House File 472 - Introduced
HOUSE FILE
BY FORD
(COMPANION TO SF 159)
Passed House, Date Passed Senate Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the creation of a consumer choice, support,
2 and education program.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 1729HH 81
5 pf/pj/5
PAG LIN
1 1 Section 1. NEW SECTION. 217.45 CONSUMER CHOICE, SUPPORT,
1 2 AND EDUCATION PROGRAM == CREATED == PURPOSE.
1 3 1. A consumer choice, support, and education program is
1 4 created within the department of human services to provide
1 5 older Iowans and their families, and others with long=term
1 6 care needs, with access to sufficient information, screening
1 7 and assessment processes, and referral resources to age
1 8 successfully and meet their long=term care needs in the most
1 9 appropriate setting.
1 10 2. The department of human services shall administer the
1 11 consumer choice, support, and education program and shall
1 12 consult with the senior living coordinating unit of the
1 13 department of elder affairs regarding the development and
1 14 implementation of the program.
1 15 Sec. 2. NEW SECTION. 217.46 FUNCTIONS OF CONSUMER
1 16 CHOICE, SUPPORT, AND EDUCATION PROGRAM.
1 17 The functions of the consumer choice, support, and
1 18 education program shall include but are not limited to all of
1 19 the following:
1 20 1. Providing access to sufficient informational and
1 21 educational resources to assist individuals in making informed
1 22 choices to address their long=term care needs.
1 23 2. Utilizing a uniform screening process to determine if
1 24 an individual requires the completion of the standardized
1 25 assessment process developed pursuant to subsection 3.
1 26 3. Developing a standardized assessment process to assess
1 27 an individual's functional and cognitive capacity, health
1 28 conditions, support services needs, environment needs, and
1 29 preferences. If an individual is eligible for the medical
1 30 assistance program, the standardized assessment process shall
1 31 also be used to determine the individual's medical necessity
1 32 and the appropriateness of provision of long=term care
1 33 services to the individual.
1 34 4. Developing a preliminary plan of care for an individual
1 35 based upon the results of the standardized assessment process.
2 1 5. Following development of a preliminary plan of care for
2 2 an individual, referring the individual for care coordination.
2 3 6. Establishing the mechanisms for implementing the
2 4 various aspects of the consumer choice, support, and education
2 5 program, including the standardized assessment process.
2 6 7. Evaluating the consumer choice, support, and education
2 7 program, including quality outcomes, consumer satisfaction,
2 8 and fiscal impacts.
2 9 8. Ensuring that the consumer choice, support, and
2 10 education assessment process complies with all applicable
2 11 federal and state requirements and programs.
2 12 9. Ensuring that the consumer choice, support, and
2 13 education program avoids duplication of and includes
2 14 appropriate coordination with other informational,
2 15 educational, and screening and assessment programs and
2 16 processes available to the populations served by the consumer
2 17 choice, support, and education program. Such coordination
2 18 shall include but is not limited to:
2 19 a. Coordination with the functional screening and
2 20 assessment process developed through the mental health, mental
2 21 retardation, developmental disabilities, and brain injury
2 22 commission's redesign of Iowa's disability services system.
2 23 b. Coordination with the information and referral
2 24 resources of Iowa's disability services system in order to
2 25 maximize access to information about state and community
2 26 supports that may be available to both older Iowans and Iowans
2 27 with disabilities.
2 28 Sec. 3. NEW SECTION. 217.47 COMPLETION OF CONSUMER
2 29 CHOICE, SUPPORT, AND EDUCATION ASSESSMENT PROCESS.
2 30 1. Beginning July 1, 2006, the consumer choice, support,
2 31 and education assessment process shall be completed prior to
2 32 admission of an individual to a licensed nursing facility or
2 33 prior to an individual's participation in the home and
2 34 community=based services waiver for the elderly under the
2 35 medical assistance program.
