Senate File 139 SENATE FILE BY SCHUERER Passed Senate, Date Passed House, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to elimination of the certificate of need 2 provisions for certain new health services. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1635SS 80 5 pf/pj/5 PAG LIN 1 1 DIVISION VI 1 2 REPORTING, ANALYSES, AND STUDIES 1 3 HEALTH CARE FACILITIES AND HOSPITALS 1 4 Section 1. NEW SECTION. 135.73A DEFINITIONS. 1 5 For the purposes of this division, unless the context 1 6 otherwise requires: 1 7 1. "Department" means the Iowa department of public 1 8 health. 1 9 2. "Director" means the director of public health, or the 1 10 director's designee. 1 11 3. "Financial reporting" means reporting by which 1 12 hospitals and health care facilities shall respectively record 1 13 their revenues, expenses, other income, other outlays, assets 1 14 and liabilities, and units of services. 1 15 4. "Health care facility" means health care facility as 1 16 defined in section 135C.1. 1 17 5. "Hospital" means hospital as defined in section 135B.1. 1 18 Sec. 2. Section 135C.2, subsection 5, unnumbered paragraph 1 19 1, Code 2003, is amended to read as follows: 1 20 The department shall establish a special classification 1 21 within the residential care facility category in order to 1 22 foster the development of residential care facilities which 1 23 serve persons with mental retardation, chronic mental illness, 1 24 a developmental disability, or brain injury, as described 1 25 under section 225C.26, and which contain five or fewer 1 26 residents.A facility within the special classification 1 27 established pursuant to this subsection is exempt from the 1 28 requirements of section 135.63.The department shall adopt 1 29 rules which are consistent with rules previously developed for 1 30 the waiver demonstration project pursuant to 1986 Iowa Acts, 1 31 chapter 1246, section 206, and which include all of the 1 32 following provisions: 1 33 Sec. 3. Section 135H.6, Code 2003, is amended to read as 1 34 follows: 1 35 135H.6 INSPECTION == CONDITIONS FOR ISSUANCE. 2 1 The department shall issue a license to an applicant under 2 2 this chapter if all the following conditions exist: 2 3 1. The department has ascertained that the applicant's 2 4 medical facilities and staff are adequate to provide the care 2 5 and services required of a psychiatric institution. 2 6 2. The proposed psychiatric institution is accredited by 2 7 the joint commission on the accreditation of health care 2 8 organizations, the commission on accreditation of 2 9 rehabilitation facilities, the council on accreditation of 2 10 services for families and children, or by any other recognized 2 11 accrediting organization with comparable standards acceptable 2 12 under federal regulation. 2 13 3. The applicant complies with applicable state rules and 2 14 standards for a psychiatric institution adopted by the 2 15 department in accordance with federal requirements under 42 2 16 C.F.R. } 441.150==441.156. 2 174. The applicant has been awarded a certificate of need 2 18 pursuant to chapter 135, unless exempt as provided in this 2 19 section.2 205.4. The department of human services has submitted 2 21 written approval of the application based on the department of 2 22 human services' determination of need. The department of 2 23 human services shall identify the location and number of 2 24 children in the state who require the services of a 2 25 psychiatric medical institution for children. Approval of an 2 26 application shall be based upon the location of the proposed 2 27 psychiatric institution relative to the need for services 2 28 identified by the department of human services and an analysis 2 29 of the applicant's ability to provide services and support 2 30 consistent with requirements under chapter 232, particularly 2 31 regarding community=based treatment. If the proposed 2 32 psychiatric institution is not freestanding from a facility 2 33 licensed under chapter 135B or 135C, approval under this 2 34 subsection shall not be given unless the department of human 2 35 services certifies that the proposed psychiatric institution 3 1 is capable of providing a resident with a living environment 3 2 similar to the living environment provided by a licensee which 3 3 is freestanding from a facility licensed under chapter 135B or 3 4 135C. 3 56.5. The department of human services shall not give 3 6 approval to an application