Bill Text: IA HF2041 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act relating to hospital practices including those involving sepsis protocols and the rights of a parent of a minor patient.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2022-02-16 - Subcommittee recommends indefinite postponement. Vote Total: 2-0 [HF2041 Detail]
Download: Iowa-2021-HF2041-Introduced.html
House
File
2041
-
Introduced
HOUSE
FILE
2041
BY
BRADLEY
A
BILL
FOR
An
Act
relating
to
hospital
practices
including
those
involving
1
sepsis
protocols
and
the
rights
of
a
parent
of
a
minor
2
patient.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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Section
1.
SHORT
TITLE.
This
Act
shall
be
known
as
“Adam’s
1
Law”.
2
Sec.
2.
NEW
SECTION
.
135B.36
Sepsis
protocols.
3
1.
As
used
in
this
section,
unless
the
context
otherwise
4
requires:
5
a.
“Sepsis”
means
a
proven
or
suspected
infection
6
accompanied
by
a
systemic
inflammatory
response.
7
b.
“Septic
shock”
means
severe
sepsis
with
persistent
8
hypotension
or
cardiovascular
organ
dysfunction
despite
9
adequate
intravenous
fluid
resuscitation.
10
c.
“Severe
sepsis”
means
sepsis
with
the
addition
of
at
11
least
one
sign
of
hypoperfusion
or
organ
dysfunction.
12
2.
A
hospital
shall
adopt,
implement,
and
periodically
13
update,
in
accordance
with
this
section,
evidence-based
14
protocols
for
the
early
recognition
and
treatment
of
patients
15
with
sepsis,
severe
sepsis,
and
septic
shock
that
are
based
16
on
generally
accepted
standards
of
care.
Sepsis
protocols
17
shall
include
components
specific
to
the
identification,
care,
18
and
treatment
of
adults
and
of
children,
and
shall
clearly
19
differentiate
the
components
applicable
to
adults
and
children.
20
The
sepsis
protocols
shall
include
all
of
the
following
21
components:
22
a.
A
process
for
the
screening
and
early
recognition
of
23
patients
with
sepsis,
severe
sepsis,
and
septic
shock.
24
b.
A
process
to
identify
and
document
patients
appropriate
25
for
treatment
through
severe
sepsis
protocols,
including
26
explicit
criteria
defining
those
patients
who
should
be
27
excluded
from
the
protocols,
such
as
patients
with
certain
28
clinical
conditions
or
patients
who
have
elected
palliative
29
care.
30
c.
Guidelines
for
hemodynamic
support
with
explicit
31
physiologic
and
biomarker
treatment
goals,
methodology
for
32
invasive
or
noninvasive
hemodynamic
monitoring,
and
time
frame
33
goals.
34
d.
For
infants
and
children,
guidelines
for
fluid
35
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resuscitation
with
explicit
time
frames
for
vascular
access
1
and
fluid
delivery
consistent
with
current,
evidence-based
2
guidelines
for
severe
sepsis
and
septic
shock
with
defined
3
therapeutic
goals
for
children.
4
e.
A
procedure
for
identification
of
the
source
of
infection
5
and
delivery
of
early
antibiotics
with
time
frame
goals.
6
f.
Criteria
for
use,
when
appropriate,
of
an
invasive
7
protocol
and
for
use
of
vasoactive
agents.
8
3.
A
hospital
shall
ensure
that
professional
staff
with
9
direct
patient
care
responsibilities
and,
as
appropriate,
staff
10
with
indirect
patient
care
responsibilities,
including
but
not
11
limited
to
laboratory
and
pharmacy
staff,
are
periodically
12
trained
to
implement
the
sepsis
protocols
specified
in
this
13
section.
The
hospital
shall
ensure
that
sepsis
training
is
14
updated
following
the
initiation
of
substantive
changes
to
the
15
protocols.
16
4.
A
hospital
shall
update
sepsis
protocols
specified
under
17
this
section
based
on
newly
emerging
evidence-based
standards.
18
5.
Following
initial
approval,
sepsis
protocols
required
19
under
this
section
shall
be
submitted
to
the
department
at
20
the
request
of
the
department
not
more
frequently
than
every
21
two
years,
unless
the
department
requires
submission
more
22
frequently
based
on
hospital-specific
performance
concerns
23
identified
by
the
department.
24
6.
