135.164 - STRATEGIC PLAN.
135.164 STRATEGIC PLAN.
1. The strategic plan for health care delivery infrastructure and
health care workforce resources shall describe the existing health
care system, describe and provide a rationale for the desired health
care system, provide an action plan for implementation, and provide
methods to evaluate the system. The plan shall incorporate
expenditure control methods and integrate criteria for evidence-based
health care. The department shall do all of the following in
developing the strategic plan for health care delivery infrastructure
and health care workforce resources:
a. Conduct strategic health planning activities related to
preparation of the strategic plan.
b. Develop a computerized system for accessing, analyzing,
and disseminating data relevant to strategic health planning. The
department may enter into data sharing agreements and contractual
arrangements necessary to obtain or disseminate relevant data.
c. Conduct research and analysis or arrange for research and
analysis projects to be conducted by public or private organizations
to further the development of the strategic plan.
d. Establish a technical advisory committee to assist in the
development of the strategic plan. The members of the committee may
include but are not limited to health economists, representatives of
the university of Iowa college of public health, health planners,
representatives of health care purchasers, representatives of state
and local agencies that regulate entities involved in health care,
representatives of health care providers and health care facilities,
and consumers.
2. The strategic plan shall include statewide health planning
policies and goals related to the availability of health care
facilities and services, the quality of care, and the cost of care.
The policies and goals shall be based on the following principles:
a. That a strategic health planning process, responsive to
changing health and social needs and conditions, is essential to the
health, safety, and welfare of Iowans. The process shall be reviewed
and updated as necessary to ensure that the strategic plan addresses
all of the following:
(1) Promoting and maintaining the health of all Iowans.
(2) Providing accessible health care services through the
maintenance of an adequate supply of health facilities and an
adequate workforce.
(3) Controlling excessive increases in costs.
(4) Applying specific quality criteria and population health
indicators.
(5) Recognizing prevention and wellness as priorities in health
care programs to improve quality and reduce costs.
(6) Addressing periodic priority issues including disaster
planning, public health threats, and public safety dilemmas.
(7) Coordinating health care delivery and resource development
efforts among state agencies including those tasked with facility,
services, and professional provider licensure; state and federal
reimbursement; health service utilization data systems; and others.
(8) Recognizing long-term care as an integral component of the
health care delivery infrastructure and as an essential service
provided by the health care workforce.
b. That both consumers and providers throughout the state
must be involved in the health planning process, outcomes of which
shall be clearly articulated and available for public review and use.
c. That the supply of a health care service has a substantial
impact on utilization of the service, independent of the
effectiveness, medical necessity, or appropriateness of the
particular health care service for a particular individual.
d. That given that health care resources are not unlimited,
the impact of any new health care service or facility on overall
health expenditures in this state must be considered.
e. That excess capacity of health care services and
facilities places an increased economic burden on the public.
f. That the likelihood that a requested new health care
facility, service, or equipment will improve health care quality and
outcomes must be considered.
g. That development and ongoing maintenance of current and
accurate health care information and statistics related to cost and
quality of health care and projections of the need for health care
facilities and services are necessary to developing an effective
health care planning strategy.
h. That the certificate of need program as a component of the
health care planning regulatory process must balance considerations
of access to quality care at a reasonable cost for all Iowans,
optimal use of existing health care resources, fostering of
expenditure control, and elimination of unnecessary duplication of
health care facilities and services, while supporting improved health
care outcomes.
i. That strategic health care planning must be concerned with
the stability of the health care system, encompassing health care
financing, quality, and the availability of information and services
for all residents.
3. The health care delivery infrastructure and health care
workforce resources strategic plan developed by the department shall
include all of the following:
a. A health care system assessment and objectives component
that does all of the following:
(1) Describes state and regional population demographics, health
status indicators, and trends in health status and health care needs.
(2) Identifies key policy objectives for the state health care
system related to access to care, health care outcomes, quality, and
cost-effectiveness.
b. A health care facilities and services plan that assesses
the demand for health care facilities and services to inform state
health care planning efforts and direct certificate of need
determinations for those facilities and services subject to
certificate of need. The plan shall include all of the following:
(1) An inventory of each geographic region's existing health care
facilities and services.
(2) Projections of the need for each category of health care
facility and service, including those subject to certificate of need.
(3) Policies to guide the addition of new or expanded health care
facilities and services to promote the use of quality,
evidence-based, cost-effective health care delivery options,
including any recommendations for criteria, standards, and methods
relevant to the certificate of need review process.
(4) An assessment of the availability of health care providers,
public health resources, transportation infrastructure, and other
considerations necessary to support the needed health care facilities
and services in each region.
c. A health care data resources plan that identifies data
elements necessary to properly conduct planning activities and to
review certificate of need applications, including data related to
inpatient and outpatient utilization and outcomes information, and
financial and utilization information related to charity care,
quality, and cost. The plan shall provide all of the following:
(1) An inventory of existing data resources, both public and
private, that store and disclose information relevant to the health
care planning process, including information necessary to conduct
certificate of need activities. The plan shall identify any
deficiencies in the inventory of existing data resources and the data
necessary to conduct comprehensive health care planning activities.
The plan may recommend that the department be authorized to access
existing data sources and conduct appropriate analyses of such data
or that other agencies expand their data collection activities as
statutory authority permits. The plan may identify any computing
infrastructure deficiencies that impede the proper storage,
transmission, and analysis of health care planning data.
(2) Recommendations for increasing the availability of data
related to health care planning to provide greater community
involvement in the health care planning process and consistency in
data used for certificate of need applications and determinations.
The plan shall also integrate the requirements for annual reports by
hospitals and health care facilities pursuant to section 135.75, the
provisions relating to analyses and studies by the department
pursuant to section 135.76, the data compilation provisions of
section 135.78, and the provisions for contracts for assistance with
analyses, studies, and data pursuant to section 135.83.
d. An assessment of emerging trends in health care delivery
and technology as they relate to access to health care facilities and
services, quality of care, and costs of care. The assessment shall
recommend any changes to the scope of health care facilities and
services covered by the certificate of need program that may be
warranted by these emerging trends. In addition, the assessment may
recommend any changes to criteria used by the department to review
certificate of need applications, as necessary.
e. A rural health care resources plan to assess the
availability of health resources in rural areas of the state, assess
the unmet needs of these communities, and evaluate how federal and
state reimbursement policies can be modified, if necessary, to more
efficiently and effectively meet the health care needs of rural
communities. The plan shall consider the unique health care needs of
rural communities, the adequacy of the rural health care workforce,
and transportation needs for accessing appropriate care.
f. A health care workforce resources plan to assure a
competent, diverse, and sustainable health care workforce in Iowa and
to improve access to health care in underserved areas and among
underserved populations. The plan shall include the establishment of
an advisory council to inform and advise the department and
policymakers regarding issues relevant to the health care workforce
in Iowa. The health care workforce resources plan shall recognize
long-term care as an essential service provided by the health care
workforce.
4. The department shall submit the initial statewide health care
delivery infrastructure and resources strategic plan to the governor
and the general assembly by January 1, 2010, and shall submit an
updated strategic plan to the governor and the general assembly every
two years thereafter. Section History: Recent Form
2008 Acts, ch 1188, §58
Referred to in § 135.153A, 135.175