House Amendment to Senate Amendment to House File 2422 S-5229 Amend the Senate amendment, H-8486 to House File 1 2422, as amended, passed, and reprinted by the House, 2 as follows: 3 1. By striking page 1, line 3, through page 3, line 4 12, and inserting: 5 < ___. By striking everything after the enacting 6 clause and inserting: 7 < Section 1. Section 135C.3, subsection 1, Code 8 2011, is amended to read as follows: 9 1. a. A licensed nursing facility shall provide 10 an organized twenty-four-hour program of services 11 commensurate with the needs of its residents and 12 under the immediate direction of a licensed nurse. 13 Medical and nursing services must be provided 14 under the direction of either a house physician 15 or an individually selected physician. Surgery or 16 obstetrical care shall not be provided within the 17 facility. An admission to the nursing facility must 18 be based on a physician’s written order certifying 19 that the individual being admitted requires no greater 20 degree of nursing care than the facility to which the 21 admission is made is licensed to provide and is capable 22 of providing. 23 b. A nursing facility is not required to admit 24 an individual through court order, referral, or 25 other means without the express prior approval of the 26 administrator of the nursing facility. For purposes of 27 this paragraph, the approval of the administrator of 28 the nursing facility cannot be withheld on the basis of 29 considerations that are otherwise prohibited by state 30 or federal law. 31 Sec. 2. Section 135C.4, Code 2011, is amended to 32 read as follows: 33 135C.4 Residential care facilities. 34 1. Each facility licensed as a residential care 35 facility shall provide an organized continuous 36 twenty-four-hour program of care commensurate with 37 the needs of the residents of the home and under 38 the immediate direction of a person approved and 39 certified by the department whose combined training and 40 supervised experience is such as to ensure adequate and 41 competent care. 42 2. All admissions to residential care facilities 43 shall be based on an order written by a physician 44 certifying that the individual being admitted does 45 not require nursing services or that the individual’s 46 need for nursing services can be avoided if home and 47 community-based services, other than nursing care, as 48 defined by this chapter and departmental rule, are 49 provided. 50 -1- H8486.6009.H (1) 84 md 1/ 10 #1.
3. For the purposes of this section , the home 1 and community-based services to be provided shall 2 be limited to the type included under the medical 3 assistance program provided pursuant to chapter 249A , 4 shall be subject to cost limitations established by 5 the department of human services under the medical 6 assistance program, and except as otherwise provided 7 by the department of inspections and appeals with 8 the concurrence of the department of human services, 9 shall be limited in capacity to the number of licensed 10 residential care facilities and the number of licensed 11 residential care facility beds in the state as of 12 December 1, 2003. 13 4. A residential care facility is not required 14 to admit an individual through court order, referral, 15 or other means without the express prior approval of 16 the administrator of the residential care facility. 17 For purposes of this subsection, the approval of the 18 administrator of the residential care facility cannot 19 be withheld on the basis of considerations that are 20 otherwise prohibited by state or federal law. 21 Sec. 3. NEW SECTION . 135C.23A Sex offender 22 notification. 23 1. Upon commitment of a person required to register 24 as a sex offender as provided in section 692A.103 to 25 a nursing facility, residential care facility, or 26 assisted living program as defined in section 231C.2, 27 the clerk of the committing court shall notify the 28 department of inspections and appeals and the admitting 29 facility or program. 30 2. Prior to admission of a resident or tenant to 31 a nursing facility, residential care facility, or 32 assisted living program, the facility or program shall 33 access and search the sex offender registry established 34 in chapter 692A to determine whether the resident 35 or tenant is a person required to register as a sex 36 offender, as provided in section 692A.103. 37 3. Upon the admission of a person required to 38 register as a sex offender, a nursing facility, 39 residential care facility, or assisted living program 40 shall provide notice of the admission, in accordance 41 with the federal Health Insurance Portability and 42 Accountability Act of 1996, Pub. L. No. 104-191, other 43 state and federal regulations, and rules adopted by the 44 department, to all of the following persons: 45 a. Residents or tenants of the facility or program. 46 b. The emergency contact person or next of kin for 47 residents or tenants of the facility or program. 48 c. Operators, owners, managers, or employees of the 49 facility or program. 50 -2- H8486.6009.H (1) 84 md 2/ 10
