House File 772 H-1373 Amend House File 772 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < Section 1. Section 135C.1, Code 2021, is amended by adding 4 the following new subsections: 5 NEW SUBSECTION . 6A. “Electronic monitoring” means the 6 placement and use of an electronic monitoring device by 7 a resident in the resident’s room in accordance with this 8 subchapter. 9 NEW SUBSECTION . 6B. “Electronic monitoring device” means a 10 camera or other device that captures, records, or broadcasts 11 audio, video, or both, that is placed in a resident’s room and 12 is used to monitor the resident or activities in the room. 13 NEW SUBSECTION . 21A. “Resident representative” means one of 14 the following in the order of priority listed, to the extent 15 the person may reasonably be identified and located: 16 a. The attorney in fact designated to make treatment 17 decisions for the resident in accordance with chapter 144B. 18 b. The guardian of the resident if one has been appointed 19 pursuant to chapter 633. 20 c. The resident’s spouse. 21 d. An adult child of the resident or, if the resident has 22 more than one adult child, a majority of the adult children who 23 are reasonably available. 24 e. A parent of the resident, or parents if both are 25 reasonably available. 26 f. An adult sibling of the resident. 27 Sec. 2. NEW SECTION . 135C.49 Electronic monitoring. 28 1. A resident or a resident representative may conduct 29 electronic monitoring of the resident’s room through the use of 30 an electronic monitoring device placed in the resident’s room 31 pursuant to this subchapter. 32 2. Nothing in this section precludes the use of electronic 33 monitoring otherwise allowed by law. 34 Sec. 3. NEW SECTION . 135C.50 Consent to electronic 35 -1- HF772.1908 (1) 89 cm/jh 1/ 10 #1.

monitoring. 1 1. Except as otherwise provided in this subchapter, 2 a resident must consent to electronic monitoring in the 3 resident’s room in writing on a notification and consent 4 form prescribed by the department. If the resident has 5 not affirmatively objected to electronic monitoring and the 6 resident’s medical professional determines that the resident 7 lacks the ability to understand and appreciate the nature 8 and consequences of electronic monitoring, the resident 9 representative may consent on behalf of the resident. For 10 purposes of this subsection, a resident affirmatively objects 11 when the resident orally, visually, or through the use of 12 auxiliary aids or services declines electronic monitoring. The 13 resident’s response shall be documented on the notification and 14 consent form. 15 2. Prior to a resident representative consenting on behalf 16 of a resident, the resident shall be asked if the resident 17 wants electronic monitoring to be conducted. The resident 18 representative shall explain all of the following to the 19 resident: 20 a. The type of electronic monitoring device to be used. 21 b. The standard conditions or restrictions that may be 22 placed on the electronic monitoring device’s use including as 23 specified in the list of standard conditions or restrictions 24 contained in the notification and consent form completed by the 25 resident as provided in section 135C.53. 26 c. The dissemination and use of any recording as provided 27 under section 135C.57 or 135C.58. 28 d. The resident’s ability to decline all recordings. 29 3. A resident, or resident representative when consenting 30 on behalf of the resident, may consent to electronic monitoring 31 with any conditions or restrictions of the resident’s or 32 resident representative’s choosing, including the list 33 of standard conditions or restrictions contained in the 34 notification and consent form completed by the resident 35 -2- HF772.1908 (1) 89 cm/jh 2/ 10

