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Senate
File
2367
-
Introduced
SENATE
FILE
2367
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
SSB
3139)
A
BILL
FOR
An
Act
relating
to
health-related
matters,
including
1
health-related
professions,
certificates
of
need,
and
2
nutrition,
and
including
applicability
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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DIVISION
I
1
CONTINUING
EDUCATION
REQUIREMENTS
——
NUTRITION
AND
METABOLIC
2
HEALTH
3
Section
1.
Section
148.3,
Code
2026,
is
amended
by
adding
4
the
following
new
subsection:
5
NEW
SUBSECTION
.
5.
The
board
shall
adopt
rules
pursuant
to
6
chapter
17A
requiring
a
licensee
practicing
family
medicine,
7
internal
medicine,
pediatrics,
psychiatry,
endocrinology,
8
gastroenterology,
cardiology,
oncology,
rheumatology,
9
neurology,
nephrology,
dermatology,
pulmonology,
surgery,
10
immunology,
hematology,
obstetrics,
or
gynecology
to
complete
a
11
minimum
of
one
hour
of
continuing
education
on
nutrition
and
12
metabolic
health
every
four
years
as
a
condition
of
license
13
renewal.
14
Sec.
2.
Section
148C.3,
subsection
1,
paragraph
c,
Code
15
2026,
is
amended
to
read
as
follows:
16
c.
Hours
of
continuing
medical
education
necessary
to
become
17
or
remain
licensed.
The
board
shall
adopt
rules
pursuant
to
18
chapter
17A
requiring
a
licensee
practicing
family
medicine,
19
internal
medicine,
pediatrics,
psychiatry,
endocrinology,
20
gastroenterology,
cardiology,
oncology,
rheumatology,
21
neurology,
nephrology,
dermatology,
pulmonology,
surgery,
22
immunology,
hematology,
obstetrics,
or
gynecology
to
complete
a
23
minimum
of
one
hour
of
continuing
education
on
nutrition
and
24
metabolic
health
every
four
years
as
a
condition
of
license
25
renewal.
26
DIVISION
II
27
CERTIFICATE
OF
NEED
28
Sec.
3.
Section
135.61,
subsection
16,
paragraphs
e,
g,
i,
29
and
k,
Code
2026,
are
amended
by
striking
the
paragraphs.
30
Sec.
4.
Section
135.61,
subsection
16,
paragraph
m,
31
subparagraphs
(2)
and
(3),
Code
2026,
are
amended
by
striking
32
the
subparagraphs.
33
Sec.
5.
Section
135.62,
subsection
2,
paragraph
a,
Code
34
2026,
is
amended
to
read
as
follows:
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a.
Private
offices
and
private
clinics
of
an
individual
1
physician,
dentist,
or
other
practitioner
or
group
of
2
health
care
providers,
except
as
provided
by
section
135.61,
3
subsection
16
,
paragraphs
“g”
,
“h”
,
and
“m”
,
and
section
135.61,
4
subsections
2
and
18
.
5
Sec.
6.
Section
135.62,
subsection
2,
paragraph
e,
6
subparagraph
(2),
Code
2026,
is
amended
to
read
as
follows:
7
(2)
Acquires
major
medical
equipment
as
provided
by
section
8
135.61,
subsection
16
,
paragraphs
“i”
and
paragraph
“j”
.
9
Sec.
7.
Section
135.62,
subsection
2,
paragraph
g,
10
subparagraph
(1),
unnumbered
paragraph
1,
Code
2026,
is
amended
11
to
read
as
follows:
12
A
reduction
in
bed
capacity
of
an
institutional
health
13
facility,
notwithstanding
any
provision
in
this
subchapter
to
14
the
contrary,
except
where
a
provision
expressly
exempts
such
a
15
reduction,
if
all
of
the
following
conditions
exist:
16
Sec.
8.
