Bill Text: MI HB5774 | 2011-2012 | 96th Legislature | Introduced

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Bill Title: Health; home health care; home health care agencies; require to be licensed. Amends secs. 1104, 20106, 20115, 20142, 21325, 21766 & 22205 of 1978 PA 368 (MCL 333.1104 et seq.) & adds pt. 218.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2012-08-15 - Printed Bill Filed 07/19/2012 [HB5774 Detail]

Download: Michigan-2011-HB5774-Introduced.html

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HOUSE BILL No. 5774

 

July 18, 2012, Introduced by Rep. Heise and referred to the Committee on Health Policy.

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 1104, 20106, 20115, 20142, 21325, 21766, and

 

22205 (MCL 333.1104, 333.20106, 333.20115, 333.20142, 333.21325,

 

333.21766, and 333.22205), section 1104 as amended by 1996 PA 307,

 

section 20106 as amended by 2000 PA 253, section 20115 as amended

 

by 1999 PA 206, section 21325 as added by 2000 PA 437, section

 

21766 as amended by 2001 PA 243, and section 22205 as amended by

 

2002 PA 619, and by adding part 218.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 1104. (1) "Acknowledgment of parentage" means an

 

acknowledgment executed as provided in the acknowledgment of

 

parentage act.

 

     (2) "Administrative procedures act of 1969" means Act No. 306

 

of the Public Acts of 1969, being sections 24.201 to 24.328 of the

 

Michigan Compiled Laws, the administrative procedures act of 1969,

 

1969 PA 306, MCL 24.201 to 24.328, or a successor act.

 

     (3) "Adult" means an individual 18 years of age or older.

 

     (4) "Code" means the public health code.

 

     (5) "Department", except as provided in article 15 and part

 

218, means the state department of community health.

 

     (6) "Director", except as provided in article 15 and part 218,

 

means the state director of community health.

 

     (7) "Governmental entity" means a government, governmental

 

subdivision or agency, or public corporation.

 

     Sec. 20106. (1) "Health facility or agency", except as

 

provided in section 20115, means:

 

     (a) An ambulance operation, aircraft transport operation,

 

nontransport prehospital life support operation, or medical first

 

response service.

 

     (b) A clinical laboratory.

 

     (c) A county medical care facility.

 

     (d) A freestanding surgical outpatient facility.

 

     (e) A health maintenance organization.

 

     (f) A home for the aged.

 

     (g) A hospital.

 

     (h) A nursing home.

 

     (i) A hospice.

 

     (j) A hospice residence.

 

     (k) A facility or agency listed in subdivisions (a) to (h)

 

located in a university, college, or other educational institution.

 

     (l) A home care agency.

 

     (2) "Health maintenance organization" means that term as

 

defined in section 3501 of the insurance code of 1956, 1956 PA 218,

 

MCL 500.3501.

 

     (3) "Home care agency" means that term as defined in section

 

21809.

 

     (4) (3) "Home for the aged" means a supervised personal care

 

facility, other than a hotel, adult foster care facility, hospital,

 

nursing home, or county medical care facility that provides room,

 

board, and supervised personal care to 21 or more unrelated,

 

nontransient, individuals 60 years of age or older. Home for the

 

aged includes a supervised personal care facility for 20 or fewer

 

individuals 60 years of age or older if the facility is operated in

 

conjunction with and as a distinct part of a licensed nursing home.

 

     (5) (4) "Hospice" means a health care program that provides a

 

coordinated set of services rendered at home or in outpatient or

 

institutional settings for individuals suffering from a disease or

 

condition with a terminal prognosis.

 

     (6) (5) "Hospital" means a facility offering inpatient,

 

overnight care, and services for observation, diagnosis, and active

 

treatment of an individual with a medical, surgical, obstetric,

 

chronic, or rehabilitative condition requiring the daily direction

 

or supervision of a physician. Hospital does not include a mental

 

health hospital licensed or operated by the department of community

 

health or a hospital operated by the department of corrections.

 

     (7) (6) "Hospital long-term care unit" means a nursing care

 

facility, owned and operated by and as part of a hospital,

 

providing organized nursing care and medical treatment to 7 or more

 

unrelated individuals suffering or recovering from illness, injury,

 

or infirmity.