as provided in section 135C.53. A resident, or resident 1 representative when consenting on behalf of the resident, may 2 request that the electronic monitoring device be turned off 3 or the visual or audio recording component of the electronic 4 monitoring device be blocked at any time. 5 4. Prior to implementing electronic monitoring, a resident, 6 or resident representative when acting on behalf of the 7 resident, shall obtain the written consent on the notification 8 and consent form of any other resident who is a roommate 9 residing in the shared room. A roommate’s or roommate’s 10 resident representative’s written consent shall comply with 11 the requirements of this section. Consent by a roommate or 12 a roommate’s resident representative under this subsection 13 authorizes the resident’s use of any recording obtained under 14 this section as provided under sections 135C.57 and 135C.58. 15 5. Any resident conducting electronic monitoring shall 16 immediately remove or disable an electronic monitoring device 17 prior to a new resident who will be a roommate moving into 18 a shared room, unless the resident conducting electronic 19 monitoring obtains the new roommate’s or new roommate’s 20 resident representative’s written consent as provided under 21 this section prior to the new roommate moving into the shared 22 room. Upon obtaining the new roommate’s or new roommate’s 23 resident representative’s signed notification and consent form 24 and submitting the form to the nursing facility as required 25 under section 135C.52, the resident may resume electronic 26 monitoring. 27 6. The resident or roommate, or the resident representative 28 or roommate’s resident representative if the representative is 29 consenting on behalf of the resident or roommate, may withdraw 30 consent at any time and the withdrawal of consent shall be 31 documented on the original consent form as provided under 32 section 135C.52. 33 Sec. 4. NEW SECTION . 135C.51 Refusal of roommate to 34 consent. 35 -3- HF772.1908 (1) 89 cm/jh 3/ 10

If a resident of a nursing facility who is residing in a 1 shared room, or the resident representative of such a resident 2 when acting on behalf of the resident, wants to conduct 3 electronic monitoring and another resident living in or moving 4 into the same shared room refuses to consent to the use of an 5 electronic monitoring device, the nursing facility shall make 6 a reasonable attempt to accommodate the resident who wants to 7 conduct electronic monitoring. A nursing facility has met 8 the requirement to make a reasonable attempt to accommodate 9 a resident or resident representative who wants to conduct 10 electronic monitoring when, upon notification that a roommate 11 has not consented to the use of an electronic monitoring device 12 in the resident’s room, the nursing facility offers to move one 13 of the residents to another shared room that is available at 14 the time of the request that accommodates the resident. If 15 a resident chooses to reside in a private room in order to 16 accommodate the use of an electronic monitoring device, the 17 resident shall be subject to a private room rate. If a nursing 18 facility is unable to accommodate a resident due to lack of 19 space, the nursing facility shall reevaluate the request 20 periodically until the request is fulfilled. 21 Sec. 5. NEW SECTION . 135C.52 Notice and consent form 22 submitted to nursing facility. 23 1. Electronic monitoring may begin only after the resident 24 or resident representative who intends to place an electronic 25 monitoring device in the resident’s room and any roommate or 26 roommate’s resident representative completes a notification and 27 consent form and submits the form to the nursing facility. 28 2. Upon receipt of the required, completed notification and 29 consent form, the nursing facility shall place the original 30 form in the resident’s file, and a copy of the form in any 31 roommate’s file. The nursing facility shall provide a copy to 32 the resident and the resident’s roommate, as applicable. 33 3. If a resident or roommate, or the resident representative 34 or roommate’s resident representative if the representative 35 -4- HF772.1908 (1) 89 cm/jh 4/ 10

is consenting on behalf of the resident or roommate, chooses 1 to alter the conditions under which consent to electronic 2 monitoring is given or chooses to withdraw consent to 3 electronic monitoring, the nursing facility shall make 4 available the original notification and consent form so that 5 the original form may be updated. Upon receipt of the updated 6 original form, the nursing facility shall place the updated 7 original form in the resident’s file. The nursing facility 8 shall provide a copy of the updated form to the resident and 9 the resident’s roommate, as applicable. 10 4. If a new roommate, or the new roommate’s resident 11 representative when consenting on behalf of the new roommate, 12 does not consent to electronic monitoring and submit a 13 completed notification and consent form to the nursing 14 facility, and the resident conducting the electronic monitoring 15 does not remove or disable an existing electronic monitoring 16 device, the nursing facility shall remove the electronic 17 monitoring device. 18 5. If a roommate, or the roommate’s resident representative 19 when withdrawing consent on behalf of the roommate, submits 20 an updated notification and consent form withdrawing consent 21 and the resident conducting electronic monitoring does not 22 remove or disable the electronic monitoring device, the nursing 23 facility shall remove the electronic monitoring device. 24 Sec. 6. NEW SECTION . 135C.53 Notification and consent form 25 requirements. 26 1. The notification and consent form completed by the 27 resident shall include, at a minimum, all of the following 28 information: 29 a. The resident’s signed consent to electronic monitoring or 30 the signature of the resident representative, if applicable. 31 If a resident representative signs the consent form, the form 32 shall document all of the following: 33 (1) The date the resident was asked if the resident wants 34 electronic monitoring to be conducted. 35 -5- HF772.1908 (1) 89 cm/jh 5/ 10

