The arrival of a new year in North Carolina brings a new State Medical Facilities Plan (“SMFP”). The SMFP is the annual planning document issued by the North Carolina Department of Health and Human Services, and signed by the Governor, setting forth need determinations for a range of health care facilities, services and equipment in North Carolina. If they are regulated by the SMFP, new facilities, services, and equipment may not be added to North Carolina’s inventory unless there is a need determination in the SMFP. For example, a hospital cannot add acute care beds unless there is need for more beds in the county where the hospital is located. Similarly, providers may not acquire additional MRI scanners unless there is a need in the SMFP. Because the health planning process is so highly regulated in North Carolina, planning for additional health care services is a year-round activity that is closely followed by existing providers and potential new entrants eager to serve the growing population of the nation’s ninth largest state. Even though the 2023 SMFP has only just been published, planning begins in earnest shortly for the 2024 SMFP. Following are some key dates providers need to know in 2023.

The Petitioning Process is Important to the Development of the SMFP

The development of the SMFP is a data driven process, guided in part by various methodologies to help determine need for facilities, services and equipment. But methodologies are not a substitute for providers’ actual experience in the market and cannot answer all relevant questions in health planning. For example, is there a geographic maldistribution of services that causes people to travel unreasonable distances to receive services? Is a methodology outdated? How has the development of new technologies or service locations influenced the demand for services? Questions like these are ideally suited to the petitioning process. As we describe below, North Carolina has two petitioning processes, one that occurs in the spring and the other that occurs in the summer. Both processes play important and distinct roles in the development of the SMFP. As 2022 demonstrated, these petitions were very influential in creating needs that are now shown in the 2023 SMFP, and we would expect to see this again in the development of the 2024 SMFP. Therefore, providers should begin their petitioning strategy early.

March 1, 2023, at 5 pm Eastern is the deadline for Spring Petitions

Spring petitions propose statewide changes to the state health planning process. For example, if a provider wants to propose a change to how North Carolina determines the need for additional acute care beds in the 2024 SMFP, the provider must file its petition with the State Health Coordinating Council (“SHCC”), which directs the development of the annual plan, by March 1, 2023. Likewise, if a provider wants to suggest a change to policies contained in the SMFP, it must file a spring petition.

March 15, 2023, at 5 pm Eastern is the deadline for written comments on Spring Petitions

Petitions will be posted to the DHSR website within a day or two of the filing deadline. Anyone who has comments for or against a petition must file the comments by the deadline.

July 26, 2023, at 5 pm Eastern is the deadline for Summer Petitions

Summer petitions propose additional need determinations for specific geographic service areas or seek to remove need determinations included in the Draft 2024 SMFP. For example, without proposing a change to the way North Carolina determines need for acute care beds, a provider might argue that special circumstances, such as extraordinary population growth, exist in a given county such that there should be a need determination for more acute care beds in that county or that, conversely, an initial need determination is based upon inaccurate or inflated data and therefore should be eliminated.

August 9, 2023, at 5 pm Eastern is the deadline for written comments on Summer Petitions

Similar to the comment process in the spring, there is also a comment process for summer petitions.

The State Health Coordinating Council Meets Three Times a Year

The SHCC and its committees, whose members are appointed by the governor, will meet regularly to evaluate petitions, comments, and assemble a final plan to propose for the Governor’s approval. The SHCC meets on the following dates in 2023, in Room 104 of the Brown Building on the Dorothea Dix Campus, 801 Biggs Drive, Raleigh:

• March 1

• May 31

• October 4

The Committees of the SHCC meet as follows:

Acute Care Services:

• April 4

• May 16

• September 12

Long-Term and Behavioral Health Committee:

• April 13

• May 11

• September 14

Technology and Equipment Committee:

• April 5

• May 17

• September 13

These meetings are open to the public. With the lessening of pandemic conditions, there will be no WebEx option for SHCC meetings in 2023, so attendance must be in person.

Since the petitioning process is a complex, data driven process with specific requirements, providers should begin strategic planning early.