| 1 | 1 | | House Study Bill 191 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED GOVERNOR BILL) A BILL FOR An Act relating to health care including a funding model for 1 the rural health care system; the elimination of several 2 health care-related award, grant, residency, and fellowship 3 programs; establishment of a health care professional 4 incentive program; Medicaid graduate medical education; the 5 health facilities council; and the Iowa health information 6 network, making appropriations, and including effective date 7 provisions. 8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 9 TLSB 1555XL (10) 91 lh/ko |
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| 3 | 3 | | S.F. _____ H.F. _____ DIVISION I 1 HEALTH CARE HUB-AND-SPOKE PARTNERSHIP FUNDING MODEL 2 Section 1. HEALTH CARE HUB-AND-SPOKE PARTNERSHIP FUNDING 3 MODEL APPROVAL. The department of health and human services 4 shall submit to the centers for Medicare and Medicaid services 5 of the United States department of health and human services 6 a request for approval for a health care hub-and-spoke 7 partnership funding model for the purpose of improving Iowas 8 rural health system to establish sufficient financial support 9 for collaboration among regional health care providers in rural 10 areas to transform health care delivery to provide quality and 11 sustainable care. 12 Sec. 2. EFFECTIVE DATE. This division of this Act, being 13 deemed of immediate importance, takes effect upon enactment. 14 DIVISION II 15 ELIMINATION OF THE PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM 16 DEPARTMENT OF HEALTH AND HUMAN SERVICES 17 Sec. 3. Section 135.107, subsection 2, Code 2025, is amended 18 to read as follows: 19 2. a. The department shall establish a primary care 20 provider recruitment and retention endeavor , to be known as 21 PRIMECARRE . The endeavor shall include a health care workforce 22 and community support grant program and a primary care provider 23 loan repayment program . The endeavor shall be developed and 24 implemented in a manner to promote and accommodate local 25 creativity in efforts to recruit and retain health care 26 professionals to provide services in the locality. The focus 27 of the endeavor shall be to promote and assist local efforts 28 in developing health care provider recruitment and retention 29 programs. The department may enter into an agreement with the 30 college student aid commission for the administration of the 31 departments grant and loan repayment programs health care 32 workforce and community support grant program . 33 a. Health care workforce and community support grant program. 34 (1) b. The department shall adopt rules establishing 35 -1- LSB 1555XL (10) 91 lh/ko 1/ 43 |
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| 5 | 5 | | S.F. _____ H.F. _____ pursuant to chapter 17A to establish flexible application 1 processes based upon the departments strategic plan to be used 2 by the department to establish a grant assistance program as 3 provided in this paragraph a the health care workforce and 4 community support grant program , and establishing to establish 5 the criteria to be used in evaluating the applications. 6 Selection criteria shall include a method for prioritizing 7 grant applications based on illustrated efforts to meet the 8 health care provider needs of the locality and surrounding 9 area. Such assistance may be in the form of a forgivable loan, 10 grant, or other nonfinancial assistance as deemed appropriate 11 by the department. An application submitted may contain 12 a commitment of matching funds for the grant assistance. 13 Application may be made for assistance by a single community or 14 group of communities or in response to programs recommended in 15 the strategic plan to address health workforce shortages. 16 (2) Grants awarded under the program shall be awarded 17 to rural, underserved areas or special populations as 18 identified by the departments strategic plan or evidence-based 19 documentation. 20 b. Primary care provider loan repayment program. 21 (1) A primary care provider loan repayment program is 22 established to increase the number of health professionals 23 practicing primary care in federally designated health 24 professional shortage areas of the state. Under the program, 25 loan repayment may be made to a recipient for educational 26 expenses incurred while completing an accredited health 27 education program directly related to obtaining credentials 28 necessary to practice the recipients health profession. 29 (2) The department shall adopt rules relating to the 30 establishment and administration of the primary care provider 31 loan repayment program. Rules adopted pursuant to this 32 paragraph shall provide, at a minimum, for all of the 33 following: 34 (a) Determination of eligibility requirements and 35 -2- LSB 1555XL (10) 91 lh/ko 2/ 43 |
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| 7 | 7 | | S.F. _____ H.F. _____ qualifications of an applicant to receive loan repayment under 1 the program, including but not limited to years of obligated 2 service, clinical practice requirements, and residency 3 requirements. One year of obligated service shall be provided 4 by the applicant in exchange for each year of loan repayment, 5 unless federal requirements otherwise require. Loan repayment 6 under the program shall not be approved for a health provider 7 whose license or certification is restricted by a medical 8 regulatory authority of any jurisdiction of the United States, 9 other nations, or territories. 10 (b) Identification of federally designated health 11 professional shortage areas of the state and prioritization of 12 such areas according to need. 13 (c) Determination of the amount and duration of the loan 14 repayment an applicant may receive, giving consideration to the 15 availability of funds under the program, and the applicants 16 outstanding educational loans and professional credentials. 17 (d) Determination of the conditions of loan repayment 18 applicable to an applicant. 19 (e) Enforcement of the states rights under a loan repayment 20 program contract, including the commencement of any court 21 action. 22 (f) Cancellation of a loan repayment program contract for 23 reasonable cause unless federal requirements otherwise require. 24 (g) Participation in federal programs supporting repayment 25 of loans of health care providers and acceptance of gifts, 26 grants, and other aid or amounts from any person, association, 27 foundation, trust, corporation, governmental agency, or other 28 entity for the purposes of the program. 29 (h) Upon availability of state funds, determination of 30 eligibility criteria and qualifications for participating 31 communities and applicants not located in federally designated 32 shortage areas. 33 (i) Other rules as necessary. 34 Sec. 4. Section 135.107, subsection 3, paragraph a, Code 35 -3- LSB 1555XL (10) 91 lh/ko 3/ 43 |
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| 9 | 9 | | S.F. _____ H.F. _____ 2025, is amended to read as follows: 1 a. Eligibility under any of the programs health care 2 workforce and community support grant program established under 3 the primary care provider recruitment and retention endeavor 4 shall be based upon a community health services assessment 5 completed under subsection 2 , paragraph a . Participation 6 in a community health services assessment process shall be 7 documented by the community or region. 8 Sec. 5. Section 135.107, Code 2025, is amended by adding the 9 following new subsection: 10 NEW SUBSECTION . 4. A health care workforce and community 11 support grant program fund is created in the state treasury 12 under the control of the department of health and human 13 services. All moneys deposited or paid into the fund are 14 appropriated to the department to be used for grant assistance 15 as provided in this section. Notwithstanding section 8.33, 16 moneys in the fund that remain unencumbered or unobligated at 17 the close of each fiscal year shall not revert but shall remain 18 available for expenditure. Notwithstanding section 12C.7, 19 subsection 2, interest or earnings on moneys in the fund shall 20 be credited to the fund. 21 Sec. 6. TRANSITION PROVISIONS ACCOUNT. 22 1. The department of health and human services shall make 23 loan repayments pursuant to a loan repayment program contract 24 entered into on or before June 30, 2025, by a recipient and 25 the department under the primary care provider loan repayment 26 program in section 135.107, Code 2025, if the recipient remains 27 in compliance with all obligations under the loan repayment 28 program contract. 29 2. a. The department of health and human services shall 30 create an account for deposit of any moneys encumbered or 31 obligated pursuant to a loan repayment program contract 32 entered into on or before June 30, 2025, by a recipient and 33 the department under the primary care provider loan repayment 34 program in section 135.107, Code 2025. The department shall 35 -4- LSB 1555XL (10) 91 lh/ko 4/ 43 |
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| 11 | 11 | | S.F. _____ H.F. _____ ensure that the encumbered and obligated moneys remain 1 available for the duration of the loan repayment program 2 contract if the recipient remains in compliance with all 3 obligations under the loan repayment program contract. 4 b. Notwithstanding section 8.33, any balance in the account 5 shall not revert but shall remain available for the duration of 6 such loan repayment program contracts. Notwithstanding section 7 12C.7, subsection 2, interest or earnings on moneys deposited 8 in the account shall be credited to the account. 9 c. Upon expiration of all loan repayment program contract 10 periods and the expenditure of all moneys encumbered and 11 obligated under such loan repayment contracts, any unencumbered 12 or unobligated moneys remaining in the account created under 13 this section shall be deposited in the health care professional 14 incentive program fund created in section 256.222, as enacted 15 by this Act. 16 DIVISION III 17 ELIMINATION OF HEALTH CARE-RELATED LOAN REPAYMENT AND FINANCIAL 18 AWARD PROGRAMS COLLEGE STUDENT AID COMMISSION 19 Sec. 7. REPEAL. Sections 256.221, 256.223, 256.224, and 20 256.225, Code 2025, are repealed. 21 Sec. 8. TRANSITION PROVISIONS. 22 1. The college student aid commission shall make loan 23 repayments pursuant to a program agreement entered into on or 24 before June 30, 2025, by an eligible student and the commission 25 under the rural Iowa primary care loan repayment program 26 in section 256.221, Code 2025, if the student remains in 27 compliance with all obligations under the program agreement. 28 2. The college student aid commission shall make loan 29 repayments pursuant to a contract entered into on or before 30 June 30, 2025, by a health care professional and the commission 31 under the health care professional recruitment program in 32 section 256.223, Code 2025, if the health care professional 33 remains in compliance with all obligations under the contract. 34 3. The college student aid commission shall provide the 35 -5- LSB 1555XL (10) 91 lh/ko 5/ 43 |
