Senate
File
506
-
Reprinted
SENATE
FILE
506
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
SSB
1117)
(As
Amended
and
Passed
by
the
Senate
March
22,
2023
)
A
BILL
FOR
An
Act
relating
to
health
facilities
and
health
services
1
including
licensing
and
the
certificate
of
need
process,
and
2
including
effective
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
SF
506
(7)
90
pf/rh/mb
S.F.
506
DIVISION
I
1
CERTIFICATE
OF
NEED
——
HEALTH
FACILITIES
COUNCIL
2
Section
1.
Section
68B.35,
subsection
2,
paragraph
e,
Code
3
2023,
is
amended
to
read
as
follows:
4
e.
Members
of
the
state
banking
council,
the
Iowa
ethics
5
and
campaign
disclosure
board,
the
credit
union
review
board,
6
the
economic
development
authority,
the
employment
appeal
7
board,
the
environmental
protection
commission,
the
health
8
facilities
council,
the
Iowa
finance
authority,
the
Iowa
public
9
employees’
retirement
system
investment
board,
the
board
of
10
the
Iowa
lottery
authority,
the
natural
resource
commission,
11
the
board
of
parole,
the
petroleum
underground
storage
tank
12
fund
board,
the
public
employment
relations
board,
the
state
13
racing
and
gaming
commission,
the
state
board
of
regents,
the
14
transportation
commission,
the
office
of
consumer
advocate,
the
15
utilities
board,
the
Iowa
telecommunications
and
technology
16
commission,
and
any
full-time
members
of
other
boards
and
17
commissions
as
defined
under
section
7E.4
who
receive
an
annual
18
salary
for
their
service
on
the
board
or
commission.
The
Iowa
19
ethics
and
campaign
disclosure
board
shall
conduct
an
annual
20
review
to
determine
if
members
of
any
other
board,
commission,
21
or
authority
should
file
a
statement
and
shall
require
the
22
filing
of
a
statement
pursuant
to
rules
adopted
pursuant
to
23
chapter
17A
.
24
Sec.
2.
Section
97B.1A,
subsection
8,
paragraph
a,
25
subparagraph
(8),
Code
2023,
is
amended
to
read
as
follows:
26
(8)
Members
of
the
state
transportation
commission
,
and
the
27
board
of
parole
,
and
the
state
health
facilities
council
.
28
Sec.
3.
Section
135.61,
subsections
1,
14,
15,
and
18,
Code
29
2023,
are
amended
to
read
as
follows:
30
1.
“Affected
persons”
means,
with
respect
to
an
application
31
for
a
certificate
of
need:
32
a.
The
person
submitting
the
application.
33
b.
Consumers
who
would
be
served
by
the
new
institutional
34
health
service
proposed
in
the
application.
35
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506
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506
c.
Each
institutional
health
facility
or
health
maintenance
1
organization
which
is
located
in
the
geographic
area
which
2
would
appropriately
be
served
by
the
new
institutional
3
health
service
proposed
in
the
application.
The
appropriate
4
geographic
service
area
of
each
institutional
health
facility
5
or
health
maintenance
organization
shall
be
determined
on
a
6
uniform
basis
in
accordance
with
criteria
established
in
rules
7
adopted
by
the
department.
8
d.
Each
institutional
health
facility
or
health
maintenance
9
organization
which,
prior
to
receipt
of
the
application
by
10
the
department,
has
formally
indicated
to
the
department
11
pursuant
to
this
subchapter
an
intent
to
furnish
in
the
future
12
institutional
health
services
similar
to
the
new
institutional
13
health
service
proposed
in
the
application.
14
e.
Any
other
person
designated
as
an
affected
person
by
15
rules
of
the
department.
16
f.
Any
payer
or
third-party
payer
for
health
services.
17
14.
“Institutional
health
facility”
means
any
of
the
18
following,
without
regard
to
whether
the
facilities
referred
19
to
are
publicly
or
privately
owned
or
are
organized
for
profit
20
or
not
or
whether
the
facilities
are
part
of
or
sponsored
by
a
21
health
maintenance
organization:
22
a.
A
hospital.
23
b.
A
health
care
facility.
24
c.
An
organized
outpatient
health
facility.
25
d.
c.
An
outpatient
surgical
facility.
26
e.
A
community
mental
health
facility.
27
f.
A
birth
center.
28
15.
“Institutional
health
service”
means
any
health
service
29
furnished
in
or
through
institutional
health
facilities
or
30
health
maintenance
organizations
,
including
mobile
health
31
services
.
32
18.
“New
institutional
health
service”
or
“changed
33
institutional
health
service”
means
any
of
the
following:
34
a.
The
construction,
development
,
or
other
establishment
of
35
-2-
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506
(7)
90
pf/rh/mb
2/
17
S.F.
