CHAPTER He-Hea 1600  MEGAVOLTAGE RADIATION THERAPY SERVICES

 

PART He-Hea 1601  DEFINITIONS

 

          He-Hea 1601.01  Definitions.

 

          (a)  “Applicant” means “applicant” as defined in RSA 151-C:2, II.

 

          (b)  “Application” means a proposal prepared by a person and filed with the board for a certificate of need.

 

          (c)  “Board” means “board” as defined in RSA 151-C:2, IV.

 

          (d)  “Board certified” means the confirmation given by a national or regional association to a professional as having passed special examinations for his/her medical specialty.

 

          (e)  “Certificate of need (CON)” means “certificate of need” as defined in RSA 151-C:2, VIII.

 

          (f)  “Dosimetrist” means a person who generates and calculates radiation dose distributions under the direction of a medical physicist and a radiation oncologist.

 

          (g)  “Health care facility” means “health care facility” as defined in RSA 151-C:2, XV-a.

 

          (h)  “Licensed facility” means an entity licensed under RSA 151 to provide health or medical services.

 

          (i)  “Market share population” means the number and/or percent of patients in a given service area utilizing a specific health care facility.

 

          (j)  “Megavolt (MeV)” means one million electron volts.

 

          (k)  “Megavoltage radiation therapy equipment” means therapeutic equipment having a maximum power rating in excess of one MeV which utilizes directed beams of ionizing radiation to kill cancerous tissues.  The term includes but is not limited to Cobalt-60 and linear accelerator machines.

 

          (l)  “Procedure” means the setup and delivery, through a single port or multiple ports, of a radiation treatment. It includes the term “external beam procedure.”

 

          (m)  “Radiation oncologist” means a physician certified by the American Board of Radiology in radiation oncology to manage patients with cancer.

 

          (n)  “Radiation therapist” means a person who is certified by the American Registry of Radiology Technology to provide patient treatment with ionizing radiation under the supervision of a radiation oncologist.

 

          (o)  “Service area” means a geographic area in which a majority of a healthcare provider’s clientele reside.

 

          (p)  “Simulator therapist” means a radiation therapist trained to mock-up or simulate a patient’s radiation treatment with radiographic documentation of treatment portals under the supervision of a radiation oncologist.

 

          (q)  “Uninsured” means a person who:

 

(1)  Is not covered or eligible for health care insurance;

 

(2)  Is eligible but not enrolled in a health insurance plan; or

 

(3)  Is otherwise covered by a health insurance plan that does not cover the medically needed radiation therapy service(s).

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

PART He-Hea 1602  STANDARDS FOR MEGAVOLTAGE RADIATION THERAPY EQUIPMENT AND PROGRAMS

 

          He-Hea 1602.01  Service Area.

 

          (a)  Each applicant for a certificate of need for megavoltage radiation therapy equipment and program shall define the proposed primary and secondary service areas for the new equipment.

 

          (b)  The primary service area shall include the populations from those towns identified in Table

1003-1 of He-Hea 1003.01;

 

          (c)  The secondary service area shall include the populations of any additional towns named by the applicant;

 

          (d)  In identifying the primary and secondary service areas, the applicant shall include:

 

(1)  A full description of the proposed service area including the size, demographic and morbidity characteristics of the service area; and

 

(2)  Current radiation therapy referral patterns from that service area.

 

Source. #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.02  Market Share Population.

 

          (a)  The applicant shall claim the following market share of its defined primary and secondary service areas as follows:

 

(1)  For the primary service area, 100% market share; and

 

(2)  For the secondary service area, 100% of those towns located equally distant to, or less than half the distance to, to the next available health care facility offering a megavoltage radiation therapy program.

 

          (b)  Notwithstanding He-Hea 1602.02(a) above, for any facility proposed to be located in the service area where a megavoltage radiation therapy program already exists, the applicant shall claim a fractional market share of the primary service area based on total existing and proposed machines.

 

          (c)  In claiming its market share the applicant shall include the following data, wherever possible:

 

(1)  Out-of-state population and utilization data;

 

(2)  Population data bases from bordering states; and

 

(3)  Admission patterns of bordering states.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.03  Volume of Patients and Procedures.

