Senate File 204 - Enrolled




                                             SENATE FILE 204

                             AN ACT
 RELATING TO THE DEPARTMENT OF ELDER AFFAIRS AND SERVICES
    PROVIDED TO OLDER IOWANS.

 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 7E.5, subsection 1, paragraph k, Code
 2009, is amended to read as follows:
    k.  The department of elder affairs on aging, created in
 section 231.21, which has primary responsibility for
 leadership and program management for programs which serve the
 senior citizens older individuals of the state.
    Sec. 2.  Section 10A.402, subsection 5, Code 2009, is
 amended to read as follows:
    5.  Investigations relative to the operations of the
 department of elder affairs on aging.
    Sec. 3.  Section 16.100, subsection 8, Code 2009, is
 amended to read as follows:
    8.  A homelessness advisory committee is created consisting
 of the executive director or the executive director's
 designee, the directors or their designees from the
 departments of economic development, elder affairs, human
 services, and human rights, the director of the department on
 aging or the director's designee, and at least three
 individuals from the private sector to be selected by the
 executive director.  The advisory committee shall advise the
 authority in coordinating programs that provide for the
 homeless.
    Sec. 4.  Section 16.100A, subsection 2, paragraph b,
 subparagraph (7), Code 2009, is amended to read as follows:
    (7)  The director of the department of elder affairs on
 aging or the director's designee.
    Sec. 5.  Section 16.183, subsection 3, Code 2009, is
 amended to read as follows:
    3.  The authority, in cooperation with the department of
 elder affairs on aging, shall annually allocate moneys
 available in the home and community=based services revolving
 loan program fund to develop and expand facilities and
 infrastructure that provide adult day services, respite
 services, congregate meals, and programming space for health
 and wellness, health screening, and nutritional assessments
 that address the needs of persons with low incomes.
    Sec. 6.  Section 22.7, Code 2009, is amended by adding the
 following new subsections:
    NEW SUBSECTION.  62.  Records of the department on aging
 pertaining to clients served by the office of substitute
 decision maker.
    NEW SUBSECTION.  63.  Records of the department on aging
 pertaining to clients served by the elder abuse prevention
 initiative.
    Sec. 7.  Section 84B.1, unnumbered paragraph 1, Code 2009,
 is amended to read as follows:
    The department of workforce development, in consultation
 with the departments of economic development, education, elder
 affairs, human services, and human rights, the department on
 aging, and the department for the blind, shall establish
 guidelines for colocating state and federal employment and
 training programs in centers providing services at the local
 level.  The centers shall be known as workforce development
 centers.  The departments shall also jointly establish an
 integrated management information system for linking the
 programs within a local center to the same programs within
 other local centers and to the state.  The guidelines shall
 provide for local design and operation within the guidelines.
 The core services available at a center shall include but are
 not limited to all of the following:
    Sec. 8.  Section 135.27A, subsection 1, Code 2009, is
 amended to read as follows:
    1.  A governor's council on physical fitness and nutrition
 is established consisting of twelve members appointed by the
 governor who have expertise in physical activity, physical
 fitness, nutrition, and promoting healthy behaviors.  At least
 one member shall be a representative of elementary and
 secondary physical education professionals, at least one
 member shall be a health care professional, at least one
 member shall be a registered dietician, at least one member
 shall be recommended by the department of elder affairs on
 aging, and at least one member shall be an active nutrition or
 fitness professional.  In addition, at least one member shall
 be a member of a racial or ethnic minority.  The governor
 shall select a chairperson for the council.  Members shall
 serve terms of three years beginning and ending as provided in
 section 69.19.  Appointments are subject to sections 69.16 and
 69.16A.  Members are entitled to receive reimbursement for
 actual expenses incurred while engaged in the performance of
 official duties.  A member of the council may also be eligible
 to receive compensation as provided in section 7E.6.
    Sec. 9.  Section 135C.20A, subsection 2, Code 2009, is
 amended to read as follows:
    2.  The report card form shall be developed by the
 department in cooperation with representatives of the
 department of elder affairs on aging, the state long=term care
 resident's advocate, representatives of resident advocate
 committees, representatives of protection and advocacy
 entities, consumers, and other interested persons.
    Sec. 10.  Section 135C.25, subsection 1, Code 2009, is
 amended to read as follows:
    1.  Each health care facility shall have a resident
 advocate committee whose members shall be appointed by the
 director of the department of elder affairs on aging or the
 director's designee.  A person shall not be appointed a member
 of a resident advocate committee for a health care facility
 unless the person is a resident of the service area where the
 facility is located.  The resident advocate committee for any
 facility caring primarily for persons with mental illness,
 mental retardation, or a developmental disability shall only
 be appointed after consultation with the administrator of the
 division of mental health and disability services of the
 department of human services on the proposed appointments.
 Recommendations to the director or the director's designee for
 membership on resident advocate committees are encouraged from
 any agency, organization, or individual.  The administrator of
 the facility shall not be appointed to the resident advocate
 committee and shall not be present at committee meetings
 except upon request of the committee.
