SF 2298 (LSB 5449SV (6) 84)

SENATE FILE 2298

BY  COMMITTEE ON STATE GOVERNMENT

(SUCCESSOR TO SSB 3078)

(As Amended and Passed by the Senate 2012-03-12)

A BILL FOR

An Act relating to direct care professionals including the establishment of a board of direct care professionals, providing for implementation, making penalties applicable, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  152F.1  Definitions.
   As used in this chapter, unless the context otherwise requires:
   1.  “Board” means the board of direct care professionals created under chapter 147.
   2.  “Community living professional” means a direct care associate who has completed advanced training and is certified to provide home and community living, instrumental activities of daily living, and personal support services.
   3.  “Direct care associate” means an individual who has completed core training and is certified to provide direct care services in the state.
   4.  “Direct care instructor” means an individual approved by the board to provide direct care instruction to direct care professionals.
   5.  “Direct care professional” means an individual who provides direct care services for compensation and is a direct care associate, a community living professional, a health support professional, or a personal support professional.
   6.  “Direct care services” means the services provided to individuals who are ill or individuals with disabilities as specified in the individual’s service plan or in documented goals, including but not limited to home and community living services, instrumental activities of daily living services, personal activities of daily living services, personal support services, and health monitoring and maintenance services. 
   7.  “Direct care trainer” means a direct care instructor who is approved by the board to train instructors.
   8.  “Health monitoring and maintenance services” means medically-oriented services that assist an individual in maintaining the individual’s health including measuring intake and output; providing catheter and ostomy care; collecting specimens; checking vital signs, including temperature, pulse, respiration, and blood pressure; measuring height and weight; performing range of motion exercises; providing assistance with urinary care; and application of thrombo embolic deterrent hose or hot and cold packs.
   9.  “Health support professional” means a direct care associate who has completed advanced training and is certified to provide personal activities of daily living and health monitoring and maintenance services or a direct care associate who has met the federal nurse aide requirements pursuant to 42 C.F.R. § 483.152.
   10.  “Home and community living services” means services to enhance or maintain independence of individuals including such activities as helping individuals develop and meet personal goals, providing direct physical and emotional support and assistance for persons with disabilities, utilizing crisis intervention and positive behavior supports, and using and following individual support plans.
   11.  “Instrumental activities of daily living services” means services provided to assist individuals with daily living tasks to allow them to function independently in a home or community setting, including but not limited to assistance with managing money, transportation, light housekeeping, and shopping and cooking.
   12.  “Personal activities of daily living services” means services to assist individuals in meeting basic needs, including but not limited to bathing, back rubs, and skin care; grooming activities; assistance with dressing and undressing; assistance with eating and feeding; assistance with toileting; and assistance with mobility, including transfers, walking, and turning in bed.
   13.  “Personal support professional” means a direct care associate who has completed advanced training and is certified to provide instrumental activities of daily living, personal activities of daily living, and personal support services.
   14.  “Personal support services” means support services provided to an individual as the individual performs personal activities of daily living including but not limited to coaching and prompting, and teaching skills and behaviors.
   15.  “Service plan” means a written, consumer-centered, outcome-based plan of services.
   16.  “Specialty endorsement” means an advanced level of certification based on requirements developed by experts in a particular discipline or professional area and approved by the board.
    Sec. 2.  NEW SECTION.  152F.2  Certification required —— exceptions —— use of title.
   1.  Unless otherwise exempt under section 152F.4, beginning January 1, 2014, an individual shall not provide direct care services in this state without being certified as a direct care associate. 
   2.  An individual who is not certified pursuant to this chapter shall not use words or titles which imply or represent that the individual is certified as a direct care professional under this chapter.
   3.  A direct care associate shall not act as or represent that the individual is a direct care professional with advanced training certification or a specialty endorsement, unless the direct care associate is first certified at the appropriate level of certification under this chapter.
   4.  Notwithstanding any provision to the contrary, an individual who completes advanced training or meets the requirements for a specialty endorsement is not required to be certified at that level if the individual does not act as or represent that the individual is certified at that level. Section 147.83 does not apply to a direct care associate who is not certified as a direct care professional with advanced training certification or a specialty endorsement if the direct care associate does not act as or represent that the individual is certified at that level.
    Sec. 3.  NEW SECTION.  152F.3  Requirements to obtain certification —— renewal —— continuing education —— reciprocity.
   1.  An applicant for certification as a direct care associate shall present evidence satisfactory to the board that the applicant meets all of the following requirements:
   a.  The applicant has successfully completed the required education for the certification from a board-approved direct care instructor or direct care trainer.
   b.  The applicant has paid all fees required by the board.
   c.  The applicant certifies that the applicant will conduct all professional activities in accordance with standards for professional conduct established by the board.
   2.  An applicant for certification as a direct care professional with advanced training or a specialty endorsement shall present evidence satisfactory to the board that the applicant meets all of the following requirements:
   a.  The applicant has successfully completed the required education for the certification from a board-approved direct care instructor or direct care trainer.
   b.  The applicant has paid all fees required by the board.
   c.  The applicant has passed a state examination approved by the board.
   d.  The applicant certifies that the applicant will conduct all professional activities in accordance with standards for professional conduct established by the board.
   3.  An individual shall renew the individual’s certification biennially. Prior to such renewal, the individual shall present evidence that the individual has satisfied continuing education requirements and shall pay a renewal fee as determined by the board.
   4.  The board shall issue the appropriate certification to an applicant who demonstrates experience in direct care services in another state and meets the requirements established by the board for the specific certification.
    Sec. 4.  NEW SECTION.  152F.4  Scope of chapter.
   1.  The provisions of this chapter do not apply to any of the following:
   a.  An individual who is providing direct care services and is governed by a collective bargaining agreement in place before July 1, 2017, until the expiration of such agreement.
   b.  An individual providing direct care services to a family member.
   c.  An individual otherwise licensed who is operating within the scope of that license and who does not represent to the public that the individual is a direct care professional.
   2.  This chapter shall not be interpreted to preclude an individual who provides direct care services but is not otherwise required to be certified under this chapter from being certified under this chapter on a voluntary basis.
    Sec. 5.  NEW SECTION.  152F.5  Duties of the board.
   The board shall do all of the following:
   1.  Adopt rules consistent with this chapter, chapter 147, chapter 272, and the recommendations of the direct care worker advisory council established pursuant to 2008 Iowa Acts, chapter 69, which are necessary for the performance of its duties.
   2.  Adopt rules to provide a transition process that allows individuals providing direct care services on or before January 1, 2014, who are subject to the certification requirements of this chapter, to continue providing direct care services while completing certification under this chapter. The rules shall provide that certification requirements for an individual subject to the transition process are based on consideration of previous training, employment history, and experience. An individual subject to the transition process shall complete the requirements for direct care associate certification within a time frame determined by rule of the board.
   3.  Establish curriculum requirements for health support professionals. The curriculum requirements established shall not exceed the curriculum requirements specified for nurse aides pursuant to 42 C.F.R. § 483.152, without prior approval of sixty percent of the members of the board and prior approval of the department of inspections and appeals.

