House
Study
Bill
612
-
Introduced
HOUSE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
SMITH)
A
BILL
FOR
An
Act
relating
to
health
care
facilities
and
programs,
1
including
hospital
inspector
requirements,
the
hospital
2
licensing
board,
and
dependent
adult
abuse.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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5594YC
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_____
Section
1.
Section
135B.9,
Code
2009,
is
amended
to
read
as
1
follows:
2
135B.9
Inspections
and
qualifications
for
hospital
3
inspectors
——
protection
and
advocacy
agency
investigations.
4
1.
The
department
shall
make
or
cause
to
be
made
inspections
5
as
it
deems
necessary
in
order
to
determine
compliance
with
6
applicable
rules.
Hospital
inspectors
shall
meet
the
following
7
qualifications:
8
a.
Upon
hire,
have
been
employed
in
a
hospital
within
9
the
last
two
years
and
have
current
knowledge
of
hospital
10
operations.
11
b.
Be
free
of
conflicts
of
interest.
A
hospital
12
inspector
shall
not
participate
in
an
inspection
or
complaint
13
investigation
of
a
hospital
in
which
the
inspector
or
a
member
14
of
the
inspector’s
immediate
family
works
or
has
worked
within
15
the
last
five
years.
For
purposes
of
this
paragraph,
“immediate
16
family
member”
means
a
spouse;
natural
or
adoptive
parent,
17
child,
or
sibling;
or
stepparent,
stepchild,
or
stepsibling.
18
c.
Complete
a
yearly
conflict
of
interest
disclosure
19
statement.
The
department
shall
submit
an
annual
conflict
of
20
interest
disclosure
report
compiling
such
conflict
of
interest
21
information
to
the
hospital
licensing
board.
22
d.
Annually,
complete
a
minimum
of
ten
hours
of
continuing
23
education
pertaining
to
hospital
operations
including
but
not
24
limited
to
quality
and
process
improvement
standards,
trauma
25
system
standards,
and
regulatory
requirements.
26
2.
In
the
state
resource
centers
and
state
mental
health
27
institutes
operated
by
the
department
of
human
services,
the
28
designated
protection
and
advocacy
agency
as
provided
in
29
section
135C.2,
subsection
4,
shall
have
the
authority
to
30
investigate
all
complaints
of
abuse
and
neglect
of
persons
31
with
developmental
disabilities
or
mental
illnesses
if
the
32
complaints
are
reported
to
the
protection
and
advocacy
agency
33
or
if
there
is
probable
cause
to
believe
that
the
abuse
has
34
occurred.
Such
authority
shall
include
the
examination
of
all
35
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_____
records
pertaining
to
the
care
provided
to
the
residents
and
1
contact
or
interview
with
any
resident,
employee,
or
any
other
2
person
who
might
have
knowledge
about
the
operation
of
the
3
institution.
4
Sec.
2.
Section
135B.11,
Code
Supplement
2009,
is
amended
5
to
read
as
follows:
6
135B.11
Functions
of
hospital
licensing
board
——
7
compensation.
8
1.
The
hospital
licensing
board
shall
have
the
following
9
responsibilities
and
duties:
10
a.
To
consult
with
and
advise
the
department
in
matters
of
11
policy
affecting
administration
of
this
chapter
the
licensure
12
of
hospitals
in
this
state
,
and
in
the
development
of
rules
13
and
standards
provided
for
under
this
chapter.
This
advisory
14
function
shall
be
construed
broadly
and
shall
not
be
limited
to
15
licensure
issues
pursuant
to
this
chapter.
16
b.
To
review
and
approve
rules
and
standards
authorized
17
under
this
chapter
prior
to
their
approval
by
the
state
board
18
of
health
and
adoption
by
the
department.
19
c.
To
make
recommendations
on
practice
issues
and
policy.
20
d.
To
review
and
approve
proposed
educational
programs
21
provided
with
licensure
fee
funds.
The
educational
programs
22
provided
may
cover
any
subject
matter
relating
to
the
licensure
23
and
operation
of
hospitals
and
is
not
limited
to
licensure
24
issues
pursuant
to
this
chapter.
25
2.
Each
member
of
the
board
may
also
be
eligible
to
receive
26
compensation
as
provided
in
section
7E.6.
27
Sec.
3.
Section
235E.1,
subsection
5,
paragraph
b,
Code
28
2009,
is
amended
by
adding
the
following
new
subparagraphs:
29
NEW
SUBPARAGRAPH
.
(4)
Circumstances
in
which
a
caretaker
30
makes
an
error
in
professional
judgment
or
medical
care
in
the
31
care
of
a
dependent
adult
regardless
of
the
outcome.
32
NEW
SUBPARAGRAPH
.
(5)
Circumstances
in
which
a
caretaker
33
who
is
providing
security
at
a
facility
who,
in
the
process
of
34
providing
protection
to
the
patients
and
staff
at
the
facility,
35
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injures
a
dependent
adult.
1
NEW
SUBPARAGRAPH
.
