SSB 3139 (LSB 6564XC (2) 91)

SENATE FILE _____ 

BY  (PROPOSED COMMITTEE ON HEALTH AND HUMAN SERVICES BILL BY CHAIRPERSON WARME)

A BILL FOR

An Act relating to health-related matters, including health-related professions, certificates of need, and nutrition, and including applicability provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
CONTINUING EDUCATION REQUIREMENTS —— NUTRITION AND METABOLIC HEALTH

    Section 1.  Section 148.3, Code 2026, is amended by adding the following new subsection:
   NEW SUBSECTION.  5.  The board shall adopt rules pursuant to chapter 17A requiring a licensee practicing family medicine, internal medicine, pediatrics, psychiatry, endocrinology, gastroenterology, cardiology, oncology, rheumatology, neurology, nephrology, dermatology, pulmonology, surgery, immunology, hematology, obstetrics, or gynecology to complete a minimum of one hour of continuing education on nutrition and metabolic health every four years as a condition of license renewal.
    Sec. 2.  Section 148C.3, subsection 1, paragraph c, Code 2026, is amended to read as follows:
   c.  Hours of continuing medical education necessary to become or remain licensed.  The board shall adopt rules pursuant to chapter 17A requiring a licensee practicing family medicine, internal medicine, pediatrics, psychiatry, endocrinology, gastroenterology, cardiology, oncology, rheumatology, neurology, nephrology, dermatology, pulmonology, surgery, immunology, hematology, obstetrics, or gynecology to complete a minimum of one hour of continuing education on nutrition and metabolic health every four years as a condition of license renewal.
DIVISION II
CERTIFICATE OF NEED

    Sec. 3.  Section 135.61, subsection 16, paragraphs e, g, i, and k, Code 2026, are amended by striking the paragraphs.
    Sec. 4.  Section 135.61, subsection 16, paragraph m, subparagraphs (2) and (3), Code 2026, are amended by striking the subparagraphs.
    Sec. 5.  Section 135.62, subsection 2, paragraph a, Code 2026, is amended to read as follows:
   a.  Private offices and private clinics of an individual physician, dentist, or other practitioner or group of health care providers, except as provided by section 135.61, subsection 16, paragraphs “g”, “h”, and “m”, and section 135.61, subsections 2 and 18.
    Sec. 6.  Section 135.62, subsection 2, paragraph e, subparagraph (2), Code 2026, is amended to read as follows:
   (2)  Acquires major medical equipment as provided by section 135.61, subsection 16, paragraphs “i” and paragraph “j”.
    Sec. 7.  Section 135.62, subsection 2, paragraph g, subparagraph (1), unnumbered paragraph 1, Code 2026, is amended to read as follows:
   A reduction in bed capacity of an institutional health facility, notwithstanding any provision in this subchapter to the contrary, except where a provision expressly exempts such a reduction, if all of the following conditions exist:
    Sec. 8.  Section 135.62, subsection 2, paragraph k, subparagraph (1), unnumbered paragraph 1, Code 2026, is amended to read as follows:
   The redistribution of beds by a hospital within the acute care category of bed usage, notwithstanding any provision in this subchapter to the contrary, except where a provision expressly exempts such a redistribution of skilled nursing facility or swing beds by a hospital, if all of the following conditions exist:
    Sec. 9.  Section 135.62, subsection 2, paragraph p, Code 2026, is amended by striking the paragraph.
    Sec. 10.  Section 135.62, subsection 2, Code 2026, is amended by adding the following new paragraphs:
   NEW PARAGRAPH.  r.  An outpatient facility that provides behavioral health services, as defined by rule by the department, to individuals on an outpatient basis, including but not limited to substitution-based treatment centers for opiate addiction.
   NEW PARAGRAPH.  s.  Open heart surgical services.
   NEW PARAGRAPH.  t.  Organ transplantation services.
   NEW PARAGRAPH.  u.  Notwithstanding any provision of this subchapter to the contrary, any acquisition whether acquired by purchase, lease, or donation by or on behalf of a health care provider or a group of health care providers of any piece of replacement equipment with a value in excess of one million five hundred thousand dollars.
   NEW PARAGRAPH.  v.  Notwithstanding any provision of this subchapter to the contrary, any acquisition whether acquired by purchase, lease, or donation by or on behalf of an institutional health facility or a health maintenance organization of any piece of replacement equipment with a value in excess of one million five hundred thousand dollars.
   NEW PARAGRAPH.  w.  Any air transportation service for transportation of patients or medical personnel offered through an institutional health facility.
   NEW PARAGRAPH.  x.  Notwithstanding any provision of this subchapter to the contrary, bed capacity changes by an institutional health facility that constitute a permanent change or reduction in, or a redistribution, deletion, or conversion of, nursing facility beds, skilled nursing facility beds, or swing beds.
   NEW PARAGRAPH.  y.  Notwithstanding any provision of this subchapter to the contrary, bed capacity changes that constitute a permanent change or reduction in, or a redistribution, deletion, or conversion of, beds in intermediate care facilities for persons with mental illness, or intermediate care facilities for persons with an intellectual disability.
    Sec. 11.  Section 135.62, subsection 4, Code 2026, is amended to read as follows:
   4.  The department shall not process applications for an intermediate care facility for persons with an intellectual disability, or consider a new or changed institutional health service for an intermediate care facility for persons with an intellectual disability, unless both of the following conditions are met:
   a.  The new or changed beds shall not result in an increase in the total number of medical assistance certified intermediate care facility beds for persons with an intellectual disability in the state, exclusive of those beds at the state resource centers or other state institutions, beyond one thousand six hundred thirty-six beds.
   b.  A a letter of support for the application is provided by the county board of supervisors, or the board’s designee, in the county in which the beds facility is or would be located.
    Sec. 12.  Section 135.65, subsection 3, paragraph b, Code 2026, is amended to read as follows:
   b.  A period for the submission of written public hearing comments from affected persons on the application, to be held scheduled prior to completion of the evaluation required by paragraph “a”.
    Sec. 13.  Section 135.65, subsection 4, Code 2026, is amended by striking the subsection.
    Sec. 14.  Section 135.70, subsection 2, Code 2026, is amended to read as follows:
   2.  Upon expiration of a certificate of need, and prior to extension of the certificate of need, any affected person shall have the right to submit to the department information which may be relevant to the question of granting an extension. The department may call a public hearing for this purpose.
DIVISION III
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —— SUMMER ELECTRONIC BENEFITS TRANSFER FOR CHILDREN PROGRAM