A
hospital
shall
collect,
use,
and
report
quality
25
measurement
data
related
to
the
recognition
and
treatment
of
26
severe
sepsis
for
purposes
of
internal
quality
improvement
27
and
data
reporting
as
required
by
the
department.
Quality
28
measurement
data
shall
include
but
is
not
limited
to
data
29
sufficient
to
evaluate
each
hospital’s
adherence
rate
to
the
30
hospital’s
own
sepsis
protocols,
including
adherence
to
time
31
frames
and
implementation
of
all
protocol
components
for
adults
32
and
children.
33
a.
Hospitals
shall
submit
the
required
quality
measurement
34
data
to
enable
the
department
to
develop
risk-adjusted
sepsis
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mortality
rates
in
consultation
with
appropriate
national,
1
hospital,
and
expert
stakeholders.
2
b.
Hospitals
shall
submit
quality
measurement
data
to
3
the
department
as
specified
by
the
department
on
an
annual
4
basis,
or
more
frequently
at
the
request
of
the
department,
and
5
such
data
shall
be
subject
to
audit
at
the
discretion
of
the
6
department.
7
Sec.
3.
NEW
SECTION
.
135B.37
Bill
of
rights
for
parent
of
a
8
minor
patient.
9
1.
For
the
purposes
of
this
section:
10
a.
“Critical
value
results”
means
the
results
of
laboratory
11
or
other
diagnostic
tests
that
suggest
a
life-threatening
or
12
otherwise
significant
condition
requiring
immediate
medical
13
attention.
14
b.
“Minor
patient”
means
an
individual
receiving
hospital
15
emergency
department
or
inpatient
care
who
is
a
minor
as
16
described
in
section
599.1.
17
c.
“Parent”
means
a
parent,
guardian,
or
other
person
with
18
legal
authority
to
make
health
care
decisions
on
behalf
of
a
19
minor
patient.
20
2.
A
hospital
shall
post
in
a
conspicuous
place
and
provide
21
a
minor
patient’s
parent
with
a
written
copy
of
the
information
22
specified
in
this
section.
The
information
shall
be
known
as
23
the
“parent’s
bill
of
rights
for
a
minor
patient”
and
shall
24
advise
that,
at
a
minimum,
and
subject
to
laws
and
regulations
25
governing
privacy
and
confidentiality,
in
connection
with
every
26
hospital
admission
or
emergency
room
visit
of
a
minor
patient,
27
all
of
the
following
shall
apply:
28
a.
The
hospital
must
ask
each
minor
patient
or
the
minor
29
patient’s
parent,
as
appropriate,
for
the
name
of
the
minor
30
patient’s
primary
care
provider,
if
known,
and
shall
document
31
such
information
in
the
minor
patient’s
medical
record.
32
b.
The
hospital
shall
admit
minor
patients
only
to
the
33
extent
consistent
with
the
hospital’s
ability
to
provide
34
qualified
staff,
space,
and
the
size-appropriate
equipment
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necessary
for
the
unique
needs
of
minor
patients.
1
c.
To
the
extent
possible
given
a
minor
patient’s
health
and
2
safety,
the
hospital
shall
allow
at
least
one
parent
to
remain
3
with
the
minor
patient
at
all
times.
4
d.
The
results
of
all
tests
completed
during
a
minor
5
patient’s
hospital
admission
or
emergency
room
visit
shall
6
be
reviewed
by
a
physician,
physician
assistant,
or
nurse
7
practitioner
who
is
familiar
with
the
minor
patient’s
8
presenting
condition.
9
e.
A
minor
patient
shall
not
be
discharged
from
the
hospital
10
or
the
emergency
room
until
the
results
of
any
tests
that
11
could
reasonably
be
expected
to
yield
critical
value
results
12
are
reviewed
by
a
physician,
physician
assistant,
or
nurse
13
practitioner
and
are
communicated
to
the
minor
patient
and
the
14
minor
patient’s
parent,
as
appropriate.
15
f.
A
minor
patient
shall
not
be
discharged
from
the
hospital
16
or
the
emergency
room
until
the
minor
patient’s
discharge
17
plan
is
provided
in
writing
and
verbally
communicated
to
the
18
minor
patient
and
the
minor
patient’s
parent,
as
appropriate.
19
The
discharge
plan
shall
identify
critical
value
results
of
20
tests
ordered
during
the
minor
patient’s
hospital
admission
or
21
emergency
room
visit
and
shall
specify
any
other
tests
that
22
have
not
yet
been
concluded.
23
g.