 

     Sec. 20115. (1) The department may promulgate rules to further

 

define the term "health facility or agency" and the definition of a

 

health facility or agency listed in section 20106 as required to

 

implement this article. The department may define a specific

 

organization as a health facility or agency for the sole purpose of

 

certification authorized under this article. For purpose of

 

certification only, an organization defined in section 20106(5),

 

20106(6), 20108(1), or 20109(4) is considered a health facility or

 

agency. The term "health facility or agency" does not mean a

 

visiting nurse service or home aide service conducted by and for

 

the adherents of a church or religious denomination for the purpose

 

of providing service for those who depend upon spiritual means

 

through prayer alone for healing.

 

     (2) The department shall promulgate rules to differentiate a

 

freestanding surgical outpatient facility from a private office of

 

a physician, dentist, podiatrist, or other health professional. The

 

department shall specify in the rules that a facility including,

 

but not limited to, a private practice office described in this

 

subsection in which 50% or more of the patients annually served at

 

the facility undergo an abortion must be licensed under this

 

article as a freestanding surgical outpatient facility.

 

     (3) The department shall promulgate rules that in effect

 

republish R 325.3826, R 325.3832, R 325.3835, R 325.3857, R

 

325.3866, R 325.3867, and R 325.3868 of the Michigan administrative

 

code, but shall include in the rules standards for a freestanding

 

surgical outpatient facility in which 50% or more of the patients

 

annually served in the freestanding surgical outpatient facility

 

undergo an abortion. The department shall assure that the standards

 

are consistent with the most recent United States supreme court

 

decisions regarding state regulation of abortions.

 

     (4) Subject to section 20145 and part 222, the department may

 

modify or waive 1 or more of the rules contained in R 325.3801 to R

 

325.3877 of the Michigan administrative code regarding construction

 

or equipment standards, or both, for a freestanding surgical

 

outpatient facility in which 50% or more of the patients annually

 

served in the freestanding surgical outpatient facility undergo an

 

abortion, if both of the following conditions are met:

 

     (a) The freestanding surgical outpatient facility was in

 

existence and operating on the effective date of the amendatory act

 

that added this subsection.March 10, 2000.

 

     (b) The department makes a determination that the existing

 

construction or equipment conditions, or both, within the

 

freestanding surgical outpatient facility are adequate to preserve

 

the health and safety of the patients and employees of the

 

freestanding surgical outpatient facility or that the construction

 

or equipment conditions, or both, can be modified to adequately

 

preserve the health and safety of the patients and employees of the

 

freestanding surgical outpatient facility without meeting the

 

specific requirements of the rules.

 

     (5) As used in this subsection, section, "abortion" means that

 

term as defined in section 17015.

 

     Sec. 20142. (1) A health facility or agency shall apply for

 

licensure or certification on a form authorized and provided by the

 

department. The application shall include attachments, additional

 

data, and information required under this article and by the

 

department.

 

     (2) An applicant shall certify the accuracy of information

 

supplied in the application and supplemental statements.

 

     (3) An applicant or a licensee under part 213, or 217, or 218

 

shall disclose the names, addresses, principal occupations, and

 

official positions of all persons individuals who have an ownership

 

interest in the health facility or agency. If the health facility

 

or agency is located on or in leased real estate, the applicant or

 

licensee shall disclose the name of the lessor and any direct or

 

indirect interest the applicant or licensee has in the lease other

 

than as lessee. A change in ownership shall be reported to the

 

director not less than 15 days before the change occurs, except

 

that a person purchasing stock of a company registered pursuant to

 

the securities exchange act of 1934, 15 U.S.C. 78a to 78kk, 15 USC

 

78a to 78oo, is exempt from disclosing ownership in the facility. A

 

person required to file a beneficial ownership report pursuant to

 

section 16(a) of the securities exchange act of 1934, 15 U.S.C. 78p

 

15 USC 78p, shall file with the department information relating to

 

securities ownership required by the department rule or order. An

 

applicant or licensee proposing a sale of a nursing home to another

 

person shall provide the department with written, advance notice of

 

the proposed sale. The applicant or licensee and the other parties

 

to the sale shall arrange to meet with specified department

 

representatives and shall obtain before the sale a determination of

 

the items of noncompliance with applicable law and rules which that

 

shall be corrected. The department shall notify the respective

 

parties of the items of noncompliance prior to the change of

 

ownership and shall indicate that the items of noncompliance must

 

be corrected as a condition of issuance of a license to the new

 

owner. The department may accept reports filed with the securities

 

and exchange commission relating to the filings. A person who

 

violates this subsection is guilty of a misdemeanor, punishable by

 

a fine of not more than $1,000.00 for each violation.

