The purpose of this webpage is to summarize home health need in Certificate of Need (“CON”) states for upcoming batching cycles in 2011. This paper has been compiled based on information published by the various states and correspondence with state officials. Research & Planning Consultants, L.P., “RPC,” believes it to be accurate as of the date of publication. However, because data, plans, regulations and the views of state officials can change at any time, the reader must be responsible for verifying the accuracy of the information at any future date. RPC does not in any way warrant the accuracy of the information after the date of publication.STATE CON REQUIREMENTS FOR HOME HEALTH AGENCIES
Other states that generally require a certificate of need services, but do not require one for home health agencies include the following:
|Louisiana||New Hampshire||Puerto Rico|
The following states require a CON to open a home health agency.  It is not the intention of this memo to describe the batching cycle or process for all of the states in the list below. For purposes of this memo, we only provide batching cycle information for the states marked with an asterisk (*).
|Hawaii||New York||West Virginia|
|Kentucky*||North Carolina*||Washington D.C. *|
CON STATES WITHOUT HOME HEALTH NEEDStates can declare that there is no home health need either through need determinations or a moratorium. The following table lists states that have determined there is no need for additional home health agencies in 2011, or states that have a moratorium in place. While Virginia does not require a CON for home health services, there is currently a moratorium on state licensure of home health care services. In addition, Alabama has adopted a rule providing that it will not accept CON applications until January 2013 to allow for time needed to collect the data required by its newly adopted need methodology.
|Moratorium||Zero Need Determination|
Maryland – is not accepting applications until new need determinations are published sometime in 2011
CON STATES WITH HOME HEALTH NEED
There are opportunities for CON applications in Alabama, the District of Columbia, Kentucky, South Carolina, and possibly Tennessee, as outlined in the text and maps below. In addition, several states are scheduled to issue need publications later in the year. Those states are discussed at the end of this webpage.
Alabama is currently accepting applications for a new home health agency in Madison County. There is no set batching cycle for home health CON applications. A batching cycle begins when an application is received, and subsequently advertised by the State Health Planning and Developing Agency who simultaneously send out notice of the batching cycle deadlines. As of April 7, 2011, there have not been any CON applications submitted for a home health agency in Madison County. Therefore, the batching cycle remains open.
Home Health Need in Alabama
District of Columbia (“D.C.”)D.C. does not publish need determinations or provide a need methodology. The next batching cycle for home health applications is in October 2011, but the State Health Planning Development Agency recommends that applications be submitted before the deadline. A letter of intent along with a copy of a notice published in a newspaper should be submitted by June 21, 2011 based on recommended deadlines. An application should be submitted by August 20, 2011 in order to ensure completeness. A complete application is due October 10, 2011.
Kentucky has released need determinations for home health services in the state, and several counties are shown as having need for additional home health services. The ongoing batching cycle (which began in December) is set to end on May 18th.Where applications have been made for home health services, the date the decision on the application will be made is indicated.  The next open batching cycle has a deadline of May 30, 2011 for Letters of Intent (“LOIs”), and June 29th, 2011 for application filing. There are no other batching cycles included in the most current batching cycle time table. 
|County||Need ||Expansion/Addition||Pending Decision|
|Calloway*||333||Addition or Expansion||Decision Pending May 18,2011 (HH+)|
|Christian||314||Addition or Expansion|
|Daviess||495||Addition or Expansion|
|Fayette||606||Addition or Expansion|
|Grayson*||159||Expansion||Decision Pending May 18,2011 (ProCare)|
|Marshall||356||Addition or Expansion|
|Muhlenberg*||133||Expansion||Decision Pending May 18,2011 (ProCare)|
|Pike||336||Addition or Expansion|
|Warren||595||Addition or Expansion|
Note: (*) Included in application submitted in December batching cycle.
Home Health Need in Kentucky
The 2010-2011 South Carolina State Health Plan identified three counties that need a home health agency: Allendale, Beaufort, and Edgefield. South Carolina has a rolling application process and applications can be submitted at any time of the month. The only exception is if an application has already been submitted, in which case a competing applicant only has 30 days to submit an application.
Since the publication of the State Health Plan, two applications have been submitted to open home health agencies in Beaufort County. SJC’s application for home health services in Beaufort County was deemed complete on March 25, 2011. Therefore, any interested party who wishes to file a competing application in the County (or to contest it or file comments) must do so by April 22.
|County||Home Health Need||Applicants|
|Beaufort*||Yes||SJC Home Health Services
J&D Health Care Services
Home Health Need in South Carolina
Tennessee has a rolling application process which allows applications to be submitted in any month. Letters of intent must be submitted between the first and the 10th of the month, followed by application and filing fee within five days of the publication of the letter of intent. The Tennessee Guidelines for Growth do not include a minimum threshold to open a home health facility. While there is no moratorium for home health CON applications, earlier conversations with a state official indicated that there is a perception among health planners that there is an oversupply of home health agencies. Furthermore, the official suggested that any applications filed in 2011 were likely to be met with significant opposition for any county submitted and that there are “numerous obstacles to overcome in filing a HH CON in 2011.”
|County ||Need (Home Health Patients)|
Home Health Need in Tennessee
UPCOMING NEED DETERMINATIONS
The next need publication for home health services in Georgia will be released in September for the fall batching cycle.
The most current batching cycle time table provides deadlines up until September 2011. It is expected that another timetable will be released in the fall which may include additional batching cycles for home health agencies for 2011.
New need determinations for home health services are expected to be published sometime in 2011.A more specific time period for the expected publication has not been issued.
 CON-Certificate of Need Laws. Accessed on April 6, 2011. Available at: http://www.ncsl.org/default.aspx?tabid=14373
 In addition, while letters of intent were filed in Pike and Marshall Counties (by Caring Companions and ProCare, respectively), complete applications were never filed; therefore there are no pending decisions in these two counties.
 Kentucky Certificate of Need Process. October 2010 Time Work Sheet. Available at: http://chfs.ky.gov/ohp/con/
 Kentucky 2009 Home Health Need. May 28, 2010. Available at: http://chfs.ky.gov/NR/rdonlyres/1AB68B1B-2040-46DF-B8A5-19D6D4264F2F/0/HomeHealth08092010.pdf
 Kentucky OHP Certificate of Need Online Search Tool. Available at: https://apps.chfs.ky.gov/CONOnline/Applicant.aspx?APP=3804
 Kentucky OHP Certificate of Need Online Search Tool. Available at: https://apps.chfs.ky.gov/CONOnline/Applicant.aspx?APP=3803
 Kentucky OHP Certificate of Need Online Search Tool. Available at: https://apps.chfs.ky.gov/CONOnline/Applicant.aspx?APP=3799
 Kentucky OHP Certificate of Need Online Search Tool. Available at: https://apps.chfs.ky.gov/CONOnline/Applicant.aspx?APP=3800
 Although the application deadline is 30 days after March 25, that date falls on a Sunday, so Friday, April 22 is the last business day to submit an application that would be deemed competing.
 Tennessee Department of Health, Office of Policy, Planning and Assessment, Division of Health Statistics. Joint Annual Report of Home Health Agencies – 2009 Final. Comparison of Population Based Need Projection vs. Annual Utilization (2015 – 2009). November 2010.