 

                 No new megavoltage radiation therapy program shall be approved unless it can be demonstrated that the proposed program can:

 

          (a)  Treat a minimum of 325 patients on an annual basis by the end of the third year of operation; and

 

          (b)  Perform an average of 6,500 procedures per machine on an annual basis by the end of the third year of operation.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.04  Megavoltage Radiation Therapy Patient and Procedure Calculation.

 

          (a)  Applicants shall calculate projected patient and procedure volume as specified in He-Hea 1602.03 in the following manner:

 

(1)  Identify the town names for all towns in the projected primary and secondary service areas pursuant to He-Hea 1602.01;

 

(2)  Obtain population estimates for the expected third year of operation of the program for each town in the projected primary and secondary service areas by the following age groups:

 

a.  Less than 15;

 

b.  15-24;

 

c.  25-34;

 

d.  35-39;

 

e.  40-44;

 

f.  45-49;

 

g.  50-54;

 

h.  55-59;

 

i.  60-64;

 

j.  65-69;

 

k.  70-74;

 

l.  75-79;

 

m.  80-84; and

 

n.  85 and older;

 

(3)  Population estimates for (2) above shall be obtained from either:

 

a.  The U. S. Census;

 

b.  A nationally recognized demographic data provider; or

 

c.  A professional demographer experienced in small-area population estimates.

 

(4)  Apply the market share developed by He-Hea 1602.02 to the population of each town named in (1) above;

 

(5)  Multiply the service area’s 2007-2011 average estimated age-specific cancer rates as obtained from the N. H. department of health and human services, bureau of public health statistics and informatics, times the age-specific population estimates from (2) above;

 

(6)  If market area level age-specific cancer rates are not available then the applicant shall use statewide age-specific cancer rates and multiply these rates times the age-specific population estimates from (2) above;

 

(7)  To determine the service area’s total estimated cancer cases, sum the results for each age grouping from (5) above for the projected operating year;

 

(8)  To determine estimated cancer cases requiring radiation therapy, multiply the result of (7) above times 0.6;

 

(9)  To determine total estimated radiation therapy procedures, multiply the result of (8) by 23.

 

          (b)  An applicant shall have successfully demonstrated that the service area can support a new megavoltage radiation therapy program when:

 

(1)  The product of (8) above is greater than or equal to 325; and

 

(2)  The product of (9) above is greater than or equal to 6,500.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.05  Impact on Existing Programs.

 

          (a)  A proposed megavoltage radiation therapy program shall not have a detrimental impact on any existing megavoltage radiation therapy program in the state.

 

          (b)  Applicants shall demonstrate that their proposed megavoltage radiation therapy program will not cause the utilization level at any existing megavoltage radiation therapy program in the state to fall below an annual average of 6,500 procedures per machine by the end of the third year of its proposed program.

 

          (c)  Demonstration shall be made in the form of an analysis made by the applicant of the impact of the proposed program on any existing program in the state performed in the following manner:

 

(1)  Obtain from the department of health and human services, health services planning and review, the annual account of procedure and patient volumes by town per MeV machine as submitted by MeV providers pursuant to He-Hea 1602.10(b);

 

(2)  To determine the proposed percentage of market capture for the applicant, multiply the result of market share by town determined in He-Hea 1602.04(a)(4) times the number of patients by town as identified in the report from (1) above;

 

(3)  Sum the results of (2) above;

 

(4)  To determine the fractional loss per machine, divide the sum of (3) above by total patients by MeV provider as obtained in (1) above;

 

(5)  For each MeV provider, multiply the average number of treatments per machine from (1) above by 1.13; and

 

(6)  For each current MeV provider, multiply the quotient of (4) above by the product in (5) above and then subtract this result from the product of (5); and

 

          (d)  If the sum of (6) above is greater than or equal to 6,500 then the applicant shall have successfully demonstrated support for an additional MeV program that will not impact current utilization levels of any existing program in the state.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.06  Equipment.

 

          (a)  Megavoltage radiation equipment shall only be located at:

 

(1)  Licensed facilities; or

 

(2)  Facilities owned or operated, directly or indirectly, by a:

 

a.  Licensed facility; or

 

b.  Licensed physician.

 

          (b)  Megavoltage radiation equipment shall be registered or licensed in accordance with the rules for control of radiation, He-P 4000.

 

          (c)  Owners of megavoltage equipment shall provide a copy of the state radiation-producing machine registration certificate or radioactive material license issued by the New Hampshire radiological health program as proof of compliance.