    Sec. 11.  Section 227.2, subsection 2, Code 2009, is
 amended to read as follows:
    2.  A copy of the written report prescribed by subsection 1
 shall be furnished to the county board of supervisors, to the
 county mental health and mental retardation coordinating board
 or to its advisory board if the county board of supervisors
 constitutes ex officio the coordinating board, to the
 administrator of the county care facility inspected and to its
 resident advocate committee, and to the department of elder
 affairs on aging.
    Sec. 12.  Section 231.1, Code 2009, is amended to read as
 follows:
    231.1  SHORT TITLE.
    This chapter, entitled the "Elder "Older Iowans Act", sets
 forth the state's commitment to its elders older individuals,
 their dignity, independence, and rights.
    Sec. 13.  Section 231.2, Code 2009, is amended to read as
 follows:
    231.2  LEGISLATIVE FINDINGS AND DECLARATION.
    The general assembly finds and declares that:
    1.  Iowa's elders older individuals constitute a
 fundamental resource which has been undervalued, and the means
 must be found to recognize and use the competence, wisdom, and
 experience of our elders such older individuals for the
 benefit of all Iowans.
    2.  The number of persons in this state age sixty and older
 is increasing rapidly, and of these elders older individuals,
 the number of women, minorities, and persons eighty=five years
 of age or older is increasing at an even greater rate.
    3.  The social and health problems of older people
 individuals and their caregivers are compounded by a lack of
 access to existing services and by the unavailability of a
 complete range of services in all areas of the state.
    4.  The ability of older people individuals to maintain
 self=sufficiency and to live their lives with dignity,
 productivity, and creativity is a matter of profound
 importance and concern for this state.
    Sec. 14.  Section 231.3, Code 2009, is amended to read as
 follows:
    231.3  STATE POLICY AND OBJECTIVES.
    The general assembly declares that it is the policy of the
 state to work toward attainment of the following objectives
 for Iowa's elders older individuals:
    1.  An adequate income.
    2.  Access to physical and mental health care without
 regard to economic status.
    3.  Suitable housing that reflects the needs of older
 people.
    4.  Full restorative services for those who require
 institutional care, and a comprehensive array of home and
 community=based, long=term care services adequate to sustain
 older people in their communities and, whenever possible, in
 their homes, including support for caregivers.
    5.  Pursuit of meaningful activity within the widest range
 of civic, cultural, educational, recreational, and employment
 opportunities.
    6.  Suitable community transportation systems to assist in
 the attainment of independent movement.
    7.  Freedom, independence, and the free exercise of
 individual initiative in planning and managing their own
 lives.
    8.  Freedom from abuse, neglect, and exploitation.
    Sec. 15.  Section 231.4, subsections 2, 3, 4, 5, and 10,
 Code 2009, are amended to read as follows:
    2.  "Commission" means the commission of elder affairs on
 aging.
    3.  "Department" means the department of elder affairs on
 aging.
    4.  "Director" means the director of the department of
 elder affairs on aging.
    5.  "Elder" "Older individual" means an individual who is
 sixty years of age or older.
    10.  "Resident's advocate program" means the state
 long=term care resident's advocate program operated
 administered by the department of elder affairs and
 administered by the long=term care resident's advocate on
 aging.
    Sec. 16.  Section 231.11, Code 2009, is amended to read as
 follows:
    231.11  COMMISSION ESTABLISHED.
    The commission of elder affairs on aging is established
 which shall consist of eleven members.  One member each shall
 be appointed by the president of the senate, after
 consultation with the majority leader of the senate, and by
 the minority leader of the senate, from the members of the
 senate to serve as ex officio, nonvoting members.  One member
 each shall be appointed by the speaker of the house of
 representatives and by the minority leader of the house of
 representatives, from the members of the house of
 representatives to serve as ex officio, nonvoting members.
 Seven members shall be appointed by the governor subject to
 confirmation by the senate.  Not more than a simple majority
 of the governor's appointees shall belong to the same
 political party.  At least four of the seven members appointed
 by the governor shall be fifty=five years of age or older when
 appointed.
    Sec. 17.  Section 231.14, subsections 3, 4, 6, 7, and 8,
 Code 2009, are amended to read as follows:
    3.  Serve as an effective and visible advocate for elders
 older individuals by establishing policies for reviewing and
 commenting upon all state plans, budgets, and policies which
 affect elders older individuals and for providing technical
 assistance to any agency, organization, association, or
 individual representing the needs of elders older individuals.
    4.  Divide the state into distinct planning and service
 areas after considering the geographical distribution of
 elders older individuals in the state, the incidence of the
 need for supportive services, nutrition services, multipurpose
 senior centers, and legal services, the distribution of elders
 older individuals who have low incomes residing in such areas,
 the distribution of resources available to provide such
 services or centers, the boundaries of existing areas within
 the state which are drawn for the planning or administration
 of supportive services programs, the location of units of
 general purpose, local government within the state, and any
 other relevant factors.
    6.  Adopt policies to assure that the department will take
 into account the views of elders older individuals in the
 development of policy.
    7.  Adopt a formula for the distribution of federal Act,
 state elder services for older individuals, and senior living
 program funds taking into account, to the maximum extent
 feasible, the best available data on the geographic
 distribution of elders older individuals in the state, and
 publish the formula for review and comment.