d. Visitors to the facility or program. 1 e. The sheriff for the county in which the facility 2 or program is located. The sheriff shall notify local 3 law enforcement agencies. 4 4. Upon the admission of a person required to 5 register as a sex offender, a nursing facility, 6 residential care facility, or assisted living program 7 shall develop and implement a written safety plan for 8 each such person in accordance with rules adopted by 9 the department. 10 5. The department shall establish by rule, all of 11 the following: 12 a. The requirements of the notice required under 13 this section. The rules shall include but are not 14 limited to provisions for the method of notice and 15 time of notice to each of the persons enumerated in 16 subsection 3. 17 b. The requirements of a safety plan for persons 18 required to register as a sex offender who are admitted 19 by a nursing facility, residential care facility, or 20 assisted living program. The rules shall include but 21 are not limited to all of the following: 22 (1) A plan for the safety of residents, tenants, 23 and staff of the facility or program. 24 (2) A plan for the safety of others when community 25 functions are held at a facility or program and when a 26 person required to register as a sex offender is not on 27 the premises of a facility or program but the person 28 remains within the care, custody, and control of the 29 facility or program. 30 (3) A provision to establish the responsibilities 31 of a nursing facility, residential care facility, and 32 assisted living program and the operators, owners, 33 managers, and employees of facilities and programs in 34 implementing a safety plan. 35 (4) A provision for the timely development and 36 implementation of a safety plan. 37 6. The department shall work with interested 38 stakeholders in developing the proposed rules under 39 this section. 40 7. A violation of this section is subject to the 41 imposition of a civil penalty in accordance with rules 42 adopted by the department pursuant to this section. 43 Sec. 4. Section 229A.8A, subsection 5, Code 2011, 44 is amended to read as follows: 45 5. Committed Except as provided in subsection 6A, 46 committed persons in the transitional release program 47 are not necessarily required to be segregated from 48 other persons. 49 Sec. 5. Section 229A.8A, Code 2011, is amended by 50 -3- H8486.6009.H (1) 84 md 3/ 10
adding the following new subsection: 1 NEW SUBSECTION . 6A. Persons in the transitional 2 release program shall not be released to a health care 3 facility as defined in section 135C.1. 4 Sec. 6. Section 229A.9A, Code 2011, is amended by 5 adding the following new subsection: 6 NEW SUBSECTION . 3A. If a release with or without 7 supervision is ordered, the committed person shall not 8 be released to a health care facility as defined in 9 section 135C.1. 10 Sec. 7. Section 231C.3, subsection 9, Code 2011, is 11 amended to read as follows: 12 9. An assisted living program shall comply with 13 section sections 135C.23A and 135C.33 . 14 Sec. 8. Section 231C.5A, Code 2011, is amended to 15 read as follows: 16 231C.5A Assessment of tenants —— program 17 eligibility. 18 1. An assisted living program receiving 19 reimbursement through the medical assistance program 20 under chapter 249A shall assist the department of 21 veterans affairs in identifying, upon admission of a 22 tenant, the tenant’s eligibility for benefits through 23 the United States department of veterans affairs. 24 The assisted living program shall also assist the 25 commission of veterans affairs in determining such 26 eligibility for tenants residing in the program on July 27 1, 2009. The department of inspections and appeals, 28 in cooperation with the department of human services, 29 shall adopt rules to administer this section , including 30 a provision that ensures that if a tenant is eligible 31 for benefits through the United States department of 32 veterans affairs or other third-party payor, the payor 33 of last resort for reimbursement to the assisted living 34 program is the medical assistance program. The rules 35 shall also require the assisted living program to 36 request information from a tenant or tenant’s personal 37 representative regarding the tenant’s veteran status 38 and to report to the department of veterans affairs 39 only the names of tenants identified as potential 40 veterans along with the names of their spouses and 41 any dependents. Information reported by the assisted 42 living program shall be verified by the department of 43 veterans affairs. 44 2. An assisted living program is not required 45 to enter into a lease or occupancy agreement with an 46 individual through court order, referral, or other 47 means without the express prior approval of the manager 48 of the assisted living program. For purposes of this 49 subsection, the approval of the manager of the assisted 50 -4- H8486.6009.H (1) 84 md 4/ 10
