Bill Text: IA SSB1117 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to the certificate of need process.(See SF 506.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2023-03-02 - Committee report approving bill, renumbered as SF 506. [SSB1117 Detail]
Download: Iowa-2023-SSB1117-Introduced.html
Senate
Study
Bill
1117
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
BILL
BY
CHAIRPERSON
EDLER)
A
BILL
FOR
An
Act
relating
to
the
certificate
of
need
process.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
Section
135.61,
subsections
1,
14,
15,
and
18,
1
Code
2023,
are
amended
to
read
as
follows:
2
1.
“Affected
persons”
means,
with
respect
to
an
application
3
for
a
certificate
of
need:
4
a.
The
person
submitting
the
application.
5
b.
Consumers
who
would
be
served
by
the
new
institutional
6
health
service
proposed
in
the
application.
7
c.
Each
institutional
health
facility
or
health
maintenance
8
organization
which
is
located
in
the
geographic
area
which
9
would
appropriately
be
served
by
the
new
institutional
10
health
service
proposed
in
the
application.
The
appropriate
11
geographic
service
area
of
each
institutional
health
facility
12
or
health
maintenance
organization
shall
be
determined
on
a
13
uniform
basis
in
accordance
with
criteria
established
in
rules
14
adopted
by
the
department.
15
d.
Each
institutional
health
facility
or
health
maintenance
16
organization
which,
prior
to
receipt
of
the
application
by
17
the
department,
has
formally
indicated
to
the
department
18
pursuant
to
this
subchapter
an
intent
to
furnish
in
the
future
19
institutional
health
services
similar
to
the
new
institutional
20
health
service
proposed
in
the
application.
21
e.
Any
other
person
designated
as
an
affected
person
by
22
rules
of
the
department.
23
f.
Any
payer
or
third-party
payer
for
health
services.
24
14.
“Institutional
health
facility”
means
any
of
the
25
following,
without
regard
to
whether
the
facilities
referred
26
to
are
publicly
or
privately
owned
or
are
organized
for
profit
27
or
not
or
whether
the
facilities
are
part
of
or
sponsored
by
a
28
health
maintenance
organization:
29
a.
A
hospital.
30
b.
A
health
care
facility.
31
c.
An
organized
outpatient
health
facility.
32
d.
An
outpatient
surgical
facility.
33
e.
A
community
mental
health
facility.
34
f.
A
birth
center.
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15.
“Institutional
health
service”
means
any
health
service
1
furnished
in
or
through
institutional
health
facilities
or
2
health
maintenance
organizations
,
including
mobile
health
3
services
.
4
18.
“New
institutional
health
service”
or
“changed
5
institutional
health
service”
means
any
of
the
following:
6
a.
The
construction,
development
,
or
other
establishment
of
7
a
new
institutional
health
facility
regardless
of
ownership.
8
b.
Relocation
of
an
institutional
health
facility.
9
c.
Any
capital
expenditure,
lease,
or
donation
by
or
10
on
behalf
of
an
institutional
health
facility
in
excess
11
of
one
five
million
five
hundred
thousand
dollars
within
a
12
twelve-month
period.
13
d.
A
permanent
change
in
the
bed
capacity,
as
determined
14
by
the
department,
of
an
institutional
health
facility.
For
15
purposes
of
this
paragraph,
a
change
is
permanent
if
it
is
16
intended
to
be
effective
for
one
year
or
more.
17
e.
Any
expenditure
in
excess
of
five
hundred
thousand
18
dollars
by
or
on
behalf
of
an
institutional
health
facility
for
19
health
services
which
are
or
will
be
offered
in
or
through
an
20
institutional
health
facility
at
a
specific
time
but
which
were
21
not
offered
on
a
regular
basis
in
or
through
that
institutional
22
health
facility
within
the
twelve-month
period
prior
to
that
23
time.
24
f.
The
deletion
of
one
or
more
health
services,
previously
25
offered
on
a
regular
basis
by
an
institutional
health
facility
26
or
health
maintenance
organization
or
the
relocation
of
one
or
27
more
health
services
from
one
physical
facility
to
another.