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| 13 | 13 | | S.F. _____ H.F. _____ annual award to a recipient selected on or before June 30, 1 2025, for an award under the health care award program in 2 section 256.224, Code 2025. 3 4. The college student aid commission shall make loan 4 repayments pursuant to a program agreement entered into on or 5 before June 30, 2025, by a mental health professional and the 6 commission under the mental health professional loan repayment 7 program in section 256.225, Code 2025, if the mental health 8 professional remains in compliance with all obligations under 9 the program agreement. 10 Sec. 9. TRANSFER OF MONEYS. On the effective date of this 11 division of this Act, any unencumbered and unobligated moneys 12 remaining in the following funds shall be transferred to the 13 health care professional incentive program fund created in 14 section 256.222, as enacted in this Act: 15 1. The rural Iowa primary care trust fund created in section 16 256.221, subsection 12, Code 2025. 17 2. The health care professional recruitment fund created in 18 section 256.223, subsection 4, Code 2025. 19 3. The health care award fund created in section 256.224, 20 subsection 6, Code 2025. 21 4. The mental health professional loan repayment fund 22 created in section 256.225, subsection 7, Code 2025. 23 Sec. 10. TRANSITION ACCOUNTS. 24 1. The department of health and human services shall create 25 individual accounts for the deposit of any moneys encumbered or 26 obligated relating to a loan repayment or award funded under 27 each of the following programs: 28 a. The rural Iowa primary care loan repayment program under 29 section 256.221, Code 2025. 30 b. The health care professional recruitment program under 31 section 256.223, Code 2025. 32 c. The health care award program under section 256.224, Code 33 2025. 34 d. The mental health professional loan repayment program 35 -6- LSB 1555XL (10) 91 lh/ko 6/ 43 |
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| 15 | 15 | | S.F. _____ H.F. _____ under section 256.225, Code 2025. 1 2. Notwithstanding section 8.33, any balance in any of 2 the accounts created under subsection 1 shall not revert but 3 shall remain available for the duration of all applicable 4 loan repayments and awards. Notwithstanding section 12C.7, 5 subsection 2, interest or earnings on moneys deposited in each 6 account shall be credited to the respective account. 7 3. Upon expiration of all program agreement, contract, 8 and award disbursement periods and the expenditure of all 9 moneys encumbered and obligated under such program agreements, 10 contracts, and awards, any unencumbered or unobligated moneys 11 remaining in the accounts created under this section shall be 12 deposited in the health care professional incentive program 13 fund created in section 256.222, as enacted by this Act. 14 DIVISION IV 15 HEALTH CARE PROFESSIONAL INCENTIVE PROGRAM ESTABLISHED 16 Sec. 11. Section 135.107, subsection 1, Code 2025, is 17 amended by adding the following new paragraph: 18 NEW PARAGRAPH . f. Coordinate with the college student aid 19 commission to administer the health care professional incentive 20 program established in section 256.222. 21 Sec. 12. NEW SECTION . 256.222 Health care professional 22 incentive program fund. 23 1. Definitions. For purposes of this section, unless the 24 context otherwise requires: 25 a. Award means either of the following: 26 (1) A loan repayment made on behalf of an eligible health 27 care professional on the total amount owed, including principal 28 and interest, by the eligible health care professional on any 29 of the following: 30 (a) A federally guaranteed Stafford loan under the federal 31 family education loan program or the federal direct loan 32 program. 33 (b) A federal grad plus loan. 34 (c) A consolidated federally guaranteed Stafford loan under 35 -7- LSB 1555XL (10) 91 lh/ko 7/ 43 |
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| 17 | 17 | | S.F. _____ H.F. _____ the federal family education loan program or the federal direct 1 loan program. 2 (d) A consolidated federal grad plus loan. 3 (2) An income bonus paid to an eligible health care 4 professional. 5 b. Commission means the college student aid commission. 6 c. Department means the department of health and human 7 services. 8 d. Eligible health care profession means health care 9 occupational categories that are in high demand, as determined 10 and maintained on a list by the department, and may include but 11 are not limited to physicians, physician assistants, registered 12 nurses, nurse practitioners, nurse educators, and mental health 13 professionals. 14 e. Eligible health care professional means an individual 15 currently employed, or who will be employed, in an eligible 16 health care profession that is located in an eligible practice 17 area. 18 f. Eligible practice area means a geographic region 19 or county in this state that has a shortage of health care 20 professionals as determined by the department. 21 g. Employment obligation means the number of consecutive 22 years an eligible health care professional must practice. 23 (1) If practicing full-time, which means two thousand 24 eighty hours of work in a calendar year, including all paid 25 holidays, vacations, sick time, and other paid leave, an 26 eligible health care professional must practice for five years. 27 (2) If practicing part-time, which means one thousand five 28 hundred sixty hours of work in a calendar year, including all 29 paid holidays, vacations, sick time, and other paid leave, 30 an eligible health care professional must practice for seven 31 years. 32 h. Program means the health care professional incentive 33 program established in this section. 34 2. Program established. The health care professional 35 -8- LSB 1555XL (10) 91 lh/ko 8/ 43 |
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| 19 | 19 | | S.F. _____ H.F. _____ incentive program is established and shall be administered 1 by the commission, in coordination with the department, for 2 the purpose of offering awards to recruit and retain eligible 3 health care professionals for employment in eligible practice 4 areas. For the fiscal year beginning July 1, 2025, and 5 each fiscal year thereafter, the commission, in coordination 6 with the department, shall determine the number of awards 7 available for each eligible health care profession prior to the 8 commencement of the fiscal year. 9 3. Legislative intent. It is the intent of the general 10 assembly that the program shall not interfere with local 11 community investments to recruit and retain health care 12 professionals. 13 4. Exceptions. An eligible health care professional shall 14 be ineligible for the program if the eligible health care 15 professional is currently participating in, or has participated 16 in, any of the following: 17 a. The primary care provider loan repayment program pursuant 18 to section 135.107, Code 2025. 19 b. The rural Iowa primary care loan repayment program 20 pursuant to section 256.221, Code 2025. 21 c. The health care professional recruitment program pursuant 22 to section 256.223, Code 2025. 23 d. The health care award program pursuant to section 24 256.224, Code 2025. 25 e. The mental health professional loan repayment program 26 pursuant to section 256.225, Code 2025. 27 5. Program requirements. 28 a. An eligible health care professional may submit an 29 application for the program to the commission in the form and 30 manner prescribed by the commission. The applicant shall 31 elect to receive an award as either a loan repayment or an 32 income bonus if selected for the program, and shall submit any 33 additional information requested by the commission. 34 b. If selected for an award, the eligible health care 35 -9- LSB 1555XL (10) 91 lh/ko 9/ 43 |
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| 21 | 21 | | S.F. _____ H.F. _____ professional and the commission shall execute a program 1 agreement that specifies all of the following: 2 (1) The date the eligible health care professionals 3 employment obligation begins, which shall be no later than six 4 months from the date the program agreement is executed. 5 (2) The date the health care professionals employment 6 obligation terminates. 7 (3) Whether the award is a loan repayment or an income 8 bonus, and the terms and conditions related to the award, 9 including the aggregate award amount that the eligible health 10 care professional will receive. 11 (4) Requirements regarding the eligible health care 12 professionals license to practice in this state while 13 participating in the program. 14 (5) All other terms and conditions agreed to by the eligible 15 health care professional and the commission. 16 6. Awards. 17 a. Upon verifying the eligible health care professional is 18 in compliance with all terms of the program agreement executed 19 pursuant to subsection 5, paragraph b , the commission shall 20 pay the eligible health care professionals award annually as 21 follows: 22 (1) For a full-time employment obligation, the award shall 23 be paid as follows: 24 (a) An amount equal to twenty percent of the aggregate award 25 shall be paid to the eligible health care professional after 26 the completion of the first year of the eligible health care 27 professionals employment obligation. 28 (b) An amount equal to fifteen percent of the aggregate 29 award shall be paid to the eligible health care professional 30 after the completion of the second year, the third year, and 31 the fourth year of the eligible health care professionals 32 employment obligation. 33 (c) An amount equal to thirty-five percent of the aggregate 34 award shall be paid to the eligible health care professional 35 -10- LSB 1555XL (10) 91 lh/ko 10/ 43 |
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| 23 | 23 | | S.F. _____ H.F. _____ after the completion of the fifth year of the eligible health 1 care professionals employment obligation. 2 (2) For a part-time employment obligation, the aggregate 3 award shall be prorated by the commission. 4 b. A minimum of every five years, and each time the 5 department adds a new eligible health care profession, 6 the commission, in consultation with the department, shall 7 establish the aggregate award amount for each eligible health 8 care profession. The aggregate award amount shall not exceed 9 two hundred thousand dollars. 10 c. An individual who entered into a program agreement under 11 subsection 5, paragraph b , before the date on which the 12 department determined the individuals health care profession 13 is no longer an eligible health care profession, shall remain 14 eligible for the program per the terms of the individuals 15 program agreement. 16 7. Health care professional incentive program fund. A 17 health care professional incentive program fund is created in 18 the state treasury under the control of the commission. All 19 moneys deposited or paid into the fund are appropriated to the 20 commission to be used for awards as provided in this section. 21 Notwithstanding section 8.33, moneys in the fund that remain 22 unencumbered or unobligated at the close of each fiscal year 23 shall not revert but shall remain available for expenditure. 24 Notwithstanding section 12C.7, subsection 2, interest or 25 earnings on moneys in the fund shall be credited to the fund 26 and may be utilized by the commission for administrative costs. 27 8. Rules. The commission, in coordination with the 28 department, shall adopt rules pursuant to chapter 17A to 29 administer this section. 30 Sec. 13. EFFECTIVE DATE. This division of this Act, being 31 deemed of immediate importance, takes effect upon enactment. 32 DIVISION V 33 ELIMINATION OF HEALTH CARE-RELATED GRANT, RESIDENCY, AND 34 FELLOWSHIP PROGRAMS DEPARTMENT OF HEALTH AND HUMAN SERVICES 35 -11- LSB 1555XL (10) 91 lh/ko 11/ 43 |
