Text: HF306            Text: HF308
Complete Bill History


House File 307

HOUSE FILE BY MASCHER Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act concerning disclosures of information regarding patient 2 safety by health care workers and providing penalties. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2211YH 83 5 ec/nh/5 PAG LIN 1 1 Section 1. NEW SECTION. 147.97 PATIENT PROTECTION == 1 2 HEALTH CARE WORKERS == REPORT OF ADVERSE EVENTS. 1 3 1. As used in this section, unless the context otherwise 1 4 requires: 1 5 a. "Direct care worker" means a trained and supervised 1 6 individual who provides services, care, and emotional support 1 7 to patients and health care recipients. 1 8 b. "Established guidelines for certified individuals and 1 9 direct care workers" includes written protocols and procedures 1 10 as defined by the department for direct care workers, 1 11 emergency medical care providers as defined in chapter 147A, 1 12 and substance abuse counselors as certified by the Iowa board 1 13 of certification. 1 14 c. "Health care worker" means any individual employed by 1 15 or under contract with a hospital, health care provider, or 1 16 health care agency to provide health care services. 1 17 d. "Professional standards of care" means authoritative 1 18 statements that describe a level of care or performance common 1 19 to the profession by which the quality of professional 1 20 practice can be judged and which reflect the values and 1 21 priorities of the profession. 1 22 2. A health care worker, who reasonably believes a 1 23 particular practice the health care worker has observed 1 24 occurring at the health care worker's place of employment or 1 25 at the health care entity where the health care worker is 1 26 rendering health care services, based on the health care 1 27 worker's professional standards of care, professional code of 1 28 ethics, or established guidelines for certified individuals 1 29 and direct care workers, is a material violation of health and 1 30 safety laws or a breach of public safety that has caused 1 31 serious harm to or creates a significant probability of 1 32 serious harm to patients or health care recipients, may report 1 33 the information relating to the violation or breach within 1 34 fourteen calendar days of its occurrence to the health care 1 35 worker's supervisor, employer, or member of management or 2 1 administration, in order that investigation can be undertaken 2 2 and, if appropriate, corrective action be initiated. The 2 3 report shall be made in writing according to the business 2 4 operational procedures of the health care entity as outlined 2 5 in the personnel manual or other similar business arrangement 2 6 document applicable to employees of the health care entity. 2 7 The health care worker shall be protected against reprisals or 2 8 retaliatory or punitive action by the individual or 2 9 institution receiving such a report. The health care entity 2 10 shall respond, in writing, to the health care worker within 2 11 fourteen calendar days of receipt of the report outlining any 2 12 investigation or corrective action initiated by the health 2 13 care entity. 2 14 3. If after fourteen calendar days following the written 2 15 report of a material violation or breach made by the health 2 16 care worker pursuant to subsection 2, the health care worker 2 17 continues to see the particular practice occurring in the 2 18 workplace giving rise to the written report, the health care 2 19 worker may report information to the appropriate licensing 2 20 board, the department, the department of inspections and 2 21 appeals, the department of human services, the Iowa healthcare 2 22 collaborative, the division of insurance in the department of 2 23 commerce, a member or employee of the general assembly, the 2 24 attorney general, a state=mandated health information 2 25 collection agency, any other public official or law 2 26 enforcement agency, federal government agency or program, the 2 27 governing board of the health care worker's employer or 2 28 institution, or the health care worker's professional 2 29 association, and shall be protected against reprisals or 2 30 retaliatory or punitive actions by the individual or employing 2 31 health care entity if disclosure of the information is not 2 32 otherwise prohibited by statute and if the information meets 2 33 any of the following requirements: 2 34 a. Constitutes state=mandated health data required to be 2 35 submitted to state agencies. 