(2) Any person present when the resident was asked. 1 (3) An acknowledgment that the resident did not 2 affirmatively object. 3 (4) The source of authority allowing the resident 4 representative to sign the notification and consent form on the 5 resident’s behalf. 6 b. The resident’s roommate’s signed consent or the signature 7 of the roommate’s resident representative, if applicable. If a 8 roommate’s resident representative signs the consent form, the 9 form shall document all of the following: 10 (1) The date the roommate was asked if the roommate wants 11 electronic monitoring to be conducted. 12 (2) Any person present when the roommate was asked. 13 (3) An acknowledgment that the roommate did not 14 affirmatively object. 15 (4) The source of authority allowing the resident 16 representative to sign the notification and consent form on the 17 roommate’s behalf. 18 c. The type of electronic monitoring device to be used. 19 d. Any installation needs, such as mounting of a device to 20 a wall or ceiling. 21 e. The proposed date of installation for scheduling 22 purposes. 23 f. A copy of any contract for maintenance of the electronic 24 monitoring device by a commercial entity. 25 g. A list of standard conditions or restrictions that the 26 resident or a roommate may elect to place on the use of the 27 electronic monitoring device including but not limited to all 28 of the following: 29 (1) Prohibiting audio recording. 30 (2) Prohibiting video recording. 31 (3) Prohibiting broadcasting of audio or video. 32 (4) Turning off the electronic monitoring device or 33 blocking the visual recording component of the electronic 34 monitoring device for the duration of an exam or procedure by a 35 -6- HF772.1908 (1) 89 cm/jh 6/ 10

health care professional. 1 (5) Turning off the electronic monitoring device or 2 blocking the visual recording component of the electronic 3 monitoring device while dressing or bathing is performed. 4 (6) Turning off the electronic monitoring device for 5 the duration of a visit with a spiritual adviser, ombudsman, 6 attorney, financial planner, intimate partner, or other 7 visitor. 8 h. Any other condition or restriction elected by the 9 resident or roommate on the use of an electronic monitoring 10 device. 11 i. A statement of the circumstances under which a recording 12 may be disseminated under section 135C.57. 13 j. A signature box to document if the resident or roommate 14 withdraws consent. 15 2. A nursing facility shall make the notification and 16 consent form available to the residents and inform residents of 17 the option to conduct electronic monitoring of the resident’s 18 room. 19 Sec. 7. NEW SECTION . 135C.54 Cost and installation. 20 1. A resident who chooses to conduct electronic monitoring 21 shall do so at the resident’s own expense, including payment of 22 any purchase, installation, maintenance, and removal costs. 23 2. If a resident chooses to place an electronic monitoring 24 device that uses internet technology for visual or audio 25 monitoring, the resident may be responsible for contracting 26 with an internet service provider. 27 3. The nursing facility shall make a reasonable attempt 28 to accommodate the resident’s installation needs, including 29 allowing access to the nursing facility’s public-use internet 30 or wi-fi systems when available for other public uses. 31 4. All electronic monitoring device installations and 32 supporting services shall comply with the requirements of the 33 national fire protection association 101 life safety code. 34 5. A nursing facility shall not charge a resident a fee 35 -7- HF772.1908 (1) 89 cm/jh 7/ 10

