H.F. 399 Section 1. NEW SECTION . 218.101 Medical and personal care 1 facility for sex offenders. 2 1. a. By July 1, 2016, the department of human services, 3 subject to funding, shall establish one or more facilities for 4 the treatment of sex offenders classified as a tier II or tier 5 III offender who require the type of medical and personal care 6 provided by a nursing facility, residential care facility, or 7 assisted living program, and are unable to obtain admission 8 to a private facility due to the persons’ status as a sex 9 offender. 10 b. The department may use or establish a state facility 11 or facilities for the purpose described in this section, or 12 may conduct a request for proposals process to contract with 13 private facilities or programs to provide some or all of the 14 necessary services described in subsection 2 for eligible 15 persons identified in subsection 3. A request for proposals 16 shall identify the reimbursement rates and the necessary 17 training for the staff and the staffing requirements for the 18 facility or program. 19 2. The purpose of a medical and personal care facility for 20 sex offenders is to provide one or more of the following: 21 a. To provide the type of care provided in a nursing 22 facility as described in section 135C.1, subsection 13. 23 b. To provide the type of care provided in a residential 24 care facility as described in section 135C.1, subsection 19. 25 c. To provide the type of care provided in assisted living 26 programs as described in section 231C.2, subsection 2. 27 3. A person is eligible for admission to a medical and 28 personal care facility for sex offenders if the person meets 29 all of the following requirements: 30 a. The person is classified as a tier II or tier III sex 31 offender pursuant to section 692A.102. 32 b. The person requires the type of medical and personal care 33 provided by a nursing facility, residential care facility, or 34 assisted living program. 35 -1- LSB 2536YH (3) 86 rh/rj 1/ 5

H.F. 399 c. The person is unable to obtain admission to a private 1 nursing facility, residential care facility, or assisted living 2 program due to the person’s status as a sex offender. 3 4. a. A person requesting admission to a facility shall 4 submit an application for admission to the department of human 5 services. 6 b. A representative of the department of inspections and 7 appeals, the department of corrections, or the department 8 of public safety, an administrator of a residential care 9 facility or nursing facility or the administrator’s designee, 10 or a manager of an assisted living program or the manager’s 11 designee, may also submit an application requesting admission 12 to a facility on behalf of a person with the permission of the 13 person or the person’s guardian. 14 c. The application shall include a statement concerning 15 the actions the person requesting admission to a facility has 16 taken, or the steps taken on the person’s behalf, to obtain 17 admission to a private nursing facility, residential care 18 facility, or assisted living program. 19 5. Upon application by or on behalf of a person meeting 20 the eligibility requirements, the department of human services 21 shall admit the resident or tenant to a medical and personal 22 care facility for sex offenders unless an alternative, adequate 23 placement for the person is arranged. 24 6. Upon admission to a state-operated medical and personal 25 care facility, the department of human services shall assess a 26 resident or tenant to identify payment options. The payor of 27 last resort for the facility is the medical assistance program 28 established pursuant to chapter 249A. 29 7. A resident or tenant may be discharged from a 30 state-operated medical and personal care facility if the person 31 is no longer required to register as a tier II or tier III sex 32 offender, if the department of human services determines the 33 person no longer requires the type of medical and personal care 34 provided by a nursing facility, residential care facility, 35 -2- LSB 2536YH (3) 86 rh/rj 2/ 5

H.F. 399 or assisted living program, or if an alternative, adequate 1 placement is arranged. 2 8. For purposes of this section, “adequate placement” means 3 a placement that will provide the level of care necessary for 4 an eligible person including the level of care provided by a 5 nursing facility, residential care facility, or assisted living 6 program. 7 9. A state-operated medical and personal care facility 8 offering the type of medical and personal care provided by 9 a nursing facility shall meet the requirements for Medicare 10 certification. A medical and personal care facility operated 11 by the state shall not be required to be licensed or certified 12 under chapter 135C or 231C. 13 10. The department shall establish by rule all of the 14 following requirements for a medical and personal care facility 15 for sex offenders: 16 a. The training requirements for staff at a facility. 17 b. The staffing plans for a facility. 18 c. The requirements of a safety plan for residents or 19 tenants of a facility. The rules shall include but are not 20 limited to all of the following: 21 (1) A plan for the safety of residents, tenants, and staff 22 of a facility. 23 (2) A plan for the safety of visitors to a facility. 24 (3) The responsibilities of employees of a facility in 25 implementing a safety plan. 26 d. The discharge policy and requirements of a state-operated 27 facility. 28 e. The security policy and the level of security that is 29 adequate for a facility. 30 11. The department of human services shall adopt rules to 31 administer this section. 32 EXPLANATION 33 The inclusion of this explanation does not constitute agreement with 34 the explanation’s substance by the members of the general assembly. 35 -3- LSB 2536YH (3) 86 rh/rj 3/ 5

H.F. 399 This bill relates to the establishment of a facility to 1 provide for the housing and care of certain sex offenders in 2 need of medical and personal care. The bill requires the 3 department of human services (DHS) to establish one or more 4 facilities, by July 1, 2016, to house and care for tier II or 5 tier III sex offenders who need personal and medical care and 6 are unable to obtain admission to a private facility because 7 of the person’s status as a sex offender. The bill states that 8 DHS may use or establish a state facility to provide care for 9 these persons or may conduct a request for proposals process to 10 contract with a private provider to provide services for these 11 persons. 12 The purpose of the establishment of the medical and personal 13 care facility for sex offenders is to provide the type of care 14 provided by a residential care facility, nursing facility, or 15 assisted living program. 16 The bill provides that a person is eligible for admission to 17 a medical and personal care facility for sex offenders if the 18 person is classified as a tier II or tier III sex offender, the 19 person requires the type of medical and personal care provided 20 by a nursing facility, residential care facility, or assisted 21 living program, and the person is unable to obtain admission 22 to a private nursing facility, residential care facility, or 23 assisted living program due to the person’s status as a sex 24 offender. If a person admitted to a state-operated medical and 25 personal care facility for sex offenders no longer meets one of 26 these eligibility requirements, the patient may be discharged. 27 A person may also be discharged from a state-operated facility 28 if an alternative, adequate placement is arranged. 29 A person must submit an application for admission to a 30 medical and personal care facility for sex offenders to DHS. 31 An application may also be submitted on the person’s behalf 32 with the person’s permission. Upon the application of an 33 eligible person, the medical and personal care facility must 34 admit that resident or tenant unless an alternative, adequate 35 -4- LSB 2536YH (3) 86 rh/rj 4/ 5

H.F. 399 placement for the person is arranged. 1 The bill requires DHS to assess a resident or tenant’s 2 payment options if accepted into a state-operated facility. 3 Medicaid is declared to be the payor of last resort. 4 The bill also mandates that a state-operated medical 5 and personal care facility for sex offenders providing 6 nursing facility care must meet requirements for Medicare 7 certification, but a state-operated medical and personal care 8 facility is not required to be licensed or certified under Code 9 chapter 135C or 231C. 10 The bill provides certain requirements that DHS must 11 establish by rule concerning the operations of a medical and 12 personal care facility for sex offenders. These requirements 13 include staff training requirements, staffing plans, safety 14 plan requirements, the discharge policy and requirements of a 15 state-operated facility, and the security policy of a facility. 16 -5- LSB 2536YH (3) 86 rh/rj 5/ 5