3 1 b. Informs state agencies or entities of violations of 3 2 state health, safety, occupational health, licensure, or 3 3 insurance laws. 3 4 c. Is reasonably believed by the health care worker to be 3 5 a material violation of health and safety laws or a breach of 3 6 public safety that has caused serious harm to or creates a 3 7 significant probability of serious harm to patients or health 3 8 care recipients, based upon the health care worker's 3 9 professional standards of care, professional code of ethics, 3 10 or established guidelines for certified individuals and direct 3 11 care workers. 3 12 A health care worker making a disclosure which violates any 3 13 provision of the federal Health Insurance Portability and 3 14 Accountability Act, Pub. L. No. 104=191, shall not be entitled 3 15 to protection pursuant to this section nor entitled to civil 3 16 remedies which might otherwise be available pursuant to 3 17 subsection 6 or 7. 3 18 4. A health care worker who, in good faith, makes a 3 19 written report of a material violation or breach pursuant to 3 20 subsection 2 or reports information described in subsection 3 3 21 shall be presumed to have established a prima facie case 3 22 showing a violation of subsection 2 or 3 by the health care 3 23 worker's employer if the individual or institution employing 3 24 the health care worker knows or has reason to know of the 3 25 disclosure, and if subsequent to the disclosure, one or more 3 26 of the following actions were initiated by the employer: 3 27 a. Discharge of the health care worker from employment. 3 28 b. Failure by the employer to take action regarding a 3 29 health care worker's appointment to, promotion or proposed 3 30 promotion to, or receipt of any advantage or benefit in the 3 31 health care worker's position of employment. 3 32 c. Any adverse change to the health care worker's terms or 3 33 conditions of employment or any administrative, civil, or 3 34 criminal action or other effort that diminished the 3 35 professional competence, reputation, stature, or marketability 4 1 of the health care worker. 4 2 An employer shall have the burden of proof regarding any 4 3 attempt to show that actions taken pursuant to this subsection 4 4 were for a legitimate business purpose or were required by law 4 5 or administrative rule, which if proven is a complete defense. 4 6 5. If an individual or institution employing a health care 4 7 worker is determined to have violated state health, safety, or 4 8 occupational health and health licensure laws or regulations, 4 9 or professional standards of care, professional code of 4 10 ethics, or established guidelines for certified individuals 4 11 and direct care workers, after a disclosure pursuant to 4 12 subsection 2 or 3 results in an action as described in 4 13 subsection 4, such a determination shall create a presumption 4 14 of retaliation or reprisal against the health care worker in 4 15 violation of this section. Disclosure of a reasonable belief 4 16 that material violations of health and safety laws or breaches 4 17 of public safety have occurred that have caused or create a 4 18 significant probability of serious harm to patients and health 4 19 care recipients shall immediately trigger the protection 4 20 afforded by this section. 4 21 6. A person who violates this section is subject to a 4 22 civil action as follows: 4 23 a. A person who violates this section is liable to an 4 24 aggrieved health care worker for affirmative relief. 4 25 b. A person or entity who prevails in a civil action based 4 26 on this section is entitled to equitable relief the court 4 27 deems appropriate. 4 28 c. When a person commits, is committing, or proposes to 4 29 commit an act in violation of this section, an injunction may 4 30 be granted through an action in district court to prohibit the 4 31 person from continuing such acts. The action for injunctive 4 32 relief may be brought by an aggrieved health care worker or by 4 33 the county attorney. 4 34 d. A civil action brought pursuant to this subsection 4 35 shall be filed within six months from the date of the alleged 5 1 violation. 5 2 7. a. In addition to any other penalties applicable to a 5 3 person who violates this section, an individual, institution, 5 4 or organization employing a person who violates this section 5 5 shall be subject to a civil penalty in the amount of one 5 6 thousand dollars per violation. 5 7 b. A health care worker found to bring a frivolous, 5 8 malicious, or nuisance cause of action against a health care 5 9 employer under this section shall be subject to a civil 5 10 penalty in the amount of one thousand dollars per violation 5 11 and up to four thousand dollars of reasonable attorney fees. 5 12 8. It is the intent of this section to protect public 5 13 safety and not to protect incompetent or unprofessional health 5 14 care workers. 