The
communication
of
critical
value
results
and
the
24
discussion
of
the
discharge
plan
shall
be
accomplished
in
a
25
manner
that
reasonably
assures
that
a
minor
patient
and
the
26
minor
patient’s
parent,
as
appropriate,
understand
the
health
27
information
provided
in
order
to
make
appropriate
health
28
decisions.
29
h.
A
hospital
shall
provide
all
laboratory
results
to
a
30
minor
patient’s
primary
care
provider,
if
known.
31
i.
A
minor
patient
and
the
minor
patient’s
parent,
as
32
appropriate,
may
request
information
about
the
diagnosis,
33
possible
diagnoses
that
were
considered
during
the
episode
34
of
care,
and
complications
that
could
develop,
as
well
as
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information
about
any
contact
made
with
the
minor
patient’s
1
primary
care
provider.
2
j.
Upon
discharge
from
the
hospital
or
emergency
room,
a
3
hospital
shall
provide
a
minor
patient
and
the
minor
patient’s
4
parent,
as
appropriate,
with
a
telephone
number
that
the
minor
5
patient
and
the
minor
patient’s
parent
may
call
for
advice
if
6
complications
or
questions
arise.
7
Sec.
4.
INITIAL
SEPSIS
PROTOCOLS
——
SUBMISSION
TO
8
DEPARTMENT
AND
IMPLEMENTATION.
A
hospital
subject
to
section
9
135B.36,
as
enacted
in
this
Act,
shall
submit
initial
sepsis
10
protocols
to
the
department
of
inspections
and
appeals
for
11
review
and
approval
by
October
1,
2022.
Within
forty-five
days
12
of
receipt
of
approval
of
the
protocols
from
the
department,
a
13
hospital
shall
implement
the
sepsis
protocols
consistent
with
14
section
135B.36,
as
enacted
in
this
Act.
15
Sec.
5.
CODE
EDITOR
DIRECTIVE.
16
1.
The
Code
editor
shall
designate
section
135B.36,
as
17
enacted
in
this
Act,
as
a
new
subchapter
within
chapter
135B,
18
entitled
“Sepsis
Protocols”.
19
2.
The
Code
editor
shall
designate
section
135B.37,
as
20
enacted
in
this
Act,
as
a
new
subchapter
within
chapter
135B,
21
entitled
“Parent’s
Bill
of
Rights
for
a
Minor
Patient”.
22
EXPLANATION
23
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
24
the
explanation’s
substance
by
the
members
of
the
general
assembly.
25
This
bill
relates
to
protocols
required
of
hospitals
26
relating
to
sepsis
and
minor
patients.
27
The
bill
provides
that
the
short
title
of
the
bill
is
“Adam’s
28
Law”.
29
The
bill
requires
hospitals
to
adopt,
implement,
30
periodically
update,
and
submit
to
the
department
of
31
inspections
and
appeals
(DIA)
for
review
and
approval,
32
evidence-based
protocols
for
the
early
recognition
and
33
treatment
of
patients
with
sepsis,
severe
sepsis,
and
septic
34
shock,
which
protocols
are
based
on
generally
accepted
35
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standards
of
care.
The
protocols
shall
include
components,
1
specified
in
the
bill,
that
are
specific
to
the
identification,
2
care,
and
treatment
of
adults
and
of
children,
and
shall
3
clearly
identify
the
differences
in
the
components
applicable
4
to
adults
and
children.
The
bill
requires
hospitals
to
5
ensure
that
professional
staff
with
direct
patient
care
6
responsibilities
and,
as
appropriate,
staff
with
indirect
7
patient
care
responsibilities
are
periodically
trained
to
8
implement
the
sepsis
protocols
and
to
update
the
training
9
following
substantive
changes
to
the
protocols.
The
bill
10
requires
hospitals
to
submit
the
required
sepsis
protocols
11
to
DIA
at
the
request
of
the
department
not
more
frequently
12
than
every
two
years,
following
initial
approval,
unless
DIA
13
requires
submission
more
frequently
based
on
hospital-specific
14
performance
concerns
identified
by
DIA.
The
bill
requires
15
hospitals
to
collect,
use,
and
report
quality
measurement
data
16
related
to
the
recognition
and
treatment
of
severe
sepsis
for
17
purposes
of
internal
quality
improvement
and
data
reporting
18
to
DIA.
