House File 44 - Introduced
HOUSE FILE
BY GASKILL and MURPHY
(COMPANION TO LSB 1031SS
BY BOLKCOM)
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the disclosure of hospital=acquired infections
2 and providing penalties.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 1031HH 81
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PAG LIN
1 1 Section 1. NEW SECTION. 135M.1 SHORT TITLE.
1 2 This chapter shall be known and may be cited as the
1 3 "Hospital Infections Disclosure Act".
1 4 Sec. 2. NEW SECTION. 135M.2 DEFINITIONS.
1 5 For purposes of this chapter, unless the context otherwise
1 6 requires:
1 7 1. "Department" means the department of inspections and
1 8 appeals.
1 9 2. "Hospital" means hospital as defined in section 135B.1
1 10 and includes a hospital=affiliated or freestanding outpatient
1 11 surgical facility as defined in section 135.61.
1 12 3. "Hospital=acquired infection" means a localized or
1 13 systemic condition that results from an adverse reaction to
1 14 the presence of an infectious agent or its toxin that was not
1 15 present or incubating at the time of admission to the
1 16 hospital.
1 17 Sec. 3. NEW SECTION. 135M.3 HOSPITAL REPORTS.
1 18 1. A hospital shall collect data on hospital=acquired
1 19 infection rates for specific clinical procedures specified by
1 20 the department by rule including but not limited to all of the
1 21 following infection categories:
1 22 a. Surgical site infections.
1 23 b. Ventilator=associated pneumonia.
1 24 c. Central line=related bloodstream infections.
1 25 d. Urinary tract infections.
1 26 e. Other infection categories as provided under subsection
1 27 4, paragraph "e".
1 28 2. a. A hospital shall submit a report on hospital=
1 29 acquired infection rates to the department on a quarterly
1 30 basis in the format and based upon the schedule established by
1 31 rule of the department. Data included in a quarterly report
1 32 shall cover the period ending no earlier than one month prior
1 33 to submission of the report.
1 34 b. A hospital's quarterly report shall be made available
1 35 to the public at the hospital and through the department.
2 1 3. If a hospital is a division or subsidiary of another
2 2 entity that owns or operates other hospitals or related
2 3 organizations, the hospital's quarterly report shall reflect
2 4 only the individual data for that specific hospital and not
2 5 for any other hospital or related organization of the entity.
2 6 4. a. The director of the department shall appoint an
2 7 advisory committee, including representatives of public and
2 8 private hospitals, hospital infection control departments,
2 9 direct care nursing staff, physicians, epidemiologists with
2 10 expertise in hospital=acquired infections, academic
2 11 researchers, consumer organizations, health insurers, health
2 12 maintenance organizations, organized labor, and purchasers of
2 13 health insurance such as employers. The majority of the
2 14 members of the advisory committee shall not represent the
2 15 interests of hospitals.
2 16 b. The advisory committee shall assist the department in
2 17 the development of the department's methodology for
2 18 collecting, analyzing, and disclosing the data collected under
2 19 this chapter.
2 20 c. In developing the methodology for collecting and
2 21 analyzing the hospital=acquired infection rate data, the
2 22 department and advisory committee shall consider existing
2 23 methodologies and systems for data collection, including but
2 24 not limited to the national nosocomial infection surveillance
2 25 system of the centers for disease control and prevention of
2 26 the United States department of health and human services, but
2 27 the department's discretion to adopt a methodology shall not
2 28 be limited or restricted to any existing methodology or
2 29 system. The data collection and analysis methodology shall be
2 30 disclosed to the public prior to any public disclosure of
2 31 hospital=acquired infection rates.
2 32 d. The department and the advisory committee shall
2 33 evaluate the quality and accuracy of hospital data reported
2 34 pursuant to this chapter and the data collection, analysis,
2 35 and disclosure methodologies on a regular basis.
3 1 e. The department may, after consultation with the
3 2 advisory committee, require hospitals to collect data on
3 3 hospital=acquired infection rates in infection categories in
3 4 addition to those specified in subsection 1.
3 5 Sec. 4. NEW SECTION. 135M.4 DEPARTMENT REPORTS.
3 6 1. The department shall submit a report to the general
3 7 assembly annually, summarizing the hospital quarterly reports
3 8 submitted pursuant to section 135M.3, and shall publish the
3 9 annual report on the department's website. The department may
3 10 issue quarterly informational bulletins at the department's
3 11 discretion, summarizing all or part of the data submitted in
3 12 the hospital quarterly reports.
