SB 86-14_ Filed 04/13/2009, 10:41 Thompson
PREVAILED Roll Call No. _______
FAILED Ayes _______
WITHDRAWN Noes _______
RULED OUT OF ORDER
HOUSE MOTION ____
I move that Engrossed Senate Bill 86 be amended to read as follows:
Delete the title and insert the following:
A BILL FOR AN ACT to amend the Indiana Code concerning
health and professions and occupations.
SOURCE: Page 1, line 1; (09)MO008622.1. -->
Page 1, between the enacting clause and line 1, begin a new
paragraph and insert:
SOURCE: IC 16-18-2-84; (09)MO008622.1. -->
"SECTION 1. IC 16-18-2-84 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2009]: Sec. 84. "Council" refers to
(1) For purposes of IC 16-21, the hospital council.
(2) For purposes of IC 16-25 and IC 16-27, the home health care
services and hospice services council.
(3) For purposes of IC 16-25.5, the dialysis facility council.
(3) (4) For purposes of IC 16-28 and IC 16-29, the Indiana health
(4) (5) For purposes of IC 16-46-6, the interagency state council
on black and minority health.
SOURCE: IC 16-18-2-94.5; (09)MO008622.2. -->
SECTION 2. IC 16-18-2-94.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2009]: Sec. 94.5. "Dialysis facility", for
purposes of IC 16-25.5, means an entity that provides therapeutic
or rehabilitative dialysis services required for the care of
individuals with renal disease.".
Page 3, between lines 38 and 39, begin a new paragraph and insert:
SOURCE: IC 16-25.5; (09)MO008622.4. -->
"SECTION 4. IC 16-25.5 IS ADDED TO THE INDIANA CODE
AS A NEW ARTICLE TO READ AS FOLLOWS [EFFECTIVE JULY
ARTICLE 25.5. DIALYSIS FACILITIES
Chapter 1. Dialysis Facility Council
Sec. 1. (a) The dialysis facility council is established. The state
department shall staff the council.
(b) The council consists of nine (9) members appointed by the
governor as follows:
(1) Two (2) physicians, each of whom is:
(A) licensed under IC 25-22.5; and
(i) a qualified nephrologist; or
(ii) experienced in the care of patients with renal disease.
(2) One (1) registered nurse licensed under IC 25-23 and
experienced in the care of patients with renal disease.
(3) Two (2) individuals engaged in the administration of
facilities that provide dialysis services.
(4) One (1) individual engaged in hospital administration.
(5) The state health commissioner or the commissioner's
(6) One (1) representative of a statewide organization or
association that assists kidney patients.
(7) One (1) individual who is not associated with a hospital or
facility that provides dialysis, except as a consumer.
Sec. 2. (a) An appointment to the council is for four (4) years,
beginning July 1 of the year of appointment. However, in the case
of a vacancy, the appointee shall serve the remainder of the
unexpired term. A vacancy shall be filled from the group
represented by the outgoing member.
(b) The governor shall appoint a chairperson from the members
of the council.
Sec. 3. A member of the council who is not a state employee is
entitled to the minimum salary per diem provided by
IC 4-10-11-2.1(b). A member is entitled to reimbursement for
traveling expenses provided under IC 4-13-1-4 and other expenses
actually incurred in connection with the member's duties, as
provided in the state policies and procedures established by the
Indiana department of administration and approved by the budget
Sec. 4. (a) The first meeting of the council shall be called by the
chairperson and held not later than thirty (30) days after the
appointment of the members of the council. The council shall meet
at least two (2) times each calendar year on dates fixed by the
(b) Special meetings of the council shall be called by the
chairperson at the request of any three (3) members of the council.
(c) Five (5) members constitute a quorum for the transaction of
Sec. 5. In the first meeting of the council and in the first annual
meeting during each subsequent year, the council shall elect from
the members a secretary who shall keep a record of all meetings.
The term of secretary is one (1) year.
Sec. 6. At the request of the council, the state department may
obtain the services of experts or other persons to assist the council
in the formulation of policy or in conducting the council's business.
