House File 182 - Introduced
HOUSE FILE
BY LENSING
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act concerning disclosures of information by health care
2 workers and providing penalties.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 2155YH 82
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PAG LIN
1 1 Section 1. NEW SECTION. 147.105 PATIENT PROTECTION ==
1 2 HEALTH CARE WORKERS == REPORT OF ADVERSE EVENTS.
1 3 1. DEFINITIONS. As used in this section, unless the
1 4 context otherwise requires:
1 5 a. "Health care worker" means any individual employed by
1 6 or under contract with a hospital, health care provider, or
1 7 health care agency to provide health care services.
1 8 b. "Professional standards of care" means authoritative
1 9 statements that describe a level of care or performance common
1 10 to the profession by which the quality of professional
1 11 practice can be judged and which reflect the values and
1 12 priorities of the profession.
1 13 2. A health care worker, who reasonably believes a
1 14 particular practice the health care worker has observed
1 15 occurring at the health care worker's place of employment,
1 16 based on the health care worker's professional standards of
1 17 care or professional code of ethics, is a violation of health
1 18 and safety laws or a breach of public safety that may lead to
1 19 harm to patients, consumers, or citizens, may report the
1 20 information relating to the violation or breach within
1 21 fourteen days of its occurrence to the health care worker's
1 22 supervisor or employer, in order that corrective action can be
1 23 taken. The health care worker shall be protected against
1 24 reprisals or retaliatory or punitive action by the individual
1 25 or institution receiving such a report.
1 26 3. If after a reasonable period of time for correction of
1 27 the violation or breach reported pursuant to subsection 2, the
1 28 health care worker continues to see the particular practice
1 29 occurring in the workplace giving rise to the report, the
1 30 health care worker may disclose information to the licensing
1 31 board, the department, the division of insurance in the
1 32 department of commerce, a member or employee of the general
1 33 assembly, the attorney general, a state=mandated health
1 34 information collection agency, any other public official or
1 35 law enforcement agency, federal government agency or program,
2 1 the governing board of the health care worker's employer or
2 2 institution, or the health care worker's professional
2 3 association, and shall be protected against reprisals or
2 4 retaliatory or punitive actions by the individual or
2 5 institution if disclosure of the information is not otherwise
2 6 prohibited by statute and if the information meets any of the
2 7 following requirements:
2 8 a. Constitutes state=mandated health data required to be
2 9 submitted to state agencies.
2 10 b. Informs state agencies or entities of violations of
2 11 state health, safety, occupational health, licensure, or
2 12 insurance laws.
2 13 c. Is reasonably believed by the health care worker to be
2 14 a violation of health and safety laws or a breach of public
2 15 safety that may lead to harm to patients, consumers, or
2 16 citizens, based upon the health care worker's professional
2 17 standards of care or professional code of ethics.
2 18 A health care worker making a disclosure which violates any
2 19 provision of the federal Health Insurance Portability and
2 20 Accountability Act, Pub. L. No. 104=191, shall not be entitled
2 21 to protection pursuant to this section nor entitled to civil
2 22 remedies which might otherwise be available pursuant to
2 23 subsection 7.
2 24 4. A health care worker disclosing in good faith the
2 25 information described in subsections 2 and 3 shall be presumed
2 26 to have established a prima facie case showing a violation of
2 27 subsection 2 or 3 by the health care worker's employer if the
2 28 individual or institution employing the health care worker
2 29 knows or has reason to know of the disclosure, and if
2 30 subsequent to and as a result of the disclosure, one or more
2 31 of the following actions were initiated by the employer:
2 32 a. Discharge of the health care worker from employment.
2 33 b. Failure by the employer to take action regarding a
2 34 health care worker's appointment to, promotion or proposed
2 35 promotion to, or receipt of any advantage or benefit in the
3 1 health care worker's position of employment.
3 2 c. Any adverse change to the health care worker's terms or
3 3 conditions of employment or any administrative, civil, or
3 4 criminal action or other effort that diminished the
3 5 professional competence, reputation, stature, or marketability
3 6 of the health care worker.
3 7 An employer shall have the burden of proof regarding any
3 8 attempt to show that actions taken pursuant to this subsection
3 9 were for a legitimate business purpose.
3 10 5. If an individual or institution employing a health care
3 11 worker is determined to have violated state health, safety, or
3 12 occupational health and health licensure laws or regulations,
3 13 or professional standards of care or a professional code of
3 14 ethics, after a disclosure pursuant to subsection 2 or 3
3 15 results in an action as described in subsection 4, such a
3 16 determination shall create a presumption of retaliation or
3 17 reprisal against the health care worker in violation of this
3 18 section. Disclosure of a reasonable belief that violations of
3 19 health and safety laws or breaches of public safety have
3 20 occurred that have caused or have a potential to cause harm to
3 21 patients, consumers, and citizens shall immediately trigger
3 22 the protection afforded by this section.
