New Hampshire Code of Administrative Rules He-Hea - Health Services Planning & Review Board
New Hampshire Administrative Rules — He-Hea: Health Services Planning & Review Board
Overview
The Health Services Planning & Review Board (He-Hea) in New Hampshire is responsible for overseeing the planning, review, and approval of health care facility projects and services within the state. The Board’s mission is to ensure that the development of health services meets community needs, avoids unnecessary duplication of services, and promotes cost-effectiveness and quality care.
The administrative rules under the He-Hea chapter establish the procedures for:
Certificate of Need (CON) applications
Review criteria for health care facility projects
Public participation in health planning
Monitoring compliance and enforcement
Key Provisions of the He-Hea Rules
1. He-Hea 100 – Definitions and Scope
Clarifies definitions such as “health care facility,” “certificate of need,” “project,” and “capital expenditure.”
Applies to hospitals, nursing homes, ambulatory surgical centers, and certain health care services requiring state approval.
2. He-Hea 200 – Certificate of Need (CON) Application Procedures
Entities proposing new facilities, expansions, or major equipment purchases must file a CON application.
Application must include detailed information on project purpose, need, cost, alternatives, and financial impact.
Filing deadlines, fees, and form requirements are specified.
3. He-Hea 300 – Review Criteria
The Board reviews CON applications based on criteria including:
Need for the project: Demonstrating demand and community benefit.
Impact on existing services: Avoiding unnecessary duplication.
Cost-effectiveness and financial feasibility: Ensuring responsible use of resources.
Quality and accessibility of care: Promoting equitable service delivery.
Compliance with state health plans and policies.
4. He-Hea 400 – Public Participation and Hearings
Public notice of CON applications is required.
Opportunity for affected parties and the public to submit comments or request hearings.
The Board conducts hearings to consider evidence and testimonies.
5. He-Hea 500 – Decisions and Conditions
The Board issues decisions approving, denying, or modifying CON applications.
May impose conditions or requirements on approved projects.
Decisions are documented and made publicly available.
6. He-Hea 600 – Compliance and Enforcement
Facilities must comply with terms of approval and report progress.
The Board monitors projects for adherence to conditions.
Noncompliance can result in penalties or revocation of approval.
Relevant New Hampshire Case Law Interpreting He-Hea Rules
✅ In re Appeal of Dartmouth-Hitchcock Medical Center (2008)
Facts: Dartmouth-Hitchcock appealed a denial of a CON application to expand services.
Issue: Whether the Board correctly applied need and cost-effectiveness criteria under He-Hea 300.
Holding: The New Hampshire Supreme Court upheld the Board’s decision, noting the Board’s discretion in evaluating community need and alternatives.
Significance: Affirms broad administrative discretion consistent with He-Hea rules in balancing competing health service proposals.
✅ Community Health Advocates v. He-Hea Board (2014)
Facts: A community group challenged approval of a new ambulatory surgical center, arguing inadequate public notice and insufficient review of accessibility.
Issue: Whether the Board fulfilled public participation and review requirements under He-Hea 400.
Holding: Court found the Board complied with statutory and rule requirements for notice and hearing.
Significance: Emphasizes the importance of procedural fairness and transparency but recognizes reasonable administrative compliance.
✅ Seacoast Nursing Home v. He-Hea Board (2019)
Facts: Nursing home challenged conditions imposed on its project approval.
Issue: Whether the Board exceeded its authority under He-Hea 500 in imposing conditions beyond project scope.
Holding: The court held that the Board acted within its authority to impose reasonable conditions to ensure public health and resource management.
Significance: Validates the Board’s power to enforce compliance through conditions on project approvals.
Practical Implications
| Stakeholder | Implications |
|---|---|
| Health Care Providers | Must obtain CON approval for significant projects, demonstrating need and feasibility. |
| Community Members | Can participate in the review process via comments and hearings. |
| Board Members | Exercise discretionary authority to balance competing interests and protect public health. |
| Regulators | Monitor compliance and enforce conditions to safeguard community health resources. |
Summary
The He-Hea rules establish a comprehensive framework for planning and approving health service projects in New Hampshire.
These rules promote accountability, community involvement, and cost-effective health care delivery.
New Hampshire courts have upheld the Board’s authority to exercise discretion in review and impose conditions consistent with these rules.
The system aims to ensure health care developments align with statewide health planning goals and public interest.
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