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ARIZONA STATE SENATE
RESEARCH STAFF
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KATHY SEEGLITZ ASSISTANT
ANALYST HEALTH COMMITTEE Telephone: (602) 542-3171 Facsimile: (602) 542-7833 |
HEALTH COMMITTEE
DATE: March 30, 2001
SUBJECT: Strike Everything Amendment to H.B. 2250 –
rural telemedicine; appropriation
Purpose
Requires, beginning January 1, 2002, the Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facilities (Board) to license assisted living referral agencies, administrators and agents.
Background
Elder care referral and placement agencies help families locate assisted living facilities that meet a patient’s needs for long term care and assisted living facility services. Currently, elder care referral and placement agencies are not regulated in Arizona. In 1997, a sunrise hearing was conducted to determine whether adult care referral and placement agencies should be regulated. Although the sunrise committee recommended the introduction of legislation to regulate this industry, legislation has not been adopted.
Federal law prohibits fee splitting and referral fees for health care institutions that receive federal monies, such as nursing care institutions and other licensed facilities in which Arizona long term care system clients reside. However, certain assisted living facilities cannot accept Medicare or Medicaid clients. In addition, Arizona law prohibits referral fees from licensed health care institutions to regulated professionals (doctors, nurses, psychologists, physician assistants, etc.) (A.R.S. §36-407). According to the Arizona Assisted Living Federation, a majority of elder care referral and placement agencies receive a fee from assisted living facilities for placement. These referral fees vary from facility to facility and may range from 50 to 100 percent of the client’s first month’s rent in the assisted living facility.
The strike everything amendment to H.B. 2250 requires the Board to license assisted living facility referral agencies, administrators and agents. Minimum qualifications and continuing education requirements for administrators and agents are established in the amendment. Additionally, assisted living facility referral agencies must disclose their source of payment and, on the client’s request, the amount of the referral fee.
The cost to the Board of regulating referral agencies has not been determined at this time; however, the amendment establishes application and licensure fees, as well as other fees, to offset costs to the Board.
Provisions
Board Duties
1. Requires the Board to:
a. Prescribe, by rule, minimum licensure requirements for referral agencies, administrators and agents.
b. Establish grievance and complaint procedures.
c. Deposit ten percent of collected fees in the state general fund and deposit the remaining amount in the nursing care institution administrators’ licensing and assisted living facility managers’ license fund.
d. Prescribe continuing education requirements.
e. Establish guidelines on fee structures, fee refund policies and client service agreements.
f. Prescribe minimum training requirements and adopt a training program meeting the requirements.
2. Requires, beginning January 1, 2002, the licensure of assisted living referral agencies, administrators and agents.
Licensure Requirements
3. Establishes licensure qualifications for agents, administrators and referral agencies.
4. Requires, beginning June 1, 2002, administrator and agent applicants to submit Board prescribed proof of minimum experience in a health-related field.
5. Requires, for licensure renewal, administrators to complete a minimum of 24 hours of continuing education.
6. Authorizes a licensed administrator to practice as an agent.
7. Requires, for licensure renewal, agents to complete a minimum of 12 hours of continuing education.
8. Requires, beginning January 1, 2002, referral agencies to be licensed and operated by a licensed administrator who provides full-time supervision to the agents.
9. Prohibits a licensed administrator from administering more than one referral agency.
10. Requires a referral agency to provide written notice to the Board at least 30 days prior to any change in ownership or administration.
11. Requires a referral agency to notify a client or client’s representative of the agency’s services, the source of payment and, on request, the amount of the referral fee.
12. Prohibits the following acts:
a. Claiming to be a referral agency, administrator or agent unless licensed.
b. Committing any act of dishonesty, fraud, incompetence or gross negligence in the performance of duties.
c. Violating statutes or rules prescribed by the Board.
d. Referring a client to an unlicensed assisted living facility.
e. Failing to report any situation that endangers the health or safety of a client.
f. Failing to disclose a conflict of interest to a client or the client’s representative.
g. Charging a client more than the published fee.
h. Accepting a fee or incentive from an assisted living facility beyond the contracted fee.
i. Engaging in fee splitting.
j. Providing a client or prospective resident with incentives or payments.
k. Receiving a fee for placing a client in an assisted living facility owned by the licensee.
Investigations and Disciplinary Actions
13. Requires the Board to conduct an investigation if a licensee appears to be in violation of Board rules or this act.
14. Requires the Board to notify the licensee within 30 days of receiving the investigative information.
15. Allows the Board to deny, revoke or suspend a license or impose a civil penalty if a person has violated the Board’s regulations.
16. Requires the Board to hold a hearing to revoke or suspend a license or to impose a civil penalty.
17. Requires, if insufficient evidence exists to support disciplinary action, the Board to issue a letter of concern recommending the licensee modify or eliminate certain practices.
18. Establishes a maximum civil penalty of $1,000 per violation.
19. Allows the Attorney General and the county attorney to bring an action to enforce civil penalties.
Miscellaneous
20. Establishes maximum fees for the Board and specifies fees are nonrefundable.
21. Requires the Board to prorate fees for initial licensure on a monthly basis.
22. Contains definitions.
23. Replaces one Board member who represents professionals concerned with the care and treatment of the chronically ill or infirm elderly patients with an assisted living facility referral agent.
24. Terminates the Board on July 1, 2005.
25. Contains a Proposition 108 clause.
26. Provides for a general effective date, except as noted.
House Action
HEA 1/22/01 DPA 9-0-0-1-0
APPROP 2/20/01 DP 14-0-0-2-0
3rd Read 3/5/01 48-2-10-0
KS/ac