 

     (4) An applicant or licensee under part 217 shall disclose the

 

names and business addresses of suppliers who furnish goods or

 

services to an individual nursing home or a group of nursing homes

 

under common ownership, the aggregate charges for which exceed

 

$5,000.00 in a 12-month period which that includes a month in a

 

nursing home's current fiscal year. An applicant or licensee shall

 

disclose the names, addresses, principal occupations, and official

 

positions of all persons individuals who have an ownership interest

 

in a business which that furnishes goods or services to an

 

individual nursing home or to a group of nursing homes under common

 

ownership, if both of the following apply:

 

     (a) The person, individual, or the person's individual's

 

spouse, parent, sibling, or child, has an ownership interest in the

 

nursing home purchasing the goods or services.

 

     (b) The aggregate charges for the goods or services purchased

 

exceeds $5,000.00 in a 12-month period which that includes a month

 

in the nursing home's current fiscal year.

 

     (5) An applicant or licensee who makes a false statement in an

 

application or statement required by the department pursuant to

 

this article is guilty of a felony , punishable by imprisonment for

 

not more than 4 years , or a fine of not more than $30,000.00, or

 

both.

 

     Sec. 21325. If a resident of a home for the aged is receiving

 

care in the facility in addition to the room, board, and supervised

 

personal care specified in section 20106(3), 20106(4), as

 

determined by a physician, the department shall not order the

 

removal of the resident from the home for the aged if both of the

 

following conditions are met:

 

     (a) The resident, the resident's family, the resident's

 

physician, and the owner, operator, and governing body of the home

 

for the aged consent to the resident's continued stay in the home

 

for the aged.

 

     (b) The owner, operator, and governing body of the home for

 

the aged commit to assuring that the resident receives the

 

necessary additional services.

 

     Sec. 21766. (1) A nursing home shall execute a written

 

contract solely with an applicant or patient or that applicant's or

 

patient's guardian or legal representative authorized by law to

 

have access to those portions of the patient's or applicant's

 

income or assets available to pay for nursing home care, at each of

 

the following times:

 

     (a) At the time an individual is admitted to a nursing home.

 

     (b) At the expiration of the term of a previous contract.

 

     (c) At the time the source of payment for the patient's care

 

changes.

 

     (2) A nursing home shall not discharge or transfer a patient

 

at the expiration of the term of a contract, except as provided in

 

section 21773.

 

     (3) A nursing home shall specifically notify in writing an

 

applicant or patient or that applicant's or patient's guardian or

 

legal representative of the availability or lack of availability of

 

hospice care in the nursing home. This written notice shall be by

 

way of a specific paragraph located in the written contract

 

described in subsection (1) and shall require the applicant or

 

patient or that applicant's or patient's guardian or legal

 

representative to sign or initial the paragraph before execution of

 

the written contract. As used in this subsection, "hospice" means

 

that term as defined in section 20106(4).20106.

 

     (4) A nursing home shall provide a copy of the contract to the

 

patient, the patient's representative, or the patient's legal

 

representative or legal guardian at the time the contract is

 

executed.

 

     (5) For a patient supported by funds other than the patient's

 

own funds, a nursing home shall make a copy of the contract

 

available to the person providing the funds for the patient's

 

support.

 

     (6) For a patient whose care is reimbursed with public funds

 

administered by the department of community health, a nursing home

 

shall maintain a copy of the contract in the patient's file at the

 

nursing home and upon request shall make a copy of the contract

 

available to the department of community health.

 

     (7) The nursing home shall ensure that the contract is written

 

in clear and unambiguous language and is printed in not less than

 

12-point type. The form of the contract shall be prescribed by the

 

department.

 

     (8) The contract shall specify all of the following:

 

     (a) The term of the contract.

