House File 273
HOUSE FILE
BY JOCHUM
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to physical access by patients to medical care.
2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
3 TLSB 1016HH 80
4 rn/sh/8
PAG LIN
1 1 Section 1. NEW SECTION. 145.1 SHORT TITLE.
1 2 This chapter may be cited as the "Physical Access To Health
1 3 Care Act".
1 4 Sec. 2. NEW SECTION. 145.2 LEGISLATIVE INTENT.
1 5 The general assembly finds that every day, in this state
1 6 and across this country, men and women, children and adults,
1 7 who are challenged by various forms of physical disability,
1 8 must confront the additional challenge of overcoming physical
1 9 barriers to their accessing the health care services they
1 10 need. These barriers include a widespread lack of physical
1 11 accommodations and medical equipment in the offices maintained
1 12 by health care professionals, such as examination tables,
1 13 dental chairs, and scanning devices, that are designed to
1 14 readily accommodate health care consumers with physical
1 15 disabilities. A clear and present public interest would be
1 16 served by the adoption of a statewide requirement for health
1 17 care professionals to ensure that their office facilities and
1 18 medical equipment meet the specialized needs of patients with
1 19 physical disabilities, in order to ensure that these
1 20 individuals have authentic and meaningful access to those
1 21 health care services that are available to all patients,
1 22 whether in a health care facility setting or the professional
1 23 office of a doctor, dentist, or other health care
1 24 professional. The requirements of this chapter are intended
1 25 to ensure compliance with, and facilitate enforcement of, the
1 26 provisions of the federal Americans With Disabilities Act of
1 27 1990, 42 U.S.C. } 12101 et seq., with respect to health care
1 28 professionals practicing, and health care facilities
1 29 operating, in this state, and to provide for even stronger
1 30 protections for physical access to health care.
1 31 Sec. 3. NEW SECTION. 145.3 DEFINITIONS.
1 32 As used in this chapter unless the context otherwise
1 33 requires:
1 34 1. "Advanced imaging technology" means computerized
1 35 tomography, magnetic resonance imaging, positron emission
2 1 tomography, or other technology that may be so designated by
2 2 the department.
2 3 2. "Board" means the examining board for the applicable
2 4 professions licensed pursuant to Title IV, subtitle 3, and
2 5 listed in subsection 5 of this section.
2 6 3. "Department" means the Iowa department of public
2 7 health.
2 8 4. "Health care facility" means a facility licensed
2 9 pursuant to section 135C.6, or a hospital licensed pursuant to
2 10 chapter 135B.
2 11 5. "Health care professional" means a person who owns or
2 12 operates the professional office in which the person conducts
2 13 the person's professional private practice and who is licensed
2 14 or otherwise authorized, pursuant to Title IV, subtitle 3, to
2 15 practice a health care profession that is regulated by the
2 16 boards of medical examiners, physician assistant examiners,
2 17 podiatry examiners, chiropractic examiners, physical and
2 18 occupational therapy examiners, nursing, dental examiners,
2 19 optometry examiners, speech pathology and audiology examiners,
2 20 pharmacy examiners, respiratory care therapists, massage
2 21 therapy examiners, and athletic training examiners.
2 22 6. "Physical accommodations" means accommodations that
2 23 comprise the professional office in which a health care
2 24 professional engages in practice, regardless of whether the
2 25 office is owned or leased by the health care professional, or
2 26 the accommodations that comprise a health care facility,
2 27 including all of the following:
2 28 a. The means of entrance to, or exit from, a health care
2 29 professional's office or a health care facility, including any
2 30 parking area that is provided for patients and members of the
2 31 general public.
2 32 b. The physical configuration of the interior of the
2 33 office or facility, including any toilet facility available to
2 34 patients.
2 35 c. The equipment used by the health care professional or
3 1 health care facility to examine or treat patients.
3 2 Sec. 4. NEW SECTION. 145.4 CERTIFICATION OF COMPLIANCE.