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| 25 | 25 | | S.F. _____ H.F. _____ Sec. 14. Section 135.179, subsection 2, Code 2025, is 1 amended to read as follows: 2 2. Funding for the program may be provided through the 3 health care workforce shortage fund or the fulfilling Iowas 4 need for dentists matching grant program account created in 5 section 135.175 . The purpose of the program is to establish, 6 expand, or support the placement of dentists in dental or rural 7 shortage areas across the state by providing education loan 8 repayments. 9 Sec. 15. Section 249M.4, subsection 2, Code 2025, is amended 10 to read as follows: 11 2. Moneys in the trust fund shall be used, subject to 12 their appropriation by the general assembly, by the department 13 to reimburse participating hospitals the medical assistance 14 program upper payment limit for inpatient and outpatient 15 hospital services as calculated in this section . Following 16 payment of such upper payment limit to participating hospitals, 17 any remaining funds in the trust fund on an annual basis may be 18 used for any of the following purposes: 19 a. To support medical assistance program utilization 20 shortfalls. 21 b. To maintain the states capacity to provide access to and 22 delivery of services for vulnerable Iowans. 23 c. To fund the health care workforce support initiative 24 created pursuant to section 135.175 . 25 d. c. To support access to health care services for 26 uninsured Iowans. 27 e. d. To support Iowa hospital programs and services which 28 expand access to health care services for Iowans. 29 Sec. 16. REPEAL. Sections 135.175, 135.176, 135.178, and 30 135.193, Code 2025, are repealed. 31 Sec. 17. APPROPRIATION PSYCHIATRIC RESIDENCIES. There 32 is appropriated from the general fund of the state to the 33 department of health and human services for the following 34 fiscal years, the following amounts, or so much thereof as is 35 -12- LSB 1555XL (10) 91 lh/ko 12/ 43 |
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| 27 | 27 | | S.F. _____ H.F. _____ necessary, for deposit in the account for rural psychiatric 1 residencies created in this division of this Act: 2 FY 2025-2026: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,000 4 FY 2026-2027: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 6 FY 2027-2028: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 200,000 8 Sec. 18. TRANSITION PROVISIONS. 9 1. a. The department of health and human services shall 10 provide matching state funding to a sponsor awarded on or 11 before June 30, 2025, under the medical residency training 12 state matching grants program in section 135.176, Code 2025, 13 until all residents in the funded residencies have completed or 14 left the program. 15 b. The department of health and human services shall provide 16 matching state funding to a sponsor for medical residency 17 training program liability costs awarded on or before June 18 30, 2025, under the medical residency training state matching 19 grants program in section 135.176, Code 2025, until June 30, 20 2026. 21 2. The department of health and human services shall provide 22 matching state funding to a sponsor awarded on or before June 23 30, 2025, under the nurse residency state matching grants 24 program in section 135.178, Code 2025, until all residents have 25 completed or left the nurse residency programs. 26 3. The department of health and human services shall fund 27 a fellowship position pursuant to a program agreement entered 28 into on or before June 30, 2025, by a participating teaching 29 hospital and a participating fellow under the state-funded 30 family medicine obstetrics fellowship program in section 31 135.193, Code 2025, if the participating fellow remains in 32 compliance with all obligations under the program agreement. 33 4. The department of health and human services shall fund 34 a rural psychiatric residency for a resident selected on or 35 -13- LSB 1555XL (10) 91 lh/ko 13/ 43 |
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| 29 | 29 | | S.F. _____ H.F. _____ before June 30, 2025, until all residents have completed 1 or left the rural psychiatric residencies, pursuant to 2 appropriations as provided in the following: 3 a. 2024 Iowa Acts, chapter 1157, section 5, subsection 3, 4 and 2024 Iowa Acts, chapter 1157, section 22, subsection 5. 5 b. 2023 Iowa Acts, chapter 112, section 5, subsection 4, 6 paragraph j, as amended by 2024 Iowa Acts, chapter 1157, 7 section 29. 8 c. 2022 Iowa Acts, chapter 1131, section 3, subsection 4, 9 paragraph j, as amended by 2024 Iowa Acts, chapter 1157, 10 section 23. 11 d. 2021 Iowa Acts, chapter 182, section 3, subsection 4, 12 paragraph j. 13 e. 2019 Iowa Acts, chapter 85, section 3, subsection 4, 14 paragraph j, as amended by 2020 Iowa Acts, chapter 1121, 15 section 19. 16 Sec. 19. TRANSFER OF MONEYS. Notwithstanding section 8.33 17 or any other provision to the contrary, any unobligated or 18 unencumbered moneys in any of the following accounts or funds 19 or constituting any specified appropriation, shall not revert 20 but are appropriated to the department of health and human 21 services to fund Medicaid graduate medical education efforts. 22 1. The health care workforce shortage fund created in 23 section 135.175, subsection 1, paragraph b, Code 2025. 24 2. The medical residency training account created in 25 section 135.175, subsection 5, paragraph a, Code 2025. 26 3. The nurse residency state matching grants program 27 account created in section 135.175, subsection 5, paragraph 28 b, Code 2025. 29 4. The health care workforce shortage national initiatives 30 account created in section 135.175, subsection 5, paragraph 31 c, Code 2025. 32 5. The fulfilling Iowas need for dentists matching grant 33 program account created in section 135.175, subsection 5, 34 paragraph d, Code 2025. 35 -14- LSB 1555XL (10) 91 lh/ko 14/ 43 |
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| 31 | 31 | | S.F. _____ H.F. _____ 6. The family medicine obstetrics fellowship program fund 1 created in section 135.193, Code 2025. 2 7. Moneys appropriated to the department of health and human 3 services for rural psychiatric residencies to fund psychiatric 4 residents to provide mental health services in underserved 5 areas of the state as described in the following: 6 a. 2024 Iowa Acts, chapter 1157, section 5, subsection 3, 7 and 2024 Iowa Acts, chapter 1157, section 22, subsection 5. 8 b. 2023 Iowa Acts, chapter 112, section 5, subsection 4, 9 paragraph j, as amended by 2024 Iowa Acts, chapter 1157, 10 section 29. 11 c. 2022 Iowa Acts, chapter 1131, section 3, subsection 4, 12 paragraph j, as amended by 2024 Iowa Acts, chapter 1157, 13 section 23. 14 d. 2021 Iowa Acts, chapter 182, section 3, subsection 4, 15 paragraph j. 16 e. 2019 Iowa Acts, chapter 85, section 3, subsection 4, 17 paragraph j, as amended by 2020 Iowa Acts, chapter 1121, 18 section 19. 19 Sec. 20. TRANSITION ACCOUNTS. 20 1. The department of health and human services shall create 21 individual accounts for the deposit of any moneys encumbered 22 or obligated relating to a grant awarded, or residency or 23 fellowship funded, under each of the following programs: 24 a. The medical residency training state matching grants 25 program under section 135.176, Code 2025. 26 b. The nurse residency state matching grants program under 27 section 135.178, Code 2025. 28 c. The state-funded family medicine obstetrics fellowship 29 program under section 135.193, Code 2025. 30 d. Rural psychiatric residencies as described in the 31 following: 32 (1) 2024 Iowa Acts, chapter 1157, section 5, subsection 3, 33 and 2024 Iowa Acts, chapter 1157, section 22, subsection 5. 34 (2) 2023 Iowa Acts, chapter 112, section 5, subsection 4, 35 -15- LSB 1555XL (10) 91 lh/ko 15/ 43 |
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| 33 | 33 | | S.F. _____ H.F. _____ paragraph j, as amended by 2024 Iowa Acts, chapter 1157, 1 section 29. 2 (3) 2022 Iowa Acts, chapter 1131, section 3, subsection 3 4, paragraph j, as amended by 2024 Iowa Acts, chapter 1157, 4 section 23. 5 (4) 2021 Iowa Acts, chapter 182, section 3, subsection 4, 6 paragraph j. 7 (5) 2019 Iowa Acts, chapter 85, section 3, subsection 4, 8 paragraph j, as amended by 2020 Iowa Acts, chapter 1121, 9 section 19. 10 2. Notwithstanding section 8.33, any balance in any of the 11 accounts created under subsection 1 shall not revert but shall 12 remain available for the duration of all applicable grants, 13 residencies, and fellowships. Notwithstanding section 12C.7, 14 subsection 2, interest or earnings on moneys deposited in each 15 account shall be credited to the respective account. 16 3. Upon expiration of all grant, residency, and fellowship 17 periods and the expenditure of all moneys encumbered under 18 such grants, residencies, and fellowships, any unencumbered or 19 unobligated moneys remaining in any of the accounts created 20 under subsection 1 are appropriated to the department of health 21 and human services for Medicaid graduate medical education 22 efforts. 23 DIVISION VI 24 ELIMINATION OF THE STATE-FUNDED PSYCHIATRY RESIDENCY AND 25 FELLOWSHIP POSITIONS UNIVERSITY OF IOWA HOSPITALS AND 26 CLINICS 27 Sec. 21. REPEAL. Section 135.180, Code 2025, is repealed. 28 Sec. 22. TRANSITION PROVISIONS. The board of regents 29 shall direct the university of Iowa hospitals and clinics to 30 distribute moneys for state-funded psychiatry residency and 31 fellowship positions approved and awarded on or before June 32 30, 2025, under the state-funded psychiatry residency and 33 fellowship positions in section 135.180, Code 2025, until all 34 residents and fellows have completed or left the state-funded 35 -16- LSB 1555XL (10) 91 lh/ko 16/ 43 |