Sec. 7. (a) Except as provided in subsection (b), the council shall
propose and the executive board may adopt rules under IC 4-22-2
necessary to protect the health, safety, rights, and welfare of
patients, including the following:
(1) Rules pertaining to the licensure, operation, and
management of a dialysis facility.
(2) Rules establishing standards for equipment, facilities, and
staffing required for efficient and quality care of patients of
a dialysis facility.
(b) The state department may request the council to propose a
new rule or an amendment to an existing rule necessary to protect
the health, safety, rights, and welfare of patients of a dialysis
facility. If the council does not propose a rule within ninety (90)
days of the state department's request, the state department may
propose the department's own rule.
(c) The state department shall consider the rules proposed by
the council and may adopt, modify, remand, or reject specific rules
or parts of rules proposed by the council.
Sec. 8. (a) The executive board may, upon recommendation by
the state health commissioner and for good cause, waive a rule
adopted under this chapter.
(b) Disapproval of a waiver request requires executive board
(c) A waiver may not adversely affect the health, safety, rights,
or welfare of the patients.
Sec. 9. If a dialysis facility is part of a hospital, IC 16-21 applies.
Sec. 10. (a) Licensure inspections of a dialysis facility shall be
made regularly in accordance with rules adopted under this
chapter. The state department shall make all health and sanitation
inspections, including inspections in response to an alleged breach
of this chapter or rules adopted under this chapter. The division of
fire and building safety shall make all fire safety inspections. The
council may provide for other inspections necessary to implement
(b) An employee of the state department who knowingly or
intentionally informs a dialysis facility of the exact date of an
unannounced inspection shall be suspended without pay for five (5)
days for a first offense and shall be dismissed for a subsequent
(c) Reports of all inspections must be in writing and sent to the
inspected dialysis facility.
(d) The report of an inspection and records relating to the
inspection may not be released to the public until the conditions set
forth in IC 16-19-3-25 are satisfied.
Sec. 11. (a) The state department shall prepare an annual report
concerning dialysis facilities. The report must provide a consumer
with information concerning dialysis facilities in Indiana and
include the following:
(1) The location of each licensed dialysis facility and the
services provided at the facility.
(2) The inspection results of each dialysis facility.
(3) Any remedial or licensure action taken against a dialysis
(4) Any other information the state department believes
would assist a consumer.
(b) The state department shall post the report required in
subsection (a) on the state department's Internet web site and
provide a written copy of the report to an individual upon request.
Chapter 2. Licensure of Dialysis Facilities
Sec. 1. (a) The state department shall license and regulate
(b) A dialysis facility must be licensed by the state department
in order to operate in the state.
Sec. 2. The council may determine if a dialysis facility is covered
by this chapter. A decision of the council under this section is
subject to review under IC 4-21.5.
Sec. 3. The state department shall administer this chapter with
the advice of the council.
Sec. 4. (a) An applicant for a license under this chapter must
submit an application for a license on a form prescribed by the
state department showing that:
(1) the applicant is of reputable and responsible character;
(2) the applicant is able to comply with the minimum
standards for a dialysis facility and with rules adopted under
(b) The submitted application must contain the following
(1) The name of the applicant.
(2) The location of the dialysis facility.
(3) The name of the person to be in charge of the dialysis
(4) Other information required by the state department.
Sec. 5. An application for a license under this chapter must be
accompanied by a licensing fee at a rate adopted by the council
under IC 4-22-2.
Sec. 6. The state health commissioner may:
(1) issue a license upon receipt of the application without
further evidence; or
(2) request additional information concerning the application
and conduct an investigation to determine whether a license
should be granted.
Sec. 7. A license issued under this chapter:
(1) expires one (1) year after the date of issuance;
(2) is not assignable or transferable;
(3) is issued only for the premises named on the application;
(4) must be posted in a conspicuous place in the dialysis
facility for which the license was issued; and
(5) may be renewed each year upon the payment of a renewal
fee at the renewal rate adopted by the council under
Sec. 8. A dialysis facility that provides to a patient notice
concerning a third party billing for a service provided to the
patient shall ensure that the notice:
(1) conspicuously states that the notice is not a bill;
(2) does not include a tear-off portion; and
(3) is not accompanied by a return mailing envelope.