 

          (d)  The document required by (c) above shall be submitted with the annual data report as required by He-Hea 1602.10.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.07  Non-Hospital Site.

 

          (a)  Any applicant who proposes a non-hospital site for support services to the new equipment shall submit, as part of the application, protocols for the transportation of patients for the provision of necessary support and emergency services.

 

          (b)  Demonstration shall be in the form of a written agreement for the acceptance and transfer of patients needing such emergency care, with:

 

(1)  The nearest acute care hospital; or

 

(2)  Any acute care hospital within 30 minutes travel time.

 

          (c)  The formal agreement submitted with the application shall be:

 

(1)  Signed by the applicant and the hospital; and

 

(2)  Dated within the past 12 months of submission with the application.

 

          (d)  The applicant shall demonstrate that it has entered a written agreement with an EMS service for its emergency transportation requirements.

 

          (e)  Demonstration of emergency transport shall be in the form of a copy of the written agreement for emergency transportation services.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06 (formerly He-Hea 1602.08), EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.08  Staffing and Support Services.

 

          (a)  The board shall not approve an application for the acquisition of megavoltage radiation therapy equipment unless the applicant includes as part of the application a staffing plan, including curriculum vitae, which details and documents the availability of or plans for obtaining the services of radiation therapy personnel.

 

          (b)  The staffing plan shall include the following personnel:

 

(1)  A radiation oncologist to serve as the director of the radiation therapy program who shall be:

 

a.  Licensed by the State of New Hampshire; and

 

b.  Certified by the American Board of Radiology in:

 

1.  Therapeutic radiology; or

 

2.  Radiation oncology;

 

(2)  A total of 2 full-time equivalent (FTE) radiation therapists per radiation therapy machine, one of whom shall demonstrate additional training or experience as a simulator therapist.

 

(3)  A dosimetrist;

 

(4)  A physicist certified by:

 

a.  The American Board of Radiology; or

 

b.  Another board recognized by the American Board of Radiology; and

 

(5)  An FTE registered nurse.

 

          (c)  The applicant shall include as part of the application a detailed description of the availability of required support services at the proposed site.

 

          (d)  The following support services shall be available to the proposed radiation therapy program:

 

(1)  Clinical oncology services, including chemotherapy and surgical treatment of tumors and follow-up capabilities;

 

(2)  Services of a tumor registry;

 

(3)  Services of a simulation capability and dose computation equipment;

 

(4)  Services of a pathology laboratory;

 

(5)  Services of a physics laboratory;

 

(6)  Computerized tomography and/or magnetic resonance imaging capability;

 

(7)  Block fabrication;

 

(8)  Services of an electronics shop for maintenance of electronic equipment;

 

(9)  Social work and counseling;

 

(10)  In-house brachytherapy or a referral arrangement for provision of the service;

 

(11)  Nutrition and dietary consultation; and

 

(12)  In-house capabilities encompassing the full range of radiation therapy modalities, including megavoltage equipment and superficial treatment equipment and systemic therapy or referral arrangements for the provision of these services.

 

          (e)  If the support services described in He-Hea 1602.08(c) are not available on-site, the applicant shall provide a description of the capital cost necessary to establish or upgrade these support services as part of the total capital cost of the proposed megavoltage radiation therapy service.

 

Source.  #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06 (formerly He-Hea 1602.09), EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.09  Other Criteria.  In addition to all other requirements in RSA 151-C:7 and He-Hea 303.02 through He-Hea 303.09, applicants shall meet the following criteria for consideration of a CON for construction, expansion, renovation or replacement of megavoltage radiation therapy equipment and services:

 

          (a)  Applicants shall demonstrate that any anticipated proposed cost per square foot shall be comparable in cost within a 10% margin to the 2014 edition of Marshall Valuation Service, section 15;

 

          (b)  Demonstration of project costs shall be made in the form of a report included with the application which provides:

 

(1)  A detail of the costs and space by department or area affected by the proposed project;

 

(2)  A comparison of these costs which shall be within 10% of the 2014 edition of Marshall Valuation Service, section 15, for the proposed class and type of construction; and

 

(3)  An identification of the square footage for each department or area before and after the project;

 

          (c)  Applicants shall include a report in the application which provides:

