Bill Text: IA HF2391 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to health care employment agencies, including the statewide maximum allowable charges schedule applicable to nursing services provided by health care employment agency workers, providing penalties, and including effective date provisions.(Formerly HF 2199.)
Spectrum: Committee Bill
Status: (Engrossed - Dead) 2024-03-11 - Subcommittee recommends passage. []. [HF2391 Detail]
Download: Iowa-2023-HF2391-Introduced.html
House
File
2391
-
Introduced
HOUSE
FILE
2391
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HF
2199)
A
BILL
FOR
An
Act
relating
to
health
care
employment
agencies,
including
1
the
statewide
maximum
allowable
charges
schedule
applicable
2
to
nursing
services
provided
by
health
care
employment
3
agency
workers,
providing
penalties,
and
including
effective
4
date
provisions.
5
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
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Section
1.
Section
135Q.1,
Code
2024,
is
amended
to
read
as
1
follows:
2
135Q.1
Definitions.
3
As
used
in
this
chapter
,
unless
the
context
otherwise
4
requires:
5
1.
“Department”
means
the
department
of
inspections,
6
appeals,
and
licensing.
7
2.
“Health
care
employment
agency”
or
“agency”
means
an
any
8
of
the
following:
9
a.
An
agency
that
contracts
with
a
health
care
entity
10
in
this
state
to
provide
agency
workers
for
temporary
or
11
temporary-to-hire
employee
placements.
12
b.
A
health
care
technology
platform.
13
3.
“Health
care
employment
agency
worker”
or
“agency
worker”
14
means
an
individual
who
contracts
with
or
is
employed
by
a
15
health
care
employment
agency
to
provide
nursing
services
to
16
health
care
entity
consumers.
17
4.
“Health
care
entity”
means
a
facility,
agency,
or
program
18
licensed
or
certified
by
the
department
or
by
the
centers
for
19
Medicare
and
Medicaid
services
of
the
United
States
department
20
of
health
and
human
services.
21
5.
“Health
care
technology
platform”
or
“platform”
includes
22
an
individual,
a
trust,
a
partnership,
a
corporation,
a
limited
23
liability
partnership
or
company,
or
any
other
business
entity
24
that
develops
and
operates,
offers,
or
maintains
a
system
or
25
technology
that
provides
an
internet-based
or
application-based
26
marketplace
through
which
an
individual
as
an
independent
27
contractor,
and
in
the
individual’s
sole
discretion,
chooses
28
when
and
how
often
to
utilize
the
platform
to
bid
on
or
select
29
open
shifts
posted
by
a
health
care
entity
to
provide
nursing
30
services
to
a
health
care
entity.
31
6.
“Individual
agency
worker
category”
includes
registered
32
nurses,
licensed
practical
nurses,
certified
nurse
aides,
33
certified
medication
aides,
home
health
aides,
medication
34
managers,
and
noncertified
or
nonlicensed
staff
providing
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personal
care
as
defined
in
section
231C.2
who
are
health
care
1
employment
agency
workers.
2
5.
7.
“Managing
entity”
means
a
business
entity,
3
owner,
ownership
group,
chief
executive
officer,
program
4
administrator,
director,
or
other
decision
maker
whose
5
responsibilities
include
directing
the
management
or
policies
6
of
a
health
care
employment
agency.
“Managing
entity”
includes
7
an
individual
who,
directly
or
indirectly,
holds
a
beneficial
8
interest
in
a
corporation,
partnership,
or
other
business
9
entity
that
constitutes
a
managing
entity.
10
6.
8.
“Nursing
services”
means
those
services
which
may
be
11
provided
only
by
or
under
the
supervision
of
a
nurse.
“Nursing
12
services”
includes
services
performed
by
a
registered
nurse,
a
13
licensed
practical
nurse,
a
certified
nurse
aide,
a
certified
14
medication
aide,
a
home
health
aide,
a
medication
manager,
or
15
by
noncertified
or
nonlicensed
staff
providing
personal
care
16
as
defined
in
section
231C.2
.
