Iowa Code § 135.63 (2026)

1. In determining whether a certificate of need shall be issued, the department 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,\n\nTue Dec 09 22:27:41 2025 Iowa Code 2026, Chapter 135 (177, 22) 31 DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH, §135.63\n\nmanagement 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. 2. In addition to the findings required with respect to any of the criteria listed in subsection 1 of this section, the department shall grant a certificate of need for a new institutional health service or changed institutional health service only if the department finds in writing, on the basis of data submitted, 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. [C79, 81, §135.64] 91 Acts, ch 225, §5; 92 Acts, ch 1043, §2; 96 Acts, ch 1129, §113; 2002 Acts, ch 1120, §11; 2014 Acts, ch 1026, §29; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1602 C2024, §10A.714\n\nTue Dec 09 22:27:41 2025 Iowa Code 2026, Chapter 135 (177, 22) §135.63, DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH 32\n\n 2025 Acts, ch 120, §29 – 31, 40, 53 C2026, §135.63 Referred to in §135.64, 135.65, 135.71 Section transferred from §10A.714 in Code 2026 pursuant to directive in 2025 Acts, ch 120, §40 Subsection 1, unnumbered paragraph 1 amended Subsection 1, paragraph r amended Subsection 2, unnumbered paragraph 1 amended Subsection 3 amended