Bill Text: IA HF537 | 2023-2024 | 90th General Assembly | Introduced

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Bill Title: A bill for an act relating to the requirements for authorized electronic monitoring in nursing facilities, and providing penalties.(See HF 2317.)

Spectrum: Partisan Bill (Republican 3-0)

Status: (Introduced - Dead) 2024-02-05 - Committee report approving bill, renumbered as HF 2317. [HF537 Detail]

Download: Iowa-2023-HF537-Introduced.html

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House File 537 - Introduced
HOUSE FILE 537
BY FRY , A. MEYER , and BODEN
A BILL FOR
An Act relating to the requirements for authorized electronic
monitoring in nursing facilities, and providing penalties.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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Section 1. NEW SECTION . 135C.49 Definitions.
As used in this subchapter, unless the context otherwise
requires:
1. “Electronic monitoring” means the placement and use of an
electronic monitoring device by a resident in the resident’s
room in accordance with this subchapter.
2. “Electronic monitoring device” means a video camera that
livestream broadcasts video only that is placed in a resident’s
room and is used to monitor the resident or activities in the
room. “Electronic monitoring device” does not include video
phone calls or video conferencing where a resident either
initiates or joins a call or conference.
3. “Resident” means an individual admitted to a nursing
facility in a manner prescribed in section 135C.23.
4. “Resident representative” means one of the following in
the order of priority listed, to the extent the person may
reasonably be identified and located:
a. The attorney in fact designated to make treatment
decisions for the resident in accordance with chapter 144B.
b. The guardian of the resident if one has been appointed
pursuant to chapter 633.
Sec. 2. NEW SECTION . 135C.50 Electronic monitoring.
1. A resident, or a resident representative when acting
on behalf of a resident, may conduct electronic monitoring
of the resident’s room through the use of an electronic
monitoring device placed in the resident’s room pursuant to
this subchapter.
2. A nursing facility or resident of the nursing facility
shall not engage in electronic monitoring or the use of
electronic monitoring devices in a resident’s room without the
written permission of the nursing facility and the consent of
the resident or resident representative when consenting on
behalf of a resident.
3. Nothing in this section precludes the use of electronic
monitoring otherwise allowed by law.
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Sec. 3. NEW SECTION . 135C.51 Consent to electronic
monitoring.
1. Except as otherwise provided in this subchapter,
a resident must consent to electronic monitoring in the
resident’s room in writing on a notification and consent
form prescribed by the department. If the resident has
not affirmatively objected to electronic monitoring and
the resident’s health care professional determines that the
resident lacks the ability to understand and appreciate the
nature and consequences of electronic monitoring, the resident
representative may consent on behalf of the resident. For
purposes of this subsection, a resident affirmatively objects
when the resident orally, visually, or through the use of
auxiliary aids or services declines electronic monitoring. The
resident’s response shall be documented on the notification and
consent form.
2. Prior to a resident representative consenting on behalf
of a resident, the resident shall be asked if the resident
wants electronic monitoring to be conducted. The resident
representative shall explain all of the following to the
resident:
a. The type of electronic monitoring device to be used.
b. The standard conditions or restrictions that may be
placed on the electronic monitoring device’s use including as
specified in the list of standard conditions or restrictions
contained in the notification and consent form completed by the
resident as provided in section 135C.54.
c. The resident’s ability to decline all electronic
monitoring.
3. A resident, or resident representative when consenting
on behalf of the resident, shall consent to electronic
monitoring with the standard conditions or restrictions
contained in the notification and consent form completed by the
resident as provided in section 135C.54.
4. Prior to implementing electronic monitoring, a resident,
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or resident representative when acting on behalf of the
resident, shall obtain the written consent on the notification
and consent form of any other resident who is a roommate
residing in the shared room. A roommate’s or roommate’s
resident representative’s written consent shall comply with the
requirements of this section.