 

     (b) The services to be provided under the contract, including

 

the availability of hospice or other special care, and the charges

 

for the services.

 

     (c) The services that may be provided to supplement the

 

contract and the charges for the services.

 

     (d) The sources liable for payments due under the contract.

 

     (e) The amount of deposit paid and the general and foreseeable

 

terms upon which the deposit will be held and refunded.

 

     (f) The rights, duties, and obligations of the patient, except

 

that the specification of a patient's rights may be furnished on a

 

separate document that complies with the requirements of section

 

20201.

 

     (9) The nursing home may require a patient's or applicant's

 

guardian or legal representative who is authorized by law to have

 

access to those portions of the patient's or applicant's income or

 

assets available to pay for nursing home care to sign a contract

 

without incurring personal financial liability other than for funds

 

received in his or her legal capacity on behalf of the patient.

 

     (10) A nursing home employee may request the appointment of a

 

guardian for an individual applicant or patient only if the nursing

 

home employee reasonably believes that the individual meets the

 

legal requirements for the appointment of a guardian.

 

     Sec. 22205. (1) "Health facility", except as otherwise

 

provided in subsection (2), means:

 

     (a) A hospital licensed under part 215.

 

     (b) A psychiatric hospital or psychiatric unit licensed under

 

the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106.

 

     (c) A nursing home licensed under part 217 or a hospital long-

 

term care unit as defined in section 20106(6).20106.

 

     (d) A freestanding surgical outpatient facility licensed under

 

part 208.

 

     (e) A health maintenance organization issued a license or

 

certificate of authority in this state.

 

     (2) "Health facility" does not include the following:

 

     (a) An institution conducted by and for the adherents of a

 

church or religious denomination for the purpose of providing

 

facilities for the care and treatment of the sick who depend solely

 

upon spiritual means through prayer for healing.

 

     (b) A health facility or agency located in a correctional

 

institution.

 

     (c) A veterans facility operated by the state or federal

 

government.

 

     (d) A facility owned and operated by the department of

 

community health.

 

     (3) "Initiate" means the offering of a covered clinical

 

service that has not been offered in compliance with this part or

 

former part 221 on a regular basis at that location within the 12-

 

month period immediately preceding the date the covered clinical

 

service will be offered.

 

     (4) "Medical equipment" means a single equipment component or

 

a related system of components that is used for clinical purposes.

 

PART 218

 

     Sec. 21801. (1) For purposes of this part, the words and

 

phrases defined in sections 21803 to 21813 have the meanings

 

ascribed to them in those sections.

 

     (2) In addition, article 1 contains general definitions and

 

principles of construction applicable to all articles in this code

 

and part 201 contains definitions applicable to this part.

 

     Sec. 21803. (1) "Certified home care agency" means an agency

 

that is certified by either the federal centers for medicare and

 

medicaid services or the department to provide skilled home health

 

or personal care services.

 

     (2) "Department" means the department of licensing and

 

regulatory affairs.

 

     (3) "Director" means the department director or his or her

 

designee.

 

     Sec. 21805. (1) "Home care agency" means a sole

 

proprietorship, partnership, association, corporation, government

 

or governmental subdivision or agency subject to the restrictions

 

of this article, nonprofit agency, or any other legal or commercial

 

entity that manages and offers, directly or by contract, skilled

 

home health services or personal care services to a home care

 

consumer in the home care consumer's temporary or permanent home or

 

place of residence. A residential health facility or agency that

 

delivers skilled home health or personal care services that the

 

health facility or agency is not licensed to provide must either be

 

licensed as a home care agency or require the skilled home health

 

or personal care services to be delivered by a licensed home care

 

agency. Home care agency does not include any of the following:

 

     (a) An organization that provides only housekeeping services.

 

     (b) A community and rural health network that furnishes home

 

visits for the purpose of public health monitoring and disease

 

tracking.

 

     (c) An individual who is not employed by or affiliated with a

 

home care agency and who acts alone, without employees or

 

contractors.

 

     (d) An outpatient rehabilitation agency or comprehensive

 

outpatient rehabilitation facility certified under title XVIII or

 

XIX.

 

     (e) A consumer-directed attendant program administered by the

 

department.