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| 35 | 35 | | S.F. _____ H.F. _____ psychiatry residency or fellowship positions. 1 Sec. 23. TRANSITION ACCOUNT. 2 1. The board of regents shall direct the university of Iowa 3 hospitals and clinics to create an account for the deposit 4 of moneys encumbered or obligated relating to residency and 5 fellowship positions funded under the state-funded psychiatry 6 residency and fellowship positions under section 135.180, Code 7 2025. 8 2. Notwithstanding section 8.33, any balance in the account 9 created under subsection 1 shall not revert but shall remain 10 available for the duration of all applicable residencies and 11 fellowships. Notwithstanding section 12C.7, subsection 2, 12 interest or earnings on moneys deposited in the account shall 13 be credited to the account. 14 3. Upon expiration of all residency and fellowship periods 15 and the expenditure of all moneys encumbered under such 16 residencies and fellowships, any unencumbered or unobligated 17 moneys remaining in the account created under subsection 1 are 18 appropriated to the department of health and human services for 19 Medicaid graduate medical education efforts. 20 Sec. 24. TRANSFER OF MONEYS. Notwithstanding section 8.33 21 or any other provision to the contrary, any unobligated or 22 unencumbered moneys in the psychiatry residency and fellowship 23 positions fund created in section 135.180, Code 2025, shall 24 not revert but are appropriated to the department of health 25 and human services to fund Medicaid graduate medical education 26 efforts. 27 DIVISION VII 28 ELIMINATION OF THE HEALTH FACILITIES COUNCIL 29 Sec. 25. Section 10A.711, subsection 5, Code 2025, is 30 amended by striking the subsection and inserting in lieu 31 thereof the following: 32 5. Department means the department of inspections, 33 appeals, and licensing. 34 Sec. 26. Section 10A.713, subsection 4, unnumbered 35 -17- LSB 1555XL (10) 91 lh/ko 17/ 43 |
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| 36 | 36 | | |
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| 37 | 37 | | S.F. _____ H.F. _____ paragraph 1, Code 2025, is amended to read as follows: 1 A copy of the application shall be sent to the department 2 of health and human services at the time the application is 3 submitted to the department. The department shall not process 4 applications for and the council shall not an intermediate 5 care facility for persons with an intellectual disability, or 6 consider a new or changed institutional health service for an 7 intermediate care facility for persons with an intellectual 8 disability , unless both of the following conditions are met: 9 Sec. 27. Section 10A.714, subsection 1, unnumbered 10 paragraph 1, Code 2025, is amended to read as follows: 11 In determining whether a certificate of need shall be 12 issued, the department and council shall consider the 13 following: 14 Sec. 28. Section 10A.714, subsection 1, paragraph r, Code 15 2025, is amended to read as follows: 16 r. The recommendations of staff personnel of the department 17 assigned to the area of certificate of need, concerning the 18 application , if requested by the council . 19 Sec. 29. Section 10A.714, subsection 2, unnumbered 20 paragraph 1, Code 2025, is amended to read as follows: 21 In addition to the findings required with respect to any 22 of the criteria listed in subsection 1 of this section , the 23 council department shall grant a certificate of need for a new 24 institutional health service or changed institutional health 25 service only if it the department finds in writing, on the 26 basis of data submitted to it by the department , that: 27 Sec. 30. Section 10A.716, subsection 3, Code 2025, is 28 amended to read as follows: 29 3. Each application accepted by the department shall be 30 formally reviewed for the purpose of furnishing to the council 31 the information necessary to enable it the department to 32 determine whether or not to grant the certificate of need. A 33 formal review shall consist , at a minimum , of the following 34 steps: 35 -18- LSB 1555XL (10) 91 lh/ko 18/ 43 |
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| 38 | 38 | | |
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| 39 | 39 | | S.F. _____ H.F. _____ a. Evaluation of the application against the criteria 1 specified in section 10A.714 135.63 . 2 b. A public hearing on the application, to be held prior to 3 completion of the evaluation required by paragraph a , shall be 4 conducted by the council . 5 Sec. 31. Section 10A.719, Code 2025, is amended to read as 6 follows: 7 10A.719 Council Department to make final decision. 8 1. The department shall complete its formal review of 9 the application within ninety days after acceptance of the 10 application, except as otherwise provided by section 10A.722 11 135.71 , subsection 4 . Upon completion of the formal review, 12 the council department shall approve or deny the application. 13 The council department shall issue written findings stating the 14 basis for its decision on the application , and the department 15 shall send copies of the councils decision and the written 16 findings supporting the decision to the applicant and to any 17 other person who so requests. 18 2. Failure by the council department to issue a written 19 decision on an application for a certificate of need within the 20 time required by this section shall constitute denial of and 21 final administrative action on the application. 22 Sec. 32. Section 10A.720, Code 2025, is amended to read as 23 follows: 24 10A.720 Appeal of certificate of need decisions. 25 The councils departments decision on an application for 26 certificate of need, when announced pursuant to section 10A.719 27 135.68 , is shall be a final decision. Any dissatisfied party 28 who is an affected person with respect to the application, 29 and who participated or sought unsuccessfully to participate 30 in the formal review procedure prescribed by section 10A.716 31 135.65 , may request a rehearing in accordance with chapter 17A 32 and rules of the department. If a rehearing is not requested 33 or an affected party remains dissatisfied after the request for 34 rehearing, an appeal may be taken in the manner provided by 35 -19- LSB 1555XL (10) 91 lh/ko 19/ 43 |
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| 40 | 40 | | |
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| 41 | 41 | | S.F. _____ H.F. _____ chapter 17A . Notwithstanding the Iowa administrative procedure 1 Act, chapter 17A , a request for rehearing is not required , 2 prior to appeal under section 17A.19 . 3 Sec. 33. Section 10A.721, Code 2025, is amended to read as 4 follows: 5 10A.721 Period for which certificate is valid extension 6 or revocation. 7 1. A certificate of need shall be valid for a maximum of 8 one year from the date of issuance. Upon the expiration of the 9 certificate, or at any earlier time while the certificate is 10 valid , the holder thereof of the certificate shall provide the 11 department such information on the development of the project 12 covered by the certificate as the department may request. 13 The council department shall determine at the end of the 14 certification period whether sufficient progress is being made 15 on the development of the project. The certificate of need may 16 be extended by the council department for additional periods 17 of time as are reasonably necessary to expeditiously complete 18 the project, but may be revoked by the council department at 19 the end of the first or any subsequent certification period for 20 insufficient progress in developing the project. 21 2. Upon expiration of a certificate of need, and prior to 22 extension thereof of the certificate of need , any affected 23 person shall have the right to submit to the department 24 information which may be relevant to the question of granting 25 an extension. The department may call a public hearing for 26 this purpose. 27 Sec. 34. Section 10A.722, unnumbered paragraph 1, Code 28 2025, is amended to read as follows: 29 The department shall adopt , with approval of the council, 30 such administrative rules as are necessary to enable it to 31 implement this part subchapter . These rules shall include: 32 Sec. 35. Section 10A.723, subsection 2, paragraph a, Code 33 2025, is amended to read as follows: 34 a. A class I violation is one in which a party offers a 35 -20- LSB 1555XL (10) 91 lh/ko 20/ 43 |
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| 42 | 42 | | |
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| 43 | 43 | | S.F. _____ H.F. _____ new institutional health service or changed institutional 1 health service modernization or acquisition without review and 2 approval by the council department . A party in violation is 3 subject to a penalty of three hundred dollars for each day of a 4 class I violation. The department may seek injunctive relief 5 which shall include restraining the commission or continuance 6 of an act which would violate the provisions of this paragraph. 7 Notice and opportunity to be heard shall be provided to a party 8 pursuant to rule of civil procedure 1.1507 and contested case 9 procedures in accordance with chapter 17A . The department may 10 reduce, alter, or waive a penalty upon the party showing good 11 faith compliance with the departments request to immediately 12 cease and desist from conduct in violation of this section . 13 Sec. 36. Section 68B.35, subsection 2, paragraph e, Code 14 2025, is amended to read as follows: 15 e. Members of the state banking council, the Iowa ethics and 16 campaign disclosure board, the credit union review board, the 17 economic development authority, the employment appeal board, 18 the environmental protection commission, the health facilities 19 council, the Iowa finance authority, the Iowa public employees 20 retirement system investment board, the Iowa lottery commission 21 created in section 99G.8 , the natural resource commission, the 22 board of parole, the state racing and gaming commission, the 23 state board of regents, the transportation commission, the 24 office of consumer advocate, the utilities commission, the Iowa 25 telecommunications and technology commission, and any full-time 26 members of other boards and commissions as defined under 27 section 7E.4 who receive an annual salary for their service 28 on the board or commission. The Iowa ethics and campaign 29 disclosure board shall conduct an annual review to determine 30 if members of any other board, commission, or authority should 31 file a statement and shall require the filing of a statement 32 pursuant to rules adopted pursuant to chapter 17A . 33 Sec. 37. Section 97B.1A, subsection 8, paragraph a, 34 subparagraph (8), Code 2025, is amended to read as follows: 35 -21- LSB 1555XL (10) 91 lh/ko 21/ 43 |
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| 44 | 44 | | |
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| 45 | 45 | | S.F. _____ H.F. _____ (8) Members of the state transportation commission , and the 1 board of parole , and the state health facilities council . 2 Sec. 38. CODE EDITOR DIRECTIVE. 3 1. The Code editor is directed to make the following 4 transfers: 5 a. Section 10A.711 to section 135.61. 6 b. Section 10A.713 to section 135.62. 7 c. Section 10A.714 to section 135.63. 8 d. Section 10A.715 to section 135.64. 9 e. Section 10A.716 to section 135.65. 10 f. Section 10A.717 to section 135.66. 11 g. Section 10A.718 to section 135.67. 12 h. Section 10A.719 to section 135.68. 13 i. Section 10A.720 to section 135.69. 14 j. Section 10A.721 to section 135.70. 15 k. Section 10A.722 to section 135.71. 16 l. Section 10A.723 to section 135.72. 17 m. Section 10A.724 to section 135.73. 18 n. Section 10A.725 to section 135.74. 19 o. Section 10A.726 to section 135.75. 20 p. Section 10A.727 to section 135.76. 21 q. Section 10A.728 to section 135.77. 22 r. Section 10A.729 to section 135.78. 23 2. The Code editor is directed to rename and retitle 24 subchapter VI of chapter 135 as HEALTH FACILITIES and include 25 sections 135.61 through 135.78. 26 3. The Code editor shall correct internal references in the 27 Code and in any enacted legislation as is necessary due to the 28 enactment of this division. 29 Sec. 39. REPEAL. Section 10A.712, Code 2025, is repealed. 30 DIVISION VIII 31 CONFORMING CHANGES ELIMINATION OF THE HEALTH FACILITIES 32 COUNCIL 33 Sec. 40. Section 10A.711, unnumbered paragraph 1, Code 34 2025, is amended to read as follows: 35 -22- LSB 1555XL (10) 91 lh/ko 22/ 43 |