3 23 6. A person who violates this section commits a simple
3 24 misdemeanor and is subject to a civil action as follows:
3 25 a. A person who violates this section is liable to an
3 26 aggrieved health care worker for affirmative relief, including
3 27 reinstatement with or without back pay, or any other equitable
3 28 relief the court deems appropriate, including attorney fees
3 29 and costs and punitive or exemplary damages.
3 30 b. When a person commits, is committing, or proposes to
3 31 commit an act in violation of this section, an injunction may
3 32 be granted through an action in district court to prohibit the
3 33 person from continuing such acts. The action for injunctive
3 34 relief may be brought by an aggrieved health care worker or by
3 35 the county attorney.
4 1 7. In addition to any other penalties applicable to a
4 2 person who violates this section, an individual, institution,
4 3 or organization employing a person who violates this section
4 4 shall be subject to a civil penalty in the amount of one
4 5 thousand dollars per violation.
4 6 EXPLANATION
4 7 This bill provides protection for health care workers
4 8 against retaliation or reprisals resulting from the disclosure
4 9 of certain information.
4 10 The bill creates new Code section 147.105 to provide
4 11 protection for health care workers against retaliation or
4 12 reprisals resulting from the disclosure of certain
4 13 information.
4 14 The new Code section provides that a health care worker who
4 15 discloses information to a state or federal board, department,
4 16 or agency, including the attorney general and law enforcement
4 17 personnel, as described in the bill, after a reasonable
4 18 opportunity to make a report and take corrective action has
4 19 transpired on the part of the individual or institution which
4 20 employs the health care worker and which is the subject of the
4 21 disclosure, shall be protected against reprisals or
4 22 retaliatory or punitive actions by the employer if disclosure
4 23 of the information is not otherwise prohibited by statute.
4 24 The bill provides that for this provision to apply, the
4 25 information disclosed shall constitute state=mandated health
4 26 data required to be submitted to a state agency, or inform a
4 27 state agency or entity of a violation of state health, safety,
4 28 occupational health, licensure, and insurance laws, or is
4 29 reasonably believed by the health care worker to be a
4 30 violation of health and safety laws or a breach of public
4 31 safety that may lead to harm to patients, consumers, or
4 32 citizens, based upon the health care worker's professional
4 33 standards of care and professional code of ethics. The bill
4 34 provides that this provision shall not be applicable to a
4 35 disclosure which constitutes a violation of the federal Health
5 1 Insurance Portability and Accountability Act.
5 2 The new Code section provides that a health care worker
5 3 disclosing in good faith this information shall be presumed to
5 4 have established a prima facie case if the employer knows or
5 5 has reason to know of the disclosure, and if following and as
5 6 a result of the disclosure the health care worker was
5 7 discharged from employment, or there was a failure by the
5 8 employer to take action regarding a health care worker's
5 9 appointment or promotion, or any adverse change to the health
5 10 care worker's terms or conditions of employment as well as any
5 11 administrative, civil, or criminal action or other effort that
5 12 diminishes the professional competence, reputation, stature,
5 13 or marketability of the health care worker. The bill provides
5 14 that the employer shall have the burden of proof regarding any
5 15 attempt to show that these actions were undertaken for a
5 16 legitimate business purpose.
5 17 The new Code section provides that if an employer is
5 18 determined to have violated state health, safety, or
5 19 occupational health or health licensure laws or regulations,
5 20 or professional standards of care or a professional code of
5 21 ethics, after a disclosure by a health care worker resulting
5 22 in an action taken against the worker as described in the
5 23 bill, this creates a presumption of retaliation or reprisal.
5 24 The bill provides that violations of health and safety laws or
5 25 breaches of public safety that have caused or have a potential
5 26 to cause harm to patients, consumers, and citizens immediately
5 27 trigger protection.
5 28 The new Code section provides that violations constitute a
5 29 simple misdemeanor, and may also be grounds for a civil
5 30 action. The bill provides that in such an action, an employer
5 31 may be liable to an aggrieved health care worker for
5 32 affirmative relief, including reinstatement with or without
5 33 back pay, and other equitable relief the court deems
5 34 appropriate, including attorney fees and costs and punitive or
5 35 exemplary damages. The bill also provides for injunctive
6 1 relief. The bill provides that in addition to other
6 2 penalties, an individual, institution, or organization
6 3 employing a person found to be in violation of the bill's
6 4 provisions shall be subject to a civil penalty in the amount
6 5 of $1,000 per violation.
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