Bill Summary – FastDemocracy

Senate File 2304 - Introduced
                                  SENATE FILE 2304
                                  BY CELSI, DONAHUE, DOTZLER,
                                      BISIGNANO, BOULTON,
                                      T. TAYLOR, PETERSEN,
                                      WEINER, QUIRMBACH, JOCHUM,
                                      TRONE GARRIOTT, WINCKLER,
                                      KNOX, WAHLS, and BENNETT
                            A BILL FOR
An Act relating to oversight for long-term care facilities,
  providing penalties, making an appropriation, and including
  effective date and retroactive applicability provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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    Section 1. NEW SECTION. 10A.904 Definitions.
    As used in this subchapter, unless the context otherwise
 requires:
    1. “Assisted living program” or “program” means the same as
 defined in section 231C.2.
    2. “Health care facility” means the same as defined in
 section 135C.1.
    3. “Long-term care facility” means a health care facility
 or an assisted living program.
    4. “Long-term care facility safety council” or “safety
 council” means the long-term care facility safety council
 created in section 10A.905.
    5. “Resident” means the same as defined in section 135C.1.
    6. “Tenant” means the same as defined in section 231C.2.
    Sec. 2. NEW SECTION. 10A.905 Long-term care facility safety
 council —— membership —— duties —— meetings.
    1. A long-term care facility safety council is created.
    a. The safety council shall include the following voting
 members:
    (1) The director of health and human services, or the
 director’s designee.
    (2) The state long-term care ombudsman, or the state
 long-term care ombudsman’s designee.
    (3) The director of an area agency on aging, or the
 director’s designee.
    (4) The state director of AARP, or the state director’s
 designee.
    (5) Three public members appointed by the governor, and
 subject to confirmation by the senate, who are consumers or
 members of consumer groups or consumer organizations.
    b. The safety council shall also include the director or the
 director’s designee as a nonvoting member.
    2. The long-term care facility safety council shall do all
 of the following:
    a. Determine and approve standards, including those relating
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 to health and safety, for long-term care facilities.
    b. Conduct informal conferences and reviews of health care
 facility applicants and licensees, and assisted living program
 applicants and certificate holders, and make recommendations
 for departmental action pursuant to sections 135C.10A and
 231C.11B.
    c. Review and make recommendations to the department
 regarding violations and penalties under chapters 135C and
 231C.
    d. Make recommendations to the department regarding the
 adoption or amendment of administrative rules.
    e. Review the operation of long-term care facilities for
 which the department has referred a complaint received by the
 department to the office of long-term care ombudsman.
    f. Receive recommendations from the state long-term care
 ombudsman regarding inspections of specific long-term care
 facilities, and changes in administrative rules regarding the
 health, safety, welfare, and rights of residents and tenants.
    g. Submit an annual report to the general assembly by
 October 31 for the immediately preceding fiscal year, including
 any recommendations for changes in law to better protect
 residents and tenants, and a summary of all recommendations
 made by long-term care facilities during informal conferences.
    3. The members shall elect a public member as the
 chairperson of the safety council annually.
    4. The safety council shall hold an organizational meeting
 in July each year, and meetings shall be held as necessary
 to enable the safety council to expeditiously discharge its
 duties. Meeting dates shall be set upon adjournment or by call
 of the chairperson upon five days’ notice to the other members.
    Sec. 3. Section 135C.1, Code 2024, is amended by adding the
 following new subsection:
    NEW SUBSECTION. 12A. “Long-term care facility safety
 council” or “safety council” means the long-term care facility
 safety council created pursuant to section 10A.905.
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    Sec. 4. Section 135C.10, unnumbered paragraph 1, Code 2024,
 is amended to read as follows:
    The department shall have the authority to deny, suspend, or
 revoke a license in any case where the department finds that
 there has been repeated failure on the part of the a facility
 to comply with the provisions of this chapter or the rules or
 minimum standards promulgated hereunder under this chapter, or
 for any of the following reasons:
    Sec. 5. Section 135C.10, Code 2024, is amended by adding the
 following new subsection:
    NEW SUBSECTION. 12. The facility is issued three or more
 class I or federal immediate jeopardy violations within a
 twelve-month period for which a penalty was assessed.
    Sec. 6. NEW SECTION. 135C.10A Multiple violations
 within a twelve-month period —— informal conference and review
 by long-term care facility safety council —— recommended
 departmental actions.
