Section 1. NEW SECTION 231D.1 DEFINITIONS.

For the purposes of this chapter, unless the context

otherwise requires:

1. "Adult day services", "adult day services program", or

"program" means an organized program providing a variety of

health, social, and related support services for sixteen hours

or less in a twenty-four-hour period to two or more persons

with a functional impairment on a regularly scheduled,

contractual basis.

2. "Department" means the department of elder affairs

created in chapter 231.

3. "Functional impairment" means a psychological,

cognitive, or physical impairment creating the inability to

perform personal and instrumental activities of daily living

and associated tasks necessitating some form of supervision or

assistance or both.

4. "Governmental unit" means the state, or any county,

municipality, or other political subdivision or any

department, division, board, or other agency of any of these

entities.

5. "Recognized accrediting entity" means a nationally

recognized accrediting entity that the department recognizes

as having specific adult day services program standards

equivalent to the standards established by the department for

adult day services.

6. "Social services" means services relating to the

psychological and social needs of the individual in adjusting

to participating in an adult day services program, and

minimizing the stress arising from that circumstance.

7. "Supervision" means direct oversight and inspection of

the act of accomplishing a function or activity.

Sec. 2. NEW SECTION 231D.2 PURPOSE — INTENT — RULES — SPECIAL CLASSIFICATIONS.

1. The purpose of this chapter is to promote and encourage

adequate and safe care for adults with functional impairments.

2. It is the intent of the general assembly that the

department of elder affairs establish policy for adult day

services programs and that the department of inspections and

appeals enforce this chapter.

3. The department shall establish, by rule in accordance

with chapter 17A, a program for certification and monitoring

of and complaint investigations related to adult day services

programs. The department, in establishing standards for adult

day services programs, may adopt by rule in accordance with

chapter 17A, nationally recognized standards for adult day

services programs. The rules shall include specification of

recognized accrediting entities. The rules and standards

adopted shall be formulated in consultation with the

department of inspections and appeals and affected industry,

professional, and consumer groups and shall be designed to

accomplish the purpose of this chapter.

4. In addition to the adoption of standards and rules for

adult day services programs, the department in consultation

with the department of inspections and appeals and affected

industry, professional, and consumer groups, shall issue

interpretive guidelines, including the expectations of program

certification monitors, to provide direction to adult day

services programs in complying with certification

requirements.

5. The department may establish by administrative rule

special classifications for adult day services providers. The

department of inspections and appeals shall issue separate

certificates for each special classification for which a

provider is certified.

Sec. 3. NEW SECTION 231D.3 CERTIFICATION REQUIRED.

1. A person or governmental unit acting severally or

jointly with any other person or governmental unit shall not

establish or operate an adult day services program and shall

not represent an adult day services program to the public as

certified unless and until the program is certified pursuant

to this chapter. If an adult day services program is

voluntarily accredited by a recognized accrediting entity with

specific adult day services standards, the department of

inspections and appeals shall accept voluntary accreditation

as the basis for certification by the department. The owner

or manager of a certified adult day services program shall

comply with the rules adopted by the department for an adult

day services program.

2. An adult day services program may provide any type of

adult day services for which the program is certified,

including any special classification of adult day services.

An adult day services program shall provide services and

supervision commensurate with the needs of the recipients. An

adult day services program shall not provide services to

individuals requiring a level or type of services for which

the program is not certified and services provided shall not

exceed the level or type of services for which the program is

certified.

3. An adult day services program that has been certified

by the department of inspections and appeals shall not alter

the program, operation, or adult day services for which the

program is certified in a manner that affects continuing

certification without prior approval of the department of

inspections and appeals. The department of inspections and

appeals shall specify, by rule, alterations that are subject

to prior approval.

4. A department, agency, or officer of this state or of

any governmental unit shall not pay or approve for payment

from public funds any amount to an adult day services program

for an actual or perspective recipient, unless the program

holds a current certificate issued by the department of

inspections and appeals and meets all current requirements for

certification.

