Text: HF00581 Text: HF00583 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 100.1, subsection 6, Code 2003, is 1 2 amended to read as follows: 1 3 6. To adopt rules designating a fee to be assessed to each 1 4 building, structure, or facility for which a fire safety 1 5 inspection or plan review by the state fire marshal is 1 6 requiredas a condition of licensureby law. The fee 1 7 designated by rule shall be set in an amount that is 1 8 reasonably related to the costs of conducting the applicable 1 9 inspection or plan review. The fees collected by the state 1 10 fire marshal shall be retained by the state fire marshal and 1 11 deposited inthe generala separate fundofcreated in the 1 12 state treasury under the authority of the state fire marshal 1 13 and are appropriated to the state fire marshal to carry out 1 14 the purpose of this subsection. Amounts deposited in the fund 1 15 shall not be transferred, used, obligated, appropriated, or 1 16 otherwise encumbered, except as provided in this subsection. 1 17 Notwithstanding section 12C.7, subsection 2, interest or 1 18 earnings on moneys deposited in the fund shall be credited to 1 19 the fund. Notwithstanding section 8.33, amounts deposited in 1 20 the fund that remain unexpended or unencumbered at the close 1 21 of the fiscal year shall remain in the fund for utilization as 1 22 provided in this subsection for the following fiscal year. 1 23 Sec. 2. Section 135C.33, subsection 5, paragraph e, Code 1 24 2003, is amended to read as follows: 1 25 e. An employee of an assisted livingfacilityprogram 1 26 certifiedor voluntarily accreditedunder chapter 231C, if the 1 27 employee provides direct services to consumers. 1 28 Sec. 3. Section 231B.1, subsection 2, Code 2003, is 1 29 amended by striking the subsection. 1 30 Sec. 4. Section 231B.1, subsection 4, Code 2003, is 1 31 amended to read as follows: 1 32 4. "Elder group home" means a single-family residence that 1 33 isa residence ofoperated by a person who is providing room, 1 34 board, and personal care to three through five elders who are 1 35 not related to the person providing the service within the 2 1 third degree of consanguinity or affinity. 2 2 Sec. 5. Section 231B.2, subsection 1, Code 2003, is 2 3 amended to read as follows: 2 4 1. The department of elder affairs, in cooperation with 2 5 the department of inspections and appeals, shall establish by 2 6 rule in accordance with chapter 17A a special classification 2 7 for elder group homes. An elder group home established 2 8 pursuant to this subsection is exempt from the requirements of 2 9 section 135.63. 2 10 Sec. 6. Section 231B.2, subsection 2, unnumbered paragraph 2 11 1, Code 2003, is amended to read as follows: 2 12 The department of elder affairs, in cooperation with the 2 13 department of inspections and appeals, shall adopt rules to 2 14 establish requirements for certification of elder group homes. 2 15 The requirements shall include but are not limited to all of 2 16 the following: 2 17 Sec. 7. Section 231B.2, subsection 2, paragraph c, Code 2 18 2003, is amended to read as follows: 2 19 c. An elder group home shall beowner-occupied, or owned2 20by a nonprofit corporation and occupied by a resident manager2 21 staffed by an on-site manager twenty-four hours per day, seven 2 22 days per week.A resident manager shall reside in and provide2 23services for no more than one elder group home.2 24 Sec. 8. Section 231B.2, subsections 3 through 5, Code 2 25 2003, are amended to read as follows: 2 26 3. An elder group home established pursuant to this 2 27 chapter shall be certified by the department of inspections 2 28 and appeals. 2 29 4. A provider under the special classification shall 2 30 comply with the rules adopted by the department of elder 2 31 affairs, in cooperation with the department of inspections and 2 32 appeals, for an elder group home. 2 33 5. Inspections and certification services shall be 2 34 provided by the department of inspections and appeals. 2 35However, beginning July 1, 1994, the department may enter into3 1contracts with the area agencies on aging to provide these3 2services.3 3 Sec. 9. Section 231B.3, subsection 2, Code 2003, is 3 4 amended to read as follows: 3 5 2. A person who has knowledge that an elder group home is 3 6 operating without certification shall report the name and 3 7 address of the home to the department of inspections and 3 8 appeals. The department of inspections and appeals shall 3 9 investigate a report made pursuant to this section. 3 10 Sec. 10. Section 231B.4, Code 2003, is amended to read as 3 11 follows: 3 12 231B.4 APPLICABILITY. 3 13 1. This chapter shall not be construed to require that a 3 14 facility, currently licensed or licensed as a different type 3 15 of facility and serving persons sixty years of age or older, 3 16 also comply with the requirements of this chapter. 3 17 2. This chapter shall apply only to those elder group 3 18 homes certified by the department of elder affairs prior to 3 19 July 1, 2003. Applications for certification as an elder 3 20 group home shall not be accepted or approved on or after July 3 21 1, 2003. 3 22 Sec. 11. Section 231C.2, subsections 1 and 6, Code 2003, 3 23 are amended to read as follows: 3 24 1. "Assisted living" means provision of housing with 3 25 services which may include but are not limited to health- 3 26 related care, personal care, and assistance with instrumental 3 27 activities of daily living tosixthree or more tenants in a 3 28 physical structure which provides a homelike environment. 