Senate File 276
SENATE FILE
BY LUNDBY
Passed Senate, Date Passed House, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the regulation of elder family homes, elder
2 group homes, and assisted living programs, providing for
3 appropriation of fees, and providing penalties.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
5 TLSB 2067SS 80
6 pf/sh/8
PAG LIN
1 1 Section 1. Section 100.1, subsection 6, Code 2003, is
1 2 amended to read as follows:
1 3 6. To adopt rules designating a fee to be assessed to each
1 4 building, structure, or facility for which a fire safety
1 5 inspection or plan review by the state fire marshal is
1 6 required as a condition of licensure by law. The fee
1 7 designated by rule shall be set in an amount that is
1 8 reasonably related to the costs of conducting the applicable
1 9 inspection or plan review. The fees collected by the state
1 10 fire marshal shall be retained by the state fire marshal and
1 11 deposited in the general a separate fund of created in the
1 12 state treasury under the authority of the state fire marshal
1 13 and are appropriated to the state fire marshal to carry out
1 14 the purpose of this subsection. Amounts deposited in the fund
1 15 shall not be transferred, used, obligated, appropriated, or
1 16 otherwise encumbered, except as provided in this subsection.
1 17 Notwithstanding section 12C.7, subsection 2, interest or
1 18 earnings on moneys deposited in the fund shall be credited to
1 19 the fund. Notwithstanding section 8.33, amounts deposited in
1 20 the fund that remain unexpended or unencumbered at the close
1 21 of the fiscal year shall remain in the fund for utilization as
1 22 provided in this subsection for the following fiscal year.
1 23 Sec. 2. Section 135C.33, subsection 5, paragraph e, Code
1 24 2003, is amended to read as follows:
1 25 e. An employee of an assisted living facility certified or
1 26 voluntarily accredited under chapter 231C, if the employee
1 27 provides direct services to consumers.
1 28 Sec. 3. Section 231B.1, subsection 2, Code 2003, is
1 29 amended by striking the subsection.
1 30 Sec. 4. Section 231B.2, subsection 1, Code 2003, is
1 31 amended to read as follows:
1 32 1. The department of elder affairs, in cooperation with
1 33 the department of inspections and appeals, shall establish by
1 34 rule in accordance with chapter 17A a special classification
1 35 for elder group homes. An elder group home established
2 1 pursuant to this subsection is exempt from the requirements of
2 2 section 135.63.
2 3 Sec. 5. Section 231B.2, subsection 2, unnumbered paragraph
2 4 1, Code 2003, is amended to read as follows:
2 5 The department of elder affairs, in cooperation with the
2 6 department of inspections and appeals, shall adopt rules to
2 7 establish requirements for certification of elder group homes.
2 8 The requirements shall include but are not limited to all of
2 9 the following:
2 10 Sec. 6. Section 231B.2, subsections 3 through 5, Code
2 11 2003, are amended to read as follows:
2 12 3. An elder group home established pursuant to this
2 13 chapter shall be certified by the department of inspections
2 14 and appeals.
2 15 4. A provider under the special classification shall
2 16 comply with the rules adopted by the department of elder
2 17 affairs, in cooperation with the department of inspections and
2 18 appeals, for an elder group home.
2 19 5. Inspections and certification services shall be
2 20 provided by the department of inspections and appeals.
2 21 However, beginning July 1, 1994, the department may enter into
2 22 contracts with the area agencies on aging to provide these
2 23 services.
2 24 Sec. 7. Section 231B.3, subsection 2, Code 2003, is
2 25 amended to read as follows:
2 26 2. A person who has knowledge that an elder group home is
2 27 operating without certification shall report the name and
2 28 address of the home to the department of inspections and
2 29 appeals. The department of inspections and appeals shall
2 30 investigate a report made pursuant to this section.
2 31 Sec. 8. Section 231B.4, Code 2003, is amended to read as
2 32 follows:
2 33 231B.4 APPLICABILITY.
2 34 1. This chapter shall not be construed to require that a
2 35 facility, currently licensed or licensed as a different type
3 1 of facility and serving persons sixty years of age or older,
3 2 also comply with the requirements of this chapter.
3 3 2. This chapter shall apply only to those elder group
3 4 homes certified by the department of elder affairs prior to
3 5 July 1, 2003. Applications for certification as an elder
3 6 group home shall not be accepted or approved on or after July
3 7 1, 2003.
3 8 Sec. 9. Section 231C.2, subsections 1 and 6, Code 2003,
3 9 are amended to read as follows:
3 10 1. "Assisted living" means provision of housing with
3 11 services which may include but are not limited to health=
3 12 related care, personal care, and assistance with instrumental
3 13 activities of daily living to six three or more tenants in a
3 14 physical structure which provides a homelike environment.
