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PAG LIN 1 1 Section 1. Section 135.61, subsection 14, Code 1997, is 1 2 amended to read as follows: 1 3 14. "Institutional health facility" means any of the 1 4 following, without regard to whether the facilities referred 1 5 to are publicly or privately owned or are organized for profit 1 6 or not or whether the facilities are part of or sponsored by a 1 7 health maintenance organization: 1 8 a. A hospital. 1 9 b. A health care facility. 1 10c. A kidney disease treatment center, including any1 11freestanding hemodialysis unit but not including any home1 12hemodialysis unit.1 13dc. An organized outpatient health facility. 1 14ed. An outpatient surgical facility. 1 15fe. A community mental health facility. 1 16gf. A birth center. 1 17 Sec. 2. Section 135.61, subsection 18, paragraphs c, e, 1 18 and g through m, Code 1997, are amended to read as follows: 1 19 c. Any capital expenditure, lease, or donation by or on 1 20 behalf of an institutional health facility in excess ofeight1 21 one million five hundred thousand dollars within a twelve- 1 22 month period. 1 23 e. Any expenditure in excess ofthreefive hundred 1 24 thousand dollars by or on behalf of an institutional health 1 25 facility for health services which are or will be offered in 1 26 or through an institutional health facility at a specific time 1 27 but which were not offered on a regular basis in or through 1 28 that institutional health facility within the twelve-month 1 29 period prior to that time. 1 30 g. Any acquisition by or on behalf of a health care 1 31 provider or a group of health care providers of any piece of 1 32 replacement equipment with a value in excess offourone 1 33 million five hundred thousand dollars, whether acquired by 1 34 purchase, lease, or donation. 1 35 h. Any acquisition by or on behalf of a health care 2 1 provider or group of health care providers of any piece of 2 2 equipment with a value in excess ofthreeone million five 2 3 hundred thousand dollars, whether acquired by purchase, lease, 2 4 or donation, which results in the offering or development of a 2 5 health service not previously provided. A mobile service 2 6 provided on a contract basis is not considered to have been 2 7 previously provided by a health care provider or group of 2 8 health care providers. 2 9 i. Any acquisition by or on behalf of an institutional 2 10 health facility or a health maintenance organization of any 2 11 piece of replacement equipment with a value in excess offour2 12 one million five hundred thousand dollars, whether acquired by 2 13 purchase, lease, or donation. 2 14 j. Any acquisition by or on behalf of an institutional 2 15 health facility or health maintenance organization of any 2 16 piece of equipment with a value in excess ofthreeone million 2 17 five hundred thousand dollars, whether acquired by purchase, 2 18 lease, or donation, which results in the offering or 2 19 development of a health service not previously provided. A 2 20 mobile service provided on a contract basis is not considered 2 21 to have been previously provided by an institutional health 2 22 facility. 2 23 k. Any air transportationsystemservice for 2 24 transportation of patients or medical personnel offered 2 25 through an institutional health facility at a specific time 2 26 but which was not offered on a regular basis in or through 2 27 that institutional health facility within the twelve-month 2 28 period prior to the specific time. 2 29 l. Any mobile health service with a value in excess of 2 30threeone million five hundred thousand dollars. 2 31 m. Any of the following: 2 32 (1) Cardiac catheterization service. 2 33 (2) Open heart surgical service. 2 34 (3) Organ transplantation service. 2 35 (4) Radiation therapy. 3 1 Sec. 3. Section 135.62, subsection 2, paragraph c, Code 3 2 1997, is amended to read as follows: 3 3 c. MEETINGS. The council shall hold an organizational 3 4 meeting in July of each odd-numbered year, or as soon 3 5 thereafter as the new appointee or appointees are confirmed 3 6 and have qualified. Other meetings shall be heldat least3 7once each month, and may be held more frequently ifas 3 8 necessary to enable the council to expeditiously discharge its 3 9 duties. Meeting dates shall be set upon adjournment or by 3 10 call of the chairperson upon five days' notice to the other 3 11 members. Each member of the council shall receive a per diem 3 12 as specified in section 7E.6 and reimbursement for actual 3 13 expenses while engaged in official duties. 