HUMAN SERVICES

SENATE FILE 416 - Dependent Adult Abuse - Facilities, Services, and Information
HOUSE FILE 386 - Policy and Services for the Elderly
HOUSE FILE 387 - Mental Health and Developmental Disabilities - Facilities - Programs - Commission
HOUSE FILE 489 - Human Services Programs and Services - Miscellaneous Provisions
HOUSE FILE 529 - Mental Health and Developmental Disabilities Services System Review
HOUSE FILE 558 - Disclosure of Information to Subjects of Child or Dependent Adult Abuse Reports
HOUSE FILE 560 - Medical Assistance - Home and Community-Based Services Waivers
HOUSE FILE 672 - Adult Day Services
HOUSE FILE 675 - Regulation of Elder Family Homes, Elder Group Homes, and Assisted Living Programs - Fire and Safety Standards

RELATED LEGISLATION

SENATE FILE 36 - Miscellaneous Supplemental and Other Appropriations

SEE APPROPRIATIONS. This Act makes supplemental appropriations for FY 2002-2003 and includes appropriations to the Department of Human Services for child and family services and certain state institutions.

SENATE FILE 303 - Child Abuse Assessment Reporting

SEE CHILDREN & YOUTH. This Act modifies the requirements for completion of a child abuse assessment report by Department of Human Services workers.

SENATE FILE 351 - Child Care - Miscellaneous Provisions

SEE CHILDREN & YOUTH. This Act revises child care requirements by applying prohibitions against particular individuals having involvement with child care, expanding record checks and evaluations performed by the Department of Human Services, expanding individual eligibility for state child care assistance, and revising child care fraud sanctions.

SENATE FILE 353 - Child Protection Assistance Teams

SEE CHILDREN & YOUTH. This Act requires each county attorney to establish a child protection assistance team that may be consulted in certain child abuse cases involving a forcible felony. The teams are directed to work with the Department of Human Services in developing protocols for those child abuse reports in which there is a law enforcement investigation.

SENATE FILE 354 - Iowa Indian Child Welfare Act

SEE CHILDREN & YOUTH. This Act implements the federal Indian Child Welfare Act of 1978 in Iowa law and includes requirements not specifically addressed by the federal law. In general, the "Iowa Indian Child Welfare Act" applies in any voluntary or involuntary child custody proceeding that will result in an Indian child's adoptive placement, foster care placement, preadoptive placement, or termination of parental rights. The Department of Human Services is subject to specific requirements.

SENATE FILE 453 - State and Local Government Financial and Regulatory Matters - Miscellaneous Provisions

SEE APPROPRIATIONS. This Act addresses state and local government financial and regulatory matters. Legislators referred to this legislation as the "Government Reinvention Bill" during debate and discussion. The Act includes provisions requiring the Department of Human Services to redesign the child welfare and juvenile justice services system, revising Medicaid Program requirements, revising FY 2003-2004 appropriations to the department, and revising funding provisions for educational programs for children placed at the department's institutions.

SENATE FILE 458 - Miscellaneous Appropriations, Reductions, Revenue Adjustments, and Other Matters

SEE APPROPRIATIONS. Division I of this Act appropriates funding for county mental health, mental retardation, and developmental disabilities (MH/MR/DD) services for FY 2004-2005 allowed growth and adjusts the funding distribution relating to MH/MR/DD services for FY 2003-2004. Division VII expands the work group for the redesign of the Medical Assistance Program which is to be established by the Department of Human Services pursuant to S.F. 453, and includes language relating to supplemental payment adjustments for physicians' services provided to Medical Assistance Program recipients. Division VIII amends H.F. 619 relating to health care facilities, nursing facilities, the Case Management Program for Frail Elders, and pharmacies, among other items.

HOUSE FILE 206 - Child Abuse Reporting Requirements Involving Sexual Abuse and Reporting by Clergy - VETOED BY THE GOVERNOR

SEE CHILDREN & YOUTH. This bill related to child abuse reporting by increasing the child age for mandatory reporting of suspected child sexual abuse perpetrated by a person other than the person responsible for the care of the child and requiring members of the clergy to be mandatory reporters of child abuse under certain circumstances.

