Application Fee:

Checks: According to Department accounting practice, checks submitted with a CON application must be dated within 60 days of the CON application to be considered received.  If an outdated check is received with an application, the Department will not process the application until a valid check for the required application fee is received.  Upon receipt of the valid check, the application will be processed pursuant to the applicable Administrative Rules.

Online Electronic Funds Transfer:  Application fees may also be paid using the online electronic funds transfer option with an electronic submission of an application through the CON e-Serv application system (CEPAS).

Cancer Registry Data and Michigan Inpatient Data Base (MIDB) :  To demonstrate need for new services, all Megavoltage Radiation Therapy (MRT) applications, excluding the Tri-county region of Macomb, Oakland, and Wayne, must use cancer patient data from calendar year 2009.  Applicants in the Tri-county area must use 2008 data reported through the Detroit Metropolitan Cancer Surveillance System.  All Positron Emission Tomography (PET) applications must use 2008 data.

Also, applicants required to demonstrate need based on MIDB data in the various standards must use calendar year 2009 MIDB data. 

Please note annual updates for the next calendar year are tentatively July for cancer registry data and October for MIDB data. Any change will be posted on this web site prior to the effective date of the change.

For questions regarding the submission of new cancer case data for CON applications involving the initiation of MRT or PET services, please contact Glenn Copeland at (517) 335-8677 or copelandg@michigan.gov . 

Change of Ownership of Real Property:  A change in the ownership of a building (real property), without a change in the licensee that provides health care services from that building and without a change in the lease terms to the licensee, such as no change in licensed use and no change in the terms of the lease greater than that granted in the most current CON approving the lease terms for the health facility, as well as no change in bed capacity or physical plant structure, does not require a certificate of need.

Section 22209 of the Public Health Code, 1978 PA 368, as amended, MCL 333.1101 et seq; MSA 14.15(1101) et seq, requires the issuance of a certificate of need prior to the acquisition of a health facility. While a building is a significant part of most types of health facilities, such as a nursing home, it is not itself the licensed health facility. A licensee, which must obtain a certificate of need, is the business entity that operates a health facility. That licensee may own or lease its building. If it leases the building, and only the landlord changes, no certificate of need is needed for that change in landlord.

Please note that any change in licensee does require certificate of need review/approval. The Department will request as part of an application identification of the current landlord, if applicable, and a draft lease agreement.   

CON e-Serve Roles for External Uses:  External users registering with Single Sign-on system for using DCH CON
e-Serve must select either "Applicant" or "Guest" role only.

Covered Imaging Equipment:   The following scanners are covered by the CON Review Standards for Computed Tomography (CT) Services and, therefore, is a covered clinical service for the purposes of Part 222 of the Public Health Code. In accordance with MCL 333.22209(1), a CON must first be obtained prior to offering services on the following scanners: Imaging Sciences i-CAT, Xoran Technologies MiniCAT, Aperio NewTom, Hitachi Mercuray, Morita 3D Accuitomo, ILUMA Ultra Cone Beam CT Scanner, Kodak 9000 3D, Planmeca Promax 3D unit/upgrades, and other similar devices. 

Doctor Commitment Forms:    The Department will only accept doctor commitment forms (i.e., surgical, CT, MRI) that are submitted with the respective CON application.    Doctor commitment forms sent directly to the Department, separate from the formal application, will not be accepted.  It is the applicant's responsibility to submit all doctor commitment forms as part of the submission of the application or during the review phase, when applicable. 

Extension Request for Enforceable Contract:   In order to assure an efficient reviewing process, the applicant must respond to the following Rule 325.9403(2).

(2) The department, upon written request of the applicant, shall have the right to extend the implementation period established in subrule (1) of this rule or in a certificate of need review standard by not more than 6 months if all of the following provisions are satisfied:
(a) The terms of the certificate are not changed.
(b) Substantial progress has been made.
(c) If applicable, an obligation for capital expenditure or establishment of a force account is likely to occur within the extended time period.
Proofs of substantial progress acceptable by the Department are:
(a) Formal commitment from architectural firm to create plans for project;
(b) Executed enforceable contract with architectural firm;
(c) Formal correspondence from vendor or landlord indicating draft lease for equipment/space will be executed;
(d) Newspaper ads of bid notices; and/or
(e) Board meeting minutes, such as local planning commission in which this project is an agenda item and/or verification project plans that have been submitted to HFES.

Please note extensions, if approved, do not extend the installation date of a covered clinical service/unit.

Lithotripsy Shielding:    A lithotripsy unit is to be operated in a room that complies with Radiation Safety Standards.  Operating or procedure rooms in which a lithotripsy unit is used must have a steel or leaded door, as well as shielding for windows in these rooms.  If a unit is to be used in an area that does not meet these criteria, approval of the radiation shielding must be obtained from the Radiation Safety Section prior to clinical use in that location. For detailed information, click on the following link to the  Radiation Safety Web site . 