for the costs of electricity used by the electronic monitoring 1 device. 2 Sec. 8. NEW SECTION . 135C.55 Notice to visitors. 3 1. A nursing facility shall post a sign at each nursing 4 facility entrance accessible to visitors that states 5 “Electronic monitoring devices may be present in the rooms of 6 residents to record persons and activities”. 7 2. A nursing facility shall post a sign clearly and 8 conspicuously at the entrance to a resident’s room where 9 electronic monitoring is being conducted. The notice shall 10 state “This room is electronically monitored”. 11 3. The nursing facility is responsible for installing and 12 maintaining the signage required in this section. 13 Sec. 9. NEW SECTION . 135C.56 Obstruction of electronic 14 monitoring devices. 15 1. A person shall not knowingly hamper, obstruct, tamper 16 with, or destroy an electronic monitoring device placed in 17 a resident’s room without the permission of the resident or 18 resident representative. 19 2. A person shall not knowingly hamper, obstruct, tamper 20 with, or destroy a video or audio recording obtained through 21 the use of an electronic monitoring device in accordance with 22 this subchapter. 23 3. It is not a violation of this section for a person to 24 turn off the electronic monitoring device or block the visual 25 recording component of the electronic monitoring device at the 26 direction of the resident or resident representative, or if 27 consent has been withdrawn. 28 4. A person who violates this section is guilty of a serious 29 misdemeanor. 30 Sec. 10. NEW SECTION . 135C.57 Dissemination of recordings. 31 1. A person shall not access any video or audio recording 32 created through electronic monitoring under this subchapter 33 without the written consent of the resident or resident 34 representative. 35 -8- HF772.1908 (1) 89 cm/jh 8/ 10

2. Except as otherwise required by law, a recording or copy 1 of a recording created as provided in this subchapter may only 2 be disseminated for the purpose of addressing health, safety, 3 or welfare concerns of a resident. 4 3. A person accessing or disseminating a recording or copy 5 of a recording created as provided in this section in violation 6 of this section is guilty of a serious misdemeanor. 7 Sec. 11. NEW SECTION . 135C.58 Admissibility of evidence. 8 Subject to applicable rules of evidence and procedure, any 9 video or audio recording created through electronic monitoring 10 under this subchapter may be admitted into evidence in a civil, 11 criminal, or administrative proceeding if the contents of the 12 recording have not been edited or artificially enhanced and the 13 recording includes the date and time the events occurred. 14 Sec. 12. NEW SECTION . 135C.59 Liability —— penalties. 15 1. A nursing facility is not civilly or criminally liable 16 for the disclosure of a recording by a resident or a person who 17 consents on behalf of a resident for any purpose not authorized 18 by this subchapter. 19 2. A nursing facility is not civilly or criminally liable 20 for a violation of a resident’s right to privacy arising out 21 of any electronic monitoring conducted in accordance and in 22 compliance with this subchapter. 23 3. A nursing facility that knowingly violates this 24 subchapter shall be subject to licensee discipline. 25 Sec. 13. NEW SECTION . 135C.60 Resident protections. 26 1. A nursing facility shall not do any of the following: 27 a. Refuse to admit a potential resident or remove a resident 28 because the nursing facility disagrees with the potential 29 resident’s or the resident’s decisions regarding electronic 30 monitoring, whether the decision is made by a resident or a 31 resident representative acting on behalf of the resident. 32 b. Retaliate or discriminate against any resident for 33 consenting or refusing to consent to electronic monitoring. 34 c. Prevent the placement or use of an electronic monitoring 35 -9- HF772.1908 (1) 89 cm/jh 9/ 10

device by a resident who has provided the nursing facility 1 with the notification and consent form as required under this 2 subchapter. 3 2. Any contractual provision prohibiting, limiting, 4 or otherwise modifying the rights and obligations in this 5 subchapter is contrary to public policy and is void and 6 unenforceable. 7 Sec. 14. NEW SECTION . 135C.61 Report to department. 8 A nursing facility shall report to the department, in a 9 manner prescribed by the department, the number of electronic 10 monitoring device notification and consent forms received by 11 the nursing facility on an annual basis. 12 Sec. 15. DIRECTIVE TO DEPARTMENT OF INSPECTIONS AND 13 APPEALS. The department of inspections and appeals shall 14 prescribe by rule pursuant to chapter 17A the notification and 15 consent form described in this Act, and shall make the form 16 available on the department’s internet site. 17 Sec. 16. CODE EDITOR DIRECTIVE. The Code editor may codify 18 the provisions of this Act as a new subchapter of chapter 135C 19 entitled “Electronic Monitoring”. > 20 2. Title page, by striking lines 1 through 5 and inserting 21 < An Act relating to the requirements for authorized electronic 22 monitoring in nursing facilities, and providing penalties. > 23 ______________________________ B. MEYER of Polk -10- HF772.1908 (1) 89 cm/jh 10/ 10 #2.