3 15 "Assisted living" also includes encouragement of family
3 16 involvement, tenant self=direction, and tenant participation
3 17 in decisions that emphasize choice, dignity, privacy,
3 18 individuality, shared risk, and independence. "Assisted
3 19 living" includes the provision of housing and assistance with
3 20 instrumental activities of daily living only if personal care
3 21 or health=related care is also included.
3 22 6. "Tenant" means an individual who receives assisted
3 23 living services through a certified or accredited assisted
3 24 living program.
3 25 Sec. 10. Section 231C.2, subsection 2, Code 2003, is
3 26 amended by striking the subsection.
3 27 Sec. 11. Section 231C.2, Code 2003, is amended by adding
3 28 the following new subsections:
3 29 NEW SUBSECTION. 2A. "Governmental unit" means the state,
3 30 or any county, municipality, or other political subdivision or
3 31 any department, division, board, or other agency of any of
3 32 these entities.
3 33 NEW SUBSECTION. 4A. "Legal representative" means a person
3 34 appointed by the court to act on behalf of the tenant, or a
3 35 person acting pursuant to a power of attorney.
4 1 NEW SUBSECTION. 5A. "Recognized accrediting entity" means
4 2 a nationally recognized accrediting entity that the department
4 3 of elder affairs, in cooperation with the department of
4 4 inspections and appeals, recognizes as having specific
4 5 assisted living program standards equivalent to the standards
4 6 established by the department of elder affairs, in cooperation
4 7 with the department of inspections and appeals, for assisted
4 8 living programs.
4 9 NEW SUBSECTION. 7. "Tenant's representative" means a
4 10 tenant's legal representative or any representative authorized
4 11 by the tenant in the tenant's occupancy agreement to act on
4 12 behalf of the tenant.
4 13 Sec. 12. Section 231C.3, Code 2003, is amended by striking
4 14 the section and inserting in lieu thereof the following:
4 15 231C.3 CERTIFICATION OF ASSISTED LIVING PROGRAMS.
4 16 1. The department of elder affairs, in cooperation with
4 17 the department of inspections and appeals, shall establish, by
4 18 rule in accordance with chapter 17A, a program for
4 19 certification and monitoring of assisted living programs. The
4 20 department of elder affairs, in cooperation with the
4 21 department of inspections and appeals, may adopt by reference
4 22 with or without amendment, nationally recognized standards and
4 23 rules for assisted living programs. The rules shall include
4 24 specification of recognized accrediting entities. The
4 25 standards and rules shall be formulated in consultation with
4 26 affected industry, professional, and consumer groups and shall
4 27 be designed to accomplish the purposes of this chapter and
4 28 shall include but are not limited to rules relating to all of
4 29 the following:
4 30 a. Provisions to ensure, to the greatest extent possible,
4 31 the health, safety, and well=being and appropriate treatment
4 32 of tenants.
4 33 b. Requirements that assisted living programs furnish the
4 34 department of elder affairs and the department of inspections
4 35 and appeals with specified information necessary to administer
5 1 this chapter.
5 2 c. Standards for tenant evaluation or assessment, which
5 3 may vary in accordance with the nature of the services
5 4 provided or the status of the tenant.
5 5 2. Each assisted living program operating in this state
5 6 shall be certified by the department of inspections and
5 7 appeals. If an assisted living program is voluntarily
5 8 accredited by a recognized accrediting entity, the department
5 9 shall certify the assisted living program on the basis of the
5 10 voluntary accreditation. An assisted living program that is
5 11 certified by the department on the basis of voluntary
5 12 accreditation shall not be subject to payment of the
5 13 certification fees prescribed in section 231C.19. An assisted
5 14 living program certified under this section is exempt from the
5 15 requirements of section 135.63 relating to certificate of need
5 16 requirements.
5 17 3. The owner or manager of a certified assisted living
5 18 program shall comply with the rules adopted by the department
5 19 of elder affairs, in cooperation with the department of
5 20 inspections and appeals, for an assisted living program. A
5 21 person including a governmental unit shall not represent an
5 22 assisted living program to the public as a certified program
5 23 unless and until the program is certified pursuant to this
5 24 chapter.
5 25 4. a. Services provided by a certified assisted living
5 26 program may be provided directly by staff of the assisted
5 27 living program, by individuals contracting with the assisted
5 28 living program to provide services, or by individuals employed
5 29 by the tenant or with whom the tenant contracts if the tenant
5 30 agrees to assume the responsibility and risk of the employment
5 31 or the contractual relationship.
5 32 b. If a tenant is terminally ill and has elected to
5 33 receive hospice services under the federal Medicare program
5 34 from a Medicare=certified hospice program, the assisted living
5 35 program and the Medicare=certified hospice program shall enter
6 1 into a written agreement under which the hospice program
6 2 retains professional management responsibility for those
6 3 services.