“Nursing
services”
does
not
17
include
the
practice
of
nursing
by
an
advanced
registered
nurse
18
practitioner
or
an
advanced
practice
registered
nurse
licensed
19
under
chapter
152
or
152E
.
20
9.
“Nursing
services
professionals”
includes
registered
21
nurses,
licensed
practical
nurses,
certified
nurse
aides,
22
certified
medication
aides,
home
health
aides,
medication
23
managers,
and
noncertified
or
nonlicensed
staff
providing
24
personal
care
as
defined
in
section
231C.2
who
are
not
health
25
care
employment
agency
workers
but
instead
are
employed
26
directly
by
or
contract
directly
with
a
health
care
entity.
27
Sec.
2.
Section
135Q.2,
Code
2024,
is
amended
to
read
as
28
follows:
29
135Q.2
Health
care
employment
agency
requirements
——
30
registration
——
liability
——
penalties
.
31
1.
a.
A
health
care
employment
agency
operating
in
the
32
state
shall
register
annually
with
the
department.
Each
33
separate
location
of
a
health
care
employment
agency
shall
34
register
annually
with
and
pay
an
annual
registration
fee
of
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five
hundred
dollars
to
the
department.
The
department
shall
1
issue
each
location
a
separate
certification
of
registration
2
upon
approval
of
registration
and
payment
of
the
fee.
The
3
annual
registration
fees
shall
be
retained
by
the
department
as
4
repayment
receipts
as
defined
in
section
8.2
.
5
b.
A
health
care
employment
agency
that
fails
to
register
6
with
the
department
as
required
under
this
section
is
7
prohibited
from
contracting
with
a
health
care
entity
in
this
8
state.
9
2.
A
health
care
employment
agency
shall
do
all
of
the
10
following:
11
a.
Ensure
that
agency
workers
comply
with
all
applicable
12
requirements
relating
to
the
health
requirements
and
13
qualifications
of
personnel
in
health
care
entity
settings.
14
b.
Document
that
each
agency
worker
meets
the
minimum
15
licensing,
certification,
training,
and
health
requirements
16
and
the
continuing
education
standards
for
the
agency
worker’s
17
position
in
the
health
care
entity
setting.
18
c.
Maintain
records
for
each
agency
worker
and
report,
19
file,
or
otherwise
provide
any
required
documentation
to
20
external
parties
or
regulators
which
would
otherwise
be
the
21
responsibility
of
the
health
care
entity
if
the
agency
worker
22
was
employed
by
the
health
care
entity.
23
d.
Maintain
professional
and
general
liability
insurance
24
coverage
with
minimum
per
occurrence
coverage
of
one
million
25
dollars
and
aggregate
coverage
of
three
million
dollars
to
26
insure
against
loss,
damage,
or
expense
incident
to
a
claim
27
arising
out
of
the
death
or
injury
of
any
person
as
the
result
28
of
negligence
or
malpractice
in
the
provision
of
services
by
29
the
agency
or
an
agency
worker.
30
3.
a.
A
health
care
employment
agency
shall
not
do
any
of
31
the
following:
32
(1)
Restrict
in
any
manner
the
employment
opportunities
33
of
an
agency
worker
by
including
a
non-compete
clause
in
any
34
contract
with
an
agency
worker
or
health
care
entity.
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(2)
In
any
contract
with
an
agency
worker
or
health
care
1
entity,
require
payment
of
liquidated
damages,
employment
fees,
2
or
other
compensation
if
the
agency
worker
is
subsequently
3
hired
as
a
permanent
employee
of
the
health
care
entity.
4
(3)
Use
the
establishment
of,
or
the
required
applicability
5
of,
the
statewide
maximum
allowable
charges
schedule
as
a
basis
6
for
prohibiting
or
otherwise
interfering
with
a
wage
increase
7
for
any
agency
worker.
8
b.
This
subsection
shall
not
apply
to
a
contract
between
9
a
health
care
employment
agency
and
an
agency
worker
or
a
10
health
care
entity
if
the
contract
meets
all
of
the
following
11
criteria:
12
(1)
The
contract
is
entered
into
for
the
purpose
of
placing
13
an
agency
worker
the
health
care
employment
agency
assisted
in
14
obtaining
authorization
to
work
in
the
United
States.