   4.  Require an individual to undergo criminal history and child and dependent adult abuse record checks prior to certification, and establish record checks requirements applicable to direct care professionals consistent with section 135C.33.
   5.  Establish dependent adult abuse reporting and training requirements consistent with chapters 235B and 235E, as applicable.
   6.  Establish standards and guidelines for certification reciprocity.
   7.  Establish standards and guidelines for direct care professionals, including minimum curriculum requirements.
   8.  Prepare and conduct, or prescribe, an examination for applicants for certification.
   9.  Establish standards and guidelines for direct care instructors and direct care trainers, including minimum curriculum requirements and continuing education requirements. Training and continuing education guidelines shall provide diverse options for completion of the training and continuing education, as appropriate, including but not limited to online, employer-based, or educational institution-based opportunities.
   10.  Define educational activities which fulfill continuing education requirements for renewal of certification.
   11.  Establish guidelines for inactive certification status and inactive certification reentry.
    Sec. 6.  NEW SECTION.  152F.6  Certification suspension and revocation.
   A certification issued by the board under this chapter may be suspended or revoked, or renewal of certification may be denied by the board, for violation of any provision of this chapter, section 147.55 or 272C.10, or rules adopted by the board.
    Sec. 7.  Section 147.1, subsections 3 and 6, Code 2011, are amended to read as follows:
   3.  “Licensed” or “certified”, when applied to a physician and surgeon, podiatric physician, osteopathic physician and surgeon, physician assistant, psychologist, chiropractor, nurse, dentist, dental hygienist, dental assistant, optometrist, speech pathologist, audiologist, pharmacist, physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant, respiratory care practitioner, practitioner of cosmetology arts and sciences, practitioner of barbering, funeral director, dietitian, marital and family therapist, mental health counselor, social worker, massage therapist, athletic trainer, acupuncturist, nursing home administrator, hearing aid dispenser, or sign language interpreter or transliterator, or direct care professional means a person licensed under this subtitle.
   6.  “Profession” means medicine and surgery, podiatry, osteopathic medicine and surgery, practice as a physician assistant, psychology, chiropractic, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, pharmacy, physical therapy, physical therapist assisting, occupational therapy, occupational therapy assisting, respiratory care, cosmetology arts and sciences, barbering, mortuary science, marital and family therapy, mental health counseling, social work, dietetics, massage therapy, athletic training, acupuncture, nursing home administration, hearing aid dispensing, or sign language interpreting or transliterating, or practice as a direct care professional.
    Sec. 8.  Section 147.2, subsection 1, Code 2011, is amended to read as follows:
   1.  A person shall not engage in the practice of medicine and surgery, podiatry, osteopathic medicine and surgery, psychology, chiropractic, physical therapy, physical therapist assisting, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, occupational therapy, occupational therapy assisting, respiratory care, pharmacy, cosmetology arts and sciences, barbering, social work, dietetics, marital and family therapy or mental health counseling, massage therapy, mortuary science, athletic training, acupuncture, nursing home administration, hearing aid dispensing, or sign language interpreting or transliterating, or shall not practice as a physician assistant
 