    8.  Adopt policies and measures to assure that preference
 will be given to providing services to elders older
 individuals with the greatest economic or social needs, with
 particular attention to low=income minority elders older
 individuals.
    Sec. 18.  Section 231.21, Code 2009, is amended to read as
 follows:
    231.21  DEPARTMENT OF ELDER AFFAIRS ON AGING.
    An Iowa department of elder affairs on aging is established
 which shall administer this chapter under the policy direction
 of the commission of elder affairs on aging.  The department
 of elder affairs on aging shall be administered by a director.
    Sec. 19.  Section 231.22, Code 2009, is amended to read as
 follows:
    231.22  DIRECTOR.
    1.  The governor, subject to confirmation by the senate,
 shall appoint a director of the department of elder affairs on
 aging who shall, subject to chapter 8A, subchapter IV, employ
 and direct staff as necessary to carry out the powers and
 duties created by this chapter.  The director shall serve at
 the pleasure of the governor.  However, the director is
 subject to reconfirmation by the senate as provided in section
 2.32, subsection 4.  The governor shall set the salary for the
 director within the range set by the general assembly.
    2.  The director shall have the following qualifications
 and training:
    a.  Training in the field of gerontology, social work,
 public health, public administration, or other related fields.
    b.  Direct experience or extensive knowledge of programs
 and services related to elders older individuals.
    c.  Demonstrated understanding and concern for the welfare
 of elders older individuals.
    d.  Demonstrated competency and recent working experience
 in an administrative, supervisory, or management position.
    Sec. 20.  Section 231.23, unnumbered paragraph 1, Code
 2009, is amended to read as follows:
    The department of elder affairs on aging director shall:
    Sec. 21.  Section 231.23, subsections 4, 7, 9, and 11, Code
 2009, are amended to read as follows:
    4.  Advocate for elders older individuals by reviewing and
 commenting upon all state plans, budgets, laws, rules,
 regulations, and policies which affect elders older
 individuals and by providing technical assistance to any
 agency, organization, association, or individual representing
 the needs of the elders older individuals.
    7.  Pursuant to commission policy, take into account the
 views of elder older Iowans.
    9.  Assist the commission in assuring that preference will
 be given to providing services to elders older individuals
 with the greatest economic or social needs, with particular
 attention to low=income minority elders older individuals.
    11.  Apply for, receive, and administer grants and,
 devises, donations, gifts, or bequests of real or personal
 property from any source to conduct projects consistent with
 the purposes of this chapter the department.  Notwithstanding
 section 8.33, moneys received by the department pursuant to
 this section are not subject to reversion to the general fund
 of the state.
    Sec. 22.  Section 231.23A, Code 2009, is amended to read as
 follows:
    231.23A  PROGRAMS AND SERVICES.
    The department of elder affairs on aging shall provide or
 administer, but is not limited to providing or administering,
 all of the following programs and services:
    1.  Elder services Services for older individuals including
 but not limited to home and community=based services such as
 adult day, assessment and intervention, transportation, chore,
 counseling, homemaker, material aid, personal care,
 reassurance, respite, visitation, caregiver support, emergency
 response system, mental health outreach, and home repair,
 meals, and nutrition counseling.
    2.  The senior internship program.
    3.  The case management program for frail elders.
    4.  The aging and disability resource center program.
    5.  The legal assistance development program.
    6.  The nutrition program.
    4.  7.  Administration relating to the long=term care
 resident's advocate program and training for resident advocate
 committees.
    5.  8.  Administration relating to the area agencies on
 aging.
    9.  Elder abuse prevention, detection, intervention, and
 awareness including neglect and exploitation.
    6.  10.  Other programs and services authorized by law.
    Sec. 23.  Section 231.31, Code 2009, is amended to read as
 follows:
    231.31  STATE PLAN ON AGING.
    The department of elder affairs on aging shall develop, and
 submit to the commission of elder affairs on aging for
 approval, a multiyear state plan on aging.  The state plan on
 aging shall meet all applicable federal requirements.
    Sec. 24.  Section 231.32, subsection 2, paragraph d,
 unnumbered paragraph 1, Code 2009, is amended to read as
 follows:
    Any public or nonprofit private agency in a planning and
 service area or any separate organizational unit within such
 agency which is under the supervision or direction for this
 purpose of the department of elder affairs on aging and which
 can engage in the planning or provision of a broad range of
 supportive services or nutrition services within the planning
 and service area.
    Sec. 25.  Section 231.33, subsections 2, 7, 8, 9, 11, 14,
 15, 16, 17, 18, 19, and 21, Code 2009, are amended to read as
 follows:
    2.  Assess the types and levels of services needed by older
 persons individuals and their caregivers in the planning and
 service area, and the effectiveness of other public or private
 programs serving those needs.
    7.  Give preference in the delivery of services under the
 area plan to elders older individuals with the greatest
 economic or social need.
    8.  Assure that elders older individuals and their
 caregivers in the planning and service area have reasonably
 convenient access to information and assistance services.
    9.  Provide adequate and effective opportunities for elders
 older individuals to express their views to the area agency on
 policy development and program implementation under the area
 plan.
    11.  Contact outreach efforts, with special emphasis on
 rural elders older individuals, to identify elders older
 individuals with greatest economic or social needs and inform
 them of the availability of services under the area plan.