5. The department shall adopt rules regarding the

conducting or operating of another business or activity in the

distinct part of the physical structure in which the adult day

services program is provided, if the business or activity

serves nonrecipients of adult day services. The rules shall

be developed in consultation with the department of

inspections and appeals and affected industry, professional,

and consumer groups.

Sec. 4. NEW SECTION 231D.4 APPLICATION AND FEES.

1. Certificates for adult day services programs shall be

obtained from the department of inspections and appeals.

Applications shall be upon such forms and shall include such

information as the department of inspections and appeals may

reasonably require, which may include affirmative evidence of

compliance with applicable statutes and local ordinances.

Each application for certification shall be accompanied by the

appropriate fee.

2.

a. The department of inspections and appeals shall

collect adult day services certification fees. The fees shall

be deposited in the general fund of the state.

b. The following certification and related fees shall

apply to adult day services programs:

(1) For a two-year initial certification, seven hundred

fifty dollars.

(2) For a two-year recertification, one thousand dollars.

(3) For a blueprint review, nine hundred dollars.

(4) For an optional preliminary plan review, five hundred

dollars.

Sec. 5. NEW SECTION 231D.5 DENIAL, SUSPENSION, OR REVOCATION.

1. The department of inspections and appeals may deny,

suspend, or revoke certification if the department of

inspections and appeals finds that there has been a

substantial or repeated failure on the part of the adult day

services program to comply with this chapter or the rules or

minimum standards adopted pursuant to this chapter, or for any

of the following reasons:

a. Cruelty or indifference to adult day services program

service recipients.

b. Appropriation or conversion of the property of an adult

day services programs service recipient without the

recipient's written consent or the written consent of the

service recipient's legal guardian.

c. Permitting, aiding, or abetting the commission of any

illegal act in the adult day services program.

d. Obtaining or attempting to obtain or retain

certification by fraudulent means, misrepresentation, or by

submitting false information.

e. Habitual intoxication or addiction to the use of drugs

by the applicant, owner, manager, or supervisor of the adult

day services program.

f. Securing the devise or bequest of the property of a

recipient of services of an adult day services program by

undue influence.

g. Failure or neglect to maintain a continuing education

and training program for all personnel employed in the adult

day services program.

h. Founded dependent adult abuse as defined in section

235B.2.

i. For any other reason as provided by law or

administrative rule.

2. In the case of an application by an existing

certificate holder for a new or newly acquired adult day

services program, continuing or repeated failure of the

certificate holder to operate any previously certified adult

day services program in compliance with this chapter or of the

rules adopted pursuant to this chapter.

3. In the case of a certificate applicant or existing

certificate holder which is an entity other than an

individual, the department of inspections and appeals may

deny, suspend, or revoke a certificate if any individual who

is in a position of control or is an officer of the entity

engages in any act or omission proscribed by this section.

Sec. 6. NEW SECTION 231D.6 NOTICE — APPEAL — EMERGENCY PROVISIONS.

1. The denial, suspension, or revocation of a certificate

shall be effected by delivering to the applicant or

certificate holder by restricted certified mail or by personal

service a notice setting forth the particular reasons for the

action. The denial, suspension, or revocation shall become

effective thirty days after the mailing or service of the

notice, unless the applicant or certificate holder, within the

thirty-day period, requests a hearing, in writing, of the

department of inspections and appeals, in which case the

notice shall be deemed to be suspended.

2. The denial, suspension, or revocation of a certificate

may be appealed in accordance with rules adopted by the

department of inspections and appeals in accordance with

chapter 17A.

3. When the department of inspections and appeals finds

that an immediate danger to the health or safety of recipients

of services from an adult day services program exists which

requires action on an emergency basis, the department of

inspections and appeals may direct the removal of all

recipients of services from an adult day services program and

suspend the certificate prior to a hearing.

Sec. 7. NEW SECTION 231D.7 CONDITIONAL OPERATION.