    1. At the time the department effects delivery of notice on
 an applicant or licensee under section 135C.11, based on the
 department’s authority under section 135C.10, subsection 12, to
 deny, suspend, or revoke a license, the department shall also
 notify the long-term care facility safety council.
    2. a. The safety council shall hold an informal conference
 with the applicant or licensee within ten working days of
 the mailing or service of notice to review the applicant’s
 or licensee’s history of violations for which a penalty was
 assessed under this chapter, and the response by the applicant
 or licensee in correcting such violations.
    b. Following the informal conference and review, the safety
 council shall report its findings to the department, including
 any recommendations for departmental action as authorized under
 this chapter. The department shall proceed in accordance with
 the recommendations of the safety council. A health care
 facility may subsequently request a formal hearing and proceed
 under section 135C.11.
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    Sec. 7. Section 135C.14, unnumbered paragraph 1, Code 2024,
 is amended to read as follows:
    The department shall, in accordance with chapter 17A and
 with the approval of the council on health and human services
 long-term care facility safety council, adopt and enforce
 rules setting minimum standards for health care facilities.
 In so doing, the department, with the approval of the council
 on health and human services long-term care facility safety
 council, may adopt by reference, with or without amendment,
 nationally recognized standards and rules, which shall be
 specified by title and edition, date of publication, or similar
 information. The rules and standards required by this section
 shall be formulated in consultation with the director of
 health and human services or the director of health and human
 services’ designee, with the director, with the state long-term
 care ombudsman, and with affected industry, professional,
 and consumer groups, and shall be designed to further the
 accomplishment of the purposes of this chapter and shall relate
 to:
    Sec. 8. Section 135C.14, subsection 5, Code 2024, is amended
 to read as follows:
    5. Equipment essential to the health and welfare of the
 resident. The rules shall require a health care facility
 that accepts state funding to annually adopt and provide to
 the department the health care facility’s policies regarding
 competitive procurement for supplies and equipment including
 transactions and associated reimbursement structures with any
 related party as defined in section 135C.7A.
    Sec. 9. Section 135C.14, subsection 8, Code 2024, is amended
 by adding the following new paragraph:
    NEW PARAGRAPH. g. Facility policies and procedures
 regarding the use of arbitration agreements. The rules and
 standards shall prohibit any health care facility that accepts
 state funding from offering a resident, or requiring a resident
 to sign, an arbitration agreement that limits the resident’s
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 inalienable right to seek full judicial review of a dispute as
 a precondition for being admitted to the facility.
    Sec. 10. Section 135C.16, subsection 1, Code 2024, is
 amended to read as follows:
    1. In addition to the inspections required by sections
 135C.9 and 135C.38, the department shall make or cause to be
 made such further unannounced inspections as it deems necessary
 to adequately enforce this chapter. At On average, at least
 one general unannounced inspection shall be conducted for each
 health care facility within a thirty-month twelve-month period,
 not to exceed a period of fifteen months. The inspector shall
 show identification to the person in charge of the facility
 and state that an inspection is to be made before beginning
 the inspection. An employee of the department who gives
 unauthorized advance notice of an inspection made or planned
 to be made under this subsection or section 135C.38 shall be
 disciplined as determined by the director, except that if the
 employee is employed pursuant to the merit system provisions of
 chapter 8A, subchapter IV, the discipline shall not exceed the
 discipline authorized pursuant to that subchapter.
    Sec. 11. Section 135C.36, subsection 1, Code 2024, is
 amended to read as follows:
    1. A class I violation is one which presents an imminent
 danger or a substantial probability of resultant death or
 physical harm to the residents of the facility in which
 the violation occurs. A physical condition or one or more
 practices in a facility may constitute a class I violation. A
 class I violation shall be abated or eliminated immediately
 unless the department determines that a stated period of time,
 specified in the citation issued under section 135C.40, is
 required to correct the violation. A licensee is subject to
 a penalty of not less than two five thousand nor more than
 ten thousand dollars for each class I violation for which the
 licensee’s facility is cited.
    Sec. 12. Section 135C.36, Code 2024, is amended by adding
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 the following new subsection:
    NEW SUBSECTION. 1A. A class I violation includes any
 confirmed instance of a facility retaliating against a resident
 or employee for filing a complaint or otherwise cooperating
 with the department or the office of long-term care ombudsman.