Medicaid Participation:   Verification of Medicaid participation is required for all applicants at the time of application submission, excluding applications for nursing homes and HLTCU beds. Proof of participation may include any official correspondence from the Medicaid program that demonstrates participation, including enrollment agreement, recent Medicaid cost report, Turnaround Form (PE-200), cost report acceptance letter, and remittance advice. 

For non-licensed health facilities (i.e., imaging centers), proof of Medicaid participation may include documentation from individual physicians affiliated with the proposed project. 

Central Service Coordinators (CSC), who may not be a direct provider of the covered clinical service as an applicant, must provide proof of Medicaid participation from at least two (2) host sites at the time of application submission and for all host sites on the proposed route prior to a proposed decision. 

Mobile Route Host Site Applications:  All MRI notices must be submitted with an application fee of $1,500. Notice applications not accompanied by the required fee shall not be considered timely and shall be deemed submitted and processed after receipt of the required fee. Further, existing host sites for all mobile services (i.e., CT, PET, Litho) to be added to existing mobile routes without data commitments will now be categorized as NONSUB [Notice] and reviewed on an expedited basis. Pursuant to MCL 333.22233, Project Costs, such as operating leases, renovations, etc., are not required to be listed for a NONSUB [Notice]. The letters of intent for such projects should not include Project Costs or Sources of Funds.

Radial Distance Verification:  The Department will verify any distance requirement set forth in the various standards using the Michigan State University (MSU) Department of Geography Geocoder available on the main page.  Please note the Department will render its final decision based on the MSU Geocoder. 

Radioactive Material: 

Nuclear Medicine Required Documentation : Applicants requesting CON approval for services that require the provision of Nuclear Medicine must submit documentation from the U. S. Nuclear Regulatory Commission (NRC).  Documentation may include either an NRC certification or NRC license number to satisfy the requirement set forth in the applicable review standards. 

Web site addresses for the NRC are:  http://nrc-stp.ornl.gov/narmtoolbox.html      

                                                       http://www.nrc.gov/reading-rm/adams.html 

Regional Review Agency:  Certificate of Need documents for proposed projects in West Central Michigan will not be accepted until the Michigan Department of Community Health (MDCH) and the Alliance for Health  each has received them pursuant to M.C.L. 333.22226(6) and Administrative Rule 325.9201.

Some applications are subject to a limited number of "window dates" for receipt by MDCH and Alliance for Health. Receipt after the designated application date will result in placement of the application in the next "window period."  Failure to submit at the proper time could therefore add 30 to 120 days to the start of the formal review period.  This obviously would impact the date on which a final decision can be expected.  Some of the data used to support the need for projects must be dated, and a delay in the start of a review could require an applicant to secure new supporting data. Applicants must adhere to this advisory.  In particular, applications will not be considered submitted to the department unless the application is received at the department's Lansing office and, if applicable, the appropriate regional review agency, before 5:00 p.m., on or before a designated application date. 

Renewal of Leases for Licensed Health Facilities:  A renewal of a lease beyond the time frame granted in the most current CON approving the lease terms for the health facility, with or without a change in the landlord, also does not require a certificate of need as long as the total lease costs for the renewal is below the covered capital expenditure threshold and there is no change in the licensed use, bed capacity, or physical plant structure (unless otherwise specified in the applicable CON Review Standards). If a licensee determines CON review/approval is not required for a renewal of a lease based on the guidance above, the licensee must maintain documentation to demonstrate that the renewed lease did not exceed the covered capital expenditure threshold and provide to the Department if requested.

Please note that any change in licensee does require certificate of need review/approval. The Department will request as part of an application identification of the current landlord, if applicable, and a draft lease agreement. 

State Holidays:  The following are the State of Michigan holidays for 2012. The CON office will be closed on these days, as well. 

Martin Luther King, Jr. Day - Monday, January 16, 2012
Presidents' Day - Monday, February 20, 2012
Memorial Day - Monday, May 28, 2012
Independence Day - Monday, July 4, 2012
Labor Day - Monday, September 3, 2012
Election Day - Tuesday, November 6, 2012
Veterans' Day - Friday, November 12, 2012
Thanksgiving - Thursday, November 22, and Friday, November 23, 2012
Christmas - Monday, December 24, and Tuesday, December 25, 2012
New Year's - Monday, December 31, 2012 and Tuesday, January 1, 2013

Utilization Forms:  When completing a utilization form as part of an application, please verify the data to assure there are no discrepancies with past annual surveys reported to the Department.  If discrepancies exist, please provide clarification/justification along with the utilization form.

Vendor Quotations:   All proposed projects involving initiation, expansion or replacement/upgrade of covered clinical equipment (CT, PET, MRI, etc.) must submit a valid vendor quote signed by a vendor representative and dated within six (6) months of the application submission date. 

State of Michigan
Department of Community Health - Certificate of Need Program
Lewis Cass Building, 320 S. Walnut Street, Lansing, MI 48913
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Updated January 3, 2012