House File 307 - Introduced
HOUSE FILE
BY MASCHER
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act concerning disclosures of information regarding patient
2 safety by health care workers and providing penalties.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 2211YH 83
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PAG LIN
1 1 Section 1. NEW SECTION. 147.97 PATIENT PROTECTION ==
1 2 HEALTH CARE WORKERS == REPORT OF ADVERSE EVENTS.
1 3 1. As used in this section, unless the context otherwise
1 4 requires:
1 5 a. "Direct care worker" means a trained and supervised
1 6 individual who provides services, care, and emotional support
1 7 to patients and health care recipients.
1 8 b. "Established guidelines for certified individuals and
1 9 direct care workers" includes written protocols and procedures
1 10 as defined by the department for direct care workers,
1 11 emergency medical care providers as defined in chapter 147A,
1 12 and substance abuse counselors as certified by the Iowa board
1 13 of certification.
1 14 c. "Health care worker" means any individual employed by
1 15 or under contract with a hospital, health care provider, or
1 16 health care agency to provide health care services.
1 17 d. "Professional standards of care" means authoritative
1 18 statements that describe a level of care or performance common
1 19 to the profession by which the quality of professional
1 20 practice can be judged and which reflect the values and
1 21 priorities of the profession.
1 22 2. A health care worker, who reasonably believes a
1 23 particular practice the health care worker has observed
1 24 occurring at the health care worker's place of employment or
1 25 at the health care entity where the health care worker is
1 26 rendering health care services, based on the health care
1 27 worker's professional standards of care, professional code of
1 28 ethics, or established guidelines for certified individuals
1 29 and direct care workers, is a material violation of health and
1 30 safety laws or a breach of public safety that has caused
1 31 serious harm to or creates a significant probability of
1 32 serious harm to patients or health care recipients, may report
1 33 the information relating to the violation or breach within
1 34 fourteen calendar days of its occurrence to the health care
1 35 worker's supervisor, employer, or member of management or
2 1 administration, in order that investigation can be undertaken
2 2 and, if appropriate, corrective action be initiated. The
2 3 report shall be made in writing according to the business
2 4 operational procedures of the health care entity as outlined
2 5 in the personnel manual or other similar business arrangement
2 6 document applicable to employees of the health care entity.
2 7 The health care worker shall be protected against reprisals or
2 8 retaliatory or punitive action by the individual or
2 9 institution receiving such a report. The health care entity
2 10 shall respond, in writing, to the health care worker within
2 11 fourteen calendar days of receipt of the report outlining any
2 12 investigation or corrective action initiated by the health
2 13 care entity.
2 14 3. If after fourteen calendar days following the written
2 15 report of a material violation or breach made by the health
2 16 care worker pursuant to subsection 2, the health care worker
2 17 continues to see the particular practice occurring in the
2 18 workplace giving rise to the written report, the health care
2 19 worker may report information to the appropriate licensing
2 20 board, the department, the department of inspections and
2 21 appeals, the department of human services, the Iowa healthcare
2 22 collaborative, the division of insurance in the department of
2 23 commerce, a member or employee of the general assembly, the
2 24 attorney general, a state=mandated health information
2 25 collection agency, any other public official or law
2 26 enforcement agency, federal government agency or program, the
2 27 governing board of the health care worker's employer or
2 28 institution, or the health care worker's professional
2 29 association, and shall be protected against reprisals or
2 30 retaliatory or punitive actions by the individual or employing
2 31 health care entity if disclosure of the information is not
2 32 otherwise prohibited by statute and if the information meets
2 33 any of the following requirements:
2 34 a. Constitutes state=mandated health data required to be
2 35 submitted to state agencies.
3 1 b. Informs state agencies or entities of violations of
3 2 state health, safety, occupational health, licensure, or
3 3 insurance laws.