3 29 "Assisted living" also includes encouragement of family 3 30 involvement, tenant self-direction, and tenant participation 3 31 in decisions that emphasize choice, dignity, privacy, 3 32 individuality, shared risk, and independence. "Assisted 3 33 living" includes the provision of housing and assistance with 3 34 instrumental activities of daily living only if personal care 3 35 or health-related care is also included. 4 1 6. "Tenant" means an individual who receives assisted 4 2 living services through a certifiedor accreditedassisted 4 3 living program. 4 4 Sec. 12. Section 231C.2, subsection 2, Code 2003, is 4 5 amended by striking the subsection. 4 6 Sec. 13. Section 231C.2, Code 2003, is amended by adding 4 7 the following new subsections: 4 8 NEW SUBSECTION. 2A. "Governmental unit" means the state, 4 9 or any county, municipality, or other political subdivision or 4 10 any department, division, board, or other agency of any of 4 11 these entities. 4 12 NEW SUBSECTION. 4A. "Legal representative" means a person 4 13 appointed by the court to act on behalf of the tenant, or a 4 14 person acting pursuant to a power of attorney. 4 15 NEW SUBSECTION. 5A. "Recognized accrediting entity" means 4 16 a nationally recognized accrediting entity that the department 4 17 of elder affairs, in cooperation with the department of 4 18 inspections and appeals, recognizes as having specific 4 19 assisted living program standards equivalent to the standards 4 20 established by the department of elder affairs, in cooperation 4 21 with the department of inspections and appeals, for assisted 4 22 living programs. 4 23 NEW SUBSECTION. 7. "Tenant's representative" means a 4 24 tenant's legal representative or any representative authorized 4 25 by the tenant to act on behalf of the tenant. 4 26 Sec. 14. Section 231C.3, Code 2003, is amended by striking 4 27 the section and inserting in lieu thereof the following: 4 28 231C.3 CERTIFICATION OF ASSISTED LIVING PROGRAMS. 4 29 1. The department of elder affairs, in cooperation with 4 30 the department of inspections and appeals, shall establish, by 4 31 rule in accordance with chapter 17A, a program for 4 32 certification and monitoring of assisted living programs. The 4 33 department of elder affairs, in cooperation with the 4 34 department of inspections and appeals, may adopt by reference 4 35 with or without amendment, nationally recognized standards and 5 1 rules for assisted living programs. The rules shall include 5 2 specification of recognized accrediting entities and 5 3 provisions related to dementia-specific programs. The 5 4 standards and rules shall be formulated in consultation with 5 5 affected industry, professional, and consumer groups and shall 5 6 be designed to accomplish the purposes of this chapter and 5 7 shall include but are not limited to rules relating to all of 5 8 the following: 5 9 a. Provisions to ensure, to the greatest extent possible, 5 10 the health, safety, and well-being and appropriate treatment 5 11 of tenants. 5 12 b. Requirements that assisted living programs furnish the 5 13 department of elder affairs and the department of inspections 5 14 and appeals with specified information necessary to administer 5 15 this chapter. 5 16 c. Standards for tenant evaluation or assessment, which 5 17 may vary in accordance with the nature of the services 5 18 provided or the status of the tenant. 5 19 2. In addition to the adoption of standards and rules for 5 20 assisted living programs, the department of elder affairs, in 5 21 cooperation with the department of inspections and appeals, 5 22 and in consultation with affected industry, professional, and 5 23 consumer groups, shall issue interpretive guidelines, 5 24 including the expectations of program certification monitors, 5 25 to provide direction to assisted living programs in complying 5 26 with certification requirements. 5 27 3. Each assisted living program operating in this state 5 28 shall be certified by the department of inspections and 5 29 appeals. If an assisted living program is voluntarily 5 30 accredited by a recognized accrediting entity, the department 5 31 of inspections and appeals shall certify the assisted living 5 32 program on the basis of the voluntary accreditation. An 5 33 assisted living program that is certified by the department on 5 34 the basis of voluntary accreditation shall not be subject to 5 35 payment of the certification fee prescribed in section 6 1 231C.19, but shall be subject to an administrative fee as 6 2 prescribed by rule. An assisted living program certified 6 3 under this section is exempt from the requirements of section 6 4 135.63 relating to certificate of need requirements. 6 5 4. The owner or manager of a certified assisted living 6 6 program shall comply with the rules adopted by the department 6 7 of elder affairs, in cooperation with the department of 6 8 inspections and appeals, for an assisted living program. A 6 9 person including a governmental unit shall not represent an 6 10 assisted living program to the public as an assisted living 6 11 program or as a certified assisted living program unless and 6 12 until the program is certified pursuant to this chapter. 6 13 5. a. Services provided by a certified assisted living 6 14 program may be provided directly by staff of the assisted 6 15 living program, by individuals contracting with the assisted 6 16 living program to provide services, or by individuals employed 6 17 by the tenant or with whom the tenant contracts if the tenant 6 18 agrees to assume the responsibility and risk of the employment 6 19 or the contractual relationship. 6 20 b. If a tenant is terminally ill and has elected to 6 21 receive hospice services under the federal Medicare program 6 22 from a Medicare-certified hospice program, the assisted living 6 23 program and the Medicare-certified hospice program shall enter 6 24 into a written agreement under which the hospice program 6 25 retains professional management responsibility for those 6 26 services. 