3 1 2. Notwithstanding subsection 1:
3 2 a. If it is medically necessary for an individual to be
3 3 admitted immediately to a licensed nursing facility, the
3 4 assessment process shall be completed as soon after admission
3 5 as possible but no later than five working days after
3 6 admission.
3 7 b. If an individual's admission to a licensed nursing
3 8 facility involves a Medicare=covered stay, the assessment
3 9 process shall be completed only if the admission exceeds
3 10 twenty days.
3 11 3. An individual shall complete a reassessment process as
3 12 follows:
3 13 a. If the individual is admitted to a licensed nursing
3 14 facility, on or about the ninetieth day following the initial
3 15 assessment, and upon a change in the individual's needs.
3 16 b. If the individual is participating in the home and
3 17 community=based services waiver for the elderly under the
3 18 medical assistance program, annually, and upon a change in the
3 19 individual's needs.
3 20 4. An individual sixty years of age or older may
3 21 participate in the consumer choice, support, and education
3 22 program to obtain information and education and may be
3 23 referred for completion of the assessment process, following
3 24 screening.
3 25 5. An individual under sixty years of age who has a
3 26 medical need for long=term care services may be referred for
3 27 completion of the assessment process, following screening.
3 28 6. Subject to available funding, the consumer choice,
3 29 support, and education assessment process shall be available
3 30 free of charge to any individual required or eligible to
3 31 complete the process.
3 32 Sec. 4. NEW SECTION. 217.48 GUIDELINES FOR CONDUCTING
3 33 CONSUMER CHOICE, SUPPORT, AND EDUCATION ASSESSMENT PROCESS.
3 34 1. The department of human services shall utilize a
3 35 competitive procurement process to contract for the conducting
4 1 of the consumer choice, support, and education assessment
4 2 process. The procurement process shall ensure all of the
4 3 following:
4 4 a. Older Iowans in every county of the state have access
4 5 to the assessment process.
4 6 b. Any contractor selected is able to assure an objective
4 7 and accurate evaluation of individuals' needs and is able to
4 8 provide support to and educate individuals and their families
4 9 about their choices for long=term care.
4 10 c. Any contractor selected completes minimum training
4 11 requirements approved by the department of human services.
4 12 d. The consumer choice, support, and education assessment
4 13 process is completed at the location of the individual
4 14 requesting the assessment process, and the level of care
4 15 determination and preliminary care plan for the individual are
4 16 determined within five working days of referral of the
4 17 individual's request to the contractor.
4 18 2. Any contractor who conducts the consumer choice,
4 19 support, and education assessment process shall be independent
4 20 from providers of long=term care services to the extent
4 21 required by the centers for Medicare and Medicaid services of
4 22 the United States department of health and human services.
4 23 EXPLANATION
4 24 This bill establishes a consumer choice, support, and
4 25 education program within the department of human services to
4 26 provide older Iowans and their families and others with long=
4 27 term care needs with information, screening and assessment
4 28 processing, and referral resources to allow them to age
4 29 successfully and meet their long=term care needs in the most
4 30 appropriate setting. The bill specifies the functions of the
4 31 program, including the development of a standardized process
4 32 to identify an individual's functional and cognitive capacity,
4 33 health conditions, supportive service needs, environment
4 34 needs, and preferences. The bill requires that beginning July
4 35 1, 2006, the consumer choice, support, and education process
5 1 is to be completed prior to admission of an individual to any
5 2 licensed nursing facility or prior to an individual's
5 3 participation in the home and community=based services waiver
5 4 for the elderly under the medical assistance program, with
5 5 some exceptions. The process may also be completed by
5 6 individuals 60 years of age or over or by individuals under 60
5 7 years of age if the individual has a medical need for long=
5 8 term care services. Subject to adequate funding, the process
5 9 is free of charge to anyone required or eligible to complete
5 10 the process. The bill also specifies guidelines for
5 11 conducting the process, including that any contractor who
5 12 conducts the process is to be independent from providers of
5 13 long=term care services to the extent required by the centers
5 14 for Medicare and Medicaid services.
5 15 LSB 1729HH 81
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