506
a
new
institutional
health
facility
regardless
of
ownership
,
in
1
excess
of
the
following
amounts,
as
applicable:
2
(1)
Beginning
January
1,
2023,
three
million
five
hundred
3
thousand
dollars.
4
(2)
Beginning
January
1,
2028,
four
million
dollars.
5
(3)
Beginning
January
1,
2033,
four
million
five
hundred
6
thousand
dollars.
7
(4)
Beginning
January
1,
2038,
five
million
dollars
.
8
b.
Relocation
of
an
institutional
health
facility.
9
c.
Any
capital
expenditure,
lease,
or
donation
by
or
on
10
behalf
of
expenditure
or
lease
by
an
institutional
health
11
facility
in
excess
of
one
million
five
hundred
thousand
dollars
12
the
following
amounts,
as
applicable,
within
a
twelve-month
13
period
.
:
14
(1)
Beginning
January
1,
2023,
three
million
five
hundred
15
thousand
dollars.
16
(2)
Beginning
January
1,
2028,
four
million
dollars.
17
(3)
Beginning
January
1,
2033,
four
million
five
hundred
18
thousand
dollars.
19
(4)
Beginning
January
1,
2038,
five
million
dollars.
20
d.
A
permanent
change
in
the
bed
capacity,
as
determined
21
by
the
department,
of
an
institutional
health
facility.
For
22
purposes
of
this
paragraph,
a
change
is
permanent
if
it
is
23
intended
to
be
effective
for
one
year
or
more.
24
e.
Any
expenditure
in
excess
of
five
hundred
thousand
25
dollars
by
or
on
behalf
of
an
institutional
health
facility
for
26
health
services
which
are
or
will
be
offered
in
or
through
an
27
institutional
health
facility
at
a
specific
time
but
which
were
28
not
offered
on
a
regular
basis
in
or
through
that
institutional
29
health
facility
within
the
twelve-month
period
prior
to
that
30
time.
31
f.
The
deletion
of
one
or
more
health
services,
previously
32
offered
on
a
regular
basis
by
an
institutional
health
facility
33
or
health
maintenance
organization
or
the
relocation
of
one
or
34
more
health
services
from
one
physical
facility
to
another.
35
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g.
Any
acquisition
by
or
on
behalf
of
a
health
care
provider
1
or
a
group
of
health
care
providers
of
any
piece
of
replacement
2
equipment
with
a
value
in
excess
of
one
million
five
hundred
3
thousand
dollars,
whether
acquired
by
purchase,
lease,
or
4
donation.
5
h.
Any
acquisition
by
or
on
behalf
of
a
health
care
provider
6
or
group
of
health
care
providers
of
any
piece
of
equipment
7
with
a
value
in
excess
of
one
million
five
hundred
thousand
8
dollars,
whether
acquired
by
purchase,
lease,
or
donation,
9
which
results
in
the
offering
or
development
of
a
health
10
service
not
previously
provided.
A
mobile
service
provided
11
on
a
contract
basis
is
not
considered
to
have
been
previously
12
provided
by
a
health
care
provider
or
group
of
health
care
13
providers.
14
i.
Any
acquisition
by
or
on
behalf
of
an
institutional
15
health
facility
or
a
health
maintenance
organization
of
any
16
piece
of
replacement
equipment
with
a
value
in
excess
of
one
17
million
five
hundred
thousand
dollars,
whether
acquired
by
18
purchase,
lease,
or
donation.
19
j.
Any
acquisition
by
or
on
behalf
of
an
institutional
20
health
facility
or
health
maintenance
organization
of
any
21
piece
of
equipment
with
a
value
in
excess
of
one
million
five
22
hundred
thousand
dollars,
whether
acquired
by
purchase,
lease,
23
or
donation,
which
results
in
the
offering
or
development
of
24
a
health
service
not
previously
provided.
A
mobile
service
25
provided
on
a
contract
basis
is
not
considered
to
have
been
26
previously
provided
by
an
institutional
health
facility.
27
k.
Any
air
transportation
service
for
transportation
of
28
patients
or
medical
personnel
offered
through
an
institutional
29
health
facility
at
a
specific
time
but
which
was
not
offered
30
on
a
regular
basis
in
or
through
that
institutional
health
31
facility
within
the
twelve-month
period
prior
to
the
specific
32
time.
33
l.
Any
mobile
health
service
with
a
value
in
excess
of
one
34
million
five
hundred
thousand
dollars.
35
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506
m.
Any
of
the
following:
1
(1)
Cardiac
catheterization
service.
2
(2)
Open
heart
surgical
service.
3
(3)
Organ
transplantation
service.
4
(4)
Radiation
therapy
service
applying
ionizing
radiation
5
for
the
treatment
of
malignant
disease
using
megavoltage
6
external
beam
equipment.
