notice of rule-making proceeding until the text of the proposed rules is published, and the text of the proposed rule shall not be published until at least 60 days after the notice of rule-making proceedings was published.
EARLIEST REGISTER ISSUE FOR PUBLICATION OF TEXT: The date of the next issue following the end of the comment period.
NOTICE OF TEXT
EARLIEST DATE FOR PUBLIC HEARING: The hearing date shall be at least 15 days after the date a notice of the hearing is published.
END OF REQUIRED COMMENT PERIOD (1) RULE WITH NON-SUBSTANTIAL ECONOMIC IMPACT: An agency shall accept comments on the text of a proposed rule for at least 30 days after the text is published or until the date of any public hearings held on the proposed rule, whichever is longer.
(2) RULE WITH SUBSTANTIAL ECONOMIC IMPACT: An agency shall accept comments on the text of a proposed rule published in the Register and that has a substantial economic impact requiring a fiscal note under G.S. 150B-21.4(b1) for at least 60 days after publication or until the date of any public hearing held on the rule, whichever is longer.
DEADLINE TO SUBMIT TO THE RULES REVIEW COMMISSION: The Commission shall review a rule submitted to it on or before the twentieth of a month by the last day of the next month.
FIRST LEGISLATIVE DAY OF THE NEXT REGULAR SESSION OF THE GENERAL ASSEMBLY: This date is the first legislative day of the next regular session of the General Assembly following approval of the rule by the Rules Review Commission. See G.S. 150B-21.3, Effective date of rules.
IN ADDITION
17:14 NORTH CAROLINA REGISTER January 15, 2003
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This Section contains public notices that are required to be published in the Register or have been approved by the Codifier of Rules for publication.
U.S. Department of Justice
Civil Rights Division
JDR:JR:NT:par Voting Section – NWB.
DJ 166-012-3 950 Pennsylvania Ave., NW
2002-5149 Washington, D.C. 20530
December 9, 2002
Albert M. Benshoff, Esq.
City Attorney
P.O. Box 1388
Lumberton, NC 28359-1388
Dear Mr. Benshoff:
This refers to four annexations (Ordinance Nos. 1798 (2000), 1825 and 1826 (2001), and 1849 (2002), and their designation to districts of the City of Lumberton in Robeson County, North Carolina, submitted to the Attorney General pursuant to Section 5 of the Voting Rights Act, 42 U.S.C. 1973c. We received your submission on October 16, 2002; supplemental information was received on November 21, 2002.
The Attorney General does not interpose any objection to the specified changes. However, we note that Section 5 expressly provides that the failure of the Attorney General to object does not bar subsequent litigation to enjoin the enforcement of the change. See the Procedures for the Administration of Section 5 (28 C.F.R. 51.41).
Sincerely,
Joseph D. Rich
Chief, Voting Section
IN ADDITION
17:14 NORTH CAROLINA REGISTER January 15, 2003
1139
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
PUBLIC NOTICE OF INTENT TO ISSUE STATE GENERAL NPDES PERMITS
Public notice of intent to reissue expiring State National Pollutant Discharge Elimination System (NPDES) General Permits for Point Source Discharges of Stormwater for the following types of discharges:
NPDES General Permit No. NCG050000 for stormwater point source discharges associated with activities classified as establishments primarily engaged in Apparel and Other Finished Products Made from Fabrics and Similar Materials [standard industrial classification (SIC) 23], Printing Publishing and Allied Industries [SIC 27], Converted Paper and Paperboard Products [SIC 267], Paperboard Containers and Boxes [SIC 265], Miscellaneous Manufacturing Industries [SIC 39], Leather and Leather Products [SIC 31], and Rubber and Miscellaneous Products [SIC 30]. The following activities are specifically excluded from coverage under this General Permit: Leather Tanning and Finishing [SIC 311] and Tires and Inner Tubes [SIC 301].
NPDES General Permit No. NCG070000 for stormwater point source discharges associated with activities classified as establishments primarily engaged in Stone, Clay, Glass, and Concrete Products [standard industrial classification (SIC) 32]. The following activities are specifically excluded from coverage under this General Permit: Ready-mixed concrete [SIC 3273].
NPDES General Permit No. NCG110000 for stormwater point source discharges associated with activities classified as Treatment Works treating domestic sewage or any other sewage sludge or wastewater treatment device or system, used in the storage, treatment, recycling, and reclamation of municipal or domestic sewage, with a design low of 1.0 million gallons per day or more, or facilities which are required to have an approved pretreatment program under Title 40 CFR Part 403, including lands dedicated to the disposal of sewage sludge that is located within the confines of the facility.
NPDES General Permit No. NCG130000 for stormwater point source discharges associated with activities classified as establishments primarily engaged in the wholesale trade of non-metal waste and scrap (hereafter referred to as the non-metal waste recycling industry) [a portion of standard industrial classification (SIC) 5093]. The following activities are specifically excluded from coverage under this General Permit: the wholesale trade of metal waste and scrap, iron and steel scrap, and nonferrous metal scrap; waste oil recycling; and automobile wrecking for scrap.
NPDES General Permit No. NCG210000 for stormwater point source discharges associated with activities classified as establishments primarily engaged in Timber Products [standard industrial classification (SIC) 24]. The following activities are specifically excluded from coverage under this General Permit: Wood Kitchen Cabinets [SIC 2434], Wood Preserving [SIC 2491], Logging [SIC 241], and Wood Chip Mills .
On the basis of preliminary staff review and application of Article 21 of Chapter 143 of the General Statutes of North Carolina, Public Law 92-500 and other lawful standards and regulations, the North Carolina Environmental Management Commission proposes to reissue State NPDES General Permits for the discharges as described above.
INFORMATION: Copies of the draft NPDES General Permits and Fact Sheets concerning the draft Permits are available by writing or calling:
Valery Stephens
Water Quality Section
N.C. Division of Water Quality
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Telephone (919) 733-5083 ext. 520
Persons wishing to comment upon or object to the proposed determinations are invited to submit their comments in writing to the above address no later than February 14, 2003. All comments received prior to that date will be considered in the final determination regarding permit issuance. A public meeting may be held where the Director of the Division of Water Quality finds a significant degree of public interest in any proposed permit issuance. The draft Permits, Fact Sheets and other information are on file at the Division of Water Quality,512 N. Salisbury Street, Room 925, Archdale Building, Raleigh, North Carolina. They may be inspected during normal office hours. Copies of the information of file are available upon request and payment of the costs of reproduction. All such comments and requests regarding these matters should make reference to the draft Permit Numbers, NCG050000, NCG070000, NCG110000, NCG130000 or NCG210000.
Date: 12/16/02 (signed Bradley Bennett)
for Alan Klimek, PE, Director
NC Division of Water Quality
RULE-MAKING PROCEEDINGS
17:14 NORTH CAROLINA REGISTER January 15, 2003
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A Notice of Rule-making Proceedings is a statement of subject matter of the agency's proposed rule making. The agency must publish a notice of the subject matter for public comment at least 60 days prior to publishing the proposed text of a rule. Publication of a temporary rule serves as a Notice of Rule-making Proceedings and can be found in the Register under the section heading of Temporary Rules. A Rule-making Agenda published by an agency serves as Rule-making Proceedings and can be found in the Register under the section heading of Rule-making Agendas. Statutory reference: G.S. 150B-21.2.
TITLE 15A – DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
CHAPTER 02 – ENVIRONMENTAL MANAGEMENT
Notice of Rule-making Proceedings is hereby given by the Environmental Management Commission in accordance with G.S. 150B-21.2. The agency shall subsequently publish in the Register the text of the rule(s) it proposes to adopt as a result of this notice of rule-making proceedings and any comments received on this notice.
Citation to Existing Rule Affected by this Rule-making: 15A NCAC 02 - Other rules may be proposed in the course of the rule-making process.
Authority for the Rule-making: G.S. 150B-4
Statement of the Subject Matter: New rules will be developed to describe the procedure for requesting declaratory rulings for rule of the Divisions of Air Quality, Water Quality and Water Resources within the Department of Environment and Natural Resources. The rules will also describe the procedures that the Environmental Management Commission must follow when considering such requests.
Reason for Proposed Action: The Administrative Procedure Act, G.S. 150B-4, requires the Environmental Management Commission to set forth in its rules the procedures to be followed by persons requesting declaratory rulings, and the procedures to follow for considering such requests.
Comment Procedures: Comments from the public shall be directed to Jeff Manning, DWQ Planning Branch, 1617 Mail Service Center, Raleigh, NC 27699, phone 733-5083, ext. 579, and email jeff.manning @ncmail.net.
* * * * * * * * * * * * * * * * * * * *
CHAPTER 10 - WILDLIFE RESOURCES AND WATER SAFETY
Notice of Rule-making Proceedings is hereby given by the NC Wildlife Resources Commission in accordance with G.S. 150B-21.2. The agency shall subsequently publish in the Register the text of the rule(s) it proposes to adopt as a result of this notice of rule-making proceedings and any comments received on this notice.
Citation to Existing Rule Affected by this Rule-making: 15A NCAC 10F - Other rules may be proposed in the course of the rule-making process.
Authority for the Rule-making: G.S. 75A-3; 75A-15
Statement of the Subject Matter: No wake zones
Reason for Proposed Action: Several county commissions have contacted the Wildlife Resources Commission requesting no wake zones to address safety concerns.
Comment Procedures: Comments from the public shall be directed to Joan B. Troy, 1701 Mail Service Center, Raleigh, NC 27699-1701.
NOTICE OF RULE MAKING PROCEEDINGS AND PUBLIC HEARING
NORTH CAROLINA BUILDING CODE COUNCIL
Notice of Rule-making Proceedings is hereby given by the N.C. Building Code Council in accordance with G.S. 150B-21.5(d).
Citation to Existing Rule Affected by this Rule-Making: North Carolina Building Code and North Carolina Fire Prevention Code.
Authority for the Rule-making: G.S. 143-136; 143-138.
Reason for Proposed Action: To incorporate changes in the NC Building Code as a result of rulemaking petitions filed with the N.C. Building Code Council and incorporate changes proposed by the Council.
Public Hearing: March 10, 2002, 1:00 p.m., Wake County Commons, 4011 Carya Drive, Raleigh, N.C.
Comment Procedures: Written comments may be sent to Wanda Edwards, Secretary, N.C. Building Code Council, c/o N.C. Department of Insurance, 410 N. Boylan Avenue, Raleigh, NC 27603. Comment period expires on March 9, 2002.
Statement of Subject Matter:
1. Revise Section 907.2.3, Exception 1, of the North Carolina Fire Code and the North Carolina Building Code as follows:
907.2.3 Group E. A manual fire alarm system shall be installed in Group E occupancies. When automatic sprinkler systems or smoke detectors are installed, such systems or detectors shall be connected to the building fire alarm system.
Exceptions: RULE-MAKING PROCEEDINGS
17:14 NORTH CAROLINA REGISTER January 15, 2003
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1. Group E occupancies with an occupant load of less than 50.
2. Manual fire alarm boxes are not required in Group E occupancies where all the following apply:
2.1 Interior corridors are protected by smoke detectors with alarm verification.
2.2 Auditoriums, cafeterias, gymnasiums and the like are protected by heat detectors or other approved detection devices.
2.3 Shops and laboratories involving dusts or vapors are protected by heat detectors or other approved detection devices.
2.4 Off-premises monitoring is provided.
2.5 The capability to activate the evacuation signal from a central point is provided.
2.6 In buildings where normally occupied spaces are provided with a two-way communication system between such spaces and a constantly attended receiving station from where a general evacuation alarm can be sounded, except in locations specifically designated by the building official.
2. Revise Section 2206.2.3, #2 of the North Carolina Fire Prevention Code as follows:
2206.2.3 Above-ground tanks located outside, above grade. Above-ground tanks shall not be used for the storage of Class I, II, or IIIA liquid motor fuels except as provided by this section.
1. Above-ground tanks used for outside, above-grade storage of Class I liquids shall be listed and labeled as protected above-ground tanks and be in accordance with Chapter 34. Such tanks shall be located in accordance with Table 2206.2.3.
2. Above-ground tanks used for above-ground storage of Class II or IIIA liquids are allowed to be protected above-ground tanks or, when approved by the code official, other above-ground tanks that comply with Chapter 34. Tank locations shall be in accordance with Table 2206.2.3.
Fleet Vehicle Service Stations:
When approved by the code official, above-ground storage tanks, 1,100 gallons or less in capacity, may be used to store Class I liquids at fleet vehicle service stations in accordance with NFPA 30A.