3 4 c. Is reasonably believed by the health care worker to be
3 5 a material violation of health and safety laws or a breach of
3 6 public safety that has caused serious harm to or creates a
3 7 significant probability of serious harm to patients or health
3 8 care recipients, based upon the health care worker's
3 9 professional standards of care, professional code of ethics,
3 10 or established guidelines for certified individuals and direct
3 11 care workers.
3 12 A health care worker making a disclosure which violates any
3 13 provision of the federal Health Insurance Portability and
3 14 Accountability Act, Pub. L. No. 104=191, shall not be entitled
3 15 to protection pursuant to this section nor entitled to civil
3 16 remedies which might otherwise be available pursuant to
3 17 subsection 6 or 7.
3 18 4. A health care worker who, in good faith, makes a
3 19 written report of a material violation or breach pursuant to
3 20 subsection 2 or reports information described in subsection 3
3 21 shall be presumed to have established a prima facie case
3 22 showing a violation of subsection 2 or 3 by the health care
3 23 worker's employer if the individual or institution employing
3 24 the health care worker knows or has reason to know of the
3 25 disclosure, and if subsequent to the disclosure, one or more
3 26 of the following actions were initiated by the employer:
3 27 a. Discharge of the health care worker from employment.
3 28 b. Failure by the employer to take action regarding a
3 29 health care worker's appointment to, promotion or proposed
3 30 promotion to, or receipt of any advantage or benefit in the
3 31 health care worker's position of employment.
3 32 c. Any adverse change to the health care worker's terms or
3 33 conditions of employment or any administrative, civil, or
3 34 criminal action or other effort that diminished the
3 35 professional competence, reputation, stature, or marketability
4 1 of the health care worker.
4 2 An employer shall have the burden of proof regarding any
4 3 attempt to show that actions taken pursuant to this subsection
4 4 were for a legitimate business purpose or were required by law
4 5 or administrative rule, which if proven is a complete defense.
4 6 5. If an individual or institution employing a health care
4 7 worker is determined to have violated state health, safety, or
4 8 occupational health and health licensure laws or regulations,
4 9 or professional standards of care, professional code of
4 10 ethics, or established guidelines for certified individuals
4 11 and direct care workers, after a disclosure pursuant to
4 12 subsection 2 or 3 results in an action as described in
4 13 subsection 4, such a determination shall create a presumption
4 14 of retaliation or reprisal against the health care worker in
4 15 violation of this section. Disclosure of a reasonable belief
4 16 that material violations of health and safety laws or breaches
4 17 of public safety have occurred that have caused or create a
4 18 significant probability of serious harm to patients and health
4 19 care recipients shall immediately trigger the protection
4 20 afforded by this section.
4 21 6. A person who violates this section is subject to a
4 22 civil action as follows:
4 23 a. A person who violates this section is liable to an
4 24 aggrieved health care worker for affirmative relief.
4 25 b. A person or entity who prevails in a civil action based
4 26 on this section is entitled to equitable relief the court
4 27 deems appropriate.
4 28 c. When a person commits, is committing, or proposes to
4 29 commit an act in violation of this section, an injunction may
4 30 be granted through an action in district court to prohibit the
4 31 person from continuing such acts. The action for injunctive
4 32 relief may be brought by an aggrieved health care worker or by
4 33 the county attorney.
4 34 d. A civil action brought pursuant to this subsection
4 35 shall be filed within six months from the date of the alleged
5 1 violation.
5 2 7. a. In addition to any other penalties applicable to a
5 3 person who violates this section, an individual, institution,
5 4 or organization employing a person who violates this section
5 5 shall be subject to a civil penalty in the amount of one
5 6 thousand dollars per violation.
5 7 b. A health care worker found to bring a frivolous,
5 8 malicious, or nuisance cause of action against a health care
5 9 employer under this section shall be subject to a civil
5 10 penalty in the amount of one thousand dollars per violation
5 11 and up to four thousand dollars of reasonable attorney fees.
