Certificate of Need Activity — 2001
September 24 –
Providence Alaska Medical Center submitted a request to modify the North Tower certificate of need. The application has been declared complete and the Department has until January 14, 2002 to complete the review and analysis and submit it to the Commissioner.
September 12 –
The Providence Alaska Medical Center ( Anchorage ) certificate of need application submitted on June 20th was declared complete after additional information was received. The application is for construction of a 60– bed child/adolescent Mental Health facility with an estimated cost of $25 million. If approved, construction is planned to begin in March 2002 with services implemented in the Fall of 2004. The application review and analysis is in process and must be completed and submitted to the Commissioner's office by December 12, 2001.
July 23 –
Valdez Community Hospital submitted a certificate of need application to build a 68,444 sq. ft. replacement Hospital . The proposed facility will have a total of 21– beds, all private rooms. The bed configuration is nine acute beds, one psych holding, one CCU holding and observation, one labor/delivery/postpartum and ten long– term care beds. The estimated cost of the project is $24.1 million. If approved, construction is planned to begin in June 2002 and be completed by June of 2004. The application has been declared complete and the Department has until January 8, 2002 , to complete the application and submit the review and analysis to the Commissioner. Information on the public meeting and public comment period schedule are listed in the next section below.
June 20 –
Ketchikan General Hospital submitted a certificate of need application to purchase a Phillips Gyroscan Intera Omni 1.0 Tesla Magnetic Resonance Imaging System and to remodel 1,653 square foot of space to house the equipment. The MRI System will be fitted with a step– up gradient that will allow it to perform like a 1.5 Tesla scanner except scans will be slower. The total cost of the project is estimated to be $1,182,720. The project was approved as requested on November 6, 2001.
April 19 –
The Bartlett Regional Hospital certificate of need was approved, with the following conditions: addition of the five new Medical/Surgical beds is not approved, however, the four isolation beds requested may be built by converting existing beds; two additional Emergency Department exam rooms may be added; the $800,000 "Healing Garden" is not considered a "health care facility" and therefore a certificate of need is not required for that portion of the project; and eight Critical Care Unit beds are approved. Bartlett is approved for a total of 63 licensed beds and may expend up to $39,200,000 for construction with an approved project completion date of December 31, 2007.
March 12 –
Sitka Community Hospital submitted a certificate of need application for conversion of existing underutilized space into 5 additional long– term care beds, an activity room, and expansion of the dining room. Currently, Sitka Community Hospital has a total of 25 beds – 10 long– term care and 15 acute beds. The total project is estimated to cost $13,500 and if approved will begin offering the expanded services by July 15, 2001 . The application was checked for completion and additional information requested. Additional information was received and on April 18th and the application declared complete. The review and analysis has been submitted to the Commissioner's office.
January 29 –
Providence Alaska Medical Center ( Anchorage ) submitted a certificate of need application to purchase and install a Positron Emission Tomography (PET) scanner. A PET scanner is a diagnostic tool that measures metabolic function. Its ability to create images of biological disease processes is helpful in early detection and treatment of cancer, heart disease and neurology. New uses are being developed. There are currently no PET scanners in Alaska , which requires travel out of state to access the service. The project will cost $3.2 million and construction is planned to begin in March 2001, and be completed by June 2001. The application was approved as requested by the Commissioner on May 17, 2001 and the applicant has until December 31, 2002 to complete the project.
Letters of Intent — 2001
The Alaska Heart Institute submitted a letter of intent to purchase and install a cardiac catheterization laboratory at their medical offices at Providence Alaska Medical Center . A determination was made that the project will not require a certificate of need because it is not for a health care facility (as defined by certificate of need law) and the cost of $550,000 is under the $1 million threshold that triggers a certificate of need review.
A letter of intent was received from North Star Behavioral Systems, LLC and additional information requested before a determination is made. The project is for a 12– 18 bed psychiatric specialty hospital and a 72– 90 bed residential facility to be built in Wasilla.
The Anchorage Fracture and Orthopedic Clinic submitted a letter of intent for a project to install a GE Lunar E– Scan unit (MRI) at their physicians' offices located at 3260 Providence Drive, Suite 200 , Anchorage . A determination was made that a certificate of need is not required because t he equipment, service contract and anticipated construction is $626,000, which is under the $1 million threshold required to trigger a certificate of need and the equipment will be located in a private physicians' office, which is not considered a "health care facility" for the purpose of the certificate of need program.
North Star Behavioral Health Systems, LLC submitted a letter of intent regarding the purchase of 74– bed North Star Behavioral Health Hospital and the 34– bed North Star Residential Treatment Center in Anchorage currently owned by Charter North Behavioral Health Systems, Inc. and Columbia Behavioral Health system, LLC. Although the cost of the project is over the $1 million threshold, there is no construction, no alteration of bed capacity, and no addition or elimination of a category of health services. As a result, it was determined that a certificate of need was not required for this project.
A determination was made that the Providence Alaska Medical Center North Tower Certificate of Need, approved in 1999 at a cost of $25 million, is required to submit a modification to the certificate. A modification is needed because the scope of the project has changed due to the Laboratory relocation that was not included in the original application and the cost of the project has increased to $31,133,260 which is over the 15% plus the inflation rate allowed in 07 AAC 07.095(a). The modification will be limited to Laboratory relocation portion of the project only, since this was the part that raised the cost over the allowable amount and was the only piece not included in the original application. The variation in scope has been determined to be minimal and an expedited review as provided for in 7 AAC 07.065 will be allowed. The applicant may submit a modification at any time between June 29, 2001 and June 28, 2002.