    14.  Monitor, evaluate, and comment on laws, rules,
 regulations, policies, programs, hearings, levies, and
 community actions which significantly affect the lives of
 elders older individuals.
    15.  Conduct public hearings on the needs of elders older
 individuals and their caregivers.
    16.  Represent the interests of elders older individuals
 and their caregivers to public officials, public and private
 agencies, or organizations.
    17.  Coordinate planning with other agencies and
 organizations to promote new or expanded benefits and
 opportunities for elders older individuals.
    18.  Coordinate planning with other agencies for assuring
 the safety of elders older individuals in a natural disaster
 or other safety threatening situation.
    19.  Require the completion by board of directors members,
 annually, of four hours of training, provided by the
 department of elder affairs on aging.
    21.  Provide the opportunity for elders older individuals
 residing in the planning and service area to offer substantive
 suggestions regarding the employment practices of the area
 agency on aging.
    Sec. 26.  Section 231.41, Code 2009, is amended to read as
 follows:
    231.41  PURPOSE.
    The purpose of this subchapter is to establish the
 long=term care resident's advocate program operated by the
 Iowa commission of elder affairs on aging in accordance with
 the requirements of the federal Act, and to adopt the
 supporting federal regulations and guidelines for its
 implementation.  In accordance with chapter 17A, the
 commission of elder affairs on aging shall adopt and enforce
 rules for the implementation of this subchapter.
    Sec. 27.  Section 231.42, unnumbered paragraph 1, Code
 2009, is amended to read as follows:
    The Iowa commission of elder affairs on aging, in
 accordance with section 712 of the federal Act, as codified at
 42 U.S.C. } 3058g, shall establish the office of long=term
 care resident's advocate within the department.  The long=term
 care resident's advocate shall administer and monitor local
 long=term care resident's advocate programs.  The long=term
 care resident's advocate and local long=term care resident's
 advocates shall:
    Sec. 28.  Section 231.42, subsection 6, Code 2009, is
 amended to read as follows:
    6.  Administer the resident advocate committee volunteer
 program.
    Sec. 29.  Section 231.42, unnumbered paragraph 2, Code
 2009, is amended to read as follows:
    The long=term care resident's advocate and local long=term
 care resident's advocates shall have access to long=term care
 facilities, private access to residents, access to residents'
 personal and medical records, and access to other records
 maintained by the facilities or governmental agencies
 pertaining only to the person on whose behalf a complaint is
 being investigated.
    Sec. 30.  Section 231.43, Code 2009, is amended to read as
 follows:
    231.43  AUTHORITY AND RESPONSIBILITIES OF THE COMMISSION.
    To ensure compliance with the federal Act the commission of
 elder affairs on aging shall establish the following:
    1.  Procedures to protect the confidentiality of a
 resident's records and files.
    2.  A statewide uniform reporting system.
    3.  Procedures to enable the long=term care resident's
 advocate to elicit, receive, and process complaints regarding
 administrative actions which may adversely affect the health,
 safety, welfare, or rights of elders older individuals in
 long=term care facilities.
    Sec. 31.  Section 231.44, subsections 1 and 4, Code 2009,
 are amended to read as follows:
    1.  The resident advocate committee volunteer program is
 administered by the long=term care resident's advocate
 program.
    4.  The state, any resident advocate committee member, and
 any resident advocate coordinator local long=term care
 resident's advocate are not liable for an action undertaken by
 a resident advocate committee member or a resident advocate
 committee coordinator local long=term care resident's advocate
 in the performance of duty, if the action is undertaken and
 carried out reasonably and in good faith.
    Sec. 32.  Section 231.52, subsections 1 and 3, Code 2009,
 are amended to read as follows:
    1.  The department shall establish administer the senior
 internship program in coordination consultation with the
 department of workforce development to encourage and promote
 the meaningful employment of older Iowans work training
 programs leading to the employment of older individuals.
    3.  The department shall require such uniform reporting and
 financial accounting by area agencies on aging and local
 projects contractors as may be necessary to fulfill the
 purposes of this section.
    Sec. 33.  Section 231.53, Code 2009, is amended to read as
 follows:
    231.53  COORDINATION WITH WORKFORCE INVESTMENT ACT.
    The employment and training program administered by the
 department senior internship program shall be coordinated with
 the training program for older individuals federal Workforce
 Investment Act administered by the department of workforce
 development under the federal Workforce Investment Act.
    Sec. 34.  Section 231.56, Code 2009, is amended to read as
 follows:
    231.56  ELDER SERVICES PROGRAM AND PROGRAMS.
    The department shall administer an elder services program
 and programs to reduce institutionalization and encourage
 community involvement to help elders older individuals remain
 in their own homes.  Funds appropriated for this purpose shall
 be instituted based on administrative rules adopted by the
 commission.  The department shall require such records as
 needed to administer this section.
    Sec. 35.  Section 231.56A, subsections 1 through 5, Code
 2009, are amended to read as follows:
    1.  Through the state's service contract process adopted
 pursuant to section 8.47, the department shall identify area
 agencies on aging entities that have demonstrated the ability
 to provide a collaborative response to the immediate needs of
 elders in the area agency on aging service area older
 individuals for the purpose of implementing elder abuse
 initiative, emergency shelter, and support services projects.