3. Tanks containing motor fuels shall not exceed 12,000 gallons (45,420 L) in individual capacity or 48,000 gallons (181,680 L) in aggregate capacity. Installations with the maximum allowable aggregate capacity shall be separated from other such installations by not less than 100 feet (30,480 mm).
3. Above-ground tanks used for above-ground storage of Class II or IIIA liquids are allowed to be protected above-ground tanks or, when approved by the code official, other above-ground tanks that comply with Chapter 34. Tank locations shall be in accordance with Table 2206.2.3.
4. Tanks located at farms, construction projects, or rural areas shall comply with Section 3406.2.
4. Tanks containing motor fuels shall not exceed 12,000 gallons (45,420 L) in individual capacity or 48,000 gallons (181,680 L) in aggregate capacity. Installations with the maximum allowable aggregate capacity shall be separated from other such installations by not less than 100 feet (30,480 mm).
5. Tanks located at farms, construction projects, or rural areas shall comply with 3406.2.
PROPOSED RULES
17:14 NORTH CAROLINA REGISTER January 15, 2003
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This Section contains the text of proposed rules. At least 60 days prior to the publication of text, the agency published a Notice of Rule-making Proceedings. The agency must accept comments on the proposed rule for at least 30 days from the publication date, or until the public hearing, or a later date if specified in the notice by the agency. The required comment period is 60 days for a rule that has a substantial economic impact of at least five million dollars ($5,000,000). Statutory reference: G.S. 150B-21.2.
TITLE 15A – DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Notice is hereby given in accordance with G.S. 150B-21.2 that the Environmental Management Commission intends to amend the rule cited as 15A NCAC 02D .0506. Notice of Rule-making Proceedings was published in the Register on August 16, 1999.
Proposed Effective Date: August 1, 2004
Reason for Proposed Action: As a result of public comments received at the public hearing, a new paragraph is proposed to be added that restricts fugitive emissions not elsewhere covered under the rule.
Comment Procedures: Comments from the public shall be directed to Thomas Allen Division of Air Quality, 1641 Mail Service Center, Raleigh, NC 27699-1641, fax (919) 715-7476, and email thom.allen@ncmail.net. Comments shall be accepted through February 15, 2003.
Fiscal Impact
State
Local
Substantive (>$5,000,000)
None
CHAPTER 02 – ENVIRONMENTAL MANAGEMENT
SUBCHAPTER 02D - AIR POLLUTION CONTROL REQUIREMENTS
SECTION .0500 - EMISSION CONTROL STANDARDS
15A NCAC 02D .0506 PARTICULATES FROM HOT
MIX ASPHALT PLANTS
(a) The allowable emission rate for particulate matter resulting from the operation of a hot mix asphalt plant that are discharged from any stack or chimney into the atmosphere shall not exceed the level calculated with the equation E = 4.9445(P)0.4376 calculated to three significant figures, where "E" equals the maximum allowable emission rate for particulate matter in pounds per hour and "P" equals the process rate in tons per hour. The allowable emission rate shall be 60.0 pounds per hour for process rates equal to or greater than 300 tons per hour.
(b) Visible emissions from stacks or vents at a hot mix asphalt plant shall be less than 20 percent opacity when averaged over a six-minute period.
(c) All hot mix asphalt batch plants shall be equipped with a scavenger process dust control system for the drying, conveying, classifying, and mixing equipment. The scavenger process dust control system shall exhaust through a stack or vent and shall be operated and maintained in such a manner as to comply with Paragraphs (a) and (b) of this Rule.
(d) Fugitive non-process dust emissions shall be controlled by Rule .0540 of this Section.
(e) Fugitive emissions for sources at a hot mix asphalt plant not covered elsewhere under this Rule shall not exceed 10 percent opacity averaged over one minute.
(f) Any asphalt batch plant that was subject to the 40-percent opacity standard in Rule .0521 of this Section before April 1, 2003 shall be in compliance with the 20-percent opacity standard by January 1, 2004.
Authority G.S. 143-215.3(a)(1); 143-215.107(a)(5).
* * * * * * * * * * * * * * * * * * * *
Notice is hereby given in accordance with G.S. 150B-21.2 that the Well Contractors Certification Commission intends to amend the rule cited as 15A NCAC 27 .0301. Notice of Rule-making Proceedings was published in the Register on June 3, 2002 as a Notice of Intent to adopt a temporary rule per Section 1.5 of Senate Bill 312 or Session Law 2002-440. Notice of the permanent rule published on September 16, 2002.
Proposed Effective Date: August 1, 2004
Public Hearing:
Date: February 5, 2003
Time: 7:00 p.m.
Location: Archdale Building, Ground Floor Hearing Room, 512 N. Salisbury St., Raleigh, NC
Reason for Proposed Action: Pursuant to a mandate by the North Carolina General Assembly, the Well Contractors Certification Commission (WCCC) approved a temporary rule in response to the passage of Session Law 2001-440 (Senate Bill 312). The temporary rule was enacted on September 12, 2002 and affects 15A NCAC 27 .0301 concerning application requirements and continuing education requirements. The rule specifies information that the Well Contractors Certification Commission will accept in applications for certification or renewal of certification. The rule also shows the qualifications that a well contractor must demonstrate to the Commission to apply for certification or renewal of certification.
As a follow-up to temporary rulemaking, a Subject Matter Notice of Permanent Rulemaking for 15A NCAC 27 .0301 was issued through the North Carolina Register on September 12, 2002. This action was taken to obtain stakeholder involvement in the rulemaking process and meet the Office of Administrative Hearings notice requirements. Comments received under the notice of the temporary rule were from the Well Contractor Certification Commission and propose minor changes and clarifications. These proposed changes by the Well Contractors Certification Commission are included in these notice materials.
The proposed rule reduces the work experience requirement for well contractors in 15A NCAC 27(f)(1-3) from 24 months to 18 PROPOSED RULES
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months of actual labor in well contractor activities. The Commission believes that requiring well contractors to have two years or 24 months of experience prior to applying for certification in this Rule is burdensome. Under Paragraph (f) of this Rule, letters from businesses, suppliers, and government agencies attesting to well contractor performance will no longer be considered necessary as proof that a well contractor meets the experience requirement. Acceptable proof may include an affidavit showing that the well contractor has been working in the trade for six months as shown in Subparagraph (f)(4) of this Rule. This new Subparagraph specifies that the applicant may furnish information showing that he has completed either a Commission approved course of study through the N.C. Community College system, an apprenticeship program approved by the Department of Labor, or a similar course or apprenticeship approved by the Well Contractor Certification Commission. Based on comments received from notices of the temporary rule and permanent rule, the permanent rule that is going to public hearing is the same as the temporary rule that went into effect on September 12, 2002.
Proposed additional changes from the Well Contractors Certification Commission to this Rule will be discussed at the public hearing and include:
1. Removal of outdated language from Paragraphs (a) and (d)) with respect to "recertification", “certification without exam" and "temporary certification";
2. Specifying that the experience in Paragraph .0301(f) be "full time" experience;
3. The deletion of 15A NCAC 27 .0301(f)(1);
4. Changing the word "letter" to "affidavit" in Rule .0301(f)(2);
5. Changing appropriate Subparagraphs of 15A NCAC .0301(f) to show that the person offering proof that an applicant for certification meets the requirements of Chapter 27 is a person who:
A. Has not committed any violation of the Well Construction Rules in 15A NCAC 02C in the past two years;
B. Has not committed any violation of the Well Contractor Certification Rules in 15A NCAC 27 in the past two years; and
C. Submits payroll records showing that the applicant has worked as a well contractor.
Comment Procedures: Interested persons may contact David Hance at (919) 715-6189 for more information. Oral comments may be made during the hearings. All written comments must be submitted by February 14, 2003. Written copies of oral statements exceeding three minutes are requested. Oral statements may be limited at the discretion of the hearing officers. Mail comments to: David Hance, DENR-DWQ-Groundwater Section, 1636 Mail Service Center, Raleigh, North Carolina, 27699-1636, Phone: (919) 715-6189; Fax: (919) 715-0588; E-Mail Address; David.Hance@ncmail.net.
Fiscal Impact
State
Local
Substantive (>$5,000,000)
None
CHAPTER 27 - WELL CONTRACTOR CERTIFICATION RULES
SECTION .0300 - CERTIFICATION OF WELL CONTRACTORS
15A NCAC 27.0301 APPLICATION
REQUIREMENTS FOR CERTIFICATION
(a) The Commission shall accept applications and renewal requests for certification as a well contractor from any person who is at least 18 years of age and whose application meets all the following conditions:
(1) Each application shall be submitted on forms provided by the Commission, which are designed for requesting certification as a well contractor by way of reexamination, certification without examination, or temporary certification and just be properly and accurately completed and submitted with an appropriate fee to the office of the chairman of the Commission.
(2) Each application has been determined as complete. Incomplete applications and applications not accompanied by an appropriate fee and attachments cannot be processed and shall be returned to the applicant.
(3) Each application shall contain proof of experience as provided in Paragraph (f) of this Rule.
(4) Each application shall include a request for the well contractor examination or include documentation that the applicant meets the requirement for certification without examination as provided in Section .0500 of this Chapter.
(b) Applicants who have intentionally supplied false information must wait 12 months before resubmitting an application for certification.
(c) The Commission shall not schedule an applicant to take the required examination until his application has been reviewed and the applicant has met all other conditions for certification. The applicant must pass the examination within three attempts or within a one year period of time after application submittal or a new application shall be required. An applicant who has failed the examination after three consecutive attempts shall be required to obtain eight PDH units prior to resubmittal of an application for certification.
(d) A certification shall not be issued until the applicant successfully passes the required examination or meets the requirements for certification without examination.
(e) A certification issued by the Commission shall be valid in every county in the state.
(f) Proof of 18 months experience in well contractor activities shall be demonstrated by providing one of the following:
(1) A list of at least 25 wells, together with their locations, major use and approximate depth PROPOSED RULES
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and diameter, for which the applicant has supervised or assisted in the construction, repair or abandonment process. This list shall provide the name and address of the owner or owners of each well, and the approximate date the construction of each well was completed. A copy of the completion report for each well shall accompany the list. Completion dates of the 25 wells shall be distributed over a consecutive 18 month period.
(2) A letter from at least one currently certified well contractor attesting that the applicant has been working in a well contractor activity for a minimum of 18 months.
(3) Any other proof of working in well contractor activities for a minimum of 18 months may be presented to the Commission and may be accepted on an individual basis.
(4) An affidavit from at least one currently certified well contractor attesting that the applicant has been working for the certified well contractor in well construction for a minimum of six months may be accepted, if the applicant also furnishes proof of completion of one of the following:
(A) Completion of a course of study in well construction techniques approved by the Well Contractor's Certification Commission and offered by a community college within the N.C. Department of Community Colleges with a passing grade; or
(B) Completion of an apprenticeship program approved by the Well Contractor's Certification Commission and approved by the N.C. Department of Labor in well construction; or
(C) Completion of a similar course of study or apprenticeship program as approved by the Well Contractor's Certification Commission.
Authority G.S. 87-98.6; 87-98.9; 143B-301.11; S.L. 2001-440.
TITLE 21 – OCCUPATIONAL LICENSING BOARDS
Notice is hereby given in accordance with G.S. 150B-21.2 that the State Board of Refrigeration Examiners intends to adopt the rules cited as 21 NCAC 60 .0212-.1213; amend the rules cited as 21 NCAC 60 .0102, .0206-.0208, .0311, .1102; and repeal the rules cited as 21 NCAC 60 .0201, .0204, .0210. Notice of Rule-making Proceedings was published in the Register on November 15, 2002.
Proposed Effective Date: August 1, 2004
Instructions on How to Demand a Public Hearing: (must be requested in writing within 15 days of notice): A demand for a hearing must be made in writing addressed to Barbara Hines, Suite 208, 875 Highway 70 West, Garner, NC 27529. The demand must be received within 15 days of this notice.
Reason for Proposed Action: Establish and set out procedure for computer based testing, clarify use of license and permit requirements and delete unnecessary information.
Comment Procedures: Comments from the public shall be directed to Barbara Hines, Suite 208, Highway 70 West, Garner, NC 27529, (919) 779-4711, fax (919) 779-4733, and email sbbre1@bellsouth.net. Comments shall be received through February 17, 2003.
Fiscal Impact
State
Local
Substantive (>$5,000,000)
None
CHAPTER 60 - BOARD OF REFRIGERATION EXAMINERS
SECTION .0100 - ORGANIZATION AND DEFINITIONS
21 NCAC 60 .0102 OFFICE OF BOARD
The Board's office is located at, 875 Highway 70, West, Suite 208, Garner, North Carolina. The Board's mailing address is Suite 208, 875 Highway 70, West, Garner, North Carolina, NC 27529. The Board's rules are available for inspection at this office during regular office hours. The materials used in rule-making decisions will be available for inspection at said office.