Providence Alaska Medical Center submitted a letter of intent to remodel the existing Maternity Center at a cost of $3 million. A determination was made that the project does not require a certificate of need because no new services are being planned, there is no expansion of square footage, no new beds will be added and most of the remodeling is being done to replace interior furnishings that are worn out, depreciated out and have reached the end of their useful lives. Therefore, under 7 AAC 07.130(3) this project is considered a routine replacement.
Alaska Psychiatric Institute submitted a letter of intent for a 72– bed, 80,000 sq. ft. replacement facility costing an estimated $50,344,000. The facility includes a 10– bed forensic unit. A determination was made that a certificate of need is required because the project is for construction of a health care facility and the cost is over $1 million. A certificate of need application may be submitted at any time between July 9, 2001 and May 10, 2002 . The applicant requested an expedited review, which has been granted because the application is for the re– issuance of a previously granted certificate of need. Once the application is declared complete, the review process will be completed in 50 days.
The Alaska Spine Center , LLC, submitted a letter of intent for a 2– suite, 4,192 sq. ft. ambulatory surgery center costing an estimated $638,079. A determination was made that a certificate of need is not required because the project cost is under $1 million. The facility will be located within the new Lake Otis Medical Building at 4100 Lake Otis Parkway in Anchorage but is a separate entity from the HealthSouth Alaska Surgery Center which is located within the same building.
Ketchikan General Hospital submitted a letter of intent to purchase a MRI scanner which will be housed in the existing hospital. Extensive remodeling will need to be done to fit the equipment into the facility. The purchase price of the scanner is $780,680, room prep is estimated at $218,000 bringing the total estimated cost to $998,860 with no contingency fund. The hospital's best estimate for the total project cost is $1,100,000. The projected service implementation date is the end of September 2001. A determination was made that a certificate of need is required and that a certificate of need application may be submitted at any time between June 3, 2001 and April 3, 2002.
The Maniilaq Association submitted a letter of intent to build a 15– bed long– term care addition to the Maniilaq Health Center . If approved, the planning and architecture for the 8,400 sq. ft. addition would begin in 2002 with construction completed by 2003. The estimated cost of the skilled nursing wing is approximately $6 million and additional physical therapy, occupational therapy and administration space will cost an additional $4 million. The applicant has been notified that a certificate of need is required and that an application may be submitted between May 28, 2001 and March 28, 2002 . A pre– application conference was held on April 16th at the Health Center.
Providence Health System submitted a letter of intent to add three "Great Rooms" to three nursing units at Providence Extended Care Center . The project will add 6,600 square feet of space to the facility at a total cost of $981,000. A determination was made that a certificate of need is not required because the project costs under the $1 million threshold, is new construction and not a conversion, and therefore, the AS 18.07.031(b) relating to nursing homes does not apply under this citation.
The Alaska Urological Association submitted a letter of intent for an endoscopy center to be built at the Alaska Medical Plaza at 1200 Airport Heights Drive in Anchorage . The two suite facility was projected to cost $720,000, however, the cost estimate for the project was incomplete and additional information requested before a determination was made. No new information was received and a follow– up call on May 29th indicated the project had been abandoned.
Providence Alaska Medical Center submitted a letter of intent to develop a 60 Bed Inpatient facility for child and adolescent psychiatry. The proposed project is expected to cost about $20 million. Planning and design will begin June 2001. If approved, the facility is expected to be operational by December 2002. The applicant has been notified that a certificate of need is required and may submit an application at any time between April 14, 2001 and February 9, 2002.
Providence Alaska Medical Center (PAMC) submitted a letter of intent for a project to replace the interventional radiology Digital Subtraction Angiography (DSA) room and associated equipment. A determination was made that this project is a "routine replacement" according to 7 AAC 07.130(3) and therefore a certificate of need is not required. The determination was based on the fact that the equipment in the DSA room is nearly 20 years old and has had limited use due to poor quality imaging since 1998 and the proposed new equipment is not a change in service but the replacement will up– grade existing technology. The applicant states that a rebuilt equipment would cost $530,000 and a new equipment $800,000 which might make the cost under the $1 million threshold. The total cost is estimated to range from $950,000 to $1.2 million, part of the $400,000 cost of room reconfiguration and construction will likely be for some asbestos abatement which is considered routine maintenance. The proposed project, known as Special Procedures Room 4, is expected to begin remodeling in January 2001 and will be completed and operational by July 2001.
Appeals — 2001
Juneau Urgent Care submitted an appeal of the Bartlett Regional Hospital Certificate of Need approval. Urgent Care is appealing the approval of the two additional Emergency Department Exam Rooms and the denial of 5 new medical/surgical beds. The appeal was denied due to lack of good cause.
On December 30, 1999, certificate of need applications to build new ambulatory surgery suites in Fairbanks were denied to Fairbanks Ambulatory Surgery Center, Inc, (FASC) Tanana Valley Clinic (TVC) and Fairbanks Memorial Hospital . FASC and TVC appealed the decisions and their appeals were accepted and consolidated since the two applicants submitted competing proposals. David Leonard of Fairbanks was appointed as the hearing officer. In July, a pre– hearing conference was held and the FASC on July. At that time, FASC chose to withdraw their appeal. The TVC appeal has also been withdrawn.