28
g.
Any
acquisition
by
or
on
behalf
of
a
health
care
provider
29
or
a
group
of
health
care
providers
of
any
piece
of
replacement
30
equipment
with
a
value
in
excess
of
one
million
five
hundred
31
thousand
dollars,
whether
acquired
by
purchase,
lease,
or
32
donation.
33
h.
Any
acquisition
by
or
on
behalf
of
a
health
care
provider
34
or
group
of
health
care
providers
of
any
piece
of
equipment
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with
a
value
in
excess
of
one
million
five
hundred
thousand
1
dollars,
whether
acquired
by
purchase,
lease,
or
donation,
2
which
results
in
the
offering
or
development
of
a
health
3
service
not
previously
provided.
A
mobile
service
provided
4
on
a
contract
basis
is
not
considered
to
have
been
previously
5
provided
by
a
health
care
provider
or
group
of
health
care
6
providers.
7
i.
Any
acquisition
by
or
on
behalf
of
an
institutional
8
health
facility
or
a
health
maintenance
organization
of
any
9
piece
of
replacement
equipment
with
a
value
in
excess
of
one
10
million
five
hundred
thousand
dollars,
whether
acquired
by
11
purchase,
lease,
or
donation.
12
j.
Any
acquisition
by
or
on
behalf
of
an
institutional
13
health
facility
or
health
maintenance
organization
of
any
14
piece
of
equipment
with
a
value
in
excess
of
one
million
five
15
hundred
thousand
dollars,
whether
acquired
by
purchase,
lease,
16
or
donation,
which
results
in
the
offering
or
development
of
17
a
health
service
not
previously
provided.
A
mobile
service
18
provided
on
a
contract
basis
is
not
considered
to
have
been
19
previously
provided
by
an
institutional
health
facility.
20
k.
Any
air
transportation
service
for
transportation
of
21
patients
or
medical
personnel
offered
through
an
institutional
22
health
facility
at
a
specific
time
but
which
was
not
offered
23
on
a
regular
basis
in
or
through
that
institutional
health
24
facility
within
the
twelve-month
period
prior
to
the
specific
25
time.
26
l.
Any
mobile
health
service
with
a
value
in
excess
of
one
27
million
five
hundred
thousand
dollars.
28
m.
Any
of
the
following:
29
(1)
Cardiac
catheterization
service.
30
(2)
Open
heart
surgical
service.
31
(3)
Organ
transplantation
service.
32
(4)
Radiation
therapy
service
applying
ionizing
radiation
33
for
the
treatment
of
malignant
disease
using
megavoltage
34
external
beam
equipment.
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Sec.
2.
Section
135.61,
subsections
2
and
16,
Code
2023,
are
1
amended
by
striking
the
subsections.
2
Sec.
3.
Section
135.62,
subsection
2,
paragraphs
a,
b,
and
3
c,
Code
2023,
are
amended
to
read
as
follows:
4
a.
Qualifications.
The
members
of
the
council
shall
be
5
chosen
so
that
the
council
as
a
whole
is
broadly
representative
6
of
various
geographical
areas
of
the
state
and
no
more
than
7
three
of
its
members
are
affiliated
with
the
same
political
8
party.
Each
council
member
shall
be
a
person
who
has
9
demonstrated
by
prior
activities
an
informed
concern
for
the
10
planning
and
delivery
of
health
services
.
A
member
of
the
11
council
and
any
spouse
of
a
member
shall
not,
during
the
12
time
that
member
is
serving
on
the
council,
do
either
of
the
13
following:
14
(1)
Be
a
health
care
provider
nor
be
otherwise
directly
or
15
indirectly
engaged
in
the
delivery
of
health
care
services
nor
16
have
a
material
financial
interest
in
the
providing
or
delivery
17
of
health
services.
