H.F. 692 Section 1. LEGISLATIVE FINDINGS AND INTENT. 1 1. The general assembly finds that the novel coronavirus 2 pandemic has shed light on the importance of the state’s direct 3 care workforce in providing essential direct care and supports 4 to vulnerable Iowans and has called attention to the need for 5 a coordinated effort to meet the demand for this essential 6 workforce. The direct care workforce is responsible for the 7 care of thousands of individuals of all ages and abilities 8 including older individuals and persons with disabilities in 9 providing assistance with daily activities, performing personal 10 tasks, and administering medications. 11 2. The intent of this Act is to enhance the portability of 12 continuing education, credentials, and certifications of the 13 direct care workforce; streamline data collection and analysis 14 to support interagency planning and legislative decision 15 making; and assist Iowans needing direct care workforce 16 services and supports and their families in living successfully 17 in their community of choice. 18 Sec. 2. DIRECT CARE WORKFORCE REGISTRY —— INCLUSION OF ALL 19 CERTIFIED NURSE ASSISTANTS —— PLAN FOR EXPANSION. 20 1. As used in this section: 21 a. “Department” means the department of inspections and 22 appeals. 23 b. “Direct care workforce” includes individuals employed 24 to provide direct care and supports to individuals of all ages 25 and abilities regardless of setting including but not limited 26 to certified nurse assistants, personal care assistants, home 27 care aides, hospice aides, medication aides, consumer directed 28 attendant care workers, universal workers, resident assistants, 29 patient care technicians, and residential treatment workers. 30 c. “Direct care workforce registry” means the registry of 31 nurse aides required to be established and maintained by a 32 state pursuant to 42 C.F.R. §483.156. 33 2. a. The department shall expand the direct care workforce 34 registry to include all certified nurse assistants regardless 35 -1- LSB 2194HV (2) 89 pf/rh 1/ 4

H.F. 692 of employment setting. 1 b. The department shall require all employers of certified 2 nurse assistants, regardless of employment setting, to report 3 the qualifying employment of a certified nurse assistant for 4 inclusion in the direct care workforce registry. 5 3. a. The department shall convene a stakeholder advisory 6 work group to develop a plan for the expansion of the direct 7 care workforce registry. The plan shall provide for all of the 8 following: 9 (1) Identification of database system content. 10 (2) A listing of the classifications of workers who provide 11 direct care to be included in the registry. 12 (3) Identification of information to be included in the 13 registry to enhance public safety. 14 (4) An estimate of the costs associated with the development 15 and maintenance of the expanded registry. 16 (5) Alignment of registry data with information collected 17 by the department of education, the department of public 18 health, and the department of workforce development. 19 (6) Development of a public portal to allow access by family 20 caregivers and individuals requiring direct care workforce 21 services and supports. 22 (7) A timeline for expansion of the registry and for 23 development of the public portal. 24 (8) Options for state, federal, and other public and private 25 funding to support initial development and maintenance of the 26 registry and public portal. 27 b. The department shall submit the plan to the governor 28 and the general assembly no later than December 15, 2021. If 29 federal or other funding becomes available, the department may 30 implement the plan without additional legislative approval. 31 Sec. 3. HEALTH, DIRECT CARE, AND LONG-TERM SERVICES AND 32 SUPPORTS WORKFORCE DATA SYSTEM —— INTERAGENCY COLLABORATION. 33 1. The department of education and the department of 34 public health, in collaboration with the department of 35 -2- LSB 2194HV (2) 89 pf/rh 2/ 4

H.F. 692 workforce development, department of human services, and the 1 department of inspections and appeals, shall incorporate the 2 enhanced direct care workforce registry created in this Act 3 into existing health, direct care, and long-term services and 4 supports workforce dashboard data, and shall utilize such data 5 in informing the state’s strategies to build a strong health, 6 direct care, and long-term services and supports workforce. 7 2. The department of education and the department of 8 public health shall submit a progress report on the work of 9 the interagency collaboration to the governor and the general 10 assembly, annually, by January 15. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill relates to the direct care workforce, including 15 the expansion of the direct care workforce registry. 16 The bill includes legislative findings and intent relating 17 to the direct care workforce and the needs of Iowans for direct 18 care workforce services and supports. 19 The bill requires the department of inspections and appeals 20 (DIA) to expand the existing federally required direct care 21 workforce registry to include all certified nurse assistants 22 regardless of employment setting. DIA shall require all 23 employers of certified nurse assistants, regardless of 24 employment setting, to report the qualifying employment of a 25 certified nurse assistant for inclusion in the direct care 26 workforce registry. Currently, only long-term care facilities 27 are required to report qualifying employment to the registry. 28 The bill defines “direct care workforce” and “direct care 29 workforce registry” for the purposes of the bill. 30 The bill also requires DIA to convene a stakeholder advisory 31 work group to develop a plan for the expansion of the direct 32 care workforce registry. The bill specifies the components to 33 be included in the plan and requires DIA to submit the plan to 34 the governor and the general assembly no later than December 35 -3- LSB 2194HV (2) 89 pf/rh 3/ 4

H.F. 692 15, 2021. If federal or other funding becomes available, DIA 1 may implement the plan without additional legislative approval. 2 The bill also requires the department of education and 3 the department of public health, in collaboration with the 4 department of workforce development, department of human 5 services, and DIA, to incorporate the enhanced direct care 6 workforce registry created in the bill into existing health, 7 direct care, and long-term services and supports workforce 8 dashboard data, and to utilize such data in informing the 9 state’s strategies to build a strong health, direct care, and 10 long-term services and supports workforce. The department of 11 education and the department of public health shall submit a 12 progress report on the work of the interagency collaboration to 13 the governor and the general assembly, annually, by January 15. 14 -4- LSB 2194HV (2) 89 pf/rh 4/ 4