3 3 A board shall require that a health care professional, as a
3 4 condition of licensure or other authorization to practice a
3 5 health care profession that is regulated by that board, or a
3 6 health care facility as a condition of licensure pursuant to
3 7 section 135B.3 or 135C.6, shall certify in writing to the
3 8 director of the department, on a form and in a manner
3 9 established by the department by rule, that the health care
3 10 professional or health care facility is in compliance with the
3 11 requirements of this chapter.
3 12 Sec. 5. NEW SECTION. 145.5 PHYSICAL ACCESS REQUIREMENTS.
3 13 1. By January 1, 2005, or any date that may be specified
3 14 in federal regulations adopted pursuant to the federal
3 15 Americans With Disabilities Act, whichever date is sooner, a
3 16 health care professional shall, within their professional
3 17 office, or a health care facility shall, within the facility:
3 18 a. Maintain at least one height=adjustable patient
3 19 examination table that is designed so that it can be lowered
3 20 to a level that is no more than eighteen inches above the
3 21 finished floor, and to facilitate the transfer of a patient
3 22 with a mobility impairment to and from its surface. At least
3 23 one height=adjustable patient examination table shall be
3 24 maintained by a health care facility within its emergency
3 25 department and outpatient clinic that is suitable for
3 26 gynecological examinations and meets the height requirements
3 27 of this paragraph.
3 28 b. Maintain, if that professional office or health care
3 29 facility provides radiological or advanced imaging technology
3 30 services, at least one height=adjustable, wheeled ambulance
3 31 litter, which is designed so that it can be lowered to a level
3 32 that is no more than eighteen inches above the finished floor,
3 33 which shall be used to facilitate the transfer of a patient
3 34 with a mobility impairment to and from the surface of
3 35 equipment that utilizes radiological technology or other
4 1 equipment used by patients as provided by the department by
4 2 rule and that is not adjustable in height.
4 3 c. If a nursing home as defined in section 155.1 provides
4 4 any treatment or diagnostic medical services to residents, the
4 5 requirements of paragraphs "a" and "b" of this section shall
4 6 apply and certification shall be required pursuant to section
4 7 145.4.
4 8 d. An emergency medical care service provider authorized
4 9 pursuant to section 147A.5 that provides radiological or
4 10 advanced imaging technology services shall maintain at least
4 11 one height=adjustable, wheeled ambulance litter, which is
4 12 designed so that it can be lowered to a level that is no more
4 13 than eighteen inches above the finished floor, which shall be
4 14 used to facilitate the transfer of a patient with a mobility
4 15 impairment to and from the surface of equipment that utilizes
4 16 radiological technology or other equipment used by patients as
4 17 provided by the department by rule and that is not adjustable
4 18 in height. An emergency medical care service provider to
4 19 which this paragraph applies shall comply with the
4 20 certification requirements pursuant to section 145.4.
4 21 2. By January 1, 2007, or any date that may be specified
4 22 in federal regulations adopted pursuant to the federal
4 23 Americans With Disabilities Act, whichever date is sooner, a
4 24 health care professional's physical accommodations, the
4 25 physical accommodations of a health care facility, or the
4 26 physical accommodations of a nursing home, if applicable,
4 27 shall be accessible to persons with mobility impairments,
4 28 including, but not limited to, those using wheelchairs, in
4 29 accordance with rules adopted by the department.
4 30 Sec. 6. NEW SECTION. 145.6 TOLL=FREE TELEPHONE SERVICE.
4 31 1. The department shall establish a toll=free telephone
4 32 service designed to be accessible to persons who are deaf or
4 33 otherwise hearing impaired. The telephone service shall
4 34 identify, at the request of patients and other members of the
4 35 general public utilizing the service, those health care
5 1 professionals who are practicing in a specific area of
5 2 professional specialty or practice in a patient's geographic
5 3 area of residence, or health care facilities located in the
5 4 geographic area of residence, that have certified their
5 5 compliance with the requirements of this chapter pursuant to
5 6 section 145.4.
5 7 2. The telephone service shall receive complaints from
5 8 patients and other members of the general public about any
5 9 health care professional, health care facility, nursing home,
5 10 or emergency medical care services provider who is alleged to
5 11 be in violation of the provisions of this chapter. The
5 12 department shall establish by rule procedures to ensure that
5 13 any such complaint is referred to the appropriate board for
5 14 investigation and follow=up action as necessary.