7
Sec.
4.
Section
135.61,
subsections
2,
4,
5,
7,
16,
and
20,
8
Code
2023,
are
amended
by
striking
the
subsections.
9
Sec.
5.
Section
135.62,
Code
2023,
is
amended
to
read
as
10
follows:
11
135.62
Department
to
administer
subchapter
——
health
12
facilities
council
established
——
appointments
——
powers
and
13
duties.
14
1.
This
subchapter
shall
be
administered
by
the
department.
15
The
director
shall
employ
or
cause
to
be
employed
the
necessary
16
persons
to
discharge
the
duties
imposed
on
the
department
by
17
this
subchapter
.
18
2.
There
is
established
a
state
health
facilities
council
19
consisting
of
five
persons
appointed
by
the
governor.
The
20
council
shall
be
within
the
department
for
administrative
and
21
budgetary
purposes.
22
a.
Qualifications.
The
members
of
the
council
shall
be
23
chosen
so
that
the
council
as
a
whole
is
broadly
representative
24
of
various
geographical
areas
of
the
state
and
no
more
than
25
three
of
its
members
are
affiliated
with
the
same
political
26
party.
Each
council
member
shall
be
a
person
who
has
27
demonstrated
by
prior
activities
an
informed
concern
for
the
28
planning
and
delivery
of
health
services.
A
member
of
the
29
council
and
any
spouse
of
a
member
shall
not,
during
the
30
time
that
member
is
serving
on
the
council,
do
either
of
the
31
following:
32
(1)
Be
a
health
care
provider
nor
be
otherwise
directly
or
33
indirectly
engaged
in
the
delivery
of
health
care
services
nor
34
have
a
material
financial
interest
in
the
providing
or
delivery
35
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of
health
services.
1
(2)
Serve
as
a
member
of
any
board
or
other
policymaking
2
or
advisory
body
of
an
institutional
health
facility,
a
health
3
maintenance
organization,
or
any
health
or
hospital
insurer.
4
b.
Appointments.
Terms
of
council
members
shall
be
six
5
years,
beginning
and
ending
as
provided
in
section
69.19
.
A
6
member
shall
be
appointed
in
each
odd-numbered
year
to
succeed
7
each
member
whose
term
expires
in
that
year.
Vacancies
8
shall
be
filled
by
the
governor
for
the
balance
of
the
9
unexpired
term.
Each
appointment
to
the
council
is
subject
to
10
confirmation
by
the
senate.
A
council
member
is
ineligible
11
for
appointment
to
a
second
consecutive
term,
unless
first
12
appointed
to
an
unexpired
term
of
three
years
or
less.
13
c.
Chairperson.
The
governor
shall
designate
one
of
14
the
council
members
as
chairperson.
That
designation
may
15
be
changed
not
later
than
July
1
of
any
odd-numbered
year,
16
effective
on
the
date
of
the
organizational
meeting
held
in
17
that
year
under
paragraph
“d”
.
18
d.
Meetings.
The
council
shall
hold
an
organizational
19
meeting
in
July
of
each
odd-numbered
year,
or
as
soon
20
thereafter
as
the
new
appointee
or
appointees
are
confirmed
21
and
have
qualified.
Other
meetings
shall
be
held
as
necessary
22
to
enable
the
council
to
expeditiously
discharge
its
duties.
23
Meeting
dates
shall
be
set
upon
adjournment
or
by
call
of
the
24
chairperson
upon
five
days’
notice
to
the
other
members.
25
e.
2.
Duties.
The
council
department
shall
do
all
of
the
26
following:
27
(1)
a.
Make
the
final
decision,
as
required
by
section
28
135.69
,
with
respect
to
each
application
for
a
certificate
of
29
need
accepted
by
the
department.
30
(2)
b.
Determine
and
adopt
such
policies
as
are
authorized
31
by
law
and
are
deemed
necessary
to
the
efficient
discharge
of
32
its
the
department’s
duties
under
this
subchapter
.
33
(3)
c.
Have
authority
to
direct
staff
personnel
of
the
34
department
assigned
to
conduct
formal
or
summary
reviews
of
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applications
for
certificates
of
need.
1
(4)
d.
Advise
and
counsel
with
the
director
concerning
the
2
provisions
of
this
subchapter
and
the
policies
and
procedures
3
adopted
by
the
department
pursuant
to
this
subchapter
.
4
(5)
Review
and
approve,
prior
to
promulgation,
all
rules
5
adopted
by
the
department
under
this
subchapter
.
6
Sec.
6.
Section
135.63,
subsection
1,
Code
2023,
is
amended
7
to
read
as
follows:
8
1.
A
new
institutional
health
service
or
changed
9
institutional
health
service
shall
not
be
offered
or
developed
10
in
this
state
without
prior
application
to
the
department
11
for
and
receipt
of
a
certificate
of
need,
pursuant
to
12
this
subchapter
.
