House File 2165
HOUSE FILE
BY HUNTER, GREIMANN,
and FOEGE
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the regulation of renal dialysis facilities
2 and providing for injunctive relief.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 5907HH 80
5 pf/gg/14
PAG LIN
1 1 Section 1. NEW SECTION. 135M.1 DEFINITIONS.
1 2 For the purposes of this chapter, unless the context
1 3 otherwise requires:
1 4 1. "Department" means the department of inspections and
1 5 appeals.
1 6 2. "Dialysis" means a process by which substances are
1 7 removed from a patient's body by diffusion from one fluid
1 8 compartment to another across a semipermeable membrane.
1 9 3. "End=stage renal disease" means end=stage renal disease
1 10 as defined in section 135.45.
1 11 4. "Renal dialysis facility" means an outpatient facility
1 12 which offers staff=assisted dialysis or training and support
1 13 services for self=dialysis at home to end=stage renal disease
1 14 patients, but does not include:
1 15 a. Facilities operated by the state or federal government.
1 16 b. Renal dialysis services provided by a licensed
1 17 hospital.
1 18 5. "Self=dialysis at home" means dialysis performed by a
1 19 patient at home when the patient has completed a course in
1 20 self=dialysis.
1 21 6. "Staff=assisted dialysis" means dialysis performed by
1 22 qualified staff of a renal dialysis facility.
1 23 Sec. 2. NEW SECTION. 135M.2 REGULATION OF RENAL DIALYSIS
1 24 FACILITIES.
1 25 1. The department of inspections and appeals shall adopt
1 26 rules for the regulation of renal dialysis facilities located
1 27 in this state. The rules shall be consistent with the end=
1 28 stage renal disease requirements for participation in the
1 29 Medicare program.
1 30 2. In addition to and consistent with the end=stage renal
1 31 disease requirements for participation in the Medicare
1 32 program, the rules adopted by the department under this
1 33 chapter shall include, but are not limited to, regulation of
1 34 all of the following:
1 35 a. Qualifications of renal dialysis facility personnel.
2 1 b. Medical staffing.
2 2 c. Transfer agreements with hospitals to provide for the
2 3 transfer of a patient for the provision of inpatient care and
2 4 other hospital services.
2 5 d. The rights and responsibilities of patients.
2 6 e. Disaster preparedness.
2 7 f. Infection control.
2 8 g. Incident and accident reports.
2 9 3. The rules relating to disaster preparedness shall
2 10 include all of the following:
2 11 a. That a renal dialysis facility have written policies
2 12 and procedures for emergencies that address fire, natural
2 13 disaster, and medical emergencies. The emergency procedures
2 14 developed shall be individualized for each patient to include
2 15 an appropriate evacuation from the facility or the patient's
2 16 home and the emergency telephone numbers needed for each
2 17 patient.
2 18 b. That a renal dialysis facility familiarize personnel
2 19 and patients with the policies and procedures developed
2 20 pursuant to paragraph "a".
2 21 c. That the renal dialysis facility familiarize each
2 22 patient with the procedure for disconnecting the patient's
2 23 dialysis equipment in the event of an emergency.
2 24 d. That in the event of a medical emergency, renal
2 25 dialysis facility personnel shall contact the patient's
2 26 physician or surgeon, as designated by the patient, and follow
2 27 the instructions provided by the physician or surgeon. If the
2 28 patient's physician or surgeon is not available, the renal
2 29 dialysis facility personnel shall contact the hospital with
2 30 which the facility has a transfer agreement to seek
2 31 instructions and shall follow the instructions provided by the
2 32 hospital personnel.
2 33 Sec. 3. NEW SECTION. 135M.3 INSPECTIONS == INJUNCTION.
2 34 1. The department shall coordinate efforts with the end=
2 35 stage renal disease network established by federal law to
3 1 provide for inspection of renal dialysis facilities. The
3 2 facilities shall be inspected on at least an annual basis.
3 3 2. The department may request that the attorney general
3 4 bring an action to enjoin the operation of a renal dialysis
3 5 facility if the department finds that the facility is in
3 6 violation of this chapter and the department determines that
3 7 an imminent threat to the health and safety of a patient of
3 8 the facility exists.
3 9 EXPLANATION
3 10 This bill relates to the regulation of renal dialysis
3 11 facilities, defined by the bill as outpatient facilities which
3 12 offer staff=assisted dialysis or training and support services
3 13 for self=dialysis at home to end=stage renal disease patients.
3 14 Renal disease facilities under the bill do not include
3 15 facilities operated by the state or federal government or
3 16 renal dialysis services provided by a licensed hospital.
3 17 The bill directs the department of inspections and appeals
3 18 to adopt rules for the regulation of renal dialysis facilities
3 19 located in this state. The rules are to be consistent with
3 20 the end=stage renal disease requirements for participation in
3 21 the Medicare program.
3 22 The rules are to include, but are not limited to,
3 23 qualifications of renal dialysis facility personnel, medical
3 24 staffing, transfer agreements with hospitals, the rights and
3 25 responsibilities of patients, disaster preparedness, infection
3 26 control, and incident and accident reports.
3 27 The bill specifies that the rules relating to disaster
3 28 preparedness are to include that a renal dialysis facility
3 29 have written policies and procedures for emergencies that
3 30 address fire, natural disaster, and medical emergencies; that
3 31 such a facility familiarize personnel and patients with the
3 32 policies and procedures; that the facility familiarize each
3 33 patient with the procedure for disconnecting the patient's
3 34 dialysis equipment in the event of an emergency; and whom
3 35 facility personnel are to contact in the event of a medical
4 1 emergency.
4 2 The bill directs the department to coordinate efforts with
4 3 the end=stage renal disease network established by federal law
4 4 to provide for inspection of renal dialysis facilities. The
4 5 network contracts with the centers for Medicare and Medicaid
4 6 services of the United States department of health and human
4 7 services to ensure the administration of the end=stage renal
4 8 disease program under the Medicare program. The bill requires
4 9 the facilities to be inspected on at least an annual basis.
4 10 The bill also provides for injunctive relief if the
4 11 department finds that a facility is in violation of the Code
4 12 chapter and the department determines that an imminent threat
4 13 to the health and safety of a patient of the facility exists.
4 14 LSB 5907HH 80
4 15 pf/gg/14