6 27 6. The department of inspections and appeals may enter 6 28 into contracts to provide certification and monitoring of 6 29 assisted living programs. The department of inspections and 6 30 appeals shall: 6 31 a. Have full access at reasonable times to all records, 6 32 materials, and common areas pertaining to the provision of 6 33 services and care to the tenants of a program during 6 34 certification and monitoring of programs seeking 6 35 certification, currently certified, or claiming to be 7 1 certified. 7 2 b. With the consent of the tenant, visit the tenant's 7 3 unit. 7 4 c. Require that the recognized accrediting entity 7 5 providing accreditation for a program provide copies to the 7 6 department of all materials related to the accreditation, 7 7 monitoring, and complaint process. 7 8 7. The department of elder affairs, in cooperation with 7 9 the department of inspections and appeals, may also establish 7 10 by rule in accordance with chapter 17A a special 7 11 classification for affordable assisted living programs. The 7 12 rules shall be formulated in consultation with affected 7 13 industry, professional, and consumer groups. 7 14 8. A department, agency, or officer of this state or of 7 15 any political subdivision shall not pay or approve for payment 7 16 from public funds any amount to an assisted living program for 7 17 an actual or prospective tenant, unless the program holds a 7 18 current certificate issued by the department of inspections 7 19 and appeals and meets all current requirements for 7 20 certification. 7 21 9. The department of elder affairs, in cooperation with 7 22 the department of inspections and appeals, shall adopt rules 7 23 regarding the conducting or operating of another business or 7 24 activity in the same physical structure in which the assisted 7 25 living program is provided, if the business or activity serves 7 26 nontenants. The rules shall be developed in consultation with 7 27 affected industry, professional, and consumer groups. 7 28 10. An assisted living program shall comply with section 7 29 135C.33. 7 30 Sec. 15. Section 231C.4, Code 2003, is amended to read as 7 31 follows: 7 32 231C.4 FIRE AND SAFETY STANDARDS. 7 33 The state fire marshal shall adopt rules, in coordination 7 34 with the department of elder affairs and the department of 7 35 inspections and appeals, relating to the certificationor8 1voluntary accreditationand monitoring of the fire and safety 8 2 standards of certifiedor voluntarily accreditedassisted 8 3 living programs. 8 4 Sec. 16. Section 231C.5, Code 2003, is amended by striking 8 5 the section and inserting in lieu thereof the following: 8 6 231C.5 WRITTEN OCCUPANCY AGREEMENT REQUIRED. 8 7 1. An assisted living program shall not operate in this 8 8 state unless a written occupancy agreement, as prescribed in 8 9 subsection 2, is executed between the assisted living program 8 10 and each tenant or tenant's representative, prior to the 8 11 tenant's occupancy, and unless the assisted living program 8 12 operates in accordance with the terms of the occupancy 8 13 agreement. The assisted living program shall deliver to the 8 14 tenant or tenant's representative a complete copy of the 8 15 occupancy agreement and all supporting documents and 8 16 attachments and shall deliver, at least thirty days prior to 8 17 any changes, a written copy of changes to the occupancy 8 18 agreement if any changes to the copy originally delivered are 8 19 subsequently made. 8 20 2. An assisted living program occupancy agreement shall 8 21 clearly describe the rights and responsibilities of the tenant 8 22 and the program. The occupancy agreement shall also include 8 23 but is not limited to inclusion of all of the following 8 24 information in the body of the agreement or in the supporting 8 25 documents and attachments: 8 26 a. A description of all fees, charges, and rates 8 27 describing tenancy and basic services covered, and any 8 28 additional and optional services and their related costs. 8 29 b. A statement regarding the impact of the fee structure 8 30 on third-party payments, and whether third-party payments and 8 31 resources are accepted by the assisted living program. 8 32 c. The procedure followed for nonpayment of fees. 8 33 d. Identification of the party responsible for payment of 8 34 fees and identification of the tenant's representative, if 8 35 any. 9 1 e. The term of the occupancy agreement. 9 2 f. A statement that the assisted living program will 9 3 notify the tenant or the tenant's representative, as 9 4 applicable, in writing at least thirty days prior to any 9 5 change being made in the occupancy agreement with the 9 6 following exceptions: 9 7 (1) When the tenant's health status or behavior 9 8 constitutes a substantial threat to the health or safety of 9 9 the tenant, other tenants, or others, including when the 9 10 tenant refuses to consent to relocation. 9 11 (2) When an emergency or a significant change in the 9 12 tenant's condition results in the need for the provision of 9 13 services that exceed the type or level of services included in 9 14 the occupancy agreement and the necessary services cannot be 9 15 safely provided by the assisted living program. 9 16 g. A statement that all tenant information will be 9 17 maintained in a confidential manner to the extent required 9 18 under state and federal law. 9 19 h. Occupancy, involuntary transfer, and transfer criteria 9 20 and procedures. 9 21 i. The program's policies and procedures for addressing 9 22 grievances between the assisted living program and the 9 23 tenants, including grievances relating to transfer and 9 24 occupancy. 