15
(2)
The
contract
contains
an
initial
duration
term
of
16
not
less
than
twenty-four
months
and
a
total
duration
term,
17
including
any
renewals
or
extensions,
of
not
more
than
18
thirty-six
months.
19
(3)
The
contract
requires
the
agency
worker
to
work
for
20
a
single
health
care
entity
for
the
entire
duration
of
the
21
contract.
22
c.
Any
contract
that
violates
this
subsection
shall
be
23
unenforceable
in
court.
24
4.
A
health
care
employment
agency
shall
submit
a
report
to
25
the
department
on
a
quarterly
basis
for
each
health
care
entity
26
participating
in
Medicare
or
Medicaid
with
whom
the
agency
27
contracts
that
includes
all
of
the
following
by
provider
type:
28
a.
A
detailed
list
of
the
average
amount
charged
to
the
29
health
care
entity
for
each
individual
agency
worker
category.
30
b.
A
detailed
list
of
the
average
amount
paid
by
the
agency
31
to
agency
workers
in
each
individual
agency
worker
category.
32
5.
a.
A
health
care
employment
agency
that
violates
33
subsection
1
or
subsection
2
is
subject
to
denial
or
revocation
34
of
registration
for
a
period
of
one
year
and
a
monetary
penalty
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of
five
hundred
dollars
for
a
first
offense
and
five
thousand
1
dollars
for
each
offense
thereafter.
2
b.
A
health
care
employment
agency
that
violates
subsection
3
3
or
that
knowingly
provides
an
agency
worker
who
has
an
4
illegally
or
fraudulently
obtained
or
issued
diploma,
5
registration,
license,
certification,
or
background
check
to
6
a
health
care
entity
is
subject
to
immediate
revocation
of
7
registration.
The
department
shall
notify
the
agency
thirty
8
days
in
advance
of
the
date
of
such
revocation.
9
c.
(1)
The
managing
entity
of
an
agency
for
which
10
registration
has
been
denied
or
revoked
under
this
subsection
11
shall
not
be
eligible
to
apply
for
or
be
granted
registration
12
for
another
agency
during
the
two-year
period
following
the
13
date
of
the
denial
or
revocation.
14
(2)
The
department
shall
not
approve
a
new
registration
15
or
renew
an
existing
registration
for
any
agency
for
which
16
the
managing
entity
is
also
the
managing
entity
of
an
agency
17
for
which
registration
has
been
denied
or
revoked
during
the
18
two-year
period
in
which
registration
of
the
violating
agency
19
is
denied
or
revoked.
20
6.
5.
The
department
shall
establish
a
system
for
members
21
of
the
public
to
report
complaints
against
an
agency
or
22
agency
worker.
The
department
shall
investigate
any
complaint
23
received
and
shall
report
the
department’s
findings
to
the
24
complaining
party
and
the
agency
involved.
25
Sec.
3.
NEW
SECTION
.
135Q.3
Statewide
maximum
allowable
26
charges
schedule
——
establishment
and
annual
revision
——
required
27
utilization
and
compliance
——
rules.
28
1.
The
department
of
health
and
human
services
shall
29
annually
establish
and
publish
by
September
30,
a
statewide
30
maximum
allowable
charges
schedule
that
shall
be
applicable
31
January
1
of
the
immediately
following
calendar
year
to
nursing
32
services
provided
by
a
health
care
employment
agency
worker.
33
The
department
of
health
and
human
services
shall
utilize
the
34
most
recently
preceding
nursing
facility
cost
report
schedule
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H
to
calculate
the
statewide
maximum
allowable
charges.
The
1
department
of
health
and
human
services,
in
collaboration
2
with
stakeholders,
shall
develop
a
process
to
periodically
3
obtain
wage
information
from
provider
types
other
than
nursing
4
facilities.
5
2.
The
amounts
established
in
the
statewide
maximum
6
allowable
charges
schedule
shall
meet
all
of
the
following
7
requirements:
8
a.