living program cannot be withheld on the basis of 1 considerations that are otherwise prohibited by state 2 or federal law. 3 Sec. 9. Section 231C.14, subsection 1, Code 2011, 4 is amended by adding the following new paragraph: 5 NEW PARAGRAPH . d. Noncompliance with section 6 135C.23A. 7 Sec. 10. Section 602.8102, Code 2011, is amended by 8 adding the following new subsection: 9 NEW SUBSECTION . 152. Notify the department of 10 inspections and appeals and the admitting entity upon 11 commitment of a person required to register as a sex 12 offender as provided in section 692A.103 to a nursing 13 facility or residential care facility as defined in 14 section 135C.1, or assisted living program as defined 15 in section 231C.2. 16 Sec. 11. PLACEMENT OF PERSONS REQUIRED TO 17 REGISTER. 18 1. For purposes of this section, “adequate 19 placement” means a placement that will provide the 20 level of care necessary for a person including the 21 level of care provided by a nursing facility or 22 residential care facility. 23 2. For the period beginning July 1, 2012, through 24 June 30, 2013, the department of human services, in 25 compliance with federal and state law, shall secure 26 adequate placements for persons required to register 27 as a sex offender pursuant to chapter 692A who are 28 being released from the custody of the department 29 of corrections and require the type of medical 30 and personal care provided by a nursing facility, 31 residential care facility, or assisted living program; 32 who are being discharged or transferred from nursing 33 facilities, residential care facilities, or assisted 34 living programs pursuant to a provision of this Act; 35 or who require the type of medical and personal care 36 provided by nursing facilities, residential care 37 facilities, or assisted living programs when the 38 persons are unable to gain access to a facility or 39 program because the persons are required to register on 40 the sex offender registry. 41 3. The department of human services may use a 42 state facility to provide care for such persons or may 43 conduct a request for proposal process to contract with 44 a private facility to care for such persons. A request 45 for proposals shall identify the reimbursement rate 46 and the necessary training for staff in the facility 47 or program. 48 4. The department of human services shall secure 49 an adequate placement for such a person within ten 50 -5- H8486.6009.H (1) 84 md 5/ 10
business days of being notified by the department of 1 corrections, the department of inspections and appeals, 2 or a nursing facility, residential care facility, 3 or assisted living program that placement is needed 4 for such person, provided that such period shall not 5 commence until the department of public safety receives 6 and approves registration data and makes such data 7 available on the sex offender registry internet site 8 pursuant to section 692A.121, subsection 12. 9 Sec. 12. WORKFORCE DEVELOPMENT WORKGROUP. 10 1. If a workgroup to address issues connected with 11 workforce development related to mental health and 12 disability services is established by or as a result 13 of legislation enacted by the 2012 regular session of 14 the Eighty-fourth General Assembly, the workgroup shall 15 also address issues connected with ensuring that an 16 adequate workforce is available in the state to provide 17 services to persons who have a history of committing 18 sexual offenses and have been determined to be likely 19 to reoffend. 20 2. a. If a workgroup to address issues connected 21 with workforce development for mental health and 22 disability services is not established by or as a 23 result of legislation enacted by the 2012 regular 24 session of the Eighty-fourth General Assembly, the 25 department of human services shall convene and provide 26 support to a health and mental health services for 27 sexual offender workforce development workgroup to 28 address issues connected with ensuring that an adequate 29 workforce is available in the state to provide health 30 and mental health services to persons who have a 31 history of committing sexual offenses and have been 32 determined to be likely to reoffend. The workgroup 33 shall report at least annually to the governor and 34 general assembly providing findings, recommendations, 35 and financing information concerning the findings and 36 recommendations. 37 b. The membership of the workgroup shall include 38 all of the following: 39 (1) The director of the department of aging or the 40 director’s designee. 41 (2) The director of the department of corrections 42 or the director’s designee. 43 (3) The director of the department of education or 44 the director’s designee. 45 (4) The director of human services or the 46 director’s designee. 47 (5) The director of the department of public health 48 or the director’s designee. 49 (6) The director of the department of workforce 50 -6- H8486.6009.H (1) 84 md 6/ 10