    Sec. 13. Section 135C.38, subsection 1, paragraph a, Code
 2024, is amended to read as follows:
    a. Upon receipt of a complaint made in accordance with
 section 135C.37, the department shall make a preliminary review
 of the complaint. Unless the department concludes that the
 complaint is intended to harass a facility or a licensee or is
 without reasonable basis, the department shall make or cause
 to be made an on-site inspection of the health care facility
 which is the subject of the complaint within the time period
 determined pursuant to the following guidelines, which period
 shall commence on the date of receipt of the complaint:
    (1) For nursing facilities, an on-site inspection shall be
 initiated as follows:
    (a) Within two one working days day for a complaint
 determined by the department to be an alleged immediate
 jeopardy situation.
    (b) Within ten five working days for a complaint determined
 by the department to be an alleged high-level, nonimmediate
 jeopardy situation.
    (c) Within forty-five calendar days for a complaint
 determined by the department to be an alleged nonimmediate
 jeopardy situation, other than a high-level situation.
    (2) For all other types of health care facilities, an
 on-site inspection shall be initiated as follows:
    (a) Within two one working days day for a complaint
 determined by the department to be an alleged immediate
 jeopardy situation.
    (b) Within twenty five working days for a complaint
 determined by the department to be an alleged high-level,
 nonimmediate jeopardy situation.
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    (c) Within forty-five calendar days for a complaint
 determined by the department to be an alleged nonimmediate
 jeopardy situation, other than a high-level situation.
    Sec. 14. Section 135C.44, Code 2024, is amended to read as
 follows:
    135C.44 Treble Additional fines for repeated violations.
    The penalties authorized by section 135C.36 shall be trebled
 quadrupled for a second or subsequent class I or violation and
 tripled for a second or subsequent class II violation occurring
 within any twelve-month period if a citation was issued for the
 same class I or class II violation occurring within that period
 and a penalty was assessed therefor for the violation.
    Sec. 15. NEW SECTION. 135C.49 Improper influence.
    1. A member of the general assembly or an employee of
 the legislative or executive branch shall not attempt to
 influence a decision of the department during the course of an
 investigation, inspection, or appeal under this chapter.
    2. An allegation of a violation of this section shall
 be investigated by the office of ombudsman established
 under section 2C.2. If the office of ombudsman determines a
 violation of this section has occurred, the office shall report
 the recommendations, including disciplinary action, pursuant to
 sections 2C.16 and 2C.19.
    3. A person who is recommended for disciplinary action for
 a violation of this section is subject to a civil penalty of
 up to five thousand dollars per violation. A civil penalty
 collected pursuant to this section shall be credited to the
 department, shall be considered repayment receipts as defined
 in section 8.2, and shall be used by the department to enforce
 this chapter.
    4. a. A civil penalty for violations committed by an
 employee of the executive branch shall be assessed by the
 department.
    b. A civil penalty for violations committed by a member or
 employee of the general assembly shall be assessed pursuant to
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 a resolution approved by a majority of the house in which the
 member serves or by which the employee is employed. If the
 general assembly is not in session at the time a recommendation
 is received from the office of ombudsman, a civil penalty shall
 be assessed by a majority vote of the legislative council.
    Sec. 16. Section 231.42, subsection 2, Code 2024, is amended
 by adding the following new paragraph:
    NEW PARAGRAPH. f. Make recommendations to the long-term
 care facility safety council created in section 10A.905
 regarding inspections of specific health care facilities and
 assisted living programs, and changes in administrative rules
 regarding the health, safety, welfare, and rights of residents
 of health care facilities and tenants of assisted living
 programs.
    Sec. 17. Section 231C.2, Code 2024, is amended by adding the
 following new subsection:
    NEW SUBSECTION. 7A. “Long-term care facility safety council”
 or “safety council” means the long-term care facility safety
 council created in section 10A.905.
    Sec. 18. NEW SECTION. 231C.11B Multiple violations
 within a twelve-month period —— informal conference and review
 by long-term care facility safety council —— recommended
 departmental actions.
    1. At the time the department effects delivery of notice
 on an applicant or certificate holder under section 231C.11,
 based on the assisted living program having been issued notice
 of three violations in a twelve-month period which presented
 immin