The
application
shall
be
made
upon
forms
13
furnished
or
prescribed
by
the
department
and
shall
contain
14
such
information
as
the
department
may
require
under
this
15
subchapter
.
The
application
shall
be
accompanied
by
an
16
economic
impact
statement
that
includes
information
specified
17
by
rule
to
assist
the
department
in
the
evaluation
of
the
18
application
pursuant
to
section
135.64.
The
application
shall
19
be
accompanied
by
a
fee
equivalent
to
three-tenths
of
one
20
percent
of
the
anticipated
cost
of
the
project
with
a
minimum
21
fee
of
six
hundred
dollars
and
a
maximum
fee
of
twenty-one
22
thousand
dollars.
The
fee
shall
be
remitted
by
the
department
23
to
the
treasurer
of
state,
who
shall
place
it
in
the
general
24
fund
of
the
state.
If
an
application
is
voluntarily
withdrawn
25
within
thirty
calendar
days
after
submission,
seventy-five
26
percent
of
the
application
fee
shall
be
refunded;
if
the
27
application
is
voluntarily
withdrawn
more
than
thirty
but
28
within
sixty
days
after
submission,
fifty
percent
of
the
29
application
fee
shall
be
refunded;
if
the
application
is
30
withdrawn
voluntarily
more
than
sixty
days
after
submission,
31
twenty-five
percent
of
the
application
fee
shall
be
refunded.
32
Notwithstanding
the
required
payment
of
an
application
fee
33
under
this
subsection
,
an
applicant
for
a
new
institutional
34
health
service
or
a
changed
institutional
health
service
35
-7-
SF
506
(7)
90
pf/rh/mb
7/
17
S.F.
506
offered
or
developed
by
an
intermediate
care
facility
for
1
persons
with
an
intellectual
disability
or
an
intermediate
care
2
facility
for
persons
with
mental
illness
as
defined
pursuant
to
3
section
135C.1
is
exempt
from
payment
of
the
application
fee.
4
Sec.
7.
Section
135.63,
subsection
2,
paragraphs
a
and
e,
5
Code
2023,
are
amended
to
read
as
follows:
6
a.
Private
offices
and
private
clinics
of
an
individual
7
physician,
dentist,
or
other
practitioner
or
group
of
8
health
care
providers,
except
as
provided
by
section
135.61,
9
subsection
18
,
paragraphs
“g”
,
“h”
,
and
“m”
,
and
section
135.61,
10
subsections
20
and
21
.
11
e.
A
health
maintenance
organization
or
combination
of
12
health
maintenance
organizations
or
an
institutional
health
13
facility
controlled
directly
or
indirectly
by
a
health
14
maintenance
organization
or
combination
of
health
maintenance
15
organizations,
except
when
the
health
maintenance
organization
16
or
combination
of
health
maintenance
organizations
does
any
of
17
the
following:
18
(1)
Constructs
constructs
,
develops,
renovates,
relocates,
19
or
otherwise
establishes
an
institutional
health
facility.
20
(2)
Acquires
major
medical
equipment
as
provided
by
section
21
135.61,
subsection
18
,
paragraphs
“i”
and
“j”
.
22
Sec.
8.
Section
135.63,
subsection
2,
paragraph
h,
Code
23
2023,
is
amended
by
striking
the
paragraph.
24
Sec.
9.
Section
135.63,
subsection
4,
unnumbered
paragraph
25
1,
Code
2023,
is
amended
to
read
as
follows:
26
A
copy
of
the
application
shall
be
sent
to
the
department
27
of
human
services
at
the
time
the
application
is
submitted
to
28
the
Iowa
department
of
public
health.
The
department
shall
not
29
process
applications
for
and
the
council
shall
not
consider
a
30
new
or
changed
institutional
health
service
for
an
intermediate
31
care
facility
for
persons
with
an
intellectual
disability
32
unless
both
of
the
following
conditions
are
met:
33
Sec.
10.
Section
135.64,
subsection
1,
unnumbered
paragraph
34
1,
Code
2023,
is
amended
to
read
as
follows:
35
-8-
SF
506
(7)
90
pf/rh/mb
8/
17
S.F.
506
In
determining
whether
a
certificate
of
need
shall
be
1
issued,
the
department
and
council
shall
consider
the
2
following:
3
Sec.
11.
Section
135.64,
subsection
1,
paragraph
r,
Code
4
2023,
is
amended
to
read
as
follows:
5
r.
The
recommendations
of
staff
personnel
of
the
department
6
assigned
to
the
area
of
certificate
of
need,
concerning
the
7
application
,
if
requested
by
the
council
.
8
Sec.
12.