Section
135.62,
subsection
2,
paragraph
k,
17
subparagraph
(1),
unnumbered
paragraph
1,
Code
2026,
is
amended
18
to
read
as
follows:
19
The
redistribution
of
beds
by
a
hospital
within
the
acute
20
care
category
of
bed
usage,
notwithstanding
any
provision
in
21
this
subchapter
to
the
contrary,
except
where
a
provision
22
expressly
exempts
such
a
redistribution
of
skilled
nursing
23
facility
or
swing
beds
by
a
hospital,
if
all
of
the
following
24
conditions
exist:
25
Sec.
9.
Section
135.62,
subsection
2,
paragraph
p,
Code
26
2026,
is
amended
by
striking
the
paragraph.
27
Sec.
10.
Section
135.62,
subsection
2,
Code
2026,
is
amended
28
by
adding
the
following
new
paragraphs:
29
NEW
PARAGRAPH
.
r.
An
outpatient
facility
that
provides
30
behavioral
health
services,
as
defined
by
rule
by
the
31
department,
to
individuals
on
an
outpatient
basis,
including
32
but
not
limited
to
substitution-based
treatment
centers
for
33
opiate
addiction.
34
NEW
PARAGRAPH
.
s.
Open
heart
surgical
services.
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NEW
PARAGRAPH
.
t.
Organ
transplantation
services.
1
NEW
PARAGRAPH
.
u.
Notwithstanding
any
provision
of
this
2
subchapter
to
the
contrary,
any
acquisition
whether
acquired
3
by
purchase,
lease,
or
donation
by
or
on
behalf
of
a
health
4
care
provider
or
a
group
of
health
care
providers
of
any
piece
5
of
replacement
equipment
with
a
value
in
excess
of
one
million
6
five
hundred
thousand
dollars.
7
NEW
PARAGRAPH
.
v.
Notwithstanding
any
provision
of
8
this
subchapter
to
the
contrary,
any
acquisition
whether
9
acquired
by
purchase,
lease,
or
donation
by
or
on
behalf
of
10
an
institutional
health
facility
or
a
health
maintenance
11
organization
of
any
piece
of
replacement
equipment
with
a
value
12
in
excess
of
one
million
five
hundred
thousand
dollars.
13
NEW
PARAGRAPH
.
w.
Any
air
transportation
service
for
14
transportation
of
patients
or
medical
personnel
offered
through
15
an
institutional
health
facility.
16
NEW
PARAGRAPH
.
x.
Notwithstanding
any
provision
of
17
this
subchapter
to
the
contrary,
bed
capacity
changes
by
an
18
institutional
health
facility
that
constitute
a
permanent
19
change
or
reduction
in,
or
a
redistribution,
deletion,
or
20
conversion
of,
nursing
facility
beds,
skilled
nursing
facility
21
beds,
or
swing
beds.
22
NEW
PARAGRAPH
.
y.
Notwithstanding
any
provision
of
23
this
subchapter
to
the
contrary,
bed
capacity
changes
24
that
constitute
a
permanent
change
or
reduction
in,
or
25
a
redistribution,
deletion,
or
conversion
of,
beds
in
26
intermediate
care
facilities
for
persons
with
mental
27
illness,
or
intermediate
care
facilities
for
persons
with
an
28
intellectual
disability.
29
Sec.
11.
Section
135.62,
subsection
4,
Code
2026,
is
amended
30
to
read
as
follows:
31
4.
The
department
shall
not
process
applications
for
an
32
intermediate
care
facility
for
persons
with
an
intellectual
33
disability,
or
consider
a
new
or
changed
institutional
health
34
service
for
an
intermediate
care
facility
for
persons
with
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an
intellectual
disability,
unless
both
of
the
following
1
conditions
are
met:
2
a.
The
new
or
changed
beds
shall
not
result
in
an
3
increase
in
the
total
number
of
medical
assistance
certified
4
intermediate
care
facility
beds
for
persons
with
an
5
intellectual
disability
in
the
state,
exclusive
of
those
beds
6
at
the
state
resource
centers
or
other
state
institutions,
7
beyond
one
thousand
six
hundred
thirty-six
beds.
8
b.