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| 46 | 46 | | |
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| 47 | 47 | | S.F. _____ H.F. _____ As used in this part subchapter , unless the context 1 otherwise requires: 2 Sec. 41. Section 10A.711, subsection 1, paragraph d, Code 3 2025, is amended to read as follows: 4 d. Each institutional health facility or health maintenance 5 organization which, prior to receipt of the application by the 6 department, has formally indicated to the department pursuant 7 to this part subchapter an intent to furnish in the future 8 institutional health services similar to the new institutional 9 health service proposed in the application. 10 Sec. 42. Section 10A.713, subsection 1, Code 2025, is 11 amended to read as follows: 12 1. A new institutional health service or changed 13 institutional health service shall not be offered or developed 14 in this state without prior application to the department 15 for and receipt of a certificate of need, pursuant to this 16 part subchapter . The application shall be made upon forms 17 furnished or prescribed by the department and shall contain 18 such information as the department may require under this part 19 subchapter . The application shall be accompanied by a fee 20 equivalent to three-tenths of one percent of the anticipated 21 cost of the project with a minimum fee of six hundred dollars 22 and a maximum fee of twenty-one thousand dollars. The fee 23 shall be remitted by the department to the treasurer of 24 state, who shall place it in the general fund of the state. 25 If an application is voluntarily withdrawn within thirty 26 calendar days after submission, seventy-five percent of the 27 application fee shall be refunded; if the application is 28 voluntarily withdrawn more than thirty but within sixty days 29 after submission, fifty percent of the application fee shall 30 be refunded; if the application is withdrawn voluntarily more 31 than sixty days after submission, twenty-five percent of 32 the application fee shall be refunded. Notwithstanding the 33 required payment of an application fee under this subsection , 34 an applicant for a new institutional health service or a 35 -23- LSB 1555XL (10) 91 lh/ko 23/ 43 |
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| 48 | 48 | | |
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| 49 | 49 | | S.F. _____ H.F. _____ changed institutional health service offered or developed by 1 an intermediate care facility for persons with an intellectual 2 disability or an intermediate care facility for persons with 3 mental illness as defined pursuant to section 135C.1 is exempt 4 from payment of the application fee. 5 Sec. 43. Section 10A.713, subsection 2, unnumbered 6 paragraph 1, Code 2025, is amended to read as follows: 7 This part subchapter shall not be construed to augment, 8 limit, contravene, or repeal in any manner any other statute 9 of this state which may authorize or relate to licensure, 10 regulation, supervision, or control of, nor to be applicable 11 to: 12 Sec. 44. Section 10A.713, subsection 2, paragraphs a, f, h, 13 j, k, m, and n, Code 2025, are amended to read as follows: 14 a. Private offices and private clinics of an individual 15 physician, dentist, or other practitioner or group of health 16 care providers, except as provided by section 10A.711 135.61 , 17 subsection 17 , paragraphs g , h , and m , and section 10A.711 18 135.61 , subsections 2 and 19 . 19 f. A residential care facility, as defined in section 20 135C.1 , including a residential care facility for persons with 21 an intellectual disability, notwithstanding any provision in 22 this part subchapter to the contrary. 23 h. (1) The deletion of one or more health services, 24 previously offered on a regular basis by an institutional 25 health facility or health maintenance organization, 26 notwithstanding any provision of this part subchapter to the 27 contrary, if all of the following conditions exist: 28 (a) The institutional health facility or health maintenance 29 organization reports to the department the deletion of the 30 service or services at least thirty days before the deletion on 31 a form prescribed by the department. 32 (b) The institutional health facility or health maintenance 33 organization reports the deletion of the service or services on 34 its next annual report to the department. 35 -24- LSB 1555XL (10) 91 lh/ko 24/ 43 |
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| 50 | 50 | | |
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| 51 | 51 | | S.F. _____ H.F. _____ (2) If these conditions are not met, the institutional 1 health facility or health maintenance organization is subject 2 to review as a new institutional health service or changed 3 institutional health service under section 10A.711 135.61 , 4 subsection 17 , paragraph f , and is subject to sanctions under 5 section 10A.723 135.72 . 6 (3) If the institutional health facility or health 7 maintenance organization reestablishes the deleted service 8 or services at a later time, review as a new institutional 9 health service or changed institutional health service may 10 be required pursuant to section 10A.711 135.61 , subsection 17 . 11 j. The construction, modification, or replacement of 12 nonpatient care services, including parking facilities, 13 heating, ventilation and air conditioning systems, computers, 14 telephone systems, medical office buildings, and other projects 15 of a similar nature, notwithstanding any provision in this part 16 subchapter to the contrary. 17 k. (1) The redistribution of beds by a hospital within 18 the acute care category of bed usage, notwithstanding any 19 provision in this part subchapter to the contrary, if all of 20 the following conditions exist: 21 (a) The hospital reports to the department the number and 22 type of beds to be redistributed on a form prescribed by the 23 department at least thirty days before the redistribution. 24 (b) The hospital reports the new distribution of beds on its 25 next annual report to the department. 26 (2) If these conditions are not met, the redistribution 27 of beds by the hospital is subject to review as a new 28 institutional health service or changed institutional health 29 service pursuant to section 10A.711 135.61 , subsection 17 , 30 paragraph d , and is subject to sanctions under section 10A.723 31 135.72 . 32 m. Hemodialysis services provided by a hospital or 33 freestanding facility, notwithstanding any provision in this 34 part subchapter to the contrary. 35 -25- LSB 1555XL (10) 91 lh/ko 25/ 43 |
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| 52 | 52 | | |
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| 53 | 53 | | S.F. _____ H.F. _____ n. Hospice services provided by a hospital, notwithstanding 1 any provision in this part subchapter to the contrary. 2 Sec. 45. Section 10A.713, subsection 2, paragraph e, 3 subparagraph (2), Code 2025, is amended to read as follows: 4 (2) Acquires major medical equipment as provided by section 5 10A.711 135.61 , subsection 17 , paragraphs i and j . 6 Sec. 46. Section 10A.713, subsection 2, paragraph g, 7 subparagraph (1), unnumbered paragraph 1, Code 2025, is amended 8 to read as follows: 9 A reduction in bed capacity of an institutional health 10 facility, notwithstanding any provision in this part subchapter 11 to the contrary, if all of the following conditions exist: 12 Sec. 47. Section 10A.713, subsection 2, paragraph g, 13 subparagraph (2), Code 2025, is amended to read as follows: 14 (2) If these conditions are not met, the institutional 15 health facility is subject to review as a new institutional 16 health service or changed institutional health service under 17 section 10A.711 135.61 , subsection 17 , paragraph d , and is 18 subject to sanctions under section 10A.723 135.72 . If the 19 institutional health facility reestablishes the deleted beds at 20 a later time, review as a new institutional health service or 21 changed institutional health service is required pursuant to 22 section 10A.711 135.61 , subsection 17 , paragraph d . 23 Sec. 48. Section 10A.713, subsection 2, paragraph l, 24 unnumbered paragraph 1, Code 2025, is amended to read as 25 follows: 26 The replacement or modernization of any institutional 27 health facility if the replacement or modernization does 28 not add new health services or additional bed capacity for 29 existing health services, notwithstanding any provision in this 30 part subchapter to the contrary. With respect to a nursing 31 facility, replacement means establishing a new facility within 32 the same county as the prior facility to be closed. With 33 reference to a hospital, replacement means establishing a new 34 hospital that demonstrates compliance with all of the following 35 -26- LSB 1555XL (10) 91 lh/ko 26/ 43 |
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| 54 | 54 | | |
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| 55 | 55 | | S.F. _____ H.F. _____ criteria through evidence submitted to the department: 1 Sec. 49. Section 10A.713, subsection 2, paragraph p, 2 unnumbered paragraph 1, Code 2025, is amended to read as 3 follows: 4 The conversion of an existing number of beds by an 5 intermediate care facility for persons with an intellectual 6 disability to a smaller facility environment, including but not 7 limited to a community-based environment which does not result 8 in an increased number of beds, notwithstanding any provision 9 in this part subchapter to the contrary, including subsection 10 4 , if all of the following conditions exist: 11 Sec. 50. Section 10A.713, subsection 3, Code 2025, is 12 amended to read as follows: 13 3. This part subchapter shall not be construed to be 14 applicable to a health care facility operated by and for the 15 exclusive use of members of a religious order, which does 16 not admit more than two individuals to the facility from the 17 general public, and which was in operation prior to July 1, 18 1986. However, this part subchapter is applicable to such 19 a facility if the facility is involved in the offering or 20 developing of a new or changed institutional health service on 21 or after July 1, 1986. 22 Sec. 51. Section 10A.714, subsection 3, Code 2025, is 23 amended to read as follows: 24 3. In the evaluation of applications for certificates 25 of need submitted by the university of Iowa hospitals and 26 clinics, the unique features of that institution relating to 27 statewide tertiary health care, health science education, and 28 clinical research shall be given due consideration. Further, 29 in administering this part subchapter , the unique capacity of 30 university hospitals for the evaluation of technologically 31 innovative equipment and other new health services shall be 32 utilized. 33 Sec. 52. Section 10A.715, subsection 2, Code 2025, is 34 amended to read as follows: 35 -27- LSB 1555XL (10) 91 lh/ko 27/ 43 |