Authority G.S. 87-54; 150B-11(2).
SECTION .0200 - EXAMINATIONS
21 NCAC 60 .0201 DATES OF BOARD MEETINGS
Authority G.S. 87-54; 87-58.
21 NCAC 60 .0204 SCORING EXAMINATIONS
Authority G.S. 87-54; 87-58.
21 NCAC 60 .0206 EXAMINATION APPLICATION
DULY FILED
An examination application shall be considered as duly filed when the applicant has has filed an application with the Board, together with information satisfactorily verifying that he meets all of the minimum requirements to sit for an examination. By filing his application with the Board, an applicant authorizes the Board or the Board's staff to verify, in any manner the Board or staff deems necessary and appropriate, the information submitted on or in support of his application.
Authority G.S. 87-54; 87-58.
21 NCAC 60 .0207 REQUIREMENTS FOR
EXAMINATION APPLICANTS PROPOSED RULES
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(a) An applicant for the commercial refrigeration examination shall be eligible to take that examination upon:
(1) Filing with the Board an application, on a form provided by the Board, together with the non-refundable combined examination-license fee.
(2) Furnishing with his application information verifying that he has acquired at least 4000 hours of commercial refrigeration experience gained while engaged actively and directly in the installation, maintenance, servicing or repairing of commercial, industrial or institutional refrigeration equipment.
(b) An applicant for the transport refrigeration examination shall be eligible to take that examination upon:
(1) Filing with the Board an application, on a form provided by the Board, together with the non-refundable combined examination license fee.
(2) Furnishing with his application information verifying that he has acquired at least 4000 hours of transport or commercial refrigeration experience or a combination of both gained while engaged actively and directly in the installation, maintenance, servicing or repairing of transport or commercial refrigeration equipment or a combination of both.
(c) Prior to filing the application, qualifying experience shall be acquired while working under the supervision of a person who holds a valid refrigeration contractor's license, who is a registered professional engineer or who has equivalent industry experience. Up to one-half of the experience may be in academic or technical training directly related to the field of endeavor for which the examination is requested. Applicants who obtain a license shall receive a certificate issued by the Board, bearing that license number. The license shall not be assigned or transferred to another individual.
(d) An individual holding a valid transport contractor refrigeration license shall be eligible to sit for the commercial refrigeration examination upon filing with the Board an application, on a form provided by the Board, together with the combined examination-license fee.
(g)(e) The Board may deny an examination applicant permission to take an examination when it finds the applicant is not eligible, regardless of whether it has previously notified the applicant that he may take the examination. The Board may refuse to issue a license to a licensee when it finds the applicant is not qualified, regardless of whether the applicant has passed the appropriate examination. An applicant may contest the Board's decision by requesting an administrative hearing.
Authority G.S. 87-54; 87-58.
21 NCAC 60 .0208 EXAMINATION REVIEW
An examination review shall be held immediately following the taking of each examination.
Authority G.S. 87-54; 87-58(d); 93B-8(c).
21 NCAC 60 .0210 SPECIAL EXAMINATION
Authority G.S. 87-54; 87-58(d); 93B-8(c).
21 NCAC 60 .0212 QUALIFYING EXAMINATIONS
(a) Commercial Refrigeration contractor examinations are divided into four parts, "A," "B," "C" and "D." Transport refrigeration contractor examinations are divided into three parts, "A", "B" and "C".
(b) Each applicant must successfully complete 70 percent of each part to pass an examination. Each candidate who passes an examination is issued a refrigeration contractor's license.
(c) All qualifying examinations administered by the Board for each license classification shall be written or computer-based examinations and must be taken by the approved applicant.
(d) The approved applicant will be scheduled for the examination and will be notified of the date, time and place.
(e) The executive director is authorized to arrange for examinations to be administered by the Board.
Authority G.S. 87-54; 87-58.
21 NCAC 60 .0213 EXAMINATIONS
(a) In order to pass the qualifying examination, an applicant is required to pass all four parts of the examinations within the same one year period and within no more than three consecutive attempts. Each time an applicant takes the examination, he shall take all parts for which he does not have currently valid passing grades. If the applicant fails to pass all four parts within one year or within three consecutive attempts (whichever period is shorter), any passing grades for individual parts shall no longer be valid and the applicant must start over by re-taking all four parts of the examination.
(b) A person who fails an examination must wait a period of five business days from the date he last failed an examination before he will be eligible to take another examination.
(c) Each person who fails an examination shall be notified of his scores and the parts of the examination he failed.
(d) If a person files an application for examination which is accepted, and takes and fails the examination, his verification of refrigeration experience shall be kept and shall be sufficient for taking any future examination, provided he files another application accompanied by the required fee.
Authority G.S. 87-54; 87-58.
SECTION .0300 - LICENSES AND FEES
21 NCAC 60 .0311 PERMITS
(a) The refrigeration license number of the licensee shall appear on all permits as issued by a municipality.
(b) A licensee shall assure that a permit is obtained from the local Building Code enforcement official before commencing any installation work for which a license is required by the Board. The licensee shall also assure that a request for final inspection is made within 10 days of subsequent completion of the work for which a license is required, absent agreement with the owner and the local Building Code enforcement official.
(c) A licensee shall obtain permits and allow his number to appear on permits only for work over which he will provide general supervision until the completion of the work, for which he holds the contract and for which he receives all contractual payments.PROPOSED RULES
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(1) General supervision is that degree of supervision which is necessary and sufficient to ensure that the work is performed in a competent manner and with the requisite skill and that the work is done timely, safely and in accordance with applicable codes and rules. General supervision requires that the review of the work be performed in person by the licensee while the work is in progress.
(2) Each business office for which a licensee is responsible shall be actively and locally supervised by that licensee who shall have primary responsibility and a corresponding amount of time personally involved in the work contracted for or performed by that office.
Authority G.S. 87-54; 87-58(g).
SECTION .1100 - DISCIPLINARY ACTION
21 NCAC 60 .1102 PREFERRING CHARGES
(a) Any person who believes that any refrigeration contractor is in violation of the provisions of G.S. 87-59 may prefer charges against such contractor by setting forth the charges in writing with particularity including, but not limited to, the date and place of the alleged violation. Such charges shall be signed and sworn to by the party preferring such charges and filed with the Executive Director of the State Board of Refrigeration Examiners at the office of the Board, Suite 208, 875 Highway 70 West, Garner, North Carolina 27629.
(b) A licensee who prefers charges against a refrigeration contractor shall cooperate with the Board in its investigation of the complaint including the execution of an affidavit covering their knowledge of the facts and circumstances concerning the complaint, if required, and participate in any legal action authorized by the Board if requested by the Board or its representative.
(c) A licensee shall fully cooperate with the Board in connection with any inquiry it shall make. Full cooperation includes responding in a timely manner to all inquiries of the Board or representative of the Board and claiming Board correspondence from the U.S. Postal Service.
Authority G.S. 87-59.
TEMPORARY RULES
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This Section includes temporary rules reviewed by the Codifier of Rules and entered in the North Carolina Administrative Code and includes, from time to time, a listing of temporary rules that have expired. See G.S. 150B-21.1 and 26 NCAC 02C .0500 for adoption and filing requirements. Pursuant to G.S. 150B-21.1(e), publication of a temporary rule in the North Carolina Register serves as a notice of rule-making proceedings unless this notice has been previously published by the agency.
TITLE 10 – DEPARTMENT OF HEALTH AND HUMAN SERVICES
Rule-making Agency: NC Medical Care Commission
Rule Citation: 10 NCAC 03D .2911
Effective Date: January 1, 2003
Findings Reviewed and Approved by: Julian Mann, III
Authority for the rulemaking: G.S. 143-508(d)(11); S.L. 2002, c. 179
Reason for Proposed Action: This temporary rule-making action was prompted by a recent change in state law. Specifically, HB 1508 (S.L. 2002-179) was amended in G.S. 143-508(d)(11) to provide more flexibility in determining who can qualify to receive emergency, on-site treatment for anaphylaxis. Prior to HB 1508, treatment was limited to anaphylaxis triggered by insect stings. Now, the authority has been extended to allow credentialed personnel to administer life-saving treatment to persons having allergic reaction to any agent that causes anaphylaxis. Such agents include, but are not limited to, peanuts, shellfish, honey, etc. Adhering to the notice and hearing requirements would be contrary to the public interest as it would delay the ability for credentialed personnel to begin responding to all agents that cause anaphylaxis. Any delay in implementing this temporary rule change will result in the loss of numerous lives.
Comment Procedures: Comments from the public shall be directed to Mark Benton, NCDFS 2701 Mail Service Center, Raleigh, NC 27699-2701, phone (919) 855-3750, and email mark.benton@ncmail.net.
CHAPTER 03 - FACILITY SERVICES
SUBCHAPTER 03D - RULES AND REGULATIONS GOVERNING AMBULANCE SERVICE
SECTION .2900 – EMS PERSONNEL
10 NCAC 03D .2911 CREDENTIALING OF
INDIVIDUALS TO ADMINISTER LIFESAVING
TREATMENT TO PERSONS SUFFERING AN ADVERSE
REACTION TO AGENTS THAT MIGHT CAUSE
ANAPHYLAXIS
(a) To become credentialed by the North Carolina Medical Care Commission to administer epinephrine to persons who suffer adverse reactions to agents that might cause anaphylaxis, a person shall meet the following:
(1) Be 18 years of age or older; and
(2) Successfully complete an educational program taught by a physician licensed to practice medicine in North Carolina or designee of the physician. The educational program shall instruct individuals in the appropriate use of procedures for the administration of epinephrine to pediatric and adult victims who suffer adverse reactions to agents that might cause anaphylaxis and shall include at a minimum the following:
(A) definition of anaphylaxis;
(B) agents which might cause anaphylaxis and the distinction between them, including drugs, insects, foods, and inhalants;
(C) recognition of symptoms of anaphylaxis for both pediatric and adult victims;
(D) Appropriate appropriate emergency treatment of anaphylaxis as a result of agents that might cause anaphylaxis;
(E) availability and design of packages containing equipment for administering epinephrine to victims suffering from anaphylaxis as a result of agents that might cause anaphylaxis;
(F) pharmacology of epinephrine including indications, contraindications, and side effects;
(G) discussion of legal implications of rendering aid; and
(H) instruction that treatment is to be utilized only in the absence of the availability of physicians or other practitioners who are authorized to administer the treatment.
(b) A credential to administer epinephrine to persons who suffer adverse reactions to agents that might cause anaphylaxis may be issued by the North Carolina Medical Care Commission upon receipt of a completed application signed by the applicant and the physician who taught or was responsible for the educational program. All credentials shall be valid for the period stated on the credential issued to the applicant and this period shall not exceed four years.
History Note: Authority G.S. 143-508(d)(11);
Temporary Adoption Eff. January 1, 2002;
Temporary Adoption Eff. January 1, 2003.
* * * * * * * * * * * * * * * * * * * *
Rule-making Agency: DHHS, Division of Facility Services
Rule Citation: 10 NCAC 03R .1125, .2213, .2217, .2411, .2713-.2715, .3603, .3701, .3703, .4201-.4203, .6401-.6433, .6436-.6444 TEMPORARY RULES
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Effective Date: January 1, 2003
Findings Reviewed and Approved by: Beecher R. Gray
Authority for the rulemaking: G.S. 131E-175; 131E-176; 131E-177; 131E-183; S.L. 2001, c. 234
Reason for Proposed Action: Temporary rule-making is necessary because the annual planning process does not leave the Department the time necessary to use permanent rule-making. The Medical Facilities Planning Section began updating its inventories of medical facilities, services, and equipment at the end of December 2001.
Comment Procedures: Comments from the public shall be directed to Mark Benton, Chief of Budget & Planning/Rule-making Coordinator, NC DHHS – DFS, 2701 Mail Service Center, Raleigh, NC 27699-2701, phone (919) 855-3750, and email mark.benton@ncmail.net.
CHAPTER 03 - FACILITY SERVICES
SUBCHAPTER 03R - CERTIFICATE OF NEED REGULATIONS
SECTION .1100 - CRITERIA AND STANDARDS FOR NURSING FACILITY OR ADULT CARE HOME
SERVICES
10 NCAC 03R .1125 INFORMATION REQUIRED OF
APPLICANT
(a) An applicant proposing to establish new nursing facility or adult care home beds shall project an occupancy level for the entire facility for each of the first eight calendar quarters following the completion of the proposed project. All assumptions, including the specific methodologies by which occupancies are projected, shall be stated.
