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Lawmakers advance bill to keep Iowa’s small, rural hospitals open
Bill creates licensing framework for ‘rural emergency hospital’
Iowa House lawmakers advanced legislation supporters say could provide a financial lifeline to Iowa’s small, rural hospitals that face closure.
The Health and Human Services Committee voted unanimously Tuesday to advance a bill to the House floor that would set up a state licensing process for “rural emergency hospitals.”
New federal rules allow rural hospitals discontinue inpatient care and instead focus on providing outpatient service and emergency medical care through a stand-alone E.R. Once a critical patient is stabilized, they would be transferred to inpatient care elsewhere, while patients with less acute emergencies could be quickly treated and discharged.
The bill also increases the government’s reimbursement rates for Medicare and Medicaid patients treated at a rural emergency hospital.
“Anything that we can do to help rural hospitals keep their doors open, and I think this will help reestablish a facility in Keokuk as well as propping up other small, rural hospitals that are in danger of closing their doors,” committee member Rep. Thomas Jay Moore, R-Griswold, said.
Congress established the new Medicare provider designation in 2021 as means to preserve access to emergency medical care and other services in areas that otherwise would be without a hospital.
Iowa Republican U.S. Sen. Chuck Grassley helped push passage of the bill. And, along with Iowa Republican U.S. Rep. Mariannette Miller-Meeks, pushed the Centers for Medicare & Medicaid Services to move quickly in releasing final rules in the wake of a hospital closure in southeast Iowa.
Quincy, Ill.-based Blessing Health closed its 49-bed Keokuk hospital last fall due to operating losses and low demand for inpatient care.
“The closure of the Keokuk hospital is just one of many hospital closures occurring in rural America and is not the last,” Keokuk Mayor Kathie Mahoney said in a statement in October of community leaders exploring options to maintain high-quality health care services in the community, including as a rural emergency hospital.
Creating the new licensing designation provides rural hospitals the option to right-size their health care infrastructure, while maintaining essential medical services for their communities, Grassley said in a statement at the time.
Enacting the program, though, requires lawmakers in each state to establish state-level requirements and licensing regulations for the new provider type.
The bill applies to a general hospital operating under a valid certificate of need with no more than 50 licensed beds in a rural area with a population between 30,000 and 35,000 people, according to the 2020 census figures.
“This is a great opportunity to support rural communities and keep rural hospitals open,” HHS Committee member Rep. Heather Matson, D-Ankeny, said.
Committee members also voted unanimously to advance legislation expanding the scope of a loan forgiveness program for mental health providers.
Lawmakers last year allocated $1.5 million to the Iowa College Student Aid Commission to pay for a student loan repayment program for mental health care practitioners.
The program was established to increase the number of non-prescribing mental health practitioners serving cities within federal mental health shortage areas in the state by providing loan repayment recipients for up to five consecutive years of full-time service, unless granted a waiver for part-time service.
The bill advanced Tuesday expands the scope to all eligible, licensed mental health professionals who work in the state during a five-year period of full-time practice. The student aid commission would give priority to eligible students who are residents of Iowa upon enrolling in a university and who agree to practice in a service commitment area located in a mental health professional shortage area.
The bill also requires recipients be enrolled as an actively participating Medicaid provider.
“This brings into Iowa a number of other mental health professionals that we need,” said Rep. Mary Madison, D-West Des Moines. “And it does give Medicaid patients care.”
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