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.
All public notices can be found here.
Guidance Regarding Compliance with Certificate of Need Standard 1.12 of the 2009 Health Resource Allocation Plan
- Procedure and Guidance for Emergency Certificate of Need Applications to Respond to the COVID-19 Pandemic
- Temporary Waiver of the Requirement for a Certificate of Need for Certain COVID-19 Pandemic-Related Projects
- Revisions to Certificate of Need Monetary Jurisdictional Thresholds
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). Applicants who concede that their project is subject to review are encouraged to submit a Letter of Intent as a means of providing preliminary information to commence and facilitate the CON application process. While conceding applicants are not required by statute to submit a Letter of Intent, many applicants find that this step improves the quality and completeness of their eventual application. Applicants who are unsure whether their project is subject to the GMCB’s statutory jurisdiction must submit a Request for Jurisdictional Determination, pursuant to 18 V.S.A. § 9440 (c)(2)(A), and (B), to enable the Green Mountain Care Board to determine if a planned health project falls within its statutory jurisdiction.
The Letter of Intent or Request for Jurisdictional Determination 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 or a Request for Jurisdictional Determination (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.)
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.