9 25 j. A statement of the prohibition against retaliation as 9 26 prescribed in section 231C.14. 9 27 k. The emergency response policy. 9 28 l. The staffing policy which specifies if the staff is 9 29 available twenty-four hours per day, if nurse delegation will 9 30 be used, and how staffing will be adapted to meet changing 9 31 tenant needs. 9 32 m. In dementia-specific assisted living programs, a 9 33 description of the services and programming provided to meet 9 34 the life skills and social activities of tenants. 9 35 3. Occupancy agreements and related documents executed by 10 1 each tenant or tenant's representative shall be maintained by 10 2 the assisted living program in program files from the date of 10 3 execution until three years from the date the occupancy 10 4 agreement is terminated. Occupancy agreements and related 10 5 documents shall be made available for on-site inspection to 10 6 the department of inspections and appeals upon request and at 10 7 reasonable times. 10 8 Sec. 17. Section 231C.6, Code 2003, is amended by striking 10 9 the section and inserting in lieu thereof the following: 10 10 231C.6 RETENTION IN AN ASSISTED LIVING PROGRAM. 10 11 1. The department of inspections and appeals shall not 10 12 require the removal and relocation of a tenant of an assisted 10 13 living program if, based upon an assessment by the department 10 14 of inspections and appeals, the department of inspections and 10 15 appeals determines that the tenant's presence in the program 10 16 does not endanger the tenant or other tenants and the tenant 10 17 is able to receive necessary care through services provided by 10 18 the program in accordance with the program's certification or 10 19 through services obtained by the tenant from providers other 10 20 than the program. In assessing whether it is possible for the 10 21 tenant to be provided or to obtain necessary care without 10 22 relocating, the department of inspections and appeals shall 10 23 consider all relevant factors, including placement preference 10 24 expressed by the tenant, the tenant's representative, or 10 25 others, and the approval of the program. 10 26 2. Notwithstanding a determination by the department of 10 27 inspections and appeals that a tenant's needs exceed occupancy 10 28 criteria as established in this chapter or rules adopted 10 29 pursuant to this chapter, the department of inspections and 10 30 appeals may grant a waiver to the assisted living program to 10 31 allow the tenant to remain in the program if, not later than 10 32 ten business days after the date the program is informed of 10 33 the specific basis of the department of inspections and 10 34 appeals' determination, the department of inspections and 10 35 appeals receives all of the following obtained by the assisted 11 1 living program: 11 2 a. A written assessment from the tenant's primary care 11 3 provider that the tenant is appropriately placed. 11 4 b. A written statement from the tenant, or from the 11 5 tenant's legal representative if the tenant lacks capacity to 11 6 provide a written statement, that the tenant wishes to remain 11 7 in the program. 11 8 c. A written statement from the program that the program 11 9 approves of the tenant remaining in the program. 11 10 3. If the department of inspections and appeals grants a 11 11 waiver pursuant to subsection 2, the waiver shall be valid for 11 12 a period of six months, unless the tenant's medical and 11 13 functional status otherwise requires. The department of 11 14 inspections and appeals may continue an existing waiver for 11 15 any subsequent period of six months each, upon request of the 11 16 program. The department of elder affairs, in cooperation with 11 17 the department of inspections and appeals, shall adopt rules 11 18 regarding administration of the waivers. 11 19 4. An assisted living program that has been granted a 11 20 waiver for a tenant under subsection 2 shall not be found in 11 21 noncompliance of occupancy criteria if the program complies 11 22 with the requirements of the waiver. 11 23 5. a. If the department of inspections and appeals 11 24 determines that a tenant is inappropriately placed in the 11 25 assisted living program or that a tenant's needs exceed 11 26 occupancy criteria and a waiver is not requested and obtained 11 27 in accordance with the requirements of subsection 2, the 11 28 program shall transfer the tenant. 11 29 b. The tenant shall be provided a transition period of 11 30 thirty days following the date of receipt of the notice of the 11 31 transfer to relinquish tenancy in the program. 11 32 c. Notwithstanding paragraph "b", if the tenant's 11 33 continued tenancy in the assisted living program following 11 34 provision of notice would present a danger to the safety or 11 35 well-being of the tenant, other tenants, or employees of the 12 1 assisted living program, the transition period of thirty days 12 2 is waived and the transition provisions relating to an 12 3 involuntary transfer as provided in the occupancy agreement 12 4 shall instead apply. 12 5 Sec. 18. NEW SECTION. 231C.8 COMPLAINTS. 12 6 1. Any person with concerns regarding the operations or 12 7 service delivery of an assisted living program may file a 12 8 complaint with the department of inspections and appeals. The 12 9 name of the person who files a complaint with the department 12 10 of inspections and appeals and any personal identifying 12 11 information of the person or any tenant identified in the 12 12 complaint shall be kept confidential and shall not be subject 12 13 to discovery, subpoena, or other means of legal compulsion for 12 14 its release to a person other than department of inspections 12 15 and appeals' employees involved with the complaint. 