3 14 Sec. 4. Section 135.63, subsection 1, Code 1997, is 3 15 amended to read as follows: 3 16 1. A new institutional health service or changed 3 17 institutional health service shall not be offered or developed 3 18 in this state without prior application to the department for 3 19 and receipt of a certificate of need, pursuant to this 3 20 division. The application shall be made upon forms furnished 3 21 or prescribed by the department and shall contain such 3 22 information as the department may require under this division. 3 23 The application shall be accompanied by a fee equivalent to 3 24 three-tenths of one percent of the anticipated cost of the 3 25 project with a minimum fee of six hundred dollars and a 3 26 maximum fee of twenty-one thousand dollars. The fee shall be 3 27 remitted by the department to the treasurer of state, who 3 28 shall place it in the general fund of the state. If an 3 29 application is voluntarily withdrawn within thirty calendar 3 30 days after submission, seventy-five percent of the application 3 31 fee shall be refunded; if the application is voluntarily 3 32 withdrawn more than thirty but within sixty days after 3 33 submission, fifty percent of the application fee shall be 3 34 refunded; if the application is withdrawn voluntarily more 3 35 than sixty days after submission, twenty-five percent of the 4 1 application fee shall be refunded. Notwithstanding the 4 2 required payment of an application fee under this subsection, 4 3 an applicant for a new institutional health service or a 4 4 changed institutional health service offered or developed by 4 5 an intermediate care facility for persons with mental 4 6 retardation or an intermediate care facility for persons with 4 7 mental illness as defined pursuant to section 135C.1 is exempt 4 8 from payment of the application fee. 4 9 Sec. 5. Section 135.63, subsection 2, Code 1997, is 4 10 amended by adding the following new paragraphs: 4 11 NEW PARAGRAPH. j. The construction, modification, or 4 12 replacement of nonpatient care services, including parking 4 13 facilities, heating, ventilation and air conditioning systems, 4 14 computers, telephone systems, medical office buildings, and 4 15 other projects of a similar nature, notwithstanding any 4 16 provision in this division to the contrary. 4 17 NEW PARAGRAPH. k. The redistribution of beds by a 4 18 hospital within the acute care category of bed usage, 4 19 notwithstanding any provision in this division to the 4 20 contrary, if all of the following conditions exist: 4 21 (1) The hospital reports to the department the number and 4 22 type of beds to be redistributed on a form prescribed by the 4 23 department at least thirty days before the redistribution. 4 24 (2) The hospital reports the new distribution of beds on 4 25 its next annual report to the department. 4 26 If these conditions are not met, the redistribution of beds 4 27 by the hospital is subject to review as a new institutional 4 28 health service or changed institutional health service 4 29 pursuant to section 135.61, subsection 18, paragraph "d", and 4 30 is subject to sanctions under section 135.73. 4 31 NEW PARAGRAPH. l. An intermediate care facility for 4 32 persons with mental retardation, as defined in section 135C.1, 4 33 notwithstanding any provision in this division to the 4 34 contrary. 4 35 NEW PARAGRAPH. m. A psychiatric medical institution for 5 1 children, as defined in section 135H.1, notwithstanding any 5 2 provision in this division to the contrary. 5 3 NEW PARAGRAPH. n. The replacement or modernization of any 5 4 institutional health facility if the replacement or 5 5 modernization does not add new health services or additional 5 6 bed capacity for existing health services, notwithstanding any 5 7 provision in this division to the contrary. 5 8 NEW PARAGRAPH. o. Hemodialysis services provided by a 5 9 hospital or freestanding facility, notwithstanding any 5 10 provision in this division to the contrary. 5 11 NEW PARAGRAPH. p. Hospice services provided by a 5 12 hospital, notwithstanding any provision in this division to 5 13 the contrary. 