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| 56 | 56 | | |
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| 57 | 57 | | S.F. _____ H.F. _____ 2. Upon request of the sponsor of the proposed new or 1 changed service, the department shall make a preliminary review 2 of the letter for the purpose of informing the sponsor of 3 the project of any factors which may appear likely to result 4 in denial of a certificate of need, based on the criteria 5 for evaluation of applications in section 10A.714 135.63 . 6 A comment by the department under this section shall not 7 constitute a final decision. 8 Sec. 53. Section 10A.716, subsection 1, Code 2025, is 9 amended to read as follows: 10 1. Within fifteen business days after receipt of an 11 application for a certificate of need, the department shall 12 examine the application for form and completeness and accept or 13 reject it. An application shall be rejected only if it fails 14 to provide all information required by the department pursuant 15 to section 10A.713 135.62 , subsection 1 . The department shall 16 promptly return to the applicant any rejected application, with 17 an explanation of the reasons for its rejection. 18 Sec. 54. Section 10A.717, subsection 1, unnumbered 19 paragraph 1, Code 2025, is amended to read as follows: 20 The department may waive the letter of intent procedures 21 prescribed by section 10A.715 135.64 and substitute a summary 22 review procedure, which shall be established by rules of the 23 department, when it accepts an application for a certificate 24 of need for a project which meets any of the criteria in 25 paragraphs a through e : 26 Sec. 55. Section 10A.722, subsections 2, 3, and 4, Code 27 2025, are amended to read as follows: 28 2. Uniform procedures for variations in application of 29 criteria specified by section 10A.714 135.63 for use in formal 30 review of applications for certificates of need, when such 31 variations are appropriate to the purpose of a particular 32 review or to the type of institutional health service proposed 33 in the application being reviewed. 34 3. Uniform procedures for summary reviews conducted under 35 -28- LSB 1555XL (10) 91 lh/ko 28/ 43 |
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| 58 | 58 | | |
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| 59 | 59 | | S.F. _____ H.F. _____ section 10A.717 135.66 . 1 4. Criteria for determining when it is not feasible to 2 complete formal review of an application for a certificate 3 of need within the time limits specified in section 10A.719 4 135.68 . The rules adopted under this subsection shall include 5 criteria for determining whether an application proposes 6 introduction of technologically innovative equipment, and if 7 so, procedures to be followed in reviewing the application. 8 However, a rule adopted under this subsection shall not permit 9 a deferral of more than sixty days beyond the time when a 10 decision is required under section 10A.719 135.68 , unless both 11 the applicant and the department agree to a longer deferment. 12 Sec. 56. Section 10A.723, subsections 1 and 3, Code 2025, 13 are amended to read as follows: 14 1. Any party constructing a new institutional health 15 facility or an addition to or renovation of an existing 16 institutional health facility without first obtaining a 17 certificate of need or, in the case of a mobile health 18 service, ascertaining that the mobile health service has 19 received certificate of need approval, as required by this part 20 subchapter , shall be denied licensure or change of licensure by 21 the appropriate responsible licensing agency of this state. 22 3. Notwithstanding any other sanction imposed pursuant 23 to this section , a party offering or developing any new 24 institutional health service or changed institutional health 25 service without first obtaining a certificate of need as 26 required by this part subchapter, may be temporarily or 27 permanently restrained from doing so by any court of competent 28 jurisdiction in any action brought by the state, any of its 29 political subdivisions, or any other interested person. 30 Sec. 57. Section 10A.723, subsection 2, unnumbered 31 paragraph 1, Code 2025, is amended to read as follows: 32 A party violating this part subchapter shall be subject 33 to penalties in accordance with this section . The 34 department shall adopt rules setting forth the violations by 35 -29- LSB 1555XL (10) 91 lh/ko 29/ 43 |
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| 60 | 60 | | |
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| 61 | 61 | | S.F. _____ H.F. _____ classification, the criteria for the classification of any 1 violation not listed, and procedures for implementing this 2 subsection . 3 Sec. 58. Section 10A.724, subsection 3, Code 2025, is 4 amended to read as follows: 5 3. The department shall, where appropriate, provide 6 for modification, consistent with the purposes of this part 7 subchapter , of reporting requirements to correctly reflect the 8 differences among hospitals and among health care facilities 9 referred to in subsection 2 , and to avoid otherwise unduly 10 burdensome costs in meeting the requirements of uniform methods 11 of financial reporting. 12 Sec. 59. Section 10A.725, subsection 2, Code 2025, is 13 amended to read as follows: 14 2. Where more than one licensed hospital or health 15 care facility is operated by the reporting organization, 16 the information required by this section shall be reported 17 separately for each licensed hospital or health care facility. 18 The department shall require preparation of specified financial 19 reports by a certified public accountant, and may require 20 attestation of responsible officials of the reporting hospital 21 or health care facility that the reports submitted are to the 22 best of their knowledge and belief prepared in accordance with 23 the prescribed methods of reporting. The department shall 24 have the right to inspect the books, audits and records of any 25 hospital or health care facility as reasonably necessary to 26 verify reports submitted pursuant to this part subchapter . 27 Sec. 60. Section 10A.726, subsection 1, Code 2025, is 28 amended to read as follows: 29 1. The department shall from time to time undertake analyses 30 and studies relating to hospital and health care facility 31 costs and to the financial status of hospitals or health care 32 facilities, or both, which are subject to the provisions of 33 this part subchapter . It shall further require the filing 34 of information concerning the total financial needs of each 35 -30- LSB 1555XL (10) 91 lh/ko 30/ 43 |
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| 62 | 62 | | |
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| 63 | 63 | | S.F. _____ H.F. _____ individual hospital or health care facility and the resources 1 currently or prospectively available to meet these needs, 2 including the effect of proposals made by health systems 3 agencies. The department shall also prepare and file such 4 summaries and compilations or other supplementary reports based 5 on the information filed with it as will, in its judgment, 6 advance the purposes of this part subchapter . 7 Sec. 61. Section 10A.727, Code 2025, is amended to read as 8 follows: 9 10A.727 Data to be compiled. 10 The department shall compile all relevant financial and 11 utilization data in order to have available the statistical 12 information necessary to properly monitor hospital and health 13 care facility charges and costs. Such data shall include 14 necessary operating expenses, appropriate expenses incurred for 15 rendering services to patients who cannot or do not pay, all 16 properly incurred interest charges, and reasonable depreciation 17 expenses based on the expected useful life of the property 18 and equipment involved. The department shall also obtain 19 from each hospital and health care facility a current rate 20 schedule as well as any subsequent amendments or modifications 21 of that schedule as it may require. In collection of the data 22 required by this section and sections 10A.724 135.73 through 23 10A.726 135.75 , the department and other state agencies shall 24 coordinate their reporting requirements. 25 Sec. 62. Section 10A.728, Code 2025, is amended to read as 26 follows: 27 10A.728 Civil penalty. 28 Any hospital or health care facility which fails to file 29 with the department the financial reports required by sections 30 10A.724 135.73 through 10A.727 135.76 is subject to a civil 31 penalty of not to exceed five hundred dollars for each offense. 32 Sec. 63. Section 10A.729, Code 2025, is amended to read as 33 follows: 34 10A.729 Contracts for assistance with analyses, studies, and 35 -31- LSB 1555XL (10) 91 lh/ko 31/ 43 |
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| 64 | 64 | | |
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| 65 | 65 | | S.F. _____ H.F. _____ data. 1 In furtherance of the departments responsibilities under 2 sections 10A.726 135.75 and 10A.727 135.76 , the director may 3 contract with the Iowa hospital association and third-party 4 payers, the Iowa health care facilities association and 5 third-party payers, or leading age Iowa and third-party 6 payers for the establishment of pilot programs dealing with 7 prospective rate review in hospitals or health care facilities, 8 or both. Such contract shall be subject to the approval of 9 the executive council and shall provide for an equitable 10 representation of health care providers, third-party payers, 11 and health care consumers in the determination of criteria 12 for rate review. No third-party payer shall be excluded from 13 positive financial incentives based upon volume of gross 14 patient revenues. No state or federal funds appropriated or 15 available to the department shall be used for any such pilot 16 program. 17 Sec. 64. Section 135.131, subsection 1, paragraph a, Code 18 2025, is amended to read as follows: 19 a. Birth center means birth center as defined in section 20 10A.711 135.61 . 21 Sec. 65. Section 135B.5A, Code 2025, is amended to read as 22 follows: 23 135B.5A Conversion relative to certain hospitals. 24 1. A conversion of a long-term acute care hospital, 25 rehabilitation hospital, or psychiatric hospital as defined by 26 federal regulations to a general hospital or to a specialty 27 hospital of a different type is a permanent change in bed 28 capacity and shall require a certificate of need pursuant to 29 section 10A.713 135.62 . 30 2. A conversion of a critical access hospital or general 31 hospital to a rural emergency hospital shall not require a 32 certificate of need pursuant to section 10A.713 135.62 . 33 3. Any change of a rural emergency hospital in licensure, 34 organizational structure, or type of institutional health 35 -32- LSB 1555XL (10) 91 lh/ko 32/ 43 |