Section
135.64,
subsection
2,
unnumbered
paragraph
9
1,
Code
2023,
is
amended
to
read
as
follows:
10
In
addition
to
the
findings
required
with
respect
to
any
11
of
the
criteria
listed
in
subsection
1
of
this
section
,
the
12
council
department
shall
grant
a
certificate
of
need
for
a
new
13
institutional
health
service
or
changed
institutional
health
14
service
only
if
it
the
department
finds
in
writing,
on
the
15
basis
of
data
submitted
to
it
by
the
department
,
that:
16
Sec.
13.
Section
135.66,
Code
2023,
is
amended
to
read
as
17
follows:
18
135.66
Procedure
upon
receipt
of
application
——
public
19
notification.
20
1.
a.
Within
fifteen
business
days
after
receipt
of
an
21
application
for
a
certificate
of
need,
the
department
shall
22
examine
the
application
for
form
and
completeness
and
accept
23
or
reject
it.
An
application
shall
be
rejected
only
if
it
24
fails
to
provide
all
information
required
by
the
department
25
pursuant
to
section
135.63,
subsection
1
.
The
department
shall
26
promptly
return
to
the
applicant
any
rejected
application,
with
27
an
explanation
of
the
reasons
for
its
rejection.
28
b.
Within
thirty
days
after
notifying
the
applicant
of
29
rejection
of
the
application,
the
applicant
may
resubmit
a
30
revised
application
for
review
under
this
subsection
and
shall
31
not
be
subject
to
payment
of
another
required
application
32
fee
pursuant
to
section
135.63.
If
a
subsequent
rejection
33
is
issued,
the
applicant
shall
resubmit
the
application
in
34
accordance
with
and
shall
be
subject
to
the
procedure
and
35
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506
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17
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506
requirements
for
an
initial
application.
1
2.
Upon
acceptance
of
an
application
for
a
certificate
2
of
need,
the
department
shall
promptly
undertake
to
notify
3
all
affected
persons
in
writing
that
formal
review
of
the
4
application
has
been
initiated.
Notification
to
those
affected
5
persons
who
are
consumers
or
third-party
payers
or
other
6
payers
for
health
services
may
be
provided
by
distribution
of
7
the
pertinent
information
to
the
news
media
by
an
electronic
8
distribution
method
available
to
the
department
.
9
3.
Each
application
accepted
by
the
department
shall
10
be
formally
reviewed
for
the
purpose
of
furnishing
to
the
11
council
department
the
information
necessary
to
enable
it
the
12
department
to
determine
whether
or
not
to
grant
the
certificate
13
of
need.
A
formal
review
shall
consist
at
a
minimum
of
the
14
following
steps:
15
a.
Evaluation
of
the
application
against
the
criteria
16
specified
in
section
135.64
.
17
b.
A
public
hearing
on
the
application,
to
be
held
prior
to
18
completion
of
the
evaluation
required
by
paragraph
“a”
,
shall
be
19
conducted
by
the
council
department
.
20
4.
When
a
hearing
is
to
be
held
pursuant
to
subsection
3,
21
paragraph
“b”
,
the
department
shall
give
at
least
ten
days’
22
notice
of
the
time
and
place
of
the
hearing.
At
Any
affected
23
person
or
that
person’s
designated
representative
may
submit
24
written
testimony
in
a
manner
prescribed
by
the
department
25
beginning
on
the
day
the
notice
of
the
hearing
is
given
until
26
the
day
prior
to
the
date
fixed
for
the
hearing,
or
at
the
27
hearing
,
any
affected
person
or
that
person’s
designated
28
representative
shall
may
have
the
opportunity
to
present
29
testimony.
30
Sec.
14.
Section
135.67,
subsection
1,
Code
2023,
is
amended
31
to
read
as
follows:
32
1.
The
department
may
waive
the
letter
of
intent
procedures
33
prescribed
by
section
135.65
and
substitute
conduct
a
summary
34
review
procedure,
which
shall
be
established
by
rules
of
the
35
-10-
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506
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90
pf/rh/mb
10/
17
S.F.
506
department,
when
it
accepts
an
application
for
a
certificate
of
1
need
for
a
project
which
meets
any
of
the
following
criteria
2
in
paragraphs
“a”
through
“e”
:
3
a.
A
project
which
is
limited
to
repair
or
replacement
of
a
4
facility
or
equipment
damaged
or
destroyed
by
a
disaster,
and
5
which
will
not
expand
the
facility
nor
increase
the
services
6
provided
beyond
the
level
existing
prior
to
the
disaster.
7
b.
A
project
necessary
to
enable
the
facility
or
service
to
8
achieve
or
maintain
compliance
with
federal,
state,
or
other
9
appropriate
licensing,
certification,
or
safety
requirements.
10
c.
