1. In determining whether a certificate of need shall be issued, the department and council shall consider the following:

 a. The contribution of the proposed institutional health service in meeting the needs of the medically underserved, including persons in rural areas, low-income persons, racial and ethnic minorities, persons with disabilities, and the elderly, as well as the extent to which medically underserved residents in the applicant’s service area are likely to have access to the proposed institutional health service.
 b. The relationship of the proposed institutional health services to the long-range development plan, if any, of the person providing or proposing the services.
 c. The need of the population served or to be served by the proposed institutional health services for those services.
 d. The distance, convenience, cost of transportation, and accessibility to health services for persons who live outside metropolitan areas.
 e. The availability of alternative, less costly, or more effective methods of providing the proposed institutional health services.
 f. The immediate and long-term financial feasibility of the proposal presented in the application, as well as the probable impact of the proposal on the costs of and charges for providing health services by the person proposing the new institutional health service.
 g. The relationship of the proposed institutional health services to the existing health care system of the area in which those services are proposed to be provided.
 h. The appropriate and efficient use or prospective use of the proposed institutional health service, and of any existing similar services, including but not limited to a consideration of the capacity of the sponsor’s facility to provide the proposed service, and possible sharing or cooperative arrangements among existing facilities and providers.
 i. The availability of resources, including, but not limited to, health care providers, management personnel, and funds for capital and operating needs, to provide the proposed institutional health services and the possible alternative uses of those resources to provide other health services.
 j. The appropriate and nondiscriminatory utilization of existing and available health care providers. Where both allopathic and osteopathic institutional health services exist, each application shall be considered in light of the availability and utilization of both allopathic and osteopathic facilities and services in order to protect the freedom of choice of consumers and health care providers.
 k. The relationship, including the organizational relationship, of the proposed institutional health services to ancillary or support services.
 l. Special needs and circumstances of those entities which provide a substantial portion of their services or resources, or both, to individuals not residing in the immediate geographic area in which the entities are located, which entities may include but are not limited to medical and other health professional schools, multidisciplinary clinics, and specialty centers.
 m. The special needs and circumstances of health maintenance organizations.
 n. The special needs and circumstances of biomedical and behavioral research projects designed to meet a national need and for which local conditions offer special advantages.
 o. The impact of relocation of an institutional health facility or health maintenance organization on other institutional health facilities or health maintenance organizations and on the needs of the population to be served, or which was previously served, or both.
 p. In the case of a construction project, the costs and methods of the proposed construction and the probable impact of the proposed construction project on total health care costs.
 q. In the case of a proposal for the addition of beds to a health care facility, the consistency of the proposed addition with the plans of other agencies of this state responsible for provision and financing of long-term care services, including home health services.
 r. The recommendations of staff personnel of the department assigned to the area of certificate of need, concerning the application, if requested by the council.

Terms Used In Iowa Code 135.64

  • changed institutional health service: means any of the following:
     a. See Iowa Code 135.61
  • Council: means the state health facilities council established by this subchapter. See Iowa Code 135.61
  • Department: means the Iowa department of public health. See Iowa Code 135.61
  • following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
  • Health care facility: means health care facility as defined in section 135C. See Iowa Code 135.61
  • Health maintenance organization: means health maintenance organization as defined in section 514B. See Iowa Code 135.61
  • Health services: means clinically related diagnostic, curative, or rehabilitative services, and includes alcoholism, drug abuse, and mental health services. See Iowa Code 135.61
  • Institutional health facility: means any of the following, without regard to whether the facilities referred to are publicly or privately owned or are organized for profit or not or whether the facilities are part of or sponsored by a health maintenance organization:
     a. See Iowa Code 135.61
  • Institutional health service: means any health service furnished in or through institutional health facilities or health maintenance organizations, including mobile health services. See Iowa Code 135.61
  • Modernization: means the alteration, repair, remodeling, replacement or renovation of existing buildings or of the equipment previously installed therein, or both. See Iowa Code 135.61
  • Offer: when used in connection with health services, means that an institutional health facility, health maintenance organization, health care provider, or group of health care providers holds itself out as capable of providing, or as having the means to provide, specified health services. See Iowa Code 135.61
  • Person: means a natural person. See Iowa Code 154A.1
  • State: means a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico. See Iowa Code 152E.3
  • Technologically innovative equipment: means equipment potentially useful for diagnostic or therapeutic purposes which introduces new technology in the diagnosis or treatment of disease, the usefulness of which is not well enough established to permit a specific plan of need to be developed for the state. See Iowa Code 135.61
 2. In addition to the findings required with respect to any of the criteria listed in subsection 1 of this section, the council shall grant a certificate of need for a new institutional health service or changed institutional health service only if it finds in writing, on the basis of data submitted to it by the department, that:

 a. Less costly, more efficient, or more appropriate alternatives to the proposed institutional health service are not available and the development of such alternatives is not practicable;
 b. Any existing facilities providing institutional health services similar to those proposed are being used in an appropriate and efficient manner;
 c. In the case of new construction, alternatives including but not limited to modernization or sharing arrangements have been considered and have been implemented to the maximum extent practicable;
 d. Patients will experience serious problems in obtaining care of the type which will be furnished by the proposed new institutional health service or changed institutional health service, in the absence of that proposed new service.
 3. In the evaluation of applications for certificates of need submitted by the university of Iowa hospitals and clinics, the unique features of that institution relating to statewide tertiary health care, health science education, and clinical research shall be given due consideration. Further, in administering this subchapter, the unique capacity of university hospitals for the evaluation of technologically innovative equipment and other new health services shall be utilized.
  Previous section
Next section  
 Chapter 135 Contents