Bill Text: IA SF2021 | 2017-2018 | 87th General Assembly | Introduced

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Bill Title: A bill for an act relating to the elimination of the certificate of need process relating to the development of a new or changed institutional health service.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2018-01-24 - Subcommittee: Garrett, Bolkcom, and Segebart. S.J. 155. [SF2021 Detail]

Download: Iowa-2017-SF2021-Introduced.html

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Senate File 2021 - Introduced




                                 SENATE FILE       
                                 BY  ZAUN

                                      A BILL FOR

  1 An Act relating to the elimination of the certificate of need
  2    process relating to the development of a new or changed
  3    institutional health service.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
    TLSB 5391XS (3) 87
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PAG LIN



  1  1    Section 1.  Section 68B.35, subsection 2, paragraph e, Code
  1  2 2018, is amended to read as follows:
  1  3    e.  Members of the state banking council, the Iowa ethics
  1  4 and campaign disclosure board, the credit union review board,
  1  5 the economic development authority, the employment appeal
  1  6 board, the environmental protection commission, the health
  1  7 facilities council, the Iowa finance authority, the Iowa public
  1  8 employees' retirement system investment board, the board of
  1  9 the Iowa lottery authority, the natural resource commission,
  1 10 the board of parole, the petroleum underground storage tank
  1 11 fund board, the public employment relations board, the state
  1 12 racing and gaming commission, the state board of regents, the
  1 13 transportation commission, the office of consumer advocate, the
  1 14 utilities board, the Iowa telecommunications and technology
  1 15 commission, and any full=time members of other boards and
  1 16 commissions as defined under section 7E.4 who receive an annual
  1 17 salary for their service on the board or commission. The Iowa
  1 18 ethics and campaign disclosure board shall conduct an annual
  1 19 review to determine if members of any other board, commission,
  1 20 or authority should file a statement and shall require the
  1 21 filing of a statement pursuant to rules adopted pursuant to
  1 22 chapter 17A.
  1 23    Sec. 2.  Section 97B.1A, subsection 8, paragraph a,
  1 24 subparagraph (8), Code 2018, is amended to read as follows:
  1 25    (8)  Members of the state transportation commission, and the
  1 26 board of parole, and the state health facilities council.
  1 27    Sec. 3.  Section 135.131, subsection 1, paragraph a, Code
  1 28 2018, is amended to read as follows:
  1 29    a.  "Birth center" means birth center as defined in section
  1 30 135.61 a facility or institution, which is not an ambulatory
  1 31 surgical center or a hospital or in a hospital, in which
  1 32 births are planned to occur following a normal, uncomplicated,
  1 33 low=risk pregnancy.
  1 34    Sec. 4.  Section 135C.2, subsection 5, unnumbered paragraph
  1 35 1, Code 2018, is amended to read as follows:
  2  1 The department shall establish a special classification
  2  2 within the residential care facility category in order to
  2  3 foster the development of residential care facilities which
  2  4 serve persons with an intellectual disability, chronic mental
  2  5 illness, a developmental disability, or brain injury, as
  2  6 described under section 225C.26, and which contain five or
  2  7 fewer residents. A facility within the special classification
  2  8 established pursuant to this subsection is exempt from the
  2  9 requirements of section 135.63. The department shall adopt
  2 10 rules which are consistent with rules previously developed
  2 11 for the waiver demonstration project pursuant to 1986 Iowa
  2 12 Acts, ch. 1246, {206, and which include all of the following
  2 13 provisions:
  2 14    Sec. 5.  Section 135H.6, Code 2018, is amended to read as
  2 15 follows:
  2 16    135H.6  Inspection == conditions for issuance.
  2 17    The department shall issue a license to an applicant under
  2 18 this chapter if all the following conditions exist:
  2 19    1.  The department has ascertained that the applicant's
  2 20 medical facilities and staff are adequate to provide the care
  2 21 and services required of a psychiatric institution.
  2 22    2.  The proposed psychiatric institution is accredited
  2 23 by the joint commission on the accreditation of health
  2 24 care organizations, the commission on accreditation of
  2 25 rehabilitation facilities, the council on accreditation of
  2 26 services for families and children, or by any other recognized
  2 27 accrediting organization with comparable standards acceptable
  2 28 under federal regulation.