The
amounts
shall
be
no
greater
than
one
hundred
fifty
9
percent
of
the
statewide
average
wage
paid
in
the
most
recently
10
preceding
cost
report
year
by
a
specific
type
of
health
care
11
entity
to
a
nursing
services
professional,
within
a
specific
12
nursing
services
professional
category,
and
within
the
13
applicable
core-based
statistical
area
of
the
state.
14
b.
The
amounts
shall
be
inclusive
of
the
hourly
rate,
15
administrative
fees,
contract
fees,
transportation
or
travel
16
stipends,
per
diems,
and
any
other
costs
a
health
care
17
employment
agency
is
authorized
to
include
in
the
charge
to
a
18
health
care
entity
for
nursing
services
provided
by
an
agency
19
worker
within
an
individual
agency
worker
category.
20
3.
Each
separate
location
of
a
health
care
employment
agency
21
registered
under
section
135Q.2
shall
utilize
and
comply
with
22
the
statewide
maximum
allowable
charges
schedule
established
23
under
this
section.
24
4.
The
department
of
health
and
human
services,
in
25
cooperation
with
the
department,
shall
adopt
rules
pursuant
to
26
chapter
17A
to
administer
this
section.
27
Sec.
4.
NEW
SECTION
.
135Q.4
Penalties
——
enforcement.
28
1.
a.
A
health
care
employment
agency
that
violates
29
section
135Q.2,
subsection
1
or
4,
is
subject
to
an
initial
30
monetary
penalty
of
five
thousand
dollars
and
shall
be
provided
31
notification
and
given
a
thirty-day
grace
period
in
which
to
32
comply.
33
b.
A
health
care
employment
agency
that
fails
to
comply
34
following
the
notification
and
within
the
thirty-day
grace
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period
under
paragraph
“a”
,
shall
be
subject
to
a
monetary
1
penalty
of
twenty-five
thousand
dollars.
2
c.
If
a
health
care
employment
agency
fails
to
comply
3
with
paragraph
“b”
,
the
health
care
employment
agency
shall
4
be
subject
to
an
additional
monetary
penalty
of
twenty-five
5
thousand
dollars,
revocation
of
registration,
and
denial
of
6
subsequent
registration
for
up
to
three
years.
7
2.
a.
A
health
care
employment
agency
that
violates
section
8
135Q.2,
subsection
2,
or
that
knowingly
provides
an
agency
9
worker
who
has
an
illegally
or
fraudulently
obtained
or
issued
10
diploma,
registration,
license,
certification,
or
background
11
check
to
a
health
care
entity
is
subject
to
a
monetary
penalty
12
of
five
thousand
dollars
for
each
violation.
13
b.
If
a
health
care
employment
agency
commits
a
second
or
14
subsequent
violation
of
section
135Q.2,
subsection
2,
within
15
any
three-year
period,
the
health
care
employment
agency
shall
16
be
subject
to
immediate
revocation
of
registration.
The
17
department
shall
notify
the
agency
thirty
days
in
advance
of
18
the
date
of
such
revocation.
19
3.
A
health
care
employment
agency
that
violates
section
20
135Q.2,
subsection
3,
is
subject
to
a
monetary
penalty
of
21
twenty-five
thousand
dollars
for
the
first
violation.
If
22
a
health
care
employment
agency
violates
section
135Q.2,
23
subsection
3,
a
second
or
subsequent
time,
the
health
care
24
employment
agency
shall
be
subject
to
immediate
revocation
of
25
registration,
and
shall
not
be
eligible
to
apply
for
or
be
26
granted
registration
for
the
three-year
period
immediately
27
following
the
date
of
revocation.
28
4.
A
health
care
employment
agency
that
violates
section
29
135Q.3
shall
be
subject
to
a
monetary
penalty
of
five
thousand
30
dollars
for
the
first
violation,
and
a
monetary
penalty
of
31
twenty-five
thousand
dollars
for
each
subsequent
violation.
32
5.
a.
The
managing
entity
of
an
agency
for
which
33
registration
has
been
denied
or
revoked
under
this
section
34
shall
not
be
eligible
to
apply
for
or
be
granted
registration
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for
another
agency
during
the
three-year
period
following
the
1
date
of
the
denial
or
revocation.
2
b.
