The District of Columbia (CON) Introduction
Like many states, The District of Columbia has an extensive CON process in place for healthcare services and facilities. Winning approval for a CON application is often a time consuming and difficult undertaking. Working with RPC provides clients with a team of consultants with experience working with CON projects.
When working on a CON project, RPC can prepare the entire CON application or sections of the application as the client prefers. When the client is defining the project and deciding whether to apply, RPC can help assess the market and regulatory situation to determine the relative likelihood of success for a project. RPC not only completes a thorough review of the competitive environment, market need and financial analysis, but also works seamlessly with the client’s staff, architects, engineers, and other outside consultants to create a solid CON application.
RPC is led by Ron Luke, JD, PhD, who has prepared CON applications and presented testimony in CON hearings since 1981 in over 20 states. RPC’s work on CON projects includes the opening of new acute care hospitals, hospices, physical rehabilitation and psychiatric specialty hospitals, ambulatory surgery centers and nursing homes, the relocation and addition of beds, and acquiring major medical equipment. Working with RPC during the CON process gives the applicant the advantage of a skilled, experienced team that can provide expert advice and produce an effective application.
Contents last updated on September 2026
State Agencies
The District of Columbia Health State Health Planning and Development Agency (SHPDA)
The State Health Planning and Development Agency (SHPDA) is a division of DC Health’s Center for Policy, Planning and Evaluation.
Address
2201 Shannon Place SE, 6th Floor
Washington, DC 20020
Office: (202) 442-5865
Fax: (202) 442-4833
Services that Require CON
As defined by the District of Columbia Official Code, a Certificate of Need is required for the following projects:
- The construction, development, or other establishment of a new health care facility, health care service or home health agency
- Redistribution of beds within a facility by 10 beds or 10 percent, whichever is less, in any two-year period
- Relocation of beds from one facility to another.
- The relocation of a health care facility or any of its major clinical services from one location to another within the District.
- Introduction into an existing health care facility of any of the services, which the facility has never provided or has not provided in the previous 12 months.
- Any capital expenditure of $6,000,000 or more in connection with a hospital and $3,500,000 in connection with a health service or health facility.
- Major medical equipment of $3.5 million or more for a hospital or $2 million or more for a healthcare facility
- A single piece of diagnostic or therapeutic equipment by a physician or group of physicians or an independent operator in excess of $350,000
- Acquiring an existing health care facility or major medical equipment, or acquiring effective control of a health care facility.
- The transfer of ten percent or more of the stock or voting rights of an entity that operates a health care facility
Certificate of Need Process Milestones
The District of Columbia Health State Health Planning and Development Agency (SHPDA) administers the CON program via an online automated portal. Review cycles begin monthly, typically on or about the 20th day of the month.
- File Letter of Intent (LOI) & Public Notice The first step is submitting a letter of intent via SHPDA’s online portal. Simultaneously, the applicant must place a public notice advertisement in a newspaper of general circulation in the District generally describing the proposed project and location. A copy of the publication certificate must be uploaded with the LOI. The LOI is valid for 180 days.
- Statutory Waiting Period Applicants must wait 60 days between the submission of the letter of intent and the formal filing of a CON application, though SHPDA may waive this waiting period upon a showing of good cause.
- Pre-Application Consultation Prior to submitting an application, the applicant must consult with a designated member of the SHPDA staff to review criteria, standards, procedures, and timelines that will be followed during the review process.
- CON Application Filing The applicant must submit the application on SHPDA’s automated CON portal along with the required filing fee.
- Deadlines for Batched Applications. The below-listed application types are “batched” and considered twice year, according to an established schedule. The current schedule is available fore review here. To be considered for a specific month’s review cycle (which starts on or about the 20th), an application must be declared complete by the 10th of that month. To ensure adequate review time, it is strongly recommended to file the application by the 20th of the preceding month.
- Alcoholism/Chemical Dependency Services
- Diagnostic Radiology and Ultrasound Services
- Renal Disease Services
- Home Health Services
- Review for Completeness Upon receipt, SHPDA staff reviews the application for completeness within 15 workdays. If incomplete, the agency transmits a list of questions to the applicant; the application is declared complete once full answers are submitted into the record.