5 14 Sec. 6. Section 135.65, subsection 1, Code 1997, is 5 15 amended to read as follows: 5 16 1. Before applying for a certificate of need, the sponsor 5 17 of a proposed new institutional health service or changed 5 18 institutional health service shall submit to the department a 5 19 letter of intent to offer or develop a service requiring a 5 20 certificate of need. The letter shall be submitted as soon as 5 21 possible after initiation of the applicant's planning process, 5 22 and in any case not less thansixtythirty days before 5 23 applying for a certificate of need and before substantial 5 24 expenditures to offer or develop the service are made. The 5 25 letter shall include a brief description of the proposed new 5 26 or changed service, its location, and its estimated cost. 5 27 Sec. 7. Section 135.71, unnumbered paragraph 1, Code 1997, 5 28 is amended to read as follows: 5 29 A certificate of need shall be valid for a maximum of one 5 30 year from the date of issuance. Upon the expiration of the 5 31 certificate, or at any earlier time while the certificate is 5 32 valid the holder thereof shall provide the department such 5 33 information on the development of the project covered by the 5 34 certificate as the department may request. The council shall 5 35 determine at the end of the certification period whether 6 1 sufficient progress is being made on the development of the 6 2 projectand whether there has been compliance with any6 3conditions on which issuance of the certificate was premised. 6 4 The certificate of need may be extended by the council for 6 5 additional periods of time as are reasonably necessary to 6 6 expeditiously complete the project, but may be revoked by the 6 7 council at the end of the first or any subsequent 6 8 certification period for insufficient progress in developing 6 9 the projector noncompliance with any conditions on which6 10issuance of the certificate was premised. 6 11 Sec. 8. Section 135H.6, subsection 4, Code 1997, is 6 12 amended by striking the subsection. 6 13 Sec. 9. REVIEW OF CERTIFICATE OF NEED PROGRAM. The Iowa 6 14 department of public health shall complete a comprehensive 6 15 review of the certificate of need program and shall submit a 6 16 written report of the findings and recommendations as to the 6 17 continued relevance of the program to the general assembly by 6 18 January 15, 2000. 6 19 EXPLANATION 6 20 This bill makes changes to the certificate of need (CON) 6 21 program. Kidney disease treatment centers and hemodialysis 6 22 units are eliminated from the definition of an institutional 6 23 health facility with the intended result being to not review 6 24 these services under the program. The capital expenditure 6 25 threshold for review of a number of services and types of 6 26 equipment are increased and certain conditions are placed on 6 27 review of other services and expenditures. The bill exempts 6 28 certain services and equipment from CON including certain 6 29 nonpatient care services such as parking facilities, 6 30 redistribution of acute care beds under certain conditions, 6 31 intermediate care facilities for persons with mental 6 32 retardation, psychiatric medical institutions for children, 6 33 replacement or modernization of an institutional health 6 34 facility under certain conditions, hemodialysis services 6 35 provided by a hospital or freestanding facility, and hospice 7 1 services provided by a hospital. The bill establishes a 7 2 minimum application fee of $600 and a maximum fee of $21,000. 7 3 The bill also shortens the period between the time a letter of 7 4 intent to offer or develop a service requiring a certificate 7 5 of need is submitted and initiation of the application process 7 6 is begun from 60 to 30 days. The bill provides that the state 7 7 health facilities council is to meet as necessary rather than 7 8 at least once monthly. The bill also deletes a reference to 7 9 CON review of psychiatric medical institutions for children 7 10 and directs the department to conduct a review of the CON 7 11 program and submit a report of findings and recommendations as 7 12 to the continued relevance of the program to the general 7 13 assembly by January 15, 2000. 7 14 LSB 2205SC 77 7 15 pf/sc/14.1
Text: SSB00126 Text: SSB00128 Text: SSB00100 - SSB00199 Text: SSB Index Bills and Amendments: General Index Bill History: General Index
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