18
(2)
Serve
as
a
member
of
any
board
or
other
policymaking
19
or
advisory
body
of
an
institutional
health
facility,
a
health
20
maintenance
organization,
or
any
health
or
hospital
insurer.
21
b.
Appointments.
Terms
of
council
members
shall
be
six
22
three
years,
beginning
and
ending
as
provided
in
section
23
69.19
.
A
member
shall
be
appointed
in
each
odd-numbered
24
year
to
succeed
each
member
whose
term
expires
in
that
year.
25
Vacancies
shall
be
filled
by
the
governor
for
the
balance
of
26
the
unexpired
term.
Each
appointment
to
the
council
is
subject
27
to
confirmation
by
the
senate.
A
council
member
is
ineligible
28
for
appointment
to
a
second
consecutive
term,
unless
first
29
appointed
to
an
unexpired
term
of
three
years
or
less.
30
c.
Chairperson.
The
governor
council
shall
designate
one
31
of
the
council
members
as
chairperson.
That
designation
may
32
be
changed
not
later
than
July
1
of
any
odd-numbered
year,
33
effective
on
the
date
of
the
organizational
meeting
held
in
34
that
year
under
paragraph
“d”
.
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Sec.
4.
Section
135.63,
subsection
1,
Code
2023,
is
amended
1
to
read
as
follows:
2
1.
A
new
institutional
health
service
or
changed
3
institutional
health
service
shall
not
be
offered
or
developed
4
in
this
state
without
prior
application
to
the
department
5
for
and
receipt
of
a
certificate
of
need,
pursuant
to
6
this
subchapter
.
The
application
shall
be
made
upon
forms
7
furnished
or
prescribed
by
the
department
and
shall
contain
8
such
information
as
the
department
may
require
under
this
9
subchapter
.
The
application
shall
be
accompanied
by
an
10
economic
impact
statement
that
includes
information
specified
11
by
rule
to
assist
the
department
and
the
council
in
the
12
evaluation
of
the
application
pursuant
to
section
135.64.
13
The
application
shall
be
accompanied
by
a
fee
equivalent
to
14
three-tenths
of
one
percent
of
the
anticipated
cost
of
the
15
project
with
a
minimum
fee
of
six
hundred
dollars
and
a
maximum
16
fee
of
twenty-one
of
one
thousand
dollars.
The
fee
shall
be
17
remitted
by
the
department
to
the
treasurer
of
state,
who
shall
18
place
it
in
the
general
fund
of
the
state.
If
an
application
19
is
voluntarily
withdrawn
within
thirty
calendar
days
after
20
submission,
seventy-five
percent
of
the
application
fee
shall
21
be
refunded
;
if
the
application
is
voluntarily
withdrawn
more
22
than
thirty
but
within
sixty
days
after
submission,
fifty
23
percent
of
the
application
fee
shall
be
refunded;
if
the
24
application
is
withdrawn
voluntarily
more
than
sixty
days
25
after
submission,
twenty-five
percent
of
the
application
fee
26
shall
be
refunded
.
Notwithstanding
the
required
payment
of
27
an
application
fee
under
this
subsection
,
an
applicant
for
a
28
new
institutional
health
service
or
a
changed
institutional
29
health
service
offered
or
developed
by
an
intermediate
care
30
facility
for
persons
with
an
intellectual
disability
or
an
31
intermediate
care
facility
for
persons
with
mental
illness
as
32
defined
pursuant
to
section
135C.1
is
exempt
from
payment
of
33
the
application
fee.
34
Sec.
5.
Section
135.63,
subsection
2,
paragraphs
a
and
e,
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Code
2023,
are
amended
to
read
as
follows:
1
a.
Private
offices
and
private
clinics
of
an
individual
2
physician,
dentist,
or
other
practitioner
or
group
of
3
health
care
providers,
except
as
provided
by
section
135.61,
4
subsection
18
,
paragraphs
“g”
,
“h”
,
and
“m”
,
and
section
135.61,
5
subsections
20
and
21
.
6
e.