 

     (f) A licensed dialysis center that provides in-home dialysis

 

services, supplies, and equipment.

 

     (g) Subject to the requirements of section 21825, a health

 

facility or agency otherwise licensed by the department.

 

     (h) A home care placement agency.

 

     (2) "Home care agency cash fund" or "fund" means the home care

 

agency cash fund created in section 21831.

 

     (3) "Home care consumer" means a person who receives skilled

 

home health services or personal care services in his or her

 

temporary or permanent home or place of residence from a home care

 

agency or home care placement agency.

 

     (4) "Home care placement agency" means an organization that,

 

for a fee, provides only referrals of providers to home care

 

consumers seeking services. A home care placement agency does not

 

include an organization that provides skilled home health services

 

or personal care services to a home care consumer in the home care

 

consumer's temporary or permanent home or place of residence

 

directly or by contract.

 

     Sec. 21809. (1) "Person" means an individual, partnership,

 

corporation, association, governmental entity, or other legal

 

entity.

 

     (2) "Personal care services" means assistance with activities

 

of daily living, including, but not limited to, bathing, dressing,

 

eating, transferring, walking or mobility, toileting, and

 

continence care. Personal care services also include housekeeping,

 

personal laundry, medication reminders, and companionship services

 

furnished to a home care consumer in the home care consumer's

 

temporary or permanent home or place of residence and those normal

 

daily routines that the home care consumer could perform for

 

himself or herself were he or she physically capable, that are

 

intended to enable that individual to remain safely and comfortably

 

in the home care consumer's temporary or permanent home or place of

 

residence.

 

     Sec. 21813. (1) "Skilled home health services" means health

 

and medical services furnished to a home care consumer in the home

 

care consumer's temporary or permanent home or place of residence

 

that include wound care services, use of medical supplies including

 

drugs and biologicals prescribed by a physician, in-home infusion

 

services, nursing services, home health aide or certified nurse

 

aide services that require the supervision of a licensed or

 

certified health care professional acting within the scope of his

 

or her license or certificate, occupational therapy, physical

 

therapy, respiratory care services, dietetics and nutrition

 

counseling services, medication administration, medical social

 

services, and speech-language pathology services. Skilled home

 

health services do not include delivery of either durable medical

 

equipment or medical supplies.

 

     (2) "Title XVIII" means title XVIII of the social security

 

act, 42 USC 1395 to 1395kkk-1.

 

     (3) "Title XIX" means title XIX of the social security act, 42

 

USC 1396 to 1396w-5.

 

     Sec. 21821. (1) Beginning January 1, 2014, a person shall not

 

conduct or maintain a home care agency that provides skilled home

 

health services without having submitted a completed application

 

for licensure as a home care agency to the department. Beginning

 

January 1, 2015, a person shall not conduct or maintain a home care

 

agency that provides skilled home health services without having

 

obtained a license from the department.

 

     (2) Beginning January 1, 2015, a person shall not conduct or

 

maintain a home care agency that provides in-home personal care

 

services without having submitted a completed application for

 

licensure as a home care agency to the department. Beginning

 

January 1, 2016, a person shall not conduct or maintain a home care

 

agency that provides in-home personal care services without having

 

obtained a license from the department.

 

     (3) A person who violates this section is guilty of a

 

misdemeanor punishable by a fine of not less than $50.00 and not

 

more than $500.00 and is subject to a civil penalty assessed by the

 

department of not more than $10,000.00 for each violation of this

 

section. The department shall assess, enforce, and collect the

 

penalty to credit to the home care agency cash fund. Enforcement

 

and collection of the penalty shall occur following a decision

 

reached in a hearing conducted under chapter 4 of the

 

administrative procedures act of 1969, MCL 24.271 to 24.287.

 

     Sec. 21823. (1) Beginning June 1, 2014, a home care placement

 

agency shall notify the department in writing that the home care

 

placement agency provides referrals for skilled home health

 

services or personal care services and shall annually update that

 

notice. The department shall maintain a list of all home care

 

placement agencies and shall make the list accessible to the

 

public.

 

     (2) A person who violates this section is subject to a civil

 

penalty assessed by the department of not less than $500.00 per

 

year and not more than $1,000.00 per year for failure to provide

 

notice required by this section to the department. Money collected

 

from a civil penalty assessed under this section shall be deposited

 

in the home care agency cash fund.