HOUSE FILE 457 - Child Welfare Services - Assessment and Plan for Transition to Adulthood

SEE CHILDREN & YOUTH. This Act expands requirements for the transition of an individual from the child welfare services system to adulthood and, if needed, to the adult services system. Legislators suggested in debate on this legislation that it was crafted to address planning problems identified in the case of a young man named Reggie Kelsey who died after he left the child welfare system upon reaching adulthood.

HOUSE FILE 472 - Federal Block Grant Appropriations

SEE APPROPRIATIONS. This Act appropriates federal block grant and other nonstate moneys to state agencies for the federal fiscal year beginning October 1, 2003, and ending September 30, 2004. The Act includes funding for maternal and child health, preventive health and health services, substance abuse programs, low-income energy assistance, mental health, child care, social services, and other health and human services-related programs.

HOUSE FILE 619 - Regulation of Health Care - Pharmaceuticals - Medical Assistance Program

SEE HEALTH & SAFETY. This Act relates to health care services and programs including health care services provided under the Medical Assistance (Medicaid) Program. The Act directs the Department of Human Services (DHS) to establish a preferred drug list program under the Medicaid Program, provides for a quality assurance assessment on nursing facilities subject to federal approval, provides for changes related to the level of care determinations for individuals seeking approval to receive services under a Medicaid home and community-based services waiver, makes changes relating to spousal support debt payment under the Medicaid Program, provides for changes in reimbursements of providers under the Medicaid Program, makes changes relating to the consolidation of home and community-based services waivers, provides for a nursing facility reimbursement adjustment under the Medicaid Program, provides for a review of recipients and providers under the Medicaid Program to determine appropriate usage and compliance, provides for a supplemental payment adjustment to physician services reimbursed under the Medicaid Program at publicly owned acute care teaching hospitals, and provides for a chronic disease management program directed by DHS. Senate File 458 amended the provisions in this Act relating to the preferred drug list, the nursing facility quality assurance assessment, home and community-based services waivers under the Medicaid Program, and reimbursement rates of providers under the Medicaid Program.

HOUSE FILE 665 - Taxation of State-Owned Property - Lease to Nonexempt Entity

SEE TAXATION. This Act relates to the taxation of land leased by the Department of Human Services.

HOUSE FILE 685 - Healthy Iowans Tobacco Trust and Tobacco Settlement Trust Fund - Appropriations

SEE APPROPRIATIONS. This Act relates to and makes appropriations from the Healthy Iowans Tobacco Trust. The Act makes appropriations involving the Medical Assistance (Medicaid) Program to the Department of Human Services (DHS) for FY 2003-2004 for reimbursement of or cost-of-living adjustments for various providers and services. The Act also provides for supplementation of the appropriation for the state children's health insurance program known as hawk-i, for supplementation of the appropriation for the Medicaid Program which includes funds for the Iowa Chronic Care Consortium (see H.F. 619, Health & Safety), and for coverage under the Medicaid Program to certain women who require treatment for breast and cervical cancer. The Act also appropriates funds from the Healthy Iowans Tobacco Trust to the Iowa Empowerment Fund for FY 2003-2004 for deposit in the School Ready Children Grants Account.

HUMAN SERVICES

SENATE FILE 416 - Dependent Adult Abuse - Facilities, Services, and Information (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to dependent adult abuse, including elder abuse, emergency shelter, and support services projects.

The Act directs the Department of Elder Affairs (DEA) to identify area agencies on aging to implement the projects. The target population of the projects is elders who are subjects of reports of suspected dependent adult abuse and who are not receiving assistance under a county management plan. The Act directs DEA to award funds for the projects in accordance with the state's service contract process.

The Act also includes provisions relating to reports of dependent adult abuse. The Act allows an agency approved by the Department of Human Services (DHS), not solely the department, to complete assessments of necessary services and make appropriate referrals following a report of suspected dependent adult abuse. The Act authorizes access to founded and unfounded dependent adult abuse information to an employee of an agency requested by DHS to provide case management or other services to the dependent adult and to the Long-Term Care Resident's Advocate when the dependent adult resides in a long-term care facility or when the alleged perpetrator is an employee of a long-term care facility.