6 4 5. The department of inspections and appeals may enter
6 5 into contracts to provide certification and monitoring of
6 6 assisted living programs. The department of inspections and
6 7 appeals shall:
6 8 a. Have full access at reasonable times to all records and
6 9 common areas pertaining to the care provided to the tenants of
6 10 a program during certification and monitoring of programs
6 11 seeking certification or currently certified.
6 12 b. With the consent of the tenant, visit the assisted
6 13 living program.
6 14 c. Require that the recognized accrediting entity
6 15 providing accreditation for a program provide copies to the
6 16 department of all materials related to the accreditation and
6 17 monitoring process.
6 18 6. The department of elder affairs, in cooperation with
6 19 the department of inspections and appeals, may also establish
6 20 by rule in accordance with chapter 17A a special
6 21 classification for affordable assisted living programs. The
6 22 rules shall be formulated in consultation with affected
6 23 industry, professional, and consumer groups.
6 24 7. A department, agency, or officer of this state or of
6 25 any political subdivision shall not pay or approve for payment
6 26 from public funds any amount to an assisted living program for
6 27 an actual or prospective tenant, unless the program holds a
6 28 current certificate issued by the department of inspections
6 29 and appeals and meets all current requirements for
6 30 certification.
6 31 8. The department of elder affairs, in cooperation with
6 32 the department of inspections and appeals, shall adopt rules
6 33 regarding the conducting or operating of another business or
6 34 activity in the same physical structure in which the assisted
6 35 living program is provided, if the business or activity serves
7 1 primarily nontenants. The rules shall be developed in
7 2 consultation with affected industry, professional, and
7 3 consumer groups.
7 4 9. An assisted living program shall comply with section
7 5 135C.33.
7 6 Sec. 13. Section 231C.4, Code 2003, is amended to read as
7 7 follows:
7 8 231C.4 FIRE AND SAFETY STANDARDS.
7 9 The state fire marshal shall adopt rules, in coordination
7 10 with the department of elder affairs and the department of
7 11 inspections and appeals, relating to the certification or
7 12 voluntary accreditation and monitoring of the fire and safety
7 13 standards of certified or voluntarily accredited assisted
7 14 living programs.
7 15 Sec. 14. Section 231C.5, Code 2003, is amended by striking
7 16 the section and inserting in lieu thereof the following:
7 17 231C.5 WRITTEN OCCUPANCY AGREEMENT REQUIRED.
7 18 1. An assisted living program shall not operate in this
7 19 state unless a written occupancy agreement, as prescribed in
7 20 subsection 2, is executed between the assisted living program
7 21 and each tenant or tenant's representative, prior to the
7 22 tenant's occupancy, and unless the assisted living program
7 23 operates in accordance with the terms of the occupancy
7 24 agreement. The assisted living program shall deliver to the
7 25 tenant or tenant's representative a complete copy of the
7 26 occupancy agreement and all supporting documents and
7 27 attachments and shall deliver a written copy of changes to the
7 28 occupancy agreement if any changes to the copy originally
7 29 delivered are subsequently made.
7 30 2. An assisted living program occupancy agreement shall
7 31 clearly describe the rights and responsibilities of the tenant
7 32 and the program. The occupancy agreement shall also include
7 33 but is not limited to inclusion of all of the following
7 34 information in the body of the agreement or in the supporting
7 35 documents and attachments:
8 1 a. A description of all fees, charges, and rates
8 2 describing tenancy and basic services covered, and any
8 3 additional and optional services and their related costs.
8 4 b. A statement regarding the impact of the fee structure
8 5 on third=party payments, and whether third=party payments and
8 6 resources are accepted by the assisted living program.
8 7 c. The procedure followed for nonpayment of fees.
8 8 d. Identification of the party responsible for payment of
8 9 fees and identification of the tenant's representative, if
8 10 any.
8 11 e. The term of the occupancy agreement.
8 12 f. A guarantee that the assisted living program will
8 13 notify the tenant or the tenant's representative, as
8 14 applicable, in writing at least thirty days prior to any
8 15 change being made in the occupancy agreement with the
8 16 following exceptions:
8 17 (1) When the tenant's health status or behavior
8 18 constitutes a substantial threat to the health or safety of
8 19 the tenant, other tenants, or others, including when the
8 20 tenant refuses to consent to relocation.
8 21 (2) When an emergency or a significant change in the
8 22 tenant's condition results in the need for the provision of
8 23 services that exceed the type or level of services included in
8 24 the occupancy agreement and the necessary services cannot be
8 25 safely provided by the assisted living program.
8 26 g. A guarantee that all tenant information will be
8 27 maintained in a confidential manner to the extent required
8 28 under state and federal law.
8 29 h. Occupancy, involuntary discharge, and transfer criteria
8 30 and procedures.
8 31 i. The program's policies and procedures for addressing
8 32 grievances between the assisted living program and the
8 33 tenants, including grievances relating to transfer and
8 34 occupancy.
8 35 j. The emergency response policy.