12 16 2. The department of elder affairs, in cooperation with 12 17 the department of inspections and appeals, shall establish 12 18 procedures for the disposition of complaints received in 12 19 accordance with this section. 12 20 Sec. 19. NEW SECTION. 231C.9 INFORMAL REVIEW. 12 21 If an assisted living program contests the regulatory 12 22 insufficiencies of a monitoring evaluation or complaint 12 23 investigation, the program shall submit written information, 12 24 demonstrating that the program was in compliance with the 12 25 applicable requirement at the time of the monitoring 12 26 evaluation or complaint investigation, in support of the 12 27 contesting of the regulatory insufficiencies, to the 12 28 department of inspections and appeals for review. The 12 29 department of inspections and appeals shall review the written 12 30 information submitted within ten working days of the receipt 12 31 of the information. At the conclusion of the review, the 12 32 department of inspections and appeals may affirm, modify, or 12 33 dismiss the regulatory insufficiencies. If the regulatory 12 34 insufficiencies are modified or dismissed, the department of 12 35 inspections and appeals shall notify the program in writing of 13 1 the reasons for the modification or dismissal and in the case 13 2 of a complaint investigation, shall notify the complainant, if 13 3 known, of the reasons for the modification or dismissal. 13 4 Sec. 20. NEW SECTION. 231C.10 PUBLIC DISCLOSURE OF 13 5 FINDINGS. 13 6 Following a monitoring evaluation or complaint 13 7 investigation of an assisted living program by the department 13 8 of inspections and appeals pursuant to this chapter, the 13 9 department of inspections and appeals' final findings with 13 10 respect to compliance by the assisted living program with 13 11 requirements for certification shall be made available to the 13 12 public in a readily available form and place. Other 13 13 information relating to an assisted living program that is 13 14 obtained by the department of inspections and appeals which 13 15 does not constitute the department's final findings from a 13 16 monitoring evaluation or complaint investigation of the 13 17 assisted living program shall not be made available to the 13 18 public except in proceedings involving the denial, suspension, 13 19 or revocation of a certificate under this chapter. 13 20 Sec. 21. NEW SECTION. 231C.11 DENIAL, SUSPENSION, OR 13 21 REVOCATION – CONDITIONAL OPERATION. 13 22 1. The department of inspections and appeals may deny, 13 23 suspend, or revoke a certificate in any case where the 13 24 department of inspections and appeals finds that there has 13 25 been a substantial or repeated failure on the part of the 13 26 assisted living program to comply with this chapter or the 13 27 rules, or minimum standards adopted under this chapter, or for 13 28 any of the following reasons: 13 29 a. Cruelty or indifference to assisted living program 13 30 tenants. 13 31 b. Appropriation or conversion of the property of an 13 32 assisted living program tenant without the tenant's written 13 33 consent or the written consent of the tenant's legal guardian. 13 34 c. Permitting, aiding, or abetting the commission of any 13 35 illegal act in the assisted living program. 14 1 d. Obtaining or attempting to obtain or retain a 14 2 certificate by fraudulent means, misrepresentation, or by 14 3 submitting false information. 14 4 e. Habitual intoxication or addiction to the use of drugs 14 5 by the applicant, administrator, executive director, manager, 14 6 or supervisor of the assisted living program. 14 7 f. Securing the devise or bequest of the property of a 14 8 tenant of an assisted living program by undue influence. 14 9 g. Failure or neglect to maintain a continuing education 14 10 and training program for all personnel employed in the 14 11 assisted living program. 14 12 h. Founded dependent adult abuse as defined in section 14 13 235B.2. 14 14 i. In the case of any officer, member of the board of 14 15 directors, trustee, or designated manager of the program or 14 16 any stockholder, partner, or individual who has greater than a 14 17 ten percent equity interest in the program, who has or has had 14 18 an ownership interest in an assisted living program, home 14 19 health agency, residential care facility, or licensed nursing 14 20 facility in any state which has been closed due to removal of 14 21 program, agency, or facility licensure or certification or 14 22 involuntary termination from participation in either the 14 23 medical assistance or Medicare programs, or who has been found 14 24 to have failed to provide adequate protection or services for 14 25 tenants to prevent abuse or neglect. 14 26 j. In the case of a certificate applicant or an existing 14 27 certified owner or operator who is an entity other than an 14 28 individual, the person is in a position of control or is an 14 29 officer of the entity and engages in any act or omission 14 30 proscribed by this chapter. 14 31 k. For any other reason as provided by law or 14 32 administrative rule. 14 33 2. The department of inspections and appeals may as an 14 34 alternative to denial, suspension, or revocation conditionally 14 35 issue or continue a certificate dependent upon the performance 15 1 by the assisted living program of reasonable conditions within 15 2 a reasonable period of time as set by the department of 15 3 inspections and appeals so as to permit the program to 15 4 commence or continue the operation of the program pending full 15 5 compliance with this chapter or the rules adopted pursuant to 15 6 this chapter. If the assisted living program does not make 15 7 diligent efforts to comply with the conditions prescribed, the 15 8 department of inspections and appeals may, under the 15 9 proceedings prescribed by this chapter, suspend, or revoke the 15 10 certificate. An assisted living program shall not be operated 15 11 on a conditional certificate for more than one year. 15 12 Sec. 22. NEW SECTION. 