 

     Sec. 21825. If a health facility or agency provides skilled

 

home health or personal care services outside of its premises, the

 

health facility or agency's license must be amended to include the

 

skilled home health or personal care services and the health

 

facility or agency must meet the requirements of this part in

 

addition to any other licensing requirement.

 

     Sec. 21827. (1) Not later than May 1, 2014, the department

 

shall promulgate rules to implement this part according to the

 

administrative procedures act of 1969. The rules promulgated under

 

this section must provide minimum standards for operating a home

 

care agency in this state. In promulgating these rules, the

 

department shall consider the different requirements appropriate to

 

the various types of skilled home health and personal care

 

services, including differentiating requirements for providers that

 

are substantially funded through medicare and medicaid

 

reimbursement, providers that are already licensed under this

 

article, and providers that are solely or substantially privately

 

funded. This differentiation may consider the requirements already

 

imposed by other federal and state regulatory agencies.

 

     (2) Rules promulgated under this section shall include, at a

 

minimum, all of the following:

 

     (a) Inspection of home care agencies by the department or its

 

designated representative.

 

     (b) Minimum educational, training, and experience standards

 

for the administrator and staff of a home care agency, including a

 

requirement that the administrator and staff be of good, moral, and

 

responsible character.

 

     (c) Requirements for disclosure notices to be provided by home

 

care agencies and home care placement agencies to home care

 

consumers concerning the duties and employment status of the

 

individual providing services.

 

     (d) Intermediate enforcement remedies as authorized in this

 

part.

 

     (e) A requirement and form for written plans, to be submitted

 

by home health care agencies to the department for approval,

 

detailing the measures that will be taken to correct violations

 

found as a result of inspections.

 

     (f) Establishing occurrence reporting requirements required

 

under this part.

 

     (g) Fees for home care agency licensure that shall not exceed

 

$1,500.00 per year for 2 years from the effective date of fees

 

established by rule for home care agencies that are certified

 

providers through the federal centers for medicare and medicaid

 

services or the department. Home care agency fees shall be payable

 

to the home care agency cash fund. The annual fee shall include a

 

component that reflects whether a survey is planned for the year

 

based on the home health care agency's compliance history. The fee

 

schedule shall also be tiered to reflect the differences in type

 

and volume of services of various home care agencies, including,

 

but not limited to, their volume of medicaid and medicare services.

 

The fee schedule shall also provide for reduced fees for home care

 

agencies that are certified through the federal centers for

 

medicare and medicaid services or the department before submitting

 

the initial license application. The department shall not charge a

 

duplicate fee for survey work conducted according to its role as

 

state survey agency for the federal centers for medicare and

 

medicaid services or the department. Not later than January 1,

 

2016, the department shall issue an independent report detailing

 

the direct and indirect costs associated with the administration of

 

home care agency licensure.

 

     (h) Requirements for home care agencies to provide evidence of

 

and maintain either liability insurance coverage or a surety bond

 

in lieu of liability insurance coverage, in amounts set through

 

rules of the department director.

 

     Sec. 21829. (1) The home care advisory committee is

 

established within the department. The home care advisory committee

 

shall make recommendations to the department and the department

 

director concerning the rules promulgated according to this part

 

and implementation of licensing home care agencies.

 

     (2) The home care advisory committee shall be appointed by the

 

department director. The home care advisory committee shall, at a

 

minimum, consist of representatives from skilled home health

 

services agencies, representatives from personal care services

 

agencies, members of the disabled community who are home care

 

consumers, seniors or representatives of seniors who are home care

 

consumers, providers of medicaid services, providers of in-home

 

support services, and representatives of the department, the

 

department of community health, and the department of human

 

services. Members of the home care advisory committee shall serve

 

at the pleasure of the appointing authority on a voluntary basis

 

and shall serve without compensation.

 

     Sec. 21831. (1) The home care agency cash fund is created

 

within the state treasury.

 

     (2) The state treasurer may receive money or other assets from

 

any source for deposit into the fund. The state treasurer shall

 

direct the investment of the fund. The state treasurer shall credit

 

to the fund interest and earnings from fund investments.

