Text: HSB00531 Text: HSB00533 Text: HSB00500 - HSB00599 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 249H.2, subsection 1, paragraph f, Code 1 2 Supplement 2001, is amended to read as follows: 1 3 f. Grants and loans are necessary to cover the 1 4 expenditures related to the development of alternative health 1 5 care services. Development of these alternatives will improve 1 6 access to and delivery of long-term care services to 1 7 underserved individuals or in underserved areas, which will in 1 8 turn contain or reduce the cost and improve the quality of 1 9 health care services. 1 10 Sec. 2. Section 249H.5, subsection 1, Code 2001, is 1 11 amended to read as follows: 1 12 1. Moneys deposited in the senior living trust fund 1 13 created in section 249H.4 shall be used only as provided in 1 14 appropriations from the trust fund to the department of human 1 15 services and the department of elder affairs, and for 1 16 purposes, including the awarding of grants and loans, as 1 17 specified in this chapter. 1 18 Sec. 3. Section 249H.6, Code Supplement 2001, is amended 1 19 to read as follows: 1 20 249H.6 NURSING FACILITY CONVERSION AND LONG-TERM CARE 1 21 SERVICES DEVELOPMENT GRANTS AND LOANS. 1 22 1. The department of human services, at the direction of 1 23 the senior living coordinating unit, may use moneys 1 24 appropriated to the department from the senior living trust 1 25 fund to award grants and loans to any of the following: 1 26 a. A licensed nursing facility that has been an approved 1 27 provider under the medical assistance program for the two-year 1 28 period prior to application for the grant or loan. The grant 1 29 or loan awarded may be used to convert all or a portion of the 1 30 licensed nursing facility to a certified assisted-living 1 31 program and may be used for capital or one-time expenditures, 1 32 including but not limited to start-up expenses, training 1 33 expenses, and operating losses for the first year of operation 1 34 following conversion associated with the nursing facility 1 35 conversion. 2 1 b. A long-term care provider or a licensed nursing 2 2 facility that has been an approved provider under the medical 2 3 assistance program for the two-year period prior to 2 4 application for the grant or loan or a provider that will meet 2 5 applicable medical assistance provider requirements as 2 6 specified in subsection 2, paragraph "c" or "d". The grant or 2 7 loan awarded may be used for capital or one-time expenditures, 2 8 including but not limited to start-up expenses, training 2 9 expenses, and operating losses for the first year of operation 2 10 for long-term care service development. 2 11 2. A grant or loan shall be awarded only to an applicant 2 12 who meets all of the following criteria, as applicable to the 2 13 type of grant or loan: 2 14 a. The applicant is a long-term care provider or a nursing 2 15 facility that is located in an area determined by the senior 2 16 living coordinating unit to be underserved with respect to a 2 17 particular long-term care alternative service, and that has 2 18 demonstrated the ability or potential to provide quality long- 2 19 term care alternative services. 2 20 b. The applicant is able to provide a minimum matching 2 21 contribution of twenty percent of the total cost of any 2 22 conversion, remodeling, or construction. 2 23 c. The applicant is applying for a nursing facility 2 24 conversion grant or loan and is able to demonstrate all of the 2 25 following: 2 26 (1) Conversion of the nursing facility or a distinct 2 27 portion of the nursing facility to an assisted-living program 2 28 is projected to offer efficient and economical care to 2 29 individuals requiring long-term care services in the service 2 30 area. 2 31 (2) Assisted-living services are otherwise not likely to 2 32 be available in the area for individuals eligible for services 2 33 under the medical assistance program. 2 34 (3) The resulting reduction in the availability of nursing 2 35 facility services is not projected to cause undue hardship on 3 1 those individuals requiring nursing facility services for a 3 2 period of at least ten years. 3 3 (4) Public support following a community-based assessment. 3 4 (5) Conversion of the nursing facility is projected to 3 5 result in a lower per client reimbursement cost to the grant 3 6 or loan applicant under the medical assistance program. 3 7 d. The applicant is applying for a long-term care service 3 8 development grant or loan and is able to demonstrate all of 3 9 the following: 3 10 (1) Long-term care service development is projected to 3 11 offer efficient and economical care to individuals requiring 3 12 long-term care services in the service area. 3 13 (2) The proposed long-term care alternative is otherwise 3 14 not likely to be available in the area for individuals 3 15 eligible for services under the medical assistance program. 3 16 (3) Public support following a community-based assessment. 3 17 e. The applicant agrees to do all of the following as 3 18 applicable to the type of grant or loan: 3 19 (1) Participate and maintain a minimum medical assistance 3 20 client base participation rate of forty percent, subject to 3 21 the demand for participation by individuals eligible for 3 22 medical assistance. 3 23 (2) Provide a service delivery package that is affordable 3 24 for those individuals eligible for services under the medical 3 25 assistance home and community-based services waiver program. 3 26 (3) Provide a refund to the senior living trust fund, on 3 27 an amortized basis, in the amount of the grant or loan, if the 3 28 applicant or the applicant's successor in interest ceases to 3 29 operate an affordable long-term care alternative within the 3 30 first ten-year period of operation following the awarding of 3 31 the grant or loan or if the applicant or the applicant's 3 32 successor in interest fails to maintain a participation rate 3 33 of forty percent in accordance with subparagraph (1). 3 34 3. The department of human services shall adopt rules in 3 35 consultation with the senior living coordinating unit, 4 1 pursuant to chapter 17A, to provide all of the following: 4 2 a. An application process and eligibility criteria for the 4 3 awarding of grants and loans. The eligibility criteria shall 4 4 include but are not limited to the applicant's demonstration 4 5 of an affordable service package, the applicant's use of the 4 6 funds for allowable costs, and the applicant's ability to 4 7 refund the funds if required under subsection 2, paragraph 4 8 "e", subparagraph (3). The primary eligibility criterion used 4 9 shall be the applicant's potential impact on the overall goal 4 10 of moving toward a balanced, comprehensive, affordable, high- 4 11 quality, long-term care system. 