A
health
maintenance
organization
or
combination
of
7
health
maintenance
organizations
or
an
institutional
health
8
facility
controlled
directly
or
indirectly
by
a
health
9
maintenance
organization
or
combination
of
health
maintenance
10
organizations,
except
when
the
health
maintenance
organization
11
or
combination
of
health
maintenance
organizations
does
any
of
12
the
following:
13
(1)
Constructs
constructs
,
develops,
renovates,
relocates,
14
or
otherwise
establishes
an
institutional
health
facility.
15
(2)
Acquires
major
medical
equipment
as
provided
by
section
16
135.61,
subsection
18
,
paragraphs
“i”
and
“j”
.
17
Sec.
6.
Section
135.63,
subsection
2,
paragraph
h,
Code
18
2023,
is
amended
by
striking
the
paragraph.
19
Sec.
7.
Section
135.63,
subsection
4,
unnumbered
paragraph
20
1,
Code
2023,
is
amended
to
read
as
follows:
21
A
copy
of
the
application
shall
be
sent
to
the
department
22
of
human
services
at
the
time
the
application
is
submitted
to
23
the
Iowa
department
of
public
health.
The
department
shall
not
24
process
applications
for
and
the
council
shall
not
consider
a
25
new
or
changed
institutional
health
service
for
an
intermediate
26
care
facility
for
persons
with
an
intellectual
disability
27
unless
both
of
the
following
conditions
are
met:
28
Sec.
8.
Section
135.66,
subsections
1
and
2,
Code
2023,
are
29
amended
to
read
as
follows:
30
1.
a.
Within
fifteen
business
days
after
receipt
of
an
31
application
for
a
certificate
of
need,
the
department
shall
32
examine
the
application
for
form
and
completeness
and
accept
33
or
reject
it.
An
application
shall
be
rejected
only
if
it
34
fails
to
provide
all
information
required
by
the
department
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pursuant
to
section
135.63,
subsection
1
.
The
department
shall
1
promptly
return
to
the
applicant
any
rejected
application,
with
2
an
explanation
of
the
reasons
for
its
rejection.
3
b.
Within
thirty
days
after
notifying
the
applicant
of
4
rejection
of
the
application,
the
applicant
may
resubmit
a
5
revised
application
for
review
under
this
subsection
and
shall
6
not
be
subject
to
payment
of
another
required
application
7
fee
pursuant
to
section
135.63.
If
a
subsequent
rejection
8
is
issued,
the
applicant
shall
resubmit
the
application
in
9
accordance
with
and
shall
be
subject
to
the
procedure
and
10
requirements
for
an
initial
application.
11
2.
Upon
acceptance
of
an
application
for
a
certificate
12
of
need,
the
department
shall
promptly
undertake
to
notify
13
all
affected
persons
in
writing
that
formal
review
of
the
14
application
has
been
initiated.
Notification
to
those
affected
15
persons
who
are
consumers
or
third-party
payers
or
other
16
payers
for
health
services
may
be
provided
by
distribution
of
17
the
pertinent
information
to
the
news
media
by
an
electronic
18
distribution
method
available
to
the
department
.
19
Sec.
9.
Section
135.67,
subsection
1,
Code
2023,
is
amended
20
to
read
as
follows:
21
1.
The
department
may
waive
the
letter
of
intent
procedures
22
prescribed
by
section
135.65
and
substitute
conduct
a
summary
23
review
procedure,
which
shall
be
established
by
rules
of
the
24
department,
when
it
accepts
an
application
for
a
certificate
of
25
need
for
a
project
which
meets
any
of
the
following
criteria
26
in
paragraphs
“a”
through
“e”
:
27
a.
A
project
which
is
limited
to
repair
or
replacement
of
a
28
facility
or
equipment
damaged
or
destroyed
by
a
disaster,
and
29
which
will
not
expand
the
facility
nor
increase
the
services
30
provided
beyond
the
level
existing
prior
to
the
disaster.
31
b.