    Sec. 15.  Section 234.1, Code 2026, is amended by adding the following new subsection:
   NEW SUBSECTION.  4A.  “Summer electronic benefits transfer for children program” or “summer EBT program” means the summer electronic benefits transfer for children program established in 42 U.S.C. §1762.
    Sec. 16.  NEW SECTION.  234.12B  Supplemental nutrition assistance program —— summer electronic benefits transfer for children program.
   1.  The department shall do all of the following:
   a.  Continuously maintain state participation in SNAP by administering the program in accordance with guidelines approved by the United States department of agriculture, food and nutrition service, that specify that eligible foods pursuant to 7 C.F.R. §271.2 are healthy foods as defined by the director or the director’s designee.
   b.  Ensure that the provision of SNAP benefits to recipients is uninterrupted.
   2.  The department may participate in the summer EBT program subject to federally approved eligible foods for the summer EBT program being consistent with eligible foods as described in subsection 1, paragraph “a”.
DIVISION IV
SCHOOL FOODS AND BEVERAGES

    Sec. 17.  Section 256E.7, subsection 2, Code 2026, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  0t.  Be subject to and comply with the requirements of section 283A.6 relating to the preparation of meals provided to students, and prohibited ingredients in meals provided to students, in the same manner as a school district, if the charter school provides a breakfast or lunch program through the national school lunch program or the school breakfast program administered by the food and nutrition service of the United States department of agriculture.
    Sec. 18.  Section 256F.4, subsection 2, Code 2026, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  v.  Be subject to and comply with the requirements of section 283A.6 relating to the preparation of meals provided to students, and prohibited ingredients in meals provided to students, in the same manner as a school district, if the charter school or innovation zone school provides a breakfast or lunch program.
    Sec. 19.  NEW SECTION.  283A.6  School district breakfast and lunch programs —— food and beverages provided to students —— prohibited ingredients.
   1.  a.  A school district shall not serve a meal to students as part of the school district’s breakfast or lunch program that contains any of the following ingredients:
   (1)  Blue dye 1.
   (2)  Blue dye 2.
   (3)  Green dye 3.
   (4)  Potassium bromate.
   (5)  Propylparaben.
   (6)  Red dye 40.
   (7)  Yellow dye 5.
   (8)  Yellow dye 6.
   b.  Paragraph “a” does not apply to food and beverages received as part of a direct delivery from the foods in schools program of the United States department of agriculture. 
   2.  An employee or contracted vendor of a school district shall not provide any food or beverages that contain an ingredient described in subsection 1 to a student enrolled in the school district during the school day.
   3.  A school district shall not permit the sale to students of any foods or beverages that contain an ingredient described in subsection 1 on the school campus, as school campus is defined in 7 C.F.R. §210.11 as of January 1, 2026, unless the sale takes place outside of the school day, as school day is defined in 7 C.F.R. §210.11 as of January 1, 2026.
    Sec. 20.  Section 283A.10, Code 2026, is amended to read as follows:
   283A.10  School breakfast or lunch in nonpublic schools.
   The authorities in charge of nonpublic schools may operate or provide for the operation of school breakfast or lunch programs in schools under their jurisdiction and may use funds appropriated to them by the general assembly, gifts, funds received from sale of school breakfasts or lunches under such programs, and any other funds available to the nonpublic school. However, school breakfast or lunch programs shall not be required in nonpublic schools. The department of education shall direct the disbursement of state funds to nonpublic schools for school breakfast or lunch programs in the same manner as state funds are disbursed to public schools. If a nonpublic school receives state funds for the operation of a school breakfast or lunch program, meals served under the program shall be nutritionally adequate meals, as defined in section 283A.1, and shall comply with the requirements of section 283A.6.