A
a
letter
of
support
for
the
application
is
provided
by
9
the
county
board
of
supervisors,
or
the
board’s
designee,
in
10
the
county
in
which
the
beds
facility
is
or
would
be
located.
11
Sec.
12.
Section
135.65,
subsection
3,
paragraph
b,
Code
12
2026,
is
amended
to
read
as
follows:
13
b.
A
period
for
the
submission
of
written
public
hearing
14
comments
from
affected
persons
on
the
application,
to
be
held
15
scheduled
prior
to
completion
of
the
evaluation
required
by
16
paragraph
“a”
.
17
Sec.
13.
Section
135.65,
subsection
4,
Code
2026,
is
amended
18
by
striking
the
subsection.
19
Sec.
14.
Section
135.70,
subsection
2,
Code
2026,
is
amended
20
to
read
as
follows:
21
2.
Upon
expiration
of
a
certificate
of
need,
and
prior
to
22
extension
of
the
certificate
of
need,
any
affected
person
shall
23
have
the
right
to
submit
to
the
department
information
which
24
may
be
relevant
to
the
question
of
granting
an
extension.
The
25
department
may
call
a
public
hearing
for
this
purpose.
26
DIVISION
III
27
SUPPLEMENTAL
NUTRITION
ASSISTANCE
PROGRAM
——
SUMMER
ELECTRONIC
28
BENEFITS
TRANSFER
FOR
CHILDREN
PROGRAM
29
Sec.
15.
Section
234.1,
Code
2026,
is
amended
by
adding
the
30
following
new
subsection:
31
NEW
SUBSECTION
.
4A.
“Summer
electronic
benefits
transfer
32
for
children
program”
or
“summer
EBT
program”
means
the
summer
33
electronic
benefits
transfer
for
children
program
established
34
in
42
U.S.C.
§1762.
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Sec.
16.
NEW
SECTION
.
234.12B
Supplemental
nutrition
1
assistance
program
——
summer
electronic
benefits
transfer
for
2
children
program.
3
1.
The
department
shall
do
all
of
the
following:
4
a.
Continuously
maintain
state
participation
in
SNAP
5
by
administering
the
program
in
accordance
with
guidelines
6
approved
by
the
United
States
department
of
agriculture,
7
food
and
nutrition
service,
that
specify
that
eligible
foods
8
pursuant
to
7
C.F.R.
§271.2
are
healthy
foods
as
defined
by
the
9
director
or
the
director’s
designee.
10
b.
Ensure
that
the
provision
of
SNAP
benefits
to
recipients
11
is
uninterrupted.
12
2.
The
department
may
participate
in
the
summer
EBT
program
13
subject
to
federally
approved
eligible
foods
for
the
summer
EBT
14
program
being
consistent
with
eligible
foods
as
described
in
15
subsection
1,
paragraph
“a”
.
16
DIVISION
IV
17
SCHOOL
FOODS
AND
BEVERAGES
18
Sec.
17.
Section
256E.7,
subsection
2,
Code
2026,
is
amended
19
by
adding
the
following
new
paragraph:
20
NEW
PARAGRAPH
.
0t.
Be
subject
to
and
comply
with
the
21
requirements
of
section
283A.6
relating
to
the
preparation
22
of
meals
provided
to
students,
and
prohibited
ingredients
in
23
meals
provided
to
students,
in
the
same
manner
as
a
school
24
district,
if
the
charter
school
provides
a
breakfast
or
lunch
25
program
through
the
national
school
lunch
program
or
the
school
26
breakfast
program
administered
by
the
food
and
nutrition
27
service
of
the
United
States
department
of
agriculture.
28
Sec.
18.
Section
256F.4,
subsection
2,
Code
2026,
is
amended
29
by
adding
the
following
new
paragraph:
30
NEW
PARAGRAPH
.
v.
Be
subject
to
and
comply
with
the
31
requirements
of
section
283A.6
relating
to
the
preparation
of
32
meals
provided
to
students,
and
prohibited
ingredients
in
meals
33
provided
to
students,
in
the
same
manner
as
a
school
district,
34
if
the
charter
school
or
innovation
zone
school
provides
a
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breakfast
or
lunch
program.
