S.F. 2210 Section 1. NEW SECTION . 135Q.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Department” means the department of inspections and 4 appeals. 5 2. “Direct services” means services provided to consumers 6 through person-to-person contact. “Direct services” excludes 7 services performed by persons in a health care entity setting 8 that do not involve the provision of any service or treatment 9 to a consumer of a health care entity. 10 3. “Health care employment agency” or “agency” means an 11 agency that contracts with a health care entity in this state 12 to provide agency workers for temporary, temporary-to-hire, 13 direct hire, or other contract or employee placements. 14 4. “Health care employment agency worker” or “agency worker” 15 means an individual who contracts with or is employed by a 16 health care employment agency to provide direct services or 17 nursing services to health care entity consumers. 18 5. “Health care entity” means a licensed or certified 19 facility, organization, or agency operated to provide services 20 and supports to meet the health or personal care needs of 21 consumers. 22 6. “Managing entity” means a business entity, owner, 23 ownership group, chief executive officer, program 24 administrator, director, or other decision maker whose 25 responsibilities include directing the management or policies 26 of a health care employment agency. “Managing entity” includes 27 an individual who, directly or indirectly, holds a beneficial 28 interest in a corporation, partnership, or other business 29 entity that constitutes a managing entity. 30 7. “Nursing services” means those services which may be 31 provided only by or under the supervision of a nurse. 32 Sec. 2. NEW SECTION . 135Q.2 Health care employment agency 33 requirements —— registration —— liability —— penalties. 34 1. A health care employment agency operating in the state 35 -1- LSB 5766XS (1) 89 pf/rh 1/ 6

S.F. 2210 shall register annually with the department. Each separate 1 location of a health care employment agency shall register 2 annually with and pay an annual registration fee of five 3 hundred dollars to the department. The department shall issue 4 each location a separate certification of registration upon 5 approval of registration and payment of the fee. 6 2. A health care employment agency shall do all of the 7 following: 8 a. Ensure that agency workers comply with all applicable 9 requirements relating to the health requirements and 10 qualifications of personnel in health care entity settings. 11 b. Document that each agency worker meets the minimum 12 licensing, certification, training, and health requirements 13 and the continuing education standards for the agency worker’s 14 position in the health care entity setting. 15 c. Maintain records for each agency worker and report, 16 file, or otherwise provide any required documentation to 17 external parties or regulators which would otherwise be the 18 responsibility of the health care entity if the agency worker 19 was employed by the health care entity. 20 d. Maintain professional and general liability insurance 21 coverage with minimum per occurrence coverage of one million 22 dollars and aggregate coverage of three million dollars to 23 insure against loss, damage, or expense incident to a claim 24 arising out of the death or injury of any person as the result 25 of negligence or malpractice in the provision of services by 26 the agency or an agency worker. 27 3. a. A health care employment agency shall not do any of 28 the following: 29 (1) Restrict in any manner the employment opportunities 30 of an agency worker by including a non-compete clause in any 31 contract with an agency worker or health care entity. 32 (2) In any contract with an agency worker or health care 33 entity, require payment of liquidated damages, employment fees, 34 or other compensation if the agency worker is subsequently 35 -2- LSB 5766XS (1) 89 pf/rh 2/ 6

S.F. 2210 hired as a permanent employee of the health care entity. 1 b. Any contract that violates this subsection shall be 2 unenforceable in court. 3 4. A health care employment agency shall submit a report to 4 the department on a quarterly basis for each health care entity 5 participating in Medicare or Medicaid with whom the agency 6 contracts that includes all of the following by provider type: 7 a. A detailed list of the average amount charged to the 8 health care entity for each individual agency worker category. 9 b. A detailed list of the average amount paid by the agency 10 to agency workers in each individual agency worker category. 11 5. a. A health care employment agency that violates 12 subsection 1 or subsection 2 is subject to denial or revocation 13 of registration for a period of one year and a monetary penalty 14 of five hundred dollars for a first offense and five thousand 15 dollars for each offense thereafter. 16 b. A health care employment agency that violates subsection 17 3 or that knowingly provides an agency worker who has an 18 illegally or fraudulently obtained or issued diploma, 19 registration, license, certification, or background check to 20 a health care entity is subject to immediate revocation of 21 registration. The department shall notify the agency thirty 22 days in advance of the date of such revocation. 23 c. (1) The managing entity of an agency for which 24 registration has been denied or revoked under this subsection 25 shall not be eligible to apply for or be granted registration 26 for another agency during the two-year period following the 27 date of the denial or revocation. 28 (2) The department shall not approve a new registration 29 or renew an existing registration for any agency for which 30 the managing entity is also the managing entity of an agency 31 for which registration has been denied or revoked during the 32 two-year period in which registration of the violating agency 33 is denied or revoked. 34 6. The department shall establish a system for members of 35 -3- LSB 5766XS (1) 89 pf/rh 3/ 6