development or the director’s designee. 1 (7) At least three individuals who have a history 2 of committing sexual offenses and have been determined 3 likely to reoffend who are receiving mental health 4 or health services or involved relatives of such 5 individuals. 6 (8) At least three providers of mental health or 7 health services for individuals who have a history of 8 committing sexual offenses and have been determined 9 likely to reoffend. 10 (9) Other persons identified by the workgroup. 11 c. In addition to the members identified in 12 paragraph “b”, the membership of the workgroup 13 shall include four members of the general assembly 14 serving in a ex officio, nonvoting capacity. One 15 member shall be designated by each of the following: 16 the majority leader of the senate, the minority 17 leader of the senate, the speaker of the house of 18 representatives, and the minority leader of the house 19 of representatives. A legislative member serves for a 20 term as provided in section 69.16B. 21 d. Except as provided in paragraph “c” for 22 legislative appointments, the workgroup shall determine 23 its own rules of procedure, membership terms, and 24 operating provisions. 25 Sec. 13. FACILITY FOR SEXUAL OFFENDERS COMMITTEE 26 AND REPORT. 27 1. The department of inspections and appeals, in 28 conjunction with the department of human services, 29 shall establish and facilitate the activities of 30 a committee of stakeholders to examine options for 31 designating a facility to provide care for persons in 32 this state who have a history of committing sexual 33 offenses and have been determined to be likely to 34 reoffend. 35 2. The membership of the committee shall include 36 but is not limited to the following: 37 a. Representatives of the departments of 38 inspections and appeals, human services, public health, 39 corrections, and aging, the office of the state public 40 defender, the office of the citizens’ aide, the office 41 of the state long-term care ombudsman, and the judicial 42 branch. 43 b. Consumers of services provided by health care 44 facilities and family members of consumers. 45 c. Representatives of the health care industry and 46 industry associations. 47 d. Direct care workers employed by health care 48 facilities. 49 e. Representatives from the Iowa legal aid. 50 -7- H8486.6009.H (1) 84 md 7/ 10
f. Representatives from AARP Iowa. 1 g. Representatives from the Iowa civil liberties 2 union. 3 h. Other stakeholders as the department of 4 inspections and appeals and the department of human 5 services deem necessary. 6 i. Four ex officio, nonvoting members from the 7 general assembly with not more than one member from 8 each chamber being from the same political party. 9 The two senators shall be appointed, one each, by 10 the majority leader of the senate and the minority 11 leader of the senate. The two representatives shall 12 be appointed, one each, by the speaker of the house of 13 representatives and the minority leader of the house 14 of representatives. 15 3. The committee shall discuss and make 16 recommendations on all of the following: 17 a. Options to create a new facility or assist 18 an existing facility to expand services to provide 19 care for elderly persons who are no longer under 20 judicial control, but have a history of committing 21 sexual offenses and have been determined to be 22 likely to reoffend. The committee shall identify 23 the characteristics of a client for such a facility, 24 the need for such a facility, options for creating 25 a new facility to house such persons, options for 26 the expansion of an existing facility to house such 27 persons, options for using any alternative facilities 28 for such purposes, options for a public-private 29 partnership for such a facility, options for 30 using part of a mental health institute to house 31 such persons, options to qualify a facility for 32 Medicaid reimbursement, cost projections for any 33 recommendations, regulatory challenges, and other 34 information deemed relevant by the department of 35 inspections and appeals and the department of human 36 services. 37 b. The responsibility of the court, the clerk of 38 the district court, the department of corrections, 39 or any other entity, department, or person to inform 40 a nursing facility, residential care facility, or an 41 assisted living program of the admission of a person 42 who has a history of committing sexual offenses. 43 c. The responsibility of the court, clerk of the 44 district court, department of corrections, a facility, 45 or any other entity, department, or person to notify 46 persons of the discharge of a person who has a history 47 of committing sexual offenses from a nursing facility, 48 residential care facility, or assisted living program. 49 d. The requirements of a treatment safety plan for 50 -8- H8486.6009.H (1) 84 md 8/ 10