  2 29    3.  The applicant complies with applicable state rules
  2 30 and standards for a psychiatric institution adopted by the
  2 31 department in accordance with federal requirements under 42
  2 32 C.F.R. {441.150 = 441.156.
  2 33    4.  The applicant has been awarded a certificate of need
  2 34 pursuant to chapter 135, unless exempt as provided in this
  2 35 section.
  3  1    5.  4.  The department of human services has submitted
  3  2 written approval of the application based on the department of
  3  3 human services' determination of need. The department of human
  3  4 services shall identify the location and number of children in
  3  5 the state who require the services of a psychiatric medical
  3  6 institution for children. Approval of an application shall be
  3  7 based upon the location of the proposed psychiatric institution
  3  8 relative to the need for services identified by the department
  3  9 of human services and an analysis of the applicant's ability to
  3 10 provide services and support consistent with requirements under
  3 11 chapter 232, particularly regarding community=based treatment.
  3 12 If the proposed psychiatric institution is not freestanding
  3 13 from a facility licensed under chapter 135B or 135C, approval
  3 14 under this subsection shall not be given unless the department
  3 15 of human services certifies that the proposed psychiatric
  3 16 institution is capable of providing a resident with a living
  3 17 environment similar to the living environment provided by a
  3 18 licensee which is freestanding from a facility licensed under
  3 19 chapter 135B or 135C.
  3 20    6.  5.  The department of human services shall not give
  3 21 approval to an application which would cause the total number
  3 22 of beds licensed under this chapter for services reimbursed by
  3 23 the medical assistance program under chapter 249A to exceed
  3 24 four hundred thirty beds.
  3 25    7.  6.  In addition to the beds authorized under subsection 6
  3 26  5, the department of human services may establish not more than
  3 27 thirty beds licensed under this chapter at the state mental
  3 28 health institute at Independence. The beds shall be exempt
  3 29 from the certificate of need requirement under subsection 4.
  3 30    8.  7.  The department of human services may give approval to
  3 31 conversion of beds approved under subsection 6 5, to beds which
  3 32 are specialized to provide substance abuse treatment. However,
  3 33 the total number of beds approved under subsection 6 5 and this
  3 34 subsection shall not exceed four hundred thirty. Conversion
  3 35 of beds under this subsection shall not require a revision of
  4  1 the certificate of need issued for the psychiatric institution
  4  2 making the conversion.  Beds for children who do not reside
  4  3 in this state and whose service costs are not paid by public
  4  4 funds in this state are not subject to the limitations on the
  4  5 number of beds and certificate of need requirements otherwise
  4  6 applicable under this section.
  4  7    9.  8.  The proposed psychiatric institution is under
  4  8 the direction of an agency which has operated a facility
  4  9 licensed under section 237.3, subsection 2, paragraph "a", as
  4 10 a comprehensive residential facility for children for three
  4 11 years or of an agency which has operated a facility for three
  4 12 years providing psychiatric services exclusively to children or
  4 13 adolescents and the facility meets or exceeds requirements for
  4 14 licensure under section 237.3, subsection 2, paragraph "a", as a
  4 15 comprehensive residential facility for children.
  4 16    10.  9.  A psychiatric institution licensed prior to July 1,
  4 17 1999, may exceed the number of beds authorized under subsection
  4 18 6 5 if the excess beds are used to provide services funded
  4 19 from a source other than the medical assistance program under
  4 20 chapter 249A.  Notwithstanding subsections 4, 5, and 6, the
  4 21 provision of services using those excess beds does not require
  4 22 a certificate of need or a review by the department of human
  4 23 services.
  4 24    11.  10.  If a child has an emotional, behavioral, or mental
  4 25 health disorder, the psychiatric institution does not require
  4 26 court proceedings to be initiated or that a child's parent,
  4 27 guardian, or custodian must terminate parental rights over
  4 28 or transfer legal custody of the child for the purpose of
  4 29 obtaining treatment from the psychiatric institution for the
  4 30 child. Relinquishment of a child's custody shall not be a
  4 31 condition of the child receiving services.
  4 32    Sec. 6.  Section 135P.1, subsection 3, Code 2018, is amended
  4 33 to read as follows:
  4 34    3.  "Health facility" means an institutional health facility
  4 35 as defined in section 135.61, hospice licensed under chapter
