Senate File 506 S-3092 Amend Senate File 506 as follows: 1 1. Page 2, by striking lines 18 through 28 and inserting: 2 < 14. “Institutional health facility” means any of the 3 following, without regard to whether the facilities referred 4 to are publicly or privately owned or are organized for profit 5 or not or whether the facilities are part of or sponsored by a 6 health maintenance organization: 7 a. A hospital. 8 b. A health care facility. 9 c. An organized outpatient health facility. 10 d. c. An outpatient surgical facility. 11 e. A community mental health facility. 12 f. A birth center. > 13 2. By striking page 2, line 35, through page 3, line 1, and 14 inserting: 15 < a. The construction, development , or other establishment of 16 a new institutional health facility regardless of ownership , in 17 excess of the following amounts, as applicable: 18 (1) Beginning January 1, 2023, three million five hundred 19 thousand dollars. 20 (2) Beginning January 1, 2028, four million dollars. 21 (3) Beginning January 1, 2033, four million five hundred 22 thousand dollars. 23 (4) Beginning January 1, 2038, five million dollars . > 24 3. Page 3, lines 3 and 4, by striking < expenditure, lease, 25 or donation by or on behalf of > and inserting < expenditure, 26 lease, or donation by or on behalf of expenditure or lease by > 27 4. Page 4, line 35, by striking < and 16, > and inserting < 5, 28 7, 16, and 20, > 29 5. Page 10, by striking lines 13 through 20 and inserting: 30 < 4. When a hearing is to be held pursuant to subsection 3, 31 paragraph “b” , the department shall give at least ten days’ 32 notice of the time and place of the hearing. At Any affected 33 person or that person’s designated representative may submit 34 written testimony in a manner prescribed by the department 35 -1- SF 506.1231 (1) 90 pf/rh 1/ 3 #1. #2. #3. #4. #5.

beginning on the day the notice of the hearing is given until 1 the day prior to the date fixed for the hearing, or at the 2 hearing , any affected person or that person’s designated 3 representative shall may have the opportunity to present 4 testimony. > 5 6. Page 11, by striking lines 9 through 25 and inserting: 6 < Sec. ___. Section 135.69, Code 2023, is amended to read as 7 follows: 8 135.69 Council Department to make final decision. 9 1. The department shall complete its formal review of 10 the application within ninety days after acceptance of the 11 application, except as otherwise provided by section 135.72, 12 subsection 4 . Upon completion of the formal review, the 13 council department shall approve or deny the application. The 14 council department shall issue written findings stating the 15 basis for its the department’s decision on the application, and 16 the department shall send copies of the council’s department’s 17 decision and the written findings supporting the decision to 18 the applicant and to any other person who so requests. 19 2. Failure by the council to issue a written decision 20 on an application for a certificate of need within the time 21 required by this section shall constitute denial of and final 22 administrative action on the application. > 23 7. Page 14, by striking lines 5 through 23. 24 8. Page 16, after line 5 by inserting: 25 < Sec. ___. 2023 Iowa Acts, Senate File 514, section 26 1443, subsection 1, if enacted, is amended by striking the 27 subsection. 28 < Sec. ___. 2023 Iowa Acts, Senate File 514, section 29 1443, subsection 5, if enacted, is amended by striking the 30 subsection. 31 Sec. ___. 2023 Iowa Acts, Senate File 514, sections 32 1584 through 1609, if enacted, are amended by striking the 33 sections. > 34 9. Page 16, line 10, by striking < and appeals > and inserting 35 -2- SF 506.1231 (1) 90 pf/rh 2/ 3 #6. #7. #8.

< , appeals, and licensing > 1 10. Page 16, by striking line 18 and inserting < expire at 2 the end of the license term and is not renewable. During the 3 term of a provisional license, a health care provider accepting 4 the transfer of a patient from a provisionally licensed birth 5 center shall not be subject to civil or criminal liability for 6 outcomes arising from actions of the provisionally licensed 7 birth center or any of the employees, agents, or contractors 8 of such birth center. > 9 11. Page 16, line 20, by striking < and appeals > and 10 inserting < , appeals, and licensing > 11 12. Page 16, line 33, by striking < and appeals > and 12 inserting < , appeals, and licensing > 13 13. Page 17, by striking lines 3 through 7 and inserting: 14 < Sec. ___. DEFINITIONS. For the purposes of this division 15 of this Act: 16 1. “Birth center” means a facility or institution, which 17 is not an ambulatory surgical center or a hospital or in a 18 hospital, in which births are planned to occur following a 19 normal, uncomplicated, low-risk pregnancy. 20 2. “Health care provider” means the same as defined in 21 section 147.136A. > 22 14. By renumbering, redesignating, and correcting internal 23 references as necessary. 24 ______________________________ JEFF EDLER -3- SF 506.1231 (1) 90 pf/rh 3/ 3 #10. #11. #12. #13. #14.