Overview of Plan Review Process for Health Care Facility Construction Projects

The Alabama Department of Public Health, Technical Services Unit

The Technical Services Unit of the Office of Facilities Management is responsible for the review and approval of drawings and specifications for the construction of new buildings, additions, alterations and renovations at health care facilities regulated by Alabama Department of Public Health. Projects are reviewed for compliance with Alabama State Board of Health regulations, and applicable codes. Technical Services Unit's telephone number is 334-206-5177, and our web site is available at  Facilities Management.. State Health Planning and Development Agency’s (SHPDA) web address is www.shpda.state.al.us.

1. Rules of the State Board of Health for the particular type of health care facility desired to be licensed and operated should be obtained for your project to assist in the design. Rules are available in PDF format on our web site.

2. Review and approval of the construction documents for health care facility construction projects, including alterations and renovations, is required by the rules of the State Board of Health, under the authority of Code of Alabama 1975, Sections 22-21-20 and following, for those facilities which are licensed and/or certified by the Department.

A. See Rule 420-5-22, "Submission of Plans and Specifications for Health Care Facilities," on our web site. A link to Facility Rules can be found on our web site.

B. Pre-License Filing must be completed by the owner of new healthcare projects. This must be approved by Provider Services prior to any plan review by Technical Services. Refer to Pre License Filing for information.

C. Transmittal Form for use when submitting documents for review is available from Technical Services and on our web site. Furnish all applicable information requested on the form. The design professional will be notified of the receipt of the documents and of the newly assigned project number.

D. Rule 420-5-21, Payment of Plan Review Fees, applies to all projects. Each preliminary submittal must be accompanied by an initial fee payment. Other fees will be due at the approval of final stage plans, and at the conclusion of the final inspection. Fees are based on a sliding scale of a percentage of project construction cost. Additional fees will be due if a project requires more than four plan submittals and reviews, or more than one on-site inspection. The additional fees also apply to projects which are constructed, and inspected by our office, in phases. Rule 420-5-21 is available on our web site.

E. Available to the public. All project documents submitted to Technical Services for review, including drawings and specifications, become public record and are open to inspection by any interested party.

F. Alabama law regarding preparation of drawings and other project documents by an architect registered in Alabama apply.

3. Written approval of each constructed project, by staff of Technical Services, is required prior to a facility’s admitting residents or patients, or providing licensed services to the public, and prior to the Department’s issuing a license to operate (when required). Refer to Provider Services for licensure information.

4. Certificate of Need (CON) is required for many facilities before they can be licensed, or have their license upgraded due to alterations or additions. This document, or a certification of exemption, must be obtained by the owner from the State Health Planning and Development Agency (SHPDA). The Department of Public Health is required by Alabama statute to confirm compliance with CON regulations prior to issuing or upgrading a license. Technical Services will not approve final stage plans for projects that do not include written documentation of compliance with Alabama CON regulations.

Project submittals for facilities which are subject to Certificate of Need regulations must be accompanied by one of the following:

A. Certificate of Need from the State Health Planning and Development Agency, or

B. Letter of non-reviewability from SHPDA, or

C. Affidavit from the owner or legal advisor, addressed to Technical Services Unit, containing all the following information:

  1. A statement of the construction and equipment cost

  2. A statement that these costs do not exceed the thresholds established by CON regulations

  3. A statement that the project complies with Alabama Code, and Rules established by SHPDA

  4. A statement that the project does not change the existing bed capacity

  5. A statement that a new service is not created

  6.  The statement: “Therefore, the project described is not subject to Certificate of Need review under Alabama Code or State Health Planning and Development Agency Rules.”

Technical Services’ acceptance of an owner’s affidavit that CON requirements are not applicable does not relieve the facility of licensure or CON requirements that may actually apply.

5. Final Inspection by the staff of Technical Services is required for each project, and should not be scheduled until construction is complete. The final plan approval letter from our office will give details concerning the architect’s written request to obtain this inspection. The following should be present at the facility at the time of inspection:

A. Representatives of the owner, architect, building contractor, and appropriate subcontractors

B. Copies of approved drawings and specifications

C. Certificate of Occupancy (C.O.) from local Building Official, as applicable

D. Close out documents for review, including:

1) Interior Wall and Ceiling Finishes: Documentation stating manufacturer, type, class, flame spread, etc., of installed finishes, and locations installed.

2) Furnishings & Decorations: New draperies, curtains and other loosely hanging furnishings and decorations shall be certified to be flame resistant, having passed tests per NFPA 701. Documentation stating manufacturer, type, class, flame spread, etc., of installed materials, and locations installed.

3) Fire Alarm System: NFPA 72 "Record of Completion" form, with all appropriate areas filled out, to include the monitoring agency information.

4) Fire Sprinkler System: (1) “Contractor’s Material and Test Certificate” for both underground and above ground piping, (2) a letter certifying that the sprinkler system installed complies with NFPA13 or 13R (as applicable) and that exposed piping is protected to maintain a minimum 40 degrees Fahrenheit. 

5) Commercial Cooking Equipment (if applicable): Documentation certifying that hoods, ductwork and exhaust systems comply with NFPA 96, and that associated extinguishing systems comply with UL 300 and NFPA 17A.

6) Mechanical Air Flow: Balanced air supply and return test report (as applicable), indicating compliance with NFPA 90A and the International Mechanical Code.

7) Medical Gas Certification: For new or altered systems. Comply with NFPA 99.

8) X-ray Shielding: Shielding Integrity Test of shielded rooms. (See paragraph 14 below.)

9) Elevators: Certification of compliance with ASME A17.1 for recall and power shutdown, including approval certificate from the Elevator Safety Division of the Alabama Department of Labor.

10) Door Locking Arrangements: Complete description of the location and function of locked or delayed-egress door hardware.

11) Other documents deemed by the architect or the Department to be applicable to the project.

12) New Emergency Generator: Provide documentation of Installation Acceptance per NFPA 110.When a project is inspected and approved, and the inspection fee is received, a Certificate of Completion (COC) will be issued by Technical Services to the Division of Provider Services within the Department. No licensing actions will be taken until the COC is received by Provider Services. Provider Services should be contacted regarding additional requirements for licensing.

13. Retention of documents by Technical Services is 5 years after completion of each project. Afterwards, the documents (drawings, specifications, reports and correspondence) may be discarded.

14. Radiation equipment and associated rooms must also be reviewed and approved by Radiation Control of the Department, per State Board of Health regulation 420-3-26.Shielding installations must also be tested prior to use. Contact The X-Ray Inspection Section of Radiation Control at 334-290-6244 for more information. Projects in Jefferson County are reviewed by the Jefferson County Department of Health.

Page last updated: December 22, 2022