 The projects shall be implemented only in the counties within
 an area agency on aging coordinated in service area areas that
 have a multidisciplinary team established pursuant to section
 235B.1, where available.
    2.  The target population of the projects shall be any
 elder older individual residing in the service area of an area
 agency on aging Iowa who meets both of the following
 conditions:
    a.  Is is at risk of or who is experiencing abuse, neglect,
 or exploitation which may include but is not limited to an
 older individual who is the subject of a report of suspected
 dependent adult abuse pursuant to chapter 235B.  This
 subsection shall not apply to an older individual who is
 receiving assistance under a county management plan approved
 pursuant to section 331.439.
    b.  Is not receiving assistance under a county management
 plan approved pursuant to section 331.439.
    3.  The area agencies on aging contractor implementing the
 projects shall identify allowable emergency shelter and
 support services, state funding, outcomes, reporting
 requirements, and approved community resources from which
 services may be obtained under the projects.  The area agency
 on aging shall identify at least one provider of case
 management services for the project area.
    4.  The area agencies on aging contractor shall implement
 the projects and shall coordinate the provider network through
 the use of referrals or other engagement of community
 resources to provide services to elders older individuals.
    5.  The department shall award funds to the area agencies
 on aging contractor in accordance with the state's service
 contract process and department rule.  Receipt and
 expenditures of moneys under the projects are subject to
 examination, including audit, by the department.
    Sec. 36.  Section 231.57, Code 2009, is amended to read as
 follows:
    231.57  COORDINATION OF ADVOCACY.
    The department shall establish administer a program for the
 coordination of information and assistance provided within the
 state to assist elders older individuals and their caregivers
 in obtaining and protecting their rights and benefits.  State
 and local agencies providing information and assistance to
 elders older individuals and their caregivers in seeking their
 rights and benefits shall cooperate with the department in
 developing and implementing administering this program.
    Sec. 37.  Section 231.58, subsection 1, Code 2009, is
 amended to read as follows:
    1.  A senior living coordinating unit is created within the
 department of elder affairs on aging.  The membership of the
 coordinating unit consists of:
    a.  The director of human services.
    b.  The director of the department of elder affairs on
 aging.
    c.  The director of public health.
    d.  The director of the department of inspections and
 appeals.
    e.  Two members appointed by the governor.
    f.  Four members of the general assembly, as ex officio,
 nonvoting members.
    Sec. 38.  Section 231.58, subsection 4, paragraphs b and i,
 Code 2009, are amended to read as follows:
    b.  Develop common intake and release procedures for the
 purpose of determining eligibility at one point of intake and
 determining eligibility for programs administered by the
 departments of human services, and public health, and elder
 affairs the department on aging, such as the medical
 assistance program, federal food stamp program, homemaker=home
 health aide programs, and the case management program for
 frail elders administered by the department of elder affairs
 on aging.
    i.  Consult with the state universities and other
 institutions with expertise in the area of elder issues older
 Iowans and the long=term care continua.
    Sec. 39.  NEW SECTION.  231.64  AGING AND DISABILITY
 RESOURCE CENTER PROGRAM.
    The aging and disability resource center program shall be
 administered by the department in accordance with the
 requirements of the federal Act.  The purpose of the program
 is to provide a coordinated local system of information and
 access in order to minimize confusion, enhance individual
 choice, and support informed decision making for older
 individuals, persons with disabilities age eighteen or older,
 and people who inquire about, or request assistance on behalf
 of, members of these groups as they seek long=term care
 services and supports.
    Sec. 40.  NEW SECTION.  231.65  LEGAL ASSISTANCE
 DEVELOPMENT PROGRAM.
    A legal assistance development program shall be
 administered by the department in accordance with the
 requirements of the federal Act.  The purpose of the program
 is to provide leadership for improving the quality and
 quantity of legal advocacy assistance as a means of ensuring a
 comprehensive elder rights system for Iowa's older
 individuals.  The extent of implementation of this program
 shall be based on available resources.
    Sec. 41.  NEW SECTION.  231.66  NUTRITION PROGRAM.
    A nutrition program shall be administered by the
 department, in accordance with the requirements of the federal
 Act, including congregate and home=delivered nutrition
 programs, nutrition education, nutrition counseling, and
 evidence=based health promotion programs to promote health and
 well=being, reduce food insecurity, promote socialization, and
 maximize independence of older individuals.
    Sec. 42.  Section 231B.19, Code 2009, is amended to read as
 follows:
    231B.19  RESIDENT ADVOCATE COMMITTEES.
    The commission of elder affairs on aging shall adopt by
 rule procedures for appointing members of resident advocate
 committees for elder group homes.
    Sec. 43.  Section 231E.3, subsections 2, 6, and 7, Code
 2009, are amended to read as follows:
    2.  "Commission" means the commission of elder affairs on
 aging.
    6.  "Department" means the department of elder affairs on
 aging established in section 231.21.
    7.  "Director" means the director of the department of
 elder affairs on aging.
