HOUSE FILE 110

BY  ISENHART and HUNTER

A BILL FOR

An Act relating to assisted living programs, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

   Section 1.  Section 231C.2, subsection 2, Code 2011, is amended to read as follows:
   2.  “Assisted living” means provision of housing with services which may include but are not limited to health-related care, personal care, and assistance with instrumental activities of daily living to three or more tenants in a physical structure which provides a homelike environment.
   a.  “Assisted living” also includes encouragement of family involvement, tenant self-direction, and tenant participation in decisions that emphasize choice, dignity, privacy, individuality, shared risk, and independence.
   b.  “Assisted living” includes the provision of housing and assistance with instrumental activities of daily living only if personal care or health-related care is also included.
   c.  “Assisted living” includes twenty-four hours per day response staff to meet scheduled and unscheduled or unpredictable needs in a manner that promotes maximum dignity and independence and provides supervision, safety, and security.
   d.  “Assisted living” includes a physical structure that provides housing to three or more tenants in which tenants receive services as described in paragraph“b” from a service provider contracting with the housing provider or contracting with or employed by the tenant if both of the following conditions are met:
   (1)  The service provider has a direct or indirect corporate affiliation with at least one entity involved in the ownership or operation of the housing.
   (2)  At least fifty percent of the tenants receive at least one service from a service provider described in subparagraph (1).
   Sec. 2.  Section 231C.3, subsection 3, Code 2011, is amended to read as follows:
   3.
  a.  The owner or manager of a certified assisted living program shall comply with the rules adopted by the department for an assisted living program.
   b.  A person including a governmental unit, that meets the definition of assisted living pursuant to section 231C.2 shall be considered an assisted living program whether or not the person represents the person to the public as an assisted living program or as a certified assisted living program, and shall not operate in this state unless and until the assisted living program is certified pursuant to this chapter.
   c.  A person, including a governmental unit shall not represent an assisted living program to the public as an assisted living program or as a certified assisted living program unless and until the program is certified pursuant to this chapter.
   Sec. 3.  Section 231C.3, subsection 4, paragraph a, Code 2011, is amended to read as follows:
   a.  Services provided by a certified assisted living program may be provided directly by staff of the assisted living program, by individuals contracting with the assisted living program to provide services, or by individuals employed by the tenant or with whom the tenant contracts if the tenant agrees to assume the responsibility and risk of the employment or the contractual relationship.  Any provider of services for an assisted living program, by whatever means employed or contracted, shall be subject to oversight and regulation applicable to staffing of an assisted living program.
   Sec. 4.  Section 231C.5, subsection 2, paragraphs b and h, Code 2011, are amended to read as follows:
   b.  A statement regarding the impact of the fee structure on third-party payments, and whether third-party payments and resources are accepted by the assisted living program.  The occupancy agreement shall also include a statement regarding whether third-party payment is a basis for involuntary transfer or transfer and the program’s policy regarding retention or involuntary transfer or transfer of a tenant following depletion of private resources. A tenant residing in an assisted living program prior to the effective date of this Act shall not be subject to involuntary transfer or transfer based solely on source of payment, unless the occupancy agreement entered into prior to that date specifically provided otherwise and was signed by the tenant or the tenant’s legal representative. An assisted living program shall amend any occupancy agreement entered into prior to the effective date of this Act to reflect the requirements of this paragraph and shall obtain the signature of the tenant or the tenant’s legal representative acknowledging the amendment to the occupancy agreement no later than one hundred twenty days after the effective date of this Act.
   h.
  (1)  Occupancy, involuntary transfer, and transfer criteria and procedures, which ensure a safe and orderly transfer.
   (2)  Involuntary transfer and transfer criteria, including criteria relating to third-party payments and resources, shall be explicitly stated in the occupancy agreement and shall also be included in a separate cover letter to the occupancy agreement and signed by the tenant or tenant’s legal representative at the time of initial tenancy. An assisted living program shall amend any occupancy agreement entered into prior to the effective date of this Act to reflect the requirements of this subparagraph and shall obtain the signature of the tenant or the tenant’s legal representative acknowledging the amendment to the occupancy agreement no later than one hundred twenty days after the effective date of this Act. 
   Sec. 5.  EFFECTIVE UPON ENACTMENT.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
   This bill relates to assisted living programs.
   The bill amends the definition of “assisted living” to provide that assisted living includes a physical structure that provides housing to three or more tenants, in which tenants receive services defined as assisted living services from a provider contracting with the provider of the housing or contracting with or employed by the tenant, if both of the following conditions are met: the service provider has a direct or indirect corporate affiliation with at least one entity involved in the ownership or operation of the housing; and at least 50 percent of the tenants receive at least one service from such service provider.
   The bill also provides that a person that meets the definition of “assisted living” shall be considered an assisted living program whether or not the entity represents the entity to the public as an assisted living program or a certified assisted living program, and shall not operate in the state unless and until the assisted living program is certified. Any provider of assisted living services, however employed or contracted, is subject to oversight and regulation applicable to staffing of an assisted living program. 
   The bill amends provisions relating to occupancy agreements for tenants of assisted living programs. The bill provides that the occupancy agreement is to include a statement regarding whether third-party payment is a basis for involuntary transfer or transfer, and the program’s policy regarding retention or involuntary transfer or transfer of a tenant following depletion of private resources. Under the bill, a tenant residing in an assisted living program prior to the effective date of the bill, is not to be subject to involuntary transfer or transfer based solely on source of payment, unless the occupancy agreement entered prior to that date specifically provides otherwise and the tenant or tenant’s legal representative signed the occupancy agreement. Additionally, the occupancy agreement is to explicitly state involuntary transfer and transfer criteria, including criteria relating to third-party payment and resources, and this information is also required to be in a separate cover letter to the occupancy agreement and signed by the tenant or tenant’s legal representative at the time of initial tenancy. Assisted living programs are required to amend occupancy agreements entered into prior to the effective date of the bill to reflect the requirements and obtain the signature of the tenant or the tenant’s legal representative on the amended occupancy agreements no later than 120 days after enactment of the bill. 
   The bill takes effect upon enactment.