West Virginia Code § 9-5-19

Summary review for certain behavioral health facilities and services
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(a) A certificate of need as provided in article two-d, chapter sixteen of this code is not
required by an entity proposing additional behavioral health care services, but only to the
extent necessary to gain federal approval of the Medicaid MR/DD waiver program, if a
summary review is performed in accordance with the provisions of this section.
(b) Prior to initiating any summary review, the secretary shall direct the revision of the state
mental health plan as required by the provisions of 42 U.S.C. 300x and section four, article
one-a, chapter twenty-seven of this code. In developing those revisions, the secretary is to
appoint an advisory committee composed of representatives of thue associations representing
providers, child care providers, physicians and advocates. The secretary shall appoint the
appropriate department employees representing regulatory tagencies, reimbursement
agencies and oversight agencies of the behavioral health system.
(c) If the secretary determines that specific services are needed but unavailable, he or she
shall provide notice of the department's intent to dlevelop those services. Notice may be
provided through publication in the state regisster, publication in newspapers or a modified
request for proposal as developed by the secretary.
(d) The secretary may initiate a sumgmary review of additional behavioral health care
services, but only to the extent necessary to gain federal approval of the Medicaid MR/DD
waiver program, by recommending exemption from the provisions of article two-d, chapter
sixteen of this code to the Health Care Authority. The recommendation is to include the
following findings:
(1) That the proposed service is consistent with the state health plan and the state mental
health plan;
(2) That the proposed service is consistent with the department's programmatic and fiscal
plan for behavioral health services;
(3) That the proposed service contributes to providing services that prevent admission to
restrictive environments or enables an individual to remain in a nonrestrictive environment;
(4) That the proposed service contributes to reducing the number of individuals admitted to
inpatient or residential treatment programs or services;
(5) If applicable, that the proposed service will be community-based, locally accessible,
provided in an appropriate setting consistent with the unique needs and potential of each
client and his or her family and located in an area that is unserved or underserved or does
not allow consumers a choice of providers; and
(6) That the secretary is determining that sufficient funds are available for the proposed
service without decreasing access to or provision of existing services. The secretary may,
from time to time, transfer funds pursuant to the general provisions of the budget bill.
(e) The secretary's findings required by this section shall be filed with the secretary's
recommendation and appropriate documentation. If the secretary's findings are supported
by the accompanying documentation, the proposal does not require a certificate of need.
(f) Any entity that does not qualify for summary review is subject to a certificate of need
review.
(g) Any provider of the proposed services denied authorization to provide those services
pursuant to the summary review has the right to appeal that decision to the state agency in
accordance with the provisions of section ten, article two-d, chapter sixteen of this code.

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