    Sec. 44.  Section 231E.4, subsection 2, Code 2009, is
 amended to read as follows:
    2.  The director shall appoint an administrator of the
 state office who shall serve as the state substitute decision
 maker.  The state substitute decision maker shall be qualified
 for the position by training and expertise in substitute
 decision=making law and shall be licensed to practice law in
 Iowa.  The state substitute decision maker shall also have
 knowledge of social services available to meet the needs of
 persons adjudicated incompetent or in need of substitute
 decision making.
    Sec. 45.  Section 231E.4, subsection 3, paragraph j, Code
 2009, is amended to read as follows:
    j.  Develop, in cooperation with the judicial council as
 established in section 602.1202, a substitute decision=maker
 education and training program.  The program may be offered to
 both public and private substitute decision makers.  The state
 office shall establish a curriculum committee, which includes
 but is not limited to probate judges, to develop the education
 and training program.  The state office shall be the sole
 authority for certifying additional curriculum trainers.
    Sec. 46.  Section 231E.4, subsection 4, paragraphs a and b,
 Code 2009, are amended to read as follows:
    a.  Accept and receive gifts, grants, or donations from any
 public or private entity in support of the state office.  Such
 gifts, grants, or donations shall be appropriated pursuant to
 section 231E.9.  Notwithstanding section 8.33, moneys retained
 by the department pursuant to this section shall not be
 subject to reversion to the general fund of the state.
    b.  Accept the services of individual volunteers and
 volunteer organizations.  Volunteers and volunteer
 organizations utilized by the state office shall not provide
 direct substitute decision=making services.
    Sec. 47.  Section 231E.6, Code 2009, is amended to read as
 follows:
    231E.6  COURT=INITIATED OR PETITION=INITIATED APPOINTMENT
 OF STATE OR LOCAL SUBSTITUTE DECISION MAKER == GUARDIANSHIP OR
 CONSERVATORSHIP == DISCHARGE.
    1.  The court may appoint on its own motion or upon
 petition of any person, the state office or local office of
 substitute decision maker, to serve as guardian or conservator
 for any proposed ward in cases in which the court determines
 that the proceeding will establish the least restrictive form
 of substitute decision making suitable for the proposed ward
 and if the proposed ward meets all of the following criteria:
    1.  a.  Is a resident of the planning and service area in
 which the local office is located from which services would be
 provided or is a resident of the state, if the state office
 would provide the services.
    2.  b.  Is eighteen years of age or older.
    3.  c.  Does not have suitable family or another
 appropriate entity willing and able to serve as guardian or
 conservator.
    4.  d.  Is incompetent.
    5.  e.  Is an individual for whom guardianship or
 conservatorship services are the least restrictive means of
 meeting the individual's needs.
    2.  For all appointments made pursuant to this section,
 notice shall be provided to the state office or local office
 of substitute decision maker prior to appointment.  For
 appointments made pursuant to this section, the state office
 or local office of substitute decision maker shall only accept
 appointments made pursuant to the filing of an involuntary
 petition for appointment of a conservator or guardianship
 pursuant to chapter 633.
    Sec. 48.  Section 231E.7, Code 2009, is amended to read as
 follows:
    231E.7  SUBSTITUTE DECISION MAKER=INITIATED APPOINTMENT ==
 INTERVENTIONS.
    The state office or local office may on its own motion or
 at the request of the court intervene in a guardianship or
 conservatorship proceeding if the state office or local office
 or the court considers the intervention to be justified
 because of any of the following:
    1.  An appointed guardian or conservator is not fulfilling
 prescribed duties or is subject to removal under section
 633.65.
    2.  A willing and qualified guardian or conservator is not
 available.
    3.  The best interests of the ward require the
 intervention.
    Sec. 49.  Section 231E.8, Code 2009, is amended by adding
 the following new subsections:
    NEW SUBSECTION.  6.  The state or a local substitute
 decision maker may petition to be removed as guardian or
 conservator.  A petition for removal shall be granted for any
 of the following reasons:
    a.  The ward displays assaultive or aggressive behavior
 that causes the substitute decision maker to fear for their
 personal safety.
    b.  The ward refuses the services of the substitute
 decision maker.
    c.  The ward refuses to have contact with the substitute
 decision maker.
    d.  The ward moves out of Iowa.
    NEW SUBSECTION.  7.  An appointment nominating the state
 office or a local office under a power of attorney shall not
 take effect unless the nominated state or local office has
 consented to the appointment in writing.
    Sec. 50.  Section 235B.1, subsection 4, paragraph b,
 subparagraph (1), Code 2009, is amended to read as follows:
    (1)  The advisory council shall consist of twelve members.
 Six members shall be appointed by and serve at the pleasure of
 the governor.  Four of the members appointed shall be
 appointed on the basis of knowledge and skill related to
 expertise in the area of dependent adult abuse including
 professionals practicing in the disciplines of medicine,
 public health, mental health, long=term care, social work,
 law, and law enforcement.  Two of the members appointed shall
 be members of the general public with an interest in the area
 of dependent adult abuse and two of the members appointed
 shall be members of the Iowa caregivers association.  In
 addition, the membership of the council shall include the
 director or the director's designee of the department of human
 services, the department of elder affairs on aging, the Iowa
 department of public health, and the department of inspections
 and appeals.