The
data
submitted
to
DIA
are
for
the
purposes
of
19
development
by
DIA
of
risk-adjusted
sepsis
mortality
rates
in
20
consultation
with
appropriate
national,
hospital,
and
expert
21
stakeholders.
Hospitals
are
required
to
submit
the
data
to
22
DIA
as
specified
by
DIA,
annually,
or
more
frequently
at
the
23
request
of
the
department.
The
data
are
subject
to
audit
at
24
the
discretion
of
DIA.
25
The
bill
requires
hospitals
to
submit
initial
sepsis
26
protocols
to
DIA
for
review
and
approval
by
October
1,
2022,
27
and
requires
hospitals
to
implement
the
protocols
within
45
28
days
of
receipt
of
approval
of
the
protocols
from
DIA.
29
The
bill
also
requires
hospitals
to
provide
parents
of
minor
30
patients
with
a
written
copy
of
information
specified
in
the
31
bill
as
the
“parent’s
bill
of
rights
for
a
minor
patient”.
32
The
information
provided
is
to
advise
that,
subject
to
laws
33
and
regulations
governing
privacy
and
confidentiality,
in
34
connection
with
every
hospital
admission
or
emergency
room
35
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visit
of
a
minor
patient,
a
hospital
must
comply
with
certain
1
requirements.
The
requirements
include
that
the
hospital
2
must
ask
each
minor
patient
or
the
minor
patient’s
parent,
as
3
appropriate,
for
the
name
of
the
minor
patient’s
primary
care
4
provider,
if
known,
and
shall
document
such
information
in
the
5
minor
patient’s
medical
record;
the
hospital
shall
admit
minor
6
patients
only
to
the
extent
consistent
with
the
hospital’s
7
ability
to
meet
the
unique
needs
of
minor
patients;
to
the
8
extent
possible
given
a
minor
patient’s
health
and
safety,
the
9
hospital
shall
allow
at
least
one
parent
to
remain
with
the
10
minor
patient
at
all
times;
the
results
of
all
tests
completed
11
during
a
minor
patient’s
admission
or
visit
shall
be
reviewed
12
by
a
physician,
physician
assistant,
or
nurse
practitioner
who
13
is
familiar
with
the
minor
patient’s
presenting
condition;
a
14
minor
patient
shall
not
be
discharged
until
the
results
of
any
15
tests
that
could
reasonably
be
expected
to
yield
critical
value
16
results
are
reviewed
by
a
physician,
physician
assistant,
or
17
nurse
practitioner
and
are
communicated
to
the
minor
patient
18
and
the
minor
patient’s
parent,
as
appropriate;
a
minor
patient
19
shall
not
be
discharged
until
the
minor
patient’s
discharge
20
plan
is
provided
in
writing
and
verbally
communicated
to
the
21
minor
patient
and
the
minor
patient’s
parent,
as
appropriate;
22
the
communication
of
critical
value
results
and
the
discussion
23
of
the
discharge
plan
shall
be
accomplished
in
a
manner
that
24
reasonably
assures
that
a
minor
patient
and
the
minor
patient’s
25
parent,
as
appropriate,
understand
the
health
information
26
provided
in
order
to
make
appropriate
health
decisions;
a
27
hospital
shall
provide
all
laboratory
results
to
a
minor
28
patient’s
primary
care
provider,
if
known;
a
minor
patient
29
and
the
minor
patient’s
parent,
as
appropriate,
may
request
30
information
about
the
diagnosis,
possible
diagnoses
that
were
31
considered
during
the
episode
of
care,
and
complications
32
that
could
develop,
as
well
as
information
about
any
contact
33
made
with
a
minor
patient’s
primary
care
provider;
and
upon
34
discharge,
a
hospital
shall
provide
a
minor
patient
and
the
35
-7-
LSB
5086YH
(1)
89
pf/rh
7/
8
H.F.
2041
minor
patient’s
parent,
as
appropriate,
with
a
telephone
number
1
that
the
minor
patient
and
the
minor
patient’s
parent
may
call
2
for
advice
if
complications
or
questions
arise.
The
bill
3
defines
“minor
patient”
as
an
individual
receiving
hospital
4
emergency
department
or
inpatient
care
who
has
not
reached
5
majority
as
specified
in
Code
section
599.1
and
“parent”
as
a
6
parent,
guardian,
or
other
person
with
legal
authority
to
make
7
health
care
decisions
on
behalf
of
a
minor
patient.
8
-8-
LSB
5086YH
(1)
89
pf/rh
8/
8