A
project
necessary
to
enable
the
facility
or
service
to
32
achieve
or
maintain
compliance
with
federal,
state,
or
other
33
appropriate
licensing,
certification,
or
safety
requirements.
34
c.
A
project
which
will
not
change
the
existing
bed
capacity
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of
the
applicant’s
facility
or
service,
as
determined
by
the
1
department,
by
more
than
ten
percent
or
ten
beds,
whichever
is
2
less,
over
a
two-year
period.
3
d.
A
project
the
total
cost
of
which
will
not
exceed
one
4
hundred
fifty
thousand
dollars.
5
e.
d.
Any
other
project
for
which
the
applicant
proposes
6
and
the
department
agrees
to
summary
review.
7
Sec.
10.
Section
135.69,
Code
2023,
is
amended
to
read
as
8
follows:
9
135.69
Council
to
make
final
decision.
10
1.
The
department
shall
complete
its
formal
review
of
11
the
application
within
ninety
thirty
days
after
acceptance
12
of
the
application,
except
as
otherwise
provided
by
section
13
135.72,
subsection
4
.
Upon
completion
of
the
formal
review,
14
the
council
shall
approve
or
deny
the
application.
The
council
15
shall
issue
written
findings
stating
the
basis
for
its
decision
16
on
the
application,
and
the
department
shall
send
copies
of
17
the
council’s
decision
and
the
written
findings
supporting
18
the
decision
to
the
applicant
and
to
any
other
person
who
so
19
requests.
20
2.
Failure
by
the
council
to
issue
a
written
decision
on
an
21
application
for
a
certificate
of
need
within
the
time
required
22
by
this
section
shall
constitute
denial
approval
of
and
final
23
administrative
action
on
the
application.
24
Sec.
11.
Section
135.72,
subsection
4,
Code
2023,
is
amended
25
to
read
as
follows:
26
4.
Criteria
for
determining
when
it
is
not
feasible
to
27
complete
formal
review
of
an
application
for
a
certificate
of
28
need
within
the
time
limits
specified
in
section
135.69
.
The
29
rules
adopted
under
this
subsection
shall
include
criteria
for
30
determining
whether
an
application
proposes
introduction
of
31
technologically
innovative
equipment,
and
if
so,
procedures
32
to
be
followed
in
reviewing
the
application.
However,
a
rule
33
adopted
under
this
subsection
shall
not
permit
a
deferral
of
34
more
than
sixty
thirty
days
beyond
the
time
when
a
decision
is
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required
under
section
135.69
,
unless
both
the
applicant
and
1
the
department
agree
to
a
longer
deferment.
2
Sec.
12.
Section
135.73,
subsection
1,
Code
2023,
is
amended
3
to
read
as
follows:
4
1.
Any
party
constructing
a
new
institutional
health
5
facility
or
an
addition
to
or
renovation
of
an
existing
6
institutional
health
facility
without
first
obtaining
a
7
certificate
of
need
or,
in
the
case
of
a
mobile
health
service,
8
ascertaining
that
the
mobile
health
service
has
received
9
certificate
of
need
approval,
as
required
by
this
subchapter
,
10
shall
be
denied
licensure
or
change
of
licensure
by
the
11
appropriate
responsible
licensing
agency
of
this
state.
12
Sec.
13.
Section
135.131,
subsection
1,
paragraph
a,
Code
13
2023,
is
amended
to
read
as
follows:
14
a.
“Birth
center”
means
birth
center
as
defined
in
section
15
135.61
a
facility
or
institution,
which
is
not
an
ambulatory
16
surgical
center
or
a
hospital
or
in
a
hospital,
in
which
17
births
are
planned
to
occur
following
a
normal,
uncomplicated,
18
low-risk
pregnancy
.
19
Sec.
14.
Section
135P.1,
Code
2023,
is
amended
to
read
as
20
follows:
21
135P.1
Definitions.
22
For
the
purposes
of
this
chapter
,
unless
the
context
23
otherwise
requires:
24
1.