 

(1)  An analysis of the class and quality of construction pursuant to section one of the 2014 Marshall Valuation Service;

 

(2)  The allocation of costs within a multiple use building;

 

(3)  The allocations of site costs and land costs where facilities are proposed to have multiple uses;

 

(4)  The methodology used in calculating construction costs for renovations;

 

(5)  The methodology used in calculating construction costs involving leasehold improvements; and

 

(6)  The anticipated useful life of the building for depreciation purposes;

 

          (d)  The following construction costs shall be compared with the 2014 Marshall Valuation Service, section 15:

 

(1)  Total costs associated with:

 

a.  Labor;

 

b.  Materials; and

 

c.  Fixed equipment;

 

(2)  Building permits;

 

(3)  Architectural and engineering fees;

 

(4)  Site preparation for the building;

 

(5)  Utilities from structure to lot line;

 

(6)  Insurance costs during construction; and

 

(7)  Interest costs during construction;

 

          (e)  The applicant shall follow the outline of the calculator method set forth in section 10 of the 2014 Marshall Valuation Service to determine construction costs;

 

          (f)  The costs and factors to take into account pursuant to (e) above shall include:

 

(1)  The base cost found in the general hospital table in section 15, page 24 of the 2014 Marshall Valuation Service;

 

(2)  An adjustment to heating, ventilation and air-conditioning costs for extreme climate;

 

(3)  Sprinkler system costs;

 

(4)  Story height multipliers;

 

(5)  Perimeter multipliers; and

 

(6)  Cost multipliers from section 99 of the 2014 Marshall Valuation Service;

 

          (g)  Applicants shall describe anticipated operational cost savings that may occur as a result of the project due to:

 

(1)  Consolidation of services;

 

(2)  Improved heating and maintenance costs;

 

(3)  Environmental design of the constructed or renovated space;

 

(4)  Space for future expansion; or

 

(5)  Other factors not listed above.

 

          (h)  The expansion, renovation or replacement of the facility at which the megavoltage radiation therapy equipment and services are provided shall be financially feasible;

 

          (i)  In order to assess the current and long-range financial feasibility of the proposed project, applicants shall demonstrate that resources:

 

(1)  Are available to fund the proposed capital costs and operating costs;

 

(2)  Will be available to maintain operations in the event of interruptions to cash flow; and

 

(3)  Will be available to ensure the continued operation of the proposed project;

 

          (j)  Demonstration of financial feasibility shall be made by providing with the application:

 

(1)  Copies of the facility’s 3-year historical and 3-year projected financial statements;

 

(2)  A statement of the sources of funds to finance the proposed project;

 

(3)  Documentation from the applicant’s lender, underwriter or other anticipated source of capital, which includes:

 

a.  Financed amount;

 

b.  Rate of interest; and

 

c.  Term of debt;

 

          (k)  Applicants shall document the assumptions used to determine the overall financial feasibility of the proposed projects to expand, renovate or replace the megavoltage radiation therapy equipment and service;

 

          (l)  Documentation of assumptions shall be made in the form of a report including the following:

 

(1)  The source of the documents used to determine the population projections of the primary and secondary service areas, if different than the office of energy and planning, 107 Pleasant Street, Concord, NH;

 

(2)  The changes in market conditions which would result in a change in market share;

 

(3)  The causes of any anticipated changes in the overall length of stay in the hospital;

 

(4)  The assumptions used to prepare the projected financial statements; and

 

(5)  Other assumptions the applicant considers pertinent to the project’s feasibility.

 

          (m)  Applicants shall identify the source of any data or information provided pursuant paragraphs (c) through (l) above.

 

Source.  #7236, eff 4-26-00

 

New.  #8774, eff 12-16-06 (formerly He-Hea 1602.10), EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1602.10  Data Reporting.

 

          (a)  Owners of megavoltage radiation equipment shall submit an annual account of volumes per machine on February 1 of each year.

 

          (b)  The volume report shall include the following information for the previous 12 months of volume, January through December:

 

(1)  Name of hospital or facility where the megavoltage equipment is in service:

 

(2)  City or town where the hospital or facility is located;

 

(3)  Total number of megavoltage radiation therapy machines in service;

 

(4)  Total patients served within the past 12 consecutive months;

 

(5)  Patient origin by city or town; and

 

(6)  Total procedures performed within the past 12 consecutive months.