A
project
which
will
not
change
the
existing
bed
capacity
11
of
the
applicant’s
facility
or
service,
as
determined
by
the
12
department,
by
more
than
ten
percent
or
ten
beds,
whichever
is
13
less,
over
a
two-year
period.
14
d.
A
project
the
total
cost
of
which
will
not
exceed
one
15
hundred
fifty
thousand
dollars.
16
e.
d.
Any
other
project
for
which
the
applicant
proposes
17
and
the
department
agrees
to
summary
review.
18
Sec.
15.
Section
135.69,
Code
2023,
is
amended
to
read
as
19
follows:
20
135.69
Council
Department
to
make
final
decision.
21
1.
The
department
shall
complete
its
formal
review
of
22
the
application
within
ninety
days
after
acceptance
of
the
23
application,
except
as
otherwise
provided
by
section
135.72,
24
subsection
4
.
Upon
completion
of
the
formal
review,
the
25
council
department
shall
approve
or
deny
the
application.
The
26
council
department
shall
issue
written
findings
stating
the
27
basis
for
its
the
department’s
decision
on
the
application,
and
28
the
department
shall
send
copies
of
the
council’s
department’s
29
decision
and
the
written
findings
supporting
the
decision
to
30
the
applicant
and
to
any
other
person
who
so
requests.
31
2.
Failure
by
the
council
to
issue
a
written
decision
32
on
an
application
for
a
certificate
of
need
within
the
time
33
required
by
this
section
shall
constitute
denial
of
and
final
34
administrative
action
on
the
application.
35
-11-
SF
506
(7)
90
pf/rh/mb
11/
17
S.F.
506
Sec.
16.
Section
135.70,
Code
2023,
is
amended
to
read
as
1
follows:
2
135.70
Appeal
of
certificate
of
need
decisions.
3
The
council’s
department’s
decision
on
an
application
for
4
certificate
of
need,
when
announced
pursuant
to
section
135.69
,
5
is
a
final
decision.
Any
dissatisfied
party
who
is
an
affected
6
person
with
respect
to
the
application,
and
who
participated
7
or
sought
unsuccessfully
to
participate
in
the
formal
review
8
procedure
prescribed
by
section
135.66
,
may
request
a
rehearing
9
in
accordance
with
chapter
17A
and
rules
of
the
department.
10
If
a
rehearing
is
not
requested
or
an
affected
party
remains
11
dissatisfied
after
the
request
for
rehearing,
an
appeal
may
be
12
taken
in
the
manner
provided
by
chapter
17A
.
Notwithstanding
13
the
Iowa
administrative
procedure
Act,
chapter
17A
,
a
request
14
for
rehearing
is
not
required,
prior
to
appeal
under
section
15
17A.19
.
16
Sec.
17.
Section
135.71,
subsection
1,
Code
2023,
is
amended
17
to
read
as
follows:
18
1.
A
certificate
of
need
shall
be
valid
for
a
maximum
of
19
one
year
from
the
date
of
issuance.
Upon
the
expiration
of
20
the
certificate,
or
at
any
earlier
time
while
the
certificate
21
is
valid
the
holder
thereof
shall
provide
the
department
such
22
information
on
the
development
of
the
project
covered
by
23
the
certificate
as
the
department
may
request.
The
council
24
department
shall
determine
at
the
end
of
the
certification
25
period
whether
sufficient
progress
is
being
made
on
the
26
development
of
the
project.
The
certificate
of
need
may
be
27
extended
by
the
council
department
for
additional
periods
of
28
time
as
are
reasonably
necessary
to
expeditiously
complete
the
29
project,
but
may
be
revoked
by
the
council
department
at
the
30
end
of
the
first
or
any
subsequent
certification
period
for
31
insufficient
progress
in
developing
the
project.
32
Sec.
18.
Section
135.72,
unnumbered
paragraph
1,
Code
2023,
33
is
amended
to
read
as
follows:
34
The
department
shall
adopt
,
with
approval
of
the
council,
35
-12-
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506
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506
such
administrative
rules
as
are
necessary
to
enable
it
the
1
department
to
implement
this
subchapter
.
These
rules
shall
2
include:
3
Sec.
19.
Section
135.72,
subsection
4,
Code
2023,
is
amended
4
to
read
as
follows:
5
4.
Criteria
for
determining
when
it
is
not
feasible
to
6
complete
formal
review
of
an
application
for
a
certificate
of
7
need
within
the
time
limits
specified
in
section
135.69
.
The
8
rules
adopted
under
this
subsection
shall
include
criteria
for
9
determining
whether
an
application
proposes
introduction
of
10
technologically
innovative
equipment,
and
if
so,
procedures
11
to
be
followed
in
reviewing
the
application.