4 12 b. Criteria to be utilized in determining the amount of 4 13 the grant or loan awarded. 4 14 c. Weighted criteria to be utilized in prioritizing the 4 15 awarding of grants or loans to individual grantees or 4 16 borrowers during a grant or loan cycle. Greater weight shall 4 17 be given to the applicant's demonstration of potential 4 18 reduction of nursing facility beds, the applicant's ability to 4 19 meet demonstrated community need, and the established history 4 20 of the applicant in providing quality long-term care services. 4 21 d. Policies and procedures for certification of the 4 22 matching funds required of applicants under subsection 2, 4 23 paragraph "b". 4 24 e. Other procedures the department of human services deems 4 25 necessary for the proper administration of this section, 4 26 including but not limited to the submission of progress 4 27 reports on a bimonthly basis to the senior living coordinating 4 28 unit. 4 29 4. The department of human services shall adopt rules to 4 30 ensure that a nursing facility that receives a nursing 4 31 facility conversion grant or loan allocates costs in an 4 32 equitable manner. 4 33 5. In addition to the types of grants and loans described 4 34 in subsection 1, the department of human services, at the 4 35 direction of the senior living coordinating unit, may also use 5 1 moneys appropriated to the department from the senior living 5 2 trust fund to award grants or loans, of not more than one 5 3 hundred thousand dollars per grant or loan, to licensed 5 4 nursing facilities that are awarded nursing facility 5 5 conversion grants or loans and agree, as part of the nursing 5 6 facility conversion, to also provide adult day services, child 5 7 care for children with special needs, safe shelter for victims 5 8 of dependent adult abuse, or respite care. 5 9 6. The department of human services shall establish a 5 10 calendar for receiving and evaluating applications and for 5 11 awarding of grants and loans. 5 12 7. a. The department of human services shall develop a 5 13 cost report to be completed by a grantee or borrower which 5 14 includes, but is not limited to, revenue, costs, loans 5 15 undertaken by the grantee or borrower, fixed assets of the 5 16 grantee or borrower, a balance sheet, and a profit and loss 5 17 statement. 5 18 b. Grantees and borrowers shall submit, annually, 5 19 completed cost reports to the department of human services 5 20 regarding the project for a period of ten years following the 5 21 date of initial operation of the grantee's or borrower's long- 5 22 term care alternative. 5 23 8. The department of human services, in consultation with 5 24 the department of elder affairs, shall provide annual reports 5 25 to the governor and the general assembly concerning grants and 5 26 loans awarded. The annual report shall include the total 5 27 number of applicants and approved applicants, an overview of 5 28 the various grants and loans awarded, and detailed reports of 5 29 the cost of each project funded by a grant or loan and 5 30 information submitted by the approved applicant. 5 31 9. For the purpose of this section, "underserved" means 5 32 areas in which four and four-tenths percent of the number of 5 33 individuals sixty-five years of age and older is not greater 5 34 than the number of currently licensed nursing facility beds 5 35 and certified assisted-living units. In addition, the 6 1 department, in determining if an area is underserved, may 6 2 consider additional information gathered through the 6 3 department's own research or submitted by an applicant, 6 4 including but not limited to any of the following: 6 5 a. Availability of and access to long-term care 6 6 alternatives relative to individuals eligible for medical 6 7 assistance. 6 8 b. The current number of seniors and persons with 6 9 disabilities and the projected number of these individuals. 6 10 c. The current number of seniors and persons with 6 11 disabilities requiring professional nursing care and the 6 12 projected number of these individuals. 6 13 d. The current availability of long-term care alternatives 6 14 and any known changes in the availability of such 6 15 alternatives. 6 16 10. This section does not create an entitlement to any 6 17 funds available for grants or loans under this section, and 6 18 the department of human services may only award grants and 6 19 loans to the extent funds are available and within its 6 20 discretion, to the extent applications are approved. 6 21 11. In addition to any other remedies provided by law, the 6 22 department of human services may recoup any grant or loan 6 23 funding previously awarded and disbursed to a grantee or 6 24 borrower or the grantee's or borrower's successor in interest 6 25 and may reduce the amount of any grant or loan awarded, but 6 26 not yet disbursed, to a grantee or borrower or the grantee's 6 27 or borrower's successor in interest, by the amount of any 6 28 refund owed by a grantee or borrower or the grantee's or 6 29 borrower's successor in interest pursuant to subsection 2, 6 30 paragraph "e", subparagraph (3). 6 31 12. The senior living coordinating unit shall review 6 32 projects that receive grants or loans under this section to 6 33 ensure that the goal to provide alternatives to nursing 6 34 facility care is being met and that an adequate number of 6 35 nursing facility services remains to meet the needs of Iowans. 7 1 Sec. 4. Section 249H.11, Code 2001, is amended to read as 7 2 follows: 7 3 249H.11 FUTURE REPEAL. 7 4 Section 249H.6 is repealed on June 30, 2005. However, 7 5 grants or loans awarded and moneys appropriated for grants or 7 6 loans on or before June 30, 2005, shall be disbursed to 7 7 eligible applicants after that date if necessary. 7 8 EXPLANATION 7 9 This bill authorizes the awarding of loans as well as 7 10 grants under the senior living trust fund. Under the bill, 7 11 loans awarded must generally meet the same criteria as grants 7 12 awarded. 7 13 LSB 5313DP 79 7 14 pf/cls/14
Text: HSB00531 Text: HSB00533 Text: HSB00500 - HSB00599 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
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