The Act provides that dependent adult abuse information determined by a preponderance of the evidence to be founded is to be sealed 10 years after the receipt of the initial report, unless good cause is shown why the information should remain available. Current law provides that information relating to particular cases of suspected dependent adult abuse is subject to the 10-year time frame. Additionally, under current law, if a subsequent report of a suspected case of dependent adult abuse involving the same dependent adult or alleged perpetrator is received by the registry within the 10-year period, the information in both reports is then to be sealed 10 years after receipt of the subsequent report unless good cause is shown. Under the Act, this time frame relates only to a subsequent report of founded dependent adult abuse.

The Act eliminates the provision that dependent adult abuse information which cannot be determined by a preponderance of the evidence to be founded or unfounded is to be expunged one year from the date of the initial report. The Act provides instead that dependent adult abuse information which is determined by a preponderance of the evidence to be unfounded is to be expunged one year from the date it is determined to be unfounded, rather than immediately upon determining that it is unfounded.

The Act also provides that if a correction of dependent adult abuse information is requested and the information is determined to be unfounded, the information is to be expunged one year from the date it is determined to be unfounded, rather than immediately.

HOUSE FILE 386 - Policy and Services for the Elderly (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to the Department of Elder Affairs (DEA) and the Elder Iowans Act. The Act amends definitions and other provisions to be consistent with the federal Older Americans Act and specifies the programs and services that DEA is to provide or administer.

The Act specifies that the Long-Term Care Resident's Advocate is to advocate for residents of long-term care facilities excluding those facilities licensed primarily to serve persons with mental retardation or mental illness. The Act decreases the number of times that the Commission on Elder Affairs is required to meet from six to four times annually. The Act eliminates the Elder Law Education Program which ended operation in FY 1992-1993 due to discontinuation of the appropriation; eliminates the role of DEA in the representative payee program, which is currently sponsored locally; eliminates the directive to DEA to develop and disseminate information regarding Medicare supplemental insurance policies as this function is performed by the Insurance Division of the Department of Commerce; and makes conforming changes.

HOUSE FILE 387 - Mental Health and Developmental Disabilities - Facilities - Programs - Commission (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to mental health and developmental disabilities services by revising requirements for intermediate care facilities for persons with mental retardation (ICFMRs), expanding an exemption to health care licensing requirements for certain residential programs that receive funding under a medical assistance (Medicaid) home and community-based services (HCBS) waiver, and revising membership provisions for the Mental Health and Developmental Disabilities Commission.

The State Fire Marshal's rules for ICFMRs are required to be based upon the fire safety requirements published in the 2000 edition of the Life Safety Code instead of the 1985 edition.

Existing law allows a health care licensing exemption for residential programs serving no more than four individuals under the HCBS waiver. A portion of this exemption that was repealed in 2002 is reenacted. The reenacted provision applies the licensing exemptions for conversion of not more than 40 residential care facilities for persons with mental retardation licensed to serve not more than five individuals under Code Chapter 135C to residential programs operating under the HCBS waiver for persons with mental retardation. The converted facilities are subject to the same requirements as other such residential programs with the exception that not more than five persons may receive services. The exemption is also allowed for residential programs approved by the department to serve up to five individuals under an HCBS waiver for persons with mental retardation, provided the program has the support of the county in which the program is located. The county must provide the support in writing and verify that certain conditions exist that would indicate a need for the program.

The membership requirements for the Mental Health and Developmental Disabilities Commission are revised to provide that candidates for a membership slot designated for community mental health centers are to be nominated by the Iowa Association of Community Providers. The Act takes effect May 1, 2003.

HOUSE FILE 489 - Human Services Programs and Services - Miscellaneous Provisions (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to programs and services under the purview of the Department of Human Services (DHS).

Under the Act, in addition to individuals practicing other disciplines, a "multidisciplinary team" under the Child Abuse Code chapter would include individuals practicing in the discipline of domestic violence.

The Act also includes provisions relating to future collection of debt due DHS from a Medical Assistance (Medicaid) recipient's estate if present collection of the debt from the recipient's estate had been waived because collection would have resulted in a reduction in the amount received from the Medicaid recipient's estate by a surviving spouse or child, or because collection would have otherwise worked an undue hardship. The Act clarifies from whom the future collection of the debt is due and under what circumstances.

The Act also updates and corrects references regarding persons with disabilities who are eligible for Medicaid under earnings disregard provisions.