a person admitted to a nursing facility, residential 1 care facility, or assisted living program who has a 2 history of committing sexual offenses. The treatment 3 safety plan shall address the procedure for notifying 4 other residents of the residency of a person required 5 to register as a sex offender. 6 e. The establishment of a formal process for 7 the department of inspections and appeals to follow 8 when completing facility or assisted living program 9 inspections or surveys. 10 f. The establishment of a system for the judicial 11 branch to identify facilities with the capacity to 12 provide an appropriate placement for a person requiring 13 commitment when the person also has a history of 14 committing sexual offenses. 15 4. The committee shall provide a report detailing 16 its findings and recommendations to the governor and 17 the general assembly by December 14, 2012. 18 Sec. 14. EMERGENCY RULES. If specifically 19 authorized by a provision of this Act, the department 20 of inspections and appeals may adopt administrative 21 rules under section 17A.4, subsection 3, and section 22 17A.5, subsection 2, paragraph “b”, to implement 23 the provisions and the rules shall become effective 24 immediately upon filing or on a later effective date 25 specified in the rules, unless the effective date is 26 delayed by the administrative rules review committee. 27 Any rules adopted in accordance with this section 28 shall not take effect before the rules are reviewed 29 by the administrative rules review committee. The 30 delay authority provided to the administrative rules 31 review committee under section 17A.4, subsection 7, and 32 section 17A.8, subsection 9, shall be applicable to a 33 delay imposed under this section, notwithstanding a 34 provision in those sections making them inapplicable 35 to section 17A.5, subsection 2, paragraph “b”. Any 36 rules adopted in accordance with the provisions of this 37 section shall also be published as a notice of intended 38 action as provided in section 17A.4. 39 Sec. 15. CURRENT RESIDENTS AND TENANTS —— 40 ACCESS AND SEARCH OF SEX OFFENDER REGISTRY AND 41 NOTIFICATION. A nursing facility, residential care 42 facility, or assisted living program, within three 43 months of the adoption of the rules by the department 44 of inspections and appeals regarding notification of 45 the admission of persons required to register as a 46 sex offender to a facility or program and development 47 and implementation of safety plans relating to such 48 admitted persons, shall access and search the sex 49 offender registry established in chapter 692A for 50 -9- H8486.6009.H (1) 84 md 9/ 10
persons who were residents or tenants of a facility 1 or program prior to the adoption of the rules and who 2 remain residents or tenants of the facility or program 3 after the adoption of the rules. Upon determining that 4 a resident or tenant is a person required to register 5 as a sex offender, the facility or program shall, 6 within three months of the adoption of the rules, 7 work with the department of inspections and appeals 8 and the department of human services to transfer a 9 sex offender living in the facility or program to a 10 state facility, based on the sex offender status as 11 an endangerment to the safety of individuals in the 12 facility or program, or notify persons as required by 13 section 135C.23A and the rules adopted pursuant to 14 that section and develop and implement a safety plan 15 as required by section 135C.23A and the rules adopted 16 pursuant to that section. The rules shall provide 17 that, for purposes of this section, a nursing facility, 18 residential care facility, or assisted living program 19 has the right to discharge a current resident or tenant 20 based solely on the person’s status as a sex offender 21 as an endangerment to the safety of individuals in the 22 facility or program. 23 Sec. 16. EFFECTIVE UPON ENACTMENT. This Act, being 24 deemed of immediate importance, takes effect upon 25 enactment. > 26 ___. Title page, line 3, after < program, > by 27 inserting < the care and housing of sex offenders and 28 sexually violent predators, >> 29 -10- H8486.6009.H (1) 84 md 10/ 10