 

     (3) Money in the fund at the close of the fiscal year shall

 

remain in the fund and shall not lapse to the general fund.

 

     (4) The department shall be the administrator of the fund for

 

auditing purposes.

 

     (5) The department of shall expend money from the fund, upon

 

appropriation, only as provided in this part.

 

     Sec. 21833. After being licensed under this part, an

 

application for license renewal to operate a home care agency must

 

be submitted to the department annually upon forms and in the

 

manner as prescribed by the department.

 

     Sec. 21835. (1) The department shall investigate and review

 

each original application and each renewal application for a

 

license. The department shall determine an applicant's compliance

 

with the rules adopted under this part before a license is issued

 

or renewed. A certified home care agency that applies for a license

 

not later than June 1, 2014 is exempt from licensure inspection

 

before being issued the initial license. The department shall make

 

inspections as it considers necessary to ensure that the health,

 

safety, and welfare of the home care consumers are being protected.

 

Inspections of a home care consumer's home are subject to the

 

consent of the home care consumer to access the property. The home

 

care agency shall submit in writing, in a form prescribed by the

 

department, a plan detailing the measures that will be taken to

 

correct any violations found by the department as a result of

 

inspections undertaken under this part.

 

     (2) The department shall keep all medical records obtained

 

during an inspection or investigation of a home care agency

 

confidential, and the medical records are exempt from disclosure

 

except as otherwise required by law.

 

     Sec. 21837. (1) Except as otherwise provided in subsections

 

(2) and (3), the department shall issue or renew a license after it

 

determines that the applicant or licensee is in compliance with the

 

requirements of this part and the rules promulgated under this

 

part. Except for provisional licenses issued in accordance with

 

subsections (2) and (3), a license issued or renewed under this

 

section expires 1 year after the date of issuance or renewal.

 

     (2) The department may issue a provisional license to an

 

applicant for the purpose of operating a home care agency for a

 

period of 90 days if the applicant is temporarily unable to conform

 

to all of the minimum standards required under this part. No

 

license shall be issued to an applicant if operating the

 

applicant's home care agency will adversely affect the health,

 

safety, or welfare of the home care consumers of that home care

 

agency. As a condition of obtaining a provisional license, the

 

applicant shall show proof to the department that attempts are

 

being made to conform and comply with applicable standards. No

 

provisional license shall be granted before completion of a

 

criminal history check required under this part and a finding in

 

accordance with section 20173a. A second provisional license may be

 

issued, for a similar period of time and similar fee, to effect

 

compliance. No further provisional licenses may be issued for the

 

current year after the second issuance.

 

     (3) The department may issue a provisional license for a

 

period of 90 days to a home health care agency that has previously

 

applied to be a certified home care agency through the federal

 

centers for medicare and medicaid services but have not received an

 

acceptance or rejection. No provisional license shall be granted

 

before completion of a criminal history check required under this

 

part and a finding in accordance with section 20173a. A second

 

provisional license may be issued, for a similar period of time and

 

similar fee, to effect compliance. No further provisional licenses

 

may be issued for the current year after the second issuance.

 

     Sec. 21839. (1) Notice of intent to deny, limit, suspend, or

 

revoke a license shall be given by certified mail or personal

 

service, shall set forth the particular reasons for the proposed

 

action, and shall fix a date, not less than 30 days after the date

 

of service, on which the applicant or licensee shall be given the

 

opportunity for a hearing before the director or the director's

 

authorized representative. The hearing shall be conducted in

 

accordance with the administrative procedures act of 1969 and rules

 

promulgated by the department. A full and complete record shall be

 

kept of the proceeding and shall be transcribed when requested by

 

an interested party, who shall pay the cost of preparing the

 

transcript.

 

     (2) On the basis of a hearing or on the default of the

 

applicant or licensee, the department may issue, deny, limit,

 

suspend, or revoke a license. A copy of the determination shall be

 

sent by certified mail or served personally upon the applicant or

 

licensee. The determination becomes final 30 days after it is

 

mailed or served, unless the applicant or licensee within the 30

 

days appeals the decision to the circuit court in the county of

 

jurisdiction or to the Ingham county circuit court.