The Act provides that beginning February 1, 2002, the state is responsible for all of the nonfederal share of the costs of intermediate care facility for persons with mental retardation (ICFMR) services provided under the Medicaid Program that are attributable to the assessment fee for ICFMRs. Beginning February 1, 2003, and notwithstanding a contrary provision, a county is not required to reimburse DHS and is not to be billed for the costs of the services provided that are attributable to the assessment fee. This provision is retroactively applicable to February 1, 2002, and takes effect April 24, 2003.

The Act also provides that the county of legal settlement of a person is to pay the nonfederal costs of rehabilitation services provided under the Medicaid Program for persons with chronic mental illness. However, if the person has no county of legal settlement, the state is responsible for payment of the nonfederal share of the costs.

The Act provides that a proceeding under the Support of Dependents Code chapter may be commenced by filing a petition not only with the court in a county where the dependent resides or is domiciled, but, if the dependent does not reside in or is not domiciled in Iowa, in the county where the petitioner or respondent resides, or where public assistance has been provided for the dependent.

HOUSE FILE 529 - Mental Health and Developmental Disabilities Services System Review (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act directs the Mental Health and Developmental Disabilities Commission to make recommendations for redesigning the mental health and developmental disabilities services system for adults.

One of the commission's duties under existing law is to perform "analyses and other functions associated with a redesign of the mental health and developmental disabilities services systems for adults and for children." The Act requires the commission to make recommendations regarding the following: standardizing clinical and financial eligibility, identifying a minimum set of core services to be available in each county statewide, developing an option for a funding formula in which funding follows an eligible individual, providing options for transition from the current legal settlement process of determining financial liability for service costs to a new system, and developing methods for improved coordination of federal, state and county funding streams.

The commission's report and recommendations are required to be submitted to the Governor and General Assembly on or before December 31, 2003.

The Act takes effect May 2, 2003.

HOUSE FILE 558 - Disclosure of Information to Subjects of Child or Dependent Adult Abuse Reports (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act authorizes the Department of Human Services to disclose information regarding the listing of an individual in the Child or Dependent Adult Abuse Registry or the Sex Offender Registry when the disclosure is necessary for the protection of a child or dependent adult. The disclosure is limited, as applicable, to persons who are the subject of a child abuse report (the child, child's parent, guardian, or legal custodian, person named in the report as having committed the abuse, and attorneys for these persons) or the subject of a dependent adult abuse report (the dependent adult, adult's guardian, custodian, or guardian ad litem, person named in the report as having committed the abuse, and attorneys for these persons).

HOUSE FILE 560 - Medical Assistance - Home and Community-Based Services Waivers (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to home and community-based services (HCBS) waivers under the Medical Assistance (Medicaid) Program.

The Act provides that beginning July 1, 2003, HCBS waivers for persons with mental retardation are to include adult day care, prevocational, and transportation services. The transportation services are to be included as a separately payable service. The Act directs the Department of Human Services (DHS) to seek federal approval to amend the HCBS waiver for persons with mental retardation to include day habilitation services. Provision of these services under the waiver is to take effect upon receipt of federal approval and not later than July 1, 2004. A person's county of legal settlement is to pay for the nonfederal share of the cost of services under the waiver and the state is to pay the nonfederal share for those without a county of legal settlement.

The Act provides that a case manager for an HCBS waiver may terminate the contract of a person providing consumer-directed attendant care services if the case manager determines that the person has breached the contract by not providing the services agreed to under the contract.

The Act directs DHS to review the reimbursement methodology for HCBS waivers for persons with mental retardation in relationship to the goals and objectives of the mental health and developmental disabilities services system redesign being conducted by the Mental Health and Developmental Disabilities Commission. The Act directs DHS to submit a report of the findings and recommendations to the General Assembly by July 1, 2004. The Act provides that for FY 2003-2004, DHS, in cooperation with the Iowa State Association of Counties and the Iowa Association of Community Providers, is to establish payment rate limitations for services provided under the HCBS waiver for persons with mental retardation that are consistent with the limitations used for the same or similar services that are funded 100 percent by the counties.

HOUSE FILE 672 - Adult Day Services (full text of bill)
BY COMMITTEE ON APPROPRIATIONS. This Act establishes regulatory provisions for adult day services.

