H.F. 2521 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. “Direct services” does 10 not include the practice of medicine and surgery or osteopathic 11 medicine and surgery by an individual licensed under chapter 12 148 or the practice of nursing by an advanced registered nurse 13 practitioner or an advanced practice registered nurse licensed 14 under chapter 152 or 152E. 15 3. “Health care employment agency” or “agency” means an 16 agency that contracts with a health care entity in this state 17 to provide agency workers for temporary, temporary-to-hire, 18 direct hire, or other contract or employee placements. 19 4. “Health care employment agency worker” or “agency worker” 20 means an individual who contracts with or is employed by a 21 health care employment agency to provide direct services or 22 nursing services to health care entity consumers. 23 5. “Health care entity” means a licensed or certified 24 facility, organization, or agency operated to provide services 25 and supports to meet the health or personal care needs of 26 consumers. 27 6. “Managing entity” means a business entity, owner, 28 ownership group, chief executive officer, program 29 administrator, director, or other decision maker whose 30 responsibilities include directing the management or policies 31 of a health care employment agency. “Managing entity” includes 32 an individual who, directly or indirectly, holds a beneficial 33 interest in a corporation, partnership, or other business 34 entity that constitutes a managing entity. 35 -1- HF 2521 (2) 89 pf/rh/md 1/ 4

H.F. 2521 7. “Nursing services” means those services which may be 1 provided only by or under the supervision of a nurse. “Nursing 2 services” does not include the practice of nursing by an 3 advanced registered nurse practitioner or an advanced practice 4 registered nurse licensed under chapter 152 or 152E. 5 Sec. 2. NEW SECTION . 135Q.2 Health care employment agency 6 requirements —— registration —— liability —— penalties. 7 1. A health care employment agency operating in the state 8 shall register annually with the department. Each separate 9 location of a health care employment agency shall register 10 annually with and pay an annual registration fee of five 11 hundred dollars to the department. The department shall issue 12 each location a separate certification of registration upon 13 approval of registration and payment of the fee. 14 2. A health care employment agency shall do all of the 15 following: 16 a. Ensure that agency workers comply with all applicable 17 requirements relating to the health requirements and 18 qualifications of personnel in health care entity settings. 19 b. Document that each agency worker meets the minimum 20 licensing, certification, training, and health requirements 21 and the continuing education standards for the agency worker’s 22 position in the health care entity setting. 23 c. Maintain records for each agency worker and report, 24 file, or otherwise provide any required documentation to 25 external parties or regulators which would otherwise be the 26 responsibility of the health care entity if the agency worker 27 was employed by the health care entity. 28 d. Maintain professional and general liability insurance 29 coverage with minimum per occurrence coverage of one million 30 dollars and aggregate coverage of three million dollars to 31 insure against loss, damage, or expense incident to a claim 32 arising out of the death or injury of any person as the result 33 of negligence or malpractice in the provision of services by 34 the agency or an agency worker. 35 -2- HF 2521 (2) 89 pf/rh/md 2/ 4

H.F. 2521 3. a. A health care employment agency shall not do any of 1 the following: 2 (1) Restrict in any manner the employment opportunities 3 of an agency worker by including a non-compete clause in any 4 contract with an agency worker or health care entity. 5 (2) In any contract with an agency worker or health care 6 entity, require payment of liquidated damages, employment fees, 7 or other compensation if the agency worker is subsequently 8 hired as a permanent employee of the health care entity. 9 b. Any contract that violates this subsection shall be 10 unenforceable in court. 11 4. A health care employment agency shall submit a report to 12 the department on a quarterly basis for each health care entity 13 participating in Medicare or Medicaid with whom the agency 14 contracts that includes all of the following by provider type: 15 a. A detailed list of the average amount charged to the 16 health care entity for each individual agency worker category. 17 b. A detailed list of the average amount paid by the agency 18 to agency workers in each individual agency worker category. 19 5. a. A health care employment agency that violates 20 subsection 1 or subsection 2 is subject to denial or revocation 21 of registration for a period of one year and a monetary penalty 22 of five hundred dollars for a first offense and five thousand 23 dollars for each offense thereafter. 24 b. A health care employment agency that violates subsection 25 3 or that knowingly provides an agency worker who has an 26 illegally or fraudulently obtained or issued diploma, 27 registration, license, certification, or background check to 28 a health care entity is subject to immediate revocation of 29 registration. The department shall notify the agency thirty 30 days in advance of the date of such revocation. 31 c. (1) The managing entity of an agency for which 32 registration has been denied or revoked under this subsection 33 shall not be eligible to apply for or be granted registration 34 for another agency during the two-year period following the 35 -3- HF 2521 (2) 89 pf/rh/md 3/ 4

H.F. 2521 date of the denial or revocation. 1 (2) The department shall not approve a new registration 2 or renew an existing registration for any agency for which 3 the managing entity is also the managing entity of an agency 4 for which registration has been denied or revoked during the 5 two-year period in which registration of the violating agency 6 is denied or revoked. 7 6. The department shall establish a system for members of 8 the public to report complaints against an agency or agency 9 worker. The department shall investigate any complaint 10 received and shall report the department’s findings to the 11 complaining party and the agency involved. 12 -4- HF 2521 (2) 89 pf/rh/md 4/ 4