Bill Text: MI SB1596 | 2009-2010 | 95th Legislature | Introduced
Bill Title: Health; home health care; in-home services agencies; require to be licensed. Amends secs. 20106, 20108, 20115 & 20142 of 1978 PA 368 (MCL 333.20106 et seq.) & adds pt. 218.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2010-12-29 - Referred To Committee On Economic Development And Regulatory Reform [SB1596 Detail]
Download: Michigan-2009-SB1596-Introduced.html
SENATE BILL No. 1596
December 29, 2010, Introduced by Senators JANSEN and KAHN and referred to the Committee on Economic Development and Regulatory Reform.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 20106, 20108, 20115, and 20142 (MCL 333.20106,
333.20108, 333.20115, and 333.20142), section 20106 as amended by
2000 PA 253, section 20108 as amended by 1990 PA 179, and section
20115 as amended by 1999 PA 206, and by adding part 218.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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) An in-home services 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 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.
(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.
(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.
(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. 20108. (1) "In-home services agency" means that term as
defined in section 21809.
(2)
(1) "Intermediate care facility" means a
hospital long-
term care unit, nursing home, county medical care facility, or
other nursing care facility, or distinct part thereof, certified by
the department to provide intermediate care or basic care that is
less than skilled nursing care but more than room and board.
(3) (2)
"License" means an authorization,
annual or as
otherwise specified, granted by the department and evidenced by a
certificate of licensure or permit granting permission to a person
to establish or maintain and operate, or both, a health facility or
agency. For purposes of part 209, "license" includes a license
issued to an individual under that part.
(4) (3)
"Licensee" means the
holder of a license or permit to
establish or maintain and operate, or both, a health facility or
agency. For purposes of part 209, "licensee" includes an individual
licensed under that part.
(5) (4)
"Limited license" means a
provisional license or
temporary permit or a license otherwise limited as prescribed by
the department.
(6) (5)
"Medically
contraindicated" means, with reference to
nursing homes only, having a substantial adverse effect on the
patient's physical health, as determined by the attending
physician, which effect is explicitly stated in writing with the
reasons
therefor for that effect in the patient's medical record.
(7) (6)
"Medical first response
service" means that term as
defined in section 20906.
(8) (7)
"Nontransport prehospital life
support operation"
means that term as defined in section 20908.
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),
20108(1) or (2), 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, "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. 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
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 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 who have an ownership interest in a business which
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, or the person'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 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.
PART 218. IN-HOME SERVICES AGENCIES
Sec. 21801. (1) For purposes of this part, the words and
phrases defined in sections 21803 to 21815 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) "Administrator" means an individual
responsible for managing the operation of an in-home services
agency.
(2) "Board" means the Michigan board of in-home services
agency licensing created in section 21833.
Sec. 21805. (1) "Director of clinical services" means an
individual responsible for nursing, therapy, nutritional, social,
and related services that support the plan of care provided by an
in-home services agency.
(2) "Family" means individuals who are important to, and
designated by, the patient or client and who need not be relatives.
Sec. 21807. (1) "Home health agency-certified" means an
enrolled medicare provider organization or part of that
organization staffed and equipped to provide skilled nursing and at
least 1 therapeutic service, including physical therapy,
occupational therapy, or speech therapy, either directly or through
a contract arrangement to patients or clients in their places of
temporary or permanent residence. A home health agency-certified
may also provide other health-related services including social
work, nutritional support, or home health aides to protect and
maintain patients or clients in their places of residence.
(2) "Home health aide services" means services provided by a
home health agency-certified or private duty home care agency and,
if required by a rule or under a contract, provided under the
supervision of a registered nurse, physical therapist, occupational
therapist, speech therapist, or respiratory therapist who is
employed by or under contract to the home health agency-certified
or private duty home care agency. Home health aide services include
ambulation and exercise, assistance with self-administered
medications, reporting changes in a patient's or client's condition
and needs, completing appropriate records, and personal care or
homemaker services.
(3) "Home health services" means services that include, but
are not limited to, nursing services, home health aide services,
physical therapy services, occupational therapy services, speech
therapy services, respiratory therapy services, nutritional
services, medical social services, and home medical supplies or
equipment services.
