(1) As indicated in ARM 37.106.804 a condition of application for a proposed specialty hospital is that it must conduct an impact study that analyzes the financial and operational impacts of the proposed specialty hospital on existing health care facilities in the service area. The impact study must be completed prior to submitting the application for licensure.

(2) The impact study process will consist of:

(a) notification of specialty hospital formation intent;

(b) public participation on impact study consultant selection and scope;

(c) selection of impact study consultant and scope finalization;

(d) impact study completion and submission; and

(e) department review and determination.

(3) The consultant selection process will include:

(a) department review of consultant qualifications;

(b) consideration of public comment on consultants; and

(c) consultant selection.

(4) consultant responsibilities include:

(a) measure and analyze changes to health care access in services area; and

(b) prepare and submit report of findings.

(5) The scope of the impact study will focus on health care costs, access, and impact to existing health care facilities.

(6) The applicant for a proposed specialty hospital:

(a) must provide the department with an overview of the proposed specialty hospital including, but not limited to:

(i) type of services to be provided in the proposed specialty hospital;

(ii) the number and type of patients or residents for which care is to be provided; and

(iii) the number of employees in all job classifications.

(b) must provide to the department a list of independent consultants who could conduct the impact study; and

(c) pay the costs of that study.

(7) The department must provide for an opportunity for public comment and participation, including opportunity to comment on the list of consultants, into the study process. Prior to designating an independent consultant to conduct the impact study, the department will afford the public an opportunity to provide comment on the independent consultants and scope of the impact study. At the discretion of the department, a public meeting may be held in lieu of a formal hearing as an additional means of soliciting public comment.

(8) The department will determine the scope of the impact study. After the department approves the consultant, the scope of the study will be finalized. The study will assess the potential positive and adverse impacts on access to the health care system in the applicant's service area. The scope of the study may include, but is not limited to:

(a) the impact on health care costs in the service area;

(b) the impacts on access to emergency care, mental health care, and other subsidized services provided in the proposed service area;

(c) the operational impacts upon existing health care facilities; and

(d) the need for the services proposed in the health service area.

(9) The independent consultants utilized in these studies must:

(a) have the necessary resources to conduct and complete the impact study within the required timeframes;

(b) not allow the results of the study or the manner in which the study is conducted to be controlled by the proposed specialty hospital applicant or members of the joint venture;

(c) address all areas designated within the scope of the study; and

(d) prepare a written report documenting the findings of the impact study which the applicant will submit to the department with the license application.

(10) The impact study must be completed within 180 days of the date the department finalizes the scope.

(11) If as a result of the impact study, the department finds that a proposed specialty hospital will have an adverse influence on an existing hospital or to the community's health care delivery system, the department will:

(a) impose conditions to mitigate the adverse effect; or

(b) deny the request for license.