9 1 k. The staffing policy which specifies if the staff is
9 2 available twenty=four hours per day, if task delegation will
9 3 be used, and how staffing will be adapted to meet changing
9 4 tenant needs.
9 5 l. In dementia=specific assisted living programs, a
9 6 description of the services and programming provided to meet
9 7 the life skills and social activities of tenants.
9 8 3. Occupancy agreements and related documents executed by
9 9 each tenant or tenant's representative shall be maintained by
9 10 the assisted living program in program files from the date of
9 11 execution until three years from the date the occupancy
9 12 agreement is terminated. Occupancy agreements and related
9 13 documents shall be made available for on=site inspection to
9 14 the department of inspections and appeals upon request and at
9 15 reasonable times.
9 16 Sec. 15. Section 231C.6, Code 2003, is amended by striking
9 17 the section and inserting in lieu thereof the following:
9 18 231C.6 RETENTION IN AN ASSISTED LIVING PROGRAM.
9 19 1. The department of inspections and appeals shall not
9 20 require the removal and relocation of a tenant of an assisted
9 21 living program if, based upon an assessment by the department,
9 22 the department determines that the tenant's presence in the
9 23 program does not endanger the tenant or other tenants and the
9 24 tenant is able to receive necessary care through services
9 25 provided by the program in accordance with the program's
9 26 certification or through services obtained by the tenant from
9 27 providers other than the program. In assessing whether it is
9 28 possible for the tenant to be provided or to obtain necessary
9 29 care without relocating, the department of inspections and
9 30 appeals shall consider all relevant factors, including
9 31 placement preference expressed by the tenant, the tenant's
9 32 representative, or others, and the approval of the program.
9 33 2. Notwithstanding a determination by the department of
9 34 inspections and appeals that a tenant's needs exceed occupancy
9 35 criteria as established in this chapter or rules adopted
10 1 pursuant to this chapter, the department may grant a waiver to
10 2 the assisted living program to allow the tenant to remain in
10 3 the program if, not later than ten business days after the
10 4 date the program is informed of the specific basis of the
10 5 department's determination, the department receives all of the
10 6 following obtained by the assisted living program:
10 7 a. A written assessment from the tenant's physician that
10 8 the tenant is appropriately placed.
10 9 b. A written statement from the tenant, or from the
10 10 tenant's legal representative if the tenant lacks capacity to
10 11 provide a written statement, that the tenant wishes to remain
10 12 in the program.
10 13 c. A written statement from the program that the program
10 14 approves of the tenant remaining in the program.
10 15 3. If a waiver is granted pursuant to subsection 2, the
10 16 department of inspections and appeals shall regularly monitor
10 17 the tenant's medical and functional information, for the
10 18 duration of the waiver, to determine the continued
10 19 appropriateness of the waiver. If the department of
10 20 inspections and appeals does not determine a waiver to be
10 21 inappropriate at any time prior to the completion of the six=
10 22 month period under the waiver, the waiver granted pursuant to
10 23 subsection 2 shall be valid for a six=month period. The
10 24 department may continue an existing waiver for any subsequent
10 25 periods of up to six months, upon request of the program, if
10 26 continuation is deemed appropriate by the department. At no
10 27 time shall ten percent or more of the program's tenancy be
10 28 based upon waivers. The department of elder affairs, in
10 29 cooperation with the department of inspections and appeals,
10 30 shall adopt rules regarding administration of the waivers.
10 31 4. An assisted living program that has been granted a
10 32 waiver for a tenant under subsection 2 shall not be found in
10 33 noncompliance of occupancy criteria if the program complies
10 34 with the requirements of the waiver.
10 35 5. a. If the department of inspections and appeals
11 1 determines that a tenant is inappropriately placed in the
11 2 assisted living program or that a tenant's needs exceed
11 3 occupancy criteria and a waiver is not requested and obtained
11 4 in accordance with the requirements of subsection 2, the
11 5 program shall discharge the tenant.
11 6 b. The tenant shall be provided a transition period of
11 7 thirty days following the date of notice of the discharge to
11 8 relinquish tenancy in the program.
11 9 c. Notwithstanding paragraph "b", if the tenant's
11 10 continued tenancy in the assisted living program following
11 11 provision of notice would present a danger to the safety or
11 12 well=being of the tenant, other tenants, or employees of the
11 13 assisted living program, the transition period of thirty days
11 14 is waived and the transition provisions relating to an
11 15 involuntary discharge as provided in the occupancy agreement
11 16 shall instead apply.
11 17 Sec. 16. NEW SECTION. 231C.7 TENANT'S BILL OF RIGHTS.
11 18 The department of elder affairs and the department of
11 19 inspections and appeals, in consultation with affected
11 20 industry, professional, and consumer groups shall develop a
11 21 tenant's bill of rights. An assisted living program certified
11 22 under this chapter shall provide a written copy of the
11 23 tenant's bill of rights to each tenant of the program.