231C.12 NOTICE – HEARINGS. 15 13 1. The denial, suspension, or revocation of a certificate 15 14 shall be effected by delivering to the applicant or 15 15 certificate holder by restricted certified mail or by personal 15 16 service a notice setting forth the particular reasons for such 15 17 action. Such denial, suspension, or revocation shall become 15 18 effective thirty days after the mailing or service of the 15 19 notice, unless the applicant or certificate holder, within 15 20 such thirty-day period, requests a hearing, in writing, of the 15 21 department of inspections and appeals, in which case the 15 22 notice shall be deemed to be suspended. 15 23 2. The denial, suspension, or revocation of a certificate 15 24 may be appealed in accordance with rules adopted by the 15 25 department of inspections and appeals in accordance with 15 26 chapter 17A. 15 27 3. When the department of inspections and appeals finds 15 28 that an imminent danger to the health or safety of tenants of 15 29 an assisted living program exists which requires action on an 15 30 emergency basis, the department of inspections and appeals may 15 31 direct removal of all tenants of an assisted living program 15 32 and suspend the certificate prior to a hearing. 15 33 Sec. 23. NEW SECTION. 231C.13 DEPARTMENT NOTIFIED OF 15 34 CASUALTIES. 15 35 The department of inspections and appeals shall be notified 16 1 within twenty-four hours, by the most expeditious means 16 2 available, of any accident causing substantial injury or 16 3 death, and any substantial fire or natural or other disaster 16 4 occurring at or near an assisted living program. 16 5 Sec. 24. NEW SECTION. 231C.14 RETALIATION BY ASSISTED 16 6 LIVING PROGRAM PROHIBITED. 16 7 1. An assisted living program shall not discriminate or 16 8 retaliate in any way against a tenant, tenant's family, or an 16 9 employee of the program who has initiated or participated in 16 10 any proceeding authorized by this chapter. An assisted living 16 11 program that violates this section is subject to a penalty as 16 12 established by administrative rule in accordance with chapter 16 13 17A and to be assessed and collected by the department of 16 14 inspections and appeals and paid into the state treasury to be 16 15 credited to the general fund of the state, or to immediate 16 16 revocation of the program's certificate. 16 17 2. Any attempt to transfer, from an assisted living 16 18 program, a tenant by whom or upon whose behalf a complaint has 16 19 been submitted to the department under section 231C.8, within 16 20 ninety days after the filing of the complaint or the 16 21 conclusion of any proceeding resulting from the complaint, 16 22 raises a rebuttable presumption that the action was taken by 16 23 the program in retaliation for the filing of the complaint, 16 24 except in situations in which the tenant is transferred due to 16 25 occupancy and transfer criteria. 16 26 Sec. 25. NEW SECTION. 231C.15 CIVIL PENALTIES. 16 27 The department of elder affairs, in cooperation with the 16 28 department of inspections and appeals, may establish by rule, 16 29 in accordance with chapter 17A, civil penalties for the 16 30 following violations by an assisted living program: 16 31 1. Noncompliance with any regulatory requirements which 16 32 presents an imminent danger or a substantial probability of 16 33 resultant death or physical harm to a tenant. 16 34 2. Following receipt of notice from the department of 16 35 inspections and appeals, continued failure or refusal to 17 1 comply within a prescribed time frame with regulatory 17 2 requirements that have a direct relationship to the health, 17 3 safety, or security of program tenants. 17 4 Sec. 26. NEW SECTION. 231C.16 CRIMINAL PENALTIES. 17 5 1. A person establishing, conducting, managing, or 17 6 operating any assisted living program without a certificate is 17 7 guilty of a serious misdemeanor. Each day of continuing 17 8 violation after conviction or notice from the department of 17 9 inspections and appeals by certified mail of a violation shall 17 10 be considered a separate offense or chargeable offense. A 17 11 person establishing, conducting, managing, or operating an 17 12 assisted living program without a certificate may be 17 13 temporarily or permanently restrained by a court of competent 17 14 jurisdiction from such activity in an action brought by the 17 15 state. 17 16 2. A person who prevents or interferes with or attempts to 17 17 impede in any way any duly authorized representative of the 17 18 department of inspections and appeals in the lawful 17 19 enforcement of this chapter or of the rules adopted pursuant 17 20 to this chapter is guilty of a simple misdemeanor. As used in 17 21 this subsection, lawful enforcement includes but is not 17 22 limited to: 17 23 a. Contacting or interviewing any tenant of an assisted 17 24 living program in private at any reasonable hour and without 17 25 advance notice. 17 26 b. Examining any relevant records of an assisted living 17 27 program. 17 28 c. Preserving evidence of any violation of this chapter or 17 29 of the rules adopted pursuant to this chapter. 17 30 Sec. 27. NEW SECTION. 231C.17 NURSING ASSISTANT AND 17 31 MEDICATION AIDE – CERTIFICATION. 