 

     (3) The department may establish procedures, hold hearings,

 

administer oaths, issue subpoenas, or order testimony to be taken

 

at a hearing or by deposition in a proceeding pending at any stage

 

of the proceeding. A person may be compelled to appear and testify

 

and to produce books, papers, or documents in a proceeding.

 

     (4) In case of disobedience of a subpoena, a party to a

 

hearing may invoke the aid of the circuit court of the jurisdiction

 

in which the hearing is held to require the attendance and

 

testimony of witnesses. The circuit court may issue an order

 

requiring an individual to appear and give testimony. Failure to

 

obey the order of the circuit court may be punished as contempt by

 

the court.

 

     Sec. 21841. (1) The department may impose intermediate

 

restrictions or conditions on a licensee that may include 1 or more

 

of the following:

 

     (a) Retaining a consultant to address corrective measures.

 

     (b) Monitoring by the department for a specific period.

 

     (c) Providing additional training to employees, owners, or

 

operators of the home care agency.

 

     (d) Complying with a directed written plan to correct a

 

violation.

 

     (e) Paying a civil fine not to exceed $10,000.00 per calendar

 

year for all violations.

 

     (2) If the department imposes an intermediate restriction or

 

condition that is not a result of a serious and immediate threat to

 

health or welfare, the licensee shall receive written notice of the

 

restriction or condition. Not later than 10 days after the date the

 

notice is received from the department, the licensee shall submit a

 

written plan that includes the time frame for completing the plan

 

and addresses the restriction or condition specified.

 

     (3) If the department imposes an intermediate restriction or

 

condition that is the result of a serious and immediate threat to

 

health, safety, or welfare, the department shall notify the

 

licensee in writing, by telephone, or in person during an on-site

 

visit. The licensee shall remedy the circumstances creating harm or

 

potential harm immediately upon receiving notice of the restriction

 

or condition. If the department provides notice of a restriction or

 

condition by telephone or in person, the department shall send

 

written confirmation of the restriction or condition to the

 

licensee within 2 business days.

 

     (4) After submission of an approved written plan, a licensee

 

may appeal any intermediate restriction or condition imposed on the

 

license to the department through an informal review process as

 

established by the department. If the restriction or condition

 

requires payment of a civil fine, the licensee may request and the

 

department shall grant a stay in payment of the fine until final

 

disposition of the restriction or condition. If a licensee is not

 

satisfied with the result of the informal review or chooses not to

 

seek informal review, no intermediate restriction or condition on

 

the licensee shall be imposed until after an opportunity for a

 

hearing has been afforded the licensee.

 

     (5) If the department assesses a civil fine under this

 

section, money received by the department shall be transmitted to

 

the state treasurer, who shall credit the money to the home care

 

agency cash fund.

 

     (6) Civil fines collected under this section shall be used for

 

expenses related to any of the following:

 

     (a) Continuing monitoring required under this section.

 

     (b) Education for licensees to avoid restrictions or

 

conditions or facilitate the application process or the change of

 

ownership process.

 

     (c) Education for home care consumers and their families about

 

resolving problems with a home care agency, rights of home care

 

consumers, and responsibilities of home care agencies.

 

     (d) Providing technical assistance to any home care agency for

 

the purpose of complying with changes in rules, state law, or

 

federal law.

 

     (e) Monitoring and assisting in the transition of home care

 

consumers to other home care agencies, when the transition is a

 

result of the revocation of a license or other appropriate medical

 

services.

 

     (f) Maintaining the operation of a home care agency pending

 

correction of violations, as determined necessary by the

 

department.

 

     Sec. 21843. (1) A home care agency shall not employ, contract

 

with, or grant clinical privileges to an individual who regularly

 

has direct access to or provides direct services to patients or

 

clients unless a criminal history check of that individual has been

 

conducted in compliance with section 20173a. An individual

 

disqualified or denied employment by a home care agency based on a

 

criminal history check conducted under this section may appeal as

 

provided in section 20173b.

 

     (2) The department shall revoke or refuse to renew the license

 

of a home care agency if the owner or licensee has been convicted

 

of a felony or misdemeanor involving moral turpitude or involving

 

conduct that the department determines could pose a risk to the

 

health, safety, or welfare of the home care consumer. A revocation

 

or refusal under this section shall be made only after a hearing is

 

provided in accordance with this part.