1
Sec.
19.
NEW
SECTION
.
283A.6
School
district
breakfast
2
and
lunch
programs
——
food
and
beverages
provided
to
students
——
3
prohibited
ingredients.
4
1.
a.
A
school
district
shall
not
serve
a
meal
to
students
5
as
part
of
the
school
district’s
breakfast
or
lunch
program
6
that
contains
any
of
the
following
ingredients:
7
(1)
Blue
dye
1.
8
(2)
Blue
dye
2.
9
(3)
Green
dye
3.
10
(4)
Potassium
bromate.
11
(5)
Propylparaben.
12
(6)
Red
dye
40.
13
(7)
Yellow
dye
5.
14
(8)
Yellow
dye
6.
15
b.
Paragraph
“a”
does
not
apply
to
food
and
beverages
16
received
as
part
of
a
direct
delivery
from
the
foods
in
schools
17
program
of
the
United
States
department
of
agriculture.
18
2.
An
employee
or
contracted
vendor
of
a
school
district
19
shall
not
provide
any
food
or
beverages
that
contain
an
20
ingredient
described
in
subsection
1
to
a
student
enrolled
in
21
the
school
district
during
the
school
day.
22
3.
A
school
district
shall
not
permit
the
sale
to
students
23
of
any
foods
or
beverages
that
contain
an
ingredient
described
24
in
subsection
1
on
the
school
campus,
as
school
campus
is
25
defined
in
7
C.F.R.
§210.11
as
of
January
1,
2026,
unless
the
26
sale
takes
place
outside
of
the
school
day,
as
school
day
is
27
defined
in
7
C.F.R.
§210.11
as
of
January
1,
2026.
28
Sec.
20.
Section
283A.10,
Code
2026,
is
amended
to
read
as
29
follows:
30
283A.10
School
breakfast
or
lunch
in
nonpublic
schools.
31
The
authorities
in
charge
of
nonpublic
schools
may
operate
32
or
provide
for
the
operation
of
school
breakfast
or
lunch
33
programs
in
schools
under
their
jurisdiction
and
may
use
funds
34
appropriated
to
them
by
the
general
assembly,
gifts,
funds
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received
from
sale
of
school
breakfasts
or
lunches
under
such
1
programs,
and
any
other
funds
available
to
the
nonpublic
2
school.
However,
school
breakfast
or
lunch
programs
shall
not
3
be
required
in
nonpublic
schools.
The
department
of
education
4
shall
direct
the
disbursement
of
state
funds
to
nonpublic
5
schools
for
school
breakfast
or
lunch
programs
in
the
same
6
manner
as
state
funds
are
disbursed
to
public
schools.
If
7
a
nonpublic
school
receives
state
funds
for
the
operation
of
8
a
school
breakfast
or
lunch
program,
meals
served
under
the
9
program
shall
be
nutritionally
adequate
meals,
as
defined
in
10
section
283A.1
,
and
shall
comply
with
the
requirements
of
11
section
283A.6
.
12
Sec.
21.
APPLICABILITY.
This
division
of
this
Act
applies
13
to
school
years
beginning
on
or
after
July
1,
2027.
14
EXPLANATION
15
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
16
the
explanation’s
substance
by
the
members
of
the
general
assembly.
17
This
bill
relates
to
the
regulation
of
health-related
18
matters,
including
health-related
professions,
certificates
of
19
need,
and
nutrition.
The
bill
is
organized
in
divisions.
20
DIVISION
I
——
CONTINUING
EDUCATION
REQUIREMENTS
——
NUTRITION
21
AND
METABOLIC
HEALTH.
The
bill
requires
the
board
of
medicine
22
and
the
board
of
physician
assistants
to
adopt
rules
requiring
23
certain
licensees
to
receive
continuing
education
credits
24
regarding
nutritional
and
metabolic
health
as
a
condition
of
25
license
renewal.
26
DIVISION
II
——
CERTIFICATE
OF
NEED.