Sec. 21809. (1) "Home medical equipment supplier" means an
organization that furnishes durable medical equipment, prosthetics,
and orthotics supplies and services, either directly or through a
contractual arrangement, to patients or clients in their places of
residence. To be licensed under this part, a home medical equipment
supplier shall comply with standards specified in the general
licensure regulations, including, but not limited to, compliance
with centers for medicare and medicaid supplier quality standards
governing the safety of home medical equipment services supplier
facilities, the safety and quality of home medical equipment, and
the safety, quality, and effectiveness of home medical equipment
service procedures; and shall maintain a physical facility and
medical equipment inventory.
(2) "Home medical supplies or equipment services" means
diagnostic, treatment, and monitoring equipment and supplies
provided for the direct care of patients or clients. Home medical
supplies or equipment services include, but are not limited to, the
delivery, installation, maintenance, replacement of, or instruction
in the use of medical equipment and related supplies used by a
patient or client.
(3) "In-home services agency" means an organization that is
required under this part to be licensed to administer or provide
home health services or private duty home care services directly or
through a contractual arrangement to patients or clients.
Sec. 21811. (1) "Organization" means any individual, business,
firm, partnership, corporation, company, association, joint stock
association, or a public or private agency or entity, or the legal
successor of any of these, that employs or contracts with 2 or more
individuals to provide home health services.
(2) "Plan of care" means a written document based on an
assessment of a patient's or client's needs that identifies home
health services necessary to meet those needs.
Sec. 21813. (1) "Private duty home care agency" means a non-
medicare-certified organization that employs, trains, supervises,
maintains liability for, arranges for, and schedules employees to
provide supports or services, or both, to a patient or client in
his or her place of residence or other environment for which the
organization receives a fee, consideration, or compensation of any
kind. A private duty home care agency may provide nonmedical or
medical services, or both, and does not include a hospice, home
health agency-certified, or volunteer provider.
(2) "Private duty home care medical services" means non-
medicare-certified skilled services ordered by a physician,
including nursing, occupational therapy, physical therapy, speech
therapy, respiratory therapy, or social work and home health aide
services.
(3) "Private duty home care nonmedical services" means
supports and services that include, but are not limited to,
assistance with activities of daily living; personal care such as
assistance with dressing, feeding, transferring, and personal
hygiene to facilitate self-care; homemaker assistance with
household tasks including housekeeping, shopping, meal planning and
preparation, and transportation; respite care assistance;
medication reminders; and support provided to family.
(4) "Private duty home care services" means medical and
nonmedical services and other assistance provided to patients or
clients in their places of residence or other environment.
Sec. 21815. (1) "Quality improvement" means reviewing and
evaluating appropriateness and effectiveness of home health
services provided under this part.
(2) "Survey" means a visit for the purposes of survey,
evaluation, and consultation conducted by the department or other
person under section 20155 to evaluate and monitor an in-home
services agency's compliance with this article.
Sec. 21821. (1) Beginning July 1, 2011, a person shall not
advertise, operate, manage, conduct, open, or maintain an in-home
services agency without a license under this part. Beginning July
1, 2011, this part applies to a nursing home, hospital, or other
organization that functions as a home health agency-certified,
private duty home care agency, or home medical equipment supplier.
(2) Except as otherwise provided in this subsection, a person
shall not use any of the following titles, words, or phrases:
(a) "Home health agency-certified", "visiting nurse", or "home
health services", in its corporate or business name, or advertise
using those titles, words, or phrases unless licensed to provide
those services under this part.
(b) "Private duty home care agency", "private duty home care
services", or "private duty home care" in its corporate or business
name, or advertise using those titles, words, or phrases unless
licensed to provide those services under this part.
(c) "Home medical equipment supplier", "home medical supplies
or equipment services", or "durable medical equipment, prosthetics,
orthotics, and supplies" in its corporate or business name, or
advertise using those titles, words, or phrases unless licensed to
provide those services under this part.
(d) "In-home services agency", "in-home services", or any
similar titles, words, or phrases to indicate that a person is a
home health agency-certified, private duty home care agency, or
home medical equipment supplier in its corporate or business name,
or advertise using those titles, words, or phrases unless licensed
to provide those services under this part.
(3) Beginning July 1, 2011, an in-home services 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 an in-
home services agency based on a criminal history check conducted
under this section may appeal as provided in section 20173b.
Sec. 21823. The following are not subject to regulation for
the purposes of this part:
(a) Family providing home health services or hospice care.
(b) An organization that provides only meal services to a
patient or client in his or her place of permanent or temporary
residence.
(c) An individual providing private duty home care services
through a direct agreement with a patient or client in his or her
place of permanent or temporary residence.
(d) An organization that provides services through a contract
with a licensed agency as long as the contract establishes that it
is the licensed agency that holds overall responsibility for
patient or client services.