“Adverse
health
care
incident”
means
an
objective
and
25
definable
outcome
arising
from
or
related
to
patient
care
that
26
results
in
the
death
or
physical
injury
of
a
patient.
27
2.
“Health
care
provider”
means
a
physician
or
osteopathic
28
physician
licensed
under
chapter
148
,
a
physician
assistant
29
licensed
and
practicing
under
a
supervising
physician
pursuant
30
to
chapter
148C
,
a
podiatrist
licensed
under
chapter
149
,
a
31
chiropractor
licensed
under
chapter
151
,
a
licensed
practical
32
nurse,
a
registered
nurse,
or
an
advanced
registered
nurse
33
practitioner
licensed
under
chapter
152
or
152E
,
a
dentist
34
licensed
under
chapter
153
,
an
optometrist
licensed
under
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chapter
154
,
a
pharmacist
licensed
under
chapter
155A
,
or
1
any
other
person
who
is
licensed,
certified,
or
otherwise
2
authorized
or
permitted
by
the
law
of
this
state
to
administer
3
health
care
in
the
ordinary
course
of
business
or
in
the
4
practice
of
a
profession.
5
3.
“Health
facility”
means
an
institutional
health
facility
6
as
defined
in
section
135.61
,
a
hospice
licensed
under
chapter
7
135J
,
a
home
health
agency
as
defined
in
section
144D.1
,
an
8
assisted
living
program
certified
under
chapter
231C
,
a
clinic,
9
a
community
health
center,
or
the
university
of
Iowa
hospitals
10
and
clinics,
and
includes
any
corporation,
professional
11
corporation,
partnership,
limited
liability
company,
limited
12
liability
partnership,
or
other
entity
comprised
of
such
health
13
facilities.
14
4.
“Institutional
health
facility”
means
any
of
the
15
following,
without
regard
to
whether
the
facilities
referred
16
to
are
publicly
or
privately
owned
or
are
organized
for
profit
17
or
not,
or
whether
the
facilities
are
part
of
or
sponsored
by
a
18
health
maintenance
organization:
19
a.
A
hospital.
20
b.
A
health
care
facility.
21
c.
An
organized
outpatient
health
facility.
22
d.
An
outpatient
surgical
facility.
23
e.
A
community
mental
health
facility.
24
f.
A
birth
center.
25
4.
5.
“Open
discussion”
means
all
communications
that
are
26
made
under
section
135P.3
,
and
includes
all
memoranda,
work
27
products,
documents,
and
other
materials
that
are
prepared
28
for
or
submitted
in
the
course
of
or
in
connection
with
29
communications
under
section
135P.3
.
30
5.
6.
“Patient”
means
a
person
who
receives
medical
care
31
from
a
health
care
provider,
or
if
the
person
is
a
minor,
32
deceased,
or
incapacitated,
the
person’s
legal
representative.
33
Sec.
15.
REPEAL.
Section
135.65,
Code
2023,
is
repealed.
34
EXPLANATION
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The
inclusion
of
this
explanation
does
not
constitute
agreement
with
1
the
explanation’s
substance
by
the
members
of
the
general
assembly.
2
This
bill
relates
to
the
health
facilities
council
(HFC)
and
3
the
certificate
of
need
(CON)
process.
4
The
bill
amends
the
definition
of
“affected
person”
with
5
respect
to
an
application
for
CON
to
eliminate
from
inclusion
6
in
the
definition
each
institutional
health
facility
or
7
health
maintenance
organization
which,
prior
to
receipt
of
8
the
application,
has
formally
indicated
an
intent
to
furnish
9
in
the
future
institutional
health
services
similar
to
the
10
new
institutional
health
service
proposed
in
the
application;
11
any
other
person
designated
as
an
affected
person
by
rules
of
12
the
department;
and
any
payer
or
third-party
payer
for
health
13
services.
14
The
bill
amends
the
definition
of
“institutional
health
15
facility”
by
removing
a
“community
mental
health
facility”
16
and
a
“birth
center”
from
inclusion
in
the
definition,
17
thereby
making
these
facilities
and
centers
exempt
from
CON
18
requirements.