The
bill
changes
the
27
definition
of
“new
institutional
health
service”
or
“changed
28
institutional
health
service”.
The
bill
alters
the
list
of
29
items
that
are
excluded
from
the
provisions
of
Code
chapter
30
135
(department
of
health
and
human
services
——
public
31
health),
subchapter
VI
(health
facilities).
The
bill
strikes
32
a
provision
restricting
the
department
of
health
and
human
33
services
(HHS)
from
processing
applications
for
an
intermediate
34
care
facility
for
persons
with
an
intellectual
disability,
or
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considering
a
new
or
changed
institutional
health
service
for
1
an
intermediate
care
facility
for
persons
with
an
intellectual
2
disability,
unless
the
new
or
changed
beds
shall
not
result
3
in
an
increase
in
the
total
number
of
medical
assistance
4
certified
intermediate
care
facility
beds
for
persons
with
an
5
intellectual
disability
in
the
state,
exclusive
of
those
beds
6
at
the
state
resource
centers
or
other
state
institutions,
7
beyond
1,636
beds.
8
The
bill
replaces
a
requirement
that
HHS
hold
a
public
9
hearing
on
an
application
for
a
certificate
of
need
with
a
10
requirement
that
the
department
provide
a
period
for
the
11
submission
of
written
comments
from
affected
persons.
The
bill
12
strikes
an
authorization
for
the
department
to
call
a
public
13
hearing
on
the
question
of
whether
to
grant
an
extension
for
an
14
expiring
certificate
of
need.
15
DIVISION
III
——
SUPPLEMENTAL
NUTRITION
ASSISTANCE
PROGRAM
——
16
SUMMER
ELECTRONIC
BENEFITS
TRANSFER
FOR
CHILDREN
PROGRAM.
The
17
bill
requires
HHS
to
continuously
maintain
state
participation
18
in
the
federal
supplemental
nutrition
assistance
program
(SNAP)
19
by
administering
the
program
in
accordance
with
guidelines
20
approved
by
the
United
States
department
of
agriculture,
food
21
and
nutrition
service,
to
define
“eligible
foods”
as
“healthy
22
foods”,
as
that
term
is
defined
by
the
department,
and
to
seek
23
any
federal
approval
necessary
to
ensure
that
provision
of
24
benefits
is
continuous.
The
bill
requires
HHS
to
ensure
that
25
the
provision
of
SNAP
benefits
to
recipients
is
uninterrupted.
26
The
bill
also
allows
HHS
to
participate
in
the
summer
27
electronic
benefits
transfer
for
children
program,
subject
to
28
federal
approval
of
guidelines
for
eligible
foods
under
the
29
program
that
are
similar
to
the
guidelines
for
eligible
foods
30
under
SNAP.
31
DIVISION
IV
——
SCHOOL
FOODS
AND
BEVERAGES.
The
bill
32
prohibits
school
districts,
certain
charter
schools,
and
33
innovation
zone
schools
from
serving
meals
to
students
as
34
part
of
the
school’s
breakfast
or
lunch
program
that
contain
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blue
dye
1,
blue
dye
2,
green
dye
3,
potassium
bromate,
1
propylparaben,
red
dye
40,
yellow
dye
5,
or
yellow
dye
6,
2
unless
the
foods
or
beverages
in
the
meal
were
received
as
3
part
of
a
direct
delivery
from
the
foods
in
schools
program
of
4
the
United
States
department
of
agriculture.
The
bill
also
5
prohibits
schools
from
permitting
the
sale
to
students
of
any
6
foods
or
beverages
that
contain
such
ingredients
on
school
7
campus
unless
the
sale
takes
place
after
the
end
of
the
school
8
day.
The
bill
requires
nonpublic
schools
that
use
moneys
9
appropriated
by
the
general
assembly
to
provide
breakfast
or
10
lunch
to
students
to
ensure
that
the
meals
comply
with
the
same
11
prohibition
on
ingredients
as
school
districts.
12
This
division
of
the
bill
applies
to
school
years
beginning
13
on
or
after
July
1,
2027.
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