(e) An employee or volunteer of a licensed agency who provides
home health services only as an employee or volunteer.
(f) Except as otherwise provided in this part, facilities and
institutions that are licensed under this or any other state law,
including, but not limited to, nursing homes, hospitals, adult
foster care facilities, psychiatric facilities or intermediate care
facilities for people with mental retardation, or other licensed
facilities and institutions.
(g) An individual providing care to patients or clients
through a contract with the department of human services.
(h) Nursing homes, hospitals, or other institutions, agencies,
organizations, or persons that contract with licensed home health
agency-certified, private duty home care agency, or home medical
equipment supplier for the delivery of services.
(i) In-home assessments of patients or clients that do not
result in regular ongoing care of that patient or client in his or
her place of residence.
(j) Services conducted by and for the adherents of a church or
religious denomination that rely upon spiritual means alone through
prayer for healing in accordance with the tenets and practices of
such church or religious denomination and the bona fide religious
beliefs genuinely held by such adherents.
(k) A medicare-approved dialysis center operating a medicare-
approved home dialysis program.
(l) A person providing case management services. For the
purposes of this subdivision, "case management" means the
assessment, coordination, authorization, planning, training, and
monitoring of home health and home care and does not include the
direct provision of care to a patient or client.
(m) A person who provides home care services without
compensation.
Sec. 21825. (1) In addition to any other requirement for
application for licensure under part 201, an applicant for an in-
home services agency license shall do all of the following:
(a) Demonstrate ability to comply with this part and the rules
promulgated under this part.
(b) Cooperate with any on-site survey.
(c) Provide evidence of and maintain professional liability,
public liability, and property damage insurance in an amount
established by the department, based on industry standards.
(d) File with the department a list of the home health
services, private duty home care services, and home medical
supplies or equipment services provided directly and under
contract.
(e) Pay to the department the license fee required under
section 21829.
(2) Notwithstanding sections 20142 and 20164, a license under
this part is transferable due to change in ownership if approved by
the department. A licensee shall submit an application for a
transfer due to change in ownership not less than 30 days before
the transfer is scheduled to occur. Subject to section 21829, the
department shall charge a reasonable fee for processing an
application for a transfer due to change in ownership. The
department shall establish a transfer approval process to ensure
that applicants for transfer due to change in ownership of an
existing licensed in-home services agency satisfy the intent and
requirements of this article.
Sec. 21827. (1) Notwithstanding any other provisions of this
act to the contrary, an in-home services agency that is certified
by the federal medicare program, or accredited by an accreditation
organization recognized and utilized by the federal medicare
program for purpose of granting eligibility for enrolled medicare
providers, including, but not limited to, the community health
accreditation program, the joint commission, or the accreditation
commission for healthcare, is not subject to a licensure survey
under this part if all of the following requirements are met:
(a) The department determines that the applicable standards of
the certification or accreditation program are substantially
equivalent to those required by this article for a survey.
(b) An on-site survey has been conducted for the purposes of
certification or accreditation during the previous 36 months or as
extended by the certifying or accrediting entity.
(c) The department receives directly from the certifying or
accrediting entity or from the applicant copies of the initial and
subsequent survey reports and other relevant reports or findings
that indicate compliance with the requirements of this part.
(2) Notwithstanding subsection (1), the department retains
authority to conduct a survey of service areas not addressed by the
national certifying or accrediting entity.
(3) The department shall review the survey standards of the
entities identified in this section for substantial equivalency to
those set forth in this article. In the event that the department
determines at any time that the survey standards are not
substantially equivalent to those required by this article, the
department shall notify the affected licensees that they are
subject to a survey under this part. The notification shall contain
a detailed description of the deficiencies in the alternative
survey process, as well as an explanation of the risk to patients
or clients.
(4) The department may perform a validation survey on in-home
services agencies that previously received a survey through
certification or accreditation under this section. The department
may perform a validation survey on no greater than 10% of each type
of certification or accreditation survey.
(5) This section does not affect the department's enforcement
authority for in-home services agencies under this part.
Sec. 21829. (1) An application for a license or license
renewal shall be accompanied by a fee, not to exceed $500.00 per
year, as established by the department. The department shall
promulgate rules to adopt a schedule of fees required under this
part. The department shall establish various fees based on a
sliding scale using such factors as the number of agency full-time
equivalents, geographic area served, number of locations, or type
and volume of home health services provided. For agencies receiving
a licensure survey that requires more than 2 on-site surveys by the
department per licensure period, an additional fee as determined by
the department under this subsection shall be charged for each
additional on-site survey. The department may set different fees
for each licensure category. Agencies receiving a license without
an on-site survey by the department under this part shall pay the
same license fee as other in-home services agencies in their
licensure category. A fee for a transfer due to a change in
ownership shall not exceed 50% of the base licensure fee.