19
The
bill
amends
the
definition
of
“new
institutional
20
health
service”
or
“changed
institutional
health
service”
21
by
striking
many
of
the
services
included
in
current
Code
22
and
only
including:
the
construction,
development,
or
other
23
establishment
of
a
new
institutional
health
facility
regardless
24
of
ownership;
relocation
of
an
institutional
health
facility;
25
any
capital
expenditure,
lease,
or
donation
by
or
on
behalf
of
26
an
institutional
health
facility
in
excess
of
$5
million
within
27
a
12-month
period,
and
a
permanent
change
(effective
for
one
28
year
or
more)
in
the
bed
capacity
of
an
institutional
health
29
facility.
Under
the
bill,
only
these
services
included
in
the
30
definition
are
subject
to
CON
requirements.
31
The
bill
eliminates
terms
defined
and
references
to
these
32
terms
under
the
Code
chapter
that
are
no
longer
necessary
due
33
to
provisions
of
the
bill
including
the
definitions
of
“birth
34
center”
and
“mobile
health
service”.
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The
bill
amends
the
qualifications
for
members
of
the
HFC
by
1
retaining
the
requirement
that
members
of
the
council
be
chosen
2
so
that
the
council
as
a
whole
is
broadly
representative
of
3
various
geographical
areas
of
the
state,
but
eliminating
the
4
requirements
that
no
more
than
three
members
are
affiliated
5
with
the
same
political
party
and
that
each
council
member
be
6
a
person
who
has
demonstrated
by
prior
activities
an
informed
7
concern
for
the
planning
and
delivery
of
health
services.
8
Code
section
69.16
requires
that
all
appointive
bodies
if
9
not
otherwise
provided
by
law
shall
be
bipartisan
in
their
10
composition.
11
The
bill
amends
HFC
member
appointment
provisions
to
provide
12
that
terms
of
council
members
shall
be
three
rather
than
six
13
years,
and
by
eliminating
the
requirements
that
a
member
shall
14
be
appointed
in
each
odd-numbered
year
to
succeed
each
member
15
whose
term
expires
in
that
year,
that
vacancies
shall
be
filled
16
by
the
governor
for
the
balance
of
the
unexpired
term,
and
that
17
each
appointment
to
the
council
is
subject
to
confirmation
by
18
the
senate.
The
bill
also
removes
the
provision
that
a
council
19
member
is
ineligible
for
appointment
to
a
second
consecutive
20
term,
unless
first
appointed
to
an
unexpired
term
of
three
21
years
or
less.
22
With
regard
to
the
chairperson
of
the
HFC,
the
bill
provides
23
that
the
council,
rather
than
the
governor,
shall
designate
one
24
of
the
council
members
as
chairperson.
25
The
bill
amends
the
fee
requirements
relating
to
the
26
application
for
a
CON
to
provide
that
instead
of
a
fee
27
equivalent
to
three-tenths
of
1
percent
of
the
anticipated
28
cost
of
the
project
with
a
minimum
fee
of
$600
and
a
maximum
29
fee
of
$21,000,
the
fee
is
$1,000.
The
bill
retains
the
30
provision
that
provides
that
if
an
application
is
voluntarily
31
withdrawn
within
30
calendar
days
after
submission,
75
percent
32
of
the
application
fee
shall
be
refunded,
but
eliminates
33
the
proportionate
refund
of
any
portion
of
the
fee
if
the
34
application
is
voluntarily
withdrawn
beyond
that
30-day
period.
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The
bill
requires
that
an
application
be
accompanied
by
an
1
economic
impact
statement
that
includes
information
required
by
2
rule
to
assist
in
evaluation
of
the
application.
3
Due
to
the
combining
of
the
department
of
human
services
4
(DHS)
and
the
department
of
public
health
(DPH)
into
the
5
department
of
health
and
human
services
(HHS),
the
bill
6
eliminates
the
requirement
that
a
copy
of
the
application
for
7
CON
be
sent
to
DHS
at
the
time
the
application
is
submitted
to
8
DPH.
