Certificate of Public Review
The primary goal of the Delaware Health Resources Board (HRB) Certificate of Public Review (CPR) process is to control health costs. This formal review process ensures public scrutiny of certain health care developments which could negatively affect the quality of health care, or threaten the ability of health care facilities to provide services to the medically indigent. The Delaware Health Care Commission administers and staffs the public review process, which regulated through the Delaware Code 16 Del. Code 9301.
Construction, development or other acquisition of a health care facility
Construction, development or other acquisition of a health care facility, or the acquisition of a nonprofit healthcare facility, requires a Certificate of Public Review.
Major capital expenditures
Major capital expenditures by, or on behalf of a health care facility, in excess of $5,800,000, or some greater amount which has designated by the Board following an annual adjustment for inflation using an annual inflation index determined by the United States Department of Labor, Bureau of Labor Statistics, which, under generally accepted accounting principles consistently applied, is a capital expenditure which requires a Certificate of Public Review.
A capital expenditure for purposes of constructing, developing or otherwise establishing a medical office building shall not be subject to review under this chapter.
In the case of major medical equipment acquired by an entity outside of Delaware, the use of that major medical equipment within Delaware, whether or not on a mobile basis, is subject to review under this chapter.
Major medical equipment which is acquired for use in a dispensary or first aid station located within a business or industrial establishment maintained solely for the use of employees or in a first aid station, dispensary or infirmary offering services exclusively for use by students and employees of a school or university or by inmates and employees of a prison is not subject to review.4
Bed capacity change
A proposed change in bed capacity, which increases the total number of beds (or distributes beds among various categories, or relocates such beds from one physical facility or site to another) by more than 10 beds or more than 10 percent of total licensed bed capacity, whichever is less, over a two-year period, requires a Certificate of Public Review.
Acquisition of major medical equipment
Acquisition of major medical equipment,whether, or not, by a health care facility and whether, or not, the acquisition is through a capital expenditure, an operating expense or a donation.
The replacement of major medical equipment with similar equipment shall not be subject to review under this chapter. In the case of major medical equipment acquired by an entity outside of Delaware, the use of that major medical equipment within Delaware, whether or not on a mobile basis, is subject to review under this chapter.
Major medical equipment which is acquired for use in a dispensary or first aid station located within a business or industrial establishment maintained solely for the use of employees or in a first aid station, dispensary or infirmary offering services exclusively for use by students and employees of a school or university or by inmates and employees of a prison is not subject to review.
Certificate of Public Review Guiding Principles
The following general principles are intended to assist potential Certificate of Public Review (CPR) applicants in understanding the Board’s expectations and also to assist the Board itself in conducting CPR reviews, particularly in matters where specific guidelines are lacking.
- The essential challenge faced by the Board is striking an appropriate balance in its consideration of access, cost and quality of care issues. Evidence that this challenge has been seriously embraced by the applicant should permeate every CPR application.
- The problem of medical indigency is extremely complex. The Delaware Health Care Commission continues to provide leadership in this area. CPR applicants are expected to contribute to the care of the medically indigent.
- Historically, health care delivery has too often been episodic and disjointed. Projects which support a managed, coordinated approach to serving the health care needs of the person/population are to be encouraged.
- Given Delaware’s small size and close proximity to major metropolitan referral centers, particularly in Philadelphia and Baltimore, every health care service need not be available within its borders. Potential CPR applicants are expected to take into account the availability of out-of-state resources.
- Historically, our cost-based reimbursement system has provided little incentive for financial restraint; over-utilization has been encouraged. Revenue centers, not cost centers, were generally emphasized. Projects which reflect or promote incentives for over-utilization (including self-referral) are to be discouraged.
- Strengthening market forces is a central theme in the health care reform strategy adopted by the Delaware Health Care Commission, a theme which is embraced by the Board. Projects resulting from or anticipated to enhance meaningful markets are to be encouraged. In the past, “competition” has often been on the basis of amenities for physicians (the medical arms race) and patients (the plushest waiting room). In meaningful markets there must be a sensitivity to elements of both cost and quality.