3 13 2. All reports issued by the department shall be risk
3 14 adjusted based upon risk=adjustment criteria adopted by rule
3 15 of the department.
3 16 3. The annual report shall provide a comparison of the
3 17 risk=adjusted hospital=acquired infection rates, collected
3 18 under section 135M.3 for each individual hospital in the
3 19 state. The department, in consultation with the advisory
3 20 committee, shall provide the comparison in a manner easily
3 21 comprehensible to the public. The annual report shall also
3 22 include an executive summary, written in plain language, that
3 23 shall include, but not be limited to, a discussion of
3 24 findings, conclusions, and trends concerning the overall state
3 25 of hospital=acquired infections in the state, including a
3 26 comparison to prior years. The report may include policy
3 27 recommendations, as deemed appropriate by the department.
3 28 4. The department shall publicize the report and its
3 29 availability to interested parties, including, but not limited
3 30 to, hospitals, health care providers, media organizations,
3 31 health insurers, health maintenance organizations, purchasers
3 32 of health insurance, organized labor, consumer or patient
3 33 advocacy groups, and individual consumers. A written copy of
3 34 the annual report shall be made available to any person upon
3 35 request.
4 1 5. A hospital report or a disclosure by the department
4 2 shall not contain information identifying a patient, employee,
4 3 or licensed health care professional in connection with a
4 4 specific hospital=acquired infection incident.
4 5 Sec. 5. NEW SECTION. 135M.5 CONFIDENTIALITY.
4 6 Any data reported or disclosed pursuant to this chapter
4 7 shall be reported and disclosed in a manner that maintains a
4 8 patient's confidentiality. Patient social security numbers
4 9 and any other information that could be used to identify an
4 10 individual patient shall not be disclosed pursuant to this
4 11 chapter notwithstanding any other provision of law.
4 12 Sec. 6. NEW SECTION. 135M.6 PENALTIES.
4 13 A hospital that violates a provision of this chapter may be
4 14 subject to any of the following:
4 15 1. Denial, suspension, or revocation of licensure pursuant
4 16 to chapter 135B.
4 17 2. A civil penalty of up to one thousand dollars per
4 18 violation for each day the hospital is in violation of this
4 19 chapter.
4 20 Sec. 7. NEW SECTION. 135M.7 CONDITION OF LICENSURE.
4 21 The department shall enforce this chapter as a condition of
4 22 licensure under chapter 135B and shall enforce such compliance
4 23 in accordance with that chapter.
4 24 Sec. 8. Section 135B.7, Code 2005, is amended by adding
4 25 the following new unnumbered paragraph:
4 26 NEW UNNUMBERED PARAGRAPH. The rules shall require that as
4 27 a condition of licensure the hospital comply with chapter 135M
4 28 and that violation of a provision of chapter 135M is grounds
4 29 for denial, suspension, or revocation of a license under this
4 30 chapter.
4 31 EXPLANATION
4 32 This bill establishes new Code chapter 135M as the hospital
4 33 infections disclosure Act. The bill defines "hospital" to
4 34 include an acute care hospital and a hospital=affiliated or
4 35 freestanding outpatient surgical center and provides that the
5 1 chapter is to be enforced by the department of inspections and
5 2 appeals. The bill requires hospitals to report specified data
5 3 relating to hospital=acquired infection rates on a quarterly
5 4 basis and in a format and schedule established by rule of the
5 5 department. The bill directs the director of the department
5 6 to appoint an advisory committee to assist in the development
5 7 of the methodology for the collecting, analyzing, and
5 8 disclosing of the data. The bill directs the department to
5 9 submit annual reports summarizing the data collected in the
5 10 quarterly reports to the general assembly and to publish the
5 11 annual report on the department's website. The bill provides
5 12 for confidentiality of the data collected and for the
5 13 protection of patients' privacy. The bill provides that a
5 14 hospital that violates a provision of the bill is subject to
5 15 denial, suspension, or revocation of licensure or a civil
5 16 penalty of up to $1,000 per day per violation. The bill
5 17 provides that compliance with the new Code chapter is a
5 18 condition of licensure under the hospital licensing chapter
5 19 (Code chapter 135B).
5 20 LSB 1031HH 81
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