5. Any resident, or resident representative when acting on
behalf of the resident, conducting electronic monitoring shall
immediately remove or disable an electronic monitoring device
prior to a new resident who will be a roommate moving into a
shared room, unless the resident or resident representative
conducting electronic monitoring obtains the new roommate’s or
new roommate’s resident representative’s written consent as
provided under this section prior to the new roommate moving
into the shared room. Upon obtaining the new roommate’s or new
roommate’s resident representative’s signed notification and
consent form and submitting the form to the nursing facility
as required under section 135C.53, the resident or resident
representative may resume electronic monitoring.
6. The resident or roommate, or the resident representative
or roommate’s resident representative if the representative is
consenting on behalf of the resident or roommate, may withdraw
consent at any time and the withdrawal of consent shall be
documented on the original consent form as provided under
section 135C.53.
Sec. 4. NEW SECTION . 135C.52 Refusal of roommate to
consent.
If a resident of a nursing facility who is residing in a
shared room, or the resident representative of such a resident
when acting on behalf of the resident, wants to conduct
electronic monitoring and another resident living in or moving
into the same shared room refuses to consent to the use of an
electronic monitoring device, the nursing facility shall make
a reasonable attempt to accommodate the resident who wants to
conduct electronic monitoring. A nursing facility has met
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the requirement to make a reasonable attempt to accommodate
a resident or resident representative who wants to conduct
electronic monitoring when, upon notification that a roommate
has not consented to the use of an electronic monitoring device
in the resident’s room, the nursing facility offers to move one
of the residents to another shared room that is available at
the time of the request that accommodates the resident. If
a resident chooses to reside in a private room in order to
accommodate the use of an electronic monitoring device, the
resident shall be subject to a private room rate. If a nursing
facility is unable to accommodate a resident, the nursing
facility shall reevaluate the request periodically until the
request is fulfilled.
Sec. 5. NEW SECTION . 135C.53 Notice and consent form
submitted to nursing facility.
1. Electronic monitoring may begin only after the resident
or resident representative who intends to place an electronic
monitoring device in the resident’s room and any roommate, or
roommate’s resident representative, completes a notification
and consent form and submits the form to the nursing facility.
2. Upon receipt of the required, completed notification and
consent form, the nursing facility shall place the original
form in the resident’s file and a copy of the form in any
roommate’s file. The nursing facility shall provide a copy
to the resident and the resident’s roommate or the resident
representative or roommate’s resident representative, as
applicable.
3. If a resident or roommate, or the resident representative
or roommate’s resident representative if the representative
is consenting on behalf of the resident or roommate, chooses
to withdraw consent to electronic monitoring, the nursing
facility shall make available the original notification and
consent form so that the original form may be updated. Upon
receipt of the updated original form, the nursing facility
shall place the updated original form in the resident’s file.
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The nursing facility shall provide a copy of the updated form
to the resident and the resident’s roommate or to the resident
representative or roommate’s resident representative, as
applicable.
4. If a new roommate, or the new roommate’s resident
representative when consenting on behalf of the new roommate,
does not consent to electronic monitoring and submit a
completed notification and consent form to the nursing
facility, and the resident or resident representative
conducting the electronic monitoring does not remove or disable
an existing electronic monitoring device, the nursing facility
shall provide the resident or the resident representative, as
applicable, a twenty-four-hour notice to remove or disable the
electronic monitoring device. If the device is not removed
or disabled within twenty-four hours of notification to the
resident or resident representative, the nursing facility may
disable or remove the electronic monitoring device.
5. If a roommate, or the roommate’s resident representative
when withdrawing consent on behalf of the roommate, submits an
updated notification and consent form withdrawing consent and
the resident or resident representative conducting electronic
monitoring does not remove or disable the electronic monitoring
device, the nursing facility shall provide the resident or
resident representative a twenty-four-hour notice to remove or
disable the electronic monitoring device. If the device is not
removed or disabled within twenty-four hours of notification to
the resident or resident representative, the nursing facility
may disable or remove the electronic monitoring device.