(b) An applicant proposing to establish new nursing facility or adult care home beds shall project patient origin by percentage by county of residence. All assumptions, including the specific methodology by which patient origin is projected, shall be stated.
(c) An applicant proposing to establish new nursing facility or adult care home beds shall show that at least 85 percent of the anticipated patient population in the entire facility lives within a 45 mile radius of the facility, with the exception that this standard shall be waived for applicants proposing to transfer existing certified nursing facility beds from a State Psychiatric Hospital to a community facility, facilities that are fraternal or religious facilities, or facilities that are part of licensed continuing care facilities which make services available to large or geographically diverse populations.
(d) An applicant proposing to establish a new nursing facility or adult care home shall specify the site on which the facility will be located. If the proposed site is not owned by or under the control of the applicant, the applicant shall specify at least one alternate site on which the services could be operated should acquisition efforts relative to the proposed site ultimately fail, and shall demonstrate that the proposed and alternate sites are available for acquisition.
(e) An applicant proposing to establish a new nursing facility or adult care home shall document that the proposed site and alternate sites are suitable for development of the facility with regard to water, sewage disposal, site development and zoning including the required procedures for obtaining zoning changes and a special use permit after a certificate of need is obtained.
(f) An applicant proposing to establish new nursing facility or adult care home beds shall provide documentation to demonstrate that the physical plant will conform with all requirements as stated in 10 NCAC 03H or 10 NCAC 42D, whichever is applicable.
History Note: Authority G.S. 131E-175; 131E-176;
131E-177(1); 131E-183(b); S.L. 2001, c. 234;
Eff. November 1, 1996;
Temporary Amendment Eff. January 1, 2002;
Temporary Amendment Eff. January 1, 2003.
SECTION .2200 - CRITERIA AND STANDARDS FOR END-STAGE RENAL DISEASE SERVICES
10 NCAC 03R .2213 INFORMATION REQUIRED OF
APPLICANTS
(a) An applicant that proposes to increase stations in an existing certified facility or relocated stations must provide the following information:
(1) Utilization rates;
(2) Mortality rates;
(3) The number of patients that are home trained and the number of patients on home dialysis;
(4) The number of transplants performed or referred;
(5) The number of patients currently on the transplant waiting list;
(6) Hospital admission rates, by admission diagnosis, i.e., dialysis related versus non-dialysis related;
(7) The number of patients with infectious disease, i.e., hepatitis and AIDS, and the number converted to infectious status during last calendar year.
(b) An applicant that proposed to increase the number of stations in an existing facility, or establish a new dialysis station, or the relocation of existing dialysis stations must provide the information requested on the End Stage Renal Disease (ESRD) Treatment application form to include the following:
(1) A signed written agreement with an acute care hospital that specifies the relationship with the dialysis facility and describes the services that the hospital will provide to patients of the dialysis facility. The agreement must comply with 42 C.F.R., Section 405.2100.
(2) A written agreement with a transplantation center describing the relationship with the dialysis facility and the specific services that the transplantation center will provide to patients of the dialysis facility. The agreements must include at least the following:
(A) timeframe for initial assessment and evaluation of patients for transplantation, TEMPORARY RULES
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(B) composition of the assessment/evaluation team at the transplant center,
(C) method for periodic re-evaluation,
(D) criteria by which a patient will be evaluated and periodically re-evaluated for transplantation, and
(E) signatures of the duly authorized persons representing the facilities and the agency providing the services.
(3) Documentation that the water supply will comply with 42 C.F.R., Section 405.2100.
(4) Documentation of standing service from a power company and back-up capabilities.
(5) The location of the site on which the services are to be operated. If such site is neither owned by nor under option to the applicant, the applicant must provide a written commitment to diligently pursue acquiring the site if and when the approval is granted, must specify a secondary site on which the services could be operated should acquisition efforts relative to the primary site ultimately fail, and must demonstrate that the primary and secondary sites are available for acquisition.
(6) Documentation that the services will be provided in conformity with applicable laws and regulations pertaining to staffing, fire safety equipment, physical environment, and other relevant health and safety requirements.
(7) The projected patient origin for the services. All assumptions, including the specific methodology by which patient origin is projected, must be clearly stated.
(8) For new facilities, documentation that at least 80 percent of the anticipated patient population resides within 30 miles of the proposed facility.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Eff. March 1, 1989;
Temporary Amendment Eff. January 1, 2003.
10 NCAC 03R .2217 PERFORMANCE STANDARDS
(a) An applicant proposing to establish a new End Stage Renal Disease facility shall document the need for at least 10 stations based on utilization of 3.2 patients per station per week as of the end of the first operating year of the facility.
(b) An applicant proposing to increase the number of dialysis stations in an existing End Stage Renal Disease facility shall document the need for the additional stations based on utilization of 3.2 patients per station per week as of the end of the first operating year of the additional stations.
(c) An applicant shall provide all assumptions, including the specific methodology by which patient utilization is projected.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. January 1, 2002;
Temporary Adoption Eff. January 1, 2003.
SECTION .2400 - CRITERIA AND STANDARDS FOR INTERMEDIATE CARE FACILITY/MENTALLY RETARDED (ICF/MR)
10 NCAC 03R .2411 PERFORMANCE STANDARDS
(a) An applicant proposing to add ICF/MR beds to an existing facility shall not be approved unless the overall average occupancy, over the six months immediately preceding the submittal of the application, of the total number of ICF/MR beds within the facility in which the new beds are to be operated was at least 90 percent.
(b) An applicant proposing to establish new ICF/MR beds shall not be approved unless occupancy is projected to be at least 90 percent for the total number of ICF/MR beds proposed to be operated in the entire facility, no later than one year following the completion of the proposed project.
(c) An applicant proposing to establish new ICF/MR beds shall comply with one of the following models:
(1) a residential community based freestanding facility with six beds or less, i.e., group home model;
(2) a community-based facility with 7 to 15 beds if documentation is provided that a facility of this size is necessary because adequate residential community based freestanding facilities are not available in the catchment area to meet the needs of the population to be served; or
(3) a facility with greater than 15 beds if the proposed new beds are to be established in response to an adjusted need determination contained in the 2003 State Medical Facilities Plan.
(d) No more than three intermediate care facilities for the mentally retarded housing a combined total of 18 persons shall be developed on contiguous pieces of property, with the exception that this standard may be waived for beds proposed to be established in response to an adjusted need determination contained in the 2003 State Medical Facilities Plan.
History Note: Authority G.S. 131E-177(1), (5); 131E-183;
Eff. November 1, 1996;
Temporary Amendment Eff. January 1, 2003.
SECTION .2700 - CRITERIA AND STANDARDS FOR MAGNETIC RESONANCE IMAGING SCANNER
10 NCAC 03R .2713 DEFINITIONS
The following definitions shall apply to all rules in this Section:
(1) "Approved MRI scanner" means an MRI scanner which was not operational prior to the beginning of the review period but which had been issued a certificate of need.
(2) "Existing MRI scanner" means an MRI scanner in operation prior to the beginning of the review period.
(3) "Magnetic Resonance Imaging" (MRI) means a non-invasive diagnostic modality in which electronic equipment is used to create tomographic images of body structure. The MRI scanner exposes the target area to TEMPORARY RULES
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nonionizing magnetic energy and radio frequency fields, focusing on the nuclei of atoms such as hydrogen in the body tissue. Response of selected nuclei to this stimulus is translated into images for evaluation by the physician.
(4) "Magnetic resonance imaging scanner" (MRI Scanner) is defined in G.S. 131E-176(14e), and includes dedicated fixed breast MRI scanners.
(5) "Mobile MRI scanner" means an MRI scanner and transporting equipment which is moved at least weekly to provide services at two or more host facilities.
(6) "MRI procedure" means a single discrete MRI study of one patient.
(7) "MRI service area" means the Magnetic Resonance Imaging Planning Areas, as defined in the applicable State Medical Facilities Plan, except for proposed new mobile MRI scanners.
(8) "MRI study" means one or more scans relative to a single diagnosis or symptom.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;
Eff. February 1, 1994;
Temporary Amendment Eff. January 1, 1999;
Temporary Eff. January 1, 1999 Expired on October 12, 1999;
Temporary Amendment Eff. January 1, 2000;
Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;
Temporary Amendment Eff. January 1, 2001;
Temporary Amendment effective January 1, 2001 amends and replaces a permanent rulemaking originally proposed to be effective April 1, 2001;
Temporary Amendment Eff. January 1, 2002;
Amended Eff. August 1, 2002;
Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;
Temporary Amendment Eff. January 1, 2003.
10 NCAC 03R .2714 INFORMATION REQUIRED OF
APPLICANT
(a) An applicant proposing to acquire an MRI scanner, including a mobile MRI scanner, shall use the Acute Care Facility/Medical Equipment application form.
(b) Except for proposals to acquire mobile MRI scanners that serve two or more host facilities, both the applicant and the person billing the patients for the MRI service shall be named as co-applicants in the application form.
(c) An applicant proposing to acquire a magnetic resonance imaging scanner, including a mobile MRI scanner, shall provide the following information:
(1) documentation that the MRI scanner shall be available and staffed for use at least 66 hours per week, with the exception of a mobile MRI scanner;
(2) projections of the annual number of procedures to be performed the average charge for each proposed procedure for each of the first three years of operation after completion of the project. This information shall be provided separately for each proposed host facility if the application proposes the acquisition of a mobile MRI scanner; for each of the first three years of operation after completion of the project;
(3) the average charge to the patient, regardless of who bills the patient, for each of the 20 most frequent MRI procedures to be performed for each of the first three years of operation after completion of the project and a description of items included in the charge; if the professional fees is included in the charge, provide the dollar amount for the professional fee;
(4) if the proposed MRI service will be provided pursuant to a service agreement, the dollar amount of the service contract fee billed by the applicant to the contracting party for each of the first three years of operation;
(5) documentation of the need for an additional MRI scanner in the proposed MRI service area and description of the methodology used to project need, including all assumptions regarding the population to be served; and
(6) letters from physicians indicating their intent to refer patients to the proposed magnetic resonance imaging scanner. scanner; and
(d) An applicant proposing to acquire a mobile MRI scanner shall provide copies of letters of intent from, and proposed contracts with, all of the proposed host facilities of the new MRI scanner.
(e) An applicant proposing to acquire a dedicated fixed breast MRI scanner shall:
(1) provide a copy of a contract or working agreement with a radiologist or practice group that has experience interpreting images and is trained to interpret images produced by an MRI scanner configured exclusively for mammographic studies;
(2) document that the applicant performed mammograms continuously for the last year; and
(3) document that the applicant's existing mammography equipment is in compliance with the U.S. Food and Drug Administration Mammography Quality Standards Act.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;
Eff. February 1, 1994; TEMPORARY RULES
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Temporary Amendment Eff. January 1, 2002;
Temporary Amendment Eff. January 1, 2003.
10 NCAC 03R .2715 REQUIRED PERFORMANCE
STANDARDS
(a) An applicant proposing to acquire a mobile magnetic resonance imaging (MRI) scanner shall:
(1) demonstrate that at least 2900 MRI procedures were performed in the last year on each of its existing mobile MRI scanners operating in the Health Service Area(s), (e.g., HSA I), in which the proposed mobile MRI scanner will be located [Note: This is not the average number of procedures performed on all of the applicant's mobile MRI scanners.];
(2) demonstrate annual utilization in the third year of operation is reasonably projected to be at least 2900 MRI procedures on each of its existing, approved and proposed mobile MRI scanners to be operated in the Health Service Area(s), (e.g., HSA I), in which the proposed equipment will be located [Note: This is not the average number of procedures performed on all of the applicant's mobile MRI scanners.];
(3) document the assumptions and provide data supporting the methodology used for each projection required in this Rule.
(b) An applicant proposing to acquire a magnetic resonance imaging (MRI) scanner for which the need determination in the State Medical Facilities Plan was based on the utilization of fixed MRI scanners, shall:
(1) demonstrate that its existing MRI scanners, except mobile MRI scanners, operating in the proposed MRI service area in which the proposed MRI scanner will be located performed an average of at least 2900 MRI procedures per scanner in the last year;
(2) demonstrate annual utilization in the third year of operation is reasonably projected to be an average of 2900 procedures per scanner for all existing, approved and proposed MRI scanners or mobile MRI scanners to be operated by the applicant in the MRI service area(s) in which the proposed equipment will be located; and
(3) document the assumptions and provide data supporting the methodology used for each projection required in this Rule.