- Ninety-Day Review Cycle Once declared complete, the formal review period begins. SHPDA must complete its review and issue a final decision within 90 days. Exception: Applications involving capital expenditures to acquire an existing health care facility are subject to an expedited 60-day review.
- Public Hearing Request During the first 30 days of the formal review period, any interested person or affected party may submit a written request to hold a public hearing on the proposed project.
- SHCC Project Review Committee Consideration The application and SHPDA’s preliminary analysis are reviewed by the Project Review Committee of the Statewide Health Coordinating Council (SHCC). Applicants are given an opportunity to deliver a brief presentation and answer questions from the committee.
- Director’s Final Decision Following the SHCC’s recommendation, the SHPDA Director reviews the record and issues the final written determination to approve or deny the Certificate of Need.
What Criteria are Used to Review a CON?
The DC State Health Planning and Development Agency (SHPDA) evaluates Certificate of Need applications using the following criteria and standards for review, as outlined in Title 22, Chapter 40 Section 4012 of the Code of D.C. Municipal Regulations. Applicants requesting bed reductions and closures must meet additional requirements. See the DC Regulations for detailed requirements:
- Consistency with the Health Systems Plan: Alignment with the goals, priorities, and health strategies outlined in the District’s active Health Systems Plan (HSP). The HSP delineates six primary criteria for demonstrating need for a proposed project: need, accessibility, quality, acceptability, continuity and coordination of care and financial impact.
- Consistency with Applicant’s Long Range Development Plan
- Consistency with Non-Health Sector Plans including plans and adopted by the District related to transportation, housing, and economic development
- Need on a Health Care System Wide Basis: Demonstration of a documented public need for the proposed service or facility
- Need on an Institutional Basis demonstration that the projected is required to meet institutional needs
- Impact on Training Opportunities: Evidence that the project will not negatively impact opportunities for health professional training and evidence that the project will not negatively impact requirements of research projects
- Evidence of Administrative and Operational Requirements: Timely project implementation, required operating policies, necessary staffing, management capability and physical structure requirements must be met.
- Access: The applicant must demonstrate the project will not negatively impact traditionally medically underserved residents including (but not limited to) residents speaking languages other than English, low-income residents, women, elderly persons, residents with disabilities, Medicaid and Medicare beneficiaries
- Quality of Care: Assessment of the applicant’s qualifications, professional credentials, and ability to meet high standards of clinical safety and care quality.
- Efficiency and Effectiveness: Applicants should provide evidence that the project is the most efficient, effective and practical manner of providing the needed services, considering other alternatives.
- Financial Feasibility: Evidence of long-term economic viability, reasonable capital expenditure costs, and sound financial projections. Applicants must demonstrate they have the required capital for the project.
- Impact on Existing System and Competition: Evaluation of how the project affects the local healthcare network, ensuring it prevents unnecessary service duplication while supporting necessary continuity of care.
Certificate of Need Application Filing Fee
The application fee for a Certificate of Need in Washington, D.C. is equal to 3.0% of the proposed capital expenditure or $5,000, whichever amount is greater. The absolute maximum fee collected for an application is capped at $300,000.
Additional Sources
(links good as of September 2026)
DC Health SHPDA Program
https://dchealth.dc.gov/service/certificate-need
SHPDA Online Application Portal
District of Columbia CON Statute (D.C. Official Code § 44-401 et seq.)
https://code.dccouncil.gov/us/dc/council/code/titles/44/chapters/4
District of Columbia CON Regulations (DCMR Title 22-B, Chapter 40 et seq.)
Contact RPC Consulting
Should you or your client need an expert team to help you with the District of Columbia Certificate of Need process (CON) please contact Regulatory Practice Manager Darcy Schaeffer, MLS at 512‑371‑8011.
Disclaimer: The information on this page has been compiled by RPC based on sources believed to be reliable. It was updated in September 2026. Where possible we have had the material reviewed by state CON officials or others knowledgeable of the state’s CON program. The information is not offered as legal advice. A state may change its rules, forms and procedures at any time and RPC offers no assurance that the information will be correct on the date it is viewed. Therefore the reader is urged to use this information only as a starting point for any CON application and to speak with state officials or seek legal or consulting advice early in the process.