However,
a
rule
12
adopted
under
this
subsection
shall
not
permit
a
deferral
of
13
more
than
sixty
thirty
days
beyond
the
time
when
a
decision
is
14
required
under
section
135.69
,
unless
both
the
applicant
and
15
the
department
agree
to
a
longer
deferment.
16
Sec.
20.
Section
135.73,
subsection
1,
Code
2023,
is
amended
17
to
read
as
follows:
18
1.
Any
party
constructing
a
new
institutional
health
19
facility
or
an
addition
to
or
renovation
of
an
existing
20
institutional
health
facility
without
first
obtaining
a
21
certificate
of
need
or,
in
the
case
of
a
mobile
health
service,
22
ascertaining
that
the
mobile
health
service
has
received
23
certificate
of
need
approval,
as
required
by
this
subchapter
,
24
shall
be
denied
licensure
or
change
of
licensure
by
the
25
appropriate
responsible
licensing
agency
of
this
state.
26
Sec.
21.
Section
135.73,
subsection
2,
paragraph
a,
Code
27
2023,
is
amended
to
read
as
follows:
28
a.
A
class
I
violation
is
one
in
which
a
party
offers
a
29
new
institutional
health
service
or
changed
institutional
30
health
service
modernization
or
acquisition
without
review
and
31
approval
by
the
council
department
.
A
party
in
violation
is
32
subject
to
a
penalty
of
three
hundred
dollars
for
each
day
of
a
33
class
I
violation.
The
department
may
seek
injunctive
relief
34
which
shall
include
restraining
the
commission
or
continuance
35
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506
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17
S.F.
506
of
an
act
which
would
violate
the
provisions
of
this
paragraph.
1
Notice
and
opportunity
to
be
heard
shall
be
provided
to
a
party
2
pursuant
to
rule
of
civil
procedure
1.1507
and
contested
case
3
procedures
in
accordance
with
chapter
17A
.
The
department
may
4
reduce,
alter,
or
waive
a
penalty
upon
the
party
showing
good
5
faith
compliance
with
the
department’s
request
to
immediately
6
cease
and
desist
from
conduct
in
violation
of
this
section
.
7
Sec.
22.
Section
135.131,
subsection
1,
paragraph
a,
Code
8
2023,
is
amended
to
read
as
follows:
9
a.
“Birth
center”
means
birth
center
as
defined
in
section
10
135.61
a
facility
or
institution,
which
is
not
an
ambulatory
11
surgical
center
or
a
hospital
or
in
a
hospital,
in
which
12
births
are
planned
to
occur
following
a
normal,
uncomplicated,
13
low-risk
pregnancy
.
14
Sec.
23.
Section
135P.1,
Code
2023,
is
amended
to
read
as
15
follows:
16
135P.1
Definitions.
17
For
the
purposes
of
this
chapter
,
unless
the
context
18
otherwise
requires:
19
1.
“Adverse
health
care
incident”
means
an
objective
and
20
definable
outcome
arising
from
or
related
to
patient
care
that
21
results
in
the
death
or
physical
injury
of
a
patient.
22
2.
“Health
care
provider”
means
a
physician
or
osteopathic
23
physician
licensed
under
chapter
148
,
a
physician
assistant
24
licensed
and
practicing
under
a
supervising
physician
pursuant
25
to
chapter
148C
,
a
podiatrist
licensed
under
chapter
149
,
a
26
chiropractor
licensed
under
chapter
151
,
a
licensed
practical
27
nurse,
a
registered
nurse,
or
an
advanced
registered
nurse
28
practitioner
licensed
under
chapter
152
or
152E
,
a
dentist
29
licensed
under
chapter
153
,
an
optometrist
licensed
under
30
chapter
154
,
a
pharmacist
licensed
under
chapter
155A
,
or
31
any
other
person
who
is
licensed,
certified,
or
otherwise
32
authorized
or
permitted
by
the
law
of
this
state
to
administer
33
health
care
in
the
ordinary
course
of
business
or
in
the
34
practice
of
a
profession.
35
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3.
“Health
facility”
means
an
institutional
health
facility
1
as
defined
in
section
135.61
,
a
hospice
licensed
under
chapter
2
135J
,
a
home
health
agency
as
defined
in
section
144D.1
,
an
3
assisted
living
program
certified
under
chapter
231C
,
a
clinic,
4
a
community
health
center,
or
the
university
of
Iowa
hospitals
5
and
clinics,
and
includes
any
corporation,
professional
6
corporation,
partnership,
limited
liability
company,
limited
7
liability
partnership,
or
other
entity
comprised
of
such
health
8
facilities.
9
4.
“Institutional
health
facility”
means
any
of
the
10
following,
without
regard
to
whether
the
facilities
referred
11
to
are
publicly
or
privately
owned
or
are
organized
for
profit
12
or
not,
or
whether
the
facilities
are
part
of
or
sponsored
by
a
13
health
maintenance
organization:
14
a.
