Senate File 143 - Introduced
SENATE FILE
BY TINSMAN
Passed Senate, Date Passed House Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the long=term living system in Iowa including
2 the establishment of a vision for Iowa's long=term living
3 system and the creation of a consumer choice, support, and
4 education program.
5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
6 TLSB 2540SS 81
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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 Sec. 5. NEW SECTION. 231E.1 VISION FOR IOWA'S LONG=TERM
4 24 LIVING SYSTEM.
4 25 1. The general assembly finds and declares that the vision
4 26 for Iowa's long=term living system is to ensure all Iowans
4 27 access to an extensive range of high=quality, affordable, and
4 28 cost=effective long=term living options that maximize
4 29 independence, choice, and dignity for consumers.
4 30 2. The long=term living system should be comprehensive,
4 31 offering multiple services and support in home, community=
4 32 based, and facility=based settings; should utilize a universal
4 33 assessment process to ensure that such services and support
4 34 are delivered in the most integrated and life=enhancing
4 35 setting; and should ensure that such services and support are
5 1 provided by a well=trained, motivated workforce.
5 2 3. The long=term living system should exist in a
5 3 regulatory climate that appropriately ensures the health,
5 4 safety, and welfare of consumers, while not being overly
5 5 restrictive or inflexible.
5 6 4. The long=term living system should sustain existing
5 7 informal care systems including family, friends, volunteers,
5 8 and community resources; should encourage innovation through
5 9 the use of technology and new delivery and financing models,
5 10 including housing; should provide incentives to consumers for
5 11 private financing of long=term living services and support;
5 12 and should allow Iowans to live independently as long as they
5 13 desire.
5 14 5. Information regarding all components of the long=term
5 15 living system should be effectively communicated to all
5 16 persons potentially impacted by the need for long=term living
5 17 services and support in order to empower consumers to plan,
5 18 evaluate, and make decisions about how best to meet their own
5 19 long=term living needs.
5 20 EXPLANATION
5 21 This bill establishes a consumer choice, support, and
5 22 education program within the department of human services to
5 23 provide older Iowans and their families and others with long=
5 24 term care needs with information, screening and assessment
5 25 processing, and referral resources to allow them to age
5 26 successfully and meet their long=term care needs in the most
5 27 appropriate setting. The bill specifies the functions of the
5 28 program, including the development of a standardized process
5 29 to identify an individual's functional and cognitive capacity,
5 30 health conditions, supportive service needs, environment
5 31 needs, and preferences. The bill requires that beginning July
5 32 1, 2006, the consumer choice, support, and education process
5 33 is to be completed prior to admission of an individual to any
5 34 licensed nursing facility or prior to an individual's
5 35 participation in the home and community=based services waiver
6 1 for the elderly under the medical assistance program, with
6 2 some exceptions. The process may also be completed by
6 3 individuals 60 years of age or over or by individuals under 60
6 4 years of age if the individual has a medical need for long=
6 5 term care services. Subject to adequate funding, the process
6 6 is free of charge to anyone required or eligible to complete
6 7 the process. The bill also specifies guidelines for
6 8 conducting the process, including that any contractor who
6 9 conducts the process is to be independent from providers of
6 10 long=term care services to the extent required by the centers
6 11 for Medicare and Medicaid services.
6 12 The bill also establishes a state vision for the long=term
6 13 living system in Iowa. The system is to ensure all Iowans
6 14 access to an extensive range of high=quality, affordable, and
6 15 cost=effective long=term living options that maximize
6 16 independence, choice, and dignity. The system is to be
6 17 comprehensive, utilize a universal assessment process, and
6 18 ensure that services and support are provided by a well=
6 19 trained, motivated workforce. The bill directs that the long=
6 20 term living system exist in a regulatory climate that
6 21 appropriately ensures the health, safety, and welfare of
6 22 consumers, while not being overly restrictive or inflexible.
6 23 The bill provides that the system should sustain existing
6 24 informal care systems, encourage innovation, provide
6 25 incentives to consumers for private financing of long=term
6 26 living services and support, and allow Iowans to live
6 27 independently as long as they desire. The bill directs that
6 28 information regarding all components of the long=term living
6 29 system should be effectively communicated to all persons
6 30 potentially impacted by the need for long=term living services
6 31 and support in order to empower consumers to plan, evaluate,
6 32 and make decisions about how best to meet their own long=term
6 33 living needs.
6 34 LSB 2540SS 81
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