The department may grant a certificate of need for a new adult elective PCI program in a planning area where the forecasting methodology does not identify numeric need. The department may also grant, at its sole discretion, a certificate of need in a concurrent or comparative review process to more programs than the forecasting methodology projects as needed.

(1) The department will consider if the applicant meets the following criteria:

(a) All applicable review criteria and standards, with the exception of numeric need, have been met;

(b) The applicant commits to serving medicare and medicaid patients;

(c) Approval under these nonnumeric need criteria will not cause existing approved provider(s) in the same planning area(s) to fall below minimum volume standards as required under WAC 246-310-720;

(d) The applicant demonstrates the ability to address at least one of the following nonnumeric criteria. Applicants must include empirical data that supports their nonnumeric need application. This information must be publicly available and replicable. The nonnumeric need criteria are:

(i) Demonstrating that an applicant's request would substantially improve access to communities with documented barriers or higher disease burdens which result in poorer cardiovascular health outcomes. These communities include low-income and uninsured/underinsured populations, as well as demographics with higher rates of identifiable risk factors for cardiovascular disease. These measures would be compared to statewide or national averages as appropriate.

(ii) They have operated an emergent-only program for a period of at least five years prior to July 1, 2025, and that the addition of elective volume will support quality and stabilize staffing and retention of providers.

(iii) Demonstrating that an applicant's request will improve cost-effectiveness, efficiency, and access at an affiliate PCI hospital. The applicant and affiliate PCI hospital(s) must be located within the same planning area. The applicant must also demonstrate the annual planning area resident PCI volumes performed by the applicant and any affiliate PCI hospital(s) within the same planning area will be sufficient to allow both the applicant and its affiliate PCI hospital to each meet minimum volume standard.