A
hospital
as
defined
in
section
135B.1.
15
b.
A
health
care
facility
as
defined
in
section
135C.1.
16
c.
An
organized
outpatient
health
facility
as
defined
in
17
section
135.61.
18
d.
An
outpatient
surgical
facility
as
defined
in
section
19
135.61.
20
e.
A
community
mental
health
center
as
defined
in
section
21
230A.102.
22
f.
A
birth
center
as
defined
in
section
135.131.
23
4.
5.
“Open
discussion”
means
all
communications
that
are
24
made
under
section
135P.3
,
and
includes
all
memoranda,
work
25
products,
documents,
and
other
materials
that
are
prepared
26
for
or
submitted
in
the
course
of
or
in
connection
with
27
communications
under
section
135P.3
.
28
5.
6.
“Patient”
means
a
person
who
receives
medical
care
29
from
a
health
care
provider,
or
if
the
person
is
a
minor,
30
deceased,
or
incapacitated,
the
person’s
legal
representative.
31
Sec.
24.
2023
Iowa
Acts,
Senate
File
514,
section
32
1443,
subsection
1,
if
enacted,
is
amended
by
striking
the
33
subsection.
34
Sec.
25.
2023
Iowa
Acts,
Senate
File
514,
section
35
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1443,
subsection
5,
if
enacted,
is
amended
by
striking
the
1
subsection.
2
Sec.
26.
2023
Iowa
Acts,
Senate
File
514,
sections
1584
3
through
1609,
if
enacted,
are
amended
by
striking
the
sections.
4
Sec.
27.
REPEAL.
Section
135.65,
Code
2023,
is
repealed.
5
DIVISION
II
6
BIRTH
CENTERS
7
Sec.
28.
BIRTH
CENTERS
——
PROVISIONAL
LICENSURE.
The
8
department
of
inspections,
appeals,
and
licensing
shall
develop
9
minimum
standards
for
provisional
licensure
of
a
birth
center
10
and
shall
adopt
rules
pursuant
to
chapter
17A
to
administer
11
birth
center
provisional
licensure.
The
department
shall
12
issue
a
provisional
license
to
a
birth
center
that
meets
the
13
minimum
standards.
A
provisional
license
may
be
granted
14
for
a
period
of
no
more
than
one
year
from
the
date
the
15
specified
administrative
rules
are
adopted.
A
provisional
16
license
shall
expire
at
the
end
of
the
license
term
and
is
17
not
renewable.
During
the
term
of
a
provisional
license,
a
18
health
care
provider
accepting
the
transfer
of
a
patient
from
19
a
provisionally
licensed
birth
center
shall
not
be
subject
to
20
civil
or
criminal
liability
for
outcomes
arising
from
actions
21
of
the
provisionally
licensed
birth
center
or
any
of
the
22
employees,
agents,
or
contractors
of
such
birth
center.
23
Sec.
29.
EMERGENCY
RULES.
The
department
of
inspections,
24
appeals,
and
licensing
shall
adopt
emergency
rules
under
25
section
17A.4,
subsection
3,
and
section
17A.5,
subsection
26
2,
paragraph
“b”,
to
implement
the
birth
center
provisional
27
licensure
provisions
of
this
division
of
this
Act,
within
six
28
months
of
the
effective
date
of
this
division
of
this
Act
and
29
shall
submit
such
rules
to
the
administrative
rules
coordinator
30
and
the
administrative
code
editor
pursuant
to
section
17A.5,
31
subsection
1,
within
the
same
period.
The
rules
shall
be
32
effective
immediately
upon
filing
unless
a
later
date
is
33
specified
in
the
rules.
Any
rules
adopted
in
accordance
with
34
this
section
shall
also
be
published
as
a
notice
of
intended
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action
as
provided
in
section
17A.4.
1
Sec.
30.
PROPOSED
LEGISLATION
——
BIRTH
CENTER
2
LICENSURE.
The
department
of
inspections,
appeals,
and
3
licensing
shall
submit
proposed
legislation
under
section
4
2.16
that
provides
for
state
licensure
of
and
inspection
5
requirements
for
birth
centers
to
be
considered
by
the
2024
6
session
of
the
general
assembly.
7
Sec.
31.
DEFINITIONS.
For
the
purposes
of
this
division
of
8
this
Act:
9
1.
“Birth
center”
means
a
facility
or
institution,
which
10
is
not
an
ambulatory
surgical
center
or
a
hospital
or
in
a
11
hospital,
in
which
births
are
planned
to
occur
following
a
12
normal,
uncomplicated,
low-risk
pregnancy.
13
2.
“Health
care
provider”
means
the
same
as
defined
in
14
section
147.136A.
15
Sec.
32.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
16
deemed
of
immediate
importance,
takes
effect
upon
enactment.
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