5 15 EXPLANATION 5 16 This bill creates new Code section 147.97 to provide 5 17 protection for health care workers against retaliation or 5 18 reprisals resulting from the disclosure of certain patient 5 19 safety information. 5 20 The new Code section provides that a health care worker who 5 21 discloses information to a state or federal board, department, 5 22 or agency, including the attorney general and law enforcement 5 23 personnel, as described in the bill, after 14 days have 5 24 transpired following a written report to the employer and 5 25 opportunity to take corrective action has transpired on the 5 26 part of the individual or institution which employs the health 5 27 care worker and which is the subject of the disclosure, shall 5 28 be protected against reprisals or retaliatory or punitive 5 29 actions by the employer if disclosure of the information is 5 30 not otherwise prohibited by statute. The bill requires that 5 31 the health care entity respond to the health care worker 5 32 within 14 days. The bill provides that for this provision to 5 33 apply, the information disclosed must constitute 5 34 state=mandated health data required to be submitted to a state 5 35 agency, or inform a state agency or entity of a violation of 6 1 state health, safety, occupational health, licensure, and 6 2 insurance laws, or is reasonably believed by the health care 6 3 worker to be a violation of health and safety laws or a breach 6 4 of public safety that has caused or creates a significant 6 5 probability of serious harm to patients or health care 6 6 recipients, based upon the health care worker's professional 6 7 standards of care, professional code of ethics, or established 6 8 guidelines for health care workers. The bill provides that 6 9 this provision shall not be applicable to a disclosure which 6 10 constitutes a violation of the federal Health Insurance 6 11 Portability and Accountability Act. 6 12 The new Code section provides that a health care worker 6 13 disclosing in good faith this information shall be presumed to 6 14 have established a prima facie case if the employer knows or 6 15 has reason to know of the disclosure, and if following the 6 16 disclosure the health care worker was discharged from 6 17 employment, or there was a failure by the employer to take 6 18 action regarding a health care worker's appointment or 6 19 promotion, or any adverse change to the health care worker's 6 20 terms or conditions of employment as well as any 6 21 administrative, civil, or criminal action or other effort that 6 22 diminishes the professional competence, reputation, stature, 6 23 or marketability of the health care worker. The bill provides 6 24 that the employer shall have the burden of proof regarding any 6 25 attempt to show that these actions were undertaken for a 6 26 legitimate business purpose. 6 27 The new Code section provides that if an employer is 6 28 determined to have violated state health, safety, or 6 29 occupational health or health licensure laws or regulations, 6 30 or professional standards of care or a professional code of 6 31 ethics, or certain guidelines, after a disclosure by a health 6 32 care worker resulting in an action taken against the worker as 6 33 described in the bill, this creates a presumption of 6 34 retaliation or reprisal. The bill provides that violations of 6 35 health and safety laws or breaches of public safety that have 7 1 caused or create a significant probability of serious harm to 7 2 patients and health care recipients immediately trigger 7 3 protection. 7 4 The new Code section provides that violations may be 7 5 grounds for a civil action. The bill provides that in such an 7 6 action, an employer may be liable to an aggrieved health care 7 7 worker for affirmative relief, and other equitable relief the 7 8 court deems appropriate. The bill also provides for 7 9 injunctive relief. The bill provides that in addition to 7 10 other penalties, an individual, institution, or organization 7 11 employing a person found to be in violation of the bill's 7 12 provisions shall be subject to a civil penalty in the amount 7 13 of $1,000 per violation. In addition, the bill provides that 7 14 a health care worker found to have brought a frivolous claim 7 15 under this new Code section is subject to a civil penalty of 7 16 up to $1,000 per violation and up to $4,000 of reasonable 7 17 attorney fees. 7 18 LSB 2211YH 83 7 19 ec/nh/5
Text: HF306            Text: HF308 Complete Bill History