(2) Subject to subsection (1), the department may establish a
late fee for failure to apply for licensure, transfer, or renewal
as required by this part.
Sec. 21831. (1) Upon receipt of an application for a license
and the license fee, the department shall issue a license if the
applicant meets the requirements established under this part. A
license, unless suspended or revoked, is effective for a period of
3 years.
(2) The department shall conduct a survey within each
licensure period and may conduct a licensure survey before or after
a transfer due to change in ownership as provided in section 21825.
Sec. 21833. The Michigan board of in-home services agency
licensing is created within the department and shall consist of 13
voting members appointed by the director. The membership of the
board shall consist of 4 representatives of the home health agency-
certified community; 4 representatives of the private duty home
care agency community; 3 representatives of the home medical
equipment supplier community; and 2 public members. The director
shall solicit candidates from the home health services industry,
including the Michigan home health association, as follows: 4
nominees for the home health agency-certified members of the board
and 3 nominees for the home medical equipment supplier members of
the board. The director shall solicit 2 nominees each from the
Michigan home health association and the Michigan chapter of the
national private duty association for the private duty home care
agency members of the board.
Sec. 21835. The department, in consultation with the board,
shall promulgate rules necessary to implement, administer, and
enforce this part on or before December 31, 2012. In order to
ensure safe and adequate care, the rules shall address, at a
minimum, all of the following:
(a) Maintenance and preservation of all records relating
directly to the care and treatment of patients and clients by
licensees.
(b) Establishment and implementation of a procedure for the
receipt, investigation, and disposition of complaints regarding
home health services provided.
(c) Establishment and implementation of a plan for ongoing
care of patients and clients and preservation of records if the
licensee ceases operations.
(d) Supervision of home health services.
(e) Establishment and implementation of written policies
regarding response to referrals and access to home health services.
(f) Establishment and implementation of written personnel
policies, procedures, and personnel records for paid staff that
provide for prehire screening, including criminal history check and
testing for communicable diseases, minimum qualifications, regular
performance evaluations that include observation in the patient's
or client's place of residence, participation in orientation and
in-service training, and involvement in quality improvement
activities. The department shall not establish experience or other
qualifications for in-home services agency personnel or contractors
beyond that required by state law.
(g) Establishment and implementation of written policies and
procedures for volunteers who have direct access to or provide
direct services to patients or clients and that provide for
criminal history and health screening, orientation, and
supervision.
(h) Establishment and implementation of written policies for
obtaining regular reports on patient or client satisfaction.
(i) Establishment and implementation of a quality improvement
process.
(j) Establishment and implementation of policies related to
the delivery of home health services, including all of the
following:
(i) Plan of care for each patient or client served.
(ii) Periodic review of the plan of care.
(iii) Supervision of care and clinical consultation as
necessary.
(iv) Care consistent with the plan.
(v) Admission, transfer, and discharge from care.
(k) Establishment and implementation of policies related to
in-home services agency implementation and oversight of delegation
of licensed health professionals.
(l) Compliance with all other applicable state and federal
laws.
(m) Establishment of policies to ensure that the in-home
services agency's caregivers are bonded or insured, or both as
applicable, and that the agency is responsible for payment of all
necessary income taxes and liability and worker's disability
compensation insurance.
Sec. 21837. The department shall continue to develop, with
cooperation and input from the state trade associations
representing the home health services industry, including the
Michigan home health association and the Michigan chapter of the
national private duty association, interpretive guidelines that are
specific to each type of home health service and consistent with
this part. The process for such continuing developments shall
provide opportunity for comment from licensees.
Sec. 21839. (1) An in-home services agency shall provide each
patient or client or the patient's or client's designated
representative with a copy of the policy established under section
20201 and this section describing the rights and responsibilities
of patients and clients served by the in-home services agency. If a
conflict exists between a requirement of this section and section
20201, the requirement of this section prevails. The policy shall
include, at a minimum, all of the following:
(a) A listing of the home health services offered by the in-
home services agency and those being provided.
(b) The names of the administrator and the director of
clinical services and the manner in which those individuals may be
contacted.