 

          (c)  The board shall make this data available in a report to any interested persons on or before April 1 of each year.

 

Source.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06 (formerly He-Hea 1602.12), EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

He-Hea 1602.11  REPEALED

 

Source.  #7236, eff 4-26-00; rpld by #8774, eff 12-16-06

 

PART He-Hea 1603  REQUEST FOR APPLICATIONS

 

          He-Hea 1603.01  Request for Applications (RFA).

 

          (a)  The board shall issue an RFA for megavoltage radiation therapy services on May 1st of each year provided that:

 

(1)  It has received a letter of intent that contains the following information:

 

a.  Name of the requestor that intends to file an application, including the names of all affiliates of such requestor;

 

b.  An outline of the proposed location of the new megavoltage radiation therapy service;

 

c.  An outline, by zip code, of the proposed service area to be served by the program;

 

d.  A detailed description of the specific type of megavoltage radiation therapy equipment to be purchased;

 

e.  An identification of any megavoltage radiation therapy providers in:

 

1.  The proposed service area; and

 

2.  Next closest service areas in all directions; and

 

(2)  Each existing provider identified in He-Hea 1603.01(a)(1)e. is performing an average of 7,000 treatments per machine during the most recent 12 months of operation, pursuant to the data collected in He-Hea 1602.10.

 

          (b)  Letters of intent shall be submitted to the board no later than April 1st of each year.

 

Source.  #4574, eff 2-6-89; ss by #4987, eff 11-21-90; ss by #5238, eff 9-27-91, EXPIRED: 9-27-97

 

New.  #7236, eff 4-26-00; ss by #7385, eff 10-25-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1603.02  Submission of Applications.  Applications shall be:

 

          (a)  Prepared using the board’s application form pursuant to He-Hea 304; and

 

          (b)  Submitted to the board within 90 days of the issuance of the RFA.

 

Source.  #7236, eff 4-26-00; ss by #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

          He-Hea 1603.03  Processing of Applications.  Applications shall be processed in accordance with the requirements of RSA 151-C:8.

 

Source.  #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

PART He-Hea 1604  GRANTING CERTIFICATES OF NEED

 

          He-Hea 1604.01  Approval of Applications.  The Board shall grant certificates of need in accordance with RSA 151-C:9, II.

 

Source.  #8774, eff 12-16-06, EXPIRED: 12-16-14

 

New.  #10800, INTERIM, eff 3-21-15, EXPIRES: 9-17-15; ss by #10838, eff 5-27-15

 

APPENDIX I – STATE STATUTES IMPLEMENTED

 

Rule

Specific State Statute the Rule Implements

 

 

He-Hea 1601

RSA 151-C:2, RSA 151-C:11, I

He-Hea 1602.01 – 1602.05

RSA 151-C:5, II(d), RSA 151-C:11, I

He-Hea 1602.06

RSA 151-C:5, II(d), RSA 151-C:11, I

He-Hea 1602.07

RSA 151-C:7, IV

He-Hea 1602.08

RSA 151-C:7, II

He-Hea 1602.09

RSA 151-C:7, I-V

He-Hea 1602.10

RSA 151-C:7, I and II

He-Hea 1603

RSA 151-C:8, RSA 151-C:11, I

He-Hea 1604

RSA 151-C:9, RSA 151-C:11, I

 

 

APPENDIX II – INCORPORATION BY REFERENCE INFORMATION

 

Rule

Title

Obtain at:

He-Hea 1602.09(a) MVS, 2014, section 15.

He-Hea1602.09(b)(2)

MVS, 2014, section 15.

He-Hea 1602.09(c)(1) MVS, 2013, section 1.

He-Hea 1602.09(d)

MVS, 2014, section 15.

He-Hea 1602.09(e) MVS, 2014, section 10.

He-Hea 1602.09(f)(1) MVS, 2014, section 15, page 24.

He-Hea 1602.09 (f)(6) MVS, 2014, section 99.

Marshall Valuation Service, 2014 edition

Marshall & Swift/Boeckh, LLC

350 S. Grand Avenue

34th Floor

Los Angeles, CA  90071

www.marshallswift.com

Telephone (800) 544-2678. 

 

Cost for the 2014 edition of the manual is $599.95.