or as a direct care professional, unless the person has obtained a license for that purpose from the board for the profession.
    Sec. 9.  Section 147.13, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  For direct care professionals, the board of direct care professionals.
    Sec. 10.  Section 147.14, subsection 1, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  x.  For the board of direct care professionals, a total of eleven members, six of whom are direct care professionals who represent diverse settings and populations served, two members of the public, one registered nurse who serves as a direct care instructor, one human services professional who serves as a direct care instructor, and one licensed nursing home administrator.
    Sec. 11.  Section 147.74, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  A direct care professional certified under chapter 152F and this chapter may use the following:
   a.  A direct care professional certified as a direct care associate may use the title “direct care associate” or the letters “D.C.A.” after the person’s name.
   b.  A direct care professional certified as a community living professional may use the title “community living professional” or the letters “C.L.P.” after the person’s name.
   c.  A direct care professional certified as a personal support professional may use the title “personal support professional” or the letters “P.S.P.” after the person’s name.
   d.  A direct care professional certified as a health support professional may use the title “health support professional” or the letters “H.S.P.” after the person’s name.
   e.  A direct care professional certified with a specialty endorsement may use the title or letters determined by the specialty endorsement entity and approved by the board of direct care professionals.
   f.  A direct care professional who complies with federal nurse aide requirements pursuant to 42 C.F.R. § 483.152 may use the title “certified nursing assistant” or the letters “C.N.A.” after the person’s name.
    Sec. 12.  Section 272C.1, subsection 6, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  ag.  The board of direct care professionals, created pursuant to chapter 147.
    Sec. 13.  TRANSITION PROVISIONS.
   1.  An individual providing direct care services on or before January 1, 2014, who is subject to the certification requirements of this Act, may continue providing direct care services while completing certification as required under this Act. The board of direct care professionals shall adopt rules to provide that certification requirements for an individual subject to the transition process are based on consideration of previous training, employment history, and experience, and require such individuals to complete the requirements for direct care associate certification within the time frame determined by rule of the board.
   2.  An individual who is registered on or before January 1, 2014, on the Iowa direct care worker registry established by the department of inspections and appeals, is deemed to meet the certification requirements for a health support professional under this Act.
   3.  Notwithstanding sections 147.14 and 147.16, for the initial board of direct care professionals, the governor may appoint, subject to confirmation by the senate, in lieu of the five members required to be direct care professionals and the two members required to be direct care instructors, members with experience and expertise that is substantially equivalent to the professional requirements for a direct care professional or direct care instructor, as applicable.
    Sec. 14.  IMPLEMENTATION.  The provisions of this Act shall be implemented as follows:
   1.  The sections of this Act relating to the board of direct care professionals including sections 152F.1 and 152F.5, as enacted in this Act; sections 147.13, 147.14, and 272C.1, as amended in this Act, and as specified in the transition provisions; and the section of this Act providing transition provisions relating to the board shall be implemented so that a board of direct care professionals is appointed no later than December 15, 2012.
   2.  The sections of this Act relating to requirements for certification of direct care professionals including sections 152F.2, 152F.3, 152F.4, and 152F.6, as enacted in this Act; and sections 147.1, 147.2, and 147.74, as amended in this Act, shall be implemented so that the requirements are applicable beginning no later than January 1, 2014.
    Sec. 15.  FUNDING PROVISIONS.
   1.  The department of public health shall limit the indirect service charge for the board of direct care professionals to not more than fifteen percent.
   2.  It is the intent of the general assembly that the board of direct care professionals be self-sustaining by January 1, 2017.
    Sec. 16.  EFFECTIVE UPON ENACTMENT.  This Act, being deemed of immediate importance, takes effect upon enactment.