Sec. 6. NEW SECTION . 135C.54 Notification and consent form
requirements.
1. The notification and consent form completed by the
resident shall include, at a minimum, all of the following
information:
a. The resident’s signed consent to electronic monitoring or
the signature of the resident representative, if applicable.
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If a resident representative signs the consent form, the form
shall document all of the following:
(1) The date the resident was asked if the resident wants
electronic monitoring to be conducted.
(2) Any person present when the resident was asked.
(3) An acknowledgment that the resident did not
affirmatively object.
(4) The source of authority allowing the resident
representative to sign the notification and consent form on the
resident’s behalf, including any court order, as applicable.
b. The resident’s roommate’s signed consent or the signature
of the roommate’s resident representative, if applicable. If a
roommate’s resident representative signs the consent form, the
form shall document all of the following:
(1) The date the roommate was asked if the roommate wants
electronic monitoring to be conducted.
(2) Any person present when the roommate was asked.
(3) An acknowledgment that the roommate did not
affirmatively object.
(4) The source of authority allowing the resident
representative to sign the notification and consent form on the
roommate’s behalf, including any court order, as applicable.
c. The type of electronic monitoring device to be used.
d. Any installation needs, such as mounting a device to a
wall or ceiling, and the costs associated with installation
and use, which are to be paid by the resident or the resident
representative, and the resident’s liability for potential
damage and repairs due to installation.
e. Fourteen days’ notice of the proposed date of
installation for scheduling purposes.
f. A copy of any contract for maintenance of the electronic
monitoring device by a commercial entity.
g. A list of standard conditions or restrictions for the use
of the electronic monitoring device including but not limited
to all of the following:
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(1) Prohibiting audio recording.
(2) Prohibiting video recording.
(3) Turning off the electronic monitoring device or
blocking the visual recording component of the electronic
monitoring device for the duration of an exam or procedure by a
health care professional.
(4) Turning off the electronic monitoring device or
blocking the visual recording component of the electronic
monitoring device while dressing or bathing is performed.
(5) Turning off the electronic monitoring device for
the duration of a visit with a spiritual adviser, ombudsman,
attorney, financial planner, intimate partner, or other
visitor.
(6) Prohibiting drop-in video access.
(7) Requiring visual verification when the electronic
monitoring device is in use.
(8) Requiring conspicuously visible placement of the
electronic monitoring device inside the resident’s room.
(9) Prohibiting that the electronic monitoring device from
being placed outside the resident’s living quarters.
h. A signature box to document if the resident or roommate
withdraws consent.
2. A nursing facility shall make the notification and
consent form available to the residents and inform residents of
the option to conduct electronic monitoring of the resident’s
room.
Sec. 7. NEW SECTION . 135C.55 Cost and installation.
1. A resident who chooses to conduct electronic monitoring
shall do so at the resident’s own expense, including payment
of any purchase, installation, maintenance, removal costs, and
costs for returning the resident’s room to preinstallation
condition.
2. If a resident chooses to place an electronic monitoring
device that uses internet technology for visual monitoring, the
resident shall be responsible for contracting with an internet
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service provider.
3. The nursing facility shall make a reasonable attempt to
accommodate the resident’s installation needs.
4. All electronic monitoring device installations and
supporting services shall comply with all applicable building
codes.
5. A nursing facility shall not charge a resident a fee
for the costs of electricity used by the electronic monitoring
device.
Sec. 8. NEW SECTION . 135C.56 Notice to visitors.
1. If electronic monitoring is being conducted, a nursing
facility shall post a sign at each nursing facility entrance
accessible to visitors that states “Electronic monitoring
devices may be present in the rooms of residents to observe
persons and activities”.
2. A nursing facility shall post a sign clearly and
conspicuously at the entrance to a resident’s room where
electronic monitoring is being conducted. The notice shall
state “This room is electronically monitored”.
3. The nursing facility is responsible for installing and
maintaining the signage required in this section.