(c) The job title of the individual supervising the patients'
or clients' care and the manner in which that individual may be
contacted.
(d) The state complaint hotline number and the appropriate
certifying or accrediting entity's hotline number.
(e) That the patient or client or the patient's or client's
designated representative may participate on an ongoing basis in
the development of the plan of care.
(f) That the patient or client or the patient's or client's
designated representative may select any licensee to provide home
health services, subject to the patient's or client's reimbursement
mechanism or other relevant contractual obligations.
(g) That the patient or client will be treated with courtesy,
respect, privacy, and freedom from abuse and discrimination.
(h) That the patient or client will have his or her property
treated with respect.
(i) That the patient or client may request and be provided a
fully itemized billing statement, including the date of each
service and the charge. Licensees providing services through a
managed care plan, medicare, medicaid, or other third-party payer
are not required to provide itemized billing statements unless
there are applicable copayments, coinsurances, or deductibles.
(j) That the patient or client, in compliance with 42 USC
1395cc, will receive information about his or her right to execute
an advance health care directive or durable power of attorney and
designation of patient advocate and the in-home services agency's
responsibility to implement those documents.
(k) That the patient or client will be informed that the in-
home services agency's caregivers have extensive training, that the
agency's caregivers are supervised, that the agency's caregivers
have undergone a criminal history check, and that the agency's
caregivers are tested for tuberculosis and other communicable
diseases.
(l) That the agency ensures that all employment laws are
followed, that the agency's caregivers are bonded or insured, or
both as applicable, and that the agency is responsible for payment
of all necessary income taxes and liability and worker's disability
compensation insurance.
(2) An in-home services agency shall treat patients and
clients in accordance with the policy established under section
20201 and this section. An in-home services agency shall implement
and update its policy as appropriate.
Sec. 21841. In addition to the authority under section 20165
to deny, limit, suspend, or revoke a license under this part or
impose an administrative fine, the department may require a refund
of any amounts billed to, and collected from, the patient or client
or third-party payer in any case in which the department determines
that any of the violations described in section 20165(1) or (2)
have occurred.
Sec. 21843. (1) Notwithstanding section 20155, the department
may at any time conduct a survey of all records and operations of a
licensee in order to determine compliance with this part.
Additionally, the department may conduct in-home visits to observe
care and services to a patient or client. The right to conduct a
survey shall extend to any premises and records of persons who the
department has reason to believe are providing home health services
without a license in violation of this part.
(2) Following a survey under this section, the department
shall proceed in the manner prescribed in part 201 with regard to
notice, right to hearing, and final determination of the matter. If
requested, the licensee shall submit to the department a written
plan of correction within the time frame designated on the notice.
The department shall provide the licensee with written notice of
the acceptance of the written plan of correction, or any changes
necessary in order for the written plan of correction to be
acceptable to the department.
Sec. 21845. Any penalties or remedies provided in this part or
part 201 are independent and cumulative and not exclusive. Neither
the department nor any other person is limited to the penalties and
remedies in this part or part 201. The use of a penalty or remedy
by a person shall not be considered a bar to the use of other
penalties or remedies by that person or to the use of any penalty
or remedy by another person.
Sec. 21847. (1) A person who violates this part by operating
an in-home services agency without a license is guilty of a
misdemeanor. Each day of the violation is considered a separate
violation.
(2) If the person who violates subsection (1) is a
corporation, it may be punished by forfeiture of its corporate
charter and all rights and franchises under that charter.
Sec. 21849. (1) The department may order a person to cease and
desist from engaging in the unlicensed operation of an in-home
services agency. The person ordered to cease and desist is entitled
to a hearing before a hearings examiner if the person files a
written request for a hearing within 20 days after the effective
date of the cease and desist order. The failure to request a
hearing constitutes a default, whereupon the department may enter a
permanent cease and desist order and proceed in the manner
prescribed in section 20165.
(2) Upon a violation of a cease and desist order issued under
subsection (1), the department of attorney general may apply in
circuit court to restrain and enjoin, temporarily or permanently,
an individual from further violating the cease and desist order.
Sec. 21851. A person who violates this part by operating an
in-home services agency without a license is also subject to the
Michigan consumer protection act, 1976 PA 331, MCL 445.901 to
445.922, because the operation of an in-home services agency
without a license in violation of this part is not reasonable in
relation to the development and preservation of business and is an
unfair, unconscionable, or deceptive method, act, or practice in
the conduct of trade or commerce.
Enacting section 1. This amendatory act takes effect July 1,
2011.