11 24 Sec. 17. NEW SECTION. 231C.8 COMPLAINTS.
11 25 1. Any person with concerns regarding the operations or
11 26 service delivery of an assisted living program may file a
11 27 complaint with the department of inspections and appeals. The
11 28 name of the person who files a complaint with the department
11 29 of inspections and appeals and any personal identifying
11 30 information of the person or any tenant identified in the
11 31 complaint shall be kept confidential and shall not be subject
11 32 to discovery, subpoena, or other means of legal compulsion for
11 33 its release to a person other than department's employees
11 34 involved with the complaint.
11 35 2. The department of elder affairs, in cooperation with
12 1 the department of inspections and appeals, shall establish
12 2 procedures for the disposition of complaints received in
12 3 accordance with this section.
12 4 Sec. 18. NEW SECTION. 231C.9 INFORMAL REVIEW.
12 5 If an assisted living program contests the results of a
12 6 monitoring evaluation or complaint investigation, the program
12 7 may submit written information in support of the contesting of
12 8 the results to the department of inspections and appeals for
12 9 review. The department of inspections and appeals shall
12 10 review the written information submitted within ten working
12 11 days of receipt of the information. At the conclusion of the
12 12 review, the department may affirm, modify, or dismiss the
12 13 results. If the results are modified or dismissed, the
12 14 department shall specify in writing the reasons for the
12 15 modification or dismissal and shall immediately transmit a
12 16 copy of the statement to the director of inspections and
12 17 appeals and to the program.
12 18 Sec. 19. NEW SECTION. 231C.10 PUBLIC DISCLOSURE OF
12 19 FINDINGS.
12 20 Following a monitoring evaluation or complaint
12 21 investigation of an assisted living program by the department
12 22 of inspections and appeals pursuant to this chapter, the
12 23 department's final findings with respect to compliance by the
12 24 assisted living program with requirements for certification
12 25 shall be made available to the public in a readily available
12 26 form and place. Other information relating to an assisted
12 27 living program that is obtained by the department of
12 28 inspections and appeals which does not constitute the
12 29 department's final findings from a monitoring evaluation or
12 30 complaint investigation of the assisted living program shall
12 31 not be made available to the public except in proceedings
12 32 involving the denial, suspension, or revocation of a
12 33 certificate under this chapter.
12 34 Sec. 20. NEW SECTION. 231C.11 DENIAL, SUSPENSION, OR
12 35 REVOCATION == CONDITIONAL OPERATION.
13 1 1. The department of inspections and appeals may deny,
13 2 suspend, or revoke a certificate in any case where the
13 3 department of inspections and appeals finds that there has
13 4 been a substantial or repeated failure on the part of the
13 5 assisted living program to comply with this chapter or the
13 6 rules, or minimum standards adopted under this chapter, or for
13 7 any of the following reasons:
13 8 a. Cruelty or indifference to assisted living program
13 9 tenants.
13 10 b. Appropriation or conversion of the property of an
13 11 assisted living program tenant without the tenant's written
13 12 consent or the written consent of the tenant's legal guardian.
13 13 c. Permitting, aiding, or abetting the commission of any
13 14 illegal act in the assisted living program.
13 15 d. Obtaining or attempting to obtain or retain a
13 16 certificate by fraudulent means, misrepresentation, or by
13 17 submitting false information.
13 18 e. Habitual intoxication or addiction to the use of drugs
13 19 by the applicant, administrator, executive director, manager,
13 20 or supervisor of the assisted living program.
13 21 f. Securing the devise or bequest of the property of a
13 22 tenant of an assisted living program by undue influence.
13 23 g. Failure or neglect to maintain a continuing education
13 24 and training program for all personnel employed in the
13 25 assisted living program.
13 26 h. Founded dependent adult abuse as defined in section
13 27 235B.2.
13 28 i. In the case of any officer, member of the board of
13 29 directors, trustee, or designated manager of the program or
13 30 any stockholder, partner, or individual who has greater than a
13 31 ten percent equity interest in the program, who has or has had
13 32 an ownership interest in an assisted living program, home
13 33 health agency, residential care facility, or licensed nursing
13 34 facility in any state which has been closed due to removal of
13 35 program, agency, or facility licensure or certification or
14 1 involuntary termination from participation in either the
14 2 medical assistance or Medicare programs, or who has been found
14 3 to have failed to provide adequate protection or services for
14 4 tenants to prevent abuse or neglect.
14 5 j. In the case of a certificate applicant or an existing
14 6 certified owner or operator who is an entity other than an
14 7 individual, the person is in a position of control or is an
14 8 officer of the entity and engages in any act or omission
14 9 proscribed by this chapter.
14 10 k. For any other reason as provided by law or
14 11 administrative rule.