(c) An applicant proposing to acquire a magnetic resonance imaging (MRI) scanner for which the need determination in the State Medical Facilities Plan was based on utilization of mobile MRI scanners, shall:
(1) if the applicant does not own or lease an MRI scanner or have an approved MRI scanner, demonstrate annual utilization in the third year of operation is reasonably projected to be at least 2080 MRI procedures per year for the proposed MRI scanner;
(2) if the applicant already owns or leases an MRI scanner or has an approved MRI scanner, demonstrate annual utilization is reasonably projected to be an average of 2900 MRI procedures per scanner for all existing, approved and proposed MRI scanners or mobile MRI scanners to be operated by the applicant in the MRI service area(s) in which the proposed equipment will be located; and
(3) document the assumptions and provide data supporting the methodology used for each projection required in this Rule.
(d) An applicant proposing to acquire a magnetic resonance imaging (MRI) scanner for which the need determination in the State Medical Facilities Plan was based on the absence of an existing or approved fixed MRI scanner in the MRI service area shall:
(1) demonstrate annual utilization of the proposed MRI scanner in the third year of operation is reasonably projected to be at least 2080 MRI procedures per year; and,
(2) document the assumptions and provide data supporting the methodology used for each projection required in this Rule.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;
Eff. February 1, 1994;
Temporary Amendment Eff. January 1, 1999;
Temporary Eff. January 1, 1999 Expired on October 12, 1999;
Temporary Amendment Eff. January 1, 2000;
Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;
Temporary Amendment Eff. January 1, 2001;
Temporary Amendment effective January 1, 2001 amends and replaces a permanent rulemaking originally proposed to be effective April 1, 2001;
Temporary Amendment Eff. January 1, 2002;
Amended Eff. August 1, 2002;
Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective, August 1, 2002;
Temporary Amendment effective January 1, 2003.
SECTION .3600 - CRITERIA AND STANDARDS FOR GAMMA KNIFE
10 NCAC 03R .3603 REQUIRED PERFORMANCE
STANDARDS
An applicant proposing to acquire a gamma knife shall:
(1) demonstrate that all existing gamma knives in the applicant's gamma knife service area performed at least 408 procedures during the 12 month period immediately preceding submittal of the application;
(2) demonstrate that the gamma knife shall be utilized at an annual rate of at least 250 procedures (i.e., 80% of 312 procedures) per machine, measured during the fourth quarter TEMPORARY RULES
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of the third year of operation following completion of the project, and shall provide all assumptions and data supporting the methodology used for the projections;
(3) for the projections provided in response to Item (2) of this Rule, calculate the number of procedures projected to be performed for clinical purposes and the number of procedures projected to be performed for research purposes; and
(4) demonstrate that all of the existing and approved gamma knives in the applicant's gamma knife service area shall be performing at least 326 gamma knife procedures per year in the third year of operation of the new gamma knife, and provide all assumptions and data supporting the methodology used for the projections.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. September 1, 1993 for a period of 180
days or until the permanent rule becomes effective, whichever is
sooner;
Eff. January 4, 1994;
Temporary Amendment Eff. January 1, 2003.
SECTION .3700 - CRITERIA AND STANDARDS FOR POSITRON EMISSION TOMOGRAPHY SCANNER
10 NCAC 03R .3701 DEFINITIONS
The following definitions shall apply to all rules in this Section:
(1) "Approved positron emission tomography (PET) scanner" means a PET scanner which was not operational prior to the beginning of the review period but which had been issued a certificate of need.
(2) "Cyclotron" means an apparatus for accelerating protons or neutrons to high energies by means of a constant magnet and an oscillating electric field.
(3) "Dedicated PET Scanner" means PET Scanners as defined in the applicable State Medical Facilities Plan.
(4) "Existing PET scanner" means a PET scanner in operation prior to the beginning of the review period.
(5) "Mobile PET Scanner" means a PET scanner and transporting equipment that is moved, at least weekly, to provide services at two or more host facilities.
(6) "PET procedure" means a single discrete study of one patient involving one or more PET scans.
)(7) "PET scan" means an image-scanning sequence derived from a single administration of a PET radiopharmaceutical, equated with a single injection of the tracer. One or more PET scans comprise a PET procedure.
(8) "PET scanner service area" means the PET Scanner Service Area as defined in the applicable State Medical Facilities Plan.
(9) "Positron emission tomographic scanner" (PET) is defined in G.S. 131E-176(19a).
(10) "Radioisotope" means a radiochemical which directly traces biological processes when introduced into the body.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;
Eff. January 4, 1994;
Temporary Amendment Eff. January 1, 2001;
Temporary Amendment Eff. January 1, 2002;
Amended Eff. August 1, 2002;
Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;
Temporary Amendment Eff. January 1, 2003.
10 NCAC 03R .3703 REQUIRED PERFORMANCE
STANDARDS
(a) An applicant proposing to acquire a dedicated PET scanner, including a mobile dedicated PET scanner, shall demonstrate that:
(1) the proposed dedicated PET scanner, including mobile dedicated PET scanners, shall be utilized at an annual rate of at least 1,220 PET procedures by the end of the third year following completion of the project;
(2) its existing dedicated PET scanners, excluding those used exclusively for research, performed an average of 1,220 PET procedures per PET scanner in the last year; and
(3) its existing and approved dedicated PET scanners shall perform an average of at least 1,220 PET procedures per PET scanner during the third year following completion of the project.
(b) The applicant shall describe the assumptions and provide data to support and document the assumptions and methodology used for each projection required in this Rule.
History Note: Authority G.S. 131E-177(1); 131E-183(b);
Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;
Eff. January 4, 1994;
Temporary Amendment Eff. January 1, 2002; January 1, 2001;
Amended Eff. August 1, 2002;
Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;
Temporary Amendment Eff. January 1, 2003.
SECTION .4200 - CRITERIA AND STANDARDS FOR HOSPICES, HOSPICE INPATIENT FACILITIES, AND HOSPICE RESIDENTIAL CARE FACILITIES
10 NCAC 03R .4201 DEFINITIONS
The following definitions shall apply to all rules in this Section:
(1) "Bereavement counseling" means counseling provided to a hospice patient's family or TEMPORARY RULES
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significant others to assist them in dealing with issues of grief and loss.
(2) "Caregiver" means the person whom the patient designates to provide the patient with emotional support, physical care, or both.
(3) "Care plan" means a plan as defined in 10 NCAC 03T .0102 of the Hospice Licensing Rules.
(4) "Continuous care" means care as defined in 42 CFR 418.204, the Hospice Medicare Regulations.
(5) "Home-like" means furnishings of a hospice inpatient facility or a hospice residential care facility as defined in 10 NCAC 03T .1110 or .1201 of the Hospice Licensing Rules.
(6) "Homemaker services" means services provided to assist the patient with personal care, maintenance of a safe and healthy environment and implementation of the patient's care plan.
(7) "Hospice" means any coordinated program of home care as defined in G.S. 131E-176(13a).
(8) "Hospice inpatient facility" means a facility as defined in G.S. 131E-176(13b).
(9) "Hospice residential care facility" means a facility as defined in G.S. 131E-176(13c).
(10) "Hospice service area" means, for residential care facilities,
the county in which the hospice residential care facility will be located and the contiguous counties for which the hospice residential care facility will provide services.
(11) "Hospice services" means services as defined in G.S. 131E-201.
(12) "Hospice staff" means personnel as defined in 10 NCAC 03T .0102 of the Hospice Licensing Rules.
(13) "Interdisciplinary team" means personnel as defined in G.S. 131E-201.
(14) "Palliative care" means treatment as defined in G.S. 131E-201.
(15) "Respite care" means care provided as defined in 42 CFR 418.98.
History Note: Authority G.S. 131E-177(1);
Eff. July 1, 1994;
Temporary Amendment Eff. January 1, 2003.
10 NCAC 03R .4202 INFORMATION REQUIRED OF
APPLICANT
(a) An applicant proposing to develop a hospice shall complete the application form for Hospice Services. An applicant proposing to develop hospice inpatient facility beds or hospice residential care facility beds shall complete the application form for Hospice Inpatient and Hospice Residential Care Services.
(b) An applicant proposing to develop a hospice, hospice inpatient facility beds, or hospice residential care facility beds shall provide the following information:
(1) the annual unduplicated number of hospice patients projected to be served in each of the first two years following completion of the project and the methodology and assumptions used to make the projections;
(2) the projected number of hospice patients to be served by quarter for the first 24 months following completion of the project and the methodology and assumptions used to make the projections;
(3) the projected number of patient care days, by level of care (i.e., routine home care, respite care, and inpatient care), by quarter, to be provided in each of the first two years of operation following completion of the project and the methodology and assumptions used to make the projections shall be clearly stated;
(4) the projected number of hours of continuous care to be provided in each of the first two years of operation following completion of the project and the methodology and assumptions used to make these projections;
(5) the projected average annual cost per hour of continuous care for each of the first two operating years following completion of the project and the methodology and assumptions used to make the projections;
(6) the projected average annual cost per patient care day, by level of care (i.e., routine home care, respite care, and inpatient care), for each of the first two operating years following completion of the project and the methodology and assumptions used to project the average annual cost;
(7) documentation of attempts made to establish working relationships with sources of referrals to the hospice services and copies of proposed agreements for the provision of inpatient care.
(c) An applicant proposing to develop a hospice shall also provide documentation that the hospice shall be licensed and shall be certified for participation in the Medicare program within one year after issuance of the certificate of need.
(d) An applicant proposing to develop hospice inpatient or hospice residential care facility beds shall also provide the following information:
(1) a description of the means by which hospice services shall be provided in the patient's own home;
(2) copies of the proposed contractual agreements, with a licensed hospice or a licensed home care agency with a hospice designation on its license, for the provision of hospice services in the patient's own home;
(3) a copy of the admission policies, including the criteria that shall be used to select persons for admission and to assure that terminally ill patients are served in their own homes as long as possible; and
(4) documentation that a home-like setting shall be provided in the facility. TEMPORARY RULES
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History Note: Authority G.S. 131E-177(1); 131E-183;
Eff. July 1, 1994;
Amended Eff. November 1, 1996;
Temporary Amendment Eff. January 1, 2003.
10 NCAC 03R .4203 REQUIRED PERFORMANCE
STANDARDS
(a) An applicant proposing to develop hospice inpatient facility beds or hospice residential care facility beds shall demonstrate that:
(1) the average occupancy rate of the licensed beds in the facility is projected to be at least 50% for the last six months of the first operating year following completion of the project;
(2) the average occupancy rate for the licensed beds in the facility is projected to be at least 65% for the second operating year following completion of the project; and
(3) if the application is submitted to address the need for a hospice residential care facility, each existing facility which is located in the hospice service area and which has licensed beds of the type proposed by the applicant attained an occupancy rate of at least 65% for the 12 month period reported on that facility's most recent Licensure Renewal Application Form.
(b) An applicant proposing to add beds to an existing hospice inpatient facility or hospice residential care facility shall document that the average occupancy of the licensed hospice inpatient and hospice residential care facility beds in its existing facility was at least 65% for the nine months immediately preceding the submittal of the proposal.
(c) An applicant proposing to develop a hospice shall demonstrate that no less than 80% of the total number of days of hospice care furnished to Medicaid and Medicare patients will be provided in the patient's residence in accordance with 42 CFR 418.302(f)(2).
History Note: Authority G.S. 131E-177(1);
Eff. July 1, 1994;
Temporary Amendment Eff. January 1, 1999;
Temporary Eff. January 1, 1999 Expired on October 12, 1999;
Temporary Amendment Eff. January 1, 2000;
Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;
Amended Eff. April 1, 2001;
Temporary Amendment Eff. January 1, 2003.
SECTION .6400 – PLANNING POLICIES AND NEED DETERMINATIONS FOR 2003
10 NCAC 03R .6401 APPLICABILITY OF RULES
RELATED TO THE 2003 STATE MEDICAL FACILITIES
PLAN
Rules .6401 through .6404 and .6406 through .6433 and .6436 through .6444 of this Section apply to certificate of need applications for which the scheduled review period begins during calendar year 2003. In addition, Rule .6405 of this Section shall be used to implement procedures described within it during calendar year 2003.
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6402 CERTIFICATE OF NEED REVIEW SCHEDULE
The Department of Health and Human Services (DHHS) has established the following review schedules for certificate of need applications.