(6)
Circumstances
in
which
a
caretaker
2
responds
to
another
caretaker’s
request
for
assistance
in
an
3
emergency
situation
and
a
dependent
adult
is
injured
as
a
4
result
of
the
emergency
response.
5
Sec.
4.
Section
235E.1,
Code
2009,
is
amended
by
adding
the
6
following
new
subsections:
7
NEW
SUBSECTION
.
6A.
“Gross
negligence”
means
an
act
or
8
omission
by
a
caretaker
where
the
caretaker
does
all
of
the
9
following:
10
a.
Has
knowledge
of
the
peril
to
be
apprehended.
11
b.
Has
knowledge
that
injury
is
a
probable,
as
opposed
to
a
12
possible,
result
of
the
peril.
13
c.
Consciously
fails
to
avoid
the
peril.
14
NEW
SUBSECTION
.
12.
“Willful
misconduct”
means
an
15
intentional
act
committed
with
disregard
for
a
known
or
obvious
16
risk
with
the
expectation
that
harm
will
follow.
17
Sec.
5.
Section
235E.2,
subsection
2,
Code
Supplement
2009,
18
is
amended
to
read
as
follows:
19
2.
a.
A
staff
member
or
employee
of
a
facility
or
program
20
who,
in
the
course
of
employment,
directly
examines,
attends,
21
counsels,
or
treats
a
dependent
adult
in
a
facility
or
program
22
and
reasonably
believes
the
dependent
adult
has
suffered
23
dependent
adult
abuse,
shall
report
the
suspected
dependent
24
adult
abuse
to
the
department.
25
b.
A
staff
member
or
employee
of
a
facility
or
program
26
who,
in
the
course
of
employment,
provides
indirect
treatment
27
or
services
to
a
dependent
adult
in
a
facility
or
program
28
and
who
reasonably
believes
the
dependent
adult
has
suffered
29
dependent
adult
abuse
may
report
the
dependent
adult
abuse
30
to
the
department.
For
purposes
of
this
paragraph,
“indirect
31
treatment
or
services”
includes
treatment
or
services
provided
32
without
person-to-person
contact
such
as
those
provided
33
by
administrative,
dietary,
housekeeping,
and
maintenance
34
employees.
A
staff
member
or
employee
of
a
facility
or
program
35
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_____
who
provides
indirect
treatment
or
services
shall,
during
an
1
orientation
program,
receive
training
regarding
the
prevention,
2
intervention,
and
detection
of
dependent
adult
abuse
and
3
neglect
and
related
reporting
requirements.
4
c.
Persons
with
de
minimus
contact
with
dependent
adults
5
in
a
facility
or
program
shall
not
be
considered
staff
members
6
or
employees
for
purposes
of
this
section.
Persons
with
de
7
minimus
contact
include
those
persons
present
in
a
facility
8
or
program
for
a
limited
purpose,
those
persons
who
are
not
9
present
in
a
facility
or
program
on
a
regular
basis,
and
those
10
persons
who
do
not
provide
any
treatment
or
services
to
the
11
dependent
adults
in
the
facility
or
program.
Such
persons
12
include
but
are
not
limited
to
part-time
volunteers,
building
13
contractors,
and
repair
workers.
14
Sec.
6.
Section
235E.2,
Code
Supplement
2009,
is
amended
by
15
adding
the
following
new
subsection:
16
NEW
SUBSECTION
.
14.
When
a
caretaker
in
a
facility
or
17
program
is
accused
of
dependent
adult
abuse,
the
department
has
18
reason
to
believe
that
dependent
adult
abuse
has
occurred,
and
19
the
caretaker
wishes
to
appeal
this
determination,
all
of
the
20
following
shall
occur
before
the
caretaker’s
name
is
listed
on
21
the
dependent
adult
abuse
registry:
22
a.
The
caretaker
shall
have
the
right
to
an
emergency
23
adjudicative
proceeding
pursuant
to
section
17A.18A
before
24
an
administrative
law
judge
to
determine
whether
the
25
caretaker
shall
be
allowed
to
continue
employment
in
the
26
facility
or
program
or
whether
the
caretaker
may
be
placed
27
on
administrative
leave
while
waiting
for
a
contested
case
28
hearing
pursuant
to
section
17A.12.
The
emergency
adjudicative
29
proceeding
shall
take
place
within
five
business
days
of
the
30
department’s
allegation
that
dependent
adult
abuse
occurred.
31
b.
The
administrative
law
judge
shall
determine
if
32
the
caretaker
shall
be
allowed
to
continue
employment
33
in
the
facility
or
program
and
in
what
capacity.
If
the
34
administrative
law
judge
determines
that
the
caretaker
shall
35
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not
continue
employment,
the
caretaker
may
be
placed
on
1
administrative
leave.
2
c.
A
contested
case
hearing
on
whether
dependent
adult
3
abuse
occurred
shall
take
place
within
forty-five
days
of
the
4
informal
hearing
in
the
manner
provided
by
section
17A.12.
5
EXPLANATION
6
This
bill
provides
for
certain
requirements
for
health
7
care
facilities
and
programs
including
hospitals.