S.F. 2210 the public to report complaints against an agency or agency 1 worker. The department shall investigate any complaint 2 received and shall report the department’s findings to the 3 complaining party and the agency involved. 4 EXPLANATION 5 The inclusion of this explanation does not constitute agreement with 6 the explanation’s substance by the members of the general assembly. 7 This bill relates to health care employment agencies. The 8 bill defines a health care employment agency (agency) as an 9 agency that contracts with a health care entity in this state 10 to provide agency workers for temporary, temporary-to-hire, 11 direct hire, or other contract or employee placements. The 12 bill also defines “department”, “direct services”, “health care 13 employment agency” or “agency”, “health care employment agency 14 worker” or “agency worker”, “health care entity”, “managing 15 entity”, and “nursing services” for purposes of the bill. 16 The bill requires an agency operating in the state to 17 register annually with the department of inspections and 18 appeals (DIA). Each separate location of an agency is required 19 to register annually with and pay an annual registration fee 20 of $500 to DIA, and DIA shall issue each location a separate 21 certification of registration upon approval of registration and 22 payment of the fee. 23 An agency is required to ensure that agency workers comply 24 with all applicable requirements relating to the health 25 requirements and qualifications of personnel in health care 26 entity settings; document that each agency worker meets 27 the minimum licensing, certification, training, and health 28 requirements and the continuing education standards for the 29 agency worker’s position in the health care entity setting; 30 maintain records for each agency worker and report, file, 31 or otherwise provide any required documentation to external 32 parties or regulators which would otherwise be required of 33 the health care entity if the agency worker was employed by 34 the health care entity; and maintain professional and general 35 -4- LSB 5766XS (1) 89 pf/rh 4/ 6

S.F. 2210 liability insurance coverage in minimum per occurrence and 1 aggregate amounts to insure against loss, damage, or expense 2 incident to a claim arising out of the death or injury of 3 any person as the result of negligence or malpractice in the 4 provision of services by the agency or an agency worker. 5 An agency shall not restrict in any manner the employment 6 opportunities of any agency worker by requiring agreement to 7 a non-compete clause in any contract with an agency worker or 8 health care entity; or require payment of liquidated damages, 9 employment fees, or other compensation if the agency worker 10 is hired as a permanent employee of the health care entity in 11 any contract with an agency worker or health care entity. Any 12 contract that violates these provisions is unenforceable in 13 court. 14 An agency shall submit a report to DIA on a quarterly 15 basis for each health care entity participating in Medicare 16 or Medicaid with whom the agency contracts that includes, by 17 health care entity type, a detailed list of the average amount 18 charged to the health care entity for each individual agency 19 worker category and a detailed list of the average amount paid 20 by the agency to agency workers in each individual agency 21 worker category. 22 An agency that fails to register in accordance with the bill 23 or does not comply with the requirements relating to agency 24 worker health and qualification requirements and standards, 25 maintenance of records and the provision of documents, or 26 maintenance of liability insurance is subject to denial or 27 revocation of registration for a period of one year and a 28 monetary penalty of $500 for a first offense and $5,000 for 29 each offense thereafter. An agency that violates prohibited 30 contract provisions or knowingly provides an agency worker who 31 has an illegally or fraudulently obtained or issued diploma, 32 registration, license, certification, or background check to 33 a health care entity is subject to immediate revocation of 34 registration. Additionally, the managing entity of an agency 35 -5- LSB 5766XS (1) 89 pf/rh 5/ 6

S.F. 2210 for which registration has been denied or revoked under the 1 bill shall not be eligible to apply for or to be granted 2 registration for another agency during the two-year period 3 following the date of the denial or revocation; DIA shall not 4 approve a new registration or renew the existing registration 5 for any agency for which the managing entity is also the 6 managing entity of an agency for which registration has been 7 denied or revoked during the two-year period during which 8 registration of the violating agency is denied or revoked. 9 DIA shall establish a system for members of the public to 10 report complaints against an agency or agency worker. DIA 11 shall investigate all complaints received and shall report DIA 12 findings to the complaining party and the agency involved. 13 -6- LSB 5766XS (1) 89 pf/rh 6/ 6