(1) Acute Care Beds (in accordance with the need determination in 10 NCAC 03R .6406)
Hospital Service System CON Beginning Review Date
Cannon Memorial Hospital October 1, 2003
(2) Operating Rooms (in accordance with the need determination in 10 NCAC 03R .6408)
Ambulatory Surgery Service Certificate of Need
Area (Constituent Counties) Beginning Review Date
27 (Hoke, Lee, Montgomery, Moore, Richmond, Scotland) September 1, 2003
(3) Fixed Cardiac Catheterization/Angioplasty Equipment (in accordance with the need determination in 10 NCAC 03R .6411)
County CON Beginning Review Date
Forsyth February 1, 2003
Guilford October 1, 2003
New Hanover July 1, 2003
Wake March 1, 2003
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(4) Shared Fixed Cardiac Catheterization/Angioplasty Equipment (in accordance with the need determination in 10 NCAC 03R .6412)
Hospital Service System CON Beginning Review Date
Randolph Hospital October 1, 2003
(5) Gamma Knife (in accordance with the need determination in 10 NCAC 03R .6417)
Gamma Knife Planning Region CON Beginning Review Date
2 (HSAs IV, V, VI) November 1, 2003
(6) Radiation Oncology Treatment Center/Linear Accelerator (in accordance with the need determination in 10 NCAC 03R .6418)
Radiation Oncology Treatment Center Service Area CON Beginning Review Date
15 (Cumberland, Bladen, Robeson, Sampson) May 1, 2003
(7) Fixed Dedicated Positron Emission Tomography (PET) Scanners (in accordance with the need determination in 10 NCAC 03R .6419)
Positron Emission Tomography (PET)
Scanners Planning Region CON Beginning Review Date
HSA I April 1, 2003
HSA II August 1, 2003
HSA III June 1, 2003
HSA V March 1, 2003
HSA VI July 1, 2003
(8) Fixed Magnetic Resonance Imaging Scanners (in accordance with the need determinations in 10 NCAC 03R .6421)
Magnetic Resonance Imaging Scanners Service Areas
(Constituent Counties) CON Beginning Review Date
1 (Cherokee, Clay) April 1, 2003
1A (Macon) June 1, 2003
2 (Graham, Jackson, Swain) April 1, 2003
4 (Buncombe, Madison, Yancey) August 1, 2003
5 (McDowell, Mitchell) August 1, 2003
7 (Alexander, Burke, Caldwell, Catawba, Lincoln) December 1, 2003
8 (Rutherford, Cleveland) October 1, 2003
11 (Cabarrus, Rowan, Stanly) October 1, 2003
13 (Alleghany, Davie, Forsyth, Stokes, Surry, Wilkes, Yadkin) October 1, 2003
15 (Davidson, Guilford, Randolph, Rockingham) December 1, 2003
16 (Hoke, Montgomery, Moore, Richmond, Scotland) July 1, 2003
17 (Anson, Mecklenburg, Union) December 1, 2003
19 (Franklin, Wake) November 1, 2003
19A (Harnett, Johnston) May 1, 2003
21 (Durham, Granville, Person, Vance, Warren) March 1, 2003
23 (Carteret, Craven, Jones, Onslow, Pamlico) March 1, 2003
24 (Wayne, Wilson) September 1, 2003
25 (Beaufort, Bertie, Greene, Hyde, Lenoir, Martin, Pitt, Washington) July 1, 2003
(9) Fixed Magnetic Resonance Imaging (MRI) Scanner Need Determination (in accordance with 10 NCAC 03R .6422)
Magnetic Resonance Imaging Scanners
Service Area CON Beginning Review Date
12 (Iredell) December 1, 2003
13 (Alleghany, Davie, Forsyth, Stokes, Surry, Wilkes, Yadkin) April 1, 2003
15 (Davidson, Guilford, Randolph, Rockingham) June 1, 2003
17 (Anson, Mecklenburg, Union) June 1, 2003
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(10) Mobile Magnetic Resonance Imaging Scanners (in accordance with the need determination in 10 NCAC 03R .6423)
Mobile Magnetic Resonance Imaging Scanners
Planning Region CON Beginning Review Date
1 (HSAs I, II, III) August 1, 2003
2 (HSAs IV, V, VI) September 1, 2003
(11) Nursing Care Beds (in accordance with the need determination in 10 NCAC 03R .6424)
County CON Beginning Review Date
Clay April 1, 2003
Dare November 1, 2003
Perquimans May 1, 2003
Union June 1, 2003
(12) Adult Care Home Beds (in accordance with the need determination in 10 NCAC 03R .6425)
County CON Beginning Review Date
Beaufort July 1, 2003
Camden May 1, 2003
Cherokee April 1, 2003
Currituck May 1, 2003
Dare November 1, 2003
Gates May 1, 2003
Graham April 1, 2003
Greene September 1, 2003
Hyde July 1, 2003
Jackson April 1, 2003
Jones September 1, 2003
Macon June 1, 2003
Madison August 1, 2003
Mitchell August 1, 2003
Pender September 1, 2003
Polk August 1, 2003
Transylvania August 1, 2003
Tyrrell May 1, 2003
Washington May 1, 2003
(13) Medicare-Certified Home Health Agencies or Offices (in accordance with the need determination in 10 NCAC 03R .6426
County CON Beginning Review Date
Pamlico November 1, 2003
(14) Hospice Home Care Program (in accordance with the need determination in 10 NCAC 03R .6427)
County CON Beginning Review Date
Vance November 1, 2003
(15) Hospice Inpatient Beds (in accordance with the need determination in 10 NCAC 03R .6428)
County CON Beginning Review Date
Catawba December 1, 2003
Forsyth December 1, 2003
Gaston June 1, 2003
Iredell February 1, 2003
Mecklenburg December 1, 2003
Richmond May 1, 2003 TEMPORARY RULES
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Union December 1, 2003
(16) Intermediate Care Facility Beds for the Mentally Retarded (in accordance with the need determination in 10 NCAC 03R .6433)
Mental Health Planning Region CON Beginning Review Date
7 (Gaston-Lincoln-Cleveland) August 1, 2003
(17) There are 10 categories of projects for certificate of need review. The DHHS shall determine the appropriate review category or categories for all applications submitted pursuant to 10 NCAC 03R .0304. The review of an application for a certificate of need shall commence in the next applicable review schedule after the application has been determined to be complete. The 10 categories are:
(a) Category A. Proposals submitted by acute care hospitals, except those proposals included in Categories B through H and Category J, including but not limited to the following types of projects: renovation, construction, equipment, and acute care services.
(b) Category B. Proposals for nursing care beds; adult care home beds; new continuing care retirement communities applying for exemption under 10 NCAC 03R .6438(b) or .6439; and relocations of nursing care beds under 10 NCAC 03R .6438(d) or 10 NCAC 03R .6438(f).
(c) Category C. Proposals for new psychiatric facilities; psychiatric beds in existing health care facilities; new intermediate care facilities for the mentally retarded (ICF/MR) and ICF/MR beds in existing health care facilities; new substance abuse and chemical dependency treatment facilities; substance abuse and chemical dependency treatment beds in existing health care facilities; transfers of nursing care beds from State Psychiatric Hospitals to local communities pursuant to 10 NCAC 03R .6438(e); transfers of psychiatric beds from State Psychiatric Hospitals to community facilities pursuant to 10 NCAC 03R .6442; transfers of ICF/MR beds from State Mental Retardation Centers to community facilities pursuant to Chapter 858 of the 1983 Sessions Laws.
(d) Category D. Proposals for new dialysis stations in response to the "county need" or "facility need" methodologies; and relocations of existing dialysis stations to another county.
(e) Category E. Proposals for inpatient rehabilitation facilities; inpatient rehabilitation beds; licensed ambulatory surgical facilities; new operating rooms and relocations of existing operating rooms as defined in 10 NCAC 03R .6408(b).
(f) Category F. Proposals for new Medicare-certified home health agencies or offices; new hospices; new hospice inpatient facility beds; and new hospice residential care facility beds.
(g) Category G. Proposals for conversion of hospital beds to nursing care under 10 NCAC 03R .6438(a); and conversion of acute care hospitals to long-term acute care hospitals.
(h) Category H. Proposals for bone marrow transplantation services, burn intensive care services, neonatal intensive care services, open heart surgery services, solid organ transplantation services, air ambulance equipment, cardiac angioplasty equipment, cardiac catheterization equipment, heart-lung bypass machines, gamma knives, lithotriptors, magnetic resonance imaging scanners, positron emission tomography scanners, major medical equipment as defined in G.S. 131E-176 (14f), diagnostic centers as defined in G.S. 131E-176 (7a), and oncology treatment centers as defined in G.S. 131E-176 (18a).
(i) Category I. Proposals involving cost overruns; expansions of existing continuing care retirement communities which are licensed by the Department of Insurance at the date the application is filed and are applying under 10 NCAC 03R .6438(b) for exemption from need determinations in 10 NCAC 03R .6424 or 10 NCAC 03R .6439 for exemption from need determinations in 10 NCAC 03R .6425; relocations within the same county of existing health service facilities, beds or dialysis stations (excluding relocation of operating rooms as defined in 10 NCAC 03R .6408(b)) which do not TEMPORARY RULES
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involve an increase in the number of health service facility beds or stations; reallocation of beds or services; Category A proposals submitted by Academic Medical Center Teaching Hospitals designated prior to January 1, 1990; proposals submitted pursuant to 10 NCAC 03R .6436 by Academic Medical Center Teaching Hospitals designated prior to January 1, 1990; acquisition of replacement equipment that does not result in an increase in the inventory; and any other proposal not included in Categories A through H and Category J.
(j) Category J. Proposals for demonstration projects.
(18) A service, facility, or equipment for which a need determination is identified in Items (1) through (16) of this Rule shall have only one scheduled review date and one corresponding application filing deadline in the calendar year as specified in these items, even though the following review schedule shows multiple review dates for the broad category. Applications for certificates of need for new institutional health services not specified in Items (1) through (16) of this Rule shall be reviewed pursuant to the following review schedule, with the exception that no reviews are scheduled if the need determination is zero. Need determinations for additional dialysis stations pursuant to the "county need" or "facility need" methodologies shall be reviewed in accordance with 10 NCAC 03R .6429 or 10 NCAC 03R .6430.
CON Beginning Review Categories Review Categories
Review Date for HSA I, II, III for HSA IV, V, VI
January 1, 2003 -- --
February 1, 2003 A, C, E, F, G, H, I, J --
March 1, 2003 -- A, C, E, G, H, I, J
April 1, 2003 B, C, D, H, I D
May 1, 2003 -- B, C, F, H, I
June 1, 2003 A, B, C, F, H, I --
July 1, 2003 -- A, B, C, H, I
August 1, 2003 B, C, E, H, I --
September 1, 2003 -- B, C, E, H, I
October 1, 2003 A, C, D, H, I D
November 1, 2003 -- A, B, C, F, H, I
December 1, 2003 C, F, H, I --
For purposes of Magnetic Resonance Imaging (MRI) scanners reviews only, Anson County in MRI Area 17 is considered to be in HSA III.
(19) In order to give the DHHS sufficient time to provide public notice of review and public notice of public hearings as required by G.S. 131E-185, the deadline for filing certificate of need applications is 5:00 p.m. on the 15th day of the month preceding the "CON Beginning Review Date." In instances when the 15th day of the month falls on a weekend or holiday, the filing deadline is 5:00 p.m. on the next business day. The filing deadline is absolute and applications received after the deadline shall not be reviewed in that review period.
