HF 919 — A bill for an act relating to children’s specialty hospital designations for certain nonprofit organizations, and including effective date provisions.

SHouse TFile A919 T- EEnrolled OHouse FFile I919 OAN WACT ARELATING KTO ICHILDREN’S MSPECIALTY RHOSPITAL EDESIGNATIONS YFOR NCERTAIN ONONPROFIT LORGANIZATIONS, DAND SINCLUDING GEFFECTIVE ODATE VPROVISIONS. E R N O R May 1,2025 The Honorable PaulPate SecretaryofStateofIowa StateCapitol Des Moines,Iowa50319 DearMr.Secretary, Iherebytransmit:

HouseFile919,anActrelatingtochildren'sspecialtyhospitaldesignationsforcertainBE nonprofitorganizations,andincludingeffectivedateprovisions.IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

TheaboveHouseFileisherebyapprovedonthisdate.

Sincerely, KinlReynolds Governor oflow^ cc:

SecretaryoftheSenate Clerk ofthe House STATE CAPITOL DES MOINES,IOWA 50319 515.281.5211 FAX 515.725.3527 WWW.GOVERNOR.IOWA.GOV PRIZE R W G K T W i a MAINTM O K N E R A l .

A S S E M B I ^9|f ii!P{H8iMiiiniiiim<iT»nntnmiii>ni»>iiiiWBiiiiHmwiiinmBiimHiiimmmiimnniiiiitmMmiiwi«ia»minmmMnimBiiiHiiiiHHimi»iii»niiiimiii»]KRit?n H o u s e F9 1 9e A NA C T RELATING TO CHILDREN'S SPECIALTY HOSPITAL DESIGNATIONS FOR CERTAIN NONPROFIT ORGANIZATIONS, AND INCLUDING EFFECTIVE D A TP R O V I S I O N S .

B E I T E N A C T T H E G E N EA S S E M B L Y S T A T E I O W A :

NEW SUBSECTION.SUBSECTION .

^Children's“Children’s specialty hospital"hospital” means a hospital described by all of the following:

The hospital specializes in pediatric rehabilitation and treating children with a behavioral health condition or complex mmedical eneeds. d i n e e d s .

1353.40135B.40 Children'sChildren’s specialty hospitals.

The department may adopt rules pursuant to chapter 17A to establish minimum standards for the licensure of children'schildren’s specialty hospitals.

Rules adopted pursuant to this section shall be formulated in consultation with the director of health and human services or the director'sdirector’s designee, and with affected industry, professional, and consumer groups.

A children'schildren’s specialty hospital shall establish formal criteria based on objective medical standards for patient admission, discharge, and continuation of care.

3,3. DEPARTMENT OF INSPECTIONS, APPEALS, AND LICENSING DEPARTMENT OF HEALTH AND HUMAN SERVICES CHILDREN'S S P E C I AH O S P I T A L S .

DEPARTMENT OF INSPECTIONS, APPEALS, AND LICENSING —— DEPARTMENT OF HEALTH AND HUMAN SERVICES —— CHILDREN’S SPECIALTY HOSPITALS.

For purposes of this section, ^^licensed“licensed entity"entity” means an entity granted a provisional children'schildren’s specialty hospital license under subsection 2, paragraph ^'a".“a”.

Within thirty calendar days of the effective date of this Act, grant a provisional children'schildren’s specialty hospital license to an entity that requests such provisional licensure provided that the entity meets the definition of children'schildren’s specialty hospital under section 135B.1.

Grant reasonable waivers from state hospital rules to permit a licensed entity to maintain the licensed entity'sentity’s operations as provided prior to the effective date of this Act, until the date the licensed entity obtains federal certification or the ability to participate in federal reimbursement programs that require hospital licensure.

