2022 -- H 8032

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LC005581

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF NURSING SERVICE

AGENCIES

     Introduced By: Representatives Bennett, Casimiro, Potter, Ajello, Handy, Speakman,
Carson, Edwards, Fogarty, and Slater

     Date Introduced: March 23, 2022

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

     SECTION 1. Sections 23-17.7.1-3, 23-17.7.1-10 and 23-17.7.1-11 of the General Laws in

Chapter 23-17.7.1 entitled "Licensing of Nursing Service Agencies" are hereby amended to read

as follows:

     23-17.7.1-3. Licensing of nursing service agencies -- Rules governing establishment of

fees.

     (a) The director may establish reasonable fees for the licensure application, licensure

renewal, and administrative actions under this chapter. Annual licensure fees shall be five hundred

dollars ($500) per licensee.

     (b) The department of health shall promulgate licensure standards, and rules and

regulations governing the operation of nursing service agencies to protect the health and welfare of

patients. These regulations shall include, but not be limited to, employee bonding, maintenance of

service records, and appropriate staff professional registration and certification, licensure training,

supervision, health screening and liability insurance.

     (c) A nursing service agency’s maximum rate for services provided to a client, including,

but not limited to, a health care facility and assisted living residence, by a nurse or nurse aide may

not exceed two hundred percent (200%) of the regional average hourly wage of each position. The

department of health shall use and publish the most current median hourly wage data reported by

the United States Department of Labor Bureau of Labor Statistics (BLS) wage estimates for the

state. The positions subject to the provisions of this subsection shall include registered nurses

(RNs), licensed practical nurses (LPNs), certified nurse assistants (CNAs), medication aides, med

technicians, therapists and therapist aides. The maximum rate shall include all charges for

administrative fees, contract fees, or other special charges in addition to the hourly rates for the

nursing personnel supplied to a client.

     23-17.7.1-10. Regulations, inspections, and investigations.

     (a) The licensing agency shall, after a public hearing pursuant to chapter 35 of title 42, give

notice, adopt, amend, promulgate, and enforce any rules and regulations and standards with respect

to nursing service agencies to be licensed under this chapter that may be designed to further the

accomplishment of the purposes of this chapter in promoting safe and adequate care of individuals

receiving nursing and nursing assistant services, in the interest of public health, safety, and welfare.

All licensed nursing service agencies shall be required to protect clients by insuring that all persons

whom it employs receive training and/or competency evaluation pursuant to the provisions of §§

23-17.9-3 and 23-17.7-11. The licensing agency shall make or cause to be made any inspections

and investigations that it deems necessary including service records. Inspection of records may

include, but are not limited to:

     (1) Records of required health examination which shall be kept confidential, all required

medical records including COVID-19 testing results, and all required vaccinations required by the

department; and

     (2) Personnel file and folder for each employee; which includes documented evidence of

credentials and other appropriate data, including documentation of orientation, and quarterly in-

service education, records of completion of required training and educational programs, medical

records, and criminal background checks.

     (b) The staffing agency shall maintain insurance coverage for workers compensation for

all nurses, med technicians, certified nursing assistants, therapists and therapist aides provided or

procured by the agency.

     23-17.7.1-11. Training and/or competency evaluation program for nursing assistants.

     (a) Every individual who is employed to provide nursing assistant services shall be required

to be registered as required by chapter 17.9 of this title.

     (b) An in-service educational program for direct patient care personnel shall be provided

on an ongoing basis which shall include orientation for new personnel and periodic programs

conducted at a minimum quarterly totaling a minimum of twelve (12) hours of instruction annually

for the continued improvement and development of skills of direct care personnel, including

competency training and department required training based on licensure.

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     SECTION 2. Chapter 23-17.7.1 of the General Laws entitled "Licensing of Nursing

Service Agencies" is hereby amended by adding thereto the following sections:

     23-17.7.1-22. Employment prohibitions.

     (a) No nursing service agency may recruit and/or hire potential employees from a client

which the nursing service agency actively provides nursing personnel services to the client under

contract.

     (b) The nursing service agency shall not, in any contract with any employee of a client,

require the payment of liquidated damages, employment fees or other compensation should the

employee be hired as a permanent employee of a client provider.

     23-17.7.1-23. Annual reporting requirements.

     (a) The agency shall submit an annual statistical report to the department of health. The

report shall include information required by the department pursuant to rules and regulations to

include, but not be limited to:

     (1) Mean, median, and average salaries and hourly pay rates of employees, by employment

type;

     (2) Number of employees currently employed;

     (3) Number of employees terminated during the reporting period;

     (4) Number of employees reported to the office of the attorney general for suspected

violation of law; and

     (5) Number of employees reported to the department for suspected abuse, neglect,

misappropriation, or job abandonment.

     (b) For every person placed for employment, or temporary performance of services by an

employment agency with a health care provider employer, the employment agency shall annually

report:

     (1) The amount charged for each person;

     (2) The amount paid to each person;

     (3) The amount of payment received that is retained by the employment agency; and

     (4) Any other information that the department, in conjunction with the Family and Social

services administration, determines relevant to determine how much health care provider

employers who participate in Medicare and Medicaid are charged by employment agency services.

     (c) Reports under this section shall be submitted by the employment agencies no later than

thirty (30) days after the end of the calendar year.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF NURSING SERVICE

AGENCIES

***

     This act would establish a nursing service agency’s maximum rate of two hundred percent

(200%) of the regional average hourly wage for each position for services provided to a client,

including, but not limited to, a health care facility and assisted living residence, by a nurse or nurse

aide. Additionally, this act would create employment prohibitions which would not allow a nursing

service agency to recruit and /or hire potential employees from a client to which it actively provides

services under contract. Also, this act would create annual reporting requirements for certain

statistics to the department in order for the department to enforce the provisions of this act.

     This act would take effect upon passage.

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