14 12 2. The department of inspections and appeals may as an
14 13 alternative to denial, suspension, or revocation conditionally
14 14 issue or continue a certificate dependent upon the performance
14 15 by the assisted living program of reasonable conditions within
14 16 a reasonable period of time as set by the department of
14 17 inspections and appeals so as to permit the program to
14 18 commence or continue the operation of the program pending full
14 19 compliance with this chapter or the rules adopted pursuant to
14 20 this chapter. If the assisted living program does not make
14 21 diligent efforts to comply with the conditions prescribed, the
14 22 department of inspections and appeals may, under the
14 23 proceedings prescribed by this chapter, suspend, or revoke the
14 24 certificate. An assisted living program shall not be operated
14 25 on a conditional certificate for more than one year.
14 26 Sec. 21. NEW SECTION. 231C.12 NOTICE == HEARINGS.
14 27 1. The denial, suspension, or revocation of a certificate
14 28 shall be effected by delivering to the applicant or
14 29 certificate holder by restricted certified mail or by personal
14 30 service a notice setting forth the particular reasons for such
14 31 action. Such denial, suspension, or revocation shall become
14 32 effective thirty days after the mailing or service of the
14 33 notice, unless the applicant or certificate holder, within
14 34 such thirty=day period, requests a hearing, in writing, of the
14 35 department of inspections and appeals, in which case the
15 1 notice shall be deemed to be suspended.
15 2 2. The denial, suspension, or revocation of a certificate
15 3 may be appealed in accordance with rules adopted by the
15 4 department of inspections and appeals in accordance with
15 5 chapter 17A.
15 6 3. When the department of inspections and appeals finds
15 7 that an imminent danger to the health or safety of tenants of
15 8 an assisted living program exists which requires action on an
15 9 emergency basis, the department of inspections and appeals may
15 10 direct removal of all tenants of an assisted living program
15 11 and suspend the certificate prior to a hearing.
15 12 Sec. 22. NEW SECTION. 231C.13 DIRECTOR NOTIFIED OF
15 13 CASUALTIES.
15 14 The director of inspections and appeals shall be notified
15 15 within twenty=four hours, by the most expeditious means
15 16 available, of any accident causing substantial injury or
15 17 death, and any substantial fire or natural or other disaster
15 18 occurring at or near an assisted living program.
15 19 Sec. 23. NEW SECTION. 231C.14 RETALIATION BY ASSISTED
15 20 LIVING PROGRAM PROHIBITED.
15 21 1. An assisted living program shall not discriminate or
15 22 retaliate in any way against a tenant, tenant's family, or an
15 23 employee of the program who has initiated or participated in
15 24 any proceeding authorized by this chapter. An assisted living
15 25 program that violates this section is subject to a penalty as
15 26 established by administrative rule in accordance with chapter
15 27 17A and to be assessed and collected by the department of
15 28 inspections and appeals and paid into the state treasury to be
15 29 credited to the general fund of the state, or to immediate
15 30 revocation of the program's certificate.
15 31 2. Any attempt to evict, from an assisted living program,
15 32 a tenant by whom or upon whose behalf a complaint has been
15 33 submitted to the department under section 231C.8, within
15 34 ninety days after the filing of the complaint or the
15 35 conclusion of any proceeding resulting from the complaint,
16 1 raises a rebuttable presumption that the action was taken by
16 2 the program in retaliation for the filing of the complaint,
16 3 except in situations in which the tenant is evicted due to
16 4 occupancy and transfer criteria.
16 5 Sec. 24. NEW SECTION. 231C.15 CIVIL PENALTIES.
16 6 The department may establish by rule, in accordance with
16 7 chapter 17A, civil penalties for the following violations by
16 8 an assisted living program:
16 9 1. Noncompliance with any regulatory requirements which
16 10 presents an imminent danger or a substantial probability of
16 11 resultant death or physical harm to a tenant.
16 12 2. Following receipt of notice from the department,
16 13 continued failure or refusal to comply within a prescribed
16 14 time frame with regulatory requirements that have a direct or
16 15 immediate relationship to the health, safety, or security of
16 16 program tenants.
16 17 Sec. 25. NEW SECTION. 231C.16 CRIMINAL PENALTIES.
16 18 1. A person establishing, conducting, managing, or
16 19 operating any assisted living program without a certificate is
16 20 guilty of a serious misdemeanor. Each day of continuing
16 21 violation after conviction or notice from the department of
16 22 inspections and appeals by certified mail of a violation shall
16 23 be considered a separate offense or chargeable offense. A
16 24 person establishing, conducting, managing, or operating an
16 25 assisted living program without a certificate may be
16 26 temporarily or permanently restrained by a court of competent
16 27 jurisdiction from such activity in an action brought by the
16 28 state.