After a licensed entity obtains federal certification or the ability to participate in federal reimbursement programs that require hospital licensure, the department of inspections, appeals, and licensing and the department of health and human services shall grant the necessary waivers to the licensed entity to ensure the licensed entity'sentity’s compliance with the requirements of the House File 919, p.

Waivers granted under this paragraph shall specifically include a waiver from state rules that require a licensed entity to maintain, or to have available, laboratory and pathology services and facilities, other than laboratory and pathology services and facilities that the licensed entity maintained prior to the effective date of this Act, and a waiver from state rules that require the provision of emergency services, other than emergency services that the licensed entity provided prior to the"effectivethe effective date of this Act.

Each waiver granted to a licensed entity under this paragraph shall be valid for no more than twenty-four consecutive months from the date the licensed entity was granted a provisional children'schildren’s specialty hospital license under paragraph ^^a",“a”, or until the date the licensed entity obtains a permanent children'schildren’s specialty hospital license, whichever date is earlier.

A licensed entity may operate under the minimum physical standards for nursing facilities in 481 lACIAC 61 under which the licensed entity operated prior to the effective date of this Act, and shall be exempt from all other construction standards applicable only to hospitals and off-site premises.

For inpatient care, prospective average allowable per diem costs adjusted for inflation pursuant to 441 lACIAC 79.1(5)(k).

For outpatient care, the licensed entity'sentity’s cost-to-charge ratio, as defined by the department of health and human services, with retrospectively adjusted prospective House File 919, p.

4 reimbursements as provided in 441 lACIAC 79.1(1)(g).

5,5. A licensed entity shall be exempt from certificate of need requirements under chapter lOA, subchapter VII, part 2, to the extent that the licensed entity is implementing a new institutional health service, or a changed institutional health service, for the purpose of converting the licensed entity to a children's specialty hospital, or to revert the licensed entity to a nursing facility.

A licensed entity shall be exempt from certificate of need requirements under chapter 10A, subchapter VII, part 2, to the extent that the licensed entity is implementing a new institutional health service, or a changed institutional health service, for the purpose of converting the licensed entity to a children’s specialty hospital, or to revert the licensed entity to a nursing facility.

The date the licensed entity obtains a permanent children'schildren’s specialty hospital license.

Twenty-four consecutive months from the date the licensed entity was granted a provisional children'schildren’s specialty hospital license.

4,4. EMERGENCY RULES.

TheEMERGENCY departmentRULES. of inspections, appeals, and licensing may adopt emergency rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph ^^b", to implement the provisions of this Act and the rules shall be effective immediately upon filing unless a later date is specified in the rules.

AnyThe department of inspections, appeals, and licensing may adopt emergency rules adoptedunder insection accordance17A.4, withsubsection this3, and section shall17A.5, alsosubsection be2, publishedparagraph as“b”, ato noticeimplement the provisions of intendedthis actionAct asand providedthe inrules sectionshall 17A.4,be Sec.effective immediately upon filing unless a later date is specified in the rules.

Any rules adopted in accordance with this section shall also be published as a notice of intended action as provided in section 17A.4.

Sec.

EFFECTIVE DATE,DATE. This Act, being deemed of immediate importance, takes effect upon enactment.

PATThis GRASSLE7Act, AMYbeing SINCLAIRdeemed Speaker of theimmediate Houseimportance, Presidenttakes ofeffect theupon Senateenactment. I hereby certify that this bill originated in the House and is known as House Pile 919, Ninety-first General Assembly.

m______________________________ e______________________________ giNNPAT EGRASSLEY LAMY SSINCLAIR OSpeaker Nof Chujthe :Clerjy-otHouse President of the HouseSenate ApprovedI 1hereby ^^certify .2that 025this Jtmbill wSnNoriginated Oin Lthe DHouse Sand Gis oknown vas eHouse rFile n919, oNinety-first rGeneral Assembly.

______________________________ MEGHAN NELSON Chief Clerk of the House Approved _______________, 2025 ______________________________ KIM REYNOLDS Governor