The department of inspections and appeals may, as an

alternative to denial, suspension, or revocation of

certification under section 231D.5, conditionally issue or

continue certification dependent upon the performance by the

adult day services program of reasonable conditions within a

reasonable period of time as prescribed by the department of

inspections and appeals so as to permit the program to

commence or continue the operation of the program pending full

compliance with this chapter or the rules adopted pursuant to

this chapter. If the adult day services program does not make

diligent efforts to comply with the conditions prescribed, the

department of inspections and appeals may, under the

proceedings prescribed by this chapter, suspend or revoke the

certificate. An adult day services program shall not be

operated under conditional certification for more than one

year.

Sec. 8. NEW SECTION 231D.8 DEPARTMENT NOTIFIED OF CASUALTIES.

The department of inspections and appeals shall be notified

within twenty-four hours, by the most expeditious means

available, of any accident causing substantial injury or

death, and any substantial fire or natural or other disaster

occurring at or near an adult day services program.

Sec. 9. NEW SECTION 231D.9 COMPLAINTS AND CONFIDENTIALITY.

1. A person with concerns regarding the operations or

service delivery of an adult day services program may file a

complaint with the department of inspections and appeals. The

name of the person who files a complaint with the department

of inspections and appeals and any personal identifying

information of the person or any recipient of program services

identified in the complaint shall be kept confidential and

shall not be subject to discovery, subpoena, or other means of

legal compulsion for its release to a person other than

employees of the department of inspections and appeals

involved in the investigation of the complaint.

2. The department, in cooperation with the department of

inspections and appeals, shall establish procedures for the

disposition of complaints received in accordance with this

section.

Sec. 10. NEW SECTION 231D.10 PUBLIC DISCLOSURE OF FINDINGS.

Following a monitoring evaluation or complaint

investigation of an adult day services program by the

department of inspections and appeals pursuant to this

chapter, the department's final findings with respect to

compliance by the adult day services program with requirements

for certification shall be made available to the public in a

readily available form and place. Other information relating

to an adult day services program that is obtained by the

department of inspections and appeals which does not

constitute the department's final findings from a monitoring

evaluation or complaint investigation of the adult day

services program shall not be made available to the public

except in proceedings involving the denial, suspension, or

revocation of a certificate under this chapter.

Sec. 11. NEW SECTION 231D.11 PENALTIES.

1. A person establishing, conducting, managing, or

operating an adult day services program without a certificate

is guilty of a serious misdemeanor. Each day of continuing

violation after conviction or notice from the department of

inspections and appeals by certified mail of a violation shall

be considered a separate offense or chargeable offense. A

person establishing, conducting, managing, or operating an

adult day services program without a certificate may be

temporarily or permanently restrained by a court of competent

jurisdiction from such activity in an action brought by the

state.

2. A person who prevents or interferes with or attempts to

impede in any way any duly authorized representative of the

department of inspections and appeals in the lawful

enforcement of this chapter or of the rules adopted pursuant

to this chapter is guilty of a simple misdemeanor. As used in

this subsection, lawful enforcement includes but is not

limited to:

a. Contacting or interviewing any participant of an adult

day services program in private at any reasonable hour and

without advance notice.

b. Examining any relevant records of an adult day services

program.

c. Preserving evidence of any violation of this chapter or

of the rules adopted pursuant to this chapter.

3. A civil penalty, as established by rule, may apply in

any of the following situations:

a. Program noncompliance with one or more regulatory

requirements has caused or is likely to cause harm, serious

injury, threat, or death to a recipient of program services.

b. Program failure or refusal to comply with regulatory

requirements within prescribed time frames.

Sec. 12. NEW SECTION 231D.12 RETALIATION BY AN ADULT DAY SERVICES PROGRAM PROHIBITED.

1. An adult day services program shall not discriminate or

retaliate in any way against a recipient, recipient's family,

or an employee of the program who has initiated or

participated in any proceeding authorized by this chapter. An

adult day services program that violates this section is

subject to a penalty as established by administrative rule, to

be assessed and collected by the department of inspections and

appeals and paid into the state treasury to be credited to the

general fund of the state.