16 29 2. A person who prevents or interferes with or attempts to
16 30 impede in any way any duly authorized representative of the
16 31 department of inspections and appeals in the lawful
16 32 enforcement of this chapter or of the rules adopted pursuant
16 33 to this chapter is guilty of a simple misdemeanor. As used in
16 34 this subsection, lawful enforcement includes but is not
16 35 limited to:
17 1 a. Contacting or interviewing any tenant of an assisted
17 2 living program in private at any reasonable hour and without
17 3 advance notice.
17 4 b. Examining any relevant records of an assisted living
17 5 program.
17 6 c. Preserving evidence of any violation of this chapter or
17 7 of the rules adopted pursuant to this chapter.
17 8 Sec. 26. NEW SECTION. 231C.17 NURSING ASSISTANT AND
17 9 MEDICATION AIDE == CERTIFICATION.
17 10 The department of inspections and appeals, in cooperation
17 11 with other appropriate agencies, shall establish a procedure
17 12 to allow nursing assistants or medication aides to claim work
17 13 within an assisted living program as credit toward sustaining
17 14 the nursing assistant's or medication aide's certification.
17 15 Sec. 27. NEW SECTION. 231C.18 COORDINATION OF THE LONG=
17 16 TERM CARE SYSTEM == TRANSITIONAL PROVISIONS.
17 17 1. An elder group home certified under chapter 231B prior
17 18 to July 1, 2003, shall be exempt from the requirements of this
17 19 chapter. If an elder group home certified under chapter 231B
17 20 prior to July 1, 2003, seeks certification as an assisted
17 21 living program on or after July 1, 2003, the elder group home
17 22 shall be granted a conditional assisted living program
17 23 certification by the department of inspections and appeals for
17 24 a period of one year from the date the conditional certificate
17 25 is issued. At the end of the one=year period, the elder group
17 26 home shall meet the requirements of this chapter to receive
17 27 subsequent certification as an assisted living program.
17 28 2. A hospital licensed pursuant to chapter 135B or a
17 29 health care facility licensed pursuant to chapter 135C may
17 30 operate an assisted living program, located in a distinct part
17 31 of or separate structure under the control of the hospital or
17 32 health care facility, if certified pursuant to this chapter.
17 33 3. This chapter shall not be construed to require that a
17 34 facility licensed as a different type of facility also comply
17 35 with the requirements of this chapter, unless the facility is
18 1 represented to the public as a certified assisted living
18 2 program.
18 3 Sec. 28. NEW SECTION. 231C.19 IOWA ASSISTED LIVING FEES.
18 4 The department of inspections and appeals shall collect and
18 5 retain assisted living program certification and related fees
18 6 as established by rule in accordance with chapter 17A. An
18 7 assisted living program that is certified by the department of
18 8 inspections and appeals on the basis of voluntary
18 9 accreditation by a recognized accrediting entity shall not be
18 10 subject to payment of certification fees. Fees collected and
18 11 retained pursuant to this section shall be deposited into an
18 12 assisted living program fund created in the state treasury
18 13 under the authority of the department of inspections and
18 14 appeals and are appropriated to the department of inspections
18 15 and appeals to carry out the purposes of this chapter.
18 16 Amounts deposited in the fund shall not be transferred, used,
18 17 obligated, appropriated, or otherwise encumbered except as
18 18 provided in this section. Notwithstanding section 12C.7,
18 19 subsection 2, interest or earnings on moneys deposited into
18 20 the fund shall be credited to the fund. Notwithstanding
18 21 section 8.33, amounts deposited in the fund that remain
18 22 unexpended or unencumbered at the close of the fiscal year
18 23 shall remain in the fund for utilization as provided in this
18 24 section for the following fiscal year.
18 25 Sec. 29. Section 235B.3, subsection 2, paragraph d, Code
18 26 2003, is amended to read as follows:
18 27 d. A person who performs inspections of elder group homes
18 28 for the department of elder affairs inspections and appeals
18 29 and a resident advocate committee member assigned to an elder
18 30 group home pursuant to chapter 231B.
18 31 Sec. 30. Chapter 231A, Code 2003, is repealed.
18 32 Sec. 31. TRANSITION OF STAFF. All employees of the
18 33 department of elder affairs performing functions related to
18 34 certification and monitoring of or complaint investigations
18 35 related to assisted living programs as of June 30, 2003, shall
19 1 become employees of the department of inspections and appeals
19 2 without loss of classification, pay, or benefits, effective
19 3 July 1, 2003. All employees of the department of elder
19 4 affairs performing functions related to affordable assisted
19 5 living as of June 30, 2003, shall become employees of the Iowa
19 6 finance authority without loss of classification, pay, or
19 7 benefits, effective July 1, 2003.
19 8 EXPLANATION
19 9 This bill provides for regulation of elder group homes and
19 10 assisted living programs.
19 11 The bill provides for regulation of elder group homes by
19 12 the department of elder affairs in cooperation with the
19 13 department of inspections and appeals. The bill also provides
19 14 that the provisions of the Code chapter apply only to elder
19 15 group homes certified by the department of elder affairs prior
19 16 to July 1, 2003, and that applications for certification as an
19 17 elder group home are not to be accepted or approved on or
19 18 after July 1, 2003.