17 32 The department of inspections and appeals, in cooperation 17 33 with other appropriate agencies, shall establish a procedure 17 34 to allow nursing assistants or medication aides to claim work 17 35 within an assisted living program as credit toward sustaining 18 1 the nursing assistant's or medication aide's certification. 18 2 Sec. 28. NEW SECTION. 231C.18 COORDINATION OF THE LONG- 18 3 TERM CARE SYSTEM – TRANSITIONAL PROVISIONS. 18 4 1. An elder group home certified under chapter 231B prior 18 5 to July 1, 2003, shall be exempt from the requirements of this 18 6 chapter. If an elder group home certified under chapter 231B 18 7 prior to July 1, 2003, seeks certification as an assisted 18 8 living program on or after July 1, 2003, the elder group home 18 9 shall be granted a conditional assisted living program 18 10 certification by the department of inspections and appeals for 18 11 a period of one year from the date the conditional certificate 18 12 is issued. At the end of the one-year period, the elder group 18 13 home shall meet the requirements of this chapter to receive 18 14 subsequent certification as an assisted living program. 18 15 2. A hospital licensed pursuant to chapter 135B or a 18 16 health care facility licensed pursuant to chapter 135C may 18 17 operate an assisted living program, located in a distinct part 18 18 of or separate structure under the control of the hospital or 18 19 health care facility, if certified pursuant to this chapter. 18 20 3. This chapter shall not be construed to require that a 18 21 facility licensed as a different type of facility also comply 18 22 with the requirements of this chapter, unless the facility is 18 23 represented to the public as a certified assisted living 18 24 program. 18 25 4. A certified assisted living program that complies with 18 26 the requirements of this chapter shall not be required to be 18 27 licensed as a health care facility pursuant to chapter 135C, 18 28 unless the facility is represented to the public as a licensed 18 29 health care facility. 18 30 Sec. 29. NEW SECTION. 231C.19 IOWA ASSISTED LIVING FEES. 18 31 The department of inspections and appeals shall collect and 18 32 retain assisted living program certification and related fees 18 33 as established by rule in accordance with chapter 17A. An 18 34 assisted living program that is certified by the department of 18 35 inspections and appeals on the basis of voluntary 19 1 accreditation by a recognized accrediting entity shall not be 19 2 subject to payment of the certification fee, but shall be 19 3 subject to an administrative fee as prescribed by rule. Fees 19 4 collected and retained pursuant to this section shall be 19 5 deposited into an assisted living program fund created in the 19 6 state treasury under the authority of the department of 19 7 inspections and appeals and are appropriated to the department 19 8 of inspections and appeals to carry out the purposes of this 19 9 chapter. Amounts deposited in the fund shall not be 19 10 transferred, used, obligated, appropriated, or otherwise 19 11 encumbered except as provided in this section. 19 12 Notwithstanding section 12C.7, subsection 2, interest or 19 13 earnings on moneys deposited into the fund shall be credited 19 14 to the fund. Notwithstanding section 8.33, amounts deposited 19 15 in the fund that remain unexpended or unencumbered at the 19 16 close of the fiscal year shall remain in the fund for 19 17 utilization as provided in this section for the following 19 18 fiscal year. 19 19 Sec. 30. Section 235B.3, subsection 2, paragraph d, Code 19 20 2003, is amended to read as follows: 19 21 d. A person who performs inspections of elder group homes 19 22 for the department ofelder affairsinspections and appeals 19 23 and a resident advocate committee member assigned to an elder 19 24 group home pursuant to chapter 231B. 19 25 Sec. 31. Chapter 231A, Code 2003, is repealed. 19 26 Sec. 32. TRANSITION OF STAFF. All employees of the 19 27 department of elder affairs performing functions related to 19 28 certification and monitoring of or complaint investigations 19 29 related to assisted living programs as of June 30, 2003, shall 19 30 become employees of the department of inspections and appeals 19 31 without loss of classification, pay, or benefits, effective 19 32 July 1, 2003. All employees of the department of elder 19 33 affairs performing functions related to affordable assisted 19 34 living as of June 30, 2003, shall become employees of the Iowa 19 35 finance authority without loss of classification, pay, or 20 1 benefits, effective July 1, 2003. 20 2 EXPLANATION 20 3 This bill provides for regulation of elder group homes and 20 4 assisted living programs. 20 5 The bill provides for regulation of elder group homes by 20 6 the department of elder affairs in cooperation with the 20 7 department of inspections and appeals. The bill changes the 20 8 definition of elder group home to mean a single-family 20 9 residence operated by a person, rather than being the 20 10 residence of the person providing room, board, and personal 20 11 care to elders. The bill also provides that rather than being 20 12 owner-occupied or owned by a nonprofit corporation and 20 13 occupied by a resident manager, the elder group home is 20 14 required only to be staffed by an on-site manager 24 hours per 20 15 day, seven days per week. The bill also provides that the 20 16 provisions of the Code chapter apply only to elder group homes 20 17 certified by the department of elder affairs prior to July 1, 20 18 2003, and that applications for certification as an elder 20 19 group home are not to be accepted or approved on or after July 20 20 1, 2003. 