9
Current
law
provides
that
within
15
business
days
after
10
receipt
of
an
application
for
a
CON,
HHS
shall
examine
the
11
application
and
accept
or
reject
it,
and
that
HHS
shall
12
promptly
return
to
the
applicant
any
rejected
application,
with
13
an
explanation
of
the
reasons
for
its
rejection.
The
bill
adds
14
a
provision
that
within
30
days
after
notifying
the
applicant
15
of
rejection
of
the
application,
the
applicant
may
resubmit
16
a
revised
application
for
review
and
shall
not
be
subject
to
17
payment
of
another
required
application
fee.
Further,
if
a
18
subsequent
rejection
is
issued,
the
applicant
shall
resubmit
19
the
application
in
accordance
with
and
shall
be
subject
to
the
20
procedure
and
requirements
for
an
initial
application.
21
Current
law
provides
that
upon
acceptance
of
an
application
22
for
a
CON,
HHS
shall
promptly
notify
all
affected
persons
23
in
writing
that
formal
review
of
the
application
has
been
24
initiated,
and
that
notification
to
those
affected
persons
who
25
are
consumers
or
third-party
payers
or
other
payers
for
health
26
services
may
be
provided
notification
by
distribution
of
the
27
pertinent
information
to
the
news
media.
The
bill
amends
this
28
provision
to
eliminate
the
reference
to
third-party
payers
or
29
other
payers
as
they
are
no
longer
included
in
the
definition
30
of
affected
persons,
and
provides
that
notification
to
affected
31
persons
who
are
consumers
may
be
provided
by
an
electronic
32
distribution
method
available
to
HHS.
33
The
bill
eliminates
the
letter
of
intent
procedure
requiring
34
that
before
applying
for
a
CON,
the
sponsor
of
a
proposed
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new
institutional
health
service
or
changed
institutional
1
health
service
submit
to
HHS
a
letter
of
intent
to
offer
or
2
develop
a
service
requiring
a
CON,
as
soon
as
possible
after
3
initiation
of
the
applicant’s
planning
process
and
not
less
4
than
30
days
before
applying
for
a
CON
and
before
substantial
5
expenditures
to
offer
or
develop
the
service
are
made.
Under
6
this
provision,
the
letter
must
include
a
brief
description
7
of
the
proposed
new
or
changed
service,
its
location,
and
its
8
estimated
cost.
If
requested
by
the
sponsor,
HHS
was
required
9
to
make
a
preliminary
review
of
the
letter
and
inform
the
10
sponsor
of
any
factors
likely
to
result
in
denial
of
a
CON.
The
11
bill
also
makes
a
conforming
change
to
eliminate
a
reference
to
12
the
letter
of
intent
procedure.
13
The
bill
amends
the
time
frames
related
to
the
HFC’s
review
14
of
CON
applications.
The
bill
requires
that
HHS
shall
complete
15
its
formal
review
of
the
application
within
30
days,
rather
16
than
the
current
90
days,
after
acceptance
of
the
application.
17
The
bill
also
provides
that
failure
by
the
council
to
issue
a
18
written
decision
on
a
CON
application
within
the
time
required
19
shall
constitute
approval
rather
than
the
current
denial
of
and
20
final
administrative
action
on
the
application.
21
The
bill
provides
that
any
administrative
rule
adopted
for
22
determining
when
it
is
not
feasible
to
complete
formal
review
23
of
an
application
for
a
CON
within
the
time
limits
specified
24
for
the
HFC’s
final
decision
shall
not
permit
a
deferral
of
25
more
than
30
days,
rather
than
the
current
60
days,
beyond
26
the
time
specified
for
a
decision
on
the
final
decision,
27
unless
both
the
applicant
and
the
department
agree
to
a
longer
28
deferment.
29
-14-
LSB
1825XC
(3)
90
pf/rh
14/
14