The
department
shall
not
approve
a
new
registration
3
or
renew
an
existing
registration
for
any
agency
for
which
4
the
managing
entity
is
also
the
managing
entity
of
an
agency
5
for
which
registration
has
been
denied
or
revoked
during
the
6
three-year
period
in
which
registration
of
the
violating
agency
7
is
denied
or
revoked.
8
6.
Any
monetary
penalties
collected
under
this
section
9
shall
be
retained
by
the
department
as
repayment
receipts
as
10
defined
in
section
8.2.
11
7.
The
attorney
general
shall
enforce
the
provisions
of
this
12
chapter.
13
Sec.
5.
NEW
SECTION
.
135Q.5
Department
annual
report.
14
The
department
shall
submit
an
annual
report
to
the
general
15
assembly
by
January
15,
for
the
immediately
preceding
fiscal
16
year,
that
includes
a
summary
of
the
number
of
registrations
17
issued
and
the
amount
of
registration
fees
collected,
the
18
violations
of
this
chapter,
the
amount
of
monetary
penalties
19
collected,
the
number
of
health
care
employment
agencies
and
20
managing
entities
for
whom
a
registration
was
revoked
or
21
denied,
the
statewide
maximum
allowable
charges
schedule,
and
22
any
recommendations
for
changes
to
the
chapter.
23
Sec.
6.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
24
importance,
takes
effect
upon
enactment.
25
EXPLANATION
26
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
27
the
explanation’s
substance
by
the
members
of
the
general
assembly.
28
This
bill
relates
to
health
care
employment
agencies
29
(agency),
including
the
maximum
allowable
charges
an
agency
may
30
charge
a
health
care
entity
for
nursing
services
provided
by
a
31
health
care
employment
agency
worker
(agency
worker).
32
The
bill
defines
terms
used
in
the
bill,
including
“health
33
care
employment
agency”
which
includes
a
“health
care
34
technology
platform”
as
defined
in
the
bill;
“individual
agency
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worker
category”
which
includes
specified
health
professionals
1
who
are
agency
workers,
and
“nursing
services
professionals”
2
which
includes
the
same
specified
health
professionals
who
are
3
not
agency
workers
but
are
instead
employed
directly
by,
or
4
contract
directly
with,
a
health
care
entity.
5
The
bill
requires
the
department
of
health
and
human
6
services
(HHS)
to
annually
establish
and
publish
by
September
7
30,
a
statewide
maximum
allowable
charges
schedule
(charges
8
schedule)
applicable
January
1
of
the
following
calendar
year
9
to
nursing
services
provided
by
agency
workers.
The
amounts
10
established
in
the
charges
schedule
must
be
no
greater
than
11
150
percent
of
the
statewide
average
wage
paid
in
the
most
12
recently
preceding
cost
report
year
by
a
specific
type
of
13
health
care
entity
to
a
nursing
services
professional,
within
14
a
specific
nursing
services
professional
category,
and
within
15
the
applicable
core-based
statistical
area
of
the
state;
and
16
must
be
inclusive
of
the
hourly
rate,
administrative
fees,
17
contract
fees,
transportation
or
travel
stipends,
per
diems,
18
and
any
other
costs
an
agency
is
authorized
to
include
in
the
19
charge
to
a
health
care
entity
for
nursing
services
provided
by
20
an
agency
worker
within
an
individual
agency
worker
category.
21
The
bill
requires
each
separate
location
of
an
agency
22
registered
in
the
state
to
utilize
and
comply
with
the
charges
23
schedule
established
under
the
bill.
The
bill
directs
HHS
in
24
cooperation
with
the
department
of
inspections,
appeals,
and
25
licensing
(DIAL)
to
adopt
administrative
rules
to
administer
26
these
provisions
of
the
bill.
The
bill
prohibits
an
agency
27
from
using
the
establishment
of,
or
the
required
applicability
28
of,
the
charges
schedule
as
a
basis
for
prohibiting
or
29
otherwise
interfering
with
a
wage
increase
for
any
agency
30
worker.
31
The
bill
amends
current
penalties
under
Code
chapter
32
135Q
and
includes
new
penalties
for
violations
of
provisions
33
included
in
the
bill.