5 15 c. The department shall distribute information in all
5 16 accessible formats about the toll=free telephone service and
5 17 the requirements of this chapter to persons with physical
5 18 disabilities and other members of the general public.
5 19 EXPLANATION
5 20 This bill establishes a new Code chapter dealing with
5 21 physical access by patients to health care.
5 22 The bill provides legislative intent regarding a statewide
5 23 requirement for health care professionals to ensure that their
5 24 office facilities and medical equipment meet the specialized
5 25 needs of patients with physical disabilities, and compliance
5 26 with the provisions of the federal Americans With Disabilities
5 27 Act of 1990.
5 28 The bill provides for several definitions, including that a
5 29 "health care facility" refers to a facility licensed pursuant
5 30 to Code section 135C.6, or a hospital licensed pursuant to
5 31 Code chapter 135B. A "health care professional" refers to a
5 32 person who owns or operates the professional office in which
5 33 the person conducts the person's professional private practice
5 34 and who is licensed to practice a health care profession
5 35 regulated by the boards of medical examiners, physician
6 1 assistant examiners, podiatry examiners, chiropractic
6 2 examiners, physical and occupational therapy examiners,
6 3 nursing, dental examiners, optometry examiners, speech
6 4 pathology and audiology examiners, pharmacy examiners,
6 5 respiratory care therapists, massage therapy examiners, and
6 6 athletic training examiners. The bill also defines "physical
6 7 accommodations" as referring to accommodations that comprise
6 8 the professional office in which a health care professional
6 9 engages in practice, regardless of whether the office is owned
6 10 or leased by the health care professional, or the
6 11 accommodations that comprise a health care facility.
6 12 The bill provides that health care professionals, health
6 13 care facilities, and, if applicable, nursing homes and
6 14 emergency medical care providers, shall, as a condition of
6 15 licensure, certify in writing to the director of the Iowa
6 16 department of public health that the individual or entity is
6 17 in compliance with the requirements of the bill.
6 18 The bill provides several requirements relating to patient
6 19 access to physical accommodations. The bill provides that by
6 20 January 1, 2005, or any date that may be specified in federal
6 21 regulations adopted pursuant to the federal Americans With
6 22 Disabilities Act, if sooner, a health care professional shall,
6 23 within their professional office, or a health care facility
6 24 shall, within the facility, maintain certain equipment to
6 25 accommodate persons with a mobility impairment.
6 26 The bill provides that a nursing home or emergency medical
6 27 care provider service shall meet some of these requirements if
6 28 providing certain services.
6 29 The bill additionally provides that by January 1, 2007, or
6 30 any date that may be specified in federal regulations adopted
6 31 pursuant to the federal Americans With Disabilities Act, if
6 32 sooner, a health care professional's physical accommodations,
6 33 the physical accommodations of a health care facility, and the
6 34 physical accommodations of a nursing home, if applicable,
6 35 shall be accessible to persons with mobility impairments,
7 1 including, but not limited to, those using wheelchairs, in
7 2 accordance with rules adopted by the department.
7 3 The bill also provides for the establishment of a toll=free
7 4 telephone service by the department, to provide information
7 5 regarding the location of and compliance by health care
7 6 professionals, health care facilities, nursing homes, or
7 7 emergency medical care service providers, if applicable, with
7 8 the provisions of the bill. The telephone service shall be
7 9 designed to be accessible to persons who are deaf or otherwise
7 10 hearing impaired, and may also be utilized to forward
7 11 complaints from patients and members of the general public
7 12 about any health care professional, health care facility,
7 13 nursing home, or emergency medical care services provider who
7 14 is alleged to be in violation of the bill's provisions. The
7 15 bill provides that the department shall distribute information
7 16 in all accessible formats about the toll=free telephone
7 17 service and the requirements of the new chapter to persons
7 18 with physical disabilities and other members of the general
7 19 public.
7 20 LSB 1016HH 80
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