Missouri's Certificate of Need Program is administered by Missouri Health Facilities Review Committee, with administrative assistance from the Department of Health and Senior Services. Since 1979, the program has been tasked with restraining health care costs in the state through coordinated expenditures for the construction, purchase, expansion, or replacement of health care facilities, equipment, or services. Report includes Oversight's comments on the program, compliance with legal requirements, management practices, program performance and related areas. As part of the program evaluation, Oversight compared Missouri's program to that of our surrounding states, as well as Georgia and Ohio. Fourteen states have discontinued their CON programs, with the other states there is a big variance in how programs are administered and what services are included.