    Sec. 51.  Section 235B.6, subsection 2, paragraph e,
 subparagraph (11), Code 2009, is amended to read as follows:
    (11)  The state office or a local office of substitute
 decision maker as defined in section 231E.3, appointed by the
 court as a guardian or conservator of the adult named in a
 report as the victim of abuse or the person designated to be
 responsible for performing or obtaining protective services on
 behalf of a dependent adult pursuant to section 235B.18 if the
 information relates to the provision of legal services for a
 client served by the state or local office of substitute
 decision maker.
    Sec. 52.  Section 235B.6, subsection 2, paragraph e, Code
 2009, is amended by adding the following new subparagraph:
    NEW SUBPARAGRAPH.  (14)  The department on aging for the
 purposes of conducting background checks of applicants for
 employment with the department on aging.
    Sec. 53.  Section 235B.16, subsections 1 and 2, Code 2009,
 are amended to read as follows:
    1.  The department of elder affairs on aging, in
 cooperation with the department, shall conduct a public
 information and education program.  The elements and goals of
 the program include but are not limited to:
    a.  Informing the public regarding the laws governing
 dependent adult abuse and the reporting requirements for
 dependent adult abuse.
    b.  Providing caretakers with information regarding
 services to alleviate the emotional, psychological, physical,
 or financial stress associated with the caretaker and
 dependent adult relationship.
    c.  Affecting public attitudes regarding the role of a
 dependent adult in society.
    2.  The department, in cooperation with the department of
 elder affairs on aging and the department of inspections and
 appeals, shall institute a program of education and training
 for persons, including members of provider groups and family
 members, who may come in contact with dependent adult abuse.
 The program shall include but is not limited to instruction
 regarding recognition of dependent adult abuse and the
 procedure for the reporting of suspected abuse.
    Sec. 54.  Section 235B.16, subsection 5, paragraph d,
 subparagraph (3), Code 2009, is amended to read as follows:
    (3)  A training program using such an approved curriculum
 offered by the department of human services, the department of
 elder affairs on aging, the department of inspections and
 appeals, the Iowa law enforcement academy, or a similar public
 agency.
    Sec. 55.  Section 249A.4B, subsection 2, paragraph d, Code
 2009, is amended to read as follows:
    d.  The director of the department of elder affairs on
 aging, or the director's designee.
    Sec. 56.  Section 249H.3, subsections 1 and 12, Code 2009,
 are amended to read as follows:
    1.  "Affordable" means rates for payment of services which
 do not exceed the rates established for providers of medical
 and health services under the medical assistance program with
 eligibility for an individual equal to the eligibility for
 medical assistance pursuant to section 249A.3.  In relation to
 services provided by a provider of services under a home and
 community=based services waiver, "affordable" means that the
 total monthly cost of the services provided under the home and
 community=based services waiver does not exceed the cost for
 that level of care as established by rule by the department of
 human services, pursuant to chapter 17A, in consultation with
 the department of elder affairs on aging.
    12.  "Senior living coordinating unit" means the senior
 living coordinating unit created within the department of
 elder affairs on aging pursuant to section 231.58, or its
 designee.
    Sec. 57.  Section 249H.5, subsection 1, Code 2009, is
 amended to read as follows:
    1.  Moneys deposited in the senior living trust fund
 created in section 249H.4 shall be used only as provided in
 appropriations from the trust fund to the department of human
 services and the department of elder affairs on aging, and for
 purposes, including the awarding of grants, as specified in
 this chapter.
    Sec. 58.  Section 249H.5, subsection 2, paragraph b, Code
 2009, is amended to read as follows:
    b.  To the department of elder affairs on aging, an amount
 necessary, annually, for expenses incurred in implementation
 and administration of the long=term care alternatives programs
 and for delivery of long=term care services to seniors with
 low or moderate incomes.
    Sec. 59.  Section 249H.7, Code 2009, is amended to read as
 follows:
    249H.7  HOME AND COMMUNITY=BASED SERVICES FOR SENIORS.
    1.  Beginning October 1, 2000, the department of elder
 affairs on aging, in consultation with the senior living
 coordinating unit, shall use funds appropriated from the
 senior living trust fund for activities related to the design,
 maintenance, or expansion of home and community=based services
 for seniors, including but not limited to adult day services,
 personal care, respite, homemaker, chore, and transportation
 services designed to promote the independence of and to delay
 the use of institutional care by seniors with low and moderate
 incomes.  At any time that moneys are appropriated, the
 department of elder affairs on aging, in consultation with the
 senior living coordinating unit, shall disburse the funds to
 the area agencies on aging.
    2.  The department of elder affairs on aging shall adopt
 rules, in consultation with the senior living coordinating
 unit and the area agencies on aging, pursuant to chapter 17A,
 to provide all of the following:
    a.  (1)  The criteria and process for disbursement of
 funds, appropriated in accordance with subsection 1, to area
 agencies on aging.
    (2)  The criteria shall include, at a minimum, all of the
 following:
    (a)  A distribution formula that triple weights all of the
 following:
    (i)  Individuals seventy=five years of age and older.
    (ii)  Individuals aged sixty and older who are members of a
 racial minority.
    (iii)  Individuals sixty years of age and older who reside
 in rural areas as defined in the federal Older Americans Act.
    (iv)  Individuals who are sixty years of age and older who
 have incomes at or below the poverty level as defined in the
 federal Older Americans Act.