Sec. 9. NEW SECTION . 135C.57 Obstruction of electronic
monitoring devices.
A person shall not knowingly hamper, obstruct, tamper
with, or destroy an electronic monitoring device placed in
a resident’s room without the permission of the resident or
resident representative, as applicable.
Sec. 10. NEW SECTION . 135C.58 Immunity from liability ——
license discipline —— inadmissability of recordings.
1. A nursing facility is not civilly or criminally liable
for the disclosure of an unlawful recording captured by an
electronic monitoring device.
2. A nursing facility is not civilly or criminally liable
for a violation of a resident’s right to privacy arising out
of any electronic monitoring conducted in accordance and in
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compliance with this subchapter.
3. The resident and resident representative, as applicable,
are responsible for complying with local, state, and federal
privacy laws and for firewall protections to prevent images
that may violate obscenity laws from being inadvertently shown
on the internet via the electronic monitoring device.
4. A nursing facility that knowingly violates this
subchapter shall be subject to licensee discipline.
5. If a resident fails to comply with the nursing facility
policies and residency agreement relating to the use of an
electronic monitoring device, nursing facility staff may
report the failure to the office of long-term care ombudsman
and law enforcement, as applicable. Continued failure by a
resident to comply with such nursing facility policies and
residency agreement may constitute grounds for termination of a
resident’s residency agreement.
6. Audio or video recordings obtained in violation of this
chapter are inadmissable in a regulatory or other disciplinary
proceeding.
Sec. 11. NEW SECTION . 135C.59 Resident protections.
1. A nursing facility shall not do any of the following:
a. Refuse to admit a potential resident or remove a resident
because the nursing facility disagrees with the potential
resident’s or the resident’s decisions regarding electronic
monitoring, whether the decision is made by a resident or a
resident representative acting on behalf of the resident.
b. Retaliate or discriminate against any resident for
consenting or refusing to consent to electronic monitoring.
c. Prevent the placement or use of an electronic monitoring
device by a resident who has provided the nursing facility
with the notification and consent form as required under this
subchapter.
2. Any contractual provision prohibiting, limiting,
or otherwise modifying the rights and obligations in this
subchapter is contrary to public policy and is void and
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unenforceable.
Sec. 12. NEW SECTION . 135C.60 Report to department.
A nursing facility shall report to the department, in a
manner prescribed by the department, the number of electronic
monitoring device notification and consent forms received by
the nursing facility on an annual basis.
Sec. 13. Section 633.635, subsection 3, Code 2023, is
amended by adding the following new paragraph:
NEW PARAGRAPH . d. Consenting to electronic monitoring
conducted in accordance with chapter 135C.
Sec. 14. DIRECTIVE TO DEPARTMENT OF INSPECTIONS AND
APPEALS. The department of inspections and appeals shall
prescribe by rule pursuant to chapter 17A the notification and
consent form described in this Act, and shall make the form
available on the department’s internet site.
Sec. 15. CODE EDITOR DIRECTIVE. The Code editor may codify
the provisions of this Act as a new subchapter of chapter 135C
entitled “Electronic Monitoring”.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill provides for authorized electronic monitoring in
nursing facilities.
The bill provides that a nursing facility resident or a
resident representative, as applicable, may conduct electronic
monitoring of the resident’s room through the use of electronic
monitoring devices placed in the resident’s room pursuant
to the bill. The bill specifies the consents that must be
obtained for a resident to conduct electronic monitoring in the
resident’s room, including from any roommate; the process to
be followed if a roommate refuses to consent; the provision
of notification to the nursing facility; the notification and
consent form requirements; the responsibility for costs and
installation relating to the electronic monitoring; notice
to visitors; prohibited obstruction of electronic monitoring
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devices; immunity from liability, licensee discipline, and
inadmissability of recordings related to violations of the
bill; resident protections; and reporting requirements. The
bill also directs the department of inspections and appeals
to prescribe the notification and consent form described in
the bill and to make the form available on the department’s
internet site.
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