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| 66 | 66 | | |
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| 67 | 67 | | S.F. _____ H.F. _____ facility shall require a certificate of need pursuant to 1 section 10A.713 135.62 . 2 Sec. 66. Section 135C.2, subsection 5, unnumbered paragraph 3 1, Code 2025, is amended to read as follows: 4 The department shall establish a special classification 5 within the residential care facility category in order to 6 foster the development of residential care facilities which 7 serve persons with an intellectual disability, chronic mental 8 illness, a developmental disability, or brain injury, as 9 described under section 225C.26 , and which contain five or 10 fewer residents. A facility within the special classification 11 established pursuant to this subsection is exempt from the 12 requirements of section 10A.713 135.62 . The department 13 shall adopt rules which are consistent with rules previously 14 developed for the waiver demonstration project pursuant to 15 1986 Iowa Acts, ch. 1246, 206 , and which include all of the 16 following provisions: 17 Sec. 67. Section 135P.1, subsection 3, Code 2025, is amended 18 to read as follows: 19 3. Health facility means an institutional health facility 20 as defined in section 10A.711 135.61 , a hospice licensed under 21 chapter 135J , a home health agency as defined in section 22 144D.1 , an assisted living program certified under chapter 23 231C , a clinic, a community health center, or the university 24 of Iowa hospitals and clinics, and includes any corporation, 25 professional corporation, partnership, limited liability 26 company, limited liability partnership, or other entity 27 comprised of such health facilities. 28 Sec. 68. Section 231C.3, subsection 2, Code 2025, is amended 29 to read as follows: 30 2. Each assisted living program operating in this state 31 shall be certified by the department. If an assisted living 32 program is voluntarily accredited by a recognized accrediting 33 entity, the department shall certify the assisted living 34 program on the basis of the voluntary accreditation. An 35 -33- LSB 1555XL (10) 91 lh/ko 33/ 43 |
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| 68 | 68 | | |
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| 69 | 69 | | S.F. _____ H.F. _____ assisted living program that is certified by the department on 1 the basis of voluntary accreditation shall not be subject to 2 payment of the certification fee prescribed in section 231C.18 , 3 but shall be subject to an administrative fee as prescribed by 4 rule. An assisted living program certified under this section 5 is exempt from the requirements of section 10A.713 135.62 6 relating to certificate of need requirements. 7 Sec. 69. Section 505.27, subsection 5, paragraph a, Code 8 2025, is amended to read as follows: 9 a. Health care provider means the same as defined in 10 section 10A.711 135.61 , a hospital licensed pursuant to chapter 11 135B , or a health care facility licensed pursuant to chapter 12 135C . 13 Sec. 70. Section 708.3A, subsection 5, paragraph d, Code 14 2025, is amended to read as follows: 15 d. Health care provider means an emergency medical care 16 provider as defined in chapter 147A or a person licensed 17 or registered under chapter 148 , 148C , 148D , or 152 who is 18 providing or who is attempting to provide emergency medical 19 services, as defined in section 147A.1 , or who is providing 20 or who is attempting to provide health services as defined in 21 section 10A.711 135.61 in a hospital. A person who commits an 22 assault under this section against a health care provider in 23 a hospital, or at the scene or during out-of-hospital patient 24 transportation in an ambulance, is presumed to know that the 25 person against whom the assault is committed is a health care 26 provider. 27 DIVISION IX 28 IOWA HEALTH INFORMATION NETWORK EXCHANGE ADVISORY COMMITTEE 29 CREATED AND BOARD OF DIRECTORS ELIMINATED 30 Sec. 71. Section 135D.2, subsection 1, Code 2025, is amended 31 by striking the subsection. 32 Sec. 72. Section 135D.2, subsection 4, Code 2025, is amended 33 to read as follows: 34 4. Designated entity means the nonprofit corporation 35 -34- LSB 1555XL (10) 91 lh/ko 34/ 43 |
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| 70 | 70 | | |
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| 71 | 71 | | S.F. _____ H.F. _____ designated selected by the department through a competitive 1 process as the entity responsible for administering and 2 governing the Iowa health information network. 3 Sec. 73. Section 135D.2, Code 2025, is amended by adding the 4 following new subsections: 5 NEW SUBSECTION . 4A. Director means the director of health 6 and human services. 7 NEW SUBSECTION . 5A. Exchange advisory committee or 8 advisory committee means the exchange advisory committee 9 appointed by the director pursuant to section 135D.6. 10 Sec. 74. Section 135D.5, subsection 1, Code 2025, is amended 11 to read as follows: 12 1. The Iowa health information network shall be 13 administered and governed by a designated entity selected by 14 the department through a competitive process. The designated 15 entity shall be established as a nonprofit corporation 16 organized under chapter 504 . Unless otherwise provided in this 17 chapter , the nonprofit corporation is subject to the provisions 18 of chapter 504 . The designated entity shall be established for 19 the purpose of administering and governing the statewide Iowa 20 health information network. Notwithstanding any provision of 21 law to the contrary, the department shall conduct a competitive 22 process to select a designated entity at least every eight 23 years. 24 Sec. 75. Section 135D.6, Code 2025, is amended by striking 25 the section and inserting in lieu thereof the following: 26 135D.6 Exchange advisory committee. 27 1. The director shall appoint an exchange advisory 28 committee. 29 2. The advisory committee shall include at least one 30 member who is a consumer of health services, and a majority 31 of the advisory committee members shall be representative of 32 participants in the Iowa health information network. 33 3. The exchange advisory committee shall do all of the 34 following: 35 -35- LSB 1555XL (10) 91 lh/ko 35/ 43 |
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| 72 | 72 | | |
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| 73 | 73 | | S.F. _____ H.F. _____ a. Advise the department regarding the needs of participants 1 and nonparticipants relating to the exchange of health 2 information. 3 b. Ensure the department develops, and the designated 4 entity complies with, the standards, requirements, policies, 5 and procedures for access to, use, secondary use, privacy, 6 and security of health information exchanged through the Iowa 7 health information network, consistent with applicable federal 8 and state standards and laws. 9 c. Direct a public and private collaborative effort to 10 promote the adoption and use of health information technology 11 in the state to improve health care quality, increase patient 12 safety, reduce health care costs, enhance public health, 13 and empower individuals and health care professionals with 14 comprehensive, real-time medical information to provide 15 continuity of care and make the best health care decisions. 16 d. Educate the public and the health care sector about 17 the value of health information technology in improving 18 patient care, and methods to promote increased support and 19 collaboration of state and local public health agencies, 20 health care professionals, and consumers in health information 21 technology initiatives. 22 e. Work to align interstate and intrastate interoperability 23 standards in accordance with national health information 24 exchange standards. 25 f. Provide an annual budget and fiscal report for the Iowa 26 health information network to the governor, the department 27 of health and human services, the department of management, 28 and the general assembly. The report shall also include 29 information about the services provided through the network and 30 information on the participant usage of the network. 31 Sec. 76. Section 135D.7, subsection 1, unnumbered paragraph 32 1, Code 2025, is amended to read as follows: 33 The board designated entity shall implement 34 industry-accepted security standards, policies, and procedures 35 -36- LSB 1555XL (10) 91 lh/ko 36/ 43 |
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| 74 | 74 | | |
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| 75 | 75 | | S.F. _____ H.F. _____ to protect the transmission and receipt of protected health 1 information exchanged through the Iowa health information 2 network, which shall, at a minimum, comply with HIPAA and shall 3 include all of the following: 4 Sec. 77. Section 135D.7, subsection 1, paragraph c, 5 subparagraph (2), Code 2025, is amended to read as follows: 6 (2) The board designated entity shall provide the means 7 and process by which a patient may decline participation. 8 The means and process utilized shall minimize the burden on 9 patients and health care professionals. 10 Sec. 78. Section 135D.7, subsection 3, Code 2025, is amended 11 to read as follows: 12 3. A participant exchanging health information and data 13 through the Iowa health information network shall grant to 14 other participants of the network a nonexclusive license to 15 retrieve and use that information in accordance with applicable 16 state and federal laws, and the policies and standards 17 established by the board department . 18 Sec. 79. Section 135D.7, subsection 6, paragraph b, Code 19 2025, is amended to read as follows: 20 b. Any health information in the possession of the 21 board designated entity due to its the designated entitys 22 administration of the Iowa health information network. 23 EXPLANATION 24 The inclusion of this explanation does not constitute agreement with 25 the explanations substance by the members of the general assembly. 26 This bill relates to health care including a funding model 27 for Iowas rural health system; health care-related award, 28 grant, residency, and fellowship programs; establishment of 29 a health care incentive program; Medicaid graduate medical 30 education; the health facilities council; and the Iowa health 31 information network. 32 DIVISION I. This division requires the department of health 33 and human services (HHS) to submit to the centers for Medicare 34 and Medicaid services of the United States department of health 35 -37- LSB 1555XL (10) 91 lh/ko 37/ 43 |
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| 76 | 76 | | |