5 12 8. It is the intent of this section to protect public
5 13 safety and not to protect incompetent or unprofessional health
5 14 care workers.
5 15 EXPLANATION
5 16 This bill creates new Code section 147.97 to provide
5 17 protection for health care workers against retaliation or
5 18 reprisals resulting from the disclosure of certain patient
5 19 safety information.
5 20 The new Code section provides that a health care worker who
5 21 discloses information to a state or federal board, department,
5 22 or agency, including the attorney general and law enforcement
5 23 personnel, as described in the bill, after 14 days have
5 24 transpired following a written report to the employer and
5 25 opportunity to take corrective action has transpired on the
5 26 part of the individual or institution which employs the health
5 27 care worker and which is the subject of the disclosure, shall
5 28 be protected against reprisals or retaliatory or punitive
5 29 actions by the employer if disclosure of the information is
5 30 not otherwise prohibited by statute. The bill requires that
5 31 the health care entity respond to the health care worker
5 32 within 14 days. The bill provides that for this provision to
5 33 apply, the information disclosed must constitute
5 34 state=mandated health data required to be submitted to a state
5 35 agency, or inform a state agency or entity of a violation of
6 1 state health, safety, occupational health, licensure, and
6 2 insurance laws, or is reasonably believed by the health care
6 3 worker to be a violation of health and safety laws or a breach
6 4 of public safety that has caused or creates a significant
6 5 probability of serious harm to patients or health care
6 6 recipients, based upon the health care worker's professional
6 7 standards of care, professional code of ethics, or established
6 8 guidelines for health care workers. The bill provides that
6 9 this provision shall not be applicable to a disclosure which
6 10 constitutes a violation of the federal Health Insurance
6 11 Portability and Accountability Act.
6 12 The new Code section provides that a health care worker
6 13 disclosing in good faith this information shall be presumed to
6 14 have established a prima facie case if the employer knows or
6 15 has reason to know of the disclosure, and if following the
6 16 disclosure the health care worker was discharged from
6 17 employment, or there was a failure by the employer to take
6 18 action regarding a health care worker's appointment or
6 19 promotion, or any adverse change to the health care worker's
6 20 terms or conditions of employment as well as any
6 21 administrative, civil, or criminal action or other effort that
6 22 diminishes the professional competence, reputation, stature,
6 23 or marketability of the health care worker. The bill provides
6 24 that the employer shall have the burden of proof regarding any
6 25 attempt to show that these actions were undertaken for a
6 26 legitimate business purpose.
6 27 The new Code section provides that if an employer is
6 28 determined to have violated state health, safety, or
6 29 occupational health or health licensure laws or regulations,
6 30 or professional standards of care or a professional code of
6 31 ethics, or certain guidelines, after a disclosure by a health
6 32 care worker resulting in an action taken against the worker as
6 33 described in the bill, this creates a presumption of
6 34 retaliation or reprisal. The bill provides that violations of
6 35 health and safety laws or breaches of public safety that have
7 1 caused or create a significant probability of serious harm to
7 2 patients and health care recipients immediately trigger
7 3 protection.
7 4 The new Code section provides that violations may be
7 5 grounds for a civil action. The bill provides that in such an
7 6 action, an employer may be liable to an aggrieved health care
7 7 worker for affirmative relief, and other equitable relief the
7 8 court deems appropriate. The bill also provides for
7 9 injunctive relief. The bill provides that in addition to
7 10 other penalties, an individual, institution, or organization
7 11 employing a person found to be in violation of the bill's
7 12 provisions shall be subject to a civil penalty in the amount
7 13 of $1,000 per violation. In addition, the bill provides that
7 14 a health care worker found to have brought a frivolous claim
7 15 under this new Code section is subject to a civil penalty of
7 16 up to $1,000 per violation and up to $4,000 of reasonable
7 17 attorney fees.
7 18 LSB 2211YH 83
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