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6403 MULTI-COUNTY GROUPINGS
(a) Health Service Areas. The Department of Health and Human Services (DHHS) has assigned the counties of the state to the following health service areas for the purpose of scheduling applications for certificates of need:
HEALTH SERVICE AREAS (HSA)
I II III IV V VI
County County County County County County
Alexander Alamance Cabarrus Chatham Anson Beaufort
Alleghany Caswell Gaston Durham Bladen Bertie
Ashe Davidson Iredell Franklin Brunswick Camden
Avery Davie Lincoln Granville Columbus Carteret TEMPORARY RULES
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Buncombe Forsyth Mecklenburg Johnston Cumberland Chowan
Burke Guilford Rowan Lee Harnett Craven
Caldwell Randolph Stanly Orange Hoke Currituck
Catawba Rockingham Union Person Montgomery Dare
Cherokee Stokes Vance Moore Duplin
Clay Surry Wake New Hanover Edgecombe
Cleveland Yadkin Warren Pender Gates
Graham Richmond Greene
Haywood Robeson Halifax
Henderson Sampson Hertford
Jackson Scotland Hyde
McDowell Jones
Macon Lenoir
Madison Martin
Mitchell Nash
Polk Northampton
Rutherford Onslow
Swain Pamlico
Transylvania Pasquotank
Watauga Perquimans
Wilkes Pitt
Yancey Tyrrell
Washington
Wayne
Wilson
(b) Mental Health Planning Areas. The DHHS has assigned the counties of the state to the following Mental Health Planning Areas for purposes of the State Medical Facilities Plan:
MENTAL HEALTH PLANNING AREAS
Area Number Constituent Counties
1 Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain
2 Buncombe, Madison, Mitchell, Yancey
3 Alleghany, Ashe, Avery, Watauga, Wilkes
4 Henderson, Transylvania
5 Alexander, Burke, Caldwell, McDowell
6 Rutherford, Polk
7 Cleveland, Gaston, Lincoln
8 Catawba
9 Mecklenburg
10 Cabarrus, Rowan, Stanly, Union
11 Surry, Yadkin, Iredell
12 Forsyth, Stokes, Davie
13 Rockingham
14 Guilford
15 Alamance, Caswell
16 Orange, Person, Chatham
17 Durham
18 Vance, Granville, Franklin, Warren
19 Davidson
20 Anson, Hoke, Montgomery, Moore, Richmond
21 Bladen, Columbus, Robeson, Scotland
22 Cumberland
23 Lee, Harnett
24 Johnston
25 Wake
26 Randolph
27 Brunswick, New Hanover, Pender
28 Onslow
29 Wayne TEMPORARY RULES
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30 Wilson, Greene
31 Edgecombe, Nash
32 Halifax
33 Carteret. Craven. Jones, Pamlico
34 Lenoir
35 Pitt
36 Bertie, Gates, Hertford, Northampton
37 Beaufort, Hyde, Martin, Tyrrell, Washington
38 Camden, Chowan, Currituck, Dare, Pasquotank, Perquimans
39 Duplin, Sampson
(c) Mental Health Planning Regions. The DHHS has assigned the counties of the state to the following Mental Health Planning Regions for purposes of the State Medical Facilities Plan:
MENTAL HEALTH PLANNING REGIONS (AREA NUMBER AND CONSTITUENT COUNTIES)
Western (W)
1 Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain
2 Buncombe, Madison, Mitchell, Yancey
3 Alleghany, Ashe, Avery, Watauga, Wilkes
4 Henderson, Transylvania
5 Alexander, Burke, Caldwell, McDowell
6 Rutherford, Polk
7 Cleveland, Gaston, Lincoln
8 Catawba
9 Mecklenburg
10 Cabarrus, Rowan, Stanly, Union
North Central (NC)
11 Surry, Yadkin, Iredell
12 Forsyth, Stokes, Davie
13 Rockingham
14 Guilford
15 Alamance, Caswell
16 Orange, Person, Chatham
17 Durham
18 Vance, Granville, Franklin, Warren
South Central (SC)
19 Davidson
20 Anson, Hoke, Montgomery, Moore, Richmond
21 Bladen, Columbus, Robeson, Scotland
22 Cumberland
23 Lee, Harnett
24 Johnston
25 Wake
26 Randolph
Eastern (E)
27 Brunswick, New Hanover, Pender
28 Onslow
29 Wayne
30 Wilson, Greene
31 Edgecombe, Nash
32 Halifax
33 Carteret, Craven, Jones, Pamlico
34 Lenoir
35 Pitt
36 Bertie, Gates, Hertford, Northampton
37 Beaufort, Hyde, Martin, Tyrrell, Washington TEMPORARY RULES
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38 Camden, Chowan, Currituck, Dare, Pasquotank, Perquimans
39 Duplin, Sampson
(d) Radiation Oncology Treatment Center Planning Areas. The DHHS has assigned the counties of the state to the following Radiation Oncology Treatment Center Planning Areas for purposes of the State Medical Facilities Plan:
RADIATION ONCOLOGY TREATMENT CENTER PLANNING AREAS
Area Number Constituent Counties
1 Cherokee, Clay, Graham, Jackson, Macon, Swain
2 Buncombe, Haywood, Madison, McDowell, Mitchell, Yancey
3 Ashe, Avery, Watauga
4 Henderson, Polk, Transylvania
5 Alexander, Burke, Caldwell, Catawba
6 Rutherford, Cleveland, Gaston, Lincoln
7 Mecklenburg, Anson, Union
8 Iredell, Rowan
9 Cabarrus, Stanly
10 Alleghany, Forsyth, Davidson, Davie, Stokes, Surry, Wilkes, Yadkin
11 Guilford, Randolph, Rockingham
12 Chatham, Orange
12B Alamance, Caswell
13 Durham, Granville, Person, Vance, Warren
14 Moore, Hoke, Lee, Montgomery, Richmond, Scotland
15 Cumberland, Bladen, Sampson, Robeson
16 New Hanover, Brunswick, Columbus, Pender
17 Wake, Franklin, Harnett, Johnston
18 Lenoir, Duplin, Wayne
19 Craven, Carteret, Onslow, Jones, Pamlico
20 Nash, Halifax, Wilson, Northampton, Edgecombe
21 Pitt, Beaufort, Bertie, Greene, Hertford, Hyde, Martin, Washington
22 Pasquotank, Camden, Chowan, Currituck, Dare, Gates, Perquimans, Tyrrell
(e) Ambulatory Surgical Facility Planning Areas. The DHHS has assigned the counties of the state to the following Ambulatory Surgical Facility Planning Areas for purposes of the State Medical Facilities Plan:
AMBULATORY SURGICAL FACILITY PLANNING AREAS
Area Constituent Counties
1 Alamance
2 Alexander, Iredell
3 Alleghany, Surry, Wilkes
4 Anson, Gaston, Mecklenburg, Union
5 Ashe, Avery, Watauga
6 Beaufort, Hyde
7 Bertie, Gates, Hertford
8 Bladen, Cumberland, Robeson, Sampson
9 Brunswick, Columbus, Duplin, New Hanover, Pender
10 Buncombe, Haywood, Madison, Mitchell, Yancey
11 Burke, McDowell, Rutherford
12 Cabarrus, Rowan, Stanly
13 Caldwell, Catawba, Lincoln
14 Camden, Currituck, Dare, Pasquotank, Perquimans
15 Carteret, Craven, Jones, Onslow, Pamlico
16 Caswell, Chatham, Orange
17 Cherokee, Clay, Graham, Jackson, Macon, Swain
18 Chowan, Tyrrell, Washington
19 Cleveland
20 Davidson, Davie, Forsyth, Stokes, Yadkin
21 Durham, Granville, Person
22 Edgecombe, Halifax, Nash, Northampton TEMPORARY RULES
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23 Franklin, Harnett, Johnston, Wake
24 Greene, Lenoir, Martin, Pitt
25 Guilford, Randolph, Rockingham
26 Henderson, Polk, Transylvania
27 Hoke, Lee, Montgomery, Moore, Richmond, Scotland
28 Vance, Warren
29 Wayne
30 Wilson
(f) Magnetic Resonance Imaging (MRI) Scanners Service Areas for fixed MRI scanners. The DHHS has assigned the counties of the state to the following Magnetic Resonance Imaging Scanners Service Areas for purposes of the State Medical Facilities Plan for fixed MRI scanners.
MAGNETIC RESONANCE IMAGING SCANNERS PLANNING AREAS
Area Number Constituent Counties
1 Cherokee, Clay
1A Macon
2 Graham, Swain, Jackson
3 Haywood
4 Buncombe, Madison, Yancey
5 Mitchell, McDowell
6 Ashe, Avery, Watauga
7 Alexander, Burke, Caldwell, Catawba, Lincoln
8 Cleveland, Rutherford
9 Henderson, Polk, Transylvania
10 Gaston
11 Cabarrus, Rowan, Stanly
12 Iredell
13 Alleghany, Davie, Forsyth, Stokes, Surry, Wilkes, Yadkin
14 Alamance, Caswell
15 Davidson, Guilford, Randolph, Rockingham
16 Richmond, Scotland, Montgomery, Moore, Hoke
17 Anson, Mecklenburg, Union
18 Cumberland, Robeson, Sampson
19 Franklin, Wake
19A Harnett, Johnston
20 Chatham, Orange, Lee
21 Durham, Granville, Person, Vance, Warren
22 Bladen, Brunswick, Columbus, Duplin, New Hanover, Pender
23 Carteret, Craven, Jones, Onslow, Pamlico
24 Wayne, Wilson
25 Beaufort, Bertie, Greene, Hyde, Lenoir, Martin, Pitt, Washington
26 Edgecombe, Halifax, Nash, Northampton
27 Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank, Perquimans, Tyrrell
(g) Mobile Magnetic Resonance Imaging Scanners Planning Regions. The DHHS has assigned the HSAs as outlined in 10 NCAC 03R .6403(a) to the following Mobile Magnetic Resonance Imaging scanners planning regions for purposes of the State Medical Facilities Plan.
MOBILE MAGNETIC RESONANCE IMAGING SCANNERS PLANNING REGIONS
Region Number
Constituent HSAs
1
2
HSAs I, II, III
HSAs IV, V, VI
(h) Positron Emission Tomography (PET) Scanners Planning Regions. The DHHS has assigned the HSAs as outlined in 10 NCAC 03R .6403(a) to the following Positron Emission Tomography (PET) Scanners Planning Regions for purposes of the State Medical Facilities Plan.
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POSITRON EMISSION TOMOGRAPHY (PET) SCANNERS PLANNING REGIONS
Region Number
Constituent HSAs
1
2
3
4
5
6
HSA I
HSA II
HSA III
HSA IV
HSA V
HSA VI
(i) Gamma Knife Planning Regions. The DHHS has assigned the HSAs as outlined in 10 NCAC 03R .6403(a) to the following Gamma Knife Planning Regions for purposes of the State Medical Facilities Plan.
GAMMA KNIFE PLANNING REGIONS
Region Number
Constituent HSAs
1
2
HSAs I, II, III
HSAs IV, V, VI
History Note: Authority G.S. 131E-176(25); 131E-177(1); 131E-183(1);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6404 SERVICE AREAS AND PLANNING AREAS
(a) An acute care bed's service area is the acute care bed planning area in which the bed is located. The acute care bed planning areas are the hospital service systems which are defined as follows:
(1) hospitals that are in the same city or within 10 miles of one another are in the same hospital service system;
(2) hospitals that are under common ownership and within the same county are in the same hospital service system; or
(3) a 10-mile radius around a hospital that is not included in one of the groups of hospitals described in Subparagraphs (1) or (2) of the Rule is a hospital service system.
(b) A rehabilitation bed's service area is the rehabilitation bed planning area in which the bed is located. The rehabilitation bed planning areas are the health service areas which are defined in 10 NCAC 03R .6403(a).
(c) An ambulatory surgical facility's service area is the ambulatory surgical facility planning area in which the facility is located. The ambulatory surgical facility planning areas are the multi-county groupings as defined in 10 NCAC 03R .6403(e).
(d) A radiation oncology treatment center's and linear accelerator's service area is the radiation oncology treatment center and linear accelerator planning area in which the facility is located. The radiation oncology treatment center and linear accelerator planning areas are the multi-county groupings as defined in 10 NCAC 03R .6403(d).
(e) A magnetic resonance imaging scanner's service area is the magnetic resonance imaging planning area in which the scanner is located. The magnetic resonance imaging planning areas are the multi-county groupings as defined in 10 NCAC 03R .6403(f).
(f) A nursing care bed's service area is the nursing care bed planning area in which the bed is located. Each of the 100 counties in the State is a separate nursing care bed planning area.
(g) A Medicare-certified home health agency office's service area is the Medicare-certified home health agency office planning area in which the office is located. Each of the 100 counties in the State is a separate Medicare-certified home health agency office planning area.
(h) A dialysis station's service area is the dialysis station planning area in which the dialysis station is located. Each of the 100 counties in the State is a separate dialysis station planning area.
(i) A hospice's service area is the hospice planning area in which the hospice is located. Each of the 100 counties in the State is a separate hospice planning area.
(j) A hospice inpatient facility bed's service area is the hospice inpatient facility bed planning area in which the bed is located. Each of the 100 counties in the State is a separate hospice inpatient facility bed planning area.
(k) A psychiatric bed's service area is the psychiatric bed planning area in which the bed is located. The psychiatric bed planning areas are the Mental Health Planning Regions which are defined in 10 NCAC 03R .6403(c).
(l) With the exception of chemical dependency (substance abuse) detoxification-only beds, a chemical dependency treatment bed’s service area is the chemical dependency treatment bed planning area in which the bed is located. The chemical dependency (substance abuse) treatment bed planning areas are the Mental Health Planning Regions which are defined in 10 NCAC 03R .6403(c).
(m) A chemical dependency detoxification-only bed's service area is the chemical dependency detoxification-only bed planning area in which the bed is located. The chemical dependency (substance abuse) detoxification-only bed planning areas are the Mental Health Planning Areas which are defined in 10 NCAC 03R .6403(b).