20 21 The bill provides for regulation of assisted living 20 22 programs by directing the department of elder affairs, in 20 23 cooperation with the department of inspections and appeals, to 20 24 establish, by rule, a program for certification and monitoring 20 25 related to assisted living programs. The rules are to be 20 26 formulated in consultation with affected industry, 20 27 professional, and consumer groups. In addition to the rules, 20 28 interpretive guidelines are also to be issued. Each assisted 20 29 living program operating in the state is to be certified by 20 30 the department of inspections and appeals. If an assisted 20 31 living program is voluntarily accredited by a recognized 20 32 accrediting entity, the department of inspections and appeals 20 33 is to certify the program based upon the voluntary 20 34 accreditation. The bill provides specifically that if the 20 35 tenant is terminally ill and has elected to receive hospice 21 1 services under the federal Medicare program from a Medicare- 21 2 certified hospice program, the assisted living program and the 21 3 hospice program are to enter an agreement under which the 21 4 hospice program retains professional management responsibility 21 5 for those services. 21 6 The bill provides that the department of elder affairs in 21 7 cooperation with the department of inspections and appeals may 21 8 establish by administrative rule a special classification for 21 9 affordable assisted living programs. The bill also provides 21 10 that a department, agency, or officer of this state, or of any 21 11 political subdivision shall not pay or approve for payment 21 12 from public funds any amount to an assisted living program for 21 13 an actual or prospective tenant, unless the program holds a 21 14 current certificate and meets all requirements for 21 15 certification. The bill also directs the department of elder 21 16 affairs in cooperation with the department of inspections and 21 17 appeals to adopt rules regarding the conducting or operating 21 18 of another business or activity in the facility in which the 21 19 assisted living program is provided, if the business or 21 20 activity serves nontenants. The rules are to be developed in 21 21 consultation with affected industry, professional, and 21 22 consumer groups. 21 23 The bill specifies requirements for written occupancy 21 24 agreements and provides for retention of a tenant in an 21 25 assisted living facility, notwithstanding a determination by 21 26 the department of inspections and appeals that the tenant's 21 27 needs exceed the occupancy criteria established. 21 28 The bill provides for the filing and disposition of 21 29 complaints; provides for an informal review of contests to the 21 30 results of a monitoring evaluation or complaint investigation; 21 31 provides for public disclosure of the final findings with 21 32 respect to a monitoring evaluation or complaint investigation; 21 33 provides the bases for the denial, suspension, or revocation 21 34 of certification and for conditional operation of a program as 21 35 an alternative to denial, suspension, or revocation of 22 1 certification; provides for notice and hearings related to 22 2 denial, suspension, or revocation of certification; provides 22 3 for the notification of the department of inspections and 22 4 appeals of any casualties at an assisted living program; 22 5 prohibits retaliation by an assisted living program against a 22 6 tenant, tenant's family, or an employee of the program who has 22 7 initiated or participated in any proceeding under the Code 22 8 chapter; establishes civil and criminal penalties for certain 22 9 violations of the bill; provides for nursing assistants and 22 10 medication aides to claim work within assisted living programs 22 11 as credit toward their certification; provides transitional 22 12 provisions for long-term care providers including elder group 22 13 homes by making elder group homes exempt from the requirements 22 14 of the assisted living chapter and providing for conditional 22 15 certification of an elder group home as an assisted living 22 16 facility if the elder group home was certified as an elder 22 17 group home prior to July 1, 2003, and seeks certification as 22 18 an assisted living program on or after July 1, 2003. The bill 22 19 provides for collection and retaining of assisted living 22 20 program fees by the department of inspections and appeals and 22 21 provides that if an assisted living program is certified based 22 22 upon voluntary accreditation, the program is not subject to 22 23 payment of the certification fee but is subject to payment of 22 24 an administrative fee as prescribed by rule. 22 25 The bill provides for transition of staff used in the 22 26 regulation of assisted living programs by providing that 22 27 employees of the department of elder affairs who performed 22 28 functions related to certification and monitoring of or 22 29 complaint investigations related to assisted living programs 22 30 as of June 30, 2003, are to become employees of the department 22 31 of inspections and appeals without loss of classification, 22 32 pay, or benefits, effective July 1, 2003. Additionally, all 22 33 employees of the department of elder affairs performing 22 34 functions related to affordable assisted living as of June 30, 22 35 2003, are to become employees of the Iowa finance authority 23 1 without loss of classification, pay, or benefits, effective 23 2 July 1, 2003. 23 3 The bill also repeals Code chapter 231A, relating to elder 23 4 family homes. 23 5 LSB 2195HV 80 23 6 pf/sh/8
Text: HF00581 Text: HF00583 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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