    Sec. 21.  APPLICABILITY.  This division of this Act applies to school years beginning on or after July 1, 2027.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to the regulation of health-related matters, including health-related professions, certificates of need, and nutrition. The bill is organized in divisions.
   DIVISION I —— CONTINUING EDUCATION REQUIREMENTS —— NUTRITION AND METABOLIC HEALTH. The bill requires the board of medicine and the board of physician assistants to adopt rules requiring certain licensees to receive continuing education credits regarding nutritional and metabolic health as a condition of license renewal.
   DIVISION II —— CERTIFICATE OF NEED. The bill changes the definition of “new institutional health service” or “changed institutional health service”. The bill alters the list of items that are excluded from the provisions of Code chapter 135 (department of health and human services —— public health), subchapter VI (health facilities). The bill strikes a provision restricting the department of health and human services (HHS) from processing applications for an intermediate care facility for persons with an intellectual disability, or considering a new or changed institutional health service for an intermediate care facility for persons with an intellectual disability, unless the new or changed beds shall not result in an increase in the total number of medical assistance certified intermediate care facility beds for persons with an intellectual disability in the state, exclusive of those beds at the state resource centers or other state institutions, beyond 1,636 beds.
   The bill replaces a requirement that HHS hold a public hearing on an application for a certificate of need with a requirement that the department provide a period for the submission of written comments from affected persons. The bill strikes an authorization for the department to call a public hearing on the question of whether to grant an extension for an expiring certificate of need.
   DIVISION III —— SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —— SUMMER ELECTRONIC BENEFITS TRANSFER FOR CHILDREN PROGRAM. The bill requires HHS to continuously maintain state participation in the federal supplemental nutrition assistance program (SNAP) by administering the program in accordance with guidelines approved by the United States department of agriculture, food and nutrition service, to define “eligible foods” as “healthy foods”, as that term is defined by the department, and to seek any federal approval necessary to ensure that provision of benefits is continuous. The bill requires HHS to ensure that the provision of SNAP benefits to recipients is uninterrupted.
   The bill also allows HHS to participate in the summer electronic benefits transfer for children program, subject to federal approval of guidelines for eligible foods under the program that are similar to the guidelines for eligible foods under SNAP.
   DIVISION IV —— SCHOOL FOODS AND BEVERAGES. The bill prohibits school districts, certain charter schools, and innovation zone schools from serving meals to students as part of the school’s breakfast or lunch program that contain blue dye 1, blue dye 2, green dye 3, potassium bromate, propylparaben, red dye 40, yellow dye 5, or yellow dye 6, unless the foods or beverages in the meal were received as part of a direct delivery from the foods in schools program of the United States department of agriculture. The bill also prohibits schools from permitting the sale to students of any foods or beverages that contain such ingredients on school campus unless the sale takes place after the end of the school day. The bill requires nonpublic schools that use moneys appropriated by the general assembly to provide breakfast or lunch to students to ensure that the meals comply with the same prohibition on ingredients as school districts.
   This division of the bill applies to school years beginning on or after July 1, 2027.