The
bill
8
establishes
explicit
qualifications
for
persons
who
inspect
9
hospitals.
Inspectors
must
have
been
employed
in
a
hospital,
10
be
free
of
conflicts
of
interest,
and
obtain
annual
continuing
11
education.
12
The
bill
also
revises
the
role
of
the
hospital
licensing
13
board
by
enumerating
the
specific
duties
of
the
board,
14
including
advising
the
department
of
inspections
and
appeals
15
concerning
hospital
licensure,
approving
legislative
proposals,
16
making
recommendations
on
practice
issues
and
policy,
and
17
reviewing
and
approving
educational
programs
provided
through
18
licensure
fee
funds.
19
The
bill
provides
certain
exclusions
from
the
definition
20
of
dependent
adult
abuse
in
a
facility
or
program
under
Code
21
chapter
235E,
including
circumstances
in
which
a
caretaker
22
makes
an
error
in
professional
judgment
or
medical
care
in
23
the
care
of
a
dependent
adult
regardless
of
the
outcome,
24
circumstances
in
which
a
caretaker
who
is
providing
security
at
25
a
facility
who,
in
the
process
of
providing
protection
to
the
26
patients
and
staff
at
the
facility,
injures
a
dependent
adult,
27
and
circumstances
in
which
a
caretaker
responds
to
another
28
caretaker’s
request
for
assistance
in
an
emergency
situation
29
and
a
dependent
adult
is
injured
as
a
result
of
the
emergency
30
response.
Under
Code
chapter
235E,
a
facility
is
defined
as
31
a
health
care
facility
as
defined
in
Code
section
135C.1
or
32
a
hospital
as
defined
in
Code
section
135B.1,
and
a
program
33
is
defined
as
an
elder
group
home
as
defined
in
Code
section
34
231B.1,
an
assisted
living
program
certified
under
Code
section
35
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231C.3,
or
an
adult
day
services
program
as
defined
in
Code
1
section
231D.1.
2
The
bill
defines
“gross
negligence”
and
“willful
misconduct”
3
for
purposes
of
the
definition
of
dependent
adult
abuse
in
4
Code
chapter
235E.
“Gross
negligence”
is
defined
as
an
act
or
5
omission
by
a
caretaker
where
the
caretaker
has
knowledge
of
6
the
peril
to
be
apprehended,
has
knowledge
that
injury
is
a
7
probable,
as
opposed
to
a
possible,
result
of
the
peril,
and
8
consciously
fails
to
avoid
the
peril.
“Willful
misconduct”
9
is
defined
as
an
intentional
act
committed
with
disregard
for
10
a
known
or
obvious
risk
with
the
expectation
that
harm
will
11
follow.
12
The
bill
provides
that
a
staff
member
or
employee
of
13
a
facility
or
program
who,
in
the
course
of
employment,
14
provides
indirect
treatment
or
services
to
a
dependent
15
adult
in
a
facility
or
program
and
who
reasonably
believes
16
the
dependent
adult
has
suffered
dependent
adult
abuse
may
17
report
the
dependent
adult
abuse
to
the
department.
Indirect
18
treatment
or
services
includes
treatment
or
services
provided
19
without
person-to-person
contact
such
as
those
provided
20
by
administrative,
dietary,
housekeeping,
and
maintenance
21
employees.
The
bill
requires
a
staff
member
or
employee
of
a
22
facility
or
program
who
provides
indirect
treatment
or
services
23
to
receive
training
regarding
the
prevention,
intervention,
24
and
detection
of
dependent
adult
abuse
and
neglect
and
related
25
reporting
requirements.
Persons
with
de
minimus
patient
26
contact
shall
not
be
considered
staff
members
or
employees
for
27
purposes
of
the
bill.
28
The
bill
provides
an
administrative
review
process
for
a
29
caretaker
in
a
facility
or
program
who
is
accused
of
dependent
30
adult
abuse.
The
caretaker
shall
have
the
right
to
an
31
emergency
adjudicative
proceeding
pursuant
to
Code
section
32
17A.18A
before
an
administrative
law
judge
to
determine
if
33
the
caretaker
shall
be
allowed
to
continue
employment
in
the
34
facility
or
program
or
whether
the
caretaker
may
be
placed
on
35
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_____
administrative
leave
while
waiting
for
a
contested
case
hearing
1
pursuant
to
Code
section
17A.12
and
an
informal
preliminary
2
hearing
shall
take
place
within
five
business
days
of
the
3
department’s
allegation
that
dependent
adult
abuse
occurred.
4
An
administrative
law
judge
shall
determine
if
the
caretaker
5
shall
be
allowed
to
continue
employment
in
the
facility
or
6
program
and
in
what
capacity
and
if
not,
whether
the
caretaker
7
may
be
placed
on
administrative
leave.
A
contested
case
8
hearing
on
whether
dependent
adult
abuse
occurred
is
required
9
to
be
held
within
45
days
of
the
emergency
adjudicative
10
proceeding
in
the
manner
provided
by
Code
section
17A.12.
11
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