District of Columbia certificate of need
District of Columbia has a certificate of need program, run by State Health Planning and Development Agency (SHPDA), DC Health. It covers 13 kinds of services, listed below.
- CON program
- Yes
- Services covered
- 13
On this page
District of Columbia CON program
District of Columbia has a certificate of need program, run by State Health Planning and Development Agency (SHPDA), DC Health. It covers 13 kinds of services, listed below.
- CON program
- Yes
- Program
- Certificate of Need
- Application fee
- Greater of 3% of the proposed capital expenditure or $5,000, capped at $300,000. Private hospitals pay an annual user fee of $4.50 per inpatient admission instead of application fees.
- Review timeline
- Letter of intent must precede the application by 60 days. SHPDA must decide within 90 days after the review process begins; it may extend once by 30 days.
- Moratoria
- SHPDA may impose a moratorium of up to 120 days on CONs for a specific service while it develops review standards; the same service cannot be placed under moratorium more than once in 12 months (D.C. Code §44-418). No standing moratorium identified.
- Recent changes
- D.C. Law 23-60 (Certificate of Need Fee Reduction Amendment Act of 2019, effective 2020) raised the review thresholds to the current levels ($6M / $3.5M capital; $3.5M / $2M / $350,000 equipment), exempted a specified nonprofit vision screening provider and reduced fees for two named nonprofits. Applications are now filed through SHPDA's online portal.
- Statute
- D.C. Official Code §44-401 et seq. (Health Services Planning Program Re-Establishment Act of 1996)
Services that need a certificate of need
- hospitals (general, psychiatric, rehabilitation, specialty)
- skilled nursing facilities
- intermediate care facilities
- ambulatory care centers / clinics
- ambulatory surgical facilities
- kidney disease treatment / freestanding hemodialysis
- diagnostic health care facilities
- home health agencies
- hospice
- new health services by facilities with operating budgets of $500,000+
- capital expenditures of $6M+ (hospitals) or $3.5M+ (other facilities)
- major medical equipment ($3.5M hospitals / $2M other facilities / $350,000 single physician-owned unit)
- bed relocations and redistribution
Frequently asked questions
Does District of Columbia have a certificate of need law?
District of Columbia has a certificate of need program, run by State Health Planning and Development Agency (SHPDA), DC Health. It covers 13 kinds of services, listed below.
How long does a District of Columbia CON review take?
Letter of intent must precede the application by 60 days. SHPDA must decide within 90 days after the review process begins; it may extend once by 30 days.
How much is a District of Columbia CON application?
Greater of 3% of the proposed capital expenditure or $5,000, capped at $300,000. Private hospitals pay an annual user fee of $4.50 per inpatient admission instead of application fees.