- Prevention activities such as early detection and the promotion of healthy lifestyles are essential to any effective health care system. The potential for a project to bring about progress in these areas will be viewed as a very positive attribute.
Certificate of Public Review Process
Letter of Intent
The Certificate of Public Review process starts with a letter of intent submitted to the Delaware Health Resources Board (HRB). The HRB reviews the application and may hold a public hearing before rendering a decision.
The Health Resources Board considers factors such as the proposal’s relationship to the state’s health plan, the population’s need for the project and the potential impact on cost and quality of care.
Procedures
- Applicant files Notice of Intent, found within the CPR Application Kit.
- Applicant files application. When application is determined to be complete, there is notification of the beginning of the review (Public Notice, etc.).
- At the first meeting of the Delaware Health Resources Board after an application is determined complete, there is an overview presentation by the applicant and an opportunity for questions. At this meeting the application is assigned as a staff review or a Review Committee is appointed.
- If a public hearing is requested, this is conducted by Review Committee.
- Review Committee meets with the applicant and deliberates as necessary to formulate a recommendation to the Board.
- Review Committee report is submitted to the Board. The Board makes the decision. From the date of notification referred to in step 2 above, generally the maximum review period is 90 days. There are exceptions, such as a public hearing is requested or it is mutually acceptable to the Board and the applicant.
Certificate of Public Review Application Fees
Certificate of Public Review applications must be accompanied by an application filing fee. Pursuant to Chapter 93 Health Planning and Resources Management, §9305, application fees shall be determined from the following table:
| Capital Expenditures | Application Fee |
|---|---|
| Less than $ 500,000 | $100 |
| $500,000 to $999,999 | $750 |
| $1,000,000 to $4,999,999 | $3,000 |
| $5,000,000 to $9,999,999 | $7,500 |
| $10,000,000 and over | $10,000 |
Filing fees shall be due 30 days after the date of notification of the beginning of review as covered under 9305 subdivision (4). This due date may be extended up to 10 additional days at the discretion of the Bureau. Applications for which filing fees have not been paid within this time frame shall be considered to be withdrawn.
Make checks payable to: Treasurer, State of Delaware and remit to:
Delaware Health Care Commission
1901 North Dupont Highway
New Castle, DE 19720
Health Resources Board Members
| Member Name | Member Designation |
|---|---|
| Brett Fallon, Esq | Board Chairman (Public at Large) |
| Leighann Hinkle | Board Vice Chairman |
| JoAnn Seppelt | Provider |
| Leighann Hinkle | State Employee Health Care Coverage |
| Vacant | Labor Representative |
| Margaret Strine | Public at Large |
| Vincent Lobo, Jr. DO | Medical Practitioner |
| Cheri Doyle | Delaware Health Care Commission |
| Vacant | Public at Large |
| Vacant | Department of Health and Social Services |
| John Hundley | Health Care Administration |
| Cheryl Heiks | Long-term Care Administration |
| Vacant | Public at Large |
| Timothy Gibbs | Public at Large |
| Pamela Price | Health Insurance Industry Representative |
| Charles “Chip” Walters Jr. | Health Care Coverage for Employers with more than 200 Employees |
Health Resources Board Bylaws
Health Resources Board 2026 Meetings
| DATE | TIME | PLACE |
|---|---|---|
| January 22, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| February 26, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| March 23, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| April 23, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| May 28, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| June 25, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| July 23, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| August 27, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| September 24, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| October 22, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| November 19, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
| December 17, 2026 | 2:00-4:00 p.m. | See public meeting calendar for details. |
Certificate of Review Notice of Filed Intents
Coming soon!
Certificate of Review Monthly Activity Reports
The information below is a listing of Delaware Certificate of Public Review activities. For years prior to 2020, please reach out to the HRB.