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| 77 | 77 | | S.F. _____ H.F. _____ and human services a request for approval for a health care 1 hub-and-spoke partnership funding model for the purpose of 2 improving Iowas rural health system. The division shall take 3 effect upon enactment. 4 DIVISION II. This division eliminates the primary care 5 provider loan repayment program in Code section 135.107 and 6 makes conforming changes. The primary care provider loan 7 repayment program provides loan repayment to increase the 8 number of health professionals practicing primary care in 9 federally designated health professional shortage areas of the 10 state. 11 The bill creates a health care workforce and community 12 support grant program fund in the state treasury under the 13 control of HHS to be used for grant assistance under the health 14 care workforce and community support grant program. 15 HHS is required to make loan repayments pursuant to a loan 16 repayment program contract entered into on or before June 30, 17 2025, to a recipient in compliance with the loan repayment 18 program contract. HHS shall create an account for the deposit 19 of encumbered or obligated moneys relating to the primary care 20 provider loan repayment program as described in the bill. 21 The division takes effect upon enactment. 22 DIVISION III. This division eliminates certain health 23 care-related programs. 24 The rural Iowa primary care loan repayment program (Code 25 section 256.221) is eliminated. The program provides loan 26 repayment for medical students who agree to practice as 27 physicians in certain service areas. 28 The health care professional recruitment program (Code 29 section 256.223) is also eliminated. The program provides loan 30 repayment for students who graduate from a certain institution 31 and become licensed as a health care professional. 32 In addition, the health care award program (Code section 33 256.224) is eliminated. The program provides financial awards 34 to registered nurses, advanced registered nurse practitioners, 35 -38- LSB 1555XL (10) 91 lh/ko 38/ 43 |
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| 78 | 78 | | |
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| 79 | 79 | | S.F. _____ H.F. _____ physician assistants, and nurse educators who practice in 1 certain areas or teach in this state. 2 Finally, the mental health professional loan repayment 3 program (Code section 256.225) is eliminated. The program 4 provides loan repayment for mental health professionals who 5 agree to practice in certain practice areas. 6 For all of the eliminated programs, the college student aid 7 commission (commission) is required to make loan repayments 8 and provide annual awards pursuant to program agreements and 9 contracts entered into on or before June 30, 2025, as detailed 10 in the bill. All unencumbered and unobligated moneys in the 11 eliminated programs funds shall be transferred to the health 12 care professional incentive program fund (program fund) created 13 in division IV. 14 HHS shall create accounts for the deposit of encumbered and 15 obligated moneys for each eliminated program as detailed in 16 the division. Upon the expiration of all program agreement, 17 contract, and award disbursement periods, any unencumbered and 18 unobligated moneys in the accounts shall be deposited in the 19 program fund created in division IV. 20 DIVISION IV. This division establishes a health care 21 professional incentive program (incentive program) to recruit 22 and retain eligible health care professionals (professionals) 23 in eligible practice areas for employment in certain areas 24 of the state by offering an award of a loan repayment or an 25 income bonus. The commission, in coordination with HHS, shall 26 administer the incentive program as detailed in the division. 27 A professional is ineligible for the incentive program if the 28 professional is currently participating in or has participated 29 in certain health care-related award programs as identified 30 in divisions II and III. The incentive program award shall 31 be distributed annually by the commission as detailed in the 32 division. The commission, in consultation with HHS, shall set 33 the aggregate award amounts, not to exceed $200,000, for each 34 profession for the applicable employment obligation. A program 35 -39- LSB 1555XL (10) 91 lh/ko 39/ 43 |
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| 80 | 80 | | |
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| 81 | 81 | | S.F. _____ H.F. _____ fund is created and moneys in the program fund are appropriated 1 to the commission to be used for the incentive program. The 2 moneys deposited in the program fund shall not revert and shall 3 remain in the program fund at the end of the fiscal year. The 4 commission may use the interest and earnings on the moneys in 5 the fund for administrative costs. All moneys received by 6 HHS or the commission from the health care-related programs 7 eliminated in divisions II and III shall be deposited into the 8 program fund. The commission, in coordination with HHS, shall 9 adopt rules to administer the incentive program. The division 10 shall take effect upon enactment. 11 DIVISION V. This division eliminates certain health 12 care-related grant, residency, and fellowship programs. 13 Current law provides that the fulfilling Iowas need for 14 dentists matching grant program may receive moneys through the 15 health care workforce shortage fund or the fulfilling Iowas 16 need for dentists matching grant program account (Code section 17 135.175). The division eliminates the fund and the account. 18 The health care workforce support initiative (Code section 19 135.175) is eliminated. The initiative provides for the 20 coordination and support of various efforts to address the 21 health care workforce shortage in the state. 22 Additionally, the medical residency training state matching 23 grants program (Code section 135.176) is eliminated. The 24 program provides matching state funding to sponsors of 25 accredited graduate medical education residency programs in 26 the state to establish, expand, or support medical residency 27 training programs. 28 The nurse residency state matching grants program (Code 29 section 135.178) is also eliminated. The program provides 30 matching state funding to sponsors of nurse residency programs 31 in the state to establish, expand, or support nurse residency 32 programs. 33 Moreover, the state-funded family medicine obstetrics 34 fellowship program (Code section 135.193) is eliminated. The 35 -40- LSB 1555XL (10) 91 lh/ko 40/ 43 |
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| 82 | 82 | | |
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| 83 | 83 | | S.F. _____ H.F. _____ program provides funding for fellowships to increase access 1 to family medicine obstetrics practitioners in rural and 2 underserved areas of the state. 3 The division appropriates from the general fund of the 4 state to HHS for deposit in the account for rural psychiatric 5 residencies created in this division, $600,000 for FY 6 2025-2026, $400,000 for FY 2026-2027, and $200,000 for 7 FY 2027-2028. The moneys are appropriated to fund rural 8 psychiatric residencies as described in the bill until all 9 residents have completed or left the residencies. 10 For all of the programs eliminated in the division, HHS is 11 required to provide matching state funding and fund residency 12 and fellowship positions awarded on or before June 30, 2025, as 13 detailed in the bill. All unencumbered and unobligated moneys 14 related to the programs eliminated in the division shall be 15 transferred to HHS to fund Medicaid graduate medical education 16 efforts. 17 HHS shall create accounts for the deposit of encumbered and 18 obligated moneys for each eliminated program as detailed in the 19 division. Upon the expiration of all grant, residency, and 20 fellowship periods, any unencumbered and unobligated moneys in 21 the account shall be appropriated to HHS for Medicaid graduate 22 medical education efforts. 23 DIVISION VI. This division eliminates the state-funded 24 psychiatry residency and fellowship positions (positions) 25 (Code section 135.180) administered by the university of 26 Iowa hospitals and clinics (U of I). The positions provide 27 financial support for up to seven residents and up to two 28 fellows annually. The board of regents (regents) shall direct 29 the U of I to distribute moneys for positions approved and 30 awarded on or before June 30, 2025, until all residents and 31 fellows have completed or left the positions. The regents must 32 also direct the U of I to create an account for the deposit 33 of moneys encumbered and obligated relating to the positions. 34 Upon the expiration of all residency and fellowship periods, 35 -41- LSB 1555XL (10) 91 lh/ko 41/ 43 |
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| 84 | 84 | | |
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| 85 | 85 | | S.F. _____ H.F. _____ any unencumbered and unobligated moneys in the account shall 1 be appropriated to HHS for Medicaid graduate medical education 2 efforts. Any unobligated or unencumbered moneys in the 3 psychiatry residency and fellowship positions fund are also 4 appropriated to HHS to fund Medicaid graduate medical education 5 efforts. 6 DIVISION VII. This division eliminates the health 7 facilities council, and transfers the councils duties to the 8 department of inspections, appeals, and licensing. 9 DIVISION VIII. This division makes conforming changes 10 to the Code related to the elimination of health facilities 11 council and the transfer of the applicable Code sections. 12 DIVISION IX. This division eliminates the board of 13 directors (board) that governs and administers the Iowa 14 health information network (network) and transfers the 15 boards administrative duties to the designated entity. The 16 division creates an exchange advisory committee (committee), 17 appointed by the director of HHS, to govern the network and 18 the designated entity. The division requires HHS to conduct a 19 competitive process every eight years to select a designated 20 entity. Current law prohibits a single industry from being 21 disproportionately represented as voting members of the 22 board, and requires the director of HHS and the director of 23 the Medicaid program or the directors designees to act as 24 voting members. The commissioner of insurance is required 25 to serve on the board as a nonvoting member, and individuals 26 serving in a nonvoting capacity on the board are not included 27 in the total number of authorized members on the board. The 28 division strikes these member requirements. Current law 29 requires the board to ensure the designated entity enters 30 into contracts with each state agency necessary for state 31 reporting requirements, and to develop, implement, and enforce 32 a single patient identifier or alternative mechanism to share 33 secure patient information that is utilized by all health care 34 professionals. The division eliminates these duties for the 35 -42- LSB 1555XL (10) 91 lh/ko 42/ 43 |
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| 86 | 86 | | |
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| 87 | 87 | | S.F. _____ H.F. _____ committee. The division requires the committee to advise 1 HHS regarding the needs relating to the exchange of health 2 information, and to ensure HHS develops, and the designated 3 entity complies with, the standards, requirements, policies, 4 and procedures related to the network. 5 -43- LSB 1555XL (10) 91 lh/ko 43/ 43 |
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