2. Any attempt to discharge a recipient from an adult day

services program by whom or upon whose behalf a complaint has

been submitted to the department of inspections and appeals

under section 231D.9, within ninety days after the filing of

the complaint or the conclusion of any proceeding resulting

from the complaint, shall raise a rebuttable presumption that

the action was taken by the program in retaliation for the

filing of the complaint, except in situations in which the

recipient is discharged due to changes in health status which

exceed the level of care offered by the adult day services

program or in other situations as specified by rule.

Sec. 13. NEW SECTION 231D.13 NURSING ASSISTANT AND MEDICATION AIDE — CERTIFICATION.

The department of inspections and appeals, in cooperation

with other appropriate agencies, shall establish a procedure

to allow nursing assistants or medication aides to claim work

within adult day services programs as credit toward sustaining

the nursing assistant's or medication aide's certification.

Sec. 14. NEW SECTION 231D.14 CRIMINAL RECORDS INVESTIGATION CHECK.

An adult day services program shall comply with section

135C.33.

Sec. 15. NEW SECTION 231D.15 FIRE AND SAFETY STANDARDS.

The state fire marshal shall adopt rules, in coordination

with the department of elder affairs and the department of

inspections and appeals, relating to the certification and

monitoring of the fire and safety standards of adult day

services programs.

Sec. 16. NEW SECTION 231D.16 TRANSITION PROVISIONS.

1. Adult day services programs voluntarily accredited by a

recognized accrediting entity prior to July 1, 2003, shall

comply with this chapter by June 30, 2004.

2. Adult day services programs that are serving at least

two but not more than five persons that are not voluntarily

accredited by a recognized accrediting entity prior to July 1,

2003, shall comply with this chapter by June 30, 2005.

Sec. 17. Section 100.1, subsection 6, Code 2003, is amended to read as follows:

6. To adopt rules designating a fee to be assessed to each

building, structure, or facility for which a fire safety

inspection or plan review by the state fire marshal is

required as a condition of licensureby law. The fee

designated by rule shall be set in an amount that is

reasonably related to the costs of conducting the applicable

inspection or plan review. The fees collected by the state

fire marshal shall be deposited in the general fund of the

state.

Sec. 18. Section 135C.1, subsection 1, Code 2003, is amended to read as follows:

1. "Adult day services" means adult day services as

defined in section 231.61231D.1 that are provided in a

licensed health care facility.

Sec. 19. Section 231C.2, Code 2003, is amended by adding the following new subsection:

NEW SUBSECTION 0A. "Adult day services" means adult day

services as defined in section 231D.1.

Sec. 20. Section 231.61, Code 2003, is repealed.

Sec. 21.

DEPARTMENTAL REPORT.

The department of

inspections and appeals, in consultation with the department

of elder affairs and the department of public safety, shall

submit a written report to the general assembly by December

31, 2004, with copies to the joint appropriations subcommittee

on health and human services that provides details regarding

the implementation of this Act, including fees collected

annually, and expenses incurred by the affected state agencies

for administration, certification issuance, inspection, and

other costs related to this Act. The department of

inspections and appeals shall also include information in the

report regarding its projections as to whether the fees

imposed under this Act are sufficient to cover future expenses

of affected state agencies under this Act.

Sec. 22.

ADULT DAY SERVICES — PERSONS WITH MENTAL RETARDATION.

For the period beginning July 1, 2003, and

ending June 30, 2004, if an adult day services program serving

persons with mental retardation is voluntarily accredited by

the commission on accreditation of rehabilitation facilities

(CARF) for personal and social services or by the council on

quality and leadership in supports for persons with

disabilities, prior to July 1, 2003, the department of

inspections and appeals shall accept voluntary accreditation

as the basis for certification as an adult day services

program by the department.

Sec. 23.

EFFECTIVE DATE.

The section of this Act relating

to adult day services serving persons with mental retardation,

being deemed of immediate importance, takes effect upon

enactment.