  5  1 135J, home health agency as defined in section 144D.1,
  5  2 assisted living program certified under chapter 231C, clinic,
  5  3 or community health center, and includes any corporation,
  5  4 professional corporation, partnership, limited liability
  5  5 company, limited liability partnership, or other entity
  5  6 comprised of such health facilities.
  5  7    Sec. 7.  Section 135P.1, Code 2018, is amended by adding the
  5  8 following new subsection:
  5  9    NEW SUBSECTION.  3A.  "Institutional health facility" means
  5 10 any of the following, without regard to whether the facilities
  5 11 referred to are publicly or privately owned or are organized
  5 12 for profit or not or whether the facilities are part of or
  5 13 sponsored by a health maintenance organization:
  5 14    a.  A hospital.
  5 15    b.  A health care facility.
  5 16    c.  An organized outpatient health facility.
  5 17    d.  An outpatient surgical facility.
  5 18    e.  A community mental health facility.
  5 19    f.  A birth center.
  5 20    Sec. 8.  Section 231C.3, subsection 2, Code 2018, is amended
  5 21 to read as follows:
  5 22    2.  Each assisted living program operating in this state
  5 23 shall be certified by the department. If an assisted living
  5 24 program is voluntarily accredited by a recognized accrediting
  5 25 entity, the department shall certify the assisted living
  5 26 program on the basis of the voluntary accreditation. An
  5 27 assisted living program that is certified by the department on
  5 28 the basis of voluntary accreditation shall not be subject to
  5 29 payment of the certification fee prescribed in section 231C.18,
  5 30 but shall be subject to an administrative fee as prescribed by
  5 31 rule. An assisted living program certified under this section
  5 32  is exempt from the requirements of section 135.63 relating to
  5 33 certificate of need requirements.
  5 34    Sec. 9.  Section 249K.2, subsection 6, Code 2018, is amended
  5 35 to read as follows:
  6  1    6.  "New construction" means the construction of a new
  6  2 nursing facility which does not replace an existing licensed
  6  3 and certified facility and requires the provider to obtain a
  6  4 certificate of need pursuant to chapter 135, division VI.
  6  5    Sec. 10.  Section 505.27, subsection 5, paragraph a, Code
  6  6 2018, is amended to read as follows:
  6  7    a.  "Health care provider" means the same as defined in
  6  8 section 135.61, a person licensed or certified under chapter
  6  9 147, 148, 148A, 148C, 149, 151, 152, 153, 154, 154B, 154F,
  6 10 or 155A to provide in this state professional health care
  6 11 service to an individual during that individual's medical care,
  6 12 treatment, or confinement; a hospital licensed pursuant to
  6 13 chapter 135B;, or a health care facility licensed pursuant to
  6 14 chapter 135C.
  6 15    Sec. 11.  Section 708.3A, subsection 5, paragraph d, Code
  6 16 2018, is amended to read as follows:
  6 17    d.  "Health care provider" means an emergency medical care
  6 18 provider as defined in chapter 147A or a person licensed
  6 19 or registered under chapter 148, 148C, 148D, or 152 who is
  6 20 providing or who is attempting to provide emergency medical
  6 21 services, as defined in section 147A.1, or who is providing
  6 22 or who is attempting to provide health services as defined
  6 23 in section 135.61 in a hospital. A person who commits an
  6 24 assault under this section against a health care provider in
  6 25 a hospital, or at the scene or during out=of=hospital patient
  6 26 transportation in an ambulance, is presumed to know that the
  6 27 person against whom the assault is committed is a health care
  6 28 provider.
  6 29    Sec. 12.  Section 708.3A, subsection 5, Code 2018, is amended
  6 30 by adding the following new paragraph:
  6 31    NEW PARAGRAPH.  0e.  "Health services" means clinically
  6 32 related diagnostic, curative, or rehabilitative services, and
  6 33 includes alcoholism, drug abuse, and mental health services.
  6 34    Sec. 13.  REPEAL.  Sections 135.61 through 135.73, Code 2018,
  6 35 are repealed.
  7  1    Sec. 14.  CODE EDITOR DIRECTIVE.  The Code editor is
  7  2 directed to modify the title of chapter 135, division VI, as
  7  3 "Hospital and health care facility reporting, data, analyses,
  7  4 and studies" and to correct internal references in the Code as
  7  5 necessary due to enactment of this Act.
  7  6                           EXPLANATION
  7  7 The inclusion of this explanation does not constitute agreement with
  7  8 the explanation's substance by the members of the general assembly.
  7  9    This bill eliminates the certificate of need (CON) process
  7 10 required prior to the offering or development of a new or
  7 11 changed institutional health service and makes conforming
  7 12 changes throughout the Code.
       LSB 5391XS (3) 87
       pf/rh