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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