19 19 The bill provides for regulation of assisted living
19 20 programs by directing the department of elder affairs, in
19 21 cooperation with the department of inspections and appeals, to
19 22 establish, by rule, a program for certification and monitoring
19 23 related to assisted living programs. The rules are to be
19 24 formulated in consultation with affected industry,
19 25 professional, and consumer groups. Each assisted living
19 26 program operating in the state is to be certified by the
19 27 department of inspections and appeals. If an assisted living
19 28 program is voluntarily accredited by a recognized accrediting
19 29 entity, the department of inspections and appeals is to
19 30 certify the program based upon the voluntary accreditation.
19 31 The bill provides specifically that if the tenant is
19 32 terminally ill and has elected to receive hospice services
19 33 under the federal Medicare program from a Medicare=certified
19 34 hospice program, the assisted living program and the hospice
19 35 program are to enter an agreement under which the hospice
20 1 program retains professional management responsibility for
20 2 those services.
20 3 The bill provides that the department of elder affairs in
20 4 cooperation with the department of inspections and appeals may
20 5 establish by administrative rule a special classification for
20 6 affordable assisted living programs. The bill also provides
20 7 that a department, agency, or officer of this state, or of any
20 8 political subdivision shall not pay or approve for payment
20 9 from public funds any amount to an assisted living program for
20 10 an actual or prospective tenant, unless the program holds a
20 11 current certificate and meets all requirements for
20 12 certification. The bill also directs the department of elder
20 13 affairs in cooperation with the department of inspections and
20 14 appeals to adopt rules regarding the conducting or operating
20 15 of another business or activity in the facility in which the
20 16 assisted living program is provided, if the business or
20 17 activity serves primarily nontenants. The rules are to be
20 18 developed in consultation with affected industry,
20 19 professional, and consumer groups.
20 20 The bill specifies requirements for written occupancy
20 21 agreements and provides for retention of a tenant in an
20 22 assisted living facility, notwithstanding a determination by
20 23 the department of inspections and appeals that the tenant's
20 24 needs exceed the occupancy criteria established.
20 25 The bill directs the department of elder affairs and the
20 26 department of inspections and appeals, in consultation with
20 27 affected industry, professional, and consumer groups to
20 28 develop a tenant's bill of rights.
20 29 The bill provides for the filing and disposition of
20 30 complaints; provides for an informal review of contests to the
20 31 results of a monitoring evaluation or complaint investigation;
20 32 provides for public disclosure of the final findings with
20 33 respect to a monitoring evaluation or complaint investigation;
20 34 provides the bases for the denial, suspension, or revocation
20 35 of certification and for conditional operation of a program as
21 1 an alternative to denial, suspension, or revocation of
21 2 certification; provides for notice and hearings related to
21 3 denial, suspension, or revocation of certification; provides
21 4 for the notification of the director of inspections and
21 5 appeals of any casualties at an assisted living program;
21 6 prohibits retaliation by an assisted living program against a
21 7 tenant, tenant's family, or an employee of the program who has
21 8 initiated or participated in any proceeding under the Code
21 9 chapter; establishes civil and criminal penalties for certain
21 10 violations of the bill; provides for nursing assistants and
21 11 medication aides to claim work within assisted living programs
21 12 as credit toward their certification; provides transitional
21 13 provisions for long=term care providers including elder group
21 14 homes by making elder group homes exempt from the requirements
21 15 of the assisted living chapter and providing for conditional
21 16 certification of an elder group home as an assisted living
21 17 facility if the elder group home was certified as an elder
21 18 group home prior to July 1, 2003, and seeks certification as
21 19 an assisted living program on or after July 1, 2003. The bill
21 20 provides for collection and retaining of assisted living
21 21 program fees by the department of inspections and appeals and
21 22 provides that if an assisted living program is certified based
21 23 upon voluntary accreditation, the program is not subject to
21 24 payment of certification fees.
21 25 The bill provides for transition of staff used in the
21 26 regulation of assisted living programs by providing that
21 27 employees of the department of elder affairs who performed
21 28 functions related to certification and monitoring of or
21 29 complaint investigations related to assisted living programs
21 30 as of June 30, 2003, are to become employees of the department
21 31 of inspections and appeals without loss of classification,
21 32 pay, or benefits, effective July 1, 2003. Additionally, all
21 33 employees of the department of elder affairs performing
21 34 functions related to affordable assisted living as of June 30,
21 35 2003, are to become employees of the Iowa finance authority
22 1 without loss of classification, pay, or benefits, effective
22 2 July 1, 2003.
22 3 The bill also repeals Code chapter 231A, relating to elder
22 4 family homes.
22 5 LSB 2067SS 80
22 6 pf/sh/8