(n) An intermediate care bed for the mentally retarded's service area is the intermediate care bed for the mentally retarded planning area in which the bed is located. The intermediate care bed for the mentally retarded planning areas are the Mental Health Planning Areas which are defined in 10 NCAC 03R .6403(b). TEMPORARY RULES
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(o) A heart-lung bypass machine's service area is the heart-lung bypass machine planning area in which the heart-lung bypass machine is located. The heart-lung bypass machine planning areas are the hospital service systems, as defined in 10 NCAC 03R .6404(a).
(p) A unit of fixed cardiac catheterization and cardiac angioplasty equipments service area is the fixed cardiac catheterization and cardiac angioplasty equipment planning area in which the equipment is located. Each of the 100 counties in the State is a separate fixed cardiac catheterization and cardiac angioplasty equipment planning area.
(q) A unit of shared fixed cardiac catheterization and cardiac angioplasty equipment’s service area is the shared fixed cardiac catheterization and cardiac angioplasty planning area in which the equipment is located. The shared fixed cardiac catheterization and cardiac angioplasty planning areas are the hospital service systems, as defined in 10 NCAC 03R .6404(a).
(r) A positron emission tomography scanner’s service area and planning region is the health service area (HSA) in which the scanner is located and the planning region as defined in 10 NCAC 03R .6403(h). The health service areas are the multi-county groupings as defined in 10 NCAC 03R .6403(a).
(s) An adult care home bed's service area is the adult care home bed planning area in which the bed is located. Each of the 100 counties in the State is a separate adult care home bed planning area.
(t) An operating room's service area is the ambulatory surgical facility planning area in which the operating room is located. The ambulatory surgical facility planning areas are the multi-county groupings as defined in 10 NCAC 03R .6403(e).
(u) A mobile magnetic resonance imaging scanner's service area is the planning region as defined in 10 NCAC 03R .6403(g). The health service areas are the multi-county groupings as defined in 10 NCAC 03R .6403(a).
(v) A gamma knife's service area is the planning region as defined in 10 NCAC 03R .6403(i). The health service areas are the multi-county groupings as defined in 10 NCAC 03R .6403(a).
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(1);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6405 REALLOCATIONS AND
ADJUSTMENTS
(a) REALLOCATIONS
(1) Reallocations shall be made only to the extent that need determinations in 10 NCAC 03R .6406, through .6433 indicate that need exists after the inventories are revised and the need determinations are recalculated.
(2) Beds or services which are reallocated once in accordance with this Rule shall not be reallocated again. Rather, the Medical Facilities Planning Section shall make any necessary changes in the next annual State Medical Facilities Plan.
(3) Dialysis stations that are withdrawn, relinquished, not applied for, decertified, denied, appealed, or pending the expiration of the 30 day appeal period shall not be reallocated. Instead, any necessary redetermination of need shall be made in the next scheduled publication of the Dialysis Report.
(4) Appeals of Certificate of Need Decisions on Applications. Need determinations of beds or services for which the CON Section decision to approve or deny the application has been appealed shall not be reallocated until the appeal is resolved.
(A) Appeals Resolved Prior to August 17: If such an appeal is resolved in the calendar year prior to August 17, the beds or services shall not be reallocated by the CON Section; rather the Medical Facilities Planning Section shall make the necessary changes in the next annual State Medical Facilities Plan, except for dialysis stations which shall be processed pursuant to Subparagraph (a)(3) of this Rule.
(B) Appeals Resolved on or After August 17: If such an appeal is resolved on or after August 17 in the calendar year, the beds or services, except for dialysis stations, shall be made available for a review period to be determined by the CON Section, but beginning no earlier than 60 days from the date that the appeal is resolved. Notice shall be mailed by the Certificate of Need Section to all persons on the mailing list for the State Medical Facilities Plan, no less than 45 days prior to the due date for receipt of new applications.
(5) Withdrawals and Relinquishments. Except for dialysis stations, a need determination for which a certificate of need is issued, but is subsequently withdrawn or relinquished, is available for a review period to be determined by the Certificate of Need Section, but beginning no earlier than 60 days from:
(A) the last date on which an appeal of the notice of intent to withdraw the certificate could be filed if no appeal is filed;
(B) the date on which an appeal of the withdrawal is finally resolved against the holder; or
(C) the date that the Certificate of Need Section receives from the holder of the certificate of need notice that the certificate has been voluntarily relinquished.
Notice of the scheduled review period for the reallocated services or beds shall be mailed by the Certificate of Need Section to all persons on the mailing list for the State Medical Facilities TEMPORARY RULES
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Plan, no less than 45 days prior to the due date for submittal of the new applications.
(6) Need Determinations for which No Applications are Received
(A) Services or beds with scheduled review in the Calendar Year on or before September 1: The Certificate of Need Section shall not reallocate the services or beds in this category for which no applications were received, because the Medical Facilities Planning Section will have sufficient time to make any necessary changes in the determinations of need for these services or beds in the next annual State Medical Facilities Plan, except for dialysis stations.
(B) Services or beds with scheduled review in the Calendar Year after September 1: Except for dialysis stations, a need determination in this category for which no application has been received by the last due date for submittal of applications shall be available to be applied for in the second Category I review period in the next calendar year for the applicable HSA. Notice of the scheduled review period for the reallocated beds or services shall be mailed by the Certificate of Need Section to all persons on the mailing list for the State Medical Facilities Plan, no less than 45 days prior to the due date for submittal of new applications.
(7) Need Determinations not Awarded because Application Disapproved
(A) Disapproval in the Calendar Year prior to August 17: Need determinations or portions of such need for which applications were submitted but disapproved by the Certificate of Need Section before August 17, shall not be reallocated by the Certificate of Need Section. Instead the Medical Facilities Planning Section shall make the necessary changes in the next annual State Medical Facilities Plan if no appeal is filed, except for dialysis stations.
(B) Disapproval in the Calendar Year on or After August 17: Need determinations or portions of such need for which applications were submitted but disapproved by the Certificate of Need Section on or after August 17, shall be reallocated by the Certificate of Need Section, except for dialysis stations. A need in this category shall be available for a review period to be determined by the Certificate of Need Section but beginning no earlier than 95 days from the date the application was disapproved, if no appeal is filed. Notice of the scheduled review period for the reallocation shall be mailed by the Certificate of Need Section to all persons on the mailing list for the State Medical Facilities Plan, no less than 80 days prior to the due date for submittal of the new applications.
(8) Reallocation of Decertified ICF/MR Beds. If an ICF/MR facility’s Medicaid certification is relinquished or revoked, the ICF/MR beds in the facility may be reallocated by the Department of Health and Human Services, Division of Facility Services, Medical Facilities Planning Section after consideration of recommendations from the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services. The Department of Health and Human Services, Division of Facility Services, Certificate of Need Section shall schedule reviews of applications for any reallocated beds pursuant to Subparagraph (a)(5) of this rule.
(b) CHANGES IN NEED DETERMINATIONS
(1) The need determinations in 10 NCAC 03R .6406 through 10 NCAC 03R .6433 shall be revised continuously by the Medical Facilities Planning Section throughout the calendar year to reflect all changes in the inventories of:
(A) the health services listed at G.S. 131E-176 (16)f;
(B) health service facilities;
(C) health service facility beds;
(D) dialysis stations;
(E) the equipment listed at G.S. 131E-176 (16)f1;
(F) mobile medical equipment; and
(G) operating rooms as defined in 10 NCAC 03R .6408(b).
as those changes are reported to the Medical Facilities Planning Section. However, need determinations in 10 NCAC 03R .6406 through .6433 shall not be reduced if the relevant inventory is adjusted upward 60 days or less prior to applicable certificate of need application due dates.
(2) Inventories shall be updated to reflect:
(A) decertification of Medicare-certified home health agencies or offices, intermediate care facilities for the mentally retarded, and dialysis stations;
(B) delicensure of health service facilities and health service facility beds;
(C) demolition, destruction, or decommissioning of equipment as TEMPORARY RULES
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listed at G.S. 131E-176(16) f1 and G.S. 131E-176(16) (s);
(D) elimination or reduction of a health service as listed at G.S. 131E-176(16) (f);
(E) addition or reduction in operating rooms as defined in 10 NCAC 03R .6408(b);
(F) psychiatric beds licensed pursuant to G.S. 131E-184(c);
(G) certificates of need awarded, relinquished, or withdrawn, subsequent to the preparation of the inventories in the State Medical Facilities Plan; and
(H) corrections of errors in the inventory as reported to the Medical Facilities Planning Section.
(3) Any person who is interested in applying for a new institutional health service for which a need determination is made in 10 NCAC 03R .6406 through 10 NCAC 03R .6433 may obtain information about updated inventories and need determinations from the Medical Facilities Planning Section.
(4) Need determinations resulting from changes in inventory shall be available for a review period to be determined by the Certificate of Need Section, but beginning no earlier than 60 days from the date of the action identified in Subparagraph (b)(2) of this Rule, except for dialysis stations which shall be determined by the Medical Facilities Planning Section and published in the next Dialysis Report. Notice of the scheduled review period for the need determination shall be mailed by the Certificate of Need Section to all persons on the mailing list for the State Medical Facilities Plan, no less than 45 days prior to the due date for submittal of the new applications.
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6406 ACUTE CARE BED NEED DETERMINATION (REVIEW CATEGORY A)
It is determined that there is need for five additional acute care beds in Cannon Memorial Hospital's "Hospital Service System." It is determined that there is no need for additional acute care beds anywhere else in the State.
Acute Care
Hospital Service System Bed Need
Determination Cannon Memorial Hospital 5
History Note: Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6407 INPATIENT REHABILITATION BED NEED DETERMINATION (REVIEW CATEGORY E)
It is determined that there is no need for additional inpatient rehabilitation beds anywhere in the State.
History Note: Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6408 OPERATING ROOM NEED DETERMINATIONS (REVIEW CATEGORY E)
(a) It is determined that there is need for three additional operating rooms in one Ambulatory Surgery Service Area as follows. It is determined that there is no need for additional operating rooms anywhere else in the State.
Ambulatory Operating Room
Surgery Counties Need
Service Area Determination 27 Hoke, Lee, Montgomery, Moore, Richmond, Scotland 3
(b) "Operating room" means an inpatient operating room, an outpatient or ambulatory surgical operating room, a shared operating room, or an endoscopy procedure room in a licensed health service facility.
History Note: Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6409 OPEN HEART SURGERY SERVICES NEED DETERMINATION (REVIEW CATEGORY H)
It is determined that there is no need for additional open heart surgery services anywhere in the State.
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(b); TEMPORARY RULES
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Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6410 HEART-LUNG BYPASS
MACHINE NEED DETERMINATION (REVIEW
CATEGORY H)
It is determined that there is no need for additional heart-lung bypass machines anywhere in the State.
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6411 FIXED CARDIAC CATHETERIZATION/ANGIOPLASTY EQUIPMENT NEED DETERMINATIONS (REVIEW CATEGORY H)
(a) It is determined that there is a need for seven additional fixed units of cardiac catheterization/angioplasty equipment in four counties. It is determined that there is no need for additional fixed units of cardiac catheterization/angioplasty equipment anywhere else in the State.
Fixed Cardiac
County Catheterization/Angioplasty
Equipment Need Determination Forsyth 1
Guilford 1
New Hanover 2
Wake 3
(b) Fixed cardiac catheterization equipment means cardiac catheterization equipment that is not mobile cardiac catheterization equipment, as that term is defined in 10 NCAC 03R .1613(14).
(c) Mobile cardiac catheterization equipment, as defined in 10 NCAC 03R .1613(14), and services shall only be approved for development on hospital sites.
History Note: Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6412 SHARED FIXED CARDIAC CATHETERIZATION/ANGIOPLASTY EQUIPMENT NEED DETERMINATION (REVIEW CATEGORY H)
(a) It is determined that there is a need for one unit of shared fixed cardiac catheterization/angioplasty equipment in Randolph Hospital's "Hospital Service System." It is determined that there is no need for additional units of shared fixed cardiac catheterization/angioplasty equipment anywhere else in the State.
Shared Fixed Cardiac
Hospital Service System Catheterization/Angioplasty
Equipment Need Determination Randolph Hospital 1
(b) Shared fixed cardiac catheterization/angioplasty equipment means fixed equipment that is used to perform both cardiac catheterization procedures and angiography procedures.
History Note: Authority G.S. 131E-176(25); 131E-177(1);
131E-183(b);
Temporary Adoption Eff. January 1, 2003.
10 NCAC 03R .6413 BURN INTENSIVE CARE SERVICES NEED DETERMINATION (REVIEW CATEGORY H)
It is determined that there is no need for additional burn inten