Chapter 3. Remedies for Violations
Sec. 1. The state health commissioner may take any of the
following actions on any of the grounds listed in section 2 of this
(1) Issue a letter of correction.
(2) Issue a probationary license.
(3) Conduct a resurvey.
(4) Deny renewal of a license.
(5) Revoke a license.
(6) Impose a civil penalty in an amount not to exceed ten
thousand dollars ($10,000).
Sec. 2. The state health commissioner may take action under
section 1 of this chapter on any of the following grounds:
(1) Violation of any of the provisions of this article or the
rules adopted under this article.
(2) Permitting, aiding, or abetting the commission of an illegal
act in a dialysis facility.
(3) Knowingly collecting or attempting to collect from a
subscriber (as defined in IC 27-13-1-32) or an enrollee (as
defined in IC 27-13-1-12) of a health maintenance
organization (as defined in IC 27-13-1-19) any amounts that
are owed by the health maintenance organization.
(4) Conduct or practice found by the council to be detrimental
to the health, safety, rights, and welfare of the patients of a
Sec. 3. (a) IC 4-21.5 applies to an action under this chapter.
(b) A licensee or an applicant for a license aggrieved by an
action under this article may request review under IC 4-21.5.
Sec. 4. The state department shall investigate a report of an
unlicensed dialysis facility and report the findings to the attorney
general. The attorney general may seek any of the following:
(1) An injunction in a court with jurisdiction in the county in
which the unlicensed dialysis facility is located or in the
circuit or superior court of Marion County.
(2) Relief under IC 4-21.5, including a civil penalty not to
exceed an amount of twenty-five thousand dollars ($25,000)
for each day of unlicensed operation.
(3) Criminal penalties as provided in section 5 of this chapter.
Sec. 5. A person who knowingly or intentionally:
(1) operates a dialysis facility that is required to be licensed
under this article that is not licensed under this article; or
(2) advertises the operation of a dialysis facility that is
required to be licensed under this article and that is not
licensed under this article;
commits a Class A misdemeanor.
SOURCE: Page 33, line 6; (09)MO008622.33. -->
Page 33, after line 6, begin a new paragraph and insert:
SOURCE: ; (09)MO008622.36. -->
"SECTION 36. [EFFECTIVE UPON PASSAGE] (a) As used in
this SECTION, "council" refers to the dialysis facility council
established by IC 16-25.5-1-1(a), as added by this act.
(b) The governor shall make the initial appointments to the
council not later than July 1, 2009. In making the initial
appointment, the governor shall indicate the length of the term for
which the individual is appointed.
(c) Notwithstanding IC 16-25.5-1-2, as added by this act, the
initial terms of the members of the council, except for the state
health commissioner appointed under IC 16-25.5-1-1(b)(5), shall be
staggered as follows:
(1) Two (2) members of the council appointed for a term of
two (2) years.
(2) Three (3) members of the council appointed for a term of
three (3) years.
(3) Three (3) members of the council appointed for a term of
four (4) years.
(d) The initial term for council members begins July 1, 2009.
(e) This SECTION expires December 31, 2013.
SOURCE: ; (09)MO008622.37. -->
SECTION 37. [EFFECTIVE UPON PASSAGE] (a) If the state
department of health grants an exemption to a person that is
required to be licensed, or that meets the definition of a person
(1) IC 16-21-2-2(4); or
(2) IC 16-25.5, as added by this act;
from a physical plant standard requirement under the person's
licensure, the state department may not grant the exemption for a
period ending later than December 31, 2011, and the person must
meet the physical plant standards required for the person's
licensure not later than January 1, 2013.
(b) This SECTION expires December 31, 2013.
SOURCE: ; (09)MO008622.38. -->
SECTION 38. An emergency is declared for this act.".
Renumber all SECTIONS consecutively.
(Reference is to ESB 86 as printed April 10, 2009.)
MO008622/DI 14 2009