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Certificate of Need

New health care projects in Vermont must obtain a Certificate of Need (CON) from the Green Mountain Care Board prior to implementation.  The CON process is intended to prevent unnecessary duplication of health care facilities and services, guide their establishment in order to best serve public needs, promote cost containment, and ensure the provision and equitable allocation of high quality health care services and resources to all Vermonters.

The law that governs the Certificate of Need process can be found in Chapter 221 of Title 18 of the Vermont Statutes and in GMCB Rule 4.000, which apply to all CON matters for which an application was filed on or after January 1, 2013.

Starting the Process

The CON process typically begins with the potential applicant filing a Letter of Intent, see 18 V.S.A. § 9440(c)(2)(A). The Letter of Intent must provide sufficient detail to allow the Board to determine whether a Certificate of Need is required. If the Board concludes that the project does not require a CON, it will issue a "no jurisdiction letter."   

To obtain a jurisdictional determination, you can email the Board a Letter of Intent (whether on the form provided or its equivalent), a Projected Project Costs spreadsheet if applicable, and any required additional information.  (Note that an applicant conceding CON jurisdiction is not required to submit a Letter of Intent prior to filing an application.) 

Application Fee

For each CON application, the applicant must remit a fee of 0.125% of project costs not to exceed $20,000 with a minimum fee of $250 regardless of project costs.  18 V.S.A. § 9441. The fee will be invoiced to the applicant upon receipt of the application, which is not considered complete for review until payment is received.

Health Resource Allocation Plan (HRAP)

A CON applicant must show that its application is consistent with the health resource allocation plan (HRAP). The HRAP identifies Vermont needs in health care services, programs, and facilities, the resources available to meet those needs, and the priorities for addressing those needs on a statewide basis.  Because of the variety of CON projects that are submitted for review, not all of its requirements must be met for any given project.  Please contact us if you have further questions on HRAP standards.

More information about the HRAP is available at 18 V.S.A. § 9405.

Pending and Issued CONs

The Board makes available through this website information regarding specific projects filed on or after January 1, 2015.  For Certificates of Need filed prior to that date, please contact Donna Jerry. To discuss a proposed project or to receive guidance on a CON application, you can email the Board or call 802-828-2177.