Ch. 688                                          LAWS OF MARYLAND

(m) In this section the terms "consolidation" and "merger"
include increases and decreases in bed capacity or services among
the components of an organization which:

(1)  Operates more than one health care facility; or

(2)  Operates one or more health care facilities and
holds an outstanding certificate of need to construct a health
care facility.

(N) (1) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION
OR APPLICABLE REGULATION, THE COMMISSION SHALL CONSIDER THE
SPECIAL NEEDS AND CIRCUMSTANCES OF A COUNTY WHERE A MEDICAL
SERVICE, AS DEFINED IN THIS SECTION, DOES NOT EXIST; AND

(2) THE COMMISSION SHALL CONSIDER AND MAY APPROVE
UNDER THIS SUBSECTION A CERTIFICATE OF NEED APPLICATION TO
ESTABLISH, BUILD, OPERATE, OR PARTICIPATE IN A HEALTH CARE
PROJECT, EXCEPT FOR THE ESTABLISHMENT OR CONSTRUCTION OF A NEW
HEALTH CARE FACILITY, TO PROVIDE A NEW MEDICAL SERVICE IN A
COUNTY IF THE COMMISSION, IN ITS SOLE DISCRETION, FINDS THAT:

(I)  THE PROPOSED MEDICAL SERVICE DOES NOT EXIST
IN THE COUNTY THAT THE PROJECT WOULD BE LOCATED;

(II)  THE PROPOSED MEDICAL SERVICE IS NECESSARY
TO MEET THE HEALTH CARE NEEDS OF THE RESIDENTS OF THAT COUNTY;

(III) THE PROPOSED MEDICAL SERVICE WOULD HAVE A
POSITIVE IMPACT ON THE EXISTING HEALTH CARE SYSTEM;

(IV) THE PROPOSED MEDICAL SERVICE WOULD RESULT
IN THE DELIVERY OF MORE EFFICIENT AND EFFECTIVE HEALTH CARE
SERVICES TO THE RESIDENTS OF THAT COUNTY; AND

(III) (V) THE APPLICATION MEETS ANY OTHER
STANDARDS OR REGULATIONS ESTABLISHED BY THE COMMISSION TO APPROVE
APPLICATIONS UNDER THIS SUBSECTION.

SECTION 2. AND BE IT FURTHER ENACTED, That, notwithstanding
the provisions of § 19-115 of the Health - General Article or
applicable regulations of the Health Resources Planning
Commission, a hospital, as defined in § 19-301 of the Health
General Article, may increase or decrease an existing acute
psychiatric medical service during a 1-year period by 15 beds or
50 percent, whichever is less.

SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act
shall take effect July 1, 1988.

Approved May 27, 1988.

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