House Study Bill 96 - Introduced HOUSE FILE _____ BY (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON MILLER) A BILL FOR An Act relating to informal conferences on contested citations 1 or regulatory insufficiencies in health care facilities 2 or assisted living programs and including applicability 3 provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1705YC (2) 85 ad/nh

H.F. _____ Section 1. Section 135C.41, subsection 2, Code 2013, is 1 amended to read as follows: 2 2. Notify the director that the facility desires to 3 contest the citation and request an informal conference with 4 a representative of the department an independent reviewer 5 pursuant to section 135C.42 . 6 Sec. 2. Section 135C.42, Code 2013, is amended to read as 7 follows: 8 135C.42 Informal conference on contested citation. 9 1. The director shall assign a representative of the 10 department, other than the inspector upon whose inspection the 11 contested citation is based, provide an independent reviewer 12 to hold an informal conference with the facility within ten 13 working days after receipt of a request made under section 14 135C.41, subsection 2 . At the conclusion of the conference the 15 representative independent reviewer may affirm or may modify or 16 dismiss the citation. In the latter case, the representative 17 The independent reviewer shall state in writing the specific 18 reasons for the affirmation, modification , or dismissal and 19 immediately transmit copies of the statement to the director, 20 and to the facility. If the facility does not desire to 21 further contest an affirmed or modified citation, it shall 22 within five working days after the informal conference, or 23 after receipt of the written explanation of the representative 24 independent reviewer , as the case may be, comply with section 25 135C.41, subsection 1 . 26 2. An independent reviewer shall be licensed as an 27 attorney in the state of Iowa and have experience or training 28 in geriatric long-term care and shall not be employed by 29 the department. The department may issue a request for 30 proposals to enter into a contract for the purpose of providing 31 independent reviewers for informal conferences. 32 Sec. 3. Section 135C.43, subsection 1, Code 2013, is amended 33 to read as follows: 34 1. A facility which that desires to further contest an 35 -1- LSB 1705YC (2) 85 ad/nh 1/ 5

H.F. _____ affirmed or modified citation for a Class I, Class II, or Class 1 III violation, may do so in the manner provided by chapter 17A 2 for contested cases. Notice of intent to formally contest a 3 citation shall be given the department in writing within five 4 days after the informal conference or after receipt of the 5 written explanation of the representative delegated independent 6 reviewer provided to hold the informal conference, whichever is 7 applicable, in the case of an affirmed or modified citation. 8 A facility which has exhausted all adequate administrative 9 remedies and is aggrieved by the final action of the department 10 may petition for judicial review in the manner provided by 11 chapter 17A . 12 Sec. 4. Section 231C.8, subsection 2, Code 2013, is amended 13 to read as follows: 14 2. The department shall review the written information 15 submitted within ten working days of the receipt of the 16 information. At the conclusion of the review, the department 17 may affirm, modify, or dismiss the regulatory insufficiencies. 18 The department shall notify the program in writing of the 19 decision to affirm, modify, or dismiss the regulatory 20 insufficiencies, and the reasons for the decision. If an 21 assisted living program desires to further contest the 22 citation after an informal review, the program shall notify 23 the department within twenty business days after service of 24 the affirmation or modification of the informal review of 25 the program’s desire to contest the citation and request an 26 informal conference with an independent reviewer. 27 Sec. 5. NEW SECTION . 231C.8A Informal conference on 28 contested regulatory insufficiencies. 29 1. The department shall provide an independent reviewer to 30 hold an informal conference with an assisted living program 31 within ten working days after receiving a request from the 32 program following an informal review pursuant to section 33 231C.8. At the conclusion of the conference the independent 34 reviewer may affirm or may modify or dismiss the regulatory 35 -2- LSB 1705YC (2) 85 ad/nh 2/ 5

H.F. _____ insufficiencies. The independent reviewer shall state in 1 writing the specific reasons for the affirmation, modification, 2 or dismissal and immediately transmit copies of the statement 3 to the department and to the program. If the program does not 4 desire to further contest an affirmed or modified regulatory 5 insufficiency, it shall within five working days after 6 the informal conference, or after receipt of the written 7 explanation of the independent reviewer, as the case may be, 8 comply with section 231C.14, subsection 2. 9 2. An independent reviewer shall be licensed as an 10 attorney in the state of Iowa and have experience or training 11 in geriatric long-term care and shall not be employed by 12 the department. The department may issue a request for 13 proposals to enter into a contract for the purpose of providing 14 independent reviewers for informal conferences. 15 Sec. 6. Section 231C.9, Code 2013, is amended to read as 16 follows: 17 231C.9 Public disclosure of findings. 18 Upon completion of a monitoring evaluation or complaint 19 investigation of an assisted living program by the department 20 pursuant to this chapter , including the conclusion of informal 21 review or an informal conference , the department’s final 22 findings with respect to compliance by the assisted living 23 program with requirements for certification shall be made 24 available to the public in a readily available form and 25 place. Other information relating to an assisted living 26 program that is obtained by the department which does not 27 constitute the department’s final findings from a monitoring 28 evaluation or complaint investigation of the assisted living 29 program shall not be made available to the public except in 30 proceedings involving the denial, suspension, or revocation of 31 a certificate under this chapter . 32 Sec. 7. APPLICABILITY. 33 1. The sections of this Act amending sections 135C.41, 34 135C.42, and 135C.43 apply to an informal conference requested 35 -3- LSB 1705YC (2) 85 ad/nh 3/ 5

H.F. _____ under chapter 135C on or after January 1, 2014. 1 2. The sections of this Act amending sections 231C.8 and 2 231C.9, and adding section 231C.8A, apply to assisted living 3 programs desiring to request an informal conference on or after 4 January 1, 2014. 5 EXPLANATION 6 This bill relates to informal conferences on contested 7 citations in health care facilities or assisted living 8 programs. Currently, the director of the department of 9 inspections and appeals assigns a representative of the 10 department who was not involved in the contested citation 11 to hold an informal conference with a health care facility 12 within 10 working days after receipt of a request made by the 13 facility to contest a citation. The bill would require that 14 an independent reviewer would hold the informal conference 15 rather than a representative of the department of inspections 16 and appeals. The bill provides that the independent reviewer 17 must be an Iowa-licensed attorney and must have experience or 18 training in geriatric long-term care. 19 The bill also adds the informal conference process 20 for assisted living programs that receive a regulatory 21 insufficiency. Current law allows assisted living programs 22 to request an informal review of contested regulatory 23 insufficiencies, but does not provide for an informal 24 conference. The bill provides that an independent reviewer 25 must be provided to hold an informal conference within 10 26 working days after the request by an assisted living program. 27 The independent reviewer may affirm or modify or dismiss the 28 regulatory insufficiency at the end of the informal conference. 29 The reviewer must provide written specific reasons for the 30 decision and immediately transmit the copies to the department 31 of inspections and appeals and to the program. If, after 32 receiving the reviewer’s statement, the program no longer 33 wishes to contest the decision, the program shall comply with 34 the payment of any civil penalty. 35 -4- LSB 1705YC (2) 85 ad/nh 4/ 5

H.F. _____ The bill applies to an informal conference requested by 1 a health care facility under Code chapter 135C on or after 2 January 1, 2014, and to assisted living programs desiring to 3 request an informal conference under Code chapter 231C on or 4 after January 1, 2014. 5 -5- LSB 1705YC (2) 85 ad/nh 5/ 5