34
The
bill
provides
that
an
agency
that
violates
Code
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section
135Q.2(1)
(relating
to
required
registration
and
the
1
prohibition
against
contracting
with
a
health
care
entity
in
2
the
state
if
the
agency
is
not
registered),
or
Code
section
3
135Q.2(4)
(relating
to
submitting
quarterly
reports
to
DIAL),
4
is
subject
to
an
initial
monetary
penalty
of
$5,000
and
shall
5
be
provided
notification
and
given
a
30-day
grace
period
in
6
which
to
comply.
If
the
agency
fails
to
comply
following
the
7
notification
and
within
the
30-day
grace
period,
the
agency
8
shall
be
subject
to
a
monetary
penalty
of
$25,000.
If
the
9
agency
continues
the
noncompliance,
the
agency
shall
be
subject
10
to
an
additional
monetary
penalty
of
$25,000,
revocation
of
11
registration,
and
denial
of
subsequent
registration
for
up
12
to
three
years.
The
bill
also
provides
that
an
agency
that
13
violates
Code
section
135Q.2(2)
(relating
to
certain
prohibited
14
restrictions
on
agency
workers
or
health
care
entities
and
15
contracting
prohibitions),
or
that
knowingly
provides
an
agency
16
worker
who
has
an
illegally
or
fraudulently
obtained
or
issued
17
diploma,
registration,
license,
certification,
or
background
18
check
to
a
health
care
entity
is
subject
to
a
monetary
penalty
19
of
$5,000
for
each
violation,
and
to
immediate
revocation
of
20
registration.
If
the
agency
commits
a
second
or
subsequent
21
violation
within
any
three-year
period,
the
health
care
22
employment
agency
shall
be
subject
to
immediate
revocation
of
23
registration.
Under
the
bill,
an
agency
that
violates
Code
24
section
135Q.2(3)
(relating
to
contracting
with
agency
workers
25
and
health
care
entities)
is
subject
to
a
monetary
penalty
of
26
$25,000
for
a
first
offense,
and
to
immediate
revocation
of
27
registration
and
denial
of
registration
for
the
three-year
28
period
following
revocation
for
a
second
or
subsequent
29
violation.
30
An
agency
that
violates
Code
section
135Q.3
(relating
31
to
requirements
regarding
the
statewide
allowable
charges
32
schedule),
shall
be
subject
to
a
monetary
penalty
of
$5,000
for
33
the
first
violation
and
a
monetary
penalty
of
$25,000
for
each
34
subsequent
violation.
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The
bill
also
provides
that
the
managing
entity
of
an
agency
1
for
which
registration
has
been
denied
or
revoked
shall
not
be
2
eligible
to
apply
for
or
be
granted
registration
for
another
3
agency
during
the
three-year
period
following
the
date
of
4
the
denial
or
revocation;
and
DIAL
shall
not
approve
a
new
5
registration
or
renew
an
existing
registration
for
any
agency
6
for
which
the
managing
entity
is
also
the
managing
entity
of
7
an
agency
for
which
registration
has
been
denied
or
revoked
8
during
the
three-year
period
in
which
registration
of
the
9
violating
agency
is
denied
or
revoked.
The
bill
provides
that
10
any
monetary
penalties
collected
shall
be
retained
by
DIAL
as
11
repayment
receipts
as
defined
in
Code
section
8.2.
The
bill
12
provides
that
the
attorney
general
shall
enforce
the
provisions
13
of
the
bill.
14
The
bill
requires
DIAL
to
submit
an
annual
report
to
15
the
general
assembly
by
January
15,
for
the
immediately
16
preceding
fiscal
year,
that
includes
a
summary
of
the
number
17
of
registrations
issued
and
the
amount
of
registration
18
fees
collected,
the
violations
of
the
chapter,
the
amount
19
of
monetary
penalties
collected,
the
number
of
health
20
care
employment
agencies
and
managing
entities
for
whom
a
21
registration
was
revoked
or
denied,
the
charges
schedule,
and
22
any
recommendations
for
changes
to
the
Code
chapter.
The
bill
23
takes
effect
upon
enactment.
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