CONDITIONS OF PARTICIPATION FOR HOME HEALTH AGENCIES.

SEC. 4021. CONDITIONS OF PARTICIPATION FOR HOME HEALTH AGENCIES. (a) Definition of Home Health Agency.— Section 1861(o)(6) of the Social Security Act (42 U.S.C. 1395x(o)(6)) is amended by inserting “the conditions of participation specified in section 1891(a) and” after “meets”. (b) Conditions of Participation.— Title XVIII of such Act is amended by adding at the end the following new section: “conditions of participation for home health agencies; home health quality “Sec. 1891. (a) The conditions of participation that a home health agency is required to meet under this subsection are as follows: “(1) The agency protects and promotes the rights of each individual under its care, including each of the following rights: “(A) The right to be fully informed in advance about the care and treatment to be provided by the agency, to be fully informed in advance of any changes in the care or treatment to be provided by the agency that may affect the individual’s well-being, and (except with respect to an individual adjudged incompetent) to participate in planning care and treatment or changes in care or treatment. “(B) The right to voice grievances with respect to treatment or care that is (or fails to be) furnished without discrimination or reprisal for voicing grievances. “(C) The right to confidentiality of the clinical records described in section 1861(o)(3). “(D) The right to have one’s property treated with respect. “(E) The right to be fully informed orally and in writing (in advance of coming under the care of the agency) of— “(i) all items and services furnished by (or under arrangements with) the agency for which payment may be made under this title, “(ii) the coverage available for such items and services under this title, title XIX, and any other Federal program of which the agency is reasonably aware, “(iii) any charges for items and services not covered under this title and any charges the individual may have to pay with respect to items and services furnished by (or under arrangements with) the agency, and “(iv) any changes in the charges or items and services described in clause (i), (ii), or (iii). “(F) The right to be fully informed in writing (in advance of coming under the care of the agency) of the individual’s rights and obligations under this title. 101 STAT. 1330–68 “(G) The right to be informed of the availability of the State home health agency hotline established under seclution 1864(a). “(2) The agency notifies the State entity responsible for the licensing or certification of the agency of a change in— “(A) the persons with an ownership or control interest (as defined in section 1124(a)(3)) in the agency, “(B) the persons who are officers, directors, agents, or managing employees (as defined in section 1126(b)) of the agency, and “(C) the corporation, association, or other company responsible for the management of the agency. Such notice shall be given at the time of the change and shall include the identity of each new person or company described in the previous sentence. “(3) (A) The agency must not use as a home health aide (on a full-time, temporary, per diem, or other basis), any individual who is not a licensed health care professional (as defined in subparagraph (F)) to provide items or services described in section 1861(m) on or after January 1, 1990, unless the individual— “(i) has completed a training and competency evaluation program, or a competency evaluation program, that meets the minimum standards established by the Secretary under subparagraph (D), and “(ii) is competent to provide such items and services. For purposes of clause (i), an individual is not considered to have completed a training and competency evaluation program, or a competency evaluation program if, since the individual’s most recent completion of such a program, there has been a continuous period of 24 consecutive months during none of which the individual provided items and services described in section 1861(m) for compensation. “(B) (i) The agency must provide, with respect to individuals used as a home health aide by the agency as of July 1, 1989, for a competency evaluation program (as described in subparagraph (A)(i)) and such preparation as may be necessary for the individual to complete such a program by January 1, 1990. “(ii) The agency must provide such regular performance review and regular in-service education as assures that individuals used to provide items and services described in section 1861(m) are competent to provide those items and services. “(C) The agency must not permit an individual, other than in a training and competency evaluation program that meets the minimum standards established by the Secretary under subparagraph (D), to provide items or services of a type for which the individual has not demonstrated competency. “(D) (i) The Secretary shall establish minimum standards for the programs described in subparagraph (A) by not later than October 1, 1988. “(ii) Such standards shall include the content of the curriculum, minimum hours of training, qualification of instructors, and procedures for determination of competency. “(iii) Such standards may permit approval of programs offered by or in home health agencies, as well as outside agencies (including employee organizations), and of programs in effect on the date of the enactment of this section; except that they may101 STAT. 1330–69 not provide for the approval of a program offered by or in a home health agency which has been determined to be out of compliance with the requirements specified in or pursuant to section 1861(o) or subsection (a) within the previous 2 years, “(iv) Such standards shall permit a determination that an individual who has completed (before July 1, 1989) a training and competency evaluation program or a competency evaluation program shall be deemed for purposes of subparagraph (A) to have completed a program that is approved by the Secretary under the standards established under this subparagraph if the Secretary determines that, at the time the program was offered, the program met such standards. “(E) In this paragraph, the term ‘home health aide’ means any individual who provides the items and services described in section 1861(m), but does not include an individual— “(i) who is a licensed health professional (as defined in subparagraph (F)), or “(ii) who volunteers to provide such services without monetary compensation. “(F) In this paragraph, the term ‘licensed health professional’ means a physician, physician assistant, nurse practitioner, physical, speech, or occupational therapist, registered professional nurse, licensed practical nurse, or licensed or certified social worker. “(4) With respect to durable medical equipment furnished to individuals for whom the agency provides items and services, suppliers of such equipment do not use (on a full-time, temporary, per diem, or other basis) any individual who does not meet minimum training standards (established by the Secretary by October 1, 1988) for the demonstration and use of any such equipment furnished to individuals with respect to whom payments may be made under this title. “(5) The agency includes an individual’s plan of care required under section 186l(m) as part of the clinical records described in section 1861(o)(3). “(6) The agency operates and provides services in compliance with all applicable Federal, State, and local laws and regulations (including the requirements of section 1124) and with accepted professional standards and principles which apply to professionals providing items and services in such an agency. “(b) It is the duty and responsibility of the Secretary to assure that the conditions of participation and requirements specified in or pursuant to section 1861(o) and subsection (a) of this section and the enforcement of such conditions and requirements are adequate to protect the health and safety of individuals under the care of a home health agency and to promote the effective and efficient use of public moneys.”. (c) Effective Date.— Except as otherwise provided, the amendments made by subsections (a) and (b) shall apply to home health agencies as of the first day of the 18th calendar month that begins after the date of the enactment of this Act.