Under existing law, provisions relating to regulation of adult day services consist of development of a system of oversight by affected state agencies, industry representatives, and consumers under the Department of Elder Affairs (DEA).

Under the Act, new Code chapter 231D is created to provide for the regulation of adult day services under DEA with enforcement provided by the Department of Inspections and Appeals (DIA). The Act directs DEA to establish a program for certification and monitoring of and complaint investigations related to adult day services. The rules and standards are to be formulated in consultation with DIA and affected industry, professional and consumer groups. In addition to rules, interpretive guidelines are also to be issued. The Act requires all adult day services programs to be certified by DIA. The Act establishes application and fee requirements; provides a procedure for denial, suspension or revocation of certification; provides an appeals process, emergency provisions, and for conditional operation of a program; provides for DIA to be notified of casualties relative to an adult day services program; provides a complaint process; provides for disclosure of final findings by DIA related to monitoring evaluations or complaint investigations; provides penalties for noncompliance with certification requirements and enforcement of the provisions of the chapter; prohibits retaliation by an adult day services program; provides for nursing assistants and medication aides to claim work within adult day services programs as credit toward certification; and provides for fire and safety standards.

The Act also requires DIA, in consultation with DEA and the Department of Public Safety, to submit a written report to the General Assembly and the Joint Appropriations Subcommittee on Health and Human Services regarding implementation of the Act. The Act also provides that if an adult day services program for persons with mental retardation is voluntarily accredited prior to July 1, 2003, DIA is to accept the voluntary accreditation as the basis for certification for the period beginning July 1, 2003, and ending June 30, 2004. This provision takes effect May 30, 2003.

HOUSE FILE 675 - Regulation of Elder Family Homes, Elder Group Homes, and Assisted Living Programs Fire and Safety Standards (full text of bill)
BY COMMITTEE ON APPROPRIATIONS. This Act provides for regulation of elder group homes and assisted living programs and eliminates the Code chapter relating to elder family homes.

The Act provides for regulation of elder group homes by the Department of Elder Affairs (DEA) and for inspection and certification of elder group homes by the Department of Inspections and Appeals (DIA). The Act changes the definition of "elder group home" to mean a single-family residence operated by a person, rather than being the residence of the person providing the room, board, and personal care to elders. The Act also provides that rather than being owner-occupied or owned by a nonprofit corporation and occupied by a resident manager, the elder group home is required only to be staffed by an on-site manager 24 hours per day, seven days per week.

The Act provides for regulation of assisted living programs. The Act requires DEA to establish policy and DIA to provide enforcement with regard to assisted living programs. The Act defines assisted living programs as those programs providing housing with services to three or more tenants, rather than to six or more tenants as under prior law. See Division III of H.F. 683 (Appropriations) for revisions relating to continuing care retirement communities.

The Act directs DEA to establish, by rule, a program for certification and monitoring of assisted living programs. The rules are to be formulated in consultation with DIA and affected industry, professional and consumer groups. In addition to the adoption of rules, DEA is also to issue interpretive guidelines. Each assisted living program in the state is to be certified by DIA. If an assisted living program is voluntarily accredited by a recognized accrediting entity, DIA is to certify the program based upon the voluntary accreditation. The Act provides that DEA may establish, by rule, a special classification for affordable assisted living programs and is to adopt rules regarding the conducting or operating of another business or activity in the distinct part of the physical structure in which the assisted living program is provided.

The Act specifies requirements for written occupancy agreements and provides a process for involuntary transfer of a tenant. The Act provides for filing and disposition of complaints; provides for an informal review of contests to the results of a monitoring evaluation or complaint investigation; provides for public disclosure of the final findings of a monitoring evaluation or complaint investigation; provides the bases for denial, suspension or revocation of certification and for conditional operation of a program; provides for notice, appeal and emergency provisions relating to a denial, suspension or revocation of certification; provides for notification of DIA of any casualties at an assisted living program; prohibits retaliation by the program; provides for application of civil and criminal penalties for certain violations and for injunctive relief; provides for nursing assistants and medication aides to claim work within an assisted living program as credit toward their certification; provides transitional provisions; establishes certification and related fees; provides that the Uniform Residential Landlord and Tenant Act applies to assisted living programs; and provides for transition of departmental staff.