which would cause the total number 3 7 of beds licensed under this chapter for services reimbursed by 3 8 the medical assistance program under chapter 249A to exceed 3 9 four hundred thirty beds. 3 107.6. In addition to the beds authorized under subsection 3 1165, the department of human services may establish not more 3 12 than thirty beds licensed under this chapter at the state 3 13 mental health institute at Independence.The beds shall be 3 14 exempt from the certificate of need requirement under 3 15 subsection 4.3 168.7. The department of human services may give approval 3 17 to conversion of beds approved under subsection65, to beds 3 18 which are specialized to provide substance abuse treatment. 3 19 However, the total number of beds approved under subsection63 20 5 and this subsection shall not exceed four hundred thirty. 3 21Conversion of beds under this subsection shall not require a 3 22 revision of the certificate of need issued for the psychiatric 3 23 institution making the conversion.3 249.8. The proposed psychiatric institution is under the 3 25 direction of an agency which has operated a facility licensed 3 26 under section 237.3, subsection 2, paragraph "a", as a 3 27 comprehensive residential facility for children for three 3 28 years or of an agency which has operated a facility for three 3 29 years providing psychiatric services exclusively to children 3 30 or adolescents and the facility meets or exceeds requirements 3 31 for licensure under section 237.3, subsection 2, paragraph 3 32 "a", as a comprehensive residential facility for children. 3 3310.9. A psychiatric institution licensed prior to July 1, 3 34 1999, may exceed the number of beds authorized under 3 35 subsection65 if the excess beds are used to provide services 4 1 funded from a source other than the medical assistance program 4 2 under chapter 249A.Notwithstanding subsections 4, 5, and 6, 4 3 the provision of services using those excess beds does not 4 4 require a certificate of need or a review by the department of 4 5 human services.4 6 Sec. 4. Section 231B.2, subsection 1, Code 2003, is 4 7 amended to read as follows: 4 8 1. The department shall establish by rule in accordance 4 9 with chapter 17A a special classification for elder group 4 10 homes.An elder group home established pursuant to this 4 11 subsection is exempt from the requirements of section 135.63.4 12 Sec. 5. Section 231C.3, subsection 1, Code 2003, is 4 13 amended to read as follows: 4 14 1. The department shall establish, by rule in accordance 4 15 with chapter 17A, a program for certification and monitoring 4 16 of assisted living programs. An assisted living program which 4 17 is voluntarily accredited is not required to also be certified 4 18 by the department and the department shall accept voluntary 4 19 accreditation in lieu of certification by the department.An 4 20 assisted living program certified or voluntarily accredited 4 21 under this section is exempt from the requirements of section 4 22 135.63 relating to certificate of need requirements.4 23 Sec. 6. Section 708.3A, subsection 5, Code 2003, is 4 24 amended to read as follows: 4 25 5. As used in this section, "health care provider" means 4 26 an emergency medical care provider as defined in chapter 147A 4 27 or a person licensed or registered under chapter 148, 148C, 4 28 148D, 150, 150A, or 152 who is providing or who is attempting 4 29 to provide emergency medical services, as defined in section 4 30 147A.1, or who is providing or who is attempting to provide 4 31 health servicesas defined in section 135.61in a hospital. 4 32 For the purposes of this section, "health services" means 4 33 clinically related diagnostic, curative, or rehabilitative 4 34 services, and includes alcoholism, drug abuse, and mental 4 35 health services. A person who commits an assault under this 5 1 section against a health care provider in a hospital, or at 5 2 the scene or during out=of=hospital patient transportation in 5 3 an ambulance, is presumed to know that the person against whom 5 4 the assault is committed is a health care provider. 5 5 Sec. 7. Sections 135.61 through 135.73, Code 2003, are 5 6 repealed. 5 7 EXPLANATION 5 8 This bill eliminates the certificate of need program for 5 9 health facilities, under the Iowa department of public health. 5 10 The bill also makes conforming changes in the Code due to the 5 11 elimination of the program. 5 12 LSB 1635SS 80 5 13 pf/pj/5