House File 633 - Introduced HOUSE FILE 633 BY COMMITTEE ON STATE GOVERNMENT (SUCCESSOR TO HF 504) A BILL FOR An Act relating to prohibitions against a person acting as a 1 provider or as an employee, contractor, or subcontractor 2 of a provider of home and community-based services waiver 3 services under the Medicaid program. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 2227HV (1) 90 pf/rh

H.F. 633 Section 1. Section 249A.29, Code 2023, is amended to read 1 as follows: 2 249A.29 Home and community-based services waiver providers , 3 employees, and contractors —— records checks. 4 1. For purposes of this section and section 249A.30 unless 5 the context otherwise requires: 6 a. “Consumer” means an individual approved by the department 7 to receive services under a waiver. 8 b. “Contractor” means a person who contracts with a provider 9 or subcontracts with a contractor to act in any capacity 10 including but not limited to in a management or consulting 11 position or as a person directly responsible for providing 12 waiver services to a consumer or with direct access to a 13 consumer when a consumer is alone. 14 c. “Employee” means a person who is employed in this state 15 for wages by a provider in any capacity including but not 16 limited to in a management or consulting position or as a 17 person directly responsible for providing waiver services to a 18 consumer or with direct access to a consumer when the consumer 19 is alone. 20 b. d. “Provider” means an agency certified by the 21 department to provide services under a waiver. 22 c. e. “Waiver” means a home and community-based services 23 waiver approved by the federal government and implemented under 24 the medical assistance program. 25 2. If a person is being considered to be a provider by the 26 Medicaid program or by a provider for employment involving 27 direct responsibility for a consumer or with access to a 28 consumer when the consumer is alone as an employee or a 29 contractor , and if the person has been convicted of a crime or 30 has a record of founded child or dependent adult abuse, the 31 department shall perform an evaluation to determine whether the 32 crime or founded abuse warrants prohibition of employment by 33 of the person as a provider or as an employee or contractor 34 of the provider. The department shall conduct criminal and 35 -1- LSB 2227HV (1) 90 pf/rh 1/ 4

H.F. 633 child and dependent adult abuse records checks of the person in 1 this state and may conduct these checks in other states. The 2 records checks and evaluations required by this section shall 3 be performed in accordance with procedures adopted for this 4 purpose by the department. 5 3. If the department determines that a person employed 6 by a provider or an employee or a contractor of a provider 7 has committed a crime or has a record of founded abuse, the 8 department shall perform an evaluation to determine whether 9 prohibition of the person’s employment person as a provider, 10 employee, or contractor is warranted. 11 4. In an evaluation, the department shall consider the 12 nature and seriousness of the crime or founded abuse in 13 relation to the position sought or held, the time elapsed since 14 the commission of the crime or founded abuse, the circumstances 15 under which the crime or founded abuse was committed, the 16 degree of rehabilitation, the likelihood that the person will 17 commit the crime or founded abuse again, and the number of 18 crimes or founded abuses committed by the person involved. The 19 department may permit a person who is evaluated to be employed 20 a provider or an employee or contractor of a provider, or to 21 continue to be employed by a provider or to be an employee or 22 contractor of the provider if the person complies with the 23 department’s conditions relating to the employment being a 24 provider or an employee or contractor of a provider , which may 25 include completion of additional training. 26 5. If the department determines that the person has 27 committed a crime or has a record of founded abuse which 28 warrants prohibition of employment as a provider or as an 29 employee or contractor of a provider , the person shall not 30 be employed by a provider or an employee or contractor of a 31 provider . 32 EXPLANATION 33 The inclusion of this explanation does not constitute agreement with 34 the explanation’s substance by the members of the general assembly. 35 -2- LSB 2227HV (1) 90 pf/rh 2/ 4

H.F. 633 This bill relates to home and community-based services 1 (HCBS) waiver providers, employees, and contractors relative 2 to the results of criminal and child or dependent adult abuse 3 (abuse) records checks. 4 Under current law, if a person who is being considered for 5 employment by an HCBS provider, and the employment involves 6 direct responsibility for a consumer of waiver services or with 7 access to the consumer when the consumer is alone, and if the 8 person has been convicted of a crime or has a record of founded 9 abuse, the department of health and human services (HHS) shall 10 perform an evaluation to determine whether the crime or founded 11 abuse warrants prohibition of the employment of the person 12 by the provider. In an evaluation, HHS considers a number 13 of factors including the nature and seriousness of the crime 14 or founded abuse in relation to the position sought or held, 15 the time that has elapsed since the commission of the crime or 16 founded abuse, the circumstances of the crime or founded abuse, 17 the degree of rehabilitation, the likelihood that the person 18 will commit the crime or founded abuse again, and the number 19 of crimes or founded abuses committed by the person involved. 20 The person may be employed or continue to be employed by the 21 provider if the person complies with HHS conditions, or the 22 person may be prohibited from being employed based upon the 23 evaluation. 24 Under the bill, the record checks, evaluations, and HHS 25 determinations apply to not only employees of providers 26 with direct responsibility for or access to consumers, but 27 also to the providers and the employees, contractors, and 28 subcontractors of providers in any capacity including those 29 in management or consulting positions. Under the bill, if a 30 person is being considered as a provider, or as an employee, 31 contractor, or subcontractor of a provider, and if the person 32 has been convicted of a crime or has a record of founded abuse, 33 HHS shall perform an evaluation to determine whether the 34 crime or founded abuse warrants prohibition of the person as 35 -3- LSB 2227HV (1) 90 pf/rh 3/ 4

H.F. 633 a provider or as an employee, contractor, or subcontractor of 1 the provider. As under current law, if HHS determines that 2 a provider or an employee, contractor, or subcontractor of 3 a provider has committed a crime or has a record of founded 4 abuse, HHS shall perform an evaluation to determine whether 5 prohibition of the person as a provider, employee, contractor, 6 or subcontractor is warranted. After the evaluation, HHS may 7 allow a provider or an employee, contractor, or subcontractor 8 of a provider to be or to continue to be a provider or an 9 employee, contractor, or subcontractor of the provider if 10 the person complies with HHS’s conditions. However, if 11 HHS determines that the person has committed a crime or has 12 a record of founded abuse which warrants prohibition as a 13 provider or as an employee, contractor, or subcontractor of a 14 provider, the person shall not be a provider or an employee, 15 contractor, or subcontractor of a provider. 16 The bill defines “employee” and “contractor” including a 17 subcontractor for purposes of the bill. 18 -4- LSB 2227HV (1) 90 pf/rh 4/ 4