    (b)  A distribution formula that single weights individuals
 sixty years of age and older who do not meet the criteria
 specified in subparagraph subdivision division (a).
    b.  The criteria for long=term care providers to receive
 funding as subcontractors of the area agencies on aging.
    c.  Other procedures the department of elder affairs on
 aging deems necessary for the proper administration of this
 section, including but not limited to the submission of
 progress reports, on a bimonthly basis, to the senior living
 coordinating unit.
    3.  This section does not create an entitlement to any
 funds available for disbursement under this section and the
 department of elder affairs on aging may only disburse moneys
 to the extent funds are available and, within its discretion,
 to the extent requests for funding are approved.
    4.  Long=term care providers that receive funding under
 this section shall submit annual reports to the appropriate
 area agency on aging.  The department of elder affairs on
 aging shall develop the report to be submitted, which shall
 include, but is not limited to, units of service provided, the
 number of service recipients, costs, and the number of units
 of service identified as necessitated but not provided.
    5.  The department of elder affairs on aging, in
 cooperation with the department of human services, shall
 provide annual reports to the governor and the general
 assembly concerning the impact of moneys disbursed under this
 section on the availability of long=term care services in
 Iowa.  The reports shall include the types of services funded,
 the outcome of those services, and the number of individuals
 receiving those services.
    Sec. 60.  Section 249H.9, Code 2009, is amended to read as
 follows:
    249H.9  SENIOR LIVING PROGRAM INFORMATION == ELECTRONIC
 ACCESS == EDUCATION == ADVISORY COUNCIL.
    1.  The department of elder affairs on aging and the area
 agencies on aging, in consultation with the senior living
 coordinating unit, shall create, on a county basis, a database
 directory of all health care and support services available to
 seniors.  The department of elder affairs on aging shall make
 the database electronically available to the public, and shall
 update the database on at least a monthly basis.
    2.  The department of elder affairs on aging shall seek
 foundation funding to develop and provide an educational
 program for individuals aged twenty=one and older which
 assists participants in planning for and financing health care
 services and other supports in their senior years.
    3.  The department of human services shall develop and
 distribute an informational packet to the public that
 explains, in layperson terms, the law, regulations, and rules
 under the medical assistance program relative to health care
 services options for seniors, including but not limited to
 those relating to transfer of assets, prepaid funeral
 expenses, and life insurance policies.
    4.  The director of human services, the director of the
 department of elder affairs on aging, the director of public
 health, the director of the department of inspections and
 appeals, the director of revenue, and the commissioner of
 insurance shall constitute a senior advisory council to
 provide oversight in the development and operation of all
 informational aspects of the senior living program under this
 section.
    Sec. 61.  Section 249H.10, Code 2009, is amended to read as
 follows:
    249H.10  CAREGIVER SUPPORT == ACCESS AND EDUCATION
 PROGRAMS.
    The department of human services and the department of
 elder affairs on aging, in consultation with the senior living
 coordinating unit, shall implement a caregiver support program
 to provide access to respite care and to provide education to
 caregivers in providing appropriate care to seniors and
 persons with disabilities.  The program shall be provided
 through the area agencies on aging or other appropriate
 agencies.
    Sec. 62.  Section 324A.4, subsection 2, unnumbered
 paragraph 1, Code 2009, is amended to read as follows:
    Upon request, the department shall provide assistance to
 political subdivisions, state agencies, and organizations
 affected by this chapter for federal aid applications for
 urban and rural transit system program aid.  The department,
 in cooperation with the regional planning agencies, shall
 maintain current information reflecting the amount of federal,
 state, and local aid received by the public and private
 nonprofit organizations providing public transit services and
 the purpose for which the aid is received.  The department
 shall annually prepare a report to be submitted to the general
 assembly, the department of management, and to the governor,
 prior to February 1 of each year, stating the receipts and
 disbursements made during the preceding fiscal year and the
 adequacy of programs financed by federal, state, local, and
 private aid in the state.  The department shall analyze the
 programs financed and recommend methods of avoiding
 duplication and increasing the efficacy of programs financed.
 The department shall receive comments from the department of
 human services, department of elder affairs on aging, and the
 officers and agents of the other affected state and local
 government units relative to the department's analysis.  The
 department shall use the following criteria to adopt rules to
 determine compliance with and exceptions to subsection 1:
    Sec. 63.  Section 324A.5, unnumbered paragraph 1, Code
 2009, is amended to read as follows:
    The department of human services, department of elder
 affairs on aging, and the officers and agents of other state
 and local governmental units shall assist the department in
 carrying out section 324A.4, subsections 1 and 2, insofar as
 the functions of these respective officers and departments are
 concerned with the health, welfare and safety of any recipient
 of transportation services.


                                                             
                               JOHN P. KIBBIE
                               President of the Senate


                                                             
                               PATRICK J. MURPHY
                               Speaker of the House

    I hereby certify that this bill originated in the Senate and
 is known as Senate File 204, Eighty=third General Assembly.


                                                             
                               MICHAEL